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Physical activity as a mediator of the impact of chronic conditions on quality of life in older adults

Richard Sawatzky1*, Teresa Liu-Ambrose2, William C Miller34 and Carlo A Marra56

Author Affiliations

1 Nursing Department, Trinity Western University, 7600 Langley, British Columbia, V2Y 1Y1, Canada

2 Department of Physical Therapy, University of British Columbia, T325 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada

3 Department of Occupational Science and Occupational Therapy, University of British Columbia, T325 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada

4 GF Strong Rehabilitation Research Laboratory, University of British Columbia, T325 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada

5 Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada

6 Centre for Health Evaluation and Outcomes Sciences, Providence Health Care, St Paul's Hospital, 620B 1081 Burrard Street, Vancouver, B.C., V6Z 1Y6, Canada

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Health and Quality of Life Outcomes 2007, 5:68  doi:10.1186/1477-7525-5-68

Published: 19 December 2007



Chronic conditions could negatively affect the quality of life of older adults. This may be partially due to a relative lack of physical activity. We examined whether physical activity mediates the relationship between different chronic conditions and several health outcomes that are important to the quality of life of older adults.


The data were taken from the Canadian Community Health Survey (cycle 1.1), a cross-section survey completed in 2001. Only respondents who were 65 years or older were included in our study (N = 22,432). The Health Utilities Index Mark 3 (HUI3) was used to measure overall quality of life, and to measure selected health outcomes (dexterity, mobility, pain, cognition, and emotional wellbeing) that are considered to be of importance to the quality of life of older adults. Leisure-time physical activity was assessed by determining weekly energy expenditure (Kcal per week) based on the metabolic equivalents of self-reported leisure activities. Linear and logistic regression models were used to determine the mediating effect of leisure-time physical activity while controlling for demographic variables (age and sex), substance use (tobacco use and alcohol consumption), and obesity.


Having a chronic condition was associated with a relative decrease in health utility scores and a relative increase in mobility limitations, dexterity problems, pain, emotional problems (i.e., decreased happiness), and cognitive limitations. These negative consequences could be partially attributed to a relative lack of physical activity in older adults with a chronic condition (14% mediation for the HUI3 score). The corresponding degree of mediation was 18% for mobility limitations, 5% for pain, and 13% for emotional wellbeing (statistically significant mediation was not observed for the other health attributes). These values varied with respect to the different chronic conditions examined in our study.


Older adults with chronic conditions are less likely to engage in leisure-time physical activities of at least 1,000 Kcal per week, and this association partially accounts for some negative consequences of chronic conditions, including mobility limitations, pain, and emotional problems. These findings provide support for health promotion programs that facilitate or encourage increased leisure-time physical activity in older people with chronic conditions.