The finding reveals that the older adults in Navrongo community were not meeting the WHO physical activity guidelines for health promotion and healthy living. Unfortunately, this situation predisposes these older adults to health challenges including limitations in their daily physical function capabilities. This result is very worrying and alarming because no participants met health-enhancing levels of physical activity levels. Therefore, the adult population in the Navrongo community may be predisposed to metabolic disorders, and other chronic non-communicable diseases such as cancer, diabetes, cerebrovascular, and cardiovascular diseases (WHO, 2019). Physical inactivity among these adults is attributable to a decline in physical activity participation due to ageing (Magyari et al., 2018). We also believe that the shift from active farming to smallholder mechanized farming and trading are increasing the sedentariness among these older adults. Moreover, there is no conscious effort by these older adults to carry out daily strength exerting activities. McPhee et al. (2016) found that age-related declines in physical activity are caused by both social and physiological factors. The avoidance of meaningful physical activity among the elderly is also influenced by physical limitations, disease, and discomfort, as well as retirement coupled with a loss of interest in social activities (including physical activity).
Many rural dwellers who hitherto were engaging in active farming are now ply trading. This is believed to be a result of devastations from climate change that are altering rainfall patterns, and increasing production of poor crop yields (Bibi & Rahman, 2023). Unfortunately, such severe weather conditions especially at the northern Ghana, is likely to push many farmers into trading so they can make some economic gains for personal and family upkeep. Our contention is that trading activities are likely to decrease physical activity lifestyles of these older adults, unlike farming.
Furthermore, McPhee et al. (2016) noted that despite being aware of the advantages of greater physical exercise, many older persons continue to be sedentary and engage in no or very little physical activity. The 53% who are minimally active may have been very active in their youthful days or they still farmers. We are of the view that being physically active as youths might have helped them to transit into minimal healthy active ageing. Thus, efforts at promoting youth physical activity are important for healthy ageing activeness. For instance, a person must perform moderate-to-vigorous physical activity for at least 30 to 60 minutes, three times a week to reach the health-enhancing physical activity levels (WHO, 2019). This, requires extra physical efforts from older adults, which may lead to few or no adult meeting such levels of physical activity, as may be the case with the elderly population in the Navrongo community (Carbone, Lavie, & Arena, 2017). Therefore, there may be the need to study, re-calibrate and re-design health-enhancing exercise threshold for older adults in rural areas and developing countries.
Age-related health issues might also lead to a decline in social interaction, including participation in physical exercise (Bernard et al., 2019). This justification is consistent with the Disengagement Theory of Ageing (Cunning & Henry, 1961), which contends that as persons age, their talents, particularly their capacity to interact with friends and family decline. Consequently, in comparison to the youths, older adults increasingly sever their relationships in their society and become more physically inactive and lonely. However, physical activity, even if initiated later in life, might delay the onset of impairment in the elderly (Lafortune et al., 2016). Additionally, a preventive effect against disability among the elderly can be achieved by engaging in regular physical activity (Moody-Ayers et al., 2005). Moreover, adults in some neighborhood may participate in less physical activity due to a poor constructed neighbourhood environment. Unfortunately, the built environment in Ghana is not exercise-friendly (Wendel-Vos et al., 2010). Unfortunately, the climate crisis is likely to exacerbate the unfriendliness of the environment for regular physical activity (Deshayes, & Périard, 2023). This may further discourages these older adults from regular outdoor physical activities, which are likely the commonest the rural Ghana.
The environment plays a crucial role in promoting physical activity. For instance, WHO (2019) made the case that incorporating physical exercise into daily life, such as walking and cycling may help people to meet recommended levels of physical activity. Moreover, beyond social and individual factors influencing physical activity (Sullivan, & Lachman, 2017), evidence further suggests that well-designed exercise friendly communities are important (Smith et al., 2017). The importance of the built environment needs to therefore, be highlighted since it motivates people to engage in regular physical activity (Smith et al., 2017). Perhaps, such as well-designed walkable path, recreational parks, cycling paths may increase physical activity, which turn to lower the risk of CVDs, obesity, and other disabilities leading improve physical functioning capacity of these older adults (Magyari et al., 2018).
