Disparity between Physical Capacity and Participation in Seniors with Chronic Disease

UNLABELLED: Consistently low rates of physical activity are reported for older adults, and there is even lower participation if a chronic disease is present. PURPOSE: To explore the predictors of physical capacity and participation in older community-dwelling individuals living with multiple chronic diseases. METHODS: This was a descriptive cross-sectional investigation of physical capacity (physiological potential) and physical activity participation (recorded engagement in physical activity). Multiple regression and odds ratios were used to investigate determinants of physical capacity (6-min walk test) and physical activity participation (Physical Activity Scale for Individuals with Physical Disabilities Questionnaire; pedometer steps per day). RESULTS: Two hundred community-dwelling ambulatory participants living with two or more chronic diseases were assessed. Sixty-five percent (65%) were women, and the mean age was 74 +/- 6 yr (range 65-90 yr). Mobility (timed up and go) was a consistent determinant across all three primary outcomes. For the 6-min walk test, determinants included mobility, BMI, grip strength, number of medications, leg strength, balance, and Chronic Disease Management Self-Efficacy Scale (r2 = 0.58; P = 0.000). The determinants for the self-reported participation measure (Physical Activity Scale for Individuals with Physical Disabilities Questionnaire) was mobility (r2 = 0.04; P = 0.007). For the mean daily pedometer steps, the determinants included mobility, body mass index (BMI), age, and Chronic Disease Management Self-Efficacy Scale (r2 = 0.27; P = 0.000). There were higher risks for inactivity associated with impairments compared with the presence of a chronic disease. In addition, more than a third of participants had sufficient physical capacity but did not meet minimal recommendations of physical activity. CONCLUSION: This study suggests that it is easier to predict an individual's physical capacity than their actual physical participation.