GENDER DIFFERENCES IN BODY COMPOSITION, PHYSICAL ACTIVITY LEVEL, PHYSICAL FITNESS, AND BONE MINERAL DENSITY AMONG ELDERLY INDIVIDUALS LIVING ALONE COMPARED TO THOSE LIVING WITH THEIR SPOUSES

Background and Objective

This study aimed to examine the differences in body composition, physical activity level, physical fitness, and bone mineral density (BMD) among elderly individuals who lived alone and those who lived with their spouses.

Material and Methods

A total of 136 elderly individuals, older than 65 years (63 males and 73 females) were surveyed according to whether they lived alone or with their spouses, age, and sex. BMI and percentage body fat were also measured, as well as 7 days of physical activities of daily life by accelerometer. The physical fitness test consisted of 6 minutes walking for cardiorespiratory fitness and grip strength and leg strength for muscular strength. BMD and T-score were measured by sonography at the calcaneus. Independent t-test was used to examine the group difference according to the living status with spouse by gender.

Results

First, in body composition, elderly females who lived alone showed higher percentage body fat compared with elderly females who lived with their spouses (p=0.010). Second, regarding total physical activity, elderly males and females who lived alone showed significantly lower calorie consumption during daily physical activity compared with elderly males and females who lived with their spouses (p<0.05). Particularly, el-derly males and females who lived alone showed significantly lower high intensity (p=0.045) and moderate intensity (p=0.015) physical activity time, respectively. Third, regarding fitness, elderly males and females who lived alone showed significantly lower upper and lower limb strength compared with elderly males and females who lived with their spouse (p<0.05), but there was no difference in cardiovascular endurance (p>0.05). Fourth, regarding BMD, only elderly males who lived alone showed significantly lower BMD and T-score (p<0.05). There was no significant difference in BMD and T-score among elderly females who lived alone and those who lived with their spouses (p>0.05).

Conclusion

Elderly individuals who lived alone showed lower physical activity levels, strength, and BMD level as well as higher percentage body fat. An exercise and physical activity program for elderly individual who live alone should be developed to improve percent body fat, strength and BMD.

1. Ministry of Health, Welfare and Family Affairs. 2014 National Elderly Survey. Seoul: Author; 2015.

2. Ng TP, Jin A, Feng L, et al. Mortality of older persons living alone: Singapore longitudinal ageing studies. BMC Geriatr 2015;15:126.

3. Statistics Korea. 2017 Statistics for Elderly (in Korean). Statistics Korea. 2017. http://kostat.go.kr/portal/korea/kor_nw/2/6/1/index.board?bmode=read&aSeq=363362.

4. Tani Y, Kondo N, Takagi D, et al. Combined effects of eating alone and living alone on unhealthy dietary behaviors, obesity and underweight in older Japanese adults: Results of the JAGES. Appetite 2015;95:1–8.

5. Park S, Smith J, Dunkle RE, Ingersoll-Dayton B, An-tonucci TC. Health and social-physical environment profiles among older adults living alone: associations with depressive symptoms. J Gerontol B Psychol Sci Soc Sci 2017;Jun 20. [Epub ahead of print]

6. Mouodi S, Bijani A, Hosseini SR, Hajian-Tilaki K. Gender differences in the health status of elderly living alone compared to those who are not alone: Evidence of the AHAP study, North of Iran. Caspian J Intern Med 2016;7:126–32.

7. Cederbom S, Rydwik E, Soderlund A, et al. A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study. Clin Interv Ag-ing 2014;9:1383–97.

8. Tabue Teguo M, Simo-Tabue N, Stoykova R, et al. Feelings of loneliness and living alone as predictors of mortality in the elderly: The PAQUID Study. Psychosom Med 2016;78:904–9.

9. Jefferis BJ, Sartini C, Ash S, et al. Trajectories of ob-jectively measured physical activity in free-living older men. Med Sci Sports Exerc 2015;47:343–9.

10. Schmitz KH, Courneya KS, Matthews C, et al. Ameri-can College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010;42:1409–26.

11. Sun F, Norman IJ, While AE. Physical activity in older people: a systematic review. BMC Public Health 2013;13:449.

12. Shin SH, Sok SR. A comparison of the factors influencing life satisfaction between Korean older people living with family and living alone. Int Nurs Rev 2012;59:252–8.

13. Brooks D, Solway S, Gibbons WJ. ATS statement on six-minute walk test. Am J Respir Crit Care Med 2003;167:1287.

14. Redfors P, Isaksen D, Lappas G, et al. Living alone predicts mortality in patients with ischemic stroke be-fore 70 years of age: a long-term prospective follow-up study. BMC Neurol 2016;16:80.

15. Kharicha K, Iliffe S, Harari D, et al. Health risk appraisal in older people 1: are older people living alone an “at-risk” group? Br J Gen Pract 2007;57:271–6.

16. Fukuda Y, Ishikawa M, Yokoyama T, et al. Physical and social determinants of dietary variety among older adults living alone in Japan. Geriatr Gerontol Int 2017;Feb 22. [Epub ahead of print]

17. Conklin AI, Forouhi NG, Surtees P, et al. Social re-lationships and healthful dietary behaviour: evidence from over-50s in the EPIC cohort, UK. Soc Sci Med 2014;100:167–75.

18. Fulkerson JA, Larson N, Horning M, Neumark-Sztainer 

D. A review of associations between family or shared meal frequency and dietary and weight status outcomes across the lifespan. J Nutr Educ Behav 2014;46:2–19.

19. Escobar-Viera CG, Jones PD, Schumacher JR, Hall AG. Association between living alone and physical inactivity among people with and without disability, Florida Behavioral Risk Factor Surveillance System, 2009. Prev Chronic Dis 2014;11:E173.

20. Kim KI. Frailty: a core geriatric concept. J Korean Geriatr Soc 2010;14:1–7.

21. Chahal J, Lee R, Luo J. Loading dose of physical ac-tivity is related to muscle strength and bone density in middle-aged women. Bone 2014;67:41–5.

22. Marques EA, Mota J, Machado L, et al. Multicompo-nent training program with weight-bearing exercises elicits favorable bone density, muscle strength, and balance adaptations in older women. Calcif Tissue Int 2011;88:117–29.

23. Faulkner JA, Larkin LM, Claflin DR, Brooks SV. Age-related changes in the structure and function of skeletal muscles. Clin Exp Pharmacol Physiol 2007;34:1091–6.