Sedentary behavior and health outcomes in older adults: A systematic review

Abstract Sedentary behavior (SB) is associated with numerous negative health outcomes, independent of physical activity behavior. Older adults are the most sedentary population in the United States. Understanding the effects and characteristics of existing interventions to reduce SB can inform practice, future research, and public health initiatives to improve older adults’ health. We conducted a systematic review and meta-analysis to examine existing SB intervention research among older adults and quantitatively synthesize intervention effects. Comprehensive searches were conducted to identify studies testing interventions to reduce SB time among adults at least 60 years old. Data on study design, intervention content and delivery, and participant characteristics were extracted from eligible studies. Standardized mean difference effect sizes (Cohen’s d) were synthesized using a random-effects model for two-group pretest–posttest design studies. Twenty-two reports describing 17 distinct studies were included in the narrative synthesis, with eight studies included in the meta-analysis (k = 8; n = 1,024). Most interventions were theory-driven and employed multiple strategies, including education, self-monitoring, and goal setting. Although SB interventions significantly reduced total sedentary time, the overall effect was small (d = −0.25, 95% confidence interval [−0.50, 0.00], p = .05). Studies were significantly heterogeneous (Q = 22.34, p < .01); however, the small number of comparisons prevented moderator analyses. Practitioners should employ diverse SB-specific strategies to encourage older adults to reduce time spent sedentary. To develop public health programs targeting SB in older adults, future research should include measures of time spent in specific SB and duration/number of breaks in sedentary time and investigate SB intervention effects on health outcomes.

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A systematic review of the impacts of intergenerational engagement on older adults’ cognitive, social, and health outcomes

Ageing Research Reviews ◽

10.1016/j.arr.2021.101400 ◽

2021 ◽

pp. 101400

Author(s):

Anna Krzeczkowska ◽

David M. Spalding ◽

William J. McGeown ◽

Alan J. Gow ◽

Michelle C. Carlson ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Outcomes

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Understanding Variations in the Health Consequences of Sedentary Behavior: A Taxonomy of Social Interaction, Novelty, Choice, and Cognition

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0360 ◽

2021 ◽

pp. 1-9

Author(s):

Wendell C. Taylor

Keyword(s):

Older Adults ◽

Social Interaction ◽

Health Outcomes ◽

Sedentary Behavior ◽

Age Groups ◽

Sedentary Behaviors ◽

Positive Health ◽

Adverse Health Outcomes ◽

Important Challenge ◽

Positive Health Outcomes

The study of sedentary behaviors requires taxonomies (classification schemes) to standardize data collection, measurements, and outcomes. Three taxonomies of sedentary behaviors have been identified, but none address an important challenge in sedentary behavior research, which is to distinguish between beneficial and detrimental health effects of various sedentary behaviors. Some sedentary behaviors (e.g., reading) are associated with positive health outcomes, whereas other sedentary behaviors (e.g., television viewing) are associated with adverse health outcomes. To address directly this complexity and present a different conception and understanding of discrepant findings related to health outcomes, a new taxonomy is needed. The development of the new taxonomy is guided by analysis of literature and selection of a relevant and informative behavioral sciences theoretical framework (i.e., self-determination theory). Because older adults are an increasing percentage of the population and report a high prevalence of sedentary behaviors, the new taxonomy was designed for older adults with potential application to all age groups. Taylor’s taxonomy of sedentary behaviors is parsimonious with four domains: social interaction (i.e., not solitary, companionship, interacting, and connecting with others); novelty (i.e., refreshingly new, unusual, or different); choice (i.e., volition, preferred option or alternative, the power, freedom, or decision to choose); and cognition (i.e., mentally stimulating and engaging).

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Interventions targeting sedentary behavior in non-working older adults: a systematic review

Maturitas ◽

10.1016/j.maturitas.2018.08.002 ◽

2018 ◽

Vol 116 ◽

pp. 89-99 ◽

Cited By ~ 11

Author(s):

Justin Avery Aunger ◽

Paul Doody ◽

Carolyn Anne Greig

Keyword(s):

Systematic Review ◽

Older Adults ◽

Sedentary Behavior

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Changes in Self-Reported Health and Psychosocial Outcomes in Older Adults Enrolled in Sedentary Behavior Intervention Study

American Journal of Health Promotion ◽

10.1177/0890117119841405 ◽

2019 ◽

Vol 33 (7) ◽

pp. 1053-1057 ◽

Cited By ~ 2

Author(s):

Theresa E. Matson ◽

Melissa L. Anderson ◽

Anne D. Renz ◽

Mikael Anne Greenwood-Hickman ◽

Jennifer B. McClure ◽

...

