Measuring Physical Health Needs for Older Adults

Who Am I and How Did I Get Where I am?

 Photo of Andrea Mayo

Photo of Andrea Mayo

I am Andrea Mayo and I was born in East Hants, Nova Scotia. My interest in physical activity, health, and aging started at the University of New Brunswick (UNB) in the Faculty of Kinesiology. At UNB, I completed my master’s degree under the supervision of Dr. Danielle Bouchard where I focused on healthy aging and physical activity within the older population. My main interest lies in developing a comprehensive approach to physical activity by using a database of information from thousands of older adults across Canada. With this database, we can investigate potential correlations between physical activity patterns, physical functioning and the ability to remain independent.

What is a Comprehensive Approach to Physical Activity and Why Is It Important?       

 Retrieved from Reference [7]

Retrieved from Reference [7]

Canada’s older adult population, those 65 and older, is increasing; more specifically, New Brunswick has one of the largest older adult populations in Canada [1]. This is concerning because as these individuals age, their ability to live independently may decrease – meaning they will be unable to live on their own. Many factors can impact an older adult’s ability to remain in their home, but one major component is their level of physical function. Physical function is the ability to complete their activities of daily living expected for their age; such as, getting in and out of bed, going up a set of stairs or being able to dress. An individual with low physical function is considered dependent and is therefore in need of support. This support could include living in a nursing home, having home nursing visits, or having a family or friend become a caregiver. Currently, one of the best ways to increase or maintain one’s physical function is through physical activity, such as walking, chores, biking, or weight lifting. Physical activity is any bodily movement produced by skeletal muscle that requires energy expenditure above resting value [2]; simply put, any movement outside of sedentary behaviour is physical activity. The term exercise differ from physical activity is that it is structured, planned, and goal oriented; therefore, exercise is a form of physical activity. Currently for older adults, Canada has a national physical activity recommendation, this includes: 1) a minimum of 150 minutes of moderate to vigorous intense physical activity, 2) two days of resistance training and, 3) balance exercises if needed, all performed over a week. If this recommendation is reached, it has been shown to have positive impacts on an older adult’s physical function level [3]. Moderate-to-vigorous intensity is any activity that brings you outside your comfort zone, makes one breathe a little harder, and makes one’s heart rate increase. This could include activities such as a brisk walk, labor-intensive chores like gardening, or tasks that might be considered exercise to an extent such as going for a run or a bike ride. 

Although many know that being physically active is beneficial for one’s overall-health, many do not reach these recommendations – when measured, only 13% of older adults meet this minimum. It is thus worth exploring to see if other methods of physical activity are more attainable for this population and if those activities could improve their physical function.

My Thesis in the Comprehensive Approach to Physical Activity

 Blue portion indicates the length of time that current guidelines account for in a 24 hour day.

Blue portion indicates the length of time that current guidelines account for in a 24 hour day.

My thesis work addresses this problem with the idea of the comprehensive approach to physical activity. Currently, the physical activity recommendations address only a small portion of a day.  In addition, the guide only looks at intensities that are moderate and vigorous when literature shows that other metrics such as the amount of sleep, time spent sitting or light intensity can also impact one’s physical function [4]–[6]. Therefore, my work looks at combining all activities done in a day, no matter how intense, how long, or how often an activity is done, to evaluate the possible physical function impacts this approach may have. Currently, this approach to physical activity is a national recommendation within youth; however, has not been studied in other populations and age groups. My goal is to explore this area of research within older populations in hopes of making the guidelines more attainable and that maybe simply moving more and sitting less or doing more activities like gardening, or chores could also have positive impacts on an older adult’s functional level.

In addition, I am also looking at physical activity indexes, or ratios between different forms of activity, that may also have a positive impact on physical function. The goals of looking at these indexes is that physical activity can be performed many ways; therefore, I was curious to see if different ratios of activity are more likely to have a positive impact on physical function. The first of which is a resistance training to aerobic activity index, this index was chosen because those who do visit their local gym, may either lift weights alone or focus on cardiovascular activities only, such as marathon runners or cyclists. This ratio presents two forms of exercise, cardiovascular and resistance training as a ratio to see how both forms of exercise can impact physical function. This is novel as the current guidelines looks at both forms separately. Secondly, another index assesses sedentary time to active time; more specifically, it addresses that some people reach the physical activity recommendation and may also sit at a desk for 8 hours a day. This index explores what physical function of older adults looks like when an individual is sedentary for long periods of time while also being considered active.

 Total Index, Resistance/Aerobic Activity, and Sedentary/Active Time Indexes, how they relate to Physical Function, and how it relates further with the Canadian Physical Activity Guidelines (CPAG)

Total Index, Resistance/Aerobic Activity, and Sedentary/Active Time Indexes, how they relate to Physical Function, and how it relates further with the Canadian Physical Activity Guidelines (CPAG)

The goal of my research is to provide another option for older adults’ when it comes to physical activity routines. Currently, many older adults do not research the current physical activity guidelines; however, they know exercise and remaining physically active is beneficial to their overall health. The comprehensive approach is a novel way to view physical activities that may be more attainable and favourable for this population. The current guidelines still should be the primary recommendation; however, for those who find those guides out of reach or who do not have the capability to reach those guidelines the comprehensive approach may also be an option for them.  My work explores parts of existing literature and presents it in a way that could be utilized as a guideline for physical activity that could be applied in conjunction to the current guidelines.


Guest Author

 
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Andrea Mayo is a PhD candidate in Health at Dalhousie University in Halifax, Nova Scotia, working on using large databases to see how lifestyle behaviours are associated with a frailty index overtime in older Canadians. Andrea grew up in East Hants, Nova Scotia and attended the University of New Brunswick for a Master's degree in Exercise and Sport Science. If you’re interested in getting in touch with Andrea, you can contact her by Email or Twitter.


References

[1]  Statistics Canada, “Census in Brief: A portrait of the population aged 85 and older in 2016 in Canada, Census year 2016,” 03-May-2016. [Online]. Available: http://www12.statcan.gc.ca/census-recensement/2016/as-sa/98-200-x/2016004/98-200-x2016004-eng.cfm. [Accessed: 21-Sep-2017].

[2]  “WHO | World Health Statistics 2014,” WHO. [Online]. Available: http://www.who.int/mediacentre/news/releases/2014/world-health-statistics-2014/en/. [Accessed: 02-Oct-2017].

[3]  “CSEP-PATH: Physical Activity Training for Health.” [Online]. Available: http://store.csep.ca/CSEP-PATH-Physical-Activity-Training-for-Health_p_52.html. [Accessed: 11-Aug-2017].

[4]  D. A. Santos et al., “Sedentary behavior and physical activity are independently related to functional fitness in older adults,” Exp. Gerontol., vol. 47, no. 12, pp. 908–912, Dec. 2012.

[5]  L. B. Sardinha, D. A. Santos, A. M. Silva, F. Baptista, and N. Owen, “Breaking-up sedentary time is associated with physical function in older adults,” J. Gerontol. A. Biol. Sci. Med. Sci., vol. 70, no. 1, pp. 119–124, Jan. 2015.

[6]  M. M. Ohayon and M.-F. Vecchierini, “Normative sleep data, cognitive function and daily living activities in older adults in the community,” Sleep, vol. 28, no. 8, pp. 981–989, Aug. 2005.

[7] Tremblay MS, Carson V, Chaput J-P, et al. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. Appl Physiol Nutr Metab. 2016;41(6 (Suppl. 3)):S311-S327. doi:10.1139/apnm-2016-0151

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