Revisiting self-regulatory techniques to promote physical activity in older adults: null-findings from a randomised controlled trial

Fear of Falling Carries Over into Overprotection in Old Age: A Cross-Lagged Panel Analysis

Fear of falling might result in overprotection by one's social environment. In turn, feeling dependent could increase fear of falling. However, the association between fear of falling and perceived overprotection and its temporal order is unknown. This longitudinal study explores this potential mutual longitudinal association. This study presents secondary analyses from a larger trial. We tested the association between fear of falling and perceived overprotection in a cross-lagged path model controlled for falls, health-related quality of life, age, gender, and trial condition. N = 310 participants (M = 70 years, range: 64-92) completed self-reports at Time 1, 7 (Time 2), and 11 weeks (Time 3) after baseline assessment. We found a positive association from fear of falling to perceived overprotection (β = .12, 95% CI[0.02, 0.21], p = .02; β = .10; [0.01, 0.18], p = .03). The reversed cross-lagged paths were not significant. Findings suggest higher fear of falling translates into perceived overprotection, which may in turn increase loss of independence in old age.

'Maintaining balance in life'-exploring older adults' long-term engagement in self-managed digital fall prevention exercise

BACKGROUND

Accidental falls are one of the greatest threats to older adults' health and well-being. The risk of falling can be significantly reduced with strength and balance interventions. However, there needs to be further knowledge into how older adults can be supported to achieve a maintained exercise behaviour. Therefore, the aim of this study was to explore factors that enabled older adults to maintain their exercise during a 1-year self-managed digital fall prevention exercise intervention.

METHODS

This study used a grounded theory methodology. Semi-structured individual interviews were conducted by phone or conference call. Eighteen community-dwelling older adults aged 70 years or more participated. The participants had a self-reported exercise dose of 60 min or more per week during the last three months of participation in a 12-months intervention of self-managed digital fall prevention exercise, the Safe Step randomized controlled trial. Open, axial, and selective coding, along with constant comparative analysis, was used to analyze the data.

RESULTS

The analysis resulted in a theoretical model. We found that the fall prevention exercise habits of adults were developed through three stages: Acting against threats to one's own identity, Coordinating strategies to establish a routine, and Forming habits through cues and evaluation. The main category of Maintaining balance in life encases the participants transition through the three stages and reflects balance in both physical aspects and in between activities in daily life. The process of maintaining balance in life and desire to do so were mediated both by intrinsic person-dependent factors and the Safe Step application acting as an external mediator.

CONCLUSION

This study identified three stages of how older adults developed self-managed fall prevention exercise habits, supported by a digital application. The generated theoretical model can inform future interventions aiming to support long-term engagement in digitally supported and self-managed fall prevention interventions.

The key values and factors identified by older adults to promote physical activity and reduce sedentary behaviour using co-production approaches: a scoping review

BACKGROUND

Inactivity and sedentary behaviour in older adults adversely impacts physical function, reduces social networks, and could contribute to population healthcare costs. To encourage and support the planning and uptake of physical activity by older adults, it is important to understand what physical activity means to older adults. Therefore, the aim of this scoping review was to collate what older adults have self-identified as the key factors for sustaining and increasing their physical activities.

METHODS

Arksey and O'Malley's Scoping Review framework was used to guide the review process. SCOPUS, ASSIA, PsychINFO and MEDLINE databases were searched. Studies were eligible for inclusion if they were peer-reviewed, the target population were older adults (aged 55 and above), co-production related research approaches were explicitly stated in the methods and there was a focus on design of physical activity interventions or products to support or enhance physical activity. Assets and values important for physical activity were first extracted from included studies and were subsequently thematically analysed. Themes are presented to provide an overview of the literature synthesis.

RESULTS

Sixteen papers were included in the analysis. Data from these papers were gathered via designing interventions or services (n = 8), products (n = 2), 'exergames' (n = 2) or mobile applications (n = 4). Outcomes were varied but common themes emerged across papers. Overarching themes identified by older adults were associated with a desire to increase activity when it was accessible, motivational, and safe. In addition, older adults want to enjoy their activities, want independence and representation, want to stay connected with families and friends, be outdoors, familiarity, activities to be tailored and resulting in measurable/observed progress.

