Skip Navigation


American Journal of Epidemiology Advance Access originally published online on April 9, 2007
American Journal of Epidemiology 2007 165(12):1356-1363; doi:10.1093/aje/kwm053
This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
165/12/1356    most recent
kwm053v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (2)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Slingerland, A. S.
Right arrow Articles by Brug, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Slingerland, A. S.
Right arrow Articles by Brug, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Aging, Retirement, and Changes in Physical Activity: Prospective Cohort Findings from the GLOBE Study

Annabelle S. Slingerland1,2,3, Frank J. van Lenthe3, J. Wouter Jukema2, Carlijn B. M. Kamphuis3, Caspar Looman3, Katrina Giskes3,4, Martijn Huisman3, K. M. Venkat Narayan5, Johan P. Mackenbach3 and Johannes Brug3,6

1 Institute of Biomedical Sciences, Peninsula Medical School, Exeter, United Kingdom
2 Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
3 Department of Public Health, Erasmus-MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
4 Center for Health Research, School of Public Health, Queensland University of Technology, Brisbane, Australia
5 Hubert Department of Global Health, The Rollins School of Public Health, Emory University, Atlanta, GA
6 EMGO Institute, VU University Medical Center, Amsterdam, the Netherlands

Correspondence to Annabelle S. Slingerland, C. van Rijplantsoen 28, 1063 MC Amsterdam, the Netherlands (e-mail: annabelleslingerland{at}hetnet.nl).

Received for publication October 29, 2006. Accepted for publication January 4, 2007.


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1
 APPENDIX 2
 References
 
There is increased recognition that determinants of health should be investigated in a life-course perspective. Retirement is a major transition in the life course and offers opportunities for changes in physical activity that may improve health in the aging population. The authors examined the effect of retirement on changes in physical activity in the GLOBE Study, a prospective cohort study known by the Dutch acronym for "Health and Living Conditions of the Population of Eindhoven and surroundings," 1991–2004. They followed respondents (n = 971) by postal questionnaire who were employed and aged 40–65 years in 1991 for 13 years, after which they were still employed (n = 287) or had retired (n = 684). Physical activity included 1) work-related transportation, 2) sports participation, and 3) nonsports leisure-time physical activity. Multinomial logistic regression analyses indicated that retirement was associated with a significantly higher odds for a decline in physical activity from work-related transportation (odds ratio (OR) = 3.03, 95% confidence interval (CI): 1.97, 4.65), adjusted for sex, age, marital status, chronic diseases, and education, compared with remaining employed. Retirement was not associated with an increase in sports participation (OR = 1.12, 95% CI: 0.71, 1.75) or nonsports leisure-time physical activity (OR = 0.80, 95% CI: 0.54, 1.19). In conclusion, retirement introduces a reduction in physical activity from work-related transportation that is not compensated for by an increase in sports participation or an increase in nonsports leisure-time physical activity.

aging; cohort studies; leisure activities; motor activity; prospective studies; retirement; sports

Abbreviations: CI, confidence interval; OR, odds ratio


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1
 APPENDIX 2
 References
 
Currently 600 million people worldwide are aged 60 years or more, and this number will grow to 1.2 billion by the year 2025 according to the World Health Organization (1). Prevalence of major chronic diseases increases with age. For example, diabetes is found in one in ten individuals. By the time a person reaches 65 years of age (retirement), this increases to one in five according to the US Centers for Disease Control and Prevention. People aged over 65 years account for almost 40 percent of the population with diabetes, and diabetes is the leading underlying cause of death in this age group (2–4). Not surprisingly, the Organization for Economic Cooperation and Development (5) reports that the medical burden and rise in public spending (from 6.7 to 13 percent of the gross domestic product by 2050) are mainly due to the health-care demands of people this age. Interventions to improve physical activity and diet can decrease diabetes incidence by 32–58 percent (4). There is strong evidence that, in the retired age group, physical activity can also decrease other diseases, falls, disability, and immobility (6–8). Physical activity can improve independence, since it contributes to maintenance of basic activities (such as climbing stairs and personal hygiene) and psychological functioning (by preventing isolation, depression, and, possibly, progression of dementia) (6–8).

Before retirement age, work-related physical activity (e.g., manual work and transportation) contributes substantially to total physical activity while, at the same time, work-related time pressures and constraints are reported as main barriers to leisure-time physical activity (sports and nonsports) (9, 10). Therefore, although retirement is expected to result in a decline in physical activity from work and work-related transportation, it may also reduce time-related barriers to sports and nonsports leisure-time physical activities.

