Hostname: page-component-848d4c4894-p2v8j Total loading time: 0 Render date: 2024-06-11T02:55:06.092Z Has data issue: false hasContentIssue false

Physical activity participation among older adults with diabetes: Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) Guidelines

Published online by Cambridge University Press:  18 November 2021

Chenchen Yang
Affiliation:
Rehabilitation and Health Services, University of North Texas, Denton, TX, USA
Elias Mpofu
Affiliation:
Rehabilitation and Health Services, University of North Texas, Denton, TX, USA School of Health Sciences, University of Sydney, Sydney, Australia Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
Xiaoli Li*
Affiliation:
Rehabilitation and Health Services, University of North Texas, Denton, TX, USA
Diana Dorstyn
Affiliation:
School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
Qiwei Li
Affiliation:
School of Nursing, John Hopkins University, Baltimore, MD, USA
Kaye Brock
Affiliation:
School of Medical Sciences, University of Sydney, Sydney, Australia
*
*Corresponding author: Email: xiaolili@my.unt.edu
Get access

Abstract

Objective:

Physical activity (PA) is a known benefit to older adults with diabetes; however, the determinants of PA are less well studied in this population. Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), a well-established biopsychosocial framework, we explored PA participation among older adult with type 2 diabetes.

Method:

Using data from the Health and Retirement Study and the RAND Center for the Study of Aging (N = 2,016; mean age = 73.19; SD = 6.16), we conducted hierarchical stepwise regression analysis to evaluate the relative contribution of different biopsychosocial predictors to PA – namely, body functions and structure, activity and participation, personal, and environmental factors.

Results:

Altogether, biopsychosocial factors accounted for 20% of the variance in PA participation. Of the personal factors, high extraversion and low neuroticism explained approximately 54% of the variance in PA among the older adults – beyond sociodemographics. Low body mass index, reduced pain, reduced depression, and higher cognitive functioning also had good explanatory power (25% of explained variance), whereas activity participation and environment did not (10% each).

Conclusion:

Aligning care with components of the ICF will help to ensure a focus on person-centric practices and, in turn, optimize participation outcomes such as PA.

Type
Articles
Copyright
© The Author(s), 2021. Published by Cambridge University Press and The Australian Journal of Rehabilitation Counselling

