A longitudinal study examining the adoption of exercise in older adults with and without heart disease

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Exercise is an important factor in the primary and secondary prevention of cardiovascular disease (CVD). However, few data are available on predictors of adopting exercise (AE) in older adults, especially the impact of a new and remote heart disease diagnosis (NHDD and RHDD, respectively) on AE. Purpose The purpose of this study was to examine predictors of AE in older adults using the Health and Retirement Survey (HRS), a prospective, nationally representative household survey examining retirement and health among older persons in the United States that is repeated every two years. Methods Data from respondents who were age 55 or older in 1998 were examined using three waves of the HRS (1998, 2000, and 2002) which provided three distinct person-wave observations for each respondent from which exercise wave changes and AE in older adults with and without CVD was determined resulting in a total of 8,975 respondents for subsequent analyses. The mean age±SD of the respondents was 69±9 years with 56% being female. Logistic regression models were developed to examine predictors of AE while controlling for a variety of demographic and health related variables. Results AE in respondents with and without CVD was relatively similar after the baseline time period, but a significantly (p<0.05) smaller percentage of respondents with CVD were observed AE compared to respondents without CVD (12% versus 20%). Significant predictors of AE included age, gender, household wealth, body mass index (BMI), medical conditions, mobility and instrumental activities of daily living (IADL) limitations, perceived health status, smoking, a new CVD event, and marriage with only marriage and household wealth positively associated with AE (odds ratio=1.133, p<0.05 and odds ratio=1.076, p<0.01, respectively). Respondents who were older, female, who had a greater BMI, had a greater number of medical conditions, had greater mobility and IADL limitations, poorer perceived health, smoked, and who experienced a new CVD event were less likely in AE. Neither a NHDD or RHDD was a significant positive predictor of AE in older adults (odds ratio=.489, p<0.001 and odds ratio=.915, p>0.05, respectively). Conclusions A smaller percentage of older adults with CVD were found AE compared to older adults without CVD. The finding that marriage was the strongest significant positive predictor of AE is important and highlights the role of spousal support. The finding that neither a NHDD or RHDD was a significant predictor of AE highlights the important role of cardiac rehabilitation in older adults. Long-term programming for AE and maintenance of exercise in older persons with a NHDD and RHDD is particularly important and requires further investigation. Examination of spousal or similar support while attending cardiac rehabilitation and modifying negative predictors of AE appears warranted and may facilitate older adults AE.