Little is known about changes in physical activity after retirement. Studies are limited by their cross-sectional design, short follow-up, and/or restrictions on the scope of physical activities addressed (10, 11). Investigating specific aspects of physical activities (such as work-related transportation, sports, and nonsports leisure-time physical activity) is of utmost importance in directing possible ways of intervention.

We examined the effect of retirement on changes in the three major aspects of physical activity (work-related transportation, sports, nonsports leisure time) over 13 years' follow-up among employees aged 40–65 years who participated in the GLOBE Study, a prospective cohort study known by the Dutch acronym for "Health and Living Conditions of the Population of Eindhoven and surroundings," 1991–2004. Specifically, we hypothesized that people who retired during follow-up would be more likely to have reduced their work-related physical activities but increased their sports and nonsports leisure-time physical activities.


   MATERIALS AND METHODS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
 APPENDIX 1
 APPENDIX 2
 References
 
Population
The GLOBE Study aimed to explain inequalities in health and living conditions in a cohort of 27,070 noninstitutionalized Dutch inhabitants, aged 15–74 years in 1991 and living in the city of Eindhoven and surroundings (the southern part of the Netherlands). A detailed description of the purpose and design of the GLOBE Study is presented elsewhere (12). We collected, with a response rate of 70.1 percent, baseline information from 18,973 inhabitants using a postal questionnaire in 1991. Nonrespondents showed no differences in age, gender, or socioeconomic position (12).

We sent a follow-up postal questionnaire in 2004 to three samples taken from the respondent population in 1991. The first sample was a random sample comprising 2,800 respondents. The second was a sample with an overrepresentation of participants with chronic diseases compared with respondents, comprising 2,867 individuals. The third sample was of respondents who resided in Eindhoven and surroundings in 1991 and who still resided there in 2004 (n = 2,190). We sent participants from these three samples and who were still alive in 2004 a questionnaire to which 4,323 responded (response rate: 66.3 percent). For our analyses, we selected participants aged 40–65 years who were employed in 1991 and responded in 2004 (n = 1,246). We excluded participants with missing values for employment status in 2004 (n = 34).

On the basis of their employment status in 2004, we classified participants as retired (n = 703, 58 percent), still employed (n = 295, 24 percent), "homemaker" (n = 74, 6 percent), unable to work (n = 59, 5 percent), unemployed (n = 27, 2 percent), owner of a company (n = 12, 1 percent), "other" employment status (n = 9, 1 percent), or nonresponder to this particular question (n = 33, 3 percent). We limited subsequent analyses to the population who were either retired or employed after 13 years' follow-up (n = 998 (703 + 295)). "Owner of a company" was not included in analyses as participants in this category had no clear point of retirement.

We performed analyses on retired and employed participants for whom complete data on age, sex, marital status, chronic disease, and education were available at baseline (n = 971 (684 + 287)).

Our study sample had more chronic disease than did the total population from which it was obtained (respondents of baseline postal questionnaire limited to those that were employed and aged 40–65 years in 1991). There were no differences in terms of sex, age, marital status, or education (table 1).


View this table:
[in this window]
[in a new window]

  		TABLE 1. Baseline characteristics of the total study population and stratified according to employment status after 13 years' follow-up, the GLOBE* Study, 1991–2004

 
Measurements
Employment status and physical activity.
We assessed employment status by a closed question, similar for 1991 and 2004, with the main categories being retired or employed as described above. Physical activity measures differed for 1991 and 2004. In 1991, participants reported their 1) work-related transportation physical activity, that is, time spent on walking and cycling to work (in minutes/day); 2) sports participation, that is, time per week spent on sport activities (hardly ever, <1 hour, 1–2 hours, >2 hours); and 3) nonsports leisure-time physical activity, that is, time per week spent on walking, cycling, and gardening during leisure time (hardly ever, <1 hour, 1–2 hours, >2 hours) (appendix 1). Work-related transportation time was categorized in the same way as were sports participation and nonsports leisure-time physical activity (appendix 1). In 2004, we used the standardized and validated questionnaire known as the SQUASH questionnaire (Short QUestionnaire to ASsess Health-enhancing physical activity) (13). For work-related transportation physical activity, participants reported frequency (days/week) and duration (minutes/day) of walking to work and cycling to work (appendix 2). Minutes per week of walking and cycling to work were summarized and recategorized (hardly ever, <1 hour, 1–2 hours, >2 hours). For sports participation and for nonsports leisure-time physical activity, the same procedure was followed. The latter comprised separate questions for walking, cycling, and gardening in leisure time, which aspects were summarized before being recategorized into the aforementioned four categories. We assessed a change in physical activity over the 13 years of follow-up by subtracting categories of physical activity in 1991 from the physical activity in 2004 for each of the aspects of physical activity. Subsequently, we expressed a downward change in categories as "decline" in physical activity and an upward change as an "increase" in physical activity.