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alcantara, M. A., De Souza, R. A., De Oliveira, F. A., & Pinhal, K. C. (2018). Using the ICF framework to evaluate the effects of environmental factors on physical disability among people with diabetes mellitus. Physiotherapy Theory and Practice, 36(3), 424431. https://doi:10.1080/09593985.2018.1488191 CrossRefGoogle Scholar
American Diabetes Association. (2017). 11. Older adults. Diabetes Care, 40(Supplement 1), S99S104. https://professional.diabetes.org/files/media/dc_40_s1_final.pdf CrossRefGoogle Scholar
Anderson, N. D., Damianakis, T., Kröger, E., Wagner, L. M., Dawson, D. R., Binns, M. A., … Cook, S. L. (2014). The benefits associated with volunteering among seniors: a critical review and recommendations for future research. Psychological Bulletin, 140(6), 15051533. https://doi:10.1037/a0037610.CrossRefGoogle ScholarPubMed
Awad, H., & Alghadir, A. (2013). Validation of the comprehensive international classification of functioning, disability and health core set for diabetes mellitus: physical therapists’ perspectives. American Journal of Physical Medicine and Rehabilitation, 92(11), 968979. https://doi:10.1097/PHM.0b013e31829b4a6d.CrossRefGoogle ScholarPubMed
Bjälkebring, P., Henning, G., Västfjäll, D., Dickert, S., Brehmer, Y., Buratti, S., Hansson, I., & Johansson, B. (2021). Helping out or helping yourself? Volunteering and life satisfaction across the retirement transition. Psychology and Aging, 36(1), 119130. https://doi.org/10.1037/pag0000576 CrossRefGoogle ScholarPubMed
Canada, B., Stephan, Y., Sutin, A. R., & Terracciano, A. (2020). Personality and falls among older adults: Evidence from a longitudinal cohort. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 75(9), 19051910. https://doi.org/10.1093/geronb/gbz040 CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (2020). National Diabetes Statistics Report, 2020. Estimates of Diabetes and Its Burden in the United States. Retrieved on August 15, 2021, from https://www.cdc.gov/diabetes/data/statistics-report/index.html Google Scholar
Cerin, E., Nathan, A., Van Cauwenberg, J., Barnett, D. W., & Barnett, A. (2017). The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 123. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0471-5 CrossRefGoogle ScholarPubMed
Chan, T., Wanigatunga, A. A., Terracciano, A., Carlson, M. C., Bandeen-Roche, K., Costa, P. T. Jr, Simonsick, E. M., & Schrack, J. A. (2021). Traits and treadmills: Association between personality and perceived fatigability in well-functioning community-dwelling older adults. Psychology and Aging, 36(6), 710717. https://doi.org/10.1037/pag0000631 CrossRefGoogle ScholarPubMed
Chen, L., Pei, J., Kuang, J., Chen, H., Chen, Z., & Li, Z. (2015). Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism, 64(2), 338347. https://doi:10.1016/j.metabol.2014.10.018.CrossRefGoogle ScholarPubMed
Craney, T. A., & Surles, J. G. (2002). Model-dependent variance inflation factor cutoff values. Quality Engineering, 14(3), 391403. https://doi.org/10.1081/QEN-120001878 CrossRefGoogle Scholar
Debast, I., van Alphen, S. P., Rossi, G., Tummers, J. H., Bolwerk, N., Derksen, J. J., & Rosowsky, E. (2014). Personality traits and personality disorders in late middle and old age: Do they remain stable? A literature review. Clinical Gerontologist, 37(3), 253271. https://doi.org/10.1080/07317115.2014.885917 CrossRefGoogle Scholar
Donnellan, M. B., & Lucas, R. E. (2008). Age differences in the Big Five across the life span: evidence from two national samples. Psychology and aging, 23(3), 558. https://doi.org/10.1037/a0012897 CrossRefGoogle ScholarPubMed
Ferland, A., Brassard, P., & Poirier, P. (2007). Is aspartame really safer in reducing the risk of hypoglycemia during exercise in patients with type 2 diabetes? Diabetes Care, 30(7), e59e59. https://doi.org/10.2337/dc06-1888.CrossRefGoogle ScholarPubMed
Fisher, K. J., Li, F., Michael, Y., & Cleveland, M. (2004). Neighborhood-level influences on physical activity among older adults: a multilevel analysis. Journal of Aging and Physical Activity, 12(1), 4563. https://doi:10.1123/japa.12.1.45.CrossRefGoogle ScholarPubMed
