Disparity between Physical Capacity and Participation in Seniors with Chronic Disease

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Abstract
Consistently low rates of physical activity are reported for older adults, and there is even lower participation if a chronic disease is present. To explore the predictors of physical capacity and participation in older community-dwelling individuals living with multiple chronic diseases. 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). 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. This study suggests that it is easier to predict an individual's physical capacity than their actual physical participation.