Physical and mental health predicts better adherence to exercise intervention in older women: A post-hoc analysis.

Background: Adherence to exercise is crucial for promoting health and maintaining functioning. Aims: To investigate predictors of adherence to exercise in the initially free supervised fall prevention RCT and its low-cost, self-sustained continuation among elderly women. Methods: In the 2-year Kuopio Fall Prevention Study RCT, 457 women (aged 71-84) were offered a free initial 6-month supervised weekly training program (gym, Tai Chi) in the municipal facilities. Women's adherence during this period was categorized into high (≥80 %) and low (<80 %). In the next six months, their free access to the premises continued without supervision. For the second year, low-cost access was offered with unsupervised independent training in these facilities. The second-year adherence was based on purchasing(yes/no) a gym card to continue exercising. Information on baseline health, functioning, and lifestyle was obtained by mailed questionnaires and physical tests. Results: For the first six months, over 60 % of the women had high adherence. Only 26 % continued into the second year. For both follow-up years, active training history was related to better adherence. Initial predictors were related to mental health i.e. having less often fear of falls limiting one's mobility, ability to cope with external, not internal hostility, and being in a loving relationship. In the second year, predictors were related to younger age, having less frequent fear of falls, better functional capacity i.e. better strengths (grip and leg extension) and faster Timed "Up and Go" -test. Conclusion: Better mental and physical health, better functional capacity and active training background were associated with higher adherence to exercise intervention in older women.