Aging Clinical and Experimental Research

, Volume 18, Issue 1, pp 40–49 | Cite as

Physical and psychological functioning of daily living in relation to physical activity. A longitudinal study among former elite male athletes and controls

  • Heli Bäckmand
  • Jaakko Kaprio
  • Urho M. Kujala
  • Seppo SarnaEmail author
  • Mikael Fogelholm
Original Article


Background and aims: Physical exercise plays an important role in the prevention and reduction of disabilities in elderly people. The aim of this study was to determine the role of physical activity in the physical and psychological functioning of daily living in a cohort of former elite male athletes representing different sports, and controls of middle and old age. Methods: Subjects were 664 former elite male athletes (mean age 64.4 years) and 500 controls (62.0 years) in middle and old age. Subjects were mailed “Physical activity and health survey” questionnaires in 1985 and 1995. The primary outcomes — the physical and psychological functioning of daily living — were assessed in 1995 using items from the Mini-Finland Health Survey. Logistic regression was used for longitudinal as well as cross-sectional analyses to estimate odds ratios (OR) for poor physical and psychological functioning of daily living in relation to recreational physical activity adjusted for age, sport group, life-style, BMI, mood, chronic diseases, personality characteristics, life-events and socio-economic status. Results: In the longitudinal analysis, low levels of physical activity (lowest MET quintile vs highest quintile) in 1985 (OR 4.91, 95% confidence interval (CI) 2.02–11.9), older age (≥70 yrs vs under 60 yrs OR 9.93, 95% CI 4.90–20.2), depression (OR 2.03, 95% CI 1.01–4.09) and anxiety in 1995 (OR 2.67, 95% CI 1.34–5.32) increased the risk of poor physical functioning of daily living in 1995, whereas an increase in a physical activity between 1985–1995 (OR 0.89, 95% CI 0.83–0.95) protected against poor physical functioning of daily living. A history of participating in specific types of sports, especially among certain power sports (weight-lifting and track & field throwers) (OR 0.19, 95% CI 0.06–0.60) and team sports (OR 0.34, 95% CI 0.15–0.81) did reveal a significant protective effect against poor psychological functioning of daily living in the longitudinal analysis. Conclusions: This study suggests that an increase in physical exercise supports physical daily functionality. A specific history of sports participation promotes psychological well-being at an older age.


