Prevalence and correlates of physician recommendations to exercise among older adults.

BACKGROUND This study explored the prevalence of and factors associated with physician suggestions to exercise in a sample of older adults. METHODS We conducted telephone interviews of a random sample of members of two Medicare health maintenance organizations (HMOs) in Northern California. Participants were 893 community-dwelling older adults of whom 63% were women, 52% were married, and 12% were in a minority group. Mean years of education was 14.8 +/- (2.6) and mean years of age was 74.9 +/- (6.5). The associations between patient self-reports of ever receiving physician recommendations to exercise and the following categories of variables were assessed: demographics, health-related quality of life, medical conditions, health/risk behaviors, and health knowledge/interest/satisfaction. RESULTS The prevalence of older adults in this study ever receiving a physician suggestion to exercise was 48.2%. In a multivariate logistic regression model, being younger, sedentary, and having a higher body mass index were independently (p < or = .05) and positively associated with increased reports of having ever received a physician's advice to exercise. Those who were precontemplators (not thinking about changing physical activity behavior), and those who reported greater frequency of endurance exercise were less likely to report receiving a physician recommendation to exercise (p < or = .05). CONCLUSIONS Although physician advice appeared to be targeted to subgroups that could benefit, physician advice on exercise could be particularly increased for patients over 75 years of age, those currently not thinking about an increase in physical activity, and those currently active patients who may benefit from ongoing physician advice to promote maintenance.

[1]  A. Bauman,et al.  Physical activity preferences, preferred sources of assistance, and perceived barriers to increased activity among physically inactive Australians. , 1997, Preventive medicine.

[2]  J O Prochaska,et al.  Stages of change in the modification of problem behaviors. , 1992, Progress in behavior modification.

[3]  K. Patrick,et al.  A controlled trial of physician counseling to promote the adoption of physical activity. , 1996, Preventive medicine.

[4]  M. Weinstein,et al.  Performance of a Five-Item Mental Health Screening Test , 1991, Medical care.

[5]  A. Stewart,et al.  Physical Functioning Measures , 1992 .

[6]  J. Manson,et al.  Physical activity and incidence of non-insulin-dependent diabetes mellitus in women , 1991, The Lancet.

[7]  E H Wagner,et al.  The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  A. Tarlov,et al.  The relationship between patient income and physician discussion of health risk behaviors. , 1997, JAMA.

[9]  W. Hershman,et al.  Exercise counseling , 1993, Journal of general internal medicine.

[10]  D. Reda,et al.  Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension. , 1995, The New England journal of medicine.

[11]  A. Stewart,et al.  The MOS short-form general health survey. Reliability and validity in a patient population. , 1988, Medical care.

[12]  E. Simonsick,et al.  Risk due to inactivity in physically capable older adults. , 1993, American journal of public health.

[13]  Sharon A Brown,et al.  Promoting Weight Loss in Type II Diabetes , 1996, Diabetes Care.

[14]  Steven N. Blair,et al.  Influences of Cardiorespiratory Fitness and Other Precursors on Cardiovascular Disease and All-Cause Mortality in Men and Women , 1996 .

[15]  B. Blanksby,et al.  Beliefs and behaviour of general practitioners regarding promotion of physical activity. , 2010, Australian journal of public health.

[16]  C. Sherbourne,et al.  Preliminary Tests of a 6-Item General Health Survey , 1992 .

[17]  C. Clancy,et al.  The counseling practices of internists. , 1991, Annals of internal medicine.

[18]  B. Stamford Exercise and the Elderly , 1988, Exercise and sport sciences reviews.

[19]  R. Suzman,et al.  Longitudinal study of physical ability in the oldest-old. , 1989, American journal of public health.

[20]  D J Madden,et al.  Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. , 1989, Journal of gerontology.

[21]  W. Applegate,et al.  A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). , 1997, JAMA.

[22]  Susan N. Lukwago,et al.  Physician recommendations for diet and physical activity: which patients get advised to change? , 1997, Preventive medicine.