PDF(Pubmed)
Abstract：
BACKGROUND: Physical activity (PA) is critical for disease prevention and maintaining functional ability with aging. Despite this, as many as 50% of older adults in populations worldwide are considered insufficiently active. There is a recognized need to mobilize policies targeted toward modifiable determinants of healthy aging like PA. This umbrella review aimed to summarize the evidence for determinants of PA in community-dwelling older adults.
METHODS: A research librarian searched six databases. Systematic and scoping reviews were included if they investigated community-dwelling people with a mean age of 60 + years and examined a relationship between a determinant and any type of PA. Two independent reviewers screened and extracted data from all reviews. JBI methodology and Critical Appraisal Checklist for Systematic Reviews and Research Syntheses were followed and information on the quality of the evidence was extracted.
RESULTS: From 17,277 records screened,11 reviews representing > 300 unique primary papers were ultimately included. Only 6% of studies included in all reviews had longitudinal designs. Included studies used a large variety of PA measures, with 76% using only self-report, 15% using only direct measures (e.g., accelerometry), 3% using both types, and 6% with no outcome measure reported. Only four reviews provided a definition of PA and there was substantial inconsistency in the way PA was categorised. Community level influences, which only included the physical environment, were the most commonly assessed (6/11) with more than 70% of the summarized relationships demonstrating null associations. Three out of four reviews reported a positive relationship between walkability and PA in general community-dwelling older adults. There was also evidence supporting relationships between presence of social support for PA, younger age, and men having higher PA from a single systematic review. None of the included reviews assessed the quality of evidence but over 60% performed a risk of bias assessment.
CONCLUSIONS: Walkability, age, gender, and social support for PA were the most supported PA determinants identified. Further research should focus on interpersonal and intrapersonal influences and incorporate direct measures of PA with clear operational definitions. There is a need for longitudinal study designs to further understand determinants of PA behaviour trajectories.
METHODS: A research librarian searched six databases. Systematic and scoping reviews were included if they investigated community-dwelling people with a mean age of 60 + years and examined a relationship between a determinant and any type of PA. Two independent reviewers screened and extracted data from all reviews. JBI methodology and Critical Appraisal Checklist for Systematic Reviews and Research Syntheses were followed and information on the quality of the evidence was extracted.
RESULTS: From 17,277 records screened,11 reviews representing > 300 unique primary papers were ultimately included. Only 6% of studies included in all reviews had longitudinal designs. Included studies used a large variety of PA measures, with 76% using only self-report, 15% using only direct measures (e.g., accelerometry), 3% using both types, and 6% with no outcome measure reported. Only four reviews provided a definition of PA and there was substantial inconsistency in the way PA was categorised. Community level influences, which only included the physical environment, were the most commonly assessed (6/11) with more than 70% of the summarized relationships demonstrating null associations. Three out of four reviews reported a positive relationship between walkability and PA in general community-dwelling older adults. There was also evidence supporting relationships between presence of social support for PA, younger age, and men having higher PA from a single systematic review. None of the included reviews assessed the quality of evidence but over 60% performed a risk of bias assessment.
CONCLUSIONS: Walkability, age, gender, and social support for PA were the most supported PA determinants identified. Further research should focus on interpersonal and intrapersonal influences and incorporate direct measures of PA with clear operational definitions. There is a need for longitudinal study designs to further understand determinants of PA behaviour trajectories.
摘要：
背景：身体活动（PA）对于预防疾病和维持衰老的功能能力至关重要。尽管如此,全球人口中多达50％的老年人被认为活动不足。人们认识到有必要动员针对诸如PA之类的健康老龄化的可修改决定因素的政策。这篇综述旨在总结社区居住老年人PA决定因素的证据。
方法：一名研究图书馆员搜索了六个数据库。如果他们调查了平均年龄为60岁以上的社区居民，并检查了决定因素与任何类型的PA之间的关系，则包括系统和范围评价。两名独立审稿人从所有评论中筛选并提取数据。遵循JBI方法和系统审查和研究综合的关键评估清单，并提取了有关证据质量的信息。
结果：从筛选的17,277条记录中，最终包括了代表300篇独特主要论文的11篇评论。所有评论中只有6％的研究具有纵向设计。纳入的研究使用了各种各样的PA措施，76%的人只使用自我报告，15%仅使用直接措施(例如，加速度计)，使用这两种类型的3%，和6%，没有结果测量报告。只有四个评论提供了PA的定义，并且对PA进行分类的方式存在很大的不一致之处。社区层面的影响，其中只包括物理环境，是最常见的评估(6/11)，超过70%的汇总关系表明零关联。四分之三的评论报告说，在普通社区居住的老年人中，步行能力与PA之间存在正相关关系。也有证据支持PA存在社会支持之间的关系，年龄较小,和男性有较高的PA从一个单一的系统评价。纳入的评价均未评估证据质量，但超过60％的评价存在偏倚风险。
结论：可步行性，年龄,性别,对PA的社会支持是确定的最受支持的PA决定因素。进一步的研究应侧重于人际和内部影响，并将PA的直接措施与明确的操作定义结合起来。需要进行纵向研究设计，以进一步了解PA行为轨迹的决定因素。
方法：一名研究图书馆员搜索了六个数据库。如果他们调查了平均年龄为60岁以上的社区居民，并检查了决定因素与任何类型的PA之间的关系，则包括系统和范围评价。两名独立审稿人从所有评论中筛选并提取数据。遵循JBI方法和系统审查和研究综合的关键评估清单，并提取了有关证据质量的信息。
结果：从筛选的17,277条记录中，最终包括了代表300篇独特主要论文的11篇评论。所有评论中只有6％的研究具有纵向设计。纳入的研究使用了各种各样的PA措施，76%的人只使用自我报告，15%仅使用直接措施(例如，加速度计)，使用这两种类型的3%，和6%，没有结果测量报告。只有四个评论提供了PA的定义，并且对PA进行分类的方式存在很大的不一致之处。社区层面的影响，其中只包括物理环境，是最常见的评估(6/11)，超过70%的汇总关系表明零关联。四分之三的评论报告说，在普通社区居住的老年人中，步行能力与PA之间存在正相关关系。也有证据支持PA存在社会支持之间的关系，年龄较小,和男性有较高的PA从一个单一的系统评价。纳入的评价均未评估证据质量，但超过60％的评价存在偏倚风险。
结论：可步行性，年龄,性别,对PA的社会支持是确定的最受支持的PA决定因素。进一步的研究应侧重于人际和内部影响，并将PA的直接措施与明确的操作定义结合起来。需要进行纵向研究设计，以进一步了解PA行为轨迹的决定因素。