CONCLUSIONS

Population demographics, personal attributes, and life experiences all affect preferences for physical activity. However, the key factors identified by older adults for increasing physical activity were common-even in separate co-production contexts. To promote physical activities in older adults, activities must fundamentally feel safe, provide a sense of social connectedness, be enjoyable and be accessible in terms of cost and ability.

What do older adults think about when formulating implementation intentions for physical activity? Evidence from a qualitative study

OBJECTIVES

Physical activity is an important health behaviour especially for older adults. Forming implementation intentions is an effective strategy to implement physical activity in daily life for young and middle-aged adults. However, evidence for older adults is inconclusive. This study explored the thoughts of older adults about implementation intentions and potential barriers and facilitators while formulating them.

METHODS

Three samples of older adults from the United Kingdom (n = 8), Germany (n = 9) and Switzerland (n = 17) were prompted to think aloud while formulating implementation intentions to be more physically active. After the task, semi-structured interviews were conducted. Data were analysed thematically.

RESULTS

Participants expressed pre-established thoughts about implementation intentions (e.g. they feel too restrictive). During the formulation of implementation intentions, several barriers to creating them were reported (e.g. problems with finding cues due to absence of recurring daily routines), but participants also mentioned that forming implementation intentions acted as a facilitator for physical activity (e.g. cues as useful reminders to be active, task itself triggering self-reflection about physical activity). After the task, participants reflected on circumstances that decrease the likelihood of enacting implementation intentions (e.g. spontaneous alternative activities, weather, health-related barriers, Covid-19-related barriers), which triggered spontaneous coping planning.

CONCLUSIONS

The results on barriers and facilitators of implementation intentions and physical activity from older adults' perspectives provide starting points for improving instructions for older adults on how to create implementation intentions for physical activity. Future studies are needed to investigate whether the findings extend to implementation intentions for other behaviours.

Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

IMPORTANCE

Unhealthful dietary patterns, low levels of physical activity, and high sedentary time increase the risk of cardiovascular disease.

OBJECTIVE

To synthesize the evidence on benefits and harms of behavioral counseling interventions to promote a healthy diet and physical activity in adults without known cardiovascular disease (CVD) risk factors to inform a US Preventive Services Task Force recommendation.

DATA SOURCES

MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials through February 2021, with ongoing surveillance through February 2022.

STUDY SELECTION

Randomized clinical trials (RCTs) of behavioral counseling interventions targeting improved diet, increased physical activity, or decreased sedentary time among adults without known elevated blood pressure, elevated lipid levels, or impaired fasting glucose.

DATA EXTRACTION AND SYNTHESIS

Independent data abstraction and study quality rating and random effects meta-analysis.

MAIN OUTCOMES AND MEASURES

CVD events, CVD risk factors, diet and physical activity measures, and harms.

RESULTS

One-hundred thirteen RCTs were included (N = 129 993). Three RCTs reported CVD-related outcomes: 1 study (n = 47 179) found no significant differences between groups on any CVD outcome at up to 13.4 years of follow-up; a combined analysis of the other 2 RCTs (n = 1203) found a statistically significant association of the intervention with nonfatal CVD events (hazard ratio, 0.27 [95% CI, 0.08 to 0.88]) and fatal CVD events (hazard ratio, 0.31 [95% CI, 0.11 to 0.93]) at 4 years. Diet and physical activity behavioral counseling interventions were associated with small, statistically significant reductions in continuous measures of blood pressure (systolic mean difference, -0.8 [95% CI, -1.3 to -0.3]; 23 RCTs [n = 57 079]; diastolic mean difference, -0.4 [95% CI, -0.8 to -0.0]; 24 RCTs [n = 57 148]), low-density lipoprotein cholesterol level (mean difference, 2.2 mg/dL [95% CI, -3.8 to -0.6]; 15 RCTs [n = 6350]), adiposity-related outcomes (body mass index mean difference, -0.3 [95% CI, -0.5 to -0.1]; 27 RCTs [n = 59 239]), dietary outcomes, and physical activity at 6 months to 1.5 years of follow-up vs control conditions. There was no evidence of greater harm among intervention vs control groups.

CONCLUSIONS AND RELEVANCE

Healthy diet and physical activity behavioral counseling interventions for persons without a known risk of CVD were associated with small but statistically significant benefits across a variety of important intermediate health outcomes and small to moderate effects on dietary and physical activity behaviors. There was limited evidence regarding the long-term health outcomes or harmful effects of these interventions.