Cohort study functioning of daily living older athletes physical activity 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lollar DJ, Crews JE. Redefining the role of public health in disability. Annu Rev Public Health 2003; 24: 195–208.PubMedCrossRefGoogle Scholar
  2. 2.
    Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower extremity function in persons over the age of 70 years as predictor of subsequent disability. N Engl J Med 1995; 332: 556–61.PubMedCrossRefGoogle Scholar
  3. 3.
    Simonsick EM, Lafferty ME, Phillips CL, et al. Risk due to inactivity in physically capable older adults. Am J Public Health 1993; 83: 1443–50.PubMedCrossRefGoogle Scholar
  4. 4.
    Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994; 49: M85–94.PubMedCrossRefGoogle Scholar
  5. 5.
    Guralnik JM, Seeman TE, Tinetti ME, Nevitt MC, Berkman LF. Validation and use of performance measures of functioning in a nondisabled older population: MacArthur studies of successful aging. Aging Clin Exp Res 1994; 6: 410–9.CrossRefGoogle Scholar
  6. 6.
    Hirvensalo M, Rantanen T, Heikkinen E. Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population. J Am Geriatr Soc 2000; 48: 493–8.PubMedGoogle Scholar
  7. 7.
    Manton KG. A longitudinal study of functional change and mortality in the United States. J Gerontol 1988; 43: S153–61.PubMedCrossRefGoogle Scholar
  8. 8.
    Beckett LA, Brock DB, Lemke JH, et al. Analysis of change in self-reported physical function among older persons in four population studies. Am J Epidemiol 1996; 143: 766–78.PubMedCrossRefGoogle Scholar
  9. 9.
    Ferrucci L, Guralnik JM, Simonsick EM, Salive ME, Corti C, Langlois J. Progressive versus catastrophic disability: a longitudinal view of the disablement process. J Gerontol 1996; 51A: M123–30.CrossRefGoogle Scholar
  10. 10.
    Kaplan GA, Strawbridge WJ, Camacho T, Cohen RD. Factors associated with change in physical functioning in the elderly: a six-year prospective study. J Aging Health 1993; 5: 140–53.CrossRefGoogle Scholar
  11. 11.
    Mor V, Murphy J, Masterson-Allen S, et al. Risk of functional decline among well elders. J Clin Epidemiol 1989; 42: 895–904.PubMedCrossRefGoogle Scholar
  12. 12.
    LaCroix AZ, Guralnik JM, Berkman LF, Wallace RB, Satterfield S. Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity and body mass index. Am J Epidemiol 1993; 137: 858–69.PubMedGoogle Scholar
  13. 13.
    Strawbridge WJ, Cohen RD, Shema SJ, Kaplan GA. Successful aging: predictors and associated activities. Am J Epidemiol 1996; 144: 135–41.PubMedCrossRefGoogle Scholar
  14. 14.
    Wallace RB, Colsher PL. Conceptual problems in identifying risk factors for functional decline in the elderly: a commentary. Ann Epidemiol 1992; 2: 825–34.Google Scholar
  15. 15.
    Pinsky JL, Jette AM, Branch LG, Kannel WB, Feinleib M. The Framingham disability study: relationship of various coronary heart disease manifestations to disability in older persons living in the community. Am J Public Health 1990; 80: 1363–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Kivelä S-L, Pahkala K, Laippala P. Prevalence of depression in an elderly population in Finland. Acta Psychiatr Scand 1988; 78: 401–13.PubMedCrossRefGoogle Scholar
  17. 17.
    Verbrugge LM, Lepkowski JM, Konkol LL. Levels of disability among U.S. adults with arthritis. J Gerontol 1991; 46: S71–83.PubMedCrossRefGoogle Scholar
  18. 18.
    Penninx B, Guarlnik MD, Bandeen-Roche K, et al. The protective effect of emotional vitality on adverse health outcomes in disabled older women. J Am Geriatr Soc 2000; 48: 1359–66.PubMedGoogle Scholar
  19. 19.
    Penninx B, Guarlnik MD, Simonsick EM, Kasper J, Ferrucci L, Fried L. Emotional vitality among disabled older women: the Women’s Health and Aging Study. J Am Geriatr Soc 1998; 46: 807–15.PubMedGoogle Scholar
  20. 20.
    Strawbridge WJ, Camacho T, Cohen RD, Kaplan GA. Gender differences in factors associated with change in physical functioning in old age: a 6-year longitudinal study. Gerontologist 1993; 33: 603–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Seeman TE, Charpentier PA, Berkman LF, et al. Predicting changes in physical performance in a high functioning elderly cohort: MacArthur studies of successful aging. J Gerontol 1994; 49: 97–108.CrossRefGoogle Scholar
  22. 22.
    Lampinen P, Hirvensalo M. Physical exercise in 1988 and 1996 among 65–69-year-old people in Jyväskylä. In Heikkinen E, Lampinen P, Suutama T, eds. Cohort differences in the functional capacity, health and leisure activities of 65–69 year-old persons. Observations from the cohort comparisons of the Evergreen project in 1988 and 1996. Helsinki: Publications of the Social Insurance Institution. Finland. Studies in Social Security and Health 47, 1999: 97–113.Google Scholar
  23. 23.
    Kujala U, Sarna S, Kaprio J, Koskenvuo M. Hospital care later life among former elite world-class Finnish athletes. JAMA 1996; 276: 216–20.PubMedCrossRefGoogle Scholar
  24. 24.
    Lawrence RH, Jette AM. Disentangling the disablement process. J Gerontol 1996; 51B: S173–82.CrossRefGoogle Scholar
  25. 25.
    Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc 1993; 25: 237–44.PubMedGoogle Scholar
  26. 26.
    Bäckmand H, Kaprio J, Kujala U, Sarna S. Personality and mood of former elite male athletes — a descriptive study. Int J Sports Med 2001; 22: 215–21.PubMedCrossRefGoogle Scholar
  27. 27.
    Aromaa A, Heliövaara M, Impivaara O, et al. Health, functional limitations and need for care in Finland. Basic results from the Mini-Finland Health Survey. Helsinki and Turku: Publications of the Social Insurance Institution, Finland, AL: 32, 1989.Google Scholar
  28. 28.
