Active Ageing a Path towards Ageing Well. Physical Functioning, Physical Activity, Falls Self-Efficacy and Social Participation in Community-Dwelling Elderly

Abstract: The overall aim of this thesis was to study factors of importance for active ageing with a focus on physical functioning, physical activity, falls self-efficacy, health-related quality of life and social participation in community-dwelling elderly above 60 years old. Methods: Study I (n=108) evaluated the psychometric properties of the Falls Efficacy Scale-International (Arabic version) (FES-I (Ar)) using validity and reliability testing. Study II (n=176) addressed the association between physical functioning and falls self-efficacy. Data were collected using five different tests of physical functioning and the FES-I (Ar). Study III (n=176) assessed the association between physical activity and health-related quality of life (HRQoL) using the Physical activity socio-cultural adapted questionnaire (PA-SCAQ) and the EuroQol-5Dimensions-5Levels (EQ-5D-5L) questionnaire. Between group comparisons were based on the PA-SCAQ by dividing the participants into three Physical activity (PA) groups: low (n=74), moderate (n=85), and high (n=17). In study IV (n=17), a narrative approach was applied as a qualitative research design to explore the participants’ experiences with social roles and role reversals. Data were collected by in-depth interviews and participant observation, and analyzed using a narrative interpretative method. Results: FES-I (Ar) was found to be a comprehensible, valid, and reliable measure of the concern about falling among community-dwelling elderly. Study II showed that values of physical functioning were significantly higher in non-fallers (p <0.05). Higher physical functioning values were associated with lower incidence of falling and lower level of fear of falling. Study III revealed strong associations between higher levels of physical activity and all dimensions of health-related quality of life. Findings from study IV yielded into three central themes: health and social roles, social connectedness, and adapting to the role reversals. Conclusions and Impact: Physical functioning, physical activity, falls self-efficacy and social participation contribute to active ageing and subsequently to the process of ageing well among community-dwelling elderly. In clinical practice and in future research, the FES-I (Ar) could be used to effectively assess concern about falling in Arabic-speaking elderly persons. Maintaining and improving physical functioning influences falls self-efficacy and risk of falling. Adopting a physically active lifestyle may result in a better HRQoL in elderly persons. In this thesis, understanding the mechanism of social roles gave a better insight about the impact of social participation on the state of well-being in elderly persons. This knowledge can be used to develop health interventions that may contribute to facilitate the process of ageing well.

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