Older adults' physical activity after lockdown: Testing the health action process approach and the moderating role of fear of Covid-19

The coronavirus pandemic has influenced many lives, particularly older adults'. Although isolation protects from infection, health behaviors like physical activity (PA) are important to reinstate after lockdown. However, fear of Covid-19 may act as a barrier, for example, by preventing people from going outside. Based on the health action process approach (HAPA), we investigated whether and why older adults' PA changed after lockdown, and whether fear of Covid-19 moderates the intention-behavior relationship. Participants of this longitudinal study aged 65+ from German-speaking Europe completed an online questionnaire about their PA, fear of Covid-19, and HAPA factors in April and May 2020. Data were analyzed using multiple linear regressions. Results showed that moderate to vigorous activity (MVPA) remained stable after lockdown and that self-efficacy most robustly influenced the intention to be active. PA was not explained by any volitional factor but was strongly related to past PA. Interestingly, the relationship of past and future MVPA was attenuated by fear of Covid-19, but this finding was not robust when outliers were removed. In conclusion, self-efficacy is the most important motivator for PA in older adults after an interruption like a lockdown. Strong physical activity habits may facilitate PA after a period of isolation.

The Effectiveness of Planning Interventions for Improving Physical Activity in the General Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Planning interventions such as action planning (AP) and coping planning (CP) have been recognized as influential strategies in promoting physical activity (PA), but mixed results of existing evidence have been observed. This study aims to perform a systematical meta-analysis to evaluate the efficacy of planning interventions for improving PA in the general population. Eight databases, including Medline, Embase, PsycINFO, Cochrane Library, Web of Science, ProQuest, CNKI, and Wanfang Data, were searched to locate relevant randomized controlled trials (RCTs) from their inception to 31 December 2021. In total, 41 trials with 5439 samples were included in this systematic review, and 35 trials were used in our meta-analysis. The results showed that PA was better promoted in the planned intervention group compared to the control group (SMD = 0.35, 95% CI = 0.25–0.44, I² = 61.4%). Based on the subgroup analyses, we found that planning strategies were more effective among patients, males, when adopting AP intervention, when using the face-to-face sessions delivery mode, and when reinforcements were conducted during the follow-up. The findings of this study indicate that planning interventions significantly improved PA behavior, and, in some contexts, the effects performed better. Future research needs to be conducted to explore the underlying mechanisms of planning interventions and validate their effects more extensively.

What makes implementation intentions (in)effective for physical activity among older adults?

OBJECTIVES

For most populations, implementation intentions (IIs) facilitate physical activity (PA). However, for older adults, previous studies found mixed evidence for the effectiveness of this behaviour change technique. To examine which characteristics of IIs predict successful enactment, the content of older participants' IIs formed within a self-regulatory intervention to prompt PA was analysed.

DESIGN

A sample of N = 126 German speaking adults aged 64 and older formed up to six IIs for PA and reported their enactment 5 weeks later.

METHODS

Controlling for age and sex, multilevel models tested associations between characteristics of IIs (e.g., chronological rank of II, hetero- and homogeneity, specificity, presence of certain cues) and enactment.

RESULTS

Significantly related to enactment were: the chronological rank of an II (first IIs superior to last IIs), greater heterogeneity in activities, greater specificity of when-cues, and greater use of pre-existing routines.

CONCLUSIONS

Participants were more likely to enact their IIs 5 weeks later if they planned different (heterogeneous) activities, created IIs with more specific when-cues (e.g., on Monday at 9 am), and in particular a routine (e.g., after breakfast). They also enacted the first three IIs (chronological rank of II) more often than the last three IIs. Future experimental studies should test whether providing instructions to create IIs based on the above significant characteristics lead to more effective health behaviour change among older adults.

Acute Bidirectional Relations Between Affect, Physical Feeling States, and Activity-Related Behaviors Among Older Adults: An Ecological Momentary Assessment Study

BACKGROUND

The majority of older adults are physically inactive; therefore, strategies are needed to effectively promote sustained engagement in physical activity.

PURPOSE

This study was designed to investigate acute bidirectional relationships between affective and physical feeling states and activity-related behaviors among older adults in the context of everyday life using Ecological Momentary Assessment (EMA).

