1.1 Introduction
It has been known since the 1950s that physical activity is linked with physical and mental health benefits for people of all ages (Kohl III et al. 2012). For example, leisure time physical activity is associated with a reduction in risk of 13 types of cancer , regardless of body size or smoking history (Moore et al. 2016). Further, participation in physical activity in mid-life can reduce the risk of poor health in later life, such as developing dementia , disability , and frailty (National Institute for Health and Care Excellence 2015). It seems that older people would like to live for many years in later life on the condition that they live a ‘healthy old age’, that is, with continued independence (Karppinenm et al. 2016). Thus, physical activity is key to helping people achieve ‘healthy ageing’ (World Health Organization [WHO] 2015).
However, we also know that many people are not as physically active as they could be, and thus their potential to maximise their health and well-being is not realised. For example, an estimated 9% of worldwide premature mortality is caused by lack of physical activity (Lee et al. 2012). As adults grow older, they are less likely to be physically active, and this decline in physical activity continues so that older people are the least likely to be physically active of all age groups (Hallal et al. 2012; McKee et al. 2015). This is why physical activity is a key component of policies aimed at improving the health and well-being of older people, such as ‘successful ageing’ in the USA and ‘active ageing’ in Europe. Successful ageing refers to the avoidance of disability and disease to enable continued activity in later life (Foster and Walker 2015). Active ageing , similarly, refers to facilitating older people to remain active—in terms of physical activity, employment, and social, economic, cultural, spiritual, and civic participation—to enable continued quality of life in later life (WHO 2002). While successful and active ageing policies are broader in scope, the focus of this handbook will solely be on physical activity promotion, a central element to any ageing well strategy. In response to current low levels of physical activity participation among older people, this handbook seeks to comprehensively answer the question, ‘How can we best promote physical activity among older people?’
1.2 An Outline of the Rationale, Scope, and Contents of the Handbook
This handbook is for researchers, practitioners, postgraduates, and final year undergraduate students. It is to meet the need for a text on the best evidence about how to achieve physical activity promotion among older people. Our handbook meets this need by providing a multidisciplinary text co-edited by a panel of experts from the relevant disciplines. The chapters provide a series of overviews from experts in the field to give the reader an understanding of the current evidence base and associated key theoretical concepts. Each chapter covers what is known about the topic, what is unknown, and the practical implications of current theory and empirical evidence.
1.2.1 The Book’s Unique Contribution to the Literature
Despite advances in the fields of gerontology and geriatrics, sports and exercise science , sociology, health psychology, and public health, knowledge is largely contained within disciplines as reflected in the current provision of academic texts on this subject. However, to address the present and substantial societal challenges such as population ageing , a multidisciplinary and collaborative approach is required. This edited volume will review the current evidence for what physical activities need to be promoted among older people and how these physical activities can be implemented to maximise engagement. The unique feature of this handbook is the team of editors and authors who represent a variety of disciplines and countries that have collaborated to produce for the first time a multidisciplinary handbook on this subject.
1.2.2 Scope of the Book
In accordance with ecological approaches to health promotion, the book will be divided into sections that follow a gradual progression from focusing on determinants of physical activity at the individual level, to the community level, and then finally to the structural level (Dahlgren and Whitehead 1991). The first section of the book will highlight the importance of promoting physical activity among older people from an epidemiological perspective. The second and third sections of the book will focus on the individual level in terms of what physical activities to promote (physiology) and how to maximise participation in physical activity (psychology). The fourth section will focus on the social and community network level (implementation of physical activities in different settings). The fifth and sixth sections will focus on the general socio-economic, cultural, and environmental conditions level in relation to both the physical (landscape and built environment architecture) and social environment (sociology). The final section will provide a discussion of current issues and debates in promoting physical activity among older people. From this handbook, the reader will benefit from the scientific knowledge of the following: why we need to promote physical activity in later life, which activities to promote and how to maximise participation, how the physical, social, and cultural environment facilitates/hinders activity, and future developments in this thriving field.
In the sections that follow, the focus of the handbook is introduced, and in particular, definitions are given for the terms ‘physical activity’ and ‘older people’. An ecological approach is then provided as the framework for the handbook, along with a brief explanation of how this maps on to the handbook’s different sections. The chapter then concludes with some applications of the material covered for practitioners working with older people.
1.3 What Do We Mean by Physical Activity?
Terms such as ‘physical activity’ and ‘exercise’ are often used interchangeably, but they actually refer to distinct concepts. ‘Physical activity refers to body movement that is produced by the contraction of skeletal muscles and that increases energy expenditure’ (Chodzko-Zajko et al. 2009, p. 1511). In contrast, ‘exercise refers to planned, structured, and repetitive movement to improve or maintain one or more components of physical fitness’ (Chodzko-Zajko et al. 2009, p. 1511), with physical fitness defined as a set of measurable health- or skill-related attributes (Caspersen et al. 1985). Exercise is therefore a subcategory of physical activity and is planned, structured, and repetitive, whereas physical activity can be spontaneous and fluid. Exercise has the express purpose of improving/maintaining physical fitness , whereas physical activity could be conducted with a different intention . For example, someone may walk home because it is a sunny day and to enjoy the weather. They have been walking for 30 minutes, but not for the purpose of getting fit, and they decided to do this spontaneously. Likewise, some physical activities such as playing in the park with grandchildren may be for fun, and while they meet the criteria for physical activity, they would not meet the criteria for exercise.
1.3.1 Rationale for This Handbook’s Focus on Physical Activity
While some chapters may focus more on exercise, for example, specific prescribed body movements for the purpose of rehabilitation and to recover strength in a certain area of the body , the handbook has an overall focus on physical activity. Physical activity encompasses a broader range of activity and so has been adopted for this handbook to encompass activities such...