Regular group exercise contributes to balanced health in older adults
In this study, the finding ‘regular group exercise contributes to balanced health in older adults’ emerged as an overarching emergent theme with seven categories (regular group exercise, functional health, active mind, enjoyment, social connectedness, mutual support, and expanding communities) (Fig. 1).
The group exercise contributed to their physical, mental, and social well-being. Although the participants perceived that they were aging physically and cognitively, the regular group exercise helped them to improve or maintain their functional health, socialize with peers, and enjoy their lives. They cared for others and supported each other. Consequently, they felt socially connected and experienced a sense of security in the community. As the older adults began to seek value beyond individuals, they gradually expanded their communities beyond geographical and generational boundaries.
Regular group exercise
For the older adults, who had plenty of free time after retirement or after they had finished their child-rearing responsibilities, regular group exercise was an important factor in balancing their overall health. Regular group exercise regulated their daily life. Without such a regular plan, they were at risk of irregular habits, such as getting up, sleeping, and eating at irregular hours:
For me, participating in this group exercise helps my daily life. After I retired, I was so free that I often tended to get up late. But when I know it’s an exercise day, I get up on time and get myself ready. I think it’s good for me (73-year-old male, Participant N).
Gathering at one place and exercising with their peers gave them an opportunity not only to participate in physical exercise but also to go out regularly, leading to interaction with others, prevention of isolation, and stimulation in their daily lives. One participant stated, ‘After my children had grown up, I had nothing to do. This group exercise helps regulate my daily life by balancing out the day-to-day tensions and stressors’ (72-year-old female, Participant I). Another participant said, ‘For me, going out is the key. Not just staying home but going out three times a week really helps’ (77-year-old female, Participant C). As for the frequency of regular gathering, a few times a week was well accepted among a majority of the participants. Having off-days motivated them more than having exercise every day.
The participants shared the importance of the group exercise to start each day. One participant emphasized, ‘My day begins with the exercise. My body feels very flexible, and I feel more energized today’ (73-year-old male, Participant N). The regular group exercise provided the older adults with a good routine and helped to build a foundation for daily life. Another participant stated, ‘It helps give my week a sense of structure and routine’ (78-year-old female, Participant Y). The exercise kept them fit, and performing daily activities helped them feel they were in good health.
Functional health
While the older adults felt elements of aging, including the decline of physical and cognitive functions, many of the participants perceived the regular group exercise as good for their functional health. One participant stated her biological changes:
Now, I feel I am growing older. I used to enjoy intense exercise, but a few years ago, I began experiencing shoulder pain, the so-called ‘shoulder pain for people aged 50’. Of course, I am older than 50 (laughs). Ever since then, I have been unable to do many things (66-year-old female, Participant R).
Other participants talked about the decline of muscle strength and their efforts to improve or at least maintain their current function. One participant stated, ‘People in their 70s are noticeably weaker, particularly their muscles’ (75-year-old female, Participant K). Another participant reported the effect of exercise by stating, ‘Like radio exercise, the +10 exercise has been very effective in improving the muscle strength in my knees’ (73-year-old female, Participant M). Another participant affirmed that it helped maintain her current physical function rather than improve it. ‘It is great if we can do now what we could do at a younger age as we are aging’ (76-year-old female, Participant U).
Decline of appetite and unbalanced nutrition rather than overweight are concerns among Japanese older adults. The participants reported an increase in appetite after the exercise as an indicator of health. One participant stated, ‘I believe that how much you enjoy eating is an indicator of your well-being. Don’t you think so? I really enjoy my meals’ (72-year-old female, Participant I). Other participants agreed with her.
Active mind
The participants believed that mental health was as important as physical health, and physical function is closely related to cognitive function. On participant stated, ‘I don’t know whether it is related to dementia, but I think that the decline of physical function leads to the decline of cognitive function, and people with poor physical function are likely to become senile’ (73-year-old male, Participant N). Multiple participants agreed with him that the decline of physical health would lead to the decline of cognitive function.
In the +10 exercise, the instructor reminds older adults to try to be aware of which muscle they are using in the exercise. One participant stated, ‘I am not just exercising but am constantly focusing on how each exercise affects each part of the body. Once I know which exercise is for which body part, I try to stretch correctly’ (73-year-old female, Participant M). They felt mentally sharp by focusing on the body action and had a sense of achievement after the exercise.
Furthermore, the participants felt that stimulation as a result of talking to people before and after the exercise would be good for their mental health. They believed that keeping the mind active and talking to peers contributed to maintaining their cognitive function:
I come here and talk to all of you. Like I said before, if I stay at home, I get isolated and have no stimulation. Being with one’s family or watching TV are forms of one-way communication. Talking to people is very stimulating and may help prevent dementia (73-year-old female, Participant M).
