Modifiable determinants of physical activity behaviors in older adults: A DE-PASS systematic review and meta-analysis
Abstract Overview
Background. Despite the well-established benefits of physical activity, older adults are often insufficiently physically active and tend to engage in excessive sedentary behavior, necessitating an evaluation of modifiable determinants.
Purpose. This systematic review with meta-analysis aims to identify best-evidence statements on modifiable determinants influencing physical activity and sedentary behavior among older adults through a comprehensive evidence assessment.
Methods. A systematic search was conducted across PubMed, EBSCOhost, and Web of Science. Eligible studies included (randomized) controlled trials addressing modifiable determinants of physical activity or sedentary behavior among older adults (≥ 65 years). Methodological quality was assessed using Cochrane’s RoB2.0, and meta-analysis was performed using random effects models with standardized mean differences (SMD) for device-based steps, moderate-to-vigorous physical activity and sedentary behavior.
Results. Fifty-two intervention studies met the inclusion criteria. Meta-analysis of the postintervention differences revealed that interventions focusing on physical health and wellbeing determinants are associated with an increase in the number of steps (SMD=0.46, 95%CI=0.15 to 0.77) and in minutes of moderate-to-vigorous physical activity (SMD=0.41, 95%CI=0.19 to 0.64) compared to the control condition, whereas interventions focusing on psychological or behavioral determinants revealed no differences in steps (SMD=0.12, 95%CI=-0.12 to 0.32) and moderate-to-vigorous physical activity (SMD=0.26, 95%CI=-0.24 to 0.75). Interventions focusing on physical health and wellbeing determinants showed significant heterogeneity (I2=90.8%, Q=196.46, p<0.001 and I2=61.6%, Q=28.68, p<0.01, respectively), but moderation analysis based on setting (community vs healthcare) did not reveal significant results (χ2(1)=2.00, p=0.16 and χ2(1)=0.99, p=0.32). No significant reductions were observed in sedentary behavior.
Conclusions. Despite the high heterogeneity, our meta-analysis suggests that interventions focusing on physical health and wellbeing can effectively enhance physical activity in older adults.
Practical implications. Addressing the knowledge gap, future research should prioritize randomized controlled trials exploring the impact of modifying psychological, behavioral, and social-cultural determinants on older adults' activity levels.
Funding: COST Action CA19101
Additional Authors
Name: Simone Ciaccioni
Affiliation: Department of Movement, Human and Health Sciences, Division of Human Movement and Sport Sciences, University of Rome “Foro Italico”, Rome, Italy.
Presenting Author: no
Name: Maren Lerfald
Affiliation: Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway, and Clinic of Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
Presenting Author: no
Name: Federico Palumbo
Affiliation: Department of Movement, Human and Health Sciences, Division of Human Movement and Sport Sciences, University of Rome “Foro Italico”, Rome, Italy
Presenting Author: no
Name: Floriana Fadda
Affiliation: Department of Public Health, Farmacy and Medicine, University of Rome La Sapienza, Rome, Italy
Presenting Author: no
Name: Ginevra Toma
Affiliation: Department of Public Health, Farmacy and Medicine, University of Rome La Sapienza, Rome, Italy
Presenting Author: no
Name: Christina Cortis
Affiliation: Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Cassino, Italy
Presenting Author: no
Name: Paul Jarle Mork
Affiliation: Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
Presenting Author: no
Name: Laura Capranica
Affiliation: Department of Movement, Human and Health Sciences, Division of Human Movement and Sport Sciences, University of Rome “Foro Italico”, Rome, Italy
Presenting Author: no
Name: Ciaran Mac Donncha
Affiliation: Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
Presenting Author: no
Name: Linda Ernstsen
Affiliation: Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
Presenting Author: no
Information
Study Type: Intervention
Subtheme: Other (please specify)
Population Group: Older Adults
Setting: Community, Healthcare
Submitting Author
Sofie Compernolle
Postdoctoral researcher
Ghent University
Belgium
