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Abstract

Background: The association between apathy and physical activity levels in older adults is well established. It is essential for older adults with chronic health conditions not only to be more active but also to adhere to a personalized exercise prescription. However, the impact of apathy on exercise adherence remains unclear. This study aimed to investigate the effect of apathy on exercise adherence in older adults with chronic health conditions. Methods: This research was a secondary longitudinal data analysis of a behavior change intervention conducted through a randomized controlled trial. The participants included older adults aged 65 years and above (n = 65) who attended three adult daycare centers. All participants engaged in a 12-week home exercise program, and the number of days they exercised was tracked across three phases using an exercise log calendar (weeks 1–4, 5–8, and 9–12). The Short Physical Performance Battery and Apathy Scale scores were assessed at baseline and again after 12 weeks. Participants were categorized into two groups: those with baseline Apathy Scale scores of 16 or higher (n = 33) and those with no apathy (n = 32). The differences between these groups for each outcome were examined using analysis of covariance. Multiple regression analysis was performed to identify factors influencing exercise adherence. Results: Analysis of 54 participants who were assessed after 12 weeks (apathy group: n = 25, no apathy group: n = 29) showed that the apathy group exercised significantly fewer days than the no-apathy group between weeks 9 and 12 (p = 0.039, f = 0.30). No significant differences were found in the other outcomes (intention-to-treat analysis). Multiple regression analysis identified the Apathy Scale score (β = -0.33, p = 0.015) and tandem standing time (β = 0.28, p = 0.030) as significant predictors of exercise adherence. Conclusion: Older adults experiencing apathy demonstrated poorer adherence to a home exercise program. Apathy was identified as an independent predictor of exercise adherence. Therefore, older adults with apathy may require additional support to encourage their engagement in exercise.

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