A quarterly journal devoted to research on ageing

Indian Journal of

Gerontology

a quarterly journal devoted to research on ageing

SPECIAL ISSUE

Vol. 20, No. 1-2, 2006

Editor Guest Editors

K.L. Sharma Gregory S. Kolt N.K. Chadha

Editorial Board

Biological Sciences Clinical Medicine Social Sciences

B.K. Patnaik S.D. Gupta Uday Jain

P.K. Dev Kunal Kothari N.K. Chadha

A.L. Bhatia P.C. Ranka Ishwar Modi

Consulting Editors

A.V. Everitt (Australia), Harold R. Massie (New York),

P.N. Srivastava (New Delhi), R.S. Sohal (Dallas, Texas),

A. Venkoba Rao (Madurai), Sally Newman (U.S.A.)

Girendra Pal (Jaipur), L.K. Kothari (Jaipur)

Rameshwar Sharma (Jaipur), Vinod Kumar (New Delhi)

V.S. Natarajan (Chennai), B.N. Puhan (Bhubaneswar),

Gireshwar Mishra (New Delhi), H.S. Asthana (Lucknow),

A.P. Mangla (Delhi), R.S. Bhatnagar (Jaipur),

R.R. Singh (Mumbai), Arup K. Benerjee (U.K.),

T.S. Saraswathi (Vadodara), Yogesh Atal (Gurgaon),

V.S. Baldwa (Jaipur), P. Uma Devi (Bhopal)

MANAGING EDITORS

A.K. Gautham & Vivek Sharma

Indian Journal of Gerontology

(A quarterly journal devoted to research on ageing)

ISSN : 0971-4189

SUBSCRIPTION RATES

Annual Subscription

US $ 50.00 (Postage Extra)

UK ^ 30.00 (Postage Extra)

Rs. 300.00 Libraries in India

Financial Assistance Received from :

ICSSR, New Delhi

Printed in India at :

Aalekh Publishers

M.I. Road, Jaipur

Typeset by :

Sharma Computers, Jaipur

Phone : 2621612

NDIAN JOURNAL OF GERONTOLOGY

Vol. 20, Nov. 1 & 2, 2006

Special Issue

on

Health, Physical Activity and Aging

Gregory S. Kolt K.L. Sharma

& Editor

Narender K. Chadha

Guest Editors

Declaration

1. Title of the Newspaper Indian Journal of Gerontology

2. Registration Number R.N. 17985/69; ISSN 0971-4189

3. Language English

4. Periodicity of its Publication Quarterly

5. Subscription Annual Subscription

US $ 50.00

UK ^30.00

Rs. 300.00 Libraries in India

Rs. 250.00 for Individuals

6. Publisher's Name Indian Gerontological Association

C-207, Manu Marg, Tilak Nagar

Jaipur - 302004

Tel. 0141-2621693

e-mail : klsvik@

7. Printer's name Aalekh Publishers

M.I. Road, Jaipur

8. Editor's name Dr. K.L. Sharma

Nationality : Indian

9. Typeset by Sharma Computers

Opp.Maheshwari School

Vijay Path, Tilak Nagar

Jaipur - 302004

Tel : 0141-2621612

CONTENTS

S.No. Chapter Page No.

- Editorial

Health and physical activity in the globally

aging population 1- 4

Gregory S. Kolt and Narender K. Chadha

1. Physical activity research and interventions with 5-20

older adults: Perspectives and issues

Melody Oliver, Gregory S. Kolt and

Grant Schofield

2. Senior residents of “Pay & Stay” homes: An

examination of health and physical activity 21-34

Jyotsna M. Kalavar and D. Jamuna

3. Physical activity and aging in the context of

HIV/AIDS in Botswana 35-50

Akpovire Oduaran and E. O. Owolabi

4 Implications of selective optimization with

compensation on the physical, formal

and informal leisure patterns of adults 51-66

Megan Janke and Adam Davey

5. Singing to more good years: Karaoke as serious

leisure for older persons in Singapore 67-80

Leng Leng Thang

6. Perceived and real body fatness in older

Asian Indians 81-92

Grant M. Schofield, Gregory S. Kolt,

Melody Oliver and Narender K. Chadha

7. Healthy aging: Genes and environment 93-98

Elaine Rush

8. A case study reflecting healthy aging in the US 99-110

Sally Newman and Catherine Tompkins

9. Bridging generations: Intergenerational strategies

for healthy ageing 111-122

Donna M. Butts

10. An overview of exercise programs that reduce

falls in older people 123-134

C. M. Vogler, C. Sherrington, J. C.

Whitney and S.J. Ogle

11. Activities of daily living and its correlates

among elderly 135-158

Narender K. Chadha, D. Chao,

Harpreet Bhatia, Mitu Rohatgi and U. A. Mir

12 Researching the health needs of elderly Indian

migrants to New Zealand 159-170

Ruth DeSouza

For Our Readers 171-172

Indian Journal of Gerontology

2006, Volume 20, No. 1 & 2, pp. 1-4

EDITORIAL

Health and physical activity in the

globally aging population

Significant shifts are evident in both population aging and the prevalence of non-communicable lifestyle diseases. The impact of such changes on society is becoming dramatic. The growing obesity problem, declining levels of physical activity, and increased prevalence of coronary heart disease and type 2 diabetes are just of few of the health issues that are requiring immediate attention from governments and health care systems across both developed and developing countries. It is argued that the advent of technology, the increasing abundance of fast food outlets, and the increased westernisation of many countries around the world are the main contributors to these health issues. Whatever the cause, it appears that slowing down the accelerating nature of these problems is becoming more and more difficult.

