The prospective and concurrent effect of exercise on health related quality of life in older adults over a 3 year period

Helen-Maria Vasiliadis, Mathieu F. Bélanger

It is not clear whether socioeconomic status influences health outcomes among older adults through its effect on physical activity. The aim of this study was to assess the effect of sex and neighborhood socio-economic status on the change in health related quality of life (HR-QOL) as a function of physical activity over a three-year period. This cohort study included French-speaking community-dwelling older adults recruited in primary care practices in the province of Quebec and participating in the 'Étude sur la Santé des Ainés' (ESA)-Services study on the health of the elderly. Primary care practices were recruited through participating general practitioners (GPs) working full-time in the health administrative region. A stratified sample was comprised of various types of primary care practices (family medicine group, local community health services centers, primary care practices with less than 3 GPs, and with at least 3 GPs). In this study sample, 967 participants with scores ≥26 on the Mini Mental State Examination (MMSE) were included and followed for 3 years to study HR-QOL as a function of reported exercise at baseline and follow-up, controlling for study variables. Analyses were also carried out to study the effect of change in reported exercise at follow-up with respect to baseline and categorised as follows: no change, decrease in exercise and increase in exercise. The interaction terms area of residence socio-economic status*exercise and sex*exercise, were tested. Exercise at baseline did not significantly predict HR-QOL at follow-up when adjusting for all other study variables. Exercise at follow-up was cross-sectionally associated with follow-up HR-QOL. Participants reporting never exercising and those reporting a decrease in exercise reported a lower HR-QOL at follow-up, when controlling for all other study variables. There was no interaction between exercise and sex and socioeconomic status. For healthy ageing, maintaining and increasing physical activity throughout the years is necessary for improved HR-QOL. Past physical activity does not confer protection against future decline of HR-QOL. Future research should focus on potential moderating and mediating psycho-social barriers associated with exercising in older age populations.