The findings further indicated that the elderly women have low cardio-respiratory function. Older people have substantially higher frequency of CVDs, with gender differentiations. For instance, Malmborg et al. (2021) state that 77.8% of females and 70.8% of males ages 65 and 74 were diagnosed of hypertension between 2013 and 2017. Furthermore, the rates of diagnosed hypertension rose sharply, reaching 80.0% for men and 85.6% for women over age 75. Additionally, among older adults, obesity, gender, and age are particularly linked to hypertension (Hajar, 2016), which disproportionately affect women. Thus, the elderly women in Navrongo community who had low physical activity levels and increased overweight may have hypertension (Hands et al., 2016). This may be due to lower stroke volumes of women and the fact that women are also likely to react emotionally to the discomforts of the neighborhood environment (du Bray et al., 2019). Moreover, Jakovljevic (2018) confirms that the lower heart size of females compared to males is another morphological trait that appears to affect VO2 max. Elderly women may need extra attention to improve their exercise life and promote their functional capacity.
Our findings also revealed that female older adults are overweight and on the borderline of obesity class 1. This condition predisposes the women to the higher risk of non-communicable diseases such as coronary heart disease, strokes, and hypertension among others. Dogra et al. (2017) claimed that because there are disparities in BMI between the sexes, females are frequently regarded as having a higher risk of experiencing negative health effects and are designated as a high priority category for physical activity interventions. Additionally, increase in weight may result in excess body fat, and more cholesterol deposits in the blood, complicating the health of women such as brain, heart and other organs, resulting in a compromised cardiovascular system (Elagizi et al., 2018). These are likely to increase the risk of hypertension and other chronic health conditions among these women. Thus, it is further found that the older women recorded a mean physical functioning capacity value of 81.02, below the average standard score of 100. Perhaps, these older women are suffering from physical functional limitations, because evidence (Poggiogalle et al., 2019) suggest that age plays a critical role in functional capacity (strength, endurance, agility, and flexibility), making daily activities more challenging among these women and can be completed with advancement in age. Therefore, when physical inactivity becomes prevalent among women, health-related fitness components, like body composition and cardio-respiratory fitness are compromised. This can lead to a decline in physical function capacity, thereby, predisposing the women to high risk of non-communicable diseases, orthopedic problems and other related illnesses.
It is also evident that BMI and cardio-respiratory endurance are good determinants of physical function capacity among these older adults. This finding reflects the statement by Magyari et al. (2018) that body composition and cardio-respiratory endurance are health-related fitness components known to predict physical function capacity among older adults. Physical functioning capacity of individuals is key to their survival, but this could be compromised by being overweight or obese, having a poor cardiovascular fitness and other illnesses. It is that obesity in the elderly, as measured by a high BMI, is substantially associated with a deterioration in functional performance, which could result in disability. One possible explanation is that excess body weight can place additional strain on the joints and muscles, which makes it difficult for individuals to perform physical activities. Additionally, carrying excess weight can increase the risk of developing chronic health conditions such as arthritis, diabetes, and CVDs, which further limit physical activity efforts and impair physical functioning ability of persons (Poggiogalle et al., 2019). As a result, older adults especially women are likely to suffer from physical functional limitations due to their high BMI (Ponti et al., 2020).
The findings of this study have important implications for promoting healthy ageing. Thus, interventions that promote healthy weight management and cardiovascular fitness may help these older adults to maintain their physical independence and improve their overall quality of life (Munt et al., 2017). This may help reduce the burden of dependency, limits both personal, family and national healthcare cost, and minimise pressures on healthcare providers and the entire healthcare system of the nation.
Limitations
Though this study provides very useful findings of physical activity levels, BMI and cardio-respiratory endurance and their relations with physical function capacity of older adults from rural community in a developing nation, there are some limitations. Other variables such as diet, medical conditions, and medication use may affect physical function capacity of these older adults. These variables were, therefore, not controlled and may possibly confound the variables studied. Thus, there is the need to control for many of these confounding variables in an attempt to explore factors influencing physical function capacity of older adults in future studies.
Practical Implications
Increased in body weight, poor cardio-respiratory fitness and physical inactivity are key contributors to the decline in physical function capacity among older adults in rural communities in Ghana. The study suggests that maintaining a healthy weight and engaging in regular physical activity promotes cardiovascular endurance which in turn has a positive impact on physical function capacity of the older adults. Thus, encouraging regular physical activity can help maintain cardiovascular endurance and healthy body weight, which in turn improve physical function ability in these older adults. Therefore, health promotion programmes can be designed to increase physical activity levels, for weight management, dietary behavior changes to promote the overall of these older adults.
Given the importance of cardiovascular endurance to physical function ability, older adults should be encouraged to engage in regular physical activity to maintain their cardiovascular health. Furthermore, for older adults who are experiencing physical limitations due to poor cardiovascular endurance or obesity, need rehabilitation programmes to help improve their physical function ability. These programmes can include exercises that increase cardiovascular endurance, muscular endurance and stabilization, and flexibility to improve overall physical function capacity. Finally, the findings can inform health policies aimed at promoting healthy ageing.