Enjoyment
The participants became more active and began enjoying their lives more. Some of the participants were not willing to go out before joining the regular group exercise. One participant said, ‘When I go out, naturally, I interact with different people. Now, I go out more often. Some people say that they do not want to go out because staying at home is easier. But if you go out, it becomes a habit, and you will enjoy it’ (75-year-old female, Participant K).
The group exercise was an opportunity not just to engage in physical activity but also to socialize. One participant stated, ‘I enjoy coming here’ (73-year-old female, Participant M). Another participant expressed, ‘I joined the exercise, and we got to know one another. Now, I can talk to you as friends. It really makes me happy’ (77-year-old female, Participant C). For the participants, talking to their peers and exchanging information with them stimulated them, and, in the process, they also laughed and shared jokes with their peers. One participant stated, ‘Yes, the laughter…they say that laughter is good for the health. I believe it is good for us, too’ (76-year-old female, Participant U).
Exercising alone at home could never have brought about this type of enjoyment. Moreover, the group exercise motivated the participants to continue engaging in physical activity. One participant stated, ‘I can hardly wait for Monday. If I have something to do, I try to finish it or rearrange my schedule, because I really look forward to Mondays’ (79-year-old female, Participant Z). As one participant said, ‘I really enjoy it. That’s why I am able to continue. It’s fun’ (79-year-old male, Participant Q). Most participants attend the exercise for enjoyment, and, furthermore, they felt connected.
Social connectedness
By participating in the regular group exercise, the participants felt that they were socially connected and that they were members of a society. One participant stated, ‘When we talk to each other, we feel connected’ (77-year-old female, Participant C).
Eventually, the participants expanded their communication beyond the group exercise. They planned social activities with their peers, including travels and eating out:
We make many plans. We are proactive when it comes to going out, and we take trains and buses. Even though we are older, it stimulates us. When we go out, we care about how we dress, which is also good (73-year-old female, Participant M).
With increased social activities, the older adults began to actively connect with others. One participant stated, ‘I get stimulated in various ways. I feel like trying. For example, I want to be creative in my cooking. If I cook well, I feel like sharing my dish with someone’ (72-year-old female, Participant I). The social connectedness is not limited to sharing enjoyment with peers but led to the momentum to build a community to care and support for each other.
Mutual support
The regular group exercise helped the older adults to develop their potential and respect each other. One participant emphasized the value of older adults by stating, ‘As we grow old, we all have our strong points’ (75-year-old female, Participant K). Other participants affirmed by saying, ‘Each of us is good at something’ (73-year-old female, Participant M), and ‘We do what we are good at’ (72-year-old female, Participant I).
As for physical and mental well-being, and social participation were increased among older adults; they began to care for their peers and other people in the community. They supported each other and felt a sense of security in the community. One participant stated, ‘(During the exercise,) I look around (laughs). If someone is absent, I wonder what happened to him or her because he or she is always present. So, to check on the absent person, I call him/her on the way home’ (75-year-old female, Participant K).
Because of aging, many older adults face late-life challenges and are concerned about the future. They felt a sense of security when they found that not only their families but also people in the community cared about them:
These interactions that I have with my peers are very helpful, because these are people I can go to for advice and who help me, even though they do not necessarily live close by. They are a source of psychological support for me, and I really appreciate it (73-year-old female, Participant M).
Expanding communities
While the participants respected and supported each other in the community, they gradually expanded communities. They perceived that they became more generous and open toward others. One participant stated, ‘People are sweet and have big hearts’ (76-year-old female, Participant U), and another said, ‘Everybody seems to be in good spirits’ (76-year-old male, Participant A).
Multiple participants shared their acceptance of others. One participant stated, ‘Everyone is nice enough to accept everyone’ (77-year-old female, Participant C). Another participant stated, ‘We accept everybody (laughs)’ (75-year-old female, Participant K). They realized that their community was expanding. One participant stated, ‘The community has really expanded naturally, from one neighbouring town to the other. I wonder how many new members have joined us’ (76-year-old male, Participant A). The group exercise in this community is not limited to older residents in the community; it is also open for neighbouring communities.
In recent times, older adults in other communities have seen or heard about the participants’ lively activities. As the number of participants increased to include people living beyond the community boundary, the wave of exchange has expanded:
People were hesitant to join us because they assumed it would be a gathering of older people. But we are active and enjoy many things. Once people realized this, even those younger than 60 wanted to join us (73-year-old female, Participant M).
This change was expressed by one participant as follows: ‘We can see the flower this much, but the roots are expanding, aren’t they?’ (78-year-old male, Participant V). The regular group exercise worked as a catalyst to expand communities beyond geographical and generational boundaries, and the participants sought to strengthen connections in a wider circle of people.