The importance of self efficacy for the adoption and maintenance of physical activity in older adults with memory complaints

Abstract

Physical activity (PA) might have protective effects on brain health even in older adults with memory complaints. In this context one of the challenges is to develop behavioral strategies to enhance self efficacy. Self efficacy is ones confidence to be physically active when faced with common barriers. This paper will present new results from the Fitness of the Ageing Brain Study (FABS) on self-efficacy as an important factor for physical activity programs. FABS is a randomized controlled trial with volunteers with memory complaints which demonstrated that a 6-month individualized home-based physical activity intervention had significant impact on cognition in comparison to a control group. During the first 6 months the PA group was given an exercise program aimed at achieving 150 minutes/week of moderate exercise and behavioral intervention based on the Stages of Change Model designed to improve self efficacy. After 6 months participants in the PA group were asked to continue their program for a further 12 months. Self efficacy was measured at baseline and follow-up at 6, 12 and 18 months. Participants wore a pedometer for 7-days at baseline and each of the follow-up time points. One hundred and seventy participants (mean age 68.5 ± 8.6 years) enrolled in the trial. Adherence to the intervention was 78 (72.5, 83.7) %. After 6 and 12 months the pedometer scores were significantly higher in the PA group (p < 0.01). Self efficacy scores were significantly higher in the PA versus the control group by 2.11 (0.70, 3.52; < 0.01) at 6 months, but not at 12 and 18 months. At 6 months having higher baseline pedometer and self efficacy scores and being in the PA group predicted physical activity. PA at 12 months was predicted by baseline pedometer scores and being in the PA group. However at 18 months only higher baseline pedometer scores predicted physical activity (p < 0.001). This behavioral intervention program increased self efficacy in the short term, but not in the long term. These findings suggest that to sustain self efficacy and achieve long term improvements in physical activity a continuing minimal intervention program is necessary.