Transcript The Influence of Body Image on Exercise in the Elderly

The Influence of Body Image on
Exercise in the Elderly
Bindu Parchuri D.O.
Geriatric Fellow
NJISA
Questions
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Is an elderly patient’s perception of aspects
of body image such as attractiveness and
functionality related to amount of exercise?
Do elderly who exercise feel more attractive
and functional than those who do not?
Specific Aims
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This study looked at whether there is a relationship
between elderly patients’ perception of body image
and physical activity
Aspects of body image such as attractiveness and
functionality may be used as a positive enabler to
help the elderly to initiate, continue and/or increase
physical activity
Perhaps elderly patients who exercise more feel
more attractive and more functional
Background
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Obesity has been increasing in all age groups since
the early 1960s
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Overall, intentional weight loss has been associated with
decreased mortality and morbidity
Exercise in later life has a positive effect on health
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Improves cardiovascular, musculoskeletal, endocrine and
psychological health
Associated with decreased mortality and age-related
morbidity in older adults
“35% of individuals aged 65 and older reported engaging in
insufficient physical activity and 28% reported being
inactive.” (Wallace)
Why don’t the elderly exercise?
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Barriers
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perceived lack of benefit
lack of motivation
fears of incurring pain
feelings of being too old.
Positive enablers have been shown to be
access to facilities and having a companion.
Motivation
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Bahram, et al., looked at 120 men and women aged
25 to 65
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“active adults had [a] more positive body image than
inactive adults.”
Hausenblas, et al., found that exercise improves
body image, regardless of age
Tiggemann, et al., also found a positive correlation
between exercise and self esteem
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Younger men and women exercised more for attractiveness
and enjoyment than older men and women
Motivation
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Heinberg, et al., looked at body image and
weight loss maintenance in elderly African
Americans with hypertension
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Found that subjective body image dissatisfaction
was a positive influence on weight loss
Not many studies have focused on the
elderly and their perception of their bodies
Motivation
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Understanding factors that relate to exercise
may be used in the future to influence the
elderly to initiate, continue and/or increase
physical activity
Body Image
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This study examined different aspects of body image
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Do subjects who exercise feel more attractive and functional
than those that do not?
Appearance
Coordination
Overall Global Self Image
Methods
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Survey/questionnaire completed prior to
lecture
Community dwelling older adults – located
through Nutrition Sites in Camden County
Demographics component of Questionnaire
PSDQ – Physical Self Description
Questionnaire (Marsh)
Leisure Time Exercise Questionnaire (Godin)
Leisure Time Exercise Questionnaire
By Godin
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During a typical 7-Day period (a week), how many times
on the average do you do the following kinds of exercise
for more than 15 minutes during your free time (write on
each line the appropriate number)
– STRENUOUS EXERCISE (HEART BEATS RAPIDLY)
– MODERATE EXERCISE (NOT EXHAUSTING)
– MILD EXERCISE (MINIMAL EFFORT)
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During a typical 7-Day period (a week), in your leisure
time, how often do you engage in any regular activity
long enough to work up a sweat (heart beats rapidly)?
Participants
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Recruited participants from 4 Nutrition Sites
in Camden County
Asked about 200 people to participate
Obtained 80 completed surveys
Participants ranged in age from 70 to 96 and
included both men and women
Results
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The participants ranged in age from 70 to 96 with the
mean age being 81.3 (SD 6.1)
75% (60) were female
70% (54) were Caucasian; 27.3% (21) were African
American; and 2.6% (2) identified themselves as
other.
A majority (55.7%) responded that they did not
discuss with their doctor increasing their physical
activity.
Results
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The subjects used 0 to 13 medications with
the mean of 4.8.
80% stated that they were not disabled, 17%
of participants considered themselves obese
88% of total participants lived in a single
family home or an apartment
14 % lived with a spouse; 36 % lived with a
family member; and 49% lived alone
The Three Groups
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The three groups were divided according to
recommendations based on current CDC
guidelines for exercise in adults and on
recommendations from Dr. Godin.
