“Getting the old limbs going”: Exploring the emotional and cognitive benefits of exercise and the barriers to participation in older adults
Creators: name: Szekeres, Zsofia Eva
Publisher: name: London South Bank University
Year: 2022

description: The aim of this thesis was to explore how community-based exercise brings cognitive and emotional benefits to older people and which barriers prevent the participation of inactive older adults. The thesis was designed into a series of 6 research studies. Chapter 2 synthesised the quantitative and qualitative evidence regarding the impact of community-based exercise programmes on cognitive function and emotional wellbeing. Although exercise positively impacts emotional wellbeing, there were few studies regarding cognitive benefits. Also, adherence was influenced by factors at different levels of the ecological model. Chapters 3 and 4 explored the perspectives of older adults actively engaged in community-based exercise programmes and their exercise instructors. These studies used qualitative methods to identify which factors participants perceive as crucial for short-term and long-term adherence. The results showed that the perspectives of older adults and their instructors were aligned; the instructors had an accurate understanding of the needs and preferences of older adults and purposefully targeted them. Program design and teaching style were key for successful sessions, and both skill development and socialising sustained the long-term engagement of older adults in exercise. Importantly, the recognition of benefits to cognitive function and emotional wellbeing also contributed to continued adherence. Chapters 5 and 6 focused on older adults who are inactive or who are transitioning to/from being inactive. Chapter 5 was a feasibility study for a randomised control design that included measures of adherence as well as pre-and post-intervention measures of cognitive function and emotional wellbeing. It followed previously inactive older adults who took part in a 12-week exercise programme, either indoor cycling or cheerleading. The findings demonstrated the positive impact of both programmes on emotional wellbeing, cognitive function, and blood pressure reactivity. Cheerleading, which was more cognitively challenging, also produced superior executive function and emotional resilience improvements than indoor cycling. Chapter 6 explored what may facilitate the engagement of inactive older adults. As this coincided with major changes happening at the policy, environmental and organisational levels, because of the Covid-19 pandemic, the study also explored how previously active older adults responded to the closure of community-based exercise programmes. Mixed methods were used to investigate the facilitators and barriers to physical activity in both inactive and previously active older adults. The interviews showed that having a sense of purpose was a key source of motivation to exercise. It was influenced by both the belief in the importance of exercise and the affective valence participants assigned to exercise. For previously inactive older adults, missing the social context of exercise led to inactivity. However, all participants found a renewed purpose in walking and outdoor activities as a response to the lockdown restrictions. Throughout the studies of this thesis, several characteristics of exercise programmes that suit the intrapersonal factors, health needs and preferences of older adults were identified, and recommendations were developed to improve current community-based services.