Ageing International

, Volume 44, Issue 4, pp 399–410 | Cite as

Prevalence and the Determinants of Physical Activity in an Elderly Cohort of 60 years and more. A Cross-Sectional Case-Control Study

  • Alijan Ahmadi Ahangar
  • Hojjat Khoshmanzar
  • Behzad Heidari
  • Ali Bijani
  • Reza Hosseini
  • Hemmat Gholinia
  • Payam Saadat
  • Mansour BabaeiEmail author


In the elderly, decline in physical activity (PA) is associated with decreased quality of life. To determine the prevalence and the associated factors of low PA in the elderly. All participants of the Amirkola town aged ≥60 years were studied. Data were collected for demographics, clinical and biochemical parametes. PA was determined by using physical activity scale for the elderly (PASE) questionnaire. In statistical analysis the study population was classified as normal or low PA defined as PASE score < 100. The two groups were compared according to demographic, clinical and biochemical characteristics using chi square test with calculation of odds ratio (OR) and corresponding 95% confidence interval (95% CI). A total of 1297 individuals with respective mean age of 70.15 ± 7.1 and 67.6 ± 6.8 years for low and normal group (p = 0.001) were studied. Low PA was observed in 612 patients (47.1%). Prevalence of low PA was negatively associated with, higher level of education (OR = 0.64, 95% CI, 0.51–0.80, p = 0.001), higher arm muscle strength (OR = 0.77, 95% CI, 0.62–0.96, p = 0.02), but positively associated with male sex (OR =1.56, 95% CI, 1.25–1.94), hypertension (OR = 1.34, 95% CI, 1.1–1.73), disequilibrium (OR = 2.2, 95% CI, 1.74–2.9) and age. Compared with age group at 60–64 years, prevalence of low PA increased by OR = 1.74 (95% CI, 1.25–2.34) in age group 70–74 years, by OR = 2.51 (95% CI, 1.52–4.15) at age group 80–84 years, and OR = 7.74 (95% CI, 3.17–18.89) in those aged ≥85 years old. The findings of this study indicate that age, male sex, hypertension and disequilibrium are positively associated with low PA whereas female sex, muscle strength and education level are protective against low PA.


Aging Physical activity Elderly Prevalence Association 



We thank the Clinical Research Development unit of Rouhani Hospital, Babol University of Medical Sciences for assistance in discussion of case and editing this article.

Authors Contribution

Study concept and design: Alijan Ahmadi Ahangar, Hojjat Khoshmanzar, Behzad Heidari, Ali Bijani, Reza Hosseini, Hemmat Gholinia, Payam Saadat, Mansour Babaei

Acquisition of data: Hojjat Khoshmanzar

Analysis and interpretation of data: Ali Bijani, Reza Hosseini, Hemmat Gholinia,

Drafting of the manuscript: Alijan Ahmadi Ahangar, Hojjat Khoshmanzar, Behzad Heidari, Ali Bijani, Reza Hosseini, Hemmat Gholinia, Payam Saadat, Mansour Babaei

Critical revision of the manuscript for important intellectual content: Alijan Ahmadi Ahangar, Hojjat Khoshmanzar, Behzad Heidari, Ali Bijani, Reza Hosseini, Hemmat Gholinia, Payam Saadat, Mansour Babaei

Statistical analysis: Behzad Heidari, Ali Bijani, Reza Hosseini, Hemmat Gholinia,

Administrative, technical, and material support: Alijan Ahmadi Ahangar, Hojjat Khoshmanzar, Behzad Heidari, Ali Bijani, Reza Hosseini, Hemmat Gholinia, Payam Saadat, Mansour Babaei

Study supervision: Alijan Ahmadi Ahangar, Hojjat Khoshmanzar, Behzad Heidari, Ali Bijani, Reza Hosseini, Hemmat Gholinia, Payam Saadat, Mansour Babaei

Compliance with Ethical Standards

Conflict of Interest


Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Treatment of Experimental Subjects (Animal and Human)

This article does not contain any studies with animals performed by any of the authors.


