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

Samantha J Meredith, Natalie Cox, Kinda Ibrahim, J Higson, J McNiff, S Mitchell, Matthew J Rutherford, Anusan Wijayendran, Susan Deborah Shenkin, Alixe Kilgour, Steven E Lim

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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.

We searched 6 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 CASP, and framework synthesis was applied using the COM-B model, which hypothesises that behaviour is influenced by three factors: capability, opportunity, and motivation.

Twenty-five studies were included in the review (N = 4978; 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), while negative sensations (e.g., pain) reduced motivation.

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.

Keywords (3-5): qualitative synthesis, physical activity, older adults, COM-B Model, systematic review
Key Points (3-5):
• Older adults’ activity was affected by interacting factors influencing their capability, opportunity, and motivation.
• Perceived capability to engage with PA was influenced by functional capacity and perceived risk of injury from PA.
• The environment ‘fit’ and socio-cultural ageing stereotypes impacted older adults’ opportunity to engage with PA.
• Immediate sensations and emotions associated with PA influenced older adults’ motivation and adherence.
• A systems approach to policy and intervention is needed to cover the wide ranging influencing factors on older adults’ PA levels and experiences.
Original languageEnglish
Article numberafad145
Number of pages16
JournalAge and Ageing
Issue number8
Publication statusPublished - 17 Aug 2023

Keywords / Materials (for Non-textual outputs)

  • older people
  • systematic review
  • Capability Oppor tunity Motivation—Behaviour (COM-B) Model
  • older adults
  • physical activity
  • qualitative synthesis


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