Foy, C. G., Vitolins, M. Z., Case, L. D., Harris, S. J., Massa-Fanale, C., Hopley, R. J., … Gaspari, J. (2013). Incorporating prosocial behavior to promote physical activity in older adults: Rationale and design of the Program for Active Aging and Community Engagement (PACE). Contemporary Clinical Trials, 36(1), 284297. https://doi:10.1016/j.cct.2013.07.004.CrossRefGoogle Scholar
Gispen, F. E., Chen, D. S., Genther, D. J., & Lin, F. R. (2014). Association between hearing impairment and lower levels of physical activity in older adults. Journal of the American Geriatrics Society, 62(8), 14271433. https://doi:10.1111/jgs.12938.CrossRefGoogle ScholarPubMed
Gottlieb, B. H., & Bergen, A. E. (2010). Social support concepts and measures. Journal of Psychosomatic Research, 69(5), 511520. https://doi:10.1016/j.jpsychores.2009.10.001.CrossRefGoogle ScholarPubMed
Henning, G., Berg, A. I., Cengia, A., Hansson, I., Spuling, S. M., & Wettstein, M. (2021). Do neuroticism and conscientiousness interact with health conditions in predicting 4-year changes in self-rated health among Swedish older adults? Psychology and Aging, 36(6), 730743. https://doi.org/10.1037/pag0000626 CrossRefGoogle ScholarPubMed
Inoue, S., Kawashima, M., Hiratsuka, Y., Nakano, T., Tamura, H., Ono, K., … Yamada, M. (2018). Assessment of physical inactivity and locomotor dysfunction in adults with visual impairment. Scientific Reports, 8(1), 17. https://www.nature.com/articles/s41598-018-30599-z CrossRefGoogle ScholarPubMed
Janevic, M. R., McLaughlin, S. J., & Connell, C. M. (2013). The association of diabetes complications with physical activity in a representative sample of older adults in the United States. Chronic Illness, 9(4), 251257. https://doi:10.1177/1742395313475461.CrossRefGoogle Scholar
Kasumov, T., Solomon, T. P., Hwang, C., Huang, H., Haus, J. M., Zhang, R., & Kirwan, J. P. (2015). Improved insulin sensitivity after exercise training is linked to reduced plasma C 14: 0 ceramide in obesity and type 2 diabetes. Obesity, 23(7), 14141421. https://doi:10.1002/oby.21117.CrossRefGoogle Scholar
Klinedinst, N. J., & Resnick, B. (2016). The Volunteering-in-Place (VIP) Program: Providing meaningful volunteer activity to residents in assisted living with mild cognitive impairment. Geriatric Nursing, 37(3), 221227. https://doi:10.1016/j.gerinurse.2016.02.012.CrossRefGoogle ScholarPubMed
Ku, P. W., Fox, K. R., Chen, L. J., & Chou, P. (2012). Physical activity and depressive symptoms in older adults: 11-year follow-up. American Journal of Preventive Medicine, 42(4), 355362. https://doi.org/10.1016/j.amepre.2011.11.010 CrossRefGoogle ScholarPubMed
Lachman, M. E., & Weaver, S. L. (1997). The Midlife Development Inventory (MIDI) personality scales: Scale construction and scoring. Waltham, MA: Brandeis University, 1–9.Google Scholar
LeRoith, D., & Halter, J. B. (2020). Diagnosis of diabetes in older adults. Diabetes Care, 43(7), 13731374. https://doi.org/10.2337/dci20-0013 CrossRefGoogle ScholarPubMed
Li, Y., White, K., O’Shields, K. R., McLain, A. C., & Merchant, A. T. (2019). Light-intensity physical activity and cardiometabolic risk among older adults with multiple chronic conditions. American Journal of Health Promotion, 33(4), 507515. https://doi.org/10.1177/0890117118796459 CrossRefGoogle ScholarPubMed
Li, X., Zhou, T., Ma, H., Liang, Z., Fonseca, V. A., & Qi, L. (2021). Replacement of sedentary behavior by various daily-life physical activities and structured exercises: genetic risk and incident type 2 diabetes. Diabetes Care, 44(10), 24032410. https://doi.org/10.2337/dc21-0455 CrossRefGoogle Scholar
Loprinzi, P. D. (2013). Objectively measured light and moderate-to-vigorous physical activity is associated with lower depression levels among older US adults. Aging & Mental Health, 17(7), 801805. https://doi.org/10.1080/13607863.2013.801066 CrossRefGoogle ScholarPubMed
Librett, J.,Yore, M. M., Buchner, D. M., & Schmid, T. L. (2005). Take pride in America's health: volunteering as a gateway to physical activity. American Journal of Health Education, 36(1), 813. https://doi.org/10.1080/19325037.2005.10608149 CrossRefGoogle Scholar
Mantantzis, K., Drewelies, J., Duezel, S., Buchmann, N., Steinhagen-Thiessen, E., Wagner, G. G., Raz, N., Lindenberger, U., Demuth, I., & Gerstorf, D. (2020). Poor glucose regulation is associated with declines in well-being among older men, but not women. Psychology and Aging, 35(2), 204211. https://doi.org/10.1037/pag0000404 CrossRefGoogle Scholar
