Barriers and motivators to undertaking physical activity in adults over 70-a systematic review of the quantitative literature

Alixe H M Kilgour; Matthew Rutherford; Joanna Higson; Samantha J Meredith; Jessica McNiff; Stephanie Mitchell; Anusan Wijayendran; Stephen E R Lim; Susan D Shenkin

doi:10.1093/ageing/afae080

Barriers and motivators to undertaking physical activity in adults over 70-a systematic review of the quantitative literature

Age Ageing. 2024 Apr 1;53(4):afae080. doi: 10.1093/ageing/afae080.

Authors

Alixe H M Kilgour¹, Matthew Rutherford², Joanna Higson³, Samantha J Meredith⁴, Jessica McNiff³, Stephanie Mitchell³, Anusan Wijayendran², Stephen E R Lim⁴, Susan D Shenkin^{1

5}

Affiliations

¹ Ageing and Health Research Group, Usher Institute, University of Edinburgh, UK.
² University of Edinburgh Medical School, UK.
³ Department of Medicine of the Elderly, NHS Lothian, UK.
⁴ Academic Geriatric Medicine, NIHR Applied Research Collaboration Wessex, University of Southampton, UK.
⁵ Advanced Care Research Centre, Usher Institute, University of Edinburgh, UK.

Abstract

Background: Physical activity (PA) has multiple benefits for older adults (≥70 years old). Despite this many older adults do not undertake the World Health Organisation guideline recommended amount of PA. This systematic review examines barriers and motivators to PA in adults aged ≥70 years.

Methods: We analysed the quantitative literature, including observational studies and baseline data from randomised controlled trials. Studies examining specific diseases (e.g. cognitive impairment), or care home residents were excluded. Database searches of ASSIA, CINAHL, Embase, Medline, PsycINFO and Web of Science were undertaken on 7 March 2023. Quality assessment was performed using the ROBANS tool. We synthesised the results using the socioecological model. The protocol was registered on PROSPERO (CRD42021160503).

Results: We identified 37 papers, n = 26,961, age 70-101 years (median 78), 62% female. We undertook a narrative review; meta-analysis was not possible. Overall risk of bias was low. A total of 23 studies addressed barriers, seven motivators, seven both. The most cited barriers were: concern about physical health/fitness (14 studies), lack of motivation/interest (13 studies), fear of falls/history of falling (11 studies) and environmental barriers (10 studies). Key motivators were: support from family/friends (five studies), social interaction (five studies), personal benefits (five studies) and outside facilities (five studies). Results varied across gender, age, functional ability and geographical location.

Discussion: To maximise PA in older adults, important modifiable factors identified in this review should be targeted: support from healthcare professionals; reducing fear of falls; and prioritising ease of access and safety of outdoor facilities. When considering future policy, a person-centred, age group appropriate approach will have the most impact.

Keywords: barriers; facilitators; older adults; older people; physical activity; systematic review.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Aged
Aged, 80 and over
Exercise* / psychology
Female
Humans
Male
Motivation*

Abstract

Publication types

MeSH terms

Grants and funding