Opportunities to be active in retirement villages and factors associated with physical activity in residents
Aoi Yoshihara 1 , Katherine Bloomfield
1 2 3 * , Zhenqiang Wu 1 , Annie Tatton 2 , Joanna Hikaka 1 , Michal Boyd 1 , Kathy Peri 1 , Martin J. Connolly 1 2
1 Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.
2 Older Adult Services, Waitematā District Health Board, Auckland, New Zealand.
3 Waitematā Clinical Campus, North Shore Hospital, PO Box 93503, Takapuna, Auckland 0740, New Zealand.
Journal of Primary Health Care 15(1) 6-13 https://doi.org/10.1071/HC22103
Published: 18 November 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Introduction: Physical activity (PA) in older people is associated with improved morbidity and mortality outcomes. Increasing numbers of older people are choosing to live in retirement villages, many of which promote themselves as providing opportunities for activity.
Aim: To explore the characteristics of PA village residents were undertaking and the associated individual and village factors.
Methods: Health, functional and wellbeing information was collected from 577 residents recruited from 34 villages in Auckland, New Zealand, using an International Resident Assessment Instrument and customised survey tools containing items on self-reported PA. Managers from villages completed a survey on village characteristics and facilities.
Results: The mean age (s.d.) of village residents was 82 (7) years, and 325 (56%) reporting doing one or more hours of PA in the 3 days prior to assessment. Moderate exercise was performed by 240 (42%) village residents, for a mean (s.d.) of 2.7 (3.4) h per week. The most common activities provided by villages included: bowls/petanque (22, 65%) and exercise classes (22, 65%), and walking was the most common activity undertaken (348, 60%). Factors independently associated with PA included individual factors (gender, fatigue, constipation, self-reported health, number of medications, moving to village for safety and security, utilising village fitness programme, use of the internet, and satisfaction with opportunities to be active) and village-related factors (access to unit, and ownership model).
Discussion: PA uptake is determined by many factors at both personal (physical and psychosocial) and environmental levels. Clinicians should focus on individualised PA promotion in those with identified risk factors for low levels of PA.
Keywords: ageing exercise, facilities, housing for the elderly, independent living.
References
[1] Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ 2019; 366 l45| Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis.Crossref | GoogleScholarGoogle Scholar |
[2] Academy of Medical Royal Ccolleges. Exercise: the miracle cure and the role of the doctor in promoting it. 2015. Available at https://www.aomrc.org.uk/wp-content/uploads/2016/05/Exercise_the_Miracle_Cure_0215.pdf [Accessed August 2020].
[3] Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54 1451–1462.
| World Health Organization 2020 guidelines on physical activity and sedentary behaviour.Crossref | GoogleScholarGoogle Scholar |
[4] Centers for Disease Control and Prevention. Adults need more physical activity. 2019. Available at https://www.cdc.gov/physicalactivity/inactivity-among-adults-50plus/index.html [Accessed August 2020].
[5] Guiney H, Keall M, Machado L. Physical activity prevalence and correlates among New Zealand older adults. J Aging Phys Act 2018; 26 75–83.
| Physical activity prevalence and correlates among New Zealand older adults.Crossref | GoogleScholarGoogle Scholar |
[6] Spiteri K, Broom D, Bekhet AH, et al. Barriers and motivators of physical activity participation in middle-aged and older adults—a systematic review. J Aging Phys Act 2019; 27 929–944.
| Barriers and motivators of physical activity participation in middle-aged and older adults—a systematic review.Crossref | GoogleScholarGoogle Scholar |
[7] Yarmohammadi S, Mozafar Saadati H, Ghaffari M, et al. A systematic review of barriers and motivators to physical activity in elderly adults in Iran and worldwide. Epidemiol Health 2019; 41 e2019049
| A systematic review of barriers and motivators to physical activity in elderly adults in Iran and worldwide.Crossref | GoogleScholarGoogle Scholar |
[8] Jones Lang LaSalle. NZ retirement villages and aged care. Whitepaper. New Zealand Retirement Village Database (NZRVD) and Aged Care Database (NZACD); 2021. Available at https://www.jll.nz/en/trends-and-insights/research/retirement-villages-market-review-2021 [Accessed October 2021].
[9] Kritz M, Thogersen-Ntoumani C, Mullan B, et al. “It’s better together”: a nested longitudinal study examining the benefits of walking regularly with peers versus primarily alone in older adults. J Aging Phys Act 2020; 29 455–465.
| “It’s better together”: a nested longitudinal study examining the benefits of walking regularly with peers versus primarily alone in older adults.Crossref | GoogleScholarGoogle Scholar |
[10] Nathan A, Wood L, Giles-Corti B. Examining correlates of self-reported and objectively measured physical activity among retirement village residents. Australas J Ageing 2014; 33 250–256.
| Examining correlates of self-reported and objectively measured physical activity among retirement village residents.Crossref | GoogleScholarGoogle Scholar |
[11] Resnick B, D’Adamo C. Factors associated with exercise among older adults in a continuing care retirement community. Rehabil Nurs 2011; 36 47–53.
| Factors associated with exercise among older adults in a continuing care retirement community.Crossref | GoogleScholarGoogle Scholar |
[12] Nathan A, Wood L, Giles-Corti B. Exploring socioecological correlates of active living in retirement village residents. J Aging Phys Act 2014; 22 1–15.
