NEW ORLEANS — Counseling about the health benefits of exercise is reaching fewer than one in three women over age 50, a national survey has shown.
Studies have shown that exercise can reduce a woman's risk of hip fracture, depression, arthritis pain, diabetes, and coronary artery disease, and that it can improve longevity and cognitive function. Yet a survey of 6,385 women over age 50 showed that only 31% of those aged 50–64 years had been counseled by their physicians to begin or continue any type of physical activity, reported Mara A. Schonberg, M.D.
The older the woman—regardless of functional status or comorbid illness—the less likely she was to have received exercise counseling. Only 29% of those aged 65–74 years received exercise counseling from their physicians, and only 22% of those aged 75–84 years and 14% of those aged 85 and older got such advice, Dr. Schonberg reported at the annual meeting of the Society of General Internal Medicine.
Dr. Schonberg and colleagues at Beth Israel Deaconess Medical Center in Boston used data from the National Center for Health Statistics' 2000 National Health Interview Survey to identify women aged 50 or older who had seen a health care provider during the previous year.
The investigators compared clinician counseling about exercise across the four age categories noted above, using multivariable logistic regression to adjust for demographic factors, body mass index, physical activity, smoking status, having a usual source of care, and number of doctor visits within the previous year. They used additional models to assess the influence of illness burden and functional status on exercise counseling habits.
The initial, unadjusted model showed that for women aged 75–84 years and those aged 85 and older, the odds ratios for receiving exercise counseling were 0.8 and 0.6, respectively, compared with younger women. When the illness burden was taken into account, the odds ratios dropped to 0.7 and 0.5 for women aged 75–84 years and those aged 85 and older, respectively.
One “surprise” finding was that “the differences in exercise counseling across the age groups were more pronounced for women with less comorbidity than those with greater comorbidity,” Dr. Schonberg said. For example, the odds ratio for exercise counseling was 0.4 for women aged 85 or older with fewer than two comorbidities, compared with women aged 50–64 years with the same comorbidity, while it was 0.7 for women older than 85 with two or more comorbidities. This trend was consistent across all age groups.
These findings suggest that age is a conceptual barrier to clinicians discussing exercise with patients, despite awareness of the benefits of physical activity. “The greatest disparity is among older women with less illness burden,” said Dr. Schonberg, noting that efforts should be made to increase provider exercise counseling for such patients.