McCrae, R. R., Costa, P. T. Jr, Ostendorf, F., Angleitner, A., Hřebíčková, M., Avia, M. D., … Smith, P. B. (2000). Nature over nurture: temperament, personality, and life span development. Journal of Personality and Social Psychology, 78(1), 173. https://doi:10.1249/MSS.0000000000001822.CrossRefGoogle ScholarPubMed
McGuire, S. (2014). Centers for Disease Control and Prevention. State indicator report on Physical Activity, 2014. Atlanta, GA: US Department of Health and Human Services; 2014. Advances in Nutrition, 5(6), 762763. https://doi.org/10.3945/an.114.007211 CrossRefGoogle ScholarPubMed
Murano, I., Asakawa, Y., Mizukami, M., Takihara, J., Shimizu, K., & Imai, T. (2014). Factors increasing physical activity levels in diabetes mellitus: a survey of patients after an inpatient diabetes education program. Journal of Physical Therapy Science, 26(5), 695699. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047234/ CrossRefGoogle ScholarPubMed
Murray, A. L., & Booth, T. (2015). Personality and physical health. Current Opinion in Psychology, 5, 5055. https://doi.org/10.1016/j.copsyc.2015.03.011 CrossRefGoogle Scholar
Pallant, J. (2010). SPSS Survival Manual: A Step by Step Guide to Data Analysis Using SPSS. 4th ed. Australia: Allen & Unwin Book Publishers. https://www.routledge.com/SPSS-Survival-Manual-A-step-by-step-guide-to-data-analysis-using-IBM-SPSS/Pallant/p/book/9781760875534 Google Scholar
Pan, X., & Ward, R. M. (2015). Self-management and self-rated health among middle-aged and older adults with type 2 diabetes in China: A structural equation model. Social Indicators Research, 120(1), 247260. https://doi.org/10.1007/s11205-014-0575-0 CrossRefGoogle Scholar
Paterson, D. H., & Warburton, D. E. (2010). Physical activity and functional limitations in older adults: a systematic review related to Canada’s Physical Activity Guidelines. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 122. https://doi:10.1186/1479-5868-7-38.CrossRefGoogle ScholarPubMed
Plotnikoff, R. C., Taylor, L. M., Wilson, P. M., Courneya, K. S., Sigal, R. J., Birkett, N., … Svenson, L. W. (2006). Factors associated with physical activity in Canadian adults with diabetes. Medicine and Science in Sports and Exercise, 38(8), 15261534. https://doi:10.1249/01.mss.0000228937.86539.95 CrossRefGoogle ScholarPubMed
Portacolone, E., Perissinotto, C., Yeh, J. C., & Greysen, S. R. (2018). “I feel trapped”: The tension between personal and structural factors of social isolation and the desire for social integration among older residents of a high-crime neighborhood. The Gerontologist, 58(1), 7988. https://academic.oup.com/gerontologist/article/58/1/79/3001859 CrossRefGoogle ScholarPubMed
Qian, J., Walkup, M. P., Chen, S. H., Brubaker, P. H., Bond, D. S., Richey, P. A., … Look AHEAD Research Group. (2021). Association of objectively measured timing of physical activity bouts with cardiovascular health in type 2 diabetes. Diabetes Care, 44(4), 10461054. https://doi.org/10.2337/dc20-2178 CrossRefGoogle ScholarPubMed
Robinson, S. A., & Lachman, M. E. (2018). Perceived control and cognition in adulthood: The mediating role of physical activity. Psychology and Aging, 33(5), 769781. https://doi.org/10.1037/pag0000273 CrossRefGoogle ScholarPubMed
Robinson, S. A., & Lachman, M. E. (2020). Daily control beliefs and cognition: The mediating role of physical activity. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 75(4), 772782. https://doi.org/10.1093/geronb/gby081 CrossRefGoogle ScholarPubMed
Ruaro, J. A., Ruaro, M. B., & Guerra, R. O. (2014). International Classification of Functioning, Disability and Health core set for physical health of older adults. Journal of Geriatric Physical Therapy, 37(4), 147153. https://doi:10.1519/JPT.0b013e3182abe7e1.CrossRefGoogle ScholarPubMed
Ruof, J, Cieza, A, Wolff, B, Angst, F, Ergeletzis, D, Omar, Z, Kostanjsek, N, Stucki, G (2004). ICF Core Sets for diabetes mellitus. Journal of Rehabilitation Medicine (44 Suppl): 100106. https://doi:10.1080/16501960410016802.Google ScholarPubMed
Saklofske, D. H., Austin, E. J., Rohr, B. A., & Andrews, J. J. (2007). Personality, emotional intelligence and exercise. Journal of Health Psychology, 12(6), 937948. https://doi:10.1177/1359105307082458 CrossRefGoogle ScholarPubMed
