title: Is diabetes associated with poorer self-efficacy and motivation for physical activity in older adults with arthritis?
abstract: OBJECTIVE
  The primary aim was to explore whether arthritis is associated with poorer self-efficacy and motivation for, and participation in, two specific types of physical activity (PA): endurance training (ET) and strength training (ST). A further objective was to determine whether the added burden of diabetes contributes to a further reduction in these PA determinants and types.
  
  
  METHODS
  Self-efficacy and motivation for exercise and minutes per week of ET and ST were measured in 347 older veterans enrolled in a home-based PA counselling intervention. Regression analyses were used to compare high versus low self-efficacy and motivation and PA minutes in persons without arthritis, with arthritis alone, and with arthritis plus diabetes.
  
  
  RESULTS
  Persons with arthritis alone reported lower self-efficacy for ET and ST than those without arthritis [odds ratio (OR)ET 0.71, 95% confidence interval (CI) 0.39–1.20; ORST 0.69, 95% CI 0.39–1.20]. A further reduction in self-efficacy for these two types of PA was observed for those with both arthritis and diabetes (ORET 0.65, 95% CI 0.44–0.92; ORST 0.64, 95% CI 0.44–0.93; trend p < 0.001). There was no trend towards a reduction in motivation for PA in those with arthritis alone or with arthritis and diabetes. Persons with arthritis exhibited higher motivation for ET than those without arthritis (ORET 1.85, 95% CI 1.12–3.33). There were no significant differences between the three groups in minutes of ET (p = 0.93), but persons with arthritis plus diabetes reported significantly less ST compared to individuals with arthritis only (p = 0.03).
  
  
  CONCLUSIONS
  Despite reduced self-efficacy for ET and ST and less ST in older persons with arthritis, motivation for both PA types remains high, even in the presence of diabetes.
authors.affiliation: Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA. Huffm007@mc.duke.edu
authors.forename: K M
authors.initials: KM
authors.lastname: Huffman
authors.forename: K S
authors.initials: KS
authors.lastname: Hall
authors.forename: R
authors.initials: R
authors.lastname: Sloane
authors.forename: M J
authors.initials: MJ
authors.lastname: Peterson
authors.forename: H B
authors.initials: HB
authors.lastname: Bosworth
authors.forename: C
authors.initials: C
authors.lastname: Ekelund
authors.forename: M
authors.initials: M
authors.lastname: Pearson
authors.forename: T
authors.initials: T
authors.lastname: Howard
authors.forename: C F
authors.initials: CF
authors.lastname: Pieper
authors.forename: M C
authors.initials: MC
authors.lastname: Morey
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D003071:Cognition; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D009042:Motivation; D009043:Motor Activity; D010358:Patient Participation / Q000523:psychology*; D010807:Physical Endurance; D012044:Regression Analysis; D055070:Resistance Training; D012649:Self Concept