Prev Med. 2016 Feb;83:56-62.

Effect of diagnosis with a chronic disease on physical activity behavior in middle-aged women.

Manon L. Dontje, PhD1,2, Wim P. Krijnen, PhD1, Mathieu H.G. de Greef, PhD1,3, G.M.E.E. (Geeske) Peeters, PhD4, Ronald P. Stolk, PhD2, Cees P. van der Schans, PhD1,6, Wendy J. Brown, PhD5 

  1. Hanze University of Applied Sciences, Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
  2. University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
  3. University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
  4. Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
  5. The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
  6. University of Groningen, University Medical Center Groningen, Department of Rehabilitation, Groningen, The Netherlands

 

Corresponding author:

M.L. Dontje, PhD

m.l.dontje@alumnus.rug.nl

Present address:

Glasgow Caledonian University

Centre for Living

A101g Govan Mbeki Building, Cowcaddens Road

Glasgow G4 0BA

 

Abstract

Objective.  Although regular physical activity is an effective secondary prevention strategy for patients with a chronic disease, it is unclear whether patients change their daily physical activity after being diagnosed. Therefore, the aims of this study were to (1) describe changes in levels of physical activity in middle-aged women before and after diagnosis with a chronic disease (heart disease, diabetes, asthma, breast cancer, arthritis, depression); and to (2) examine whether diagnosis with a chronic disease affects levels of physical activity in these women.

Methods. Data from 5 surveys (1998-2010) of the Australian Longitudinal Study on Women’s Health (ALSWH) were used. Participants (N=4840, born 1946-1951) completed surveys every three years, with questions about diseases and leisure time physical activity. The main outcome measure was physical activity, categorised as: nil/sedentary, low active, moderately active, highly active.

Results. At each survey approximately half the middle-aged women did not meet the recommended level of physical activity. Between consecutive surveys, 41%-46% of the women did not change, 24%-30% decreased, and 24%-31% increased their physical activity level. These proportions of change were similar directly after diagnosis with a chronic disease, and in the years before or after diagnosis. Generalized estimating equations showed that there was no statistically significant effect of diagnosis with a chronic disease on levels of physical activity in women.

Conclusion. Despite the importance of physical activity for the management of chronic diseases, most women did not increase their physical activity after diagnosis. This illustrates a need for tailored interventions to enhance physical activity in newly diagnosed patients. 

Keywords: Physical activity, chronic disease, longitudinal, older adults, women

 

Supplement:

Regular physical activity plays an important role in the primary prevention of chronic diseases, as it reduces the risk of chronic diseases, such as cardiovascular disease, type 2 Diabetes, metabolic syndrome, and some cancers [1]. Regular physical activity also plays an important role in secondary prevention, as it can slow down the progression of many diseases and improve patients’ psychosocial well-being [1-4]. Therefore, almost all patients with a chronic disease are recommended to be regularly physically active. This means that they should achieve a minimum of 30 minutes of moderate-intensity physical activity on most days of the week [5, 6].

Worldwide, an increasing number of people are being diagnosed with a chronic disease. In this paper, we focused on six of the most prevalent chronic diseases for which physical activity is known to be beneficial: heart disease, diabetes, asthma, breast cancer, arthritis and depression [2, 7, 8]. Being diagnosed with a chronic disease may be a wake-up call for some patients for adopting a healthier lifestyle and becoming more physically active. In contrast, newly diagnosed patients may be afraid to be physically active or experience too many physical limitations to increase their activity level. Before the study it was not clear whether newly diagnosed patients actually change their daily physical activity or not.

We used data from 4840 middle-aged women from the Australian Longitudinal Study on Women’s Health to describe the changes in levels of physical activity before and after diagnosis with a chronic disease. We also examined whether diagnosis with a chronic disease affected the level of physical activity in these women.

Participants completed surveys every three years between 1998 and 2010, with questions about diagnoses with diseases and leisure time physical activity. We categorized their physical activity as nil/sedentary, low active, moderately active, and highly active. Women in the moderate and high levels were meeting the physical activity guidelines. We calculated the proportions of women who remained at the same physical activity level (i.e. same category), who decreased, and who increased their physical activity level (i.e. by one or more physical activity categories) between subsequent surveys.

Changes in levels of physical activity after being diagnosed with a chronic disease are visually presented in Figure 1. It shows the proportion of women who remained at the same level (42%), and the proportion who decreased (28%), and who increased (30%) their physical activity level after being diagnosed with a chronic disease. Although approximately 58% of the women changed their level of physical activity after diagnosis, the pattern of change was not different compared with any other two pairs of surveys. This means that between every pair of subsequent surveys the proportions of women who increased their physical activity level, women who decreased their physical activity level and women who remained at the same level were similar before, during and after the time of diagnosis. This suggested that the diagnosis of a chronic disease did not affect physical activity level. These findings were confirmed by the results from the statistical modelling.

We found that approximately 50% of the women in our study sample were not meeting the recommended levels of physical activity in the years before being diagnosed with a chronic disease. Despite the important role of physical activity in the management of chronic diseases, most of the women who did not meet the physical activity guidelines before diagnosis did not increase their physical activity after diagnosis. This is an important finding for healthcare providers and policy makers, as it illustrates a need for tailored interventions to enhance physical activity in newly diagnosed patients.

 

 

fig1Figure 1. Changes in physical activity level after being diagnosed with a chronic disease.

 

Acknowledgements

The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health, based at the University of Newcastle and the University of Queensland. We are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data.

 

Financial disclosure

The Australian Longitudinal Study on Women’s Health is supported by the Australian Government Department of Health and GP was supported by a program grant (Brown 569940) and a Centre of Research Excellence grant (Dobson 1000986) from the (Australian) National Health and Medical Research Council. None of the other authors have financial disclosures.

 

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