The number of ageing people has been on the rise in the last decade. In the year 2017 a total of 962 million, aged 60 or above individuals have been recorded which is about 13% of the population of the world. The ratio of elderly is greatest in Europe (25%). By estimation, the world will have about 3.1 billion old persons in 2100 [1].
In order to describe where old age begins there seems to be a misperception in the literature. To define young, middle and old age generations, a gap has emerged that makes it more difficult to find a solid cut point [2]. In this paper, old age has been defined as 60 years and above, reason being that due to various sociopolitical regulations some members of society are able to retire at age 60, hence inactivity, the main interest of our inquiry, may begin. As of 2019, the National Bureau of Statistics reported 2.6 million people living 60 or above, that is 27.1% of the total population of Hungary. Of those in this age group 60% were women, 13.7% were reported to be 60–69 years old, 8.8% between 70 and 79 of age, and 4.6% above 80 years [3]. Their proportion will continue to increase, people 80 years or above is expected to reach 29% by 2070 as forecasted by Eurostat [4,5,6]. Life expectancy at birth in the countries of the EU was 83.3 years for women and 77.9 for men while Hungary reported 79.0 for women and 72.4 for men [7].
There is a complex need to intervene in order to increase the life expectancy as well as quality of life of senior citizens. One area of improvement clearly is physical activity. A nationally representative sample of 2000 respondents were surveyed in May–June of 2018. The survey was implemented in an age range of 15–74, our data concerns those who reported their age being 60–74. The focus of our investigation was the level of physical and sports activity in the group above. Our hypotheses included that doing sports at older age is positively related to life satisfaction as well as not being engaged in physical activity has to do with earlier socialization that lacked exercising culture. We aimed to explore whether elderly physical activity, namely types of sports, are different from other generations.
International literature describes physical activities and activities of daily living concerning the elderly. Literature is less replete with studies exploring and evaluating sports acitivies of older people, there seems to be a specific lack of studies about the motivation of elderly to partcipate in sports and why they withdraw from sports. However, such studies would help us understand how to engage elderly generations and ensure that they enjoy health benefits of sporting. In this particular study, we made an effort to quantify the influence of sport both on quality of life and self-assessed health. Our study outcomes further confirm that the level of elderly engagement in sports activities is unnecessarily low.
Impact of physical activity on health
Physical activity has been found to have a string positive impact on health outcomes, especially in prevention of chronic diseases and early death. Exercising positively impacts mood, boosts self-efficacy and improves coping with stress. Regular physical activity has been observed to improve social relations, cohesion and also social support [8,9,10,11,12,13]. In older age, physical activity has a positive influence on quality of life and mental health of individuals [14, 15]. It is very effective in maintaining physical balance and preventing falls [16, 17]. Physical exercise may also help to reduce the cost of healthcare by preventing or pushing out disease onset to a later age [18]. Epidemiological studies prove that physical inactivity is the biggest factor of mortality overtaking smoking and high blood pressure [19]. Lack of exercise is said to cause at least 5 million death annually in the world as it may be connected to 6% of cardiovascular diseases, to 7% of type 2 diabetes, to 10% of breast and colon cancers, and is a known factor of osteoporosis and precursor of depression [20, 21]. The level, intensity and frequency of exercise for a balanced and healthy life has been defined by the World Health Organization, the European Council and the US government as well [22,23,24]. These guidelines include very specific recommendations for daily activities for those 65 years old and above to enjoy full mobility, independent functioning and mental health.