METHODS

Older adults (n = 103, Mage = 72, Range: 60-98) participated in a 10-day study where they completed up to 6 smartphone-based EMA prompts/day. At each EMA prompt, participants reported their current positive and negative affect and physical feeling states. Participants wore an activPAL accelerometer to measure time spent standing and time spent stepping before and after the prompt. Separate multilevel random coefficient linear and logistic regression models examined these bidirectional relationships.

RESULTS

On occasions when older adults engaged in more standing and more stepping than was typical for them in the 15 and 30 min prior to the EMA prompt, they tended to report greater feelings of energy at the prompt. On occasions when older adults reported greater feelings of energy than was typical for them, they engaged in more standing and more stepping in the 15 and 30 min following the EMA prompt. Positive and negative affect was unrelated to activity-related behaviors.

CONCLUSIONS

Feelings of energy appear to be strongly linked to activity-related behaviors in older adults; however, this was not the case for positive or negative affect. These findings may have implications for optimal delivery of just-in-time intervention context based on affective states or current behaviors.

Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map

Background

By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value.

Objectives

This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence.

Search Methods

We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and ClinicalTrials.gov).

Selection Criteria

Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on-going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps.

Data Collection and Analysis

We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist.

Main Results

After de-duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews (n = 71, 59%) were rated low or critically low for methodological quality.The most common interventions were home-based rehabilitation for older adults (n = 276) and home-based health services for disease prevention (n = 233), mostly delivered by visiting healthcare professionals (n = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental function (n = 269) and neuromusculoskeletal function (n = 164). The most measured outcomes for functional ability were basic needs (n = 277) and mobility (n = 160). There were few studies which evaluated outcome domains of social participation, financial security, ability to maintain relationships and communication.There was a lack of studies in low- and middle-income countries (LMICs) and a gap in the assessment of health equity issues.

Authors' Conclusions

There is substantial evidence for interventions to promote functional ability in older adults at home including mostly home-based rehabilitation for older adults and home-based health services for disease prevention. Remotely delivered home-based services are of greater importance to policy-makers and practitioners in the context of the COVID-19 pandemic. This map of studies published prior to the pandemic provides an initial resource to identify relevant home-based services which may be of interest for policy-makers and practitioners, such as home-based rehabilitation and social support, although these interventions would likely require further adaptation for online delivery during the COVID-19 pandemic. There is a need to strengthen assessment of social support and mobility interventions and outcomes related to making decisions, building relationships, financial security, and communication in future studies. More studies are needed to assess LMIC contexts and health equity issues.

Do age stereotype-based interventions affect health-related outcomes in older adults? A systematic review and future directions

PURPOSE

Developing interventions that target population-specific motivational barriers to promote health behaviours is crucial, especially for older adults who are confronted with negative age stereotypes. This systematic review evaluates randomized and non-randomized field studies that tested the effects of age stereotype-based interventions on health outcomes in adults aged 50 years and over.

METHODS

MEDLINE, SPORTDiscus, Scopus, Web of Science Core Collection and PsychINFO were searched to identify articles published up until May 2019. Data were extracted from all articles independently and assessed for risk-of-bias using Cochrane Collaboration tools.

RESULTS

Ten articles met the inclusion criteria. Health-related outcome measures were identified across three domains: physical, psychological/psychosocial well-being, and quality of life/subjective health, with age stereotypes reported as an additional outcome. Intervention structure varied substantially between studies regarding content, duration, frequency, and length of follow-up.

CONCLUSIONS

Most studies showed that age stereotype-based interventions significantly improved physical function or physical activity as well as self-perceptions of ageing. However, more rigorous studies are needed. Indeed, given the detrimental health effects of age stereotypes, the potential for impact of interventions designed to challenge them is important. Future research should explore the implications of intervening on different stereotype mechanisms, whether intervention effects are comparable across health domains, and whether age stereotype-based interventions are more effective than non-age-specific interventions. PROSPERO Registration CRD42018094006.

Interventions Promoting Physical Activity Among Older Adults: A Systematic Review and Meta-Analysis

BACKGROUND AND OBJECTIVES

Frequent participation in physical activity (PA) has benefits across the lifespan but is particularly important for older adults. PA levels are either measured by objective or self-reported survey methods. Objective PA measurement is used to increase accuracy. This systematic review investigated the effect of physical activity-based interventions on objectively measured PA levels among community-dwelling adults aged 60 years and older.