    Katz S, Ford AB, Moskowitz RW, Jakson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function JAMA 1963; 185: 914–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.PubMedCrossRefGoogle Scholar
  30. 30.
    McWhinnie JR. Disability assessment in population surveys: results of the O.E.C.D Common Development Effort. Rev Epidemiol Santé Publique 1981; 29: 413–9.PubMedGoogle Scholar
  31. 31.
    Kattainen A, Koskinen S, Reunanen A, Martelin T, Knekt P, Aromaa A. Impact of cardiovascular diseases on activity limitations and need for help among older persons. J Clin Epidemiol 2004; 57: 82–8.PubMedCrossRefGoogle Scholar
  32. 32.
    Kattainen A, Reunanen A, Koskinen S, et al. Secular changes in disability among middle-aged and elderly Finns with and without coronary heart disease from 1978–1980 to 2000–2001. Ann Epidemiol 2004; 14: 479–85.PubMedCrossRefGoogle Scholar
  33. 33.
    Kattainen A, Reunanen A, Koskinen S, Martelin T, Knekt P, Aromaa A. Disability predicted mortality in men but not women with coronary heart disease. J Clin Epidemiol 2004; 57: 513–21.PubMedCrossRefGoogle Scholar
  34. 34.
    Palmore EB, Nowlin JB, Wang HS. Predictors of function among the old-old: a 10-year follow-up. J Gerontol 1985; 40: 244–50.PubMedCrossRefGoogle Scholar
  35. 35.
    Niinistö L. The elderly at home and in permanent institutional care. Helsinki: Health Services Research by the National Board of Health in Finland, 46, 1987.Google Scholar
  36. 36.
    Bäckmand H, Kaprio J, Kujala U, Sarna S. Influence of physical activity on depression and anxiety of former elite athletes. Int J Sports Med 2003; 24: 609–19.PubMedCrossRefGoogle Scholar
  37. 37.
    Romanov K, Rose RJ, Kaprio J, Koskenvuo M, Langinvainio H, Sarna S. Self-reported alcohol use: a longitudinal study of 12,954 adults. In Lindros KO, Ylikarhi R, Kiianmaa K, eds. Advances in Biomedical Alcohol Res. Alcohol and Alcoholism 1987; Suppl 1: 619–23.Google Scholar
  38. 38.
    Kaprio J, Koskenvuo M. A prospective study of psychological and socio-economic characteristics, health behaviour and morbidity in cigarette smokers prior to quitting compared to persistent smokers and non-smokers. J Clin Epidemiol 1988; 41: 139–50.PubMedCrossRefGoogle Scholar
  39. 39.
    Derogatis LR, Melisaratos N. The Brief Symptom Inventory: an introductory report. Psychol Med 1983; 13: 595–605.PubMedCrossRefGoogle Scholar
  40. 40.
    Fogelholm M, Kujala U, Kaprio J, Sarna S. Predictors of weight change in middle-aged and old men. Obes Res 2000; 8: 367–73.PubMedCrossRefGoogle Scholar
  41. 41.
    Floderus B. Psychosocial factors in relation to coronary heart disease and associated risk factors. Nord Hyg Tidskr 6 (Suppl): 1974.Google Scholar
  42. 42.
    Korkeila M, Kaprio J, Rissanen A, Koskenvuo M, Sörensen TIA. Predictors of major weight gain in adult Finns: stress, life satisfaction and personality traits. Int J Obes 1998; 22: 949–57.CrossRefGoogle Scholar
  43. 43.
    Viken RJ, Rose RJ, Kaprio J, Koskenvuo M. A developmental generic analysis of adult personality: extroversion and neuroticism from 18 to 59 years of age. Person Soc Psychol 1994; 66: 722–30.CrossRefGoogle Scholar
  44. 44.
    Koivumaa-Honkanen H, Honkanen R, Viinamäki H, Heikkilä K, Kaprio J. Koskenvuo M. Life satisfaction and suicide: a 20-year follow-up study. Am J Psychiatry 2001; 158: 433–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Koskenvuo M, Kaprio J, Rose R, et al. Hostility as a risk factor for mortality and ischemic heart disease in men. Psychosom Med 1988; 50: 330–40.PubMedGoogle Scholar
  46. 46.
    Holmes TH, Rahe HR. The social readjustment rating scale. J Psychosom Res 1967; 11: 213–8.PubMedCrossRefGoogle Scholar
  47. 47.
    Central Statistical Office: Alphabetical list of occupations and classification of social class (in Finnish). Helsinki, Finland: Central Statistical Office, 1972.Google Scholar
  48. 48.
    Simonsick EM, Kasper J, Guralnik MD, et al. Severity of upper and lower extremity functional limitation: scale development and validation with self-report and performance-based measures of physical function. J Gerontol 2001; 56: 10–9.CrossRefGoogle Scholar
  49. 49.
    Kujala U, Kaprio J, Sarna S. Osteoarthritis of weight-bearing joints of lower limbs in former elite male athletes. BMJ 1994; 308: 231–4.PubMedCrossRefGoogle Scholar
  50. 50.
    Mäkelä M, Heliövaara M, Sievers K, Knekt P, Maatela J, Aromaa A. Musculoskeletal disorders as determinants of disability in Finns aged 30 years or more. J Clin Epidemiol 1993; 46: 549–59.PubMedCrossRefGoogle Scholar
  51. 51.
    Katz S, Branch LG, Branson MH, Papsidero JA, Beck JC, Creer DS, Active life expectancy. N Engl J Med 1983; 17: 1218–24.CrossRefGoogle Scholar
  52. 52.
    Heikkinen E, Era P, Jokela J, Jylhä M, Lyyra AL, Pohjolainen P. Socio-economic and life-style factors as modulators of health and functional capacity with age. In Schroots JJF, ed. Aging, Health and Competence. Amsterdam: Elsevier, 1993: 65–86.Google Scholar
  53. 53.
    Guralnik JM, LaCroix AZ, Abbot RD, et al. Maintaining mobility in later life. I. Demographic characteristics and chronic conditions. Am J Epidemiol 1993; 137: 845–57.PubMedGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2006

Authors and Affiliations

  • Heli Bäckmand
    • 1
  • Jaakko Kaprio
    • 1
    • 2
  • Urho M. Kujala
    • 3
  • Seppo Sarna
    • 1
    Email author
  • Mikael Fogelholm
    • 4
  1. 1.Department of Public HealthUniversity of HelsinkiHelsinkiFinland
  2. 2.Department of Mental HealthNational Public Health InstituteHelsinkiFinland
  3. 3.Department of Health SciencesUniversity of JyväskyläJyväskyläFinland
  4. 4.UKK Institute for Health Promotion and ResearchTampereFinland

Personalised recommendations