Barriers to and facilitators of physical activity among community-dwelling older adults: a systematic review

Abstract

Objective: This study aims to systematically review the evidence on barriers to and facilitators of physical activity (PA) engagement among community-dwelling older adults.

Design: Systematic review.

Data sources: Electronic databases MEDLINE, Embase, APA PsycINFO, SPORTDiscus, CINAHL Plus, AgeLine and Scopus were searched from their inception to 14 April 2024.

Eligibility criteria: Eligible studies were qualitative, quantitative or mixed-methods studies, published in English and investigating barriers to and/or facilitators of PA among independently living adults aged ≥65 years.

Data extraction and synthesis: Content analysis was performed using a narrative synthesis adapted from the socioecological model of health behaviour by three independent assessors. Barriers and facilitators were categorised into intrapersonal, interpersonal and environmental factors.

Results: Of 27 779 screened articles, 20 eligible studies were synthesised (11 qualitative, 1 mixed-method and 8 quantitative), with a total of 18 597 participants. The main barriers to PA included intrapersonal factors: fear of injury, pain, low motivation and lack of spare time; interpersonal factors: lack of social support and family obligations; environmental factors: poor weather, poor built environment/high cost accessing PA facilities. The main facilitators to PA included intrapersonal: health and well-being, fitness devices, better self-perceived body image, sense of bodily control and enjoyment; interpersonal: social support and having a partner/group/pet to engage in PA together; environmental: age-friendly built environment and access to PA programmes.

Conclusion: There are multiple barriers to and facilitators of PA engagement among community-dwelling older adults that should be considered by policy makers when designing PA programmes to help increase PA in older adults.

Prospero registration number: CRD42023417404.

Keywords: GERIATRIC MEDICINE; PUBLIC HEALTH; Physical Fitness; Systematic Review.