Keyword(s):

Older Adults ◽

Health Outcomes ◽

Sedentary Behavior ◽

Psychosocial Factors ◽

Self Efficacy ◽

Behavior Intervention ◽

Habit Strength ◽

Sitting Time ◽

Group I ◽

Reported Health

Purpose: To estimate changes in self-reported health and psychosocial factors associated with a 12-week sedentary behavior intervention for older adults. Design: Exploratory secondary analysis of pilot randomized controlled trial. Setting: Kaiser Permanente Washington Subjects: Sixty adults aged 60 to 89 with body mass index ≥30 kg/m2. Intervention: Participants were randomized to the I-STAND intervention or control group. I-STAND involved 6 coaching sessions, a study workbook, Jawbone UP activity tracker to prompt breaks from sitting, and activPAL feedback on objective sitting time. Measures: At baseline and 12-week follow-up, participants completed a survey with validated measures of self-reported health outcomes (depression, stress, memory/concentration, sleep, pain, ability to do daily activities, energy, and quality of life) and modified scales measuring psychosocial factors (perceived benefits/barriers, social support, self-efficacy, and sedentary habit strength) regarding sedentary behavior. Analysis: Generalized linear models assessed associations between group assignment and change in each self-reported health and psychosocial score, adjusting for baseline scores. Results: I-STAND participants demonstrated improvements in self-efficacy (β = 0.35, 95% confidence interval [CI]: 0.10 to 0.60) and reduced habit strength (β= −0.23, 95% CI: −0.42 to −0.04) compared to control participants. There were no significant differences in self-reported health outcomes, although power was limited in this exploratory analysis. Conclusion: A sedentary behavior reduction intervention for older adults resulted in improvements for some psychosocial factors. Health outcomes may require longer than 12 weeks to observe improvements.

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Acceptance and Feasibility of Seated Elliptical Pedaling to Replace Sedentary Behavior in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2019-0388 ◽

2020 ◽

Vol 28 (6) ◽

pp. 844-853

Author(s):

Nicholas L. Lerma ◽

Chi C. Cho ◽

Ann M. Swartz ◽

Hotaka Maeda ◽

Young Cho ◽

...

Keyword(s):

Older Adults ◽

Light Intensity ◽

Health Outcomes ◽

Sedentary Behavior ◽

Activity Monitor ◽

Group Differences ◽

Significant Group ◽

Significant Difference ◽

The Impact

The purpose of this study was to explore the feasibility and acceptability of a seated pedaling device to reduce sedentary behavior (SB) in the homes of older adults. Methods: Each participant (N = 20) was outfitted with an activity monitor and seated pedaling device in the home for 7 days and randomly assigned to one of four light-intensity pedaling groups (15, 30, 45, and 60 min/day). Results: There was 100% adherence in all groups and significant group differences in the minutes pedaled per day (p < .001), with no significant difference in the total pedaling days completed (p = .241). The 15-, 30-, 45-, and 60-min groups experienced a 4.0%, 5.4%, 10.6%, and 11.3% reduction in SB on the days pedaled, respectively. Conclusion: Clinically relevant reductions in SB time were achievable in this 1-week trial. Long-term adherence and the impact of replacing SB with seated light activities on geriatric-relevant health outcomes should be investigated.

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Association between social class and cognitive health outcomes in older adults: Systematic review and meta‐analysis of longitudinal studies

Alzheimer s & Dementia ◽

10.1002/alz.040375 ◽

2020 ◽

Vol 16 (S10) ◽

Author(s):

Yuliya Bodryzlova ◽

Emmanuelle Belanger ◽

Gregory Moullec

Keyword(s):

Systematic Review ◽

Older Adults ◽

Social Class ◽

Health Outcomes ◽

Longitudinal Studies ◽

Meta Analysis ◽

Cognitive Health

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Postdiagnosis sedentary behavior and health outcomes in cancer survivors: A systematic review and meta‐analysis

Cancer ◽

10.1002/cncr.32578 ◽

2019 ◽

Vol 126 (4) ◽

pp. 861-869 ◽

Cited By ~ 1

Author(s):

Christopher T. V. Swain ◽

Nga H. Nguyen ◽

Tobyn Eagles ◽

Jeff K. Vallance ◽

Terry Boyle ◽

...

Keyword(s):

Systematic Review ◽

Health Outcomes ◽

Cancer Survivors ◽

Sedentary Behavior ◽

Meta Analysis

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Dynapaenic obesity and its association with health outcomes in older adult populations: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-027728 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027728 ◽

Cited By ~ 2

Author(s):

Siobhan Leahy ◽

Marica Cassarino ◽

Matthew DL O' Connell ◽

Liam Glynn ◽

Rose Galvin

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Older Adult ◽

Observational Studies ◽

Functional Disability ◽

Age Groups ◽

Ageing Population ◽

Cross Sectional ◽

Age Related

IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.

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