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Factors that influence older adults’ participation in physical activity: a systematic review of qualitative studies

2023/08/01 by Samantha Meredith, Samantha J Meredith, Natalie Cox +14 · 231 citations
Health Professions · Medicine · Nursing · Psychology · #Alternative medicine #Balance, Gait, and Falls Prevention #Cognition #Critical appraisal #Focus group #Gerontology #Medicine #Motivation and Self-Concept in Sports #Neighbourhood (mathematics) #Nursing #Physical Activity and Health #Psychological intervention #Psychology #Qualitative research #Rigour

paper · pdf · doi:10.1093/ageing/afad145

published in Age and Ageing 52(8) (Oxford University Press)

openalex publication_date 2023/08/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/04

Abstract

BACKGROUND: Despite the advantages of physical activity (PA), older adults are often insufficiently active to maximise health. Understanding factors that influence PA engagement will support well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adults' engagement in PA. METHODS: We searched six electronic databases for studies of community-dwelling older adults (≥70 years) including qualitative methods. We excluded studies of a single-disease group, individuals with cognitive impairment and care home residents. Methodological rigour was assessed with the Critical Appraisal Skills Programme, and framework synthesis was applied using the Capability Opportunity Motivation-Behaviour (COM-B) model, which hypothesises that behaviour is influenced by three factors: capability, opportunity and motivation. RESULTS: Twenty-five studies were included in the review (N = 4,978; mean 79 years) and 32 themes were identified. Older adults' capability was influenced by functional capacity (e.g. strength) and perceived risk of injury from PA (e.g. falls). Opportunity was impacted by the environment 'fit' (e.g. neighbourhood safety), the availability of social interaction and socio-cultural ageing stereotypes. PA was motivated by identifying as an 'exerciser', health gains and experiencing positive emotions (e.g. enjoyment), whereas negative sensations (e.g. pain) reduced motivation. CONCLUSIONS: The qualitative synthesis showcased a complex web of interacting factors influencing PA between the sub-domains of COM-B, pinpointing directions for intervention, including a focus on whole systems approaches. There was a lack of research exploring PA influences in the oldest old and in low-income countries. Future research should seek to involve under-served groups, including a wider diversity of older people.

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