The acceptability of physical activity interventions to older adults: A systematic review and meta-synthesis

Devereux-Fitzgerald, Angela; Powell, Rachael; Dewhurst, Anne; French, David P.

doi:10.1016/j.socscimed.2016.04.006

Cited by 239 publications

(256 citation statements)

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“…For question (3) on barriers and facilitators to PA, nine qualitative systematic reviews met the inclusion criteria with a median of 10 (range = 4–132) primary studies and 22,413 participants [48–57]. Of these, five reviewed purely qualitative studies [48, 49, 51, 54, 56], while the rest included a mixture of studies [50, 52, 53, 57]. …”

Section: Resultsmentioning

confidence: 99%

“…Nine qualitative reviews explored barriers, facilitators and influences of physical activity (PA) uptake among older adults [48–54, 56, 57]. Three reviews [49–51] investigated barriers and facilitators (B&F) to the uptake of falls prevention exercise programmes, one review focused on recreational PA [48], one explored sports activities [53], while the final two explored PA in general [52, 54].…”

Section: Resultsmentioning

confidence: 99%

“…Three reviews [49–51] investigated barriers and facilitators (B&F) to the uptake of falls prevention exercise programmes, one review focused on recreational PA [48], one explored sports activities [53], while the final two explored PA in general [52, 54]. Two reviews explored the perceptions of older adults towards PA participation and the acceptability of PA interventions [56, 57]. One review explored facilitators and barriers among South Asian older adults [54], while another review explored PA uptake among older adults after retirement [48].…”

Section: Resultsmentioning

confidence: 99%

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Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context

Olanrewaju¹,

Kelly²,

Cowan³

et al. 2016

PLoS ONE

180

136

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BackgroundThe promotion and maintenance of higher physical activity (PA) levels in the older population is an imperative for cognitive and healthy ageing but it is unclear what approaches are best suited to achieve this for the increasing number of older people living in the community. Effective policies should be informed by robust, multi-disciplinary and multi-dimensional evidence, which not only seeks what works, but in ‘what context? In addition to evidence on the efficacy and effectiveness of PA for maintaining cognitive health, social contexts such as ‘how do we actually get older people to partake in PA?’ and ‘how do we sustain that activity long-term?’ also need highlighting. This review is part of a comprehensive evidence synthesis of preventive interventions in older age, with a focus on healthy behaviours to identify evidence gaps and inform policy relating to ageing well and cognitive health. An overview of systematic reviews of PA was conducted to explore three topics: (1) PA efficacy or effectiveness for primary prevention of cognitive decline in 55+; (2) Interventions efficacious or effective for increasing PA uptake and maintenance in 55+; (3) barriers and facilitators to PA in 55+.MethodsMultiple databases were searched for studies in English from OECD countries between 2000 and 2016. Quality of included reviews in questions (1) and (2) were assessed using AMSTAR. Review protocols were registered on PROSPERO (CRD42014015554, 42014015584, CRD42014015557) and reviews follow PRISMA guideline.FindingsOverall, 40 systematic reviews were included. Question 1 (n = 14). 8,360 participants. Evidence suggests that PA confer mild positive effects on cognition in older adults with and without previous cognitive impairment. However, there is insufficient evidence of a dose-response relationship. Evidence on the effects of PA on delay of dementia onset is inconclusive. Question 2 (n = 17). 79,650 participants. Evidence supports the effectiveness of a variety of interventions, including group delivered, centre-based and cognitive approaches on short-term uptake of PA behaviour. Question 3 (n = 9). 22,413 participants. Barriers include health status, previous PA habits and experiences, and cultural sensitivity, while facilitators include enjoyable activities and convenient scheduling.ConclusionPA can offer small benefits to brain health, but evidence on how much activity is required to produce this effect is lacking. Evidence on the effectiveness of PA for preventing dementia and cognitive decline is lacking. Behavioural (walking, exercise) and cognitive (counselling and motivational interviews) interventions are effective for short-term uptake of physical activity in older people. In order to maintain long-term participation in PA, individualised interventions modelled using behavioural theories may be required. Public health messages should be aimed at promoting acceptable levels of PA above normal daily activities in older people. Policy and strategies aimed at increasing PA in older people should be encourag...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context

Olanrewaju¹,

Kelly²,

Cowan³

et al. 2016

PLoS ONE

180

136

View full text Add to dashboard Cite

show abstract

“…Even older individuals who do receive referrals to exercise programs or other falls interventions may not participate, due to lack of social support or lack of education or lack of involvement in decision-making about the interventions (Stevens et al, 2010). Individuals may not participate in exercise programs, for instance, due to concerns about medical problems, pain, fear of injury, or lack of interest; this may be particularly true of depressed older individuals (Devereux-Fitzgerald et al, 2016; Taylor & Pescatello, 2016). …”