Covariates.
Participants reported baseline covariates in the postal questionnaire of 1991 that included questions on sex (male/female), age (years), marital status, having chronic diseases, and education. We adjusted for these factors in subsequent analysis. Questions on chronic disease were part of a standard Dutch 24-item checklist that is used for national health statistics research (Statistics Netherlands' general survey), comprising heart disease, pulmonary disease, stroke, peptic ulcer, kidney disorders, diabetes, rheumatism or arthritis, illness of the nervous system, and cancer. From this checklist, we calculated the number of chronic diseases and categorized participants as having no chronic disease, having one chronic disease, or having two or more chronic diseases. The question on education asked for the highest educational level attained and had eight categories that were recategorized into four: 1) elementary education (primary school), 2) lower secondary education (lower vocational), 3) higher secondary education (intermediate vocational), and 4) tertiary education (higher vocational).

Analyses
We applied weighing factors to make the sample representative of the original source population, taking into account the sampling design and nonresponse. We described the continuous variable age by mean (standard deviation) and categorical variables by frequency (percent) and odds ratio (95 percent confidence intervals). We compared retired participants with participants who were still employed in 2004 by using independent t tests for the normally distributed continuous variable age and {chi}2 tests for comparing baseline categorical variables and the categorical variables of physical activity.

To explore the effect of retirement on the change in physical activity between baseline and follow-up, we used multinomial logistic regression. Full models without missing values were used for each of the aspects of physical activity (transportation, leisure time, and sports). We calculated odds ratios and 95 percent confidence intervals for the decline and increase in physical activity with no change as the referent of retired compared with employed participants 13 years after follow-up. SPSS, version 10, software (SPSS, Inc., Chicago, Illinois) was used to analyze the data. All tests were two sided, and significance was defined as p < 0.05 or if the confidence interval did not contain the value of unity.


   RESULTS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
DISCUSSION
 APPENDIX 1
 APPENDIX 2
 References
 
Among the employed participants at baseline (40–65 years of age), 70 percent had retired during 13 years of follow-up. As expected, retired participants were older at baseline than participants still employed at follow-up. Furthermore, retirees reported chronic disease more frequently and were generally less educated (table 1).

There were small baseline differences between participants who had retired and those still employed after 13 years of follow-up (table 2). The proportion of participants that hardly ever spent time on sports participation was lower at baseline in those that were still employed after 13 years of follow-up than in those who had retired. At the end of follow-up, the proportion of retirees spending time on work-related transportation physical activity had dropped substantially. The proportion of participants that hardly ever spent time on work-related physical activity rose from 55 percent to 90 percent. The reduction among those still employed was much smaller (from 27 percent to 24 percent). Those still employed had increased their sports participation while the retirees had not, and the distribution of respondents over the three sports participation categories was similar between retirees and those still employed. The proportion of retirees that participated in nonsports leisure-time physical activity was slightly higher than the proportion among those still employed. The difference was most apparent in the highest category of nonsports leisure-time activity (>2 hours/week).


View this table:
[in this window]
[in a new window]

  		TABLE 2. Physical activity of the study population at baseline and after 13-year follow-up, stratified by employment status after 13 years, the GLOBE* Study, 1991–2004

 
Multinomial logistic regression analyses indicated that retirement was associated with a significantly higher odds for a decline in work-related transportation physical activity (odds ratio (OR) = 3.03, 95 percent confidence interval (CI): 1.97, 4.65, adjusted for sex, age, marital status, chronic disease, and education) (table 3). Remarkably, retirement was not significantly associated with a decline (OR = 0.66, 95 percent CI: 0.39, 1.10) or an increase (OR = 1.12, 95 percent CI: 0.71, 1.75) in sports participation. Retirement was associated with a significantly lower odds for a decline in nonsports leisure-time physical activity (OR = 0.35, 95 percent CI: 0.19, 0.68) compared with those remaining employed but not with an increase in nonsports leisure-time physical activity (OR = 0.80, 95 percent CI: 0.19, 0.68).


