1) The study examined how motivation and employment status influence the time spent exercising and health outcomes in older adults. 2) It found that motivations like enjoyment of exercise and believing it is good for one's health increased time spent exercising, and retirement also increased exercise time. 3) Exercising moderately to heavily was shown to improve health-related quality of life scores and metabolic risk scores.

1. Motives and costs of
physical exercise with
regard to health
production:
The DR's EXTRA Study
Virpi Kuvaja-Köllner a, Hannu Valtonen a, Pirjo Komulainen b, Maija
Hassinen b and Rainer Rauramaa b,c
a Department of Health and Social Management, University of
Eastern Finland, Kuopio Campus, Kuopio, Finland
b Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
c) Department of Clinical Physiology and Nuclear Medicine, Kuopio
University Hospital, Kuopio, Finland

2. The content of
presentation
• The aim of the study
• Theory
• Data
• Methods
• Results
• Conclusion
• Acknowledgements

3. The idea and aim of the
study
How motivation and labour market
position (time) explain the time
used for
Physical exercise
Health outcomes
by older adults

4. Theory
• Grossman’s health production function
• The individual’s health investment
• The individual’s own effort
• The allocation of time (working or retired)
• Opportunity cost of time (Hatziandreu et al.
1988; Hagberg et al 2009 & 2010)

5. Data
• We used 2-year data (n=1292) from
the Dose-Responses to Exercise
Training (DR’s EXTRA) Study.
• the target population was a
representative sample of Eastern
Finnish men and women who were 55-
74 years of age in 2002

6. Variables
• Moderate-to-heavy physical exercise
(hours/week)
• Health-related quality of life was
evaluated by Rand 36-item survey
using Physical and Mental Component
Summary (PCS, MCS) scores.
• Metabolic risk factor (MetS) score was
defined by NCEP criteria.

7. What motivates people to exercise?

8. Methods
• Motivational factors were asked in the
baseline in the form: Which of the
following factors motivate (encourage)
you to do physical exercise?
• Also freely worded answers
• Motivation; principal component
analysis

9. Methods continue
• In the statistical analysis, exercise and
health outcomes were assumed to be
endogenous variables explained with
a set of exogenous variables.
• The statistical modelling was done by
panel data instrumental variable
regressions.

10. Results
• The motivational factors, "joy" or “exercise is
good for me”, increased the amount of
exercise (p<0.001)
• Retirement increased the time spent on
moderate-to-heavy exercise
• The instrumented variable, moderate-to-
heavy exercise increased the PCS and MCS
scores and decreased the MetS score

11. Conclusion
The opportunity cost of time,
measured with the labour market
position, either retired or working, and
motivation, such as joy, had a
significant effect on the amount of time
spent on exercise.

12. Enjoyment!

13. Connection to the health
policy
• The employers should put more effort and
make it possible for the age group of people
over 55 years old to do more physical
exercise, perhaps even during working time
• Health policy should be open minded
towards all different kind of physical
exercise. If people enjoy dancing, they
should have the possibility to do that also
elsewhere than in restaurants

14. Acknowledgements
* the DR’s EXTRA participants
*Financial support:
• Ministry of Education in Finland, Academy of Finland,
European Union/ EXGENESIS, City of Kuopio,
• Kuopio University Hospital,
• Finnish Diabetes Association,
• Finnish Heart Association,
• the Social Insurance Institution of Finland and
• Päivikki and Sakari Sohlberg Foundation
• Yrjö Jahnsson Foundation
* the DR’s EXTRA study group