A growing literature in the areas of physical activity and health has been evident over the past two decades. This literature has progressed from epidemiological studies to those that examine the efficacy of a wide range of interventions. The findings from such literature are paramount in addressing the health problems of older adults, and it is this literature that must inform government decision making.

Despite declining physical activity rates, ironically it was an early morning walk through a park in suburban New Delhi that triggered the idea of a Special Issue of the Indian Journal of Gerontology on the topic of Health, Physical Activity, and Aging. We marvelled at the many hundreds of people that were active as the sun was rising, engaging in walking, jogging, cricket, yoga, and a variety of other active games. The population was well represented: there were males, females, children, teenagers, adults, and the elderly all challenging themselves with physically active pursuits. It was this event that triggered the idea of a collection of papers that addressed health and physical activity in the ageing population.

In this Special Issue we have assembled a large group of researchers, health professionals, and other practitioners from India, New Zealand, the United States, Singapore, Botswana, Australia, and the United Kingdom to contribute papers around the theme of Health, Physical Activity, and Aging. This theme was left intentionally broad to demonstrate the variety of activities that older people engage in that can provide health benefits, and the variety of research and practice that is evident in all regions of the world.

The issue leads with three papers focussed on physical activity as it relates to health. Melody Oliver and colleagues discuss important issues for planning and conducting physical activity interventions and research with older adults. They use as examples a randomised controlled trial of telephone counselling to improve physical activity in sedentary older adults, and a cross-sectional study of physical activity and body size in older Asian Indians. Jyotsna Kalavar and D. Jamuna report on their study that examined the health status and physical activities of older residents of “pay and stay” homes in south India. They also explored the barriers to physical activity in the residents of these homes, concluding that the physical environment itself was the main barrier to engagement in physical activity. Akpovire Oduaran and E. O. Owolabi contribute a paper that examines physical activity and ageing within the context of HIV/AIDS in Botswana. They report that ageing in this African nation is jeopardised by HIV/AIDS, and they discuss the role that physical activity may play in mitigating the impact of this disease.

Two papers in this issue focus on leisure issues in the ageing population. Megan Janke and Adam Davey examine the evidence for selective optimisation with compensation in three domains of leisure (informal, formal, and activity). They found that older adults are able to maintain informal leisure patterns despite changes in disability, and that disability may prevent the buffering effects for the physical forms of leisure. An important implication of this research is that helping older adults to maintain participation in formal leisure activities may promote well-being in later life. Leng Leng Thang, through case studies of activity centres for older people in Singapore, investigated the role of karaoke singing in ageing within the framework of activity in later life. It was concluded that karaoke plays an important role in promoting social support, providing links with younger generations, and in promoting learning and development beneficial to the health of older people.

Grant Schofield and his colleagues investigated perceived and real body fatness in older Asian Indians living in urban India and in New Zealand. They found a high prevalence of overweight and obesity, and interestingly, that the majority of overweight or obese people perceived themselves to be of normal weight. They discuss their findings in relation to implications for effective weight management programs. In a paper on healthy ageing, Elaine Rush discusses the possible aetiology of disease (especially cardiovascular disease and type 2 diabetes) from an environment and gene perspective with reference to a migrant Asian Indian population in New Zealand. She also examines the opportunities for reduction of disease throughout the life cycle.

Two papers are included on healthy ageing. The first by Sally Newman and Catherine Tompkins explores the concepts behind activity theory and continuity theory as they relate to healthy ageing and independence. A case study is used to illustrate the concept of “life competencies” in relation to ageing well. In the second paper on the theme of healthy ageing Donna Butts discusses intergenerational strategies and programs that contribute to health behaviours and healthy ageing. She concludes that older adults engaged in interactions with children and youth appear to maintain their own health to a higher degree than those who do not. Such interactions at the same time teach young people healthy habits early in life.

Two further papers round off this Special Issue. The paper by Narender Chadha and his colleagues examines the relationship between physical activities in everyday life and marital status, educational level, and socioeconomic status. They demonstrate that positive correlations exist between these variables. In the final paper of this issue Ruth DeSouza identifies the gaps in current health research and practices for Asian Indians living in New Zealand. She discusses the importance of cultural safety and the development of a health workforce to work with Asian Indian and other migrants, to health policy and research.

