Abstract
“Use it or lose it” in many ways dictates how we think about successful aging. It has long been theorized and demonstrated that activity (cognitive, social, and/or physical) is often associated with a number of positive outcomes, including increased cognitive performance, better subjective health, and improved quality of life (Hillman, Erickson, & Kramer, 2008; House, Landis, & Umberson, 2003; King, Rejeski, & Buchner, 1998; McAuley et al., 2000; Rejeski & Mihalko, 2001; Rowe & Kahn, 1997; Seeman, Lusignolo, Albert, & Berkman, 2001; Spirduso, Francis, & MacRae, 2005). Nonetheless, the explanatory mechanisms of activity and aging are sometimes challenging to disentangle. For example, does activity predict/influence key outcomes directly, or are those who are more cognitively able or in better health simply more likely to engage in physical activity? Or, as is most likely, is there a dynamic bidirectional relationship between activity and key outcomes in aging? Given the ongoing search for behaviors/strategies to help postpone the morbidity that can influence the aging process, the study of activity and its relationship to successful aging continues to inspire important scholarly advances in gerontology.
This issue of the Journal of Applied Gerontology approaches activity as outcome, as intervention, and as predictor in various scientific contexts. The first article by Holfeld and Ruthig (2014) performs an interesting bidirectional analysis to examine the empirical associations between physical activity and sleep quality over a 2-year period in older persons. Utilizing a well-controlled cross-lagged panel analysis, Holfeld and Ruthig found that initial sleep quality predicted physical activity 2 years later, whereas the converse was not apparent. Sleep and sleep quality is sometimes an under-appreciated dimension when considering its contributions to the well-being older adults, and the compelling results of Holfeld and Ruthig emphasize the important, longitudinal effects of sleep quality on the activity levels of older adults. In another large, well-controlled study, Dong and colleagues utilized data from the Chicago Health and Aging Project (n = 8,932) to examine how physical function was associated with reported elder abuse (Dong, Simon, & Evans, 2014). A range of objective and subjective reports of physical function, including the Nagi physical activity scale, was empirically associated with an increased risk of elder abuse. Lower levels of physical function also appeared linked to specific forms of elder abuse, including psychological abuse, caregiver neglect, and financial exploitation. The results highlight how impaired physical activity/function is a risk factor for elder abuse in a large, representative sample of older persons. Another impressive longitudinal study from Japan examined the effects of activity limitations on healthy life expectancy over a 6-year period. A large sample of 7,905 respondents 65 years of age and over from Tama City, Tokyo, completed surveys in 2001 and 2004, and additional data were collected from a health registry until 2007 (Yang, Hoshi, Wang, Nakayama, & Kong, 2014). Structural equation modeling found that fewer activity limitations were associated with improved healthy life expectancy, with the empirical models fitting better in women than men. In an interesting analysis of accessibility problems in senior housing, Helle, Iwarsson, and Brandt (2014) utilized observational data and self-reports in a sample of 30 older persons who either utilized no mobility device, used a wheelchair, or utilized a rollator. In a setting designed as a kitchen, Helle and colleagues found that accessibility issues were prevalent, and that placing older persons in a real-world environment while observing their everyday activities can help to identify, and potentially enhance accessibility for older persons who experience a range of functional impairments (Helle et al., 2014).
The final two articles of this issue suggest how activity interventions can result in considerable benefits for older persons. In a diverse cross-sectional sample (91.4% African American), Varma and colleagues examined the empirical associations between low-intensity walking activity and health and physical function in older persons. Interestingly, a small percentage of the sample engaged in moderate physical activity, but older persons who even engaged in low-intensity walking (less than 100 steps per minute) indicated greater well-being and physical function (Varma et al., 2014). As this study correctly notes, the findings can serve as the basis for subsequent longitudinal research as the cross-sectional design raises questions as to the directionality of effects (see Holfeld & Ruthig, 2014). Winstead and colleagues evaluate whether participation in discretionary activities improves the transition to continuing care communities. Their findings suggested that, compared with non-participants, those who participated in 8 weeks of discretionary activities indicated greater life satisfaction and less social isolation. Preserving continuity of activity during transitions to different living situations could help enhance these potentially disruptive life events (Winstead, Yost, Cotten, Berkowsky, & Anderson, 2014).
The complex role of activity in aging demands continued attention in descriptive and intervention research. The articles in this issue of the Journal of Applied Gerontology demonstrate the wide array of key health outcomes that activity can influence and vice versa. The findings also imply that activity promotion does not necessarily require clinically intensive intervention, but instead should be integrated into the day-to-day lives of older adults to help navigate the residential and health transitions that are commonplace in later life.