Impact of physical activity on health in Hungary
Old age in Hungary is often associated with decline, elderly respondents believe that it is difficult to adjust to age related challenges, they become dependent on others, their physical and mental health deteriorated, altogether negative associations are predominant [5, 25]. According to the Global Age Watch Index in 2015 they found that out of the 96 countries surveyed Hungary ranked 57th based on health conditions and well-being of the elderly [26]. Health status of people 65 and above in Hungary was appraised in 2016 explicitly unsatisfactory by 18% of respondents, 10% said they were quite disappointed with their health, about a quarter reported being satisfied [27, 28]. When considering genders, women are more critical of their health status than men. The process of aging brings forward chronic diseases that negatively impacts on mobility and exercise [29]. Chronic diseases affect 80% of the elderly population, 39% report serious restrictions of mobility and sensory disabilities while 35% are affected by diseases that prevent them from full functioning and managing a household [5]. Most prevalent diseases in this population include high blood pressure (66.9%), back and lumbar pain (51.4%), joint diseases (46.8%), neck pain (27.5%), cardiac fibrillation (23.4%), high cholesterol (22.9%) and osteoporosis (21.1%). Based on the European Household Survey 2014 data one in seven Hungarian is engaged in physical activity, 5% exercises daily, 2% weekly on 1–3 occasions. While 25% of this sample reported biking another 25% did not walk more than 10 min weekly. Despite that doing sports has been proven to reduce cardiovascular morbidity and contributes to better weight management [30,31,32,33], physical inactivity has been well documented in Hungarian literature [18, 34,35,36]. Exercise activity increases by level of education, the more people are educated the more affluent they become thus they spend time and resources on sports more than lower educated peers [5, 37]. Regularly exercising men, those living in cities and having higher education, reported better health compared to peers [38,39,40]. Retirement however causes people to change lifestyles, restrict their activities in and around their homes, and recreation activities are pushed back significantly. Loss of certain muscular functions and independent living reduce physical activity that may increase the risk of cardiovascular disease [41, 42]. Regular exercise however can minimize the risk of osteoporosis and diseases that affect the locomotive system [43]. Fear from falling may also decrease physical activity in 65 and older, research shows that at least one-third of people at and above the age of 65 fall annually [44]. Reasons behind falls are numerous; instability, muscle tone changes, weight changes and the slowing of the nervous system may all contribute to losing stature. The loss of physical activity can easily lead to depressive symptoms which then further exacerbates loneliness and a worsening quality of life [45]. Exercise is a critical tool to keep the elderly socially integrated and to avoid serious disabilities. Health promotion including improving exercise capacity is not late beyond 60 years of age as such programs have proven to be effective in maintaining independent living and functioning [46,47,48].
As for the comparison with other European countries, Eurobarometer 2017 data showed marked differences in the motivation of elderly between East and West. Elderly in Western Europe find it important to exercise in order to stay fit and healthy, be in control over their weight, and use exercise as means of relaxation and social bonding. Clearly, while 49.2% of 60-above in Western Europe walked at least 10 min 5 days a week, the proportion of the same age group was only 33.1% in Hungary.
Measuring physical activity
According to Ainsworth, physical activity may be measured by physical assessments (i.e., gait and velocity meters, heart rate monitors etc.) or other quantitative/qualitative tools such as personal interviews and surveys [49, 50]. For greater number of subjects however using survey tools is more frequent as they can collect a large amount of data in a relatively standardized, comparable fashion. There are a number of validated questionnaires available on the topic of physical activity that have been tested in large population surveys. Among those, the European Activity Surveillance System (EUPASS) is the most dominant in Europe [51]. Another tool, by recommendation of WHO, used in Europe is the International Physical Activity Questionnaire (IPAQ) [52, 53] and its revised sibling the Global Physical Activity Questionnaire [54, 55]. As for measuring sports activities across Europe, a valid approach has been the Eurobarometer study in 2002, 2009, 2013 and 2017 [56,57,58]. The last survey concerned 28 European member states and included data from 28,031 European citizens from various sociodemographic groups. The survey assessed the level and frequency of physical activity from moderate to intense and accounted for activities like walking. It also evaluated the place and venue of the exercise including riding a bike, dancing or gardening. The survey explored reasons why people chose or declined to be active and reasons that either supported or impeded being physically active including the role of municipal governments and local environments. Finally, the survey also looked at whether people took any voluntary role in supporting sport events [34]. The final instrument utilized in this research reflected items and measurement principles both of EUPASS and IPAQ. Additional survey items were added to the instrument in order to account for cultural values and differences.