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BackgroundPhysical activity (PA) has multiple important benefits for older adults, but many do not undertake the recommended amount. This systematic review examined the quantitative literature detailing barriers and motivators to PA in older adults: a concurrent qualitative review is underway. Previous reviews investigated younger age groups or specific diseases.MethodsWe included adults ≥70 years, observational studies and baseline data for randomised controlled trials (RCTs); we excluded studies of specific disease groups, care home residents, and rates of cognitive impairment above population norms. We searched Medline, Embase, CINAHL and PsycINFO on 25th February 2020. We assessed risk-of-bias using ROBANS. We undertook a narrative review; meta-analysis was not possible. The protocol was registered on PROSPERO (CRD42021160503).ResultsWe identified 35 papers (24 cross-sectional studies, eight prospective cohort studies, two studies of baseline data from RCTs and one mixed methods study); n= 26,264 subjects, median age 77.7 years (range 70-101) and median percentage female 62.1% (range 0-100). Quality assessment identified low risk-of-bias overall, except two studies were identified as having a high risk-of-bias for one section (confounding variables). The most cited barriers were physical health (N=14 studies), environmental factors (N=12), fear of falls (N=7) and lack of interest (N=4). Other barriers identified were lack of company (N=1) and urine leakage (in women) (N=1). Key motivating factors included social aspects of PA (N=8), intrinsic/psychological (e.g. self-determination, future orientation) (N=8), health (e.g. doctor’s advice) (N=7) and environmental (e.g. nearby green space) (N=4).DiscussionThis review identified key barriers and motivators to PA in older adults. There is a lack of evidence for the oldest old. These findings should be used to create trials of suitable interventions which enable older adults to take up and maintain recommended levels of PA. The wide range of factors we identified indicates an individualised approach may be best.

IntroductionDespite the myriad advantages associated with physical activity (PA), older adults are often insufficiently active to maximise health benefits. Understanding factors that influence engagement in PA will support practitioners in providing well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adult’s engagement in PA. MethodsFour electronic databases were searched: CINAHL, Embase, MEDLINE and PsycINFO. Inclusion criteria were community-dwelling older adults (≥70 years), and studies including qualitative methods. Exclusion criteria were studies examining a single disease group, individuals with cognitive impairment, care home residents, and PA interventions. The Critical Appraisal Skills Programme (CASP) checklist was used to assess methodological rigour. Framework synthesis using the COM-B model was applied to analyse data, and the GRADE-CERQual approach was used to assess confidence in findings. (PROSPERO: CRD42021160503)ResultsTwenty-one studies were included in the review. Participants (N = 3955; mean age 78.9 years) included 64% female and 36% male older adults. Most studies were methodologically rigorous (17/21 scored ≥8 CASP). We identified 32 themes mapped against the COM-B framework (16 high confidence). Older adult’s perceived capability was influenced by their functional capacity, illness symptoms and perceived risk of injury from PA. PA was motivated by identifying as an ‘exerciser’, health gains and positive emotions (e.g., enjoyment), while negative sensations reduced motivation (e.g., pain). Opportunity was impacted by the weather, the environment ‘fit’, and the availability of social interaction during PA. Moreover, social opportunity was impacted by socio-cultural ageing stereotypes and discourses, influencing older adults’ PA through media outlets, social norms, and self-stigma. ConclusionsThe review found a complex web of interacting factors that influenced older people’s PA between the sub-domains of capability, motivation, and opportunity. Future initiatives to increase PA in older adults should focus on social influences, environmental barriers, and physical limitations.

BACKGROUND: This trial aimed to determine the efficacy of leucine and/or perindopril in improving physical function in older people with sarcopenia. METHODS: Placebo-controlled, parallel group, double-blind, randomized two-by-two factorial trial. We recruited adults aged?70years with sarcopenia, defined as low gait speed (

BackgroundThe European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines have recently been published to aid diagnosis of sarcopenia in the clinical setting and to allow for better comparison between research studies. The guidelines recommend several different tests for diagnosing sarcopenia. We hypothesised that the prevalence of sarcopenia might vary depending on which tests are used.MethodsWe used data from Wave 3 of the Lothian Birth Cohort 1936 study, a longitudinal ageing study of healthy, community dwelling older adults (n= 697, 52% men, mean age 76y), to assess the prevalence of sarcopenia using the suggested cut-offs in the EWGSOP2 guidelines. Probable sarcopenia was defined as low muscle strength (measured by handgrip strength and 5x chair stand test), confirmed sarcopenia was defined as low muscle strength + low lean mass (measured by bioimpedance analysis), and severe sarcopenia was defined as confirmed sarcopenia + low muscle performance (measured by gait speed and short physical performance battery score). SPSS version 24.0 was used for statistical analysis.ResultsThe maximum prevalence of probable sarcopenia was 24.2% in men and 24.8% in women, of confirmed sarcopenia was 7.4% in men and 11.0% in women, and of severe sarcopenia was 4.6% in men and 5.9% in women, when either of the cut-offs for muscle strength +/- muscle performance were met. When using only one measure of muscle strength +/- performance, rates of probable sarcopenia ranged from 7.7% to 21.1% in men and 5.9% to 21.3% in women; rates of confirmed sarcopenia ranged from 3.9% to 5.3% in men and 5.1% to 9% in women; and rates of severe sarcopenia ranged from 1.4% to 3.9% in men and from 2.0% to 5.1% in women.ConclusionsIn a UK-based longitudinal ageing study we found that the prevalence of probable, confirmed and severe sarcopenia varied widely using the EWGSOP2 guidelines depending on which identifying tests were used. We found that the cut-off points suggested for some of the measures in the guidelines are not comparable and may lead to differing groups being identified as sarcopenic between different trials. We suggest modification of the cut-offs to adjust for this.