Section: Discussionmentioning

confidence: 99%

Depressive symptomatology and fall risk among community-dwelling older adults

Hoffman

Wallace

Shapiro³

et al. 2017

Social Science & Medicine

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Rationale Falls are common among older adults and may be related to depressive symptoms (DS). With advancing age, there is an onset of chronic conditions, sensory impairments, and activity limitations that are associated with falls and with depressive disorders. Prior cross-sectional studies have observed significant associations between DS and subsequent falls as well as between fractures and subsequent clinical depression and DS. Objective The directionality of these observed relationship between falls and DS is in need of elaboration given that cross-sectional study designs can yield biased estimates of the DS-falls relationship. Methods Using 2006–2010 Health and Retirement Study data, cross-lagged panel structural equation models were used to evaluate associations between falls and DS among 7,233 community-dwelling adults ages ≥65. Structural coefficients between falls and DS (in 2006➔2008, 2008➔2010) were estimated. Results A good-fitting model was found: Controlling for baseline (2006) physical functioning, vision, chronic conditions, and social support and neighborhood social cohesion, falls were not associated with subsequent DS, but a 0.5 standard deviation increase in 2006 DS was associated with a 30% increase in fall risk two years later. This DS-falls relationship was no longer significant when use of psychiatric medications, which positively associated with falls, was included in the model. Conclusion Using sophisticated methods and a large U.S. sample, we found larger magnitudes of effect in the DS-falls relationship than in prior studies—highlighting the risk of falls for older adults with DS. Medical providers might assess older individuals for DS as well as use of psychotropic medications as part of a broadened falls prevention approach. National guidelines for fall risk assessments as well as quality indicators for fall prevention should include assessment for clinical depression.

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“…To date, there is a dearth of research employing the TTM to examine the efficacy of WATbased interventions to increase physical activity among older adults [34][35]. We apply the model to compare how older adults aged 65 and older in different WAT use stages (nonusers, short-term, long-term, and former users) think about their physical activity level in relation to WAT use, what processes of change they undergo, and how they weigh pros and cons of WAT use.…”

Section: Transtheoretical Model (Ttm) Of Behavior Changementioning

confidence: 99%

The Use of Wearable Activity Trackers Among Older Adults: Focus Group Study of Tracker Perceptions, Motivators, and Barriers in the Maintenance Stage of Behavior Change (Preprint)

Kononova¹,

Li²,

Kamp³

et al. 2018

Preprint

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Background: Physical activity benefits older adults by protecting against morbidity and mortality. Wearable activity trackers (WATs) offer the opportunity to increase physical activity through continuous monitoring. We explore the nuances of WAT use and adoption among older adults using the transtheoretical model (TTM) of behavior change. Objective: We investigate older adults' perceptions and uses of WATs in different stages of WAT adoption. Method: Data for the research come from 10 focus groups. The first set of focus groups was with participants who had never used WATs. These focus groups included a WAT trial. Other focus groups (without the trial) were conducted with short-term, long-term, and former WAT users. Results: Older adults in different WAT use stages liked and wished for different WAT features, with long-term users being the most diverse and sophisticated users of WATs. Long-term users had developed a habit of WAT use while other participants needed to employ various encouragement strategies. Social support, with the focus on collaboration, was the primary motivator for long-term users, while short-term and former users focused on competition, and non-users engaged in vicarious WAT use experiences. Finally, longterm users were more likely to see benefits of WATs while other participants focused on obstacles related to WAT use. Conclusion: WATs may be an effective technology to encourage physical activity among older adults. Yet, WATs alone are not likely to be successful in changing behavior. Tailored approaches based on the TTM stage of change as well as motivations, facilitators, and specific WAT characteristics that are important for older adults will ensure successful longterm use.Keywords: older adults, wearable activity trackers, Transtheoretical Model, physical activity, focus groups IntroductionThe focus of the present study is on exploring the nuances of adopting wearable activity trackers (WATs) in the population of adults who are 65 years of age or older using the transtheoretical model of behavior change (TTM) [1]. Academic and industry research has shown that the use of WATs can increase physical activity through continuous monitoring of activity progress [2][3]. Physical activity is beneficial for older adults due to its protective power against chronic diseases, many of which increase with older age [4].Despite the evident benefits of WATs for older generations, digital care today is more available to younger populations, leaving older adults on the periphery of the industry [5]. 1As little as 7% of older adults owned an activity tracker in 2014 [6]. Only a few studies have been done to understand how and why older adults use WATs and why they choose not to use or stop using this wearable technology [7][8][9].Even if individuals decide to use WATs, it does not guarantee that they will continue using them on a long-term basis. One in three WAT users of all adult ages stop using the device within six months after purchase [10][11]. Length of use is correlated with age, with th...

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The acceptability of physical activity interventions to older adults: A systematic review and meta-synthesis

Abstract: To increase engagement, interventions should focus on physical activity as a fun, sociable, achievable pastime for older adults with relevant short-term benefits.

Cited by 239 publications

References 22 publications

Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context

Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context

Depressive symptomatology and fall risk among community-dwelling older adults

The Use of Wearable Activity Trackers Among Older Adults: Focus Group Study of Tracker Perceptions, Motivators, and Barriers in the Maintenance Stage of Behavior Change (Preprint)

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