Effect of physical activity characteristics on activities of daily living in older adults: systematic review

Abstract

Background: Physical activity (PA) is associated with improved independence in old age, however, questions regarding the optimal level (frequency, intensity, duration) and type required to achieve benefit remain. As living independently requires mental (e.g. memory, concentration), physical (e.g. balance, co-ordination) and social (e.g. social interaction) skills, it is possible that PA types with mental, physical and social demands (i.e. multitask activities) will be more beneficial than others. The present study aimed to systematically analyse the effects of different PA characteristics on activities of daily living (ADL) performance in older adults. Method: Randomised controlled trials (n=47) exploring the effects of PA on ADLs in older adults were systematically identified. Subjective and objective ADL measures included the Barthel Index and the Timed Up and Go. Quality was assessed using the PEDro scale. Frequency, intensity and time of PAs were extracted and used to calculate PA level. Mental, physical and social demands of different activities were coded and used to classify PAs as high, moderate or low multitask activities. Using a random effects model, meta-analyses were performed on 31 studies. Findings: A significant effect of PA on ADL (SMD=0.77 [95% CI=0.51-1.03]) was found. Greater effect sizes were found for moderate PA levels (SMD=1.23 [95% CI=0.68-1.77]) than high and low levels. High multitask activities produced a larger beneficial effect than moderate and low multitask activities (SMD=1.22 [95% CI=0.67-1.78]). Discussion: While any PA may be beneficial to ADL in old age, future interventions should consider using moderate levels of high multitask activities for optimal results.