Acceptability of physical activity to inactive older adults: a systematic review and meta-synthesis

Abstract

Background: Despite the significant health benefits of regular physical activity for older adults, only a minority achieve the nationally recommended levels. To develop effective interventions, the reasons for the low levels of physical activity in this population must be understood. The present review identifies and synthesises qualitative studies concerning inactive older adults’ perceptions of physical activity. Methods: A systematic search of four electronic databases identified 10 studies meeting inclusion criteria of being inactive, non-clinical samples, and all participants over 65 years old. These were appraised and findings combined and compared using Thematic Synthesis, a systematic three-step process of synthesising qualitative studies. Results: The synthesis produced three overarching themes. Inactive older adults generally construed physical activity as a by-product of other activities, rather than as a purposeful activity of itself. This seemed to be linked to their self-perceptions as ageing members of society. Purposeful physical activity appeared to become less relevant to their changing values, goals and commitments within wider society, with physical activity perceived as having little relevance during the latter stages of life. Older adults also appeared to experience conflict between their desire to maintain autonomy and control and accepting the physical and social vulnerabilities associated with ageing. Discussion: As many inactive older adults do not see physical activity as purposeful of itself, interventions promoting moderate or vigorous physical activity are likely to have limited success. As even small increases in physical activity benefits older adults, future interventions could instead target the reduction of sedentary behaviour in this population.