Seaton, L., & Brown, T. (2018). The Relationship between Body Function and Structure Factors and the Activity-Participation of healthy community-dwelling older adults. Physical & Occupational Therapy in Geriatrics, 36(2–3), 121135. https://doi.org/10.1080/02703181.2018.1443193 CrossRefGoogle Scholar
Sesti, G., Incalzi, R. A., Bonora, E., Consoli, A., Giaccari, A., Maggi, S., … Ferrara, N. (2018). Management of diabetes in older adults. Nutrition, Metabolism and Cardiovascular Diseases, 28(3), 206218. https://doi.org/10.1016/j.numecd.2017.11.007 CrossRefGoogle ScholarPubMed
Smith, G. L., Banting, L., Eime, R., O’Sullivan, G., & Van Uffelen, J. G. (2017). The association between social support and physical activity in older adults: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 121. https://link.springer.com/article/10.1186/s12966-017-0509-8 Google Scholar
Stephan, Y., Sutin, A. R., Bayard, S., Križan, Z., & Terracciano, A. (2018). Personality and sleep quality: Evidence from four prospective studies. Journal of Research in Personality, 73, 173179. https://doi.org/10.1037/hea0000577 CrossRefGoogle Scholar
Strickhouser, J. E., Zell, E., & Krizan, Z. (2017). Does personality predict health and well-being? A metasynthesis. Health Psychology, 36(8), 797. https://doi.org/10.1037/hea0000475 CrossRefGoogle ScholarPubMed
Sugiyama, T., Cerin, E., Mridha, M., Koohsari, M. J., & Owen, N. (2018). Prospective associations of local destinations and routes with middle-to-older aged adults’ walking. The Gerontologist, 58(1), 121129. https://doi:10.1093/geront/gnx088.CrossRefGoogle ScholarPubMed
Sutin, A. R., Stephan, Y., Luchetti, M., Artese, A., Oshio, A., & Terracciano, A. (2016). The five-factor model of personality and physical inactivity: A meta-analysis of 16 samples. Journal of Research in Personality, 63, 2228. https://doi.org/10.1016/j.jrp.2016.05.001 CrossRefGoogle ScholarPubMed
Thorpe, A. A., Healy, G. N., Winkler, E., Clark, B. K., Gardiner, P. A., Owen, N., & Dunstan, D. W. (2012). Prolonged sedentary time and physical activity in workplace and non-work contexts: a cross-sectional study of office, customer service and call centre employees. International Journal of Behavioral Nutrition and Physical Activity, 9(1), 19. https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-9-128 Google Scholar
Tolea, M. I., Terracciano, A., Simonsick, E. M., Metter, E. J., Costa, P. T. Jr, & Ferrucci, L. (2012). Associations between personality traits, physical activity level, and muscle strength. Journal of Research in Personality, 46(3), 264270. https://doi:10.1016/j.jrp.2012.02.002.CrossRefGoogle ScholarPubMed
Wanko, N. S., Brazier, C. W., Young-Rogers, D., Dunbar, V. G., Boyd, B., George, C. D., … Cook, C. B. (2004). Exercise preferences and barriers in urban African Americans with type 2 diabetes. The Diabetes Educator, 30(3), 502513. https://doi:10.1177/014572170403000322 CrossRefGoogle ScholarPubMed
WHO (2001). International Classification of Functioning, Disability, and Health. Author. https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health Google Scholar
WHO (2018). Diabetes. Retrieved on August 15, 2020 from https://www.who.int/health-topics/diabetes#tab=tab_1 Google Scholar
Wildeboer, A. T., Stallinga, H. A., & Roodbol, P. F. (2020). Validation of the International Classification of Functioning, Disability and Health (ICF) core set for Diabetes Mellitus from nurses’ perspective using the Delphi method. Disability and Rehabilitation, https://doi:10.1080/09638288.2020.1763485 CrossRefGoogle ScholarPubMed
Wilson, K. E., & Dishman, R. K. (2015). Personality and physical activity: A systematic review and meta-analysis. Personality and Individual Differences, 72, 230242. https://doi.org/10.1016/j.paid.2014.08.023 CrossRefGoogle Scholar
Wortman, J., Lucas, R. E., & Donnellan, M. B. (2012). Stability and change in the Big Five personality domains: evidence from a longitudinal study of Australians. Psychology and aging, 27(4), 867874. doi: 10.1037/a0029322. Epub 2012CrossRefGoogle ScholarPubMed
Zhao, G., Ford, E. S., Li, C., & Balluz, L. S. (2011). Physical activity in US older adults with diabetes mellitus: prevalence and correlates of meeting physical activity recommendation. Journal of the American Geriatrics Society, 59(1), 132137. https://doi:10.1111/j.1532-5415.2010.03236.x.CrossRefGoogle Scholar