The effects of co-designed physical activity interventions in older adults: A systematic review and meta-analysis

• Published in: PloS one 2024-05, Vol.19 (5), p.e0297675-e0297675
• Main Authors: Zacharuk, Amanda, Ferguson, Alison, Komar, Chelsea, Bentley, Nicole, Dempsey, Alexandra, Louwagie, Michelle, O'Hoski, Sachi, D'Amore, Cassandra, Beauchamp, Marla
• Format: Article
• Language: English
• Subjects: Adults; Aged; Aged, 80 and over; Analysis; Bias; Chronic illnesses; Co-design; Exercise; Humans; Intervention; Mental Health; Meta-analysis; Middle Aged; Older people; Physical activity; Physical fitness; Quality; Quality of Life; Reviews; Software; Systematic review
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0297675

Physical activity (PA) declines with age despite the knowledge that physical inactivity is a leading cause of disease, death, and disability worldwide. To better tailor PA interventions to older adults, researchers are turning to the collaborative principles of co-design. The purpose of this systematic review was to compare the effectiveness of co-designed PA interventions and standard care for increasing PA and other health outcomes (i.e., physical function, quality of life, mental health, functional independence, attendance and attrition rates) in older adults. A search was conducted in MEDLINE, AgeLine, CINAHL, Embase, and SPORTDiscus. Records were screened by independent pairs of reviewers. Primary research studies conducted among community-dwelling older adults (age 60+) comparing co-designed PA interventions to standard care were considered for inclusion. Controls included wait-list control, usual care, sham interventions, PA interventions without the use of co-design, and no intervention. A random effects meta-analysis was conducted, and the standardized mean difference (SMD) was used to report effect estimates. Quality of evidence was rated using GRADE. Of 16,191 studies screened, eight (N = 16,733) were included in this review. Most studies reported results favouring the effect of co-design on physical activity; however, only two studies (N = 433) could be pooled for meta-analysis resulting in a SMD of 0.28, (95% CI = -0.13 to 0.69; p = 0.19; I2 = 56%) immediately post-intervention. The GRADE quality of evidence was very low. The quantitative analysis of three studies reported improved physical function. This review did not demonstrate that co-designed PA interventions are more effective than standard care for increasing PA in older adults; however, evidence was limited and of very low quality. Further well-designed trials are warranted to better understand the impacts of co-designed PA interventions and how to best implement them into practice. PROSPERO registration number: CRD42022314217.