View this table:
[in this window]
[in a new window]

  		TABLE 3. Change in physical activity and odds ratios (confidence interval) of the change in physical activity over 13 years for the retired versus employed after a 13-year follow-up adjusted for age, sex, marital status, chronic disease, and education at baseline, the GLOBE* Study, 1991–2004

 

   DISCUSSION
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
APPENDIX 1
 APPENDIX 2
 References
 
In a 13-year prospective follow-up into retirement of employees aged 40–65 years at baseline, work-related transportation physical activity greatly reduced. This reduction was not compensated for by increased sports participation or nonsports leisure-time physical activity, with retirement associated with a lower odds for a decline in nonsports leisure-time physical activity only. These results indicate that retirement results in a net reduction in physical activity rates.

Our study is, to our knowledge, the first longer-term prospective cohort study investigating the effect of retirement on physical activity. It is the first to separately address work-related transportation physical activity, sports participation, and nonsports leisure-time physical activity; the results confirm the importance of making this distinction. A number of limitations should be acknowledged. One potential limitation of the study was the use of self-reported, single-item assessments for the different categories of physical activity. We have, however, no reason to expect that the vulnerability to the potential bias of giving socially desirable answers would be different according to employment status. At baseline, no validated physical activity questionnaire was available and, therefore, at follow-up the standardized and validated SQUASH questionnaire was available and adopted. Using two different physical activity questionnaires may have biased our results, but both questionnaires were quite similar in format and content and allowed categorization in identical categories of physical activity. There is no reason to believe that differential misclassification was stronger in one of the questionnaires by employment status.

Another potential limitation could be the external validity of our findings. Our study was carried out in a medium-sized city in the Netherlands (190,000 inhabitants) and, although it seems reasonable to generalize our findings to other cities of similar sizes, findings might have been different if the study had been conducted in more rural or larger city environments. A possible selection bias could have resulted if participants of ill health had retired earlier because of their ill health and if their ill health rather than their retirement per se negatively influenced their physical activity. We adjusted for chronic disease and have, therefore, minimized the possibility of this selection bias. Selection bias could have also resulted if the retirees with ill health had died without our knowing, resulting in the retired participants being healthier (the healthy worker effect). In that case, our results are an underestimation of the true effects, and the absence of compensatory sports participation and nonsports leisure-time physical activity cannot be ascribed to health issues.

Our results are, to some degree, consistent with those from a study that showed that people who retired were more likely to maintain leisure-time physical activity than were those who continued working (11). The authors of that study had suggested extending their follow-up of 6 years, as they were uncertain that their results were maintained. We extended that study and showed that their findings of a protective effect of retirement on a decline in physical activity is not maintained 13 years after follow-up. In addition, by including work-related transportation physical activity, we showed that losses in this area would not be compensated for by just maintenance of preretirement physical activity. Currently, the average home-to-work distance in the Netherlands is 18.2 km. Twenty-five percent commute by bike, while 3 percent walk to work, taking 15 minutes and 10 minutes on average (Statistics Netherlands). The net decline in physical activity would be even larger if loss in physical activity due to loss in manual work would have been taken into account (14).

There are several explanations for the failure to compensate for a loss in work-related physical activity after retirement. Time pressures and work-constraints before retirement might be perceived rather than actual barriers to physical activity. Alternatively, time pressures and constraints might continue from other sources, but our study lacks such data. Aging might be another explanation. However, our data were adjusted for this, as well as for possible increased chronic disease. Moreover, according to a recent study (15), increased age is no limitation for physical activity and, hence, one should not infer with expectations that the extra time after retirement would be used for extra physical activity. This implies that retirement, seen as a hallmark in the transition to old age, should still open excellent opportunities to increase physical activity (16).

Our results are reason for concern, since retirement appears to be associated with a relative reduction in physical activity, while the objective opportunities for being more physically active should be better after retirement (16). Remaining physically active at older age has great health benefits, and it is therefore important that physical activity promotion should be targeted toward people who are preparing for retirement and who have recently retired (14, 17–23).

Further research should be aimed at replication of the present study findings in other study populations and at investigations of the underlying social, physical, environmental, and personal factors that may encourage or discourage leisure-time physical activity after retirement in order to inform tailored physical-activity-promotion interventions (24). Future such studies also need to investigate the impact of a net decrease in physical activity during retirement on outcome measures, such as depression, disability, quality of life, and health-care costs.