RESEARCH DESIGN AND METHODS

Literature searches were conducted in five electronic databases and four clinical trial registries. Randomized controlled trials investigating the effect of physical activity-based interventions on objectively measured PA levels (e.g., accelerometers or pedometers) in community-dwelling adults aged 60 years and older compared with no/minimal intervention were considered eligible. Data were pooled using the most conservative estimates reported from each study using the standardized mean difference (SMD). Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the overall quality of the evidence.

RESULTS

Fourteen published trials and 3 ongoing trials were identified. There were significant effects favoring physical activity-based interventions compared with minimal intervention at short-term (less than or equal to 3 months) (SMD: 0.30, 95% CI: 0.17 to 0.43) and intermediate-term (more than 3 months and less than 12 months; SMD: 0.27, 95% CI: 0.06 to 0.49) follow-ups. The quality of evidence was moderate according to GRADE (downgraded for risk of bias).

DISCUSSION AND IMPLICATIONS

Our findings suggest that physical activity-based interventions may increase objectively measured PA levels in community-dwelling older adults. Further studies are still needed to identify the optimal dose, intensity, and mode of delivery of physical activity-based interventions.

Applying Social Cognition Models to Explain Walking Duration in Older Adults: The Role of Intrinsic Motivation

This study examined the applicability of the health action process approach (HAPA) to walking duration in older adults and the added value of extending the HAPA by intrinsic motivation. Self-reports from older adults (N = 309; Mage = 78.7, 70-95 years) regarding activity-related intrinsic motivation and HAPA variables were collected at the baseline of a fall prevention intervention study. Walking duration at ≥3 metabolic equivalents of task was measured for 7 days via body-worn accelerometers. Two structural equation models with walking duration as a manifest outcome were specified. In both models, the model fit was acceptable, but intention and planning were not associated with walking duration. Intrinsic motivation was significantly related to most HAPA variables and walking duration. Variance explained for walking duration was R2 = .14 in the HAPA and R2 = .17 in the extended model. For explaining older adults' walking duration, intrinsic motivation, but not HAPA-based intention and planning, seemed to be important.

How Does the Understanding, Experience, and Enactment of Self-Regulation Behaviour Change Techniques Vary with Age? A Thematic Analysis

BACKGROUND

Self-regulatory behaviour change techniques (BCTs) appear less effective in promoting physical activity amongst older than younger adults. This study aimed to identify reasons for this by examining how participants of different ages understand, experience, and use these BCTs.

METHODS

Twelve participants (aged 39-75) in a walking intervention study were interviewed twice: immediately post-intervention and 3 months later to examine understanding and enactment of self-regulation BCTs. Thematic analysis was used, organised using the framework approach.

RESULTS

Participants acknowledged the importance of setting realistic goals and found pedometers useful. In older adults, the use of goal setting was influenced by previous experience in work settings of this BCT. Occupational status appeared to influence the participants' responses to action planning, irrespective of age, with retired participants preferring not to restrict themselves to specific times. Self-monitoring with diaries appeared to be more useful in assisting the memory of older adults. For most BCTs, differences in understanding and enactment were apparent according to participant age.

CONCLUSIONS

Problems with using self-regulation BCTs were apparent, which appeared more common with older adults. Occupational status, cognitive status, or a perceived lack of value of physical activity or of some BCTs are all promising explanations that warrant further investigation.

Examining Potential Psychosocial Mediators in a Physical Activity Intervention for Older Adults

The purpose of this study was to examine psychosocial constructs targeted as potential mediators in a prior physical activity (PA) intervention study. This secondary analysis used data from 102 older adults randomized to one of four conditions-within a 2 (Interpersonal Strategies: yes, no) x 2 (Intrapersonal Strategies: yes, no) factorial design. We tested intervention effects on social support, self-efficacy, self-regulation, and goal attainment, and whether these constructs mediated intervention effects on PA. Participants who received interventions with interpersonal strategies, compared to those who did not, increased their readiness (post-intervention), the self-regulation subscale of self-assessment, and goal attainment (post-intervention, 6-months). Participants who received interventions with intrapersonal strategies, compared to those who did not, increased their social support from family (post-intervention). There was no statistically significant mediation. To understand mechanisms through which interventions increase older adults' PA and to improve intervention effectiveness, researchers should continue to examine potential psychosocial mediators.Clinical Trial Registry: NCT02433249.

