Effects of Multicomponent Exercise on Quality of Life, Coping With Stress, and Well-Being in Older Women: A Randomized Controlled Trial

Aging is a natural and inevitable process of change that begins in the fetal period and continues until death in all living things. Old age refers to a period in which many people experience feelings of loss, lose their physical, functional, psychological and social independence and increase their dependency. The World Health Organization (WHO) accepts the age limit as 65 years and above, while the United Nations accepts it as 60 years and above. In parallel with the developments in technology, science and health, 9.3% of the world's population and 9.1% in our country constitute the elderly population. 61% of the population aged 80 and above in the world are women, and the female/male ratio in this population is increasing day by day.

Biological differences cause women to spend more than a third of their lives in old age and to have more health-seeking behaviors due to men's higher rates of smoking, alcohol and substance use. This situation causes older women to experience chronic diseases, violence, abuse and reproductive health problems, psychological and mental problems, care and housing problems longer than older men. According to the study of Ko et al. (2019), it was found that women have lower socioeconomic and health status than men, and their health status and social service needs are higher than men. In addition, studies have shown that urinary incontinence, osteoporosis, vision, hearing problems, cardiovascular diseases such as hypertension, which are common in elderly women, negatively affect their mobility and quality of life.

The care that should be given to the elderly should be multifaceted, and in addition to physical and medical aspects, social and psychological aspects should not be neglected. Functional losses and social losses that occur in old age naturally affect women more. Coping with stress is defined as a series of cognitive and behavioral efforts aimed at managing special needs that exceed the individual's internal resources. Although the life behaviors developed by women to cope with stress in the literature vary from culture to culture, most studies have focused on education, physical activity/exercise, healthy nutrition, stress management, developing healthy behaviors, and preventing diseases and osteoporosis. Some problems such as increasing health problems in old age, loss of professional and social status, loss of function, and increased dependence on others deteriorate the quality of life and negatively affect well-being. Although wellness is simply defined as a process, a lifestyle, it consists of multifaceted sub-dimensions such as social, physical, and spiritual well-being. In geriatric studies aimed at maintaining well-being, studies are carried out on social activities, psychological support, and exercise, nutrition, and the ability of the individual to continue their daily activities independently. In the study of Östh et al. (2019), it is reported that yoga is effective in improving well-being, mobility, mood and cognition, and that yoga can be added to the exercise program of the elderly. In addition, in the study of Sorusa et al., it was determined that yoga applied during the climacteric period positively affects the quality of life and well-being.

Current geriatric studies target active aging and report that exercise is necessary for a healthy aging process. While exercising increases muscle mass, muscle strength, balance and speed, it also helps elderly individuals increase their independence and reduce functional disability. WHO's exercise recommendations for elderly individuals include both strength exercises and balance exercises to reduce the risk of falls, as well as aerobic exercises. The recommendation for older adults is 150 minutes of moderate-intensity exercise per week, and it is stated that it is more appropriate to divide this time into certain days of the week. Epidemiological studies have shown that people with high levels of physical activity have lower levels of depression and anxiety. On the other hand, high levels of habitual physical activity are associated with a reduced risk of cognitive decline, dementia, and Alzheimer's disease in later life. Physical exercise improves memory function in older people with mild cognitive impairment.