Despite the demonstrated benefits of regular physical activity — decreased risk of cardiovascular disease, diabetes, dementia, and some types of cancer, along with enhanced mental health — studies indicate that less than 20% of older adults meet recommended levels of exercise on a weekly basis. Gerontologists have thus focused on social support as a key factor in enhancing engagement with and maintenance of routine physical activity for this population. While researchers have long studied the relationship between social support and its positive influence on physical activity, better defining how that relationship works can help identify potential engagement-enhancing interventions.
Cary Reid, MD, PhD, a geriatrician at NewYork-Presbyterian and Weill Cornell Medicine, recently conducted a cross-sectional study along with other NewYork-Presbyterian and Weill Cornell Medicine investigators to determine the association between social support and physical activity levels in older adults and to assess whether general health can help mediate that relationship. Below, Dr. Reid shares key takeaways from the study and implications for future research.
Study Design and Initial Findings
Our study analyzed baseline data collected as part of a randomized controlled trial comparing the Fittle Senior System (FSS), a digital physical activity intervention with social support features drawing on social cognitive theory, with a tablet-based educational control.
Among the 181 participants (mean age 70.1 years), we observed a significant association between overall social support and physical activity and a significant mediating effect of general health on that relationship. The results suggest that augmentation of social support, particularly when coupled with other modes of improving personal well-being, may be a valuable component of physical activity promotion programs.
Measuring Interrelated Factors
We employed validated instruments to assess each of the measures in the study. For general health, we used the first question from the 36-item Short Form Survey (SF-36): “In general would you say your health is...?,” to which possible responses range from 1 (excellent) to 5 (poor).
Social support was measured across three subscales — appraisal, belonging, and tangible — using the 12-item Interpersonal Support Evaluation List, which scores each item on a scale ranging from 1 (definitely false) to 4 (definitely true).
Finally, physical activity was measured using the 16-item Global Physical Activity Questionnaire, which assesses physical activity across multiple domains, including activity performed at work, during travel to and from places, and recreational activities, as well as sedentary behavior. All three measures rely on self-reported data.
Assessing the Impact of Social Support
Our results reinforce that interventions to enhance engagement in physical activity among aging adults should incorporate mechanisms or strategies that focus on social support, as these may also have a positive impact on general health. Further, interventions should focus on ways to enhance an individual’s perception of their own health status to optimize outcomes.
Our study also confirms prior work demonstrating that the level of social support positively impacts physical activity level among older adults. Adequate social support can enhance a person’s sense of well-being and mental health, which in turn facilitates their willingness to engage in routine physical activity. Our results further help us to understand that some of this effect may be happening through a person’s overall perception of their health status.
Limitations
Unfortunately, this study cannot answer the question of how social support impacts perceived health status and then an individual’s willingness or ability to engage in physical activity, as the relationships were examined cross-sectionally as opposed to longitudinally. Additionally, the study was conducted at the height of the COVID pandemic, which could have affected individuals’ social support, perceived health, and physical activity levels. Moreover, we used a self-reported measure of physical activity, which may have led to over-reporting of participants’ activity levels.
Implications for Future Research
Future research that employs objective measures of social support or physical activity would help to further define the nature of these constructs and their relationship to general health. Studies that seek to enhance physical activity levels in older adults should not only measure social support prior to study entry but also perceived health status. Also, interventions need to be multicomponent and address various factors that impact engagement in physical exercise.
