Comparison of national and international sedentary behaviour and physical activity guidelines for older adults: A systematic review and quality appraisal with AGREE II

Amy Huang; Ellen Wang; Stephanie Sanger; Alexandra Papaioannou; Isabel B Rodrigues

doi:10.1371/journal.pone.0294784

Comparison of national and international sedentary behaviour and physical activity guidelines for older adults: A systematic review and quality appraisal with AGREE II

PLoS One. 2023 Nov 27;18(11):e0294784. doi: 10.1371/journal.pone.0294784. eCollection 2023.

Authors

Amy Huang¹, Ellen Wang^{2

3}, Stephanie Sanger⁴, Alexandra Papaioannou^{1

5}, Isabel B Rodrigues^{1

6}

Affiliations

¹ Department of Medicine, McMaster University, Hamilton, ON, Canada.
² Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
³ Arthritis Research Canada, Vancouver, BC, Canada.
⁴ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
⁵ Health Sciences Library, McMaster University, Hamilton, ON, Canada.
⁶ Knowledge Translation Program, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Abstract

Most older adults 65 years and older accumulate over 8.5 hours/day of sedentary time, which is associated with increased risk of metabolic syndromes and falls. The impact of increased sedentary time in older adults has prompted development of sedentary behaviour guidelines. The purpose of our review was to compare national and international sedentary behaviour and physical activity guidelines for older adults and appraise the quality of guidelines using AGREE II. We conducted our search in Medline, Embase, Global Health, Web of Science, CINAHL, and relevant grey literature. We included the most recent guidelines for older adults written in English. We identified 18 national and international guidelines; ten of the 18 guidelines included sedentary behaviour recommendations while all 18 included physical activity recommendations for older adults. The ten sedentary behaviour guidelines were developed using cohort studies, knowledge users' opinions, systematic reviews, or other guidelines while the physical activity guidelines were developed using randomized controlled trials, systematic reviews, meta-analysis, and overview of reviews. The definition of sedentary behaviour and the recommendations were inconsistent between the guidelines and were based on very low to low quality and certainty of evidence. All guidelines provided consistent recommendations for aerobic and resistance training; the recommendations were developed using moderate to high quality and certainty of evidence. Only eight physical activity guidelines provided recommendations for balance training and six on flexibility training; the balance training recommendations were consistent between guidelines and based on moderate quality evidence. Further work is needed to develop evidenced-based sedentary behaviour recommendations and flexibility training recommendations for older adults.

Copyright: © 2023 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Systematic Review

MeSH terms

Aged
Exercise
Health Promotion
Humans
Practice Guidelines as Topic*
Resistance Training*
Sedentary Behavior*

Grants and funding

We received financial support from the Hamilton Health Sciences New Investigators Fund, AGE-WELL-McMaster Institute for Research on Aging (MIRA) Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.