We hope you enjoy reading this Special Issue of the Indian Journal of Gerontology, and encourage you to take the challenge to improve the health of older people through the various methods and contexts provided in these papers.

Guest Editors :

Gregory S. Kolt,

Centre for Physical Activity and Nutrition Research

Faculty of Health and Environmental Sciences,

Auckland University of Technology,

New Zealand

&

Narender K. Chadha

Department of Psychology,

University of Delhi, India

Indian Journal of Gerontology

2006, Vol. 20, No. 1 & 2. pp 5 - 20

Physical Activity Research and Interventions with Older Adults: Perspectives and Issues

Melody Oliver, Gregory S. Kolt and Grant M. Schofield

Centre for Physical Activity and Nutrition Research

Faculty of Health and Environmental Sciences

Auckland University of Technology, New Zealand

ABSTRACT

The population is ageing worldwide. Concurrently, diseases related to insufficient physical activity such as cardiovascular disease and Type 2 diabetes mellitus are increasing. Participation in regular, moderate intensity physical activity is related to a multitude of physical and psychological health benefits in older adults. Despite this, older adults are a population at risk of insufficient activity. Therefore, effective intervention is essential to increase physical activity participation in the elderly. Elements related to intervention success with older adult populations have been reported extensively, however, limited information on the practical design and implementation of interventions and research is available. The current paper considers important issues for planning and conducting physical activity interventions and research with older adults. Considerations such as health status, participant safety, and physician involvement are discussed.

Keywords: Physical activity, Older adults, Elderly, Intervention

Globally the population is ageing. The proportion of people aged 60 years or older is estimated to double from ten percent of the world population in 2002, to approximately twenty percent in 2050 (United Nations Population Division, 2002). Older age is associated with disproportionate utilisation of healthcare services and expenditure (Meara, White, and Cutler, 2004; Ministry of Health, 1999; Yang, Norton, and Stearns, 2003), however, this may be mitigated somewhat by improving the health status of older adults (Lubitz, Cai, Kramarow, and Lentzner, 2003). Physical activity participation is considered an ideal method by which to achieve this. A substantial body of evidence exists for the physical and psychological health benefits that physical activity may confer to the older adult. For example, regular participation in moderate physical activity (such as walking) is associated with a reduced risk of falling (Sherrington, Lord, and Finch, 2004), as well as reduced incidence (or symptoms of) of colon and breast cancer (Thune and Furberg, 2001), cardiovascular disease (Rastogi et al., 2004), type 2 diabetes mellitus (Mohan, Gokulakrishnan, Deepa, Shanthirani, and Datta, 2005), and obesity (Bauman, 2004). Recent research in the US has also shown that older men and women who are more physically active are less likely to experience cognitive decline (Abbott et al., 2004; Mazzeo et al., 1998; McAuley, Marquez, Jerome, Blissmer, and Katula, 2002; Weuve et al., 2004; Yaffe, Barnes, Nevitt, Lui, and Covinsky, 2001). Quality of life may also be improved through physical activity participation in older adults, via increased bone health, functional capacity and independent living, as well as reduced depression, anxiety, and stress (Carr, 2001; Ministry of Health, 2003; National Health Committee, 1998).

Despite the strong evidence for the health benefits associated with physical activity, older adults are a population at risk of insufficient physical activity to achieve these health benefits (National Ageing Research Institute, 2003; Taylor et al., 2004). Concurrently, the prevalence of diseases related to inactivity such as obesity, diabetes, and cardiovascular disease are increasing internationally (World Health Organization, 2004). Asian Indians are a group of particular interest, as they have been shown to exhibit a high prevalence of overweight and obesity, hypertension, and diabetes (Ramachandran et al., 2001; Ramaiya, Kodali, and Alberti, 1991). Additionally, this prevalence of lifestyle related diseases is even higher in the older Asian Indian population (Swami, Bhatia, Gupta, and Bhatia, 2005).

The World Health Organization has advocated for the promotion of participating in regular moderate-intensity physical activity on most days for all people, from youth into old age (World Health Organization, 2004). The development and effectiveness of physical activity research and interventions with older populations has been well documented. Intervention components identified as important for success with older adults include: providing telephone counselling, using motivational interviewing and the transtheoretical model, and enlisting General Practitioners (family physicians) to provide physical activity advice (Conn, Minor, Burks, Rantz, and Pomeroy, 2003; King, 2001; Sherrington et al., 2004; Taylor et al., 2004).

But what of the practicalities of conducting such interventions and research? While a plethora of literature is available that reports on physical activity research with older adults, a paucity of information pertaining to the successful elements of conducting such research with this population exists. Therefore, this paper outlines important issues to consider when planning and conducting physical activity research with older adults. Information is drawn from the literature and also from practical experience gained from two physical activity studies for older adults in Auckland, New Zealand, which are described separately below. The purpose of this description of these two studies is to allow the reader a context from which to consider the suggestions made later in this paper.

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