As in other countries, with varied societies and economies, both in Europe and beyond, physical activity (PA) remains at an unsatisfactory level among seniors in Poland. A study of participation in recreational activity and sport by the Polish Central Statistical Office (GUS) in 2008 found that 79.3% of the population aged 60 years and above was not physically active. The situation was little better in younger age groups: it was found that 73.4% of those aged 50–59 years were inactive, as well as 67.5% of those aged 40–49 years, and more than half of those (59.6%) aged 30–39 years . Older people, aged over 65 years, were the least physically active of all the groups [2–3].
Participation in Leisure Time Physical Activity (LPTA) is influenced by a range of socio-demographic, personal, behavioral, and psychological factors, as well as various environmental influences [4–7]. In addition, a literature analysis suggests that age, sex, education, occupation and place of residence can also play a role. LPTA is more often engaged in by people with higher education, those living in large cities, and those working professionally, i.e. without the need for physical effort [8–15]. Such sociodemographic determinants should be taken into consideration by local government when forming physical activity policies aimed at including seniors.
It should be remembered that PA is necessary for the proper development and functioning of a person at all stages of life, particularly during old age. A low level of PA leads to a fall in physical fitness to below norms. It is accepted that physical fitness gradually decreases with age during adulthood ; however, physically-active people can maintain their physical fitness level within the age norm by undertaking regular activity at a level above their daily functional needs. Despite this, a decline in physical fitness above the norm, usually occurring in inactive people, can lead to the elderly experiencing great difficulties in coping with utilitarian domestic and self-care activities; this can hamper their own ability to meet their needs and incur greater state expenditure on medical care and social assistance. For seniors, maintaining an appropriate level of physical fitness allows them to retain their independence and the possibility of self-fulfilment.
As they age, those who do not take part in regular physical activity demonstrate a greater decline in physical fitness than those who participate in regular physical activity at a higher level than normal daily activities. They also demonstrate a decline in physical efficiency, which is one of the features of the body’s motor skills, which reflects the ability of the human body to undertake long-term physical efforts without signs of rapidly increasing fatigue. Sedentary people demonstrate a faster rate of decline in physical capacity with age, amounting to about 10% per decade of life, compared to around 5% in the case of very physically-active people [17–18].
A similar trend can be seen for muscle mass, and hence muscle strength. It has been found that in 80-year-olds typically demonstrate 30–50% less muscle mass than 40-year-olds. [19–20]. This decline in muscle strength, particularly in the elderly, can also contribute to a loss of independence [21–22]. One reason for the decline in exercise capacity with age is, apart from chronic diseases, a sedentary lifestyle [23–24].
Although skeletal muscle mass accounts for about 45% of the body weight in young people, it decreases to about 27% in those over 70 years of age . This decline in strength is also typically accompanied by a decrease in flexibility, as well as physical endurance, which determines exercise capacity. Agility and motor coordination also deteriorate. Regular PA may slow the loss of muscle strength, thus improving functional performance and reducing the risk of falls in the elderly [26–28].
The beneficial effects of regular PA among the elderly are manifested as reductions in the risk of premature death, coronary artery disease, stroke and arterial hypertension, as well as type II diabetes, metabolic syndrome, colon and breast cancer . Systematic exercise also reduces body weight, improves cardiovascular, muscular and cognitive performance, and reduces the risk of depression [30–31].
The 2020 WHO guidelines indicate that PA plays an important role in the prevention of chronic diseases; however, people over 65 and those with disabilities or chronic diseases should be careful and consult a doctor before exercising. In the elderly, PA helps to maintain good bone health and overall body function. As part of their weekly physical activity, older people should engage in a variety of multi-component physical exercises emphasizing balance, and in strength training of moderate or greater intensity. These exercises should be performed three or more days a week to increase exercise capacity and prevent falls. The 2020 WHO guidelines, updating those issued in 2010, should be implemented into national health policies in line with the WHO Global Action Plan on Physical Activity 2018–2030 .
Podlasie, currently the Podlaskie voivodeship, is one of the green regions of Poland, with a forest cover of 30.9%: the mean afforestation for the whole of Poland being 30.34%. It is situated in the north-eastern part of the country, located at the geographical center of Europe. It is the voivodeship with the largest number of national parks, with four in the area: Białowieża National Park, Biebrza National Park, Narew National Park and Wigry National Park. This is far higher than the average for Poland, being 1.43 per voivodship . Podlasie is also interesting because of its international neighbourhood: its position in the north-eastern corner of Poland borders ex-Soviet Belarus to the east, and Lithuania, a European Union member, to the north-east.
In 2011, the population of the voivodeship aged 65 and above comprised over 176,000 people: 108 thousand women and 67 thousand men. More than half of the women aged 65 and above (53%) live in cities, and 47% in villages; in turn, 51% of men live in cities, and 49% in rural areas. Life expectancy in the voivodeship is 82.7 years for women and 73.9 years for men .
The aim of the study was to evaluate engagement in LTPA and investigate its determinants among seniors aged 65 and above living in Podlasie, based on the results of the nationwide PolSenior project. It also aims to formulate recommendations for health policies implemented by both national and local government. In the presented work, particular attention is paid to the formulation of health policy aimed at seniors living in the Podlaskie voivodeship, which is shaped by local government. However, to formulate effective programs for increasing participation in PA in any social groups, it is first necessary to know its determinants .