Considerations in Planning Physical Activity for Older Adults in Hot Climates: A Narrative Review

Abstract

Regular physical activity has multiple health benefits for both the prevention and management of disease, including for older adults. However, additional precautions are needed with ageing given physiological changes and the increasing prevalence of comorbidities. Hot ambient temperatures increase the risks of exercise at any age, but are particularly important given thermoregulatory changes in older people. This narrative review informs planning of physical activity programs for older people living in rural areas with very hot climates for a period of the year. A multi-database search of peer-reviewed literature was undertaken with attention to its relevance to Australia, starting with definitions and standard advice in relation to physical activity programming and the incremental limitations imposed by age, rurality, and extreme heat. The enablers of and barriers to increasing physical activities in older adults and how they can be modified for those living in extreme hot climates is described. We describe multiple considerations in program design to improve safety, adherence and sustaining physical activity, including supervision, simple instructions, provision of reminders, social support, encouraging self-efficacy. Group-based activities may be preferred by some and can accommodate special populations, cultural considerations. Risk management is an important consideration and recommendations are provided to assist program planning.

Physical literacy, health and interactive aging: a position paper

“…Over 295 publications were retrieved, however we limited our contextual readings to 55 based on their relevancy to our focus on PL, active aging, and health. These publications included: Five studies focused on the definitions and perspectives of PL ( 16 , 55 – 58 ), Six systematic reviews ( 7 , 9 , 15 , 21 , 59 , 60 ), Five scoping reviews ( 1 , 10 , 11 , 13 , 61 ), One integrated review ( 12 ), A narrative review ( 14 ), Twenty-six studies of healthy aging ( 7 , 8 , 10 , 14 , 15 , 18 , 22 , 62 – 80 ), Four articles addressing PL measurement and measuring tools [( 9 , 13 , 21 , 61 ); Robinson and Randall, 2017], Five articles on perceived PL instruments and questionnaires ( 81 – 85 ), and Two articles that posed new PL models for active aging ( 12 , 86 ). …”

“…Physical literacy (PL) is a widely accepted concept that aligns physical activity with cognitive, affective, and behavioural attributions (1)(2)(3)(4)(5)(6). It has been the focus of a large number of recent narrative, scoping and systematic reviews [e.g., (1,(7)(8)(9)(10)(11)(12)(13)(14)(15)]. Some of the recurring criticisms within these reviews have to do with the overemphasis on tying PL to the early and school-age years [e.g., (7); Edwards et al 2018], associating PL narrowly with acquiring a select number of fundamental "sport" skills [e.g., (6,(16)(17)(18)], and the challenge in assessing an attitude (19,20) by either breaking it into distinct parts or operationalizing it as an end-state PL determinant (1,21,22).…”

Climate change and healthy ageing: An assessment of the impact of climate hazards on older people

“…Increased greenspaces to protect against extreme temperatures, mitigate pollution, provide shade, and offer aesthetic spaces for multiple types of activities for older people [108,109] Ensure walking paths are smooth surfaced, and well-lit to mitigate falls and safety concerns [109] In areas prone to heatwaves, heat shelters around the community should offer both physical safety and areas for social connection [56] Transport and mobility Ensure strong transport networks for timely evacuation and aid delivery, particularly for older people [56] In flood-prone areas, roads could be fitted on either side with bioswales, which are mulched and vegetated channels that facilitate water runoffs [110] Energy and resource poverty Local governments/municipalities to introduce new technologies like solar panels to provide low-emission, clean-energy power to homes [111] Provide information, technological training, or finances to older people to access renewable energy, which may help mitigate climate change and secure energy sources [56] Agriculture, food, and water security Utilise and support older people's knowledge on how to deal with agricultural losses during extreme climatic events, such as planting different crops and changing farming techniques [56] Provide information and economic aid to more vulnerable older people to ensure food security [112] Provide information and training on recycling water, practicing adequate water storage techniques, and restricting excessive water use within the community [113] Health and social systems Adaption and contextualising of WHO 'Operational framework for building climate resilient health systems' for older people [114] Develop institutional policies and enhance the knowledge of health practitioners to facilitate the discussion of climate change with patients [115] Introduction of new technology, telehealth, remote monitoring, precision health, and artificial intelligence [116] Pathogen control Execute wider municipal programmes to control pathogen proliferation and improve sanitation to mediate the risk of CSID in older people [56] Public health programmes should be implemented in areas vulnerable to climate-sensitive vectors, educate older people and providers, and encourage behavioural changes Maintaining the quality and supply of community water sources is important for older people who are vulnerable to gastrointestinal illnesses.…”

Leveraging Mobile Technology for Public Health Promotion: A Multidisciplinary Perspective

“…External and internal characteristics can also be jointly personalized. For example, See and colleagues (91) review the literature to identify approaches to tailor a safe and effective physical activity intervention for older adults living in rural areas with hot climates by customizing the timing and nature of activity, along with providing hydration reminders.…”