Ciaccioni Simone, Compernolle Sofie, Lerfald Maren, Palumbo Federico, Fadda Floriana, Toma Ginevra, Akpinar Selcuk, Borodulin Katja, Caglar Emine, Cardon Greet, Celen Murat Cenk, Cieślińska-Świder Joanna, Cortis Cristina, Di Credico Andrea, Emirzeoğlu Murat, Fusco Andrea, Gallardo Gómez Daniel, Hagen Linn Marita, Karaca Ayda, Khudair Mohammed, De Maio Marianna, Mork Paul Jarle, Oddi Livia, Sakalidis Kandianos Emmanouil, Sandu Petru, Turhan Sevil, Wang Wei, Yargıç Melda Pelin, Zotcheva Ekaterina, Capranica Laura, MacDonncha Ciaran, Ernstsen Linda
Department of Education and Sport Sciences, Pegaso Telematic University, Naples, Italy.
Department of Movement, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy.
Eur Rev Aging Phys Act. 2025 May 24;22(1):9. doi: 10.1186/s11556-025-00373-y.
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.
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.
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; I = 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).
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.
PROSPERO: CRD42022287606.
确定涉及老年人的干预措施所针对的可改变决定因素，并确定这些干预措施中哪些能有效增加身体活动（PA）和/或减少久坐行为（SB）。此外，探讨这些干预措施的效果是否因实施环境而异。
在Medline、美国心理学会心理学文摘数据库（APA PsycArticles）、体育与运动科学全文数据库（SPORTDiscus）和科学网（Web of Science）中检索随机对照试验（RCT）和对照试验（CT）。使用Cochrane工具进行偏倚风险评估。对可改变决定因素进行叙述性综合分析，并采用随机效应模型对报告通过设备测量的身体活动或久坐行为的研究进行荟萃分析。进行调节分析以研究实施环境的作用。使用具有95%置信区间（CI）的标准化组间平均差异（SMD）来表示效应大小。
从31727条个体记录中，确定了2012年至2022年间发表的52项符合条件的研究，分别有30项和22项研究来自社区和医疗保健环境。身体健康和幸福类别中的决定因素（n = 23）报告得最为频繁，而只有一项研究报告了社会或文化背景下的决定因素。18项研究纳入了荟萃分析。与对照组相比，针对身体健康和幸福的干预措施显示干预参与者的步数增加（SMD = 0.46；95%CI：0.15至0.77）以及中度至剧烈强度身体活动的分钟数增加（SMD = 0.41；95%CI：0.19至0.64），而针对心理或行为决定因素的干预措施在步数（SMD = 0.10；95%CI：-0.12至0.32）和中度至剧烈强度身体活动方面未显示出组间差异（SMD = 0.26；95%CI：-0.24至-0.75）。针对身体健康和幸福的干预措施显示出显著的异质性（p < 0.0001；I² = 73.10%）。亚组分析显示，八项基于社区的干预措施对通过设备测量的身体活动有显著影响（SMD = 0.42；95%CI：0.07至0.77），而在医疗保健环境中进行的八项研究未发现显著影响（SMD = 0.26；95%CI：-0.10至0.62）。
针对身体健康和幸福的干预措施可能会增加老年人的身体活动，基于社区的研究似乎比医疗保健环境中的研究更有效。研究结果的显著异质性表明，需要进一步研究以充分了解身体活动和久坐行为决定因素在不同环境中的影响，特别是与心理、行为、社会和文化因素相关的影响。
国际前瞻性系统评价注册库（PROSPERO）：CRD42022287606。
