Modifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysis

Abstract Objectives To identify the modifiable determinants targeted in interventions involving older adults, and to determine which of these interventions effectively increased physical activity (PA) and/or reduced sedentary behaviour (SB). Additionally, to explore whether the effects of these inte...

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Main Authors: Simone Ciaccioni, Sofie Compernolle, Maren Lerfald, Federico Palumbo, Floriana Fadda, Ginevra Toma, Selcuk Akpinar, Katja Borodulin, Emine Caglar, Greet Cardon, Murat Cenk Celen, Joanna Cieślińska-Świder, Cristina Cortis, Andrea Di Credico, Murat Emirzeoğlu, Andrea Fusco, Daniel Gallardo Gómez, Linn Marita Hagen, Ayda Karaca, Mohammed Khudair, Marianna De Maio, Paul Jarle Mork, Livia Oddi, Kandianos Emmanouil Sakalidis, Petru Sandu, Sevil Turhan, Wei Wang, Melda Pelin Yargıç, Ekaterina Zotcheva, Laura Capranica, Ciaran MacDonncha, Linda Ernstsen
Format: Article
Language:English
Published: BMC 2025-05-01
Series:European Review of Aging and Physical Activity
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Online Access:https://doi.org/10.1186/s11556-025-00373-y
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author Simone Ciaccioni
Sofie Compernolle
Maren Lerfald
Federico Palumbo
Floriana Fadda
Ginevra Toma
Selcuk Akpinar
Katja Borodulin
Emine Caglar
Greet Cardon
Murat Cenk Celen
Joanna Cieślińska-Świder
Cristina Cortis
Andrea Di Credico
Murat Emirzeoğlu
Andrea Fusco
Daniel Gallardo Gómez
Linn Marita Hagen
Ayda Karaca
Mohammed Khudair
Marianna De Maio
Paul Jarle Mork
Livia Oddi
Kandianos Emmanouil Sakalidis
Petru Sandu
Sevil Turhan
Wei Wang
Melda Pelin Yargıç
Ekaterina Zotcheva
Laura Capranica
Ciaran MacDonncha
Linda Ernstsen
author_facet Simone Ciaccioni
Sofie Compernolle
Maren Lerfald
Federico Palumbo
Floriana Fadda
Ginevra Toma
Selcuk Akpinar
Katja Borodulin
Emine Caglar
Greet Cardon
Murat Cenk Celen
Joanna Cieślińska-Świder
Cristina Cortis
Andrea Di Credico
Murat Emirzeoğlu
Andrea Fusco
Daniel Gallardo Gómez
Linn Marita Hagen
Ayda Karaca
Mohammed Khudair
Marianna De Maio
Paul Jarle Mork
Livia Oddi
Kandianos Emmanouil Sakalidis
Petru Sandu
Sevil Turhan
Wei Wang
Melda Pelin Yargıç
Ekaterina Zotcheva
Laura Capranica
Ciaran MacDonncha
Linda Ernstsen
author_sort Simone Ciaccioni
collection DOAJ
description Abstract Objectives To identify the modifiable determinants targeted in interventions involving older adults, and to determine which of these interventions effectively increased physical activity (PA) and/or reduced sedentary behaviour (SB). Additionally, to explore whether the effects of these interventions vary based on the implementation setting. Methods A search of randomized controlled trials (RCTs) and controlled trials (CTs) was performed in Medline, APA PsycArticles, SPORTDiscus, and Web of Science. Risk of bias assessment was performed with Cochrane’s tool. Modifiable determinants were narratively synthesized, and random-effects models were performed to meta-analyse studies reporting device-measured physical activity or sedentary behaviour. Moderator analyses were performed to investigate the role of implementation setting. Standardized between-group mean difference (SMD) with 95% confidence interval (CI) was used to indicate effect sizes. Results From 31,727 individual records, 52 eligible studies published between 2012–2022 were identified, 30 and 22 studies from community and health care settings, respectively. Determinants within the category physical health and wellbeing (n = 23) were most frequently reported while only one study reported determinants within a social or cultural context. Eighteen studies were included in the meta-analysis. Interventions targeting physical health and wellbeing revealed an increase in steps (SMD = 0.46; 95%CI: 0.15 to 0.77) and minutes of moderate-to-vigorous intensity physical activity (SMD = 0.41; 95%CI: 0.19 to 0.64) among intervention participants compared to controls, whereas interventions targeting psychological or behavioural determinants showed no between-group differences in steps (SMD = 0.10; 95%CI: -0.12 to 0.32) and moderate-to-vigorous intensity physical activity (SMD = 0.26; 95%CI: -0.24 to -0.75). Interventions targeting physical health and wellbeing showed significant heterogeneity (p < 0.0001; I2 = 73.10%). Subgroup analyses showed a significant effect on device-measured physical activity for the eight community-based interventions (SMD = 0.42; 95%CI: 0.07 to 0.77), while no significant effect was found for the eight studies performed in healthcare settings (SMD = 0.26; 95%CI; -0.10 to 0.62). Conclusion Interventions targeting physical health and wellbeing may increase PA in older adults, with community-based studies appearing more effective than studies in healthcare settings. The significant heterogeneity of study findings indicates that further research is needed to fully understand the influence of PA and SB determinants across settings, particularly those related to psychological, behavioural, social, and cultural factors. Systematic review registration PROSPERO: CRD42022287606.
