Barriers to and facilitators of physical activity among community-dwelling older adults: a systematic review

Objective This study aims to systematically review the evidence on barriers to and facilitators of physical activity (PA) engagement among community-dwelling older adults. Design Systematic review. Data sources Electronic databases MEDLINE, Embase, APA PsycINFO, SPORTDiscus, CINAHL Plus, AgeLine and Scopus were searched from their inception to 14 April 2024. Eligibility criteria Eligible studies were qualitative, quantitative or mixed-methods studies, published in English and investigating barriers to and/or facilitators of PA among independently living adults aged ≥65 years. Data extraction and synthesis Content analysis was performed using a narrative synthesis adapted from the socioecological model of health behaviour by three independent assessors. Barriers and facilitators were categorised into intrapersonal, interpersonal and environmental factors. Results Of 27 779 screened articles, 20 eligible studies were synthesised (11 qualitative, 1 mixed-method and 8 quantitative), with a total of 18 597 participants. The main barriers to PA included intrapersonal factors: fear of injury, pain, low motivation and lack of spare time; interpersonal factors: lack of social support and family obligations; environmental factors: poor weather, poor built environment/high cost accessing PA facilities. The main facilitators to PA included intrapersonal: health and well-being, fitness devices, better self-perceived body image, sense of bodily control and enjoyment; interpersonal: social support and having a partner/group/pet to engage in PA together; environmental: age-friendly built environment and access to PA programmes. Conclusion There are multiple barriers to and facilitators of PA engagement among community-dwelling older adults that should be considered by policy makers when designing PA programmes to help increase PA in older adults. PROSPERO registration number CRD42023417404.