Physical activity and functional performance in Iranian 75-year-olds : a cross-sectional population study compared with a Swedish study

摘要

Background: Population ageing is highly complex and varies with the context. Forinstance, people’s health can be influenced by behavioral and cultural factors andeconomic resources. Cross-national comparisons are helpful when exploring thesefactors.Aims: To provide a Persian version of the Falls Efficacy Scale, Swedish version(FES(S)) and explore its validity and reliability in an Iranian population.To investigate whether Iranian 75-year-olds differ from their Swedish peers withrespect to physical activity level, physical performance and certain health-relatedfactors.To explore if walking for at least 30 min a day is related to health, fitness, physiologicalcapacity and functional performance in older Iranians.To establish whether health-related behavior (HRB) and independence (I) intermediatethe link between the socioeconomic status (SES) and the health status (HS) of olderadults in Iran.Material and methods: A representative sample of 637 Swedish 75-year olds, fromthe longitudinal Gerontological and Geriatric Population Studies in Gothenburg, and anIranian sample of 851 75-year-olds, living in Tehran, were included. Physical activitylevel, health-related factors, and the results of functional tests including walking speed,muscle strength and balance function were evaluated. SPSS and Mplus 5 softwareswere used for data analysis.Results: The Persian FES (S) was shown to be a culturally relevant, valid, and reliabletool for measuring fall-related self-perceived confidence in Iranian older adults. Iranian75-year-olds had a lower physical activity level, a worse physical function apart from abetter grip strength, a worse physical health status but smoked less than their Swedishcounterparts. There were no differences between the two cohorts regarding vertigo orfalls. The extent of gender differences was about the same in most aspects and to thedisadvantage of women. Iranian old people who walked at least 30 minutesdaily/almost daily were better in most health-related outcomes, ADL and functionalperformance than people who walked less. A structural equation model showed thatolder people with a high SES had a higher level of physical activity and were moreindependent in ADL than others. SES was a positive predictor of HS, not directly butthrough the intermediation of HRB and I.Conclusions: The Persian version of FES(S) was shown to be a valid and reliable tool.75-year-old Iranians were less physically active than their Swedish peers and theirfunctional performance, apart from grip strength, was worse, while similar genderdifferences were found, mainly to the advantage of men. Iranians who took a dailywalk of at least 30 min a day showed better results in most health-related outcomes,ADL and functional performance than persons who walked less. As physical activity isa strong determinant of functional performance and health, activities like taking a dailywalk of at least 30 minutes should be promoted. Gender-specific discrepancies foundin relation to physical activity and performance call for longitudinal studies to clarifythe causes.