  1. Al Snih, S., Graham, J. E., Kuo, Y.-F., Goodwin, J. S., Markides, K. S., & Ottenbacher, K. J. (2010). Obesity and disability: Relation among older adults living in Latin America and the Caribbean. American Journal of Epidemiology, 171(12), 1282–1288.CrossRefGoogle Scholar
  2. An, R., & Shi, Y. (2015). Body weight status and onset of functional limitations in US middle-aged and older adults. Disability and Health Journal, 8(3), 336–344.CrossRefGoogle Scholar
  3. Arnau, A., Espaulella, J., Serrarols, M., Canudas, J., Formiga, F., & Ferrer, M. (2016). Risk factors for functional decline in a population aged 75 years and older without total dependence: A one-year follow-up. Archives of Gerontology and Geriatrics, 65, 239–247.CrossRefGoogle Scholar
  4. Bell, J. A., Sabia, S., Singh-Manoux, A., Hamer, M., & Kivimäki, M. (2017). Healthy obesity and risk of accelerated functional decline and disability. International Journal of Obesity, 41(6), 866–872.CrossRefGoogle Scholar
  5. Downer, B., Crowe, M., & Markides, K. S. (2017). Influence of type II diabetes and high depressive symptoms on the likelihood for developing activities of daily living (ADL) disability and mortality in older Puerto Ricans. Journal of Aging and Health. Scholar
  6. Ferrucci, L., Baroni, M., Ranchelli, A., Lauretani, F., Maggio, M., Mecocci, P., & Ruggiero, C. (2014). Interaction between bone and muscle in older persons with mobility limitations. Current Pharmaceutical Design, 20(19), 3178–3197.CrossRefGoogle Scholar
  7. Firouzjahi, A., Monadi, M., Karimpoor, F., Heidari, B., Dankoob, Y., Hajian-Tilaki, K., & Firozjaii, M. G. (2013). Serum C-reactive protein level and distribution in chronic obstructive pulmonary disease versus healthy controls: A case-control study from Iran. Inflammation, 36(5), 1122.CrossRefGoogle Scholar
  8. Freiberger, E., Sieber, C., & Pfeifer, K. (2011). Physical activity, exercise, and sarcopenia–future challenges. WMW Wiener Medizinische Wochenschrift, 161(17), 416–425.CrossRefGoogle Scholar
  9. Geffken, D. F., Cushman, M., Burke, G. L., Polak, J. F., Sakkinen, P. A., & Tracy, R. P. (2001). Association between physical activity and markers of inflammation in a healthy elderly population. American Journal of Epidemiology, 153(3), 242–250.CrossRefGoogle Scholar
  10. Giacomin, K. C., Peixoto, S. V., Uchoa, E., & Lima-Costa, M. F. (2008). A population-based study on factors associated with functional disability among older adults in the great metropolitan Belo Horizonte, Minas Gerais state, Brazil. Cadernos de Saúde Pública, 24(6), 1260–1270.CrossRefGoogle Scholar
  11. Gretebeck, K. A., Sabatini, L. M., Black, D. R., & Gretebeck, R. J. (2017). Physical activity, functional ability, and obesity in older adults: A gender difference. Journal of Gerontological Nursing, 43(9), 38–46.CrossRefGoogle Scholar
  12. Grimby, G. (1986). Physical activity and muscle training in the elderly. Journal of Internal Medicine, 220(S711), 233–237.Google Scholar
  13. Hajian-Tilaki, K., & Heidari, B. (2007). Prevalence of obesity, central obesity and the associated factors in urban population aged 20–70 years, in the north of Iran: A population-based study and regression approach. Obesity Reviews, 8(1), 3–10.CrossRefGoogle Scholar
  14. Hajian-Tilaki, K., Heidari, B., Firouzjahi, A., Bagherzadeh, M., Hajian-Tilaki, A., & Halalkhor, S. (2014). Prevalence of metabolic syndrome and the association with socio-demographic characteristics and physical activity in urban population of Iranian adults: A population-based study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 8(3), 170–176.CrossRefGoogle Scholar