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spelling doaj-art-f8bebe89babd4f5d8c005ddfd6407cd12025-08-20T01:52:25ZengBMCEuropean Review of Aging and Physical Activity1861-69092025-05-0122112210.1186/s11556-025-00373-yModifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysisSimone Ciaccioni0Sofie Compernolle1Maren Lerfald2Federico Palumbo3Floriana Fadda4Ginevra Toma5Selcuk Akpinar6Katja Borodulin7Emine Caglar8Greet Cardon9Murat Cenk Celen10Joanna Cieślińska-Świder11Cristina Cortis12Andrea Di Credico13Murat Emirzeoğlu14Andrea Fusco15Daniel Gallardo Gómez16Linn Marita Hagen17Ayda Karaca18Mohammed Khudair19Marianna De Maio20Paul Jarle Mork21Livia Oddi22Kandianos Emmanouil Sakalidis23Petru Sandu24Sevil Turhan25Wei Wang26Melda Pelin Yargıç27Ekaterina Zotcheva28Laura Capranica29Ciaran MacDonncha30Linda Ernstsen31Department of Education and Sport Sciences, Pegaso Telematic UniversityDepartment of Movement and Sports Sciences - Physical Activity and Health, Ghent UniversityDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Movement, Human and Health Sciences, Foro Italico University of RomeDepartment of Public Health, Farmacy and Medicine, Sapienza University of RomeDepartment of Physiology and Pharmacology “V. Erspamer”, Sapienza University of RomeDepartment of Physical Education and Sport Teaching, Faculty of Sport Sciences, Nevşehir Hacı Bektaş Veli UniversityAge InstituteDepartment of Physical Education and Sport Teaching, Faculty of Sport Sciences, Hacettepe UniversityDepartment of Movement and Sports Sciences - Physical Activity and Health, Ghent UniversityDepartment of Biophysics, Faculty of Medicine, Bursa Uludag UniversityDepartment of Physiotherapy of Movement Disorders and Sports Medicine, The Jerzy Kukuczka Academy of Physical Education in KatowiceDepartment of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Viale dell’UniversitàDepartment of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-PescaraDepartment of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karadeniz Technical UniversityDepartment of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-PescaraAndalusian Health Technology Assessment Area (AETSA), Progress and Health Public Foundation (FPS)Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Division of Physical Activity and Health, Department of Recreation, Faculty of Sport Sciences, Hacettepe UniversitySchool of Psychology, Cardiff UniversityDepartment of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Viale dell’UniversitàDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Information Engineering, Control and Management, Faculty of Information Engineering, Computer Science and Statistics, Sapienza University of RomeDepartment of Psychology, Northumbria UniversityNational Institute of Public Health in Romania- Regional Public Health CenterDepartment of Public Health, Karadeniz Technical University Medical FacultyDepartment of Sport and Exercise Sciences, Durham UniversityDepartment of Physiology, Faculty of Medicine, Ankara Medipol UniversityNorwegian National Centre for Ageing and Health, Vestfold Hospital TrustDepartment of Movement, Human and Health Sciences, Foro Italico University of RomeDepartment of Physical Education and Sport Sciences, Health Research Institute, University of LimerickDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Abstract Objectives To identify the modifiable determinants targeted in interventions involving older adults, and to determine which of these interventions effectively increased physical activity (PA) and/or reduced sedentary behaviour (SB). Additionally, to explore whether the effects of these interventions vary based on the implementation setting. Methods A search of randomized controlled trials (RCTs) and controlled trials (CTs) was performed in Medline, APA PsycArticles, SPORTDiscus, and Web of Science. Risk of bias assessment was performed with Cochrane’s tool. Modifiable determinants were