title: Health condition and physical function as predictors of adherence in long-term strength and balance training among community-dwelling older adults.
abstract: OBJECTIVE
  Strength and balance training (SBT) has remarkable health benefits, but little is known regarding exercise adherence in older adults. We examined the adherence to strength and balance training and determinants of adherence among ≥75 year old adults.
  
  
  METHODS
  182 community-dwelling individuals (aged 75-98 years, 71% female) began group-based SBT as part of a population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly study. Training was offered once a week for 2.3 years. Adherence was defined as the proportion of attended sessions relative to offered sessions. Participants were classified based on their adherence level into low (≤33.3%), moderate (33.4-66.5%) and high (≥66.6%) adherers.
  
  
  RESULTS
  The mean length of training was 19 ± 9 months, and 68% continued participation for at least two years. The mean training adherence was 55 ± 29% for all participants and 18%, 53% and 82% for low, moderate and high adherers, respectively. High adherence was predicted by female sex; younger age; better cognition; independence in Instrumental Activities of Daily Living; higher knee extension strength; faster walking speed; and better performance on the Berg Balance Scale and Timed Up and Go tests. Poorer self-perceived health and the use of a walking aid were related to low adherence.
  
  
  CONCLUSIONS
  Long-term continuation of training is possible for older community-dwelling adults, although poorer health and functional limitations affect training adherence. Our findings have implications for tailoring interventions and support for older adults to optimize their exercise adherence.
authors.affiliation: Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland. Electronic address: eeva.m.aartolahti@jyu.fi.
authors.forename: Eeva
authors.initials: E
authors.lastname: Aartolahti
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland.
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Tolppanen
authors.affiliation: Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland.
authors.forename: Eija
authors.initials: E
authors.lastname: Lönnroos
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
authors.affiliation: Department of Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland; Department of Physical and Rehabilitation Medicine, Central Finland Health Care District, Jyväskylä, Finland.
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015444:Exercise; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D009068:Movement; D010349:Patient Compliance / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities; D004856:Postural Balance; D012111:Residence Characteristics; D055070:Resistance Training / Q000379:methods*; D012959:Socioeconomic Factors; D016138:Walking
keywords: Aging; Exercise; Geriatric assessment; Mobility; Physical function