   APPENDIX 1
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1
APPENDIX 2
 References
 
Postal Questionnaire 1991: Questions Used to Assess Self-reported Physical Activity
Work-related transport physical activity.
How many minutes do you spend on walking or cycling to work and/or shops on an average day? About ... minutes a day?

Leisure time physical activity.
How many hours of your leisure time a week do you spend on walking, cycling, gardening, letting the dog out?

  • hardly ever
  • less than 1 hour
  • 1–2 hours
  • more than 2 hours

Sports participation.
Are you participating in sports?

  • hardly ever
  • less than 1 hour
  • 1–2 hours
  • more than 2 hours


   APPENDIX 2
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1
 APPENDIX 2
References
 
Postal Questionnaire 2004: Questions Used to Assess Self-reported Physical Activity
Imagine a normal week of the past few months. Could you state how many days a week you participated in physical activity and how many hours and minutes you spent on an average day?

Work-related transportation physical activity.

            No. of days a week    Average time a day
Walking to/from work or school    {square} days        {square} hours  {square} minutes
Cycling to/from work or school    {square} days        {square} hours  {square} minutes

Leisure-time physical activity.

        No. of days a week    Average time a day
Walking    {square} days        {square} hours  {square} minutes
Cycling    {square} days        {square} hours  {square} minutes
Gardening    {square} days        {square} hours  {square} minutes

Sports participation.

        No. of days a week    Average time a day
Sport 1    {square} days        {square} hours  {square} minutes
Sport 2    {square} days        {square} hours  {square} minutes
Sport 3    {square} days        {square} hours  {square} minutes
Sport 4    {square} days        {square} hours  {square} minutes


   ACKNOWLEDGMENTS
 
The Prevention Fund and the Dutch Ministry of Public Health, Welfare, and Sports have financially supported the GLOBE Study. The study was conducted by the Department of Public Health of the Erasmus University Rotterdam, in collaboration with the Public Health Services of the city of Eindhoven and the region of South-East Brabant.

The authors wish to thank all collaborators without whose help this study would have been impossible, as well as Dr. Andrew T. Hattersley and Lorna W. Harries, Institute of Biomedical and Clinical Sciences, Peninsula Medical School, Exeter, United Kingdom. They also would like to acknowledge the organizers and participants of Diabetes, Exercise, and Sports Association 2006; the Cambridge Diabetes Seminar 2006; and Dr. Peter H. Bennett, Epidemiology and Clinical Research Branch, Phoenix, Arizona, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, for suggestions and helpful comments.

This paper has been dedicated to Dr. G. Jan (Mu) Bruining and Dr. Peter H. Bennett, professors of diabetes who refused to retire, and to J. M. Slingerland and A. M. Slingerland-Wennekers, who actively integrated physical activity into retirement planning.

Conflict of interest: none declared.


   References
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1
 APPENDIX 2
 References
 

