Older Australians, physical activity, and health: Why are some doing well? A salutogenic study

Abstract

Objectives: This study used Aaron Antonovsky’s salutogenic approach to understanding the health of a sample of older Australians. In particular, the study investigated the place that physical activity played in their lives and its relationship to the concept of Sense of Coherence (SOC) as conceived by Antonovsky. Methods: Data was collected between July 2011 and April 2012 from community-dwelling volunteers in the greater Brisbane area of Australia who were at least 65 years old, free of severe memory problems, and able to walk without the assistance of another person. Participants completed a survey asking for basic demographic information, for their assessment of their health, and about chronic illnesses for which they had been diagnosed or treated during the previous 12 months. They wore accelerometers and kept a logbook for one week, and responded to Antonovsky’s SOC-13. All participants were interviewed and asked about any difficulties they had experienced (a) during the previous five years and (b) about any difficulties they had experienced prior to the previous five years. About these two time periods, they were asked the following questions: 'What was involved? Did physical activities help or hinder you? Did you have help from others that made a difference? Did you find that you had internal resources that made a difference’? Participants were also asked to rate how poorly or well they had adjusted to or dealt with change up to that point in their lives and how successfully they expected to do so during the subsequent 12 months. Data from the diaries, surveys, accelerometer results, and interviews were compiled and analysed. Results: The salutogenic approach of this study required a focus on what had helped participants to be as healthy as they were. Health resources that participants identified as having helped them to overcome (sometimes deeply traumatic) difficulties included social contacts, work outside the home, high self-rating of health (SRH), secular and religious faith, physical activity (PA), experience-based self confidence, and having relatively high SOC. Those with higher levels of SOC averaged more steps per day, engaged in more moderate-to-vigorous physical activity (MVPA), and reported fewer chronic disease problems than those with low levels of SOC. Both men and women who spoke of having worked outside the home had higher scores on the manageability (MA) component of the SOC than those who did not mention having been so employed. Married participants living with partners had higher SOC scores than did those living alone. Discussion: Data from this study supported SOC concepts in several ways. Those with higher SOC were shown to be more likely to make the health-enhancing choice of engaging in regular PA, had fewer chronic diseases, and rated themselves as being healthier. Separate analysis of the three components of SOC, comprehensibility, meaningfulness, and manageability (C, ME, MA), revealed information that was not discernible from overall SOC scores. Although a number of participants said nothing about PA as a health resource, it was the health resource most often mentioned and was identified by many as both a significant source of health and as being a means of making social contact. Conclusions: Antonovsky’s salutogenic approach to understanding health and his SOC concept can be useful in the study of PA and health in older Australians. Since high SOC levels seem to promote positive health choices such as PA, programs designed to heighten the sense older persons have of coherence in their lives may help them sustain health and functionality farther into their later years, a potential result of value both to individuals and to the societies in which they live.