Enhancing Support for Physical Activity in Older Adults: A Public Health Call to Action
Physical activity (PA) is an effective form of primary, secondary, and tertiary prevention against a myriad of noncommunicable diseases, including cardiovascular disease, diabetes, and certain cancers.1 Almost 90% of older adults (65+ years) have 1 chronic disease and 65% have 2 or more chronic diseases,2 which create a vicious downward spiral of lower PA engagement and further incidence of disease.3 This carries significant economic costs, given that older adults who are active 1 to 3 days per week have 8% to 20% lower health care costs and those who are active at least 4 days per week realize an additional 8% to 11% reduction in health care costs,4 compared with sedentary counterparts. Despite public health interventions aimed specifically at promoting PA in older adults,5–7 they have been ineffective to thwart steadily declining PA levels and proliferating chronic diseases. This is influenced by a myriad of variables, including rapid expansion and diversification of older adults,8 a wide-ranging list of mediating variables to PA adoption and maintenance,9 and a public health workforce ill-prepared in the field of active aging.10 Accordingly, such complexities represent immense opportunities to realize the public health and concomitant economic benefits associated with increasing PA levels among older adults.
While acting as president of the Association of State and Territorial Health Officials, Jewel Mullen10 discussed the importance of collaborative efforts for improving the health of older adults. The purpose of this commentary, which expands upon Mullen's recommendations, is to provide tangible, evidence-based action steps for increasing PA in older adults, with consideration to individual-, social-, and environmental-level mediating barriers to behavior change. Supplementary strategies to accomplishing action steps are provided in an effort to bolster translational impact. Adopting these steps will ultimately result in minimizing the individual and public health impacts of chronic disease among older adults while minimizing health disparities across socioeconomic status, environmental, gender, and ethnic subgroups of older adults.