  1. World Health Organization. Health topics. In: Ageing and life course (2006) Geneva, Switzerland: World Health Organization. (http://www.who.int/ageing/en).
  2. Narayan KM, Boyle JP, Geiss LS, et al. Impact of recent increase in incidence on future diabetes burden: U.S. 2005 –2050. Diabetes Care (2006) 29:2114–16.[Free Full Text]
  3. Narayan KM, Boyle JP, Thompson TJ, et al. Lifetime risk for diabetes mellitus in the United States. JAMA (2003) 290:1884–90.[Abstract/Free Full Text]
  4. Centers for Disease Control and Prevention. Diabetes public health resource (2006) Atlanta, GA: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. (www.cdc.gov/diabetes/).
  5. Organization for Economic Cooperation and Development. Study projects growing pressure on public health spending over and above effects of ageing society (2006) Paris, France: Organization for Economic Cooperation and Development. (http://www.oecd.org/topic/).
  6. Mensink GB, Ziese T, Kok FJ. Benefits of leisure-time physical activity on the cardiovascular risk profile at older age. Int J Epidemiol (1999) 28:659–66.[Abstract/Free Full Text]
  7. Young A, Dinan S. Activity in later life. BMJ (2005) 330:189–91.[Free Full Text]
  8. Haight T, Tager I, Sternfeld B, et al. Effects of body composition and leisure-time physical activity on transitions in physical functioning in the elderly. Am J Epidemiol (2005) 162:607–17.[Abstract/Free Full Text]
  9. Popham F, Mitchell R. Leisure time exercise and personal circumstances in the working age population: longitudinal analysis of the British household panel survey. J Epidemiol Community Health (2006) 60:270–4.[Abstract/Free Full Text]
  10. Mein GK, Shipley MJ, Hillsdon M, et al. Work, retirement and physical activity: cross-sectional analyses from the Whitehall II study. Eur J Public Health (2005) 15:317–22.[Abstract/Free Full Text]
  11. Evenson KR, Rosamond WD, Cai J, et al. Influence of retirement on leisure-time physical activity: the Atherosclerosis Risk in Communities Study. Am J Epidemiol (2002) 155:692–9.[Abstract/Free Full Text]
  12. Mackenbach JP, van de Mheen H, Stronks K. A prospective cohort study investigating the explanation of socio-economic inequalities in health in the Netherlands. Soc Sci Med (1994) 38:299–308.[CrossRef][ISI][Medline]
  13. Wendel-Vos GC, Schuit AJ, Saris WH, et al. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol (2003) 56:1163–9.[CrossRef][ISI][Medline]
  14. Nooyens AC, Visscher TL, Schuit AJ, et al. Effects of retirement on lifestyle in relation to changes in weight and waist circumference in Dutch men: a prospective study. Public Health Nutr (2005) 8:1266–74.[CrossRef][ISI][Medline]
  15. Aijanseppa S, Notkola IL, Tijhuis M, et al. Physical functioning in elderly Europeans: 10 year changes in the North and South: the HALE project. J Epidemiol Community Health (2005) 59:413–19.[Abstract/Free Full Text]
  16. Keller KB, Lemberg L. Retirement is no excuse for physical inactivity or isolation. Am J Crit Care (2002) 11:270–2.[Free Full Text]
  17. Caspersen CJ, Pereira MA, Curran KM. Changes in physical activity patterns in the United States, by sex and cross-sectional age. Med Sci Sports Exerc (2000) 32:1601–9.
  18. Harland J, White M, Drinkwater C, et al. The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care. BMJ (1999) 319:828–32.[Abstract/Free Full Text]
  19. Elley CR, Kerse N, Arroll B, et al. Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ (2003) 326:793–8.[Abstract/Free Full Text]
  20. Davies BL, Matte-Lewis L, O'Connor AM, et al. Evaluation of the "Time to Quit" self-help smoking cessation program. Can J Public Health (1992) 83:19–23.[ISI][Medline]
  21. Davis AL. Fighting obesity: physical activity has major role. BMJ (2004) 329:53.[Free Full Text]
  22. Siegenthaler JK, Brenner AM. Flexible work schedules, older workers, and retirement. J Aging Soc Policy (2000) 12:19–34.[Medline]
  23. Nothwehr F, Stump T. Health-promoting behaviors among adults with type 2 diabetes: findings from the Health and Retirement Study. Prev Med (2000) 30:407–14.[CrossRef][ISI][Medline]
  24. Brug J, Oenema A, Ferreira I. Theory, evidence and intervention mapping to improve behavior nutrition and physical activity interventions. Int J Behav Nutr Phys Act (2005) 2:2–8.[CrossRef][Medline]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Age AgeingHome page
S. Dogra, B. A. Meisner, and J. Baker
Psychosocial predictors of physical activity in older aged asthmatics
Age Ageing, July 1, 2008; 37(4): 449 - 454.
[Abstract] [Full Text] [PDF]

Home page
 HEALTH PROMOT INTHome page
S. Allender, L. Hutchinson, and C. Foster
Life-change events and participation in physical activity: a systematic review
Health Promot. Int., June 1, 2008; 23(2): 160 - 172.
[Abstract] [Full Text] [PDF]

Home page
 Am J EpidemiolHome page
K. Henkens, H. van Solinge, and W. Gallo
RE: "AGING, RETIREMENT, AND CHANGES IN PHYSICAL ACTIVITY: PROSPECTIVE COHORT FINDINGS FROM THE GLOBE STUDY"
Am. J. Epidemiol., September 1, 2007; 166(5): 616 - 616.
[Full Text] [PDF]

Home page
 Am J EpidemiolHome page
A. S. Slingerland, F. J. van Lenthe, J. W. Jukema, C. B. M. Kamphuis, C. Looman, K. Giskes, M. Huisman, K. M. V. Narayan, J. P. Mackenbach, and J. Brug
THE AUTHORS REPLY
Am. J. Epidemiol., September 1, 2007; 166(5): 616 - 617.
[Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
165/12/1356    most recent
kwm053v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (2)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Slingerland, A. S.
Right arrow Articles by Brug, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Slingerland, A. S.
Right arrow Articles by Brug, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?