Abstract
ObjectivesWhile there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old.MethodsMajor databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes.ResultsOf 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended).ConclusionThe evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies and BCTs might be less suitable for older adults than motivators more meaningful to them, including social and environmental support, and enjoyment coming from being physically active. A whole system-oriented approach is required that is tailored to meet the needs of older adults and aligned with social, individual and environmental factors.
Highlights
There is considerable and consistent evidence that regular participation in physical activity (PA) has physical and mental health benefits for people of any age [1,2]
The current review suggests that multi-modal and multi-component interventions have the potential to be effective at increasing physical activity of older adults living in the community
While our review confirms the Physical activity promotion for community dwelling older adults already robust evidence that person-centeredness is important for enhanced benefits of PA promotion, we found that direct contact with participants does not seem necessary while tailoring and individualisation seems to be more beneficial when focused on environmental mediators rather than on psychosocial mediators alone
Summary
There is considerable and consistent evidence that regular participation in physical activity (PA) has physical and mental health benefits for people of any age [1,2]. Guideline recommendations suggest that older people should participate in at least 150 minutes of moderate PA per week [9,10,11], in addition to aerobic and strengthening exercise, and to sit less, to achieve health benefits. UK Health surveys from the four UK nations show that 43–77% of men and 48–85% of women aged 65–74 years are not meeting these guidelines and that proportion of inactive older adults increases with increasing age and in those with mobility impairment and disability. Similar trends are apparent in health surveys worldwide: only 20% of Canadians aged 60–79 meet the guideline of 10,000 steps per day [14] and prevalence of inactivity among Americans aged 65–74 reaches nearly 27% and increases to over 35% for those aged over 75 [15]
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