Contributions of Leisure-Based Selective Optimization with Compensation and Leisure Activity Expenditure to the Health of Adults with Arthritis

Involvement in leisure activities has consistently been associated with promoting health and well-being in later life. Research suggests that participation in these types of activities is associated with decreases in mortality (Glass, Mendes de Leon, Marottoli, & Berkman, 1999; Janssen, Carson, Lee, Katzmarzyk, & Blair, 2013), depressive symptoms (Herzog, Franks, Markus, & Holmberg, 1998; Lee et al., 2012), and functional limitations (Everard, Lach, Fisher, 8c Baum, 2000) as well as improvements in cognitive functioning (Kâreholt, Lennartsson, Gatz, 8c Parker, 2011) and life satisfaction (Nimrod, 2007). Thus, maintaining involvement in leisure activities is an important factor in fostering quality of life and successful aging. However, as adults age, other factors, such as chronic conditions, may limit their ability to participate in some leisure activities.Arthritis is one of the most common chronic conditions that affects middle-aged and older adults and is a leading cause of disability (CDC, 2010). Currently, over 46 million people have been diagnosed with arthritis in the U.S., and this number is expected to increase 50% by the year 2030 (CDC). Arthritis is progressively debilitating and incurable (Pimm & Weinman, 1998), and people are living with arthritis for longer periods of time than ever before (Leveille, Wee, 8t Iezzoni, 2005). A diagnosis of severe arthritis is associated with mobility limitations and poor health (Peat, Thomas, 8c Croft, 2006) as well as depression (Adams et al, 2008), anxiety (Covic et al., 2012), and pain (Parmelee, Harralson, McPherron, Decoster, 8c Schumacher, 2012).Participation in physically active leisure may help mitigate symptoms for arthritis sufferers. Research suggests that a wide range of aerobic and muscle-building activities may provide relief. For example, walking combined with strength training has been associated with decreased pain intensity, pain frequency and self-reported disability (Messier et al., 2000). Aquatic exercise may improve quality of life for obese adults with osteoarthritis (Cadmus et al., 2010). Research on the Arthritis Foundation's exercise programs has demonstrated that physical activity can lead to improvements in functional health and symptom management (Callahan et al., 2008; Suomi 8c Lindauer, 1997). Additionally, research on the "Fit & Strong!" arthritis-based exercise program (CDC, 2010) revealed significant increases in self-efficacy and physical activity and decreases in lower extremity stiffness after two months as well as maintenance after six and 12 months (Hughes et al" 2006).Although physically active leisure may improve health outcomes in adults with arthritis, there is reason to believe individuals may find it difficult to participate. Katz (1995) indicated that, on average, adults stop participating in 10% of their valued daily activities due to arthritis pain and symptoms. This was supported by a recent study by Machado, Gignac, and Bradley (2008) that identified the importance of both physical and psychological aspects of arthritis as they may serve as pathways to subsequent restrictions in activity. Other research studies indicate the effect of arthritis on adults' leisure participation is even more severe. For instance, Wikstrom, Isacsson, and Jacobsson (2001) have suggested adults may cease up to two-thirds of their leisure activities after receiving an arthritis diagnosis. Additionally, as many as 44% of adults with arthritis participate in no physically active leisure (Shih, Hootman, Krueger, & Helmick, 2002). One study by Wilcox et al. (2006) indicated that sedentary adults viewed arthritis symptoms as barriers to participation and were more likely to have stopped being physically active with the onset of symptoms. These research findings are concerning given the role that leisure activities play in promoting the health and well-being of individuals. Mock and colleagues (2010) noted that a sense of belonging, which can be fostered by participating in physical activities with others, may actually increase adults' ability to cope with their rheumatoid arthritis. …