Older Adults Physical Activity Summit I am pleased to be here today and to present to you the outcomes of the Ministerial Summit on Physical Activity and Older Adults. As previously explained by Maureen, the Summit was held in November 2010 and a series of recommendations were proposed. Before I get into the detail of the recommendations, I though that it would be useful to give a bit of background to Physical Activity and Older Adults, and put this into a Scottish Context. Sharon Allison Physical Activity and Health Alliance Coordinator

Active for Later Life Framework A framework for practice Summary of evidence, benefits Guidance on policy, programming fit Working papers The needs of different older population cohorts The ‘Active for Later Life Framework’ is a useful resource for those developing physical activity programmes for older people of all ages and abilities. It includes summaries of evidence and recommendations, guidance on policy as well as a series of working papers. The resource is no a new one, it was published in the Scottish context in 2007, but still holds it’s relevance. Within this framework, it recognizes that chronological age is neither a reliable or desirable means of deciding when a person becomes ‘old’. Many people aged 50+ have inactivity related diseases and conditions, whereas many others participate in high levels of physical activity well into later life and beyond the age of 80. http://www.paha.org.uk/Resource/active-for-later-life-scotland

Active for Later Life Framework Making Activity Choices Increasing the Circle of Life Moving in the Later Years The framework therefore refers to life stage, health status and functional capacity and has identified three categories: Making activity choices Increasing the circle of life Moving in the later years This category includes people who enjoy independent living but may also be experiencing some functional decline. The focus here would be on encouraging and sustaining ‘activity choices’ that will meet social, physical and psychological needs and also a focus on disease prevention. This category includes those who are still living independently but who are experiencing significant functional decline and are losing independence and mobility. The focus here would be to reduce disability and maintain mobility, independence and daily living. This category includes people who are dependant with very limited function. The main focus here is not to push engagement in recreation/leisure/play, but to encourage physical activity as incorporation to a range of activities that are relevant to the individual’s daily living and that will have purpose and meaning. So you can see that there are a range of ‘older adults’ that we are trying to target to increase activity levels, and programmes need to be structured according to their target category.

What are the current activity levels of older adults in Scotland? Scottish Health Survey 2008 To put older adults physical activity into perspective in Scotland, I thought that it would be useful to go over the current trends for physical activity as identified from the 2008 Scottish Health Survey. I have opted not to use the results from the 2009 survey as this is the first year of the annual analysis so the results may not be comparable with those from 3 years ago.

2008 Activity Rates and Target: All Ages This slide shows the physical activity levels of males and females from 2 years to 75+. It also shows the physical activity targets that we are striving to reach by 2022 for children and adults. It can be seen that young boys are close to meeting the recommendations and that from age 11/12 there is a substantial drop off in girls as was highlighted in Niamh’s presentation. In the adults category, it can be seen that males from 16-35 are meeting and in some cases exceeding the targets however after this age there are again substantial drop offs into later life for males and more-so for females.

If we focus in on men’s activity patterns over the ten year period from 1998-2008 it can be seen that physical activity levels are increasing and the same patterns can be seen for women of this age. So the story is not necessarily all doom and gloom, we are making some progress to increase physical activity levels, it seems however that we need to do more of what we’ve been doing and we need to do it at a quicker rate.

In contrast, were increases amongst all age groups for women over the 10 year period (1998-08) with the largest increases in the oldest groups: +9% percentage points (from 20% to 29%) in women aged 55-64 +12% percentage points (8% to 20%) among those aged 65-74

Percentage Points to Target If we take a closer look at the percentage points from the SHS data, an look specifically at older adults, it would appear that with men we are very close to achieving the recommendations and with women there is a bit more work to be done. Adult’s target Children’s target

Percentage Points to Target Men 45 plus However when we break this down into age groups, it becomes apparent that the younger more active males push up the percentage for men, but as we come into 55+ PA levels drop quite significantly. The same pattern can be seen in women, with an even more dramatic effect.

Percentage Points to Target Women 45 plus It can therefore be seen that older adults physical activity levels are a particular concern as identified in the five year review of LMSMA and hopefully this gives a better understanding of why the older adults was selected as a topic for the Ministerial Summits.

