Abstract
BackgroundFamily support can help older adults better adhere to exercise routine, but it remains unclear whether an exercise program targeting older married couples would have stronger effects on exercise adherence than would a program for individuals. The purpose of this study was to determine the effects of an exercise program on the exercise adherence of older married couples over a 24-week follow-up period.MethodsThirty-four older married couples and 59 older adults participated in this study as couple and non-couple groups (CG and NCG, respectively). All participants attended an 8-week supervised program (once a week and a home-based exercise program comprising walking and strength exercises) and then participated in a follow-up measurement (24 weeks after post-intervention measurement). Exercise adherence was prospectively measured via an exercise habituation diary during the follow-up period—specifically, we asked them to record practice rates for walking (≥2 days/week) and strength exercises (≥6 items for 2 days/week). A multivariate logistic regression analysis was conducted to obtain the CG’s odds ratios (ORs) and 95% confidence intervals (CIs) for adherence to walking and strength exercise adjusted for potential confounders (with NCG as the reference).ResultsAlthough the adherence rate of walking exercise in the CG was significantly higher than that in the NCG (29.2%; P < 0.001), there was no significant difference in the adherence rate of strength exercise between the two groups (P = 0.199). The multivariate logistic regression analysis showed that CG had significantly higher odds of adherence to walking exercise compared with the NCG (3.68 [1.57–8.60]). However, the odds of adherence to strength exercise did not significantly differ between the two groups (1.30 [0.52–3.26]).ConclusionsThese results suggest that an exercise program targeting older married couples may be a useful strategy for maintaining walking adherence, even six months after the supervised program has ceased. A blinded randomized controlled trial will be needed to confirm this conclusion.Trial registrationRetrospectively registered. UMIN Clinical Trials Registry (Registered: 02/11/16) UMIN000024689.
Highlights
Support can help older adults better adhere to exercise routine, but it remains unclear whether an exercise program targeting older married couples would have stronger effects on exercise adherence than would a program for individuals
We hypothesized that individuals who participated in an exercise class with their spouse would maintain higher exercise adherence compared to individuals who participated in the program alone, since attending the exercise class with a spouse would enhance self-efficacy
Thirty-four older married couples and 59 older adults were enrolled in this study as members of the couple group (CG) and non-couple group (NCG), respectively
Summary
Support can help older adults better adhere to exercise routine, but it remains unclear whether an exercise program targeting older married couples would have stronger effects on exercise adherence than would a program for individuals. Regular exercise is widely known as one of the most important health behaviors for maintaining quality of life and preventing falls, hospitalization and functional impairment among older adults [1] Despite these benefits, around 50% of Japanese older adults do not participate in regular exercise [2], and approximately 50% of older adults fail to continue exercising within 6 months [3]. Our previous study identified that attending an exercise class as older married couples significantly enhanced exercise adherence during a 3-month intervention period [9]. These previous studies indicate that involvement of one’s spouse may be an effective strategy to improve exercise adherence among older adults. To our knowledge, there were no prospective follow-up studies that examined the effect of spousal-based exercise programs on longterm exercise adherence among older adults
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