| Exploring socioecological correlates of active living in retirement village residents.Crossref | GoogleScholarGoogle Scholar |
[13] Peri K, Broad JB, Hikaka J, et al. Study protocol: older people in retirement villages. A survey and randomised trial of a multi-disciplinary invention designed to avoid adverse outcomes. BMC Geriatr 2020; 20 247
| Study protocol: older people in retirement villages. A survey and randomised trial of a multi-disciplinary invention designed to avoid adverse outcomes.Crossref | GoogleScholarGoogle Scholar |
[14] Broad JB, Wu Z, Bloomfield K, et al. Health profile of residents of retirement villages in Auckland, New Zealand: findings from a cross-sectional survey with health assessment. BMJ Open 2020; 10 e035876
| Health profile of residents of retirement villages in Auckland, New Zealand: findings from a cross-sectional survey with health assessment.Crossref | GoogleScholarGoogle Scholar |
[15] Connolly MJ, Hikaka J, Bloomfield K, et al. Research in the retirement village community—the problems of recruiting a representative cohort of residents in Auckland, New Zealand. Australas J Ageing 2021; 40 177–183.
| Research in the retirement village community—the problems of recruiting a representative cohort of residents in Auckland, New Zealand.Crossref | GoogleScholarGoogle Scholar |
[16] Cheung G, Clugston A, Croucher M, et al. Performance of three cognitive screening tools in a sample of older New Zealanders. Int Psychogeriatr 2015; 27 981–989.
| Performance of three cognitive screening tools in a sample of older New Zealanders.Crossref | GoogleScholarGoogle Scholar |
[17] Hirdes JP, Ljunggren G, Morris JN, et al. Reliability of the interRAI suite of assessment instruments: a 12-country study of an integrated health information system. BMC Health Serv Res 2008; 8 277
| Reliability of the interRAI suite of assessment instruments: a 12-country study of an integrated health information system.Crossref | GoogleScholarGoogle Scholar |
[18] Morris J, Berg K, Bjorkgren M, et al. interRAI Clinical Assessment Protocols (CAPS) for use with community and long-term care assessment instruments. Washington, DC: interRAI; 2010.
[19] Schutzer KA, Graves BS. Barriers and motivations to exercise in older adults. Prev Med 2004; 39 1056–1061.
| Barriers and motivations to exercise in older adults.Crossref | GoogleScholarGoogle Scholar |
[20] Holt A, Lee AH, Jancey J, et al. Are retirement villages promoting active aging? J Aging Phys Act 2016; 24 407–411.
| Are retirement villages promoting active aging?Crossref | GoogleScholarGoogle Scholar |
[21] Wrights AP, Fain CW, Miller ME, et al. Assessing physical and cognitive function of older adults in continuing care retirement communities: who are we recruiting? Contemp Clin Trials 2015; 40 159–165.
| Assessing physical and cognitive function of older adults in continuing care retirement communities: who are we recruiting?Crossref | GoogleScholarGoogle Scholar |
[22] Bloomfield K, Wu Z, Tatton A, et al. An interRAI-derived frailty index is associated with prior hospitalisations in older adults residing in retirement villages. Australas J Ageing 2021; 40 66–71.
| An interRAI-derived frailty index is associated with prior hospitalisations in older adults residing in retirement villages.Crossref | GoogleScholarGoogle Scholar |
[23] Kotlarczyk MP, Hergenroeder AL, Gibbs BB, et al. Personal and environmental contributors to sedentary behavior of older adults in independent and assisted living facilities. Int J Environ Res Public Health 2020; 17 6415
| Personal and environmental contributors to sedentary behavior of older adults in independent and assisted living facilities.Crossref | GoogleScholarGoogle Scholar |
[24] Carlson JA, Sallis JF, Conway TL, et al. Interactions between psychosocial and built environment factors in explaining older adults’ physical activity. Prev Med 2012; 54 68–73.
| Interactions between psychosocial and built environment factors in explaining older adults’ physical activity.Crossref | GoogleScholarGoogle Scholar |
[25] Smith L, Gardner B, Fisher A, et al. Patterns and correlates of physical activity behaviour over 10 years in older adults: prospective analyses from the English longitudinal study of ageing. BMJ Open 2015; 5 e007423
| Patterns and correlates of physical activity behaviour over 10 years in older adults: prospective analyses from the English longitudinal study of ageing.Crossref | GoogleScholarGoogle Scholar |
[26] Law M. The environment: a focus for occupational therapy. Can J Occup Ther 1991; 58 171–179.
| The environment: a focus for occupational therapy.Crossref | GoogleScholarGoogle Scholar |
[27] Levasseur M, Généreux M, Bruneau JF, et al. Importance of proximity to resources, social support, transportation and neighborhood security for mobility and social participation in older adults: results from a scoping study. BMC Public Health 2015; 15 503
| Importance of proximity to resources, social support, transportation and neighborhood security for mobility and social participation in older adults: results from a scoping study.Crossref | GoogleScholarGoogle Scholar |
[28] Grant B, Jones P, McLean G, et al. Physical activity in the lives of midlife and older New Zealanders. Australas Parks Leisure 2007; 10 45–48.
| Physical activity in the lives of midlife and older New Zealanders.Crossref | GoogleScholarGoogle Scholar |