  15. Heidari, B. (2011). Knee osteoarthritis diagnosis, treatment and associated factors of progression: Part II. Caspian journal of internal medicine, 2(3), 249.Google Scholar
  16. Heidari, B. (2012). The importance of C-reactive protein and other inflammatory markers in patients with chronic obstructive pulmonary disease. Caspian journal of internal medicine, 3(2), 428.Google Scholar
  17. Heidari, B., & Mirghassemi, M. B. H. (2012). Seasonal variations in serum vitamin D according to age and sex. Caspian journal of internal medicine, 3(4), 535.Google Scholar
  18. Heidari, B., Hoshmand, S., Hajian, K., & Heidari, P. (2010). Comparing bone mineral density in postmenopausal women with and without vertebral fracture and its value in recognizing high-risk individuals. Eastern Mediterranean Health Journal, 16(8), 868–873.CrossRefGoogle Scholar
  19. Heidari, B., Heidari, P., Nourooddini, H. G., & Hajian-Tilaki, K. O. (2012). Relationship between parity and bone mass in postmenopausal women according to number of parities and age. The Journal of Reproductive Medicine, 58(9–10), 389–394.Google Scholar
  20. Heidari, B., Heidari, P., & HajianTilaki, K. (2014). Relationship between unexplained arthralgia and vitamin D deficiency: A case control study. Acta Medica Iranica, 52(5), 400.Google Scholar
  21. Heidari, B., Hosseini, R., Javadian, Y., Bijani, A., Sateri, M. H., & Nouroddini, H. G. (2015). Factors affecting bone mineral density in postmenopausal women. Archives of Osteoporosis, 10(1), 217.CrossRefGoogle Scholar
  22. Heidari, B., Muhammadi, A., Javadian, Y., Bijani, A., Hosseini, R., & Babaei, M. (2016). Associated factors of bone mineral density and osteoporosis in elderly males. International Journal of Endocrinology and Metabolism, 15(1), e39662.CrossRefGoogle Scholar
  23. Hosseini, S. R., Cumming, R. G., Kheirkhah, F., Nooreddini, H., Baiani, M., Mikaniki, E., et al. (2013). Cohort profile: The Amirkola health and ageing project (AHAP). International Journal of Epidemiology, 43(5), 1393–1400.CrossRefGoogle Scholar
  24. Hughes, V. A., Frontera, W. R., Wood, M., Evans, W. J., Dallal, G. E., Roubenoff, R., & Singh, M. A. F. (2001). Longitudinal muscle strength changes in older adults: Influence of muscle mass, physical activity, and health. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(5), B209–B217.CrossRefGoogle Scholar
  25. Janssen, I., Heymsfield, S. B., & Ross, R. (2002). Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. Journal of the American Geriatrics Society, 50(5), 889–896.CrossRefGoogle Scholar
  26. Koye, D. N., Shaw, J. E., & Magliano, D. J. (2017). Diabetes and disability in older Australians: The Australian diabetes, obesity and lifestyle (AusDiab) study. Diabetes Research and Clinical Practice, 126, 60–67.CrossRefGoogle Scholar
  27. Lisko, I., Tiainen, K., Raitanen, J., Jylhävä, J., Hurme, M., Hervonen, A., et al. (2017). Body mass index and waist circumference as predictors of disability in nonagenarians: The vitality 90+ study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 72(11), 1569–1574. Scholar
  28. Menéndez, J., Guevara, A., Arcia, N., León Díaz, E. M., Marín, C., & Alfonso, J. C. (2005). Chronic diseases and functional limitation in older adults: A comparative study in seven cities of Latin America and the Caribbean. Revista Panamericana de Salud Publica, 17(5–6), 353–361.Google Scholar
