Is diabetes associated with poorer self-efficacy and motivation for physical activity in older adults with arthritis?

Abstract

Objectives: The primary aim was to explore whether arthritis is associated with poorer self-efficacy and motivation for, and participation in, two specific types of physical activity (PA): endurance training (ET) and strength training (ST). A further objective was to determine whether the added burden of diabetes contributes to a further reduction in these PA determinants and types.

Methods: Self-efficacy and motivation for exercise and minutes per week of ET and ST were measured in 347 older veterans enrolled in a home-based PA counselling intervention. Regression analyses were used to compare high versus low self-efficacy and motivation and PA minutes in persons without arthritis, with arthritis alone, and with arthritis plus diabetes.

Results: Persons with arthritis alone reported lower self-efficacy for ET and ST than those without arthritis [odds ratio (OR)ET 0.71, 95% confidence interval (CI) 0.39–1.20; ORST 0.69, 95% CI 0.39–1.20]. A further reduction in self-efficacy for these two types of PA was observed for those with both arthritis and diabetes (ORET 0.65, 95% CI 0.44–0.92; ORST 0.64, 95% CI 0.44–0.93; trend p < 0.001). There was no trend towards a reduction in motivation for PA in those with arthritis alone or with arthritis and diabetes. Persons with arthritis exhibited higher motivation for ET than those without arthritis (ORET 1.85, 95% CI 1.12–3.33). There were no significant differences between the three groups in minutes of ET (p = 0.93), but persons with arthritis plus diabetes reported significantly less ST compared to individuals with arthritis only (p = 0.03).

Conclusions: Despite reduced self-efficacy for ET and ST and less ST in older persons with arthritis, motivation for both PA types remains high, even in the presence of diabetes.

Figure 1. Impact of Arthritis and Diabetes on Self-Efficacy and Motivation for Physical Activity

Persons with no arthritis (n=85), arthritis only (n=178), and arthritis plus diabetes (n=84) indicated self-efficacy and motivation for moderate intensity endurance and strength training using a 5-point scale with higher scores reflecting greater efficacy and greater motivation . Responses were dichotomized into high and low self-efficacy as described in Methods. Group differences were compared with logistic regression. Asterisks indicate P<0.05 for the post-hoc pair-wise comparisons.