What Keeps Them Going, and What Gets Them Back? Older Adults’ Beliefs About Physical Activity Maintenance

Background and Objectives

The overall purpose of this article was to investigate beliefs related to physical activity maintenance among adults aged 60 years or older.

Research Design and Methods

Study 1 identified modal, salient behavioral, normative, and control beliefs using a free-response format. Study 2 was designed to gain a deeper understanding about these beliefs through in-depth semistructured interviews.

Results

Findings indicate that perceived physical and emotional benefits, scheduling and having a physical activity routine, social support, and features of indoor and outdoor locations are facilitating of maintenance. Some beliefs appear more relevant to sustained engagement in physical activity, while others may be more helpful for reengagement after 1 week of inactivity.

Discussion and Implications

This investigation raises new hypotheses for future research and provides insight for the use and adaptation of behavior change strategies that are potentially more acceptable and effective for the promotion of physical activity maintenance for older adults.

Cognitive function of older adults engaging in physical activity

BACKGROUND

Physical activity can be classified as open-skilled or closed-skilled. Open-skilled physical activity, such as tennis, require participants to perform within a dynamic setting and respond to unpredictable and frequent environmental changes throughout the activity. Closed-skilled types of physical activity, such as swimming, are predictable and self-directed. However, the benefits of cognitive function in these two types of physical activities to older adults are unknown. This study examined the effects of participation in open- and closed-skilled physical activity on the cognitive function of older adults.

METHODS

The study recruited a total of 61 participants aged 65 years and over. Participant recruitment was achieved by distributing flyers asking for volunteers in various sports venues. Participants self-reported to be without medical conditions affecting their physical and cognitive function. All participants underwent a two-hour assessment session involving the completion of seven standardised cognitive function assessments, which were used to assess a range of cognitive function.

RESULTS

Overall mean scores across all of the assessments showed superior performance for the open- or closed-skilled participants when compared with the no-physical-activity group. The results of 61 adults who participated in this study showed that closed-skilled physical activity was associated with better selective attention and visuospatial function while open-skilled physical activity was associated with better inhibition and cognitive flexibility function. No significant difference in self-regulation ability was found between the open- or closed-skilled groups.

CONCLUSIONS

Open-skilled physical activity was associated with better inhibition, visual tracking, and cognitive flexibility while closed-skilled physical activity was associated with better selective attention and visuospatial perception. The findings have important practical implications for the health and quality of life of ageing populations, knowing which particular types of physical activity might affect the cognitive function.

There Is Still Time to Be Active: Self-Perceptions of Aging, Physical Activity, and the Role of Perceived Residual Lifetime Among Older Adults

Self-perceptions of aging (SPA) are a resource in later life. As aging is accompanied with perceptions of the finitude of life, it is assumed that perceived residual lifetime may play a role in the relationship between SPA and health behavior. Among older adults aged 65 years and older, the present study tested whether the relationships between gain- and loss-related SPA and two kinds of physical activity are moderated by perceived residual lifetime. Data were based on 2.367 participants over a 3-year period. Participants with less gain-related SPA were less likely to walk on a regular basis; however, a longer residual lifetime compensated for this negative effect. In addition, participants did sports more often if they not only held less loss-related SPA but also perceived a longer residual lifetime. These results emphasize the importance of perceived residual lifetime in health promotion interventions targeting physical activity in older adults.

A life fulfilled: positively influencing physical activity in older adults - a systematic review and meta-ethnography

BACKGROUND

Increasing physical activity in older adults remains a key public health priority in countries with a high burden of non-communicable disease, yet current interventions have failed to substantially increase population uptake with UK data suggesting that only half of 65-74 year olds report meeting recommended levels. The aim of this study was to conduct a systematic and inductive qualitative synthesis of the large body of qualitative research describing what influences physical activity at this age, and older adults' experiences of physical activity.