  29. Nam, S., Kuo, Y.-F., Markides, K. S., & Al Snih, S. (2012). Waist circumference (WC), body mass index (BMI), and disability among older adults in Latin American and the Caribbean (LAC). Archives of Gerontology and Geriatrics, 55(2), e40–e47.CrossRefGoogle Scholar
  30. Ojagbemi, A., Bello, T., Luo, Z., & Gureje, O. (2016). Chronic conditions, new onset, and persistent disability in the Ibadan study of aging. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 72(7), 997–1005.CrossRefGoogle Scholar
  31. Paterson, D. H., & Warburton, D. E. (2010). Physical activity and functional limitations in older adults: A systematic review related to Canada's physical activity guidelines. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 38.CrossRefGoogle Scholar
  32. Ridker, P. M., Hennekens, C. H., Buring, J. E., & Rifai, N. (2000). C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. New England Journal of Medicine, 342(12), 836–843.CrossRefGoogle Scholar
  33. Rodrigues, M. A. P., Facchini, L. A., Thumé, E., & Maia, F. (2009). Gender and incidence of functional disability in the elderly: A systematic review. Cadernos de Saúde Pública, 25, S464–S476.CrossRefGoogle Scholar
  34. Schroll, M., Avlund, K., & Davidsen, M. (1996). Predictors of five-year functional ability in a longitudinal survey of men and women aged 75 to 80. The 1914-population in Glostrup, Denmark. Aging (Milan, Italy), 9(1–2), 143–152.Google Scholar
  35. Su, P., Ding, H., Zhang, W., Duan, G., Yang, Y., Long, J., et al. (2016). Joint association of obesity and hypertension with disability in the elderly—A community-based study of residents in shanghai, China. The Journal of Nutrition, Health & Aging, 4(21), 362–369.Google Scholar
  36. Sun, F., Norman, I. J., & While, A. E. (2013). Physical activity in older people: A systematic review. BMC Public Health, 13(1), 449.CrossRefGoogle Scholar
  37. Valderrama-Hinds, L. M., Al Snih, S., Rodriguez, M. A., & Wong, R. (2017). Association of arthritis and vitamin D insufficiency with physical disability in Mexican older adults–findings from the Mexican health and aging study. Rheumatology International, 37(4), 607.CrossRefGoogle Scholar
  38. Yokota, R. T. D. C., Van der Heyden, J., Nusselder, W. J., Robine, J.-M., Tafforeau, J., Deboosere, P., & Van Oyen, H. (2016). Impact of chronic conditions and multimorbidity on the disability burden in the older population in Belgium. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 71(7), 903–909.CrossRefGoogle Scholar
  39. Zunzunegui, M. V., Nunez, O., Durban, M., García de Yébenes, M.-J., Béland, F., & Otero, Á. (2006). Decreasing prevalence of disability in activities of daily living, functional limitations and poor self-rated health: A 6-year follow-up study in Spain. Aging Clinical and Experimental Research, 18(5), 352–358. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Alijan Ahmadi Ahangar
    • 1
  • Hojjat Khoshmanzar
    • 2
  • Behzad Heidari
    • 1
  • Ali Bijani
    • 3
  • Reza Hosseini
    • 3
  • Hemmat Gholinia
    • 4
  • Payam Saadat
    • 1
  • Mansour Babaei
    • 5
    Email author
  1. 1.Mobility Impairment Research CenterBabol University of Medical SciencesBabolIran
  2. 2.Babol University of Medical SciencesBabolIran
  3. 3.Department of Social Determinants of Health (SDH) Research CentreBabol University of Medical SciencesBabolIran
  4. 4.Health Research InstituteBabol University of Medical SciencesBabolIran
  5. 5.Department of Internal Medicine, Division of Rheumatology, Rouhani Hospital, Clinical Research Development Unit of Rouhani HospitalBabol University of Medical SciencesBabolIran

Personalised recommendations