narratively synthesized, and random-effects models were performed to meta-analyse studies reporting device-measured physical activity or sedentary behaviour. Moderator analyses were performed to investigate the role of implementation setting. Standardized between-group mean difference (SMD) with 95% confidence interval (CI) was used to indicate effect sizes. Results From 31,727 individual records, 52 eligible studies published between 2012–2022 were identified, 30 and 22 studies from community and health care settings, respectively. Determinants within the category physical health and wellbeing (n = 23) were most frequently reported while only one study reported determinants within a social or cultural context. Eighteen studies were included in the meta-analysis. Interventions targeting physical health and wellbeing revealed an increase in steps (SMD = 0.46; 95%CI: 0.15 to 0.77) and minutes of moderate-to-vigorous intensity physical activity (SMD = 0.41; 95%CI: 0.19 to 0.64) among intervention participants compared to controls, whereas interventions targeting psychological or behavioural determinants showed no between-group differences in steps (SMD = 0.10; 95%CI: -0.12 to 0.32) and moderate-to-vigorous intensity physical activity (SMD = 0.26; 95%CI: -0.24 to -0.75). Interventions targeting physical health and wellbeing showed significant heterogeneity (p < 0.0001; I2 = 73.10%). Subgroup analyses showed a significant effect on device-measured physical activity for the eight community-based interventions (SMD = 0.42; 95%CI: 0.07 to 0.77), while no significant effect was found for the eight studies performed in healthcare settings (SMD = 0.26; 95%CI; -0.10 to 0.62). Conclusion Interventions targeting physical health and wellbeing may increase PA in older adults, with community-based studies appearing more effective than studies in healthcare settings. The significant heterogeneity of study findings indicates that further research is needed to fully understand the influence of PA and SB determinants across settings, particularly those related to psychological, behavioural, social, and cultural factors. Systematic review registration PROSPERO: CRD42022287606.https://doi.org/10.1186/s11556-025-00373-yExerciseInactiveInterventionsRandomized controlled trialsControlled trialsCommunity-dwelling older adults
spellingShingle Simone Ciaccioni
Sofie Compernolle
Maren Lerfald
Federico Palumbo
Floriana Fadda
Ginevra Toma
Selcuk Akpinar
Katja Borodulin
Emine Caglar
Greet Cardon
Murat Cenk Celen
Joanna Cieślińska-Świder
Cristina Cortis
Andrea Di Credico
Murat Emirzeoğlu
Andrea Fusco
Daniel Gallardo Gómez
Linn Marita Hagen
Ayda Karaca
Mohammed Khudair
Marianna De Maio
Paul Jarle Mork
Livia Oddi
Kandianos Emmanouil Sakalidis
Petru Sandu
Sevil Turhan
Wei Wang
Melda Pelin Yargıç
Ekaterina Zotcheva
Laura Capranica
Ciaran MacDonncha
Linda Ernstsen
Modifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysis
European Review of Aging and Physical Activity
Exercise
Inactive
Interventions
Randomized controlled trials
Controlled trials
Community-dwelling older adults
title Modifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysis
title_full Modifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysis
title_fullStr Modifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysis
title_full_unstemmed Modifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysis
title_short Modifiable determinants of older adults’ physical activity and sedentary behavior in community and healthcare settings: a DE-PASS systematic review and meta-analysis
title_sort modifiable determinants of older adults physical activity and sedentary behavior in community and healthcare settings a de pass systematic review and meta analysis
topic Exercise
Inactive
Interventions
Randomized controlled trials
Controlled trials
Community-dwelling older adults
url https://doi.org/10.1186/s11556-025-00373-y
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