Update from the Older Adults Summit As Maureen said earlier today, the outcomes of the Older Adults Summit has not gone to Scottish Government as recommendations as of yet. With that in mind, there is no supporting paper like teenage girls have, but I can share with you today an update on the discussions that took place and areas of focus moving into the future. There was a general feeling from the day that if physical activity levels in older adults are to be addressed focus needs to be on: Involving older people in the development of programmes Providing high quality and accessible programmes with local partners Promoting positive images of older people Building the skills of the workforce through education and training

Categories of key issues raised POLICY PRACTICE The key issues raised on the day, that delegates felt if were addresses, would offer the most promise to reducing barriers to an active lifestyle that are specific to older adults in Scotland can be categorized into three areas: Policy Practice Research Immediate development of a national communications and social marketing strategy, as recommended in the 5 year review of the national physical activity strategy Direct engagement with and support for older adults to be involved in policy development and act as advocates Ensure older adult’s right to a sustained participation in an active life is a high priority status in national and local policy Develop a cross-departmental approach (at national and local government levels) that aims to normalise and facilitate active living in older adults, e.g. consideration in environment, transport decisions etc Create an economic argument, evidencing how sustained active living in this target group improves health and decreases healthcare costs Practice: Service providers will provide workforce development opportunities to staff, in terms of addressing; (i) their own personal development and, (ii) in relation to their professional roles in educating the public Improve collaborative links with research facilities in order to maximise the potential of applying evidence base in a practical and meaningful way, e.g. consider establishing a Knowledge Broker post that is jointly funded by university and local authority/health board, with responsibility for translating policy and evidence into practice Identify local and national role models/champions that can help service providers and older adults overcome some of their own perceived barriers to sustained participation in an active life Pilot an incentivised GP exercise prescription programme, as part of a research proposal, to assess the practicalities of using this setting to increasing activity in older adults Research: Undertaking a cost benefit analysis of physical activity in relation to general health expenditure Undertake a cost benefit analysis that would specifically examine the effect of encouraging GP’s to offer exercise prescription before offering a medical prescription Examine perceptions and attitudes that children have about being active in later years, with a view to using this information to inform educational curricular content Develop a model of advocacy that is relevant and appropriate for use in local communities Evaluate the value and impact of social marketing campaigns targeting older adults Need to find a mechanism that allows for easy and timely dissemination of; (i) practical information from research and, (ii) sharing of good practice between practitioners and professionals Examine the potential of using outdoor environments specially designed for older adult activities, as a means of widely and sustainably increasing activity levels RESEARCH

Key Issues from the Older Adults Summit Policy: Direct engagement with and support for older adults to be involved in policy development and act as advocates Develop a cross-departmental approach that aims to normalise and facilitate active living in older adults, e.g. consideration in environment, transport decisions etc Within the suggestions of the older adults summit, there are many action for Scottish Government. I have pulled out the ones that may be relevant for local interpretation and will share these with you now, and it is these that we will consider in this afternoons session.

Key Issues from the Older Adults Summit Practice: Service providers will provide workforce development opportunities to staff, in terms of addressing; (i) their own personal development and, (ii) in relation to their professional roles in educating the public Improve collaborative links with research facilities in order to maximise the potential of applying evidence base in a practical and meaningful way Identify local and national role models/champions that can help service providers and older adults overcome some of their own perceived barriers to sustained participation in an active life

Key Issues from the Older Adults Summit Research: Evaluate the value and impact of social marketing campaigns targeting older adults Need to find a mechanism that allows for easy and timely dissemination of; (i) practical information from research and, (ii) sharing of good practice between practitioners and professionals Examine the potential of using outdoor environments specially designed for older adult activities, as a means of widely and sustainably increasing activity levels

Translating national learning into local action How are these recommendations currently being taken forward? What needs to happen to strengthen this work? What is not currently being progressed? - What needs to be done to address this? - Who needs to be involved in making it happen?

Contact Details Sharon Allison Physical Activity & Health Alliance Coordinator NHS Health Scotland E-mail: sharon.allison1@nhs.net Tel: 0131 313 7527 Mob: 07879 668819