Generations on the move: intergenerational exercise and health promotion

Background
In light of demographic and societal changes as well as increasing inactivity within the last decades, the intergenerational exercise setting has been gaining attraction as it possesses the potential to becoming an innovative strategy to promote physical activity in children and seniors. Nevertheless, the effects of such intergenerational exercise programs on physical and psychosocial health have not been examined yet.
Aim
This PhD project aimed to examine the effects of an intergenerational exercise intervention on physical and psychosocial health-outcomes in preschool children and residential seniors. In this regard, the effects of the exercise setting were compared to peer-group exercise and control conditions in both generations. Furthermore, specific research on the relationship between various health outcomes and physical activity in children and seniors were evaluated.
Methods
The Generations on the Move Study is a five-armed controlled trial with a 25-week physical exercise training intervention and pre- and post-intervention assessments. Six kindergartens with 68 healthy children and five senior homes with 47 residential seniors from Basel-Stadt and surroundings participated in this study. The kindergartens and senior homes were assigned either to an intergenerational (IG), a peer (PG) or a control group (CON). Children were assessed in gross motor skills (TGMD-2), jump performance, handgrip strength as well as micro- and macrovascular health. Social-emotional skills were assessed by kindergarten teachers with a questionnaire (KOMPIK). Seniors performed the Short Physical Performance Battery (SPPB), including gait speed. Central hemodynamics as well as arterial stiffness were also examined. Questionnaires assessing psychosocial wellbeing (SF-36; FES; AQoL-8) were filled in with staff. IG and PG received one comparable exercise session a week lasting 45 minutes for 25 weeks. The training sessions were conducted in the respective institutions, whereby IG children were accompanied to their partnering residence home. Both CON groups received no intervention and were asked to uphold daily habits. Measurements were performed before and after the intervention. Between group differences were calculated using linear regression models.
Results
Children: Our analyses show at least moderate improvements of IG over CON in most main physical performance parameters (0.45<d≤1.07) and no relevant differences in social-emotional skills (-0.12<d≤0.14). Compared to PG, IG showed moderate effects in gross motor skills (TGMD-2: d=0.58 [0.13;1.03]) and handgrip strength (d=0.66 [0.26;1.07]). Small effects for IG over PG were found in all social-emotional dimensions (0.25<d≤0.40).
Seniors: Moderate to very large improvements in IG compared to CON were found in all physical performance parameters (0.76<d≤2.53) as well as in markers of cardiovascular health (0.35<d≤0.56). Small to large differences in favor of IG over CON are compatible with data in all questionnaires (SF-36: d=0.94 [0.28;1.59]; FES: d=0.89 [0.21;1.58]; AQoL-8: d=1.20 [0.62;1.79]). Data comparing IG to PG show compatibility with trivial to at least moderate effects in favor of IG in SPPB (d=0.45 [0.04;0.86]), single task gait speed (d=0.40; [0.05;0.74]) and blood pressure (0.58<d≤0.63). IG showed moderate effects in general health score (d=0.68 [0.07;1.29]) and small to moderate effects over PG in all AQoL-8 dimensions (0.23<d≤0.51) whereby data is compatible with small to large effects.
Conclusion
Children in the intergenerational group show largest improvements in motor skills while intergenerational seniors benefit especially in functional mobility necessary for everyday life and psychosocial wellbeing. The intergenerational exercise setting is comparable and in certain dimensions superior to peer-group training and is, therefore, a promising strategy to promote physical performance parameters essential for lifelong fitness and health in children while simultaneously challenging their social-emotional learning skills. The maintenance and, more importantly, the improvements in physical health in seniors are very promising insights, speaking in favor of this setting, especially in combination with the improvements in mental health and quality of life. Future fields of research should examine the underlying mechanisms, long-term effects as well as different populations of children and seniors.