The formula used was (Strenuous Ex x
9)+(Moderate Ex x 5)+(Mild Ex x 3)
Minimal – less than 23
Moderate – 24 to 50
Strenuous – over 50
PSDQ Scores by Exercise Group
Group
Appearance
Coordination
Global
Mean
4.59
1 (N=45)
4.6
2 (N=20)
St Dev
1.13
Mean
3.91
St Dev
1.22
Mean
4.5
St Dev
1.22
1.04
4.47
3.02
4.38
1.50
5.08
1.02
4.83
1.32
5.33
1.29
3 (N=10)
Results
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When scores were examined using
Kruskal-Wallis, differences between groups
were not significant (Appearance, p =.446;
Coordination, p = .279; Global Score, p =
.138)
Among the strenuous exercisers, none
considered themselves obese or disabled;
23% of moderate and minimal exercisers
considered themselves obese or disabled
Conclusions
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This study explored the relationship
between appearance, functionality, body
image and total exercise
There were no statistically significant
relationships between amount of exercise
and measures of perceived body image
Of those that did strenuous exercise, 100%
did not consider themselves to be disabled
or obese
Problems
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Not enough participants
There were not enough participants who
exercised strenuously
Some difficulty having participants complete
entire questionnaire
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“Too Long”
Some confusion on how too complete the PSDQ
scale
A few agreed to complete with assistance
References
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Bahram, A and Shafizadeh. A Comparative and Correlation Study of Body Image in Active and
Inactive Adults and with Body Composition and Somatotype. Journal of Applied Sciences (6): 24562460. 2006
Chau, D, Cho, L, Jani, P et al Individualizing recommendations for weight management in the
elderly Cuur Opin Clin Nutr Metab Care (11) p 27-31 2008
Conn, V. Older Women’s Beliefs about Physical Activity Public Health Nursing (15) p370-378 1998
Oct
Degerance, J et al barriers to and Benefits of Leisure Time Physical Activity in the Elderly:
Differences across cultures. JAGS (51) p 863-868, 2003
Furnham, A, Badmin, N and Sneade, I. Body Image Dissatisfaction: Gender Differences in Eating
Attitudes, Self Esteem, and Reasons for Exercise. Journal of Psychology, 136(6) p581-596, 2002
Marsh, H et al. PSDQ Instrument Self Research Center 1999
Marsh, H et al. Structure of Physical Self-Concept: Elite Athletes and Physical Education Students
Journal of Educational Psychology 1997 vol 89 p 369-380
Marsh, H. Physical Self Description Questionaire: Stability and Discriminant Validity Research
Quarterly for exercise and Sport 1996 Vol 67 p 249-264
Heinberg, L et al Body Image and weight loss Maintenance in Elderly African American
Hypertensives American Journal of Health Behavior (24) p 163 – 174, 2000 May
Hui, E, Rubenstein, L. Promoting Physical Activity and exercise in Older Adults JAMDA(7) p310-314
2006 June
Kennedy, R. et al Obesity in the Elderly: who should we be treating, and why, and how? Cuur Opin
Clin Nutr Metab Care (7) p 3-9 2004
McAuley, E. Blissmer, B. Katular, J, et al. Physical Activity, Self Esteem, and Self-Efficacy
Relationships in Older Adults: A randomized Controlled Trial. Annals of Behavioral Medicine (22) p
131-139 2000 Nov
Neid,R Promoting and Prescribing Exercise in the Elderly American Family Physican Feb 2002 Vol
65,
References
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Wallace, K et al. Motivation In Later Life Topics in Geriatric Rehabilitation Vol 21 p 95-106
Cooper K. et al Health Barriers to Walking for Exercise in Elderly Primary Care. Geriatric Nursing
2001 vol 22 , 5
Belza, B et al. Older Adult Perspectives on Physical Activity and Exercise: Vioces from Multiple
Cultures Preventing Chronic Disease Vol 1 Oct 2004
Tiggemann, M et al. The Effect of Exercise on Body Satisfaction and Self Esteem as a Function of
Gender and Age Sex Roles Vol 43 2000
Tiggemann, M Body image across the adult life span: stability and change Body Image Vol 1 2004 p
29-41
Hausenblas H. et al Exercise and body image: A meta-analysis
Psychology & Health, 1476-8321, Volume 21, Issue 1, 2006, Pages 33 – 47
Godin, G et al Assessment of Leisure Time Exercise Behavior by Self-Report: A concurrent Validity
Study Canadian Journal of Public Health Vol 77 p 359-362
Peart, N et al. The Physical Self Description Questionnaire: furthering research linking physical self
concept, physical activity and physical education https://www.aare.edu.au/05pap/pea05307.pdf
Clark, D. Identifying Psychological, Physiological and Environmental Barriers and Facilitators to
Exercise among Older Low Income Adults Journal of Clinical Geropsuchology Vol 5 1999
CDC exercise guidelines, www.cdc.gov/physicalactivity/everyone/guidelines, accessed August 2009.