METHODS

A qualitative meta-ethnography was chosen as the study design as this inductive approach can provide novel insights and generate new theory about physical activity and ageing. Papers were identified by searching electronic databases and key citations. Peer-reviewed primary qualitative studies and systematic reviews were included if they met the following inclusion criteria: community-dwelling participants aged 60 years or older or in the retirement transition period; reporting on leisure-time physical activity; utilising a rigorous qualitative methodology. A line of argument approach was employed to generate a theory about how older adults think and feel about physical activity.

RESULTS

Thirty-nine papers met the inclusion criteria and were synthesised. The emergent theory suggested transition to older age can challenge people's sense of self and their role in life. Physical activity can help in regaining feelings of purpose, of being needed in collective group activity, and by creating habitual routine and structure to the day. In overcoming real and perceived barriers, and by taking up or sustaining physical activities, older adults can further build self-esteem all of which contributes to a fulfilling older age.

CONCLUSION

Current failures to increase population levels of physical activity in older adults may be explained by an approach overly focused on the health benefits of activity. Insights from this study suggest we need to reframe our approach to consider the wider set of goals and aspirations which are of greater personal importance to older adults, and future interventions should focus on how physical activity can contribute to life satisfaction, sense of purpose, and sense of role fulfilment in older age.

TRIAL REGISTRATION

Registered prospectively on PROSPERO on 29th March 2013: CRD42013003796 .

Behaviour change techniques to facilitate physical activity in older adults: what and how

Physical inactivity in older adults presents a significant problem within modern societies globally. Using a mixed-method approach, this study explored strategies for the development and delivery of physical activity (PA) interventions by investigating what behaviour change techniques (BCTs) are useful, and how these techniques should be implemented to be feasible for older adults. Sixty-six older adults completed a survey indicating the most useful BCTs, mapping on to motivational, volitional and automatic factors. Of these, 48 older adults participated in an interview exploring strategies for a PA intervention targeted at older adults. The most useful BCT identified in the survey was autonomy support (61.3%), followed by instruction to perform the behaviour (43.5%) and having a credible source of information about PA (42.6%). The key themes discussed in the interviews included providing support in making an informed choice, instruction on how to perform PA, information about health consequences, social support, goal setting, action and coping plans, behavioural demonstration and practice, and monitoring PA. The interviews also revealed key aspects of programme implementation including face-to-face delivery, followed up with additional materials; low cost; age-appropriate PA level; and individualised approach. Interventions assisting older adults in increasing their PA participation across a range of settings should incorporate BCTs targeting multiple processes, while tailoring their delivery to older adults’ preferences to ensure their feasibility in supporting regular PA engagement.

Perceived somatic and affective barriers for self-efficacy and physical activity

According to Bandura's social-cognitive theory, perceptions of somatic and affective barriers are sources of self-efficacy. This longitudinal study compares general indicators of health barriers with measures of perceived somatic and affective barriers to predict self-efficacy and accelerometer-assessed physical activity in a subsample of n = 153 (selected at random from N = 310) community-dwelling German older adults. Perceived somatic and affective barriers longitudinally predicted physical activity mediated by self-efficacy, whereas general health barriers did not. Perceived health barriers to physical activity might be more important than more objective health barriers for older adults' physical activity levels.

Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews

OBJECTIVES

While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old.

METHODS

Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes.

RESULTS

Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended).

CONCLUSION

The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies and BCTs might be less suitable for older adults than motivators more meaningful to them, including social and environmental support, and enjoyment coming from being physically active. A whole system-oriented approach is required that is tailored to meet the needs of older adults and aligned with social, individual and environmental factors.

Applying the Integrated Behavior Change Model to Understanding Physical Activity Among Older Adults: A Qualitative Study

We explored older adults' experiences of physical activity (PA) and related decision-making processes underlying PA. Twenty Australians (M_age = 73.8 years) participated in semistructured interviews. Data were analyzed using thematic analysis, and identified themes were matched deductively within motivational, volitional, and implicit processes of the integrated behavior change model for PA. Motivational influences such as participants' time orientation toward health and perceptions of what PA should be like were frequently featured in participants' narratives. Volitional processes were also identified, with participants reporting different ways of coping with competing priorities. Physical surroundings and habitual PA were the identified themes within implicit processes. Together, these findings contribute to a better understanding of subjective experiences of older adults regarding PA. They also add to a more contextual understanding of multiple decision-making processes underpinning older adults' PA engagement. Identified concepts may be used in future research and PA interventions targeting older adults.