Frail older adults and patterns of exercise engagement: understanding exercise behaviours as a means of maintaining continuity of self

In this article, we draw on data from in-depth interviews with five men and five women, aged 71-87, who had between four and 17 chronic conditions, to explore patterns of engagement in exercise amongst frail older adults. Having experienced marked declines in their health statuses over the previous two-year period, our participants scored low on tests of functional abilities and reported profound physical changes and concomitant social losses. Despite their grave health statuses, seven were engaged in formal exercise programmes. We use Atchley's continuity theory of ageing to discuss the three patterns of participation in exercise across the life course that emerged in our analysis, namely, lifelong participation, lifelong non-engagement and later-life adoption. In all three patterns, participants' decisions to engage or not engage in exercise reflected efforts to maintain continuities of self and valued social or physical activities. We argue that rather than simply focusing on barriers and facilitators, we need to situate older adults' decisions regarding exercise in the context of continuities of self.