Abstract
BackgroundThe health benefits of regular physical activity and exercise have been widely acknowledged. Unfortunately, a decline in physical activity is observed in older adults. Knowledge of the determinants of physical activity (unstructured activity incorporated in daily life) and exercise (structured, planned and repetitive activities) is needed to effectively promote an active lifestyle. Our aim was to systematically review determinants of physical activity and exercise participation among healthy older adults, considering the methodological quality of the included studies.MethodsLiterature searches were conducted in PubMed/Medline and PsycINFO/OVID for peer reviewed manuscripts published in English from 1990 onwards. We included manuscripts that met the following criteria: 1) population: community dwelling healthy older adults, aged 55 and over; 2) reporting determinants of physical activity or exercise. The outcome measure was qualified as physical activity, exercise, or combination of the two, measured objectively or using self-report. The methodological quality of the selected studies was examined and a best evidence synthesis was applied to assess the association of the determinants with physical activity or exercise.ResultsThirty-four manuscripts reporting on 30 studies met the inclusion criteria, of which two were of high methodological quality. Physical activity was reported in four manuscripts, exercise was reported in sixteen and a combination of the two was reported in fourteen manuscripts. Three manuscripts used objective measures, twenty-two manuscripts used self-report measures and nine manuscripts combined a self-report measure with an objective measure. Due to lack of high quality studies and often only one manuscript reporting on a particular determinant, we concluded "insufficient evidence" for most associations between determinants and physical activity or exercise.ConclusionsBecause physical activity was reported in four manuscripts only, the determinants of physical activity particularly need further study. Recommendations for future research include the use of objective measures of physical activity or exercise as well as valid and reliable measures of determinants.
Highlights
The health benefits of regular physical activity and exercise have been widely acknowledged
EX was reported in 16 manuscripts [22,24,25,28,29,31,32,33,34, 36,37,38,40,42,43,45] and a combination of physical activity (PA) and EX (PA/EX) was reported in 14 manuscripts [13,14,16,17,18,19,20,21, 26,27,30,39,41,44]
This was mainly due to multiple low quality studies reporting inconsistent findings, lack of high quality studies, and often only one manuscript reporting on a particular determinant
Summary
The health benefits of regular physical activity and exercise have been widely acknowledged. Knowledge of the determinants of physical activity (unstructured activity incorporated in daily life) and exercise (structured, planned and repetitive activities) is needed to effectively promote an active lifestyle. Our aim was to systematically review determinants of physical activity and exercise participation among healthy older adults, considering the methodological quality of the included studies. Even though regular physical activity (PA: unstructured activities incorporated in daily life) and participation in exercise (EX: structured and planned activities) have many health benefits, levels of PA and EX decrease with increasing age [1]. The age related decline in physical capacity is experienced as an increased effort needed to Recent literature reviews on determinants of PA and EX in older adults have included Randomized Controlled Trials (RCTs) and prospective studies to draw conclusions on causal relationships [6,7]. Van Stralen and colleagues [7] explored determinants of initiation and maintenance of physical activity among older adults and suggested that determinants are partly phase-specific and differ for initiating (up to six months) or maintaining (more than six months) physical activity
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