Interventions for reducing sedentary behaviour in community-dwelling older adults
Article
Article Title | Interventions for reducing sedentary behaviour in community-dwelling older adults |
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ERA Journal ID | 15305 |
Article Category | Article |
Authors | Chastin, Sebastien (Author), Gardiner, Paul A. (Author), Harvey, Juliet A. (Author), Leask, Calum F. (Author), Jerez-Roig, Javier (Author), Rosenberg, Dori (Author), Ashe, Maureen C. (Author), Helbostad, Jorunn L. (Author) and Skelton, Dawn A. (Author) |
Journal Title | Cochrane Database of Systematic Reviews |
Journal Citation | 2021 (6) |
Article Number | CD012784 |
Number of Pages | 70 |
Year | 2021 |
Publisher | John Wiley & Sons |
Place of Publication | Hoboken, NJ, United States |
ISSN | 1469-493X |
1361-6137 | |
Digital Object Identifier (DOI) | https://doi.org/10.1002/14651858.CD012784.pub2 |
Web Address (URL) | https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012784.pub2/full |
Abstract | BACKGROUND: Older adults are the most sedentary segment of society, often spending in excess of 8.5 hours a day sitting. Large amounts of time spent sedentary, defined as time spend sitting or in a reclining posture without spending energy, has been linked to an increased risk of chronic diseases, frailty, loss of function, disablement, social isolation, and premature death. OBJECTIVES: To evaluate the effectiveness of interventions aimed at reducing sedentary behaviour amongst older adults living independently in the community compared to control conditions involving either no intervention or interventions that do not target sedentary behaviour. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, EPPI-Centre databases (Trials Register of Promoting Health Interventions (TRoPHI) and the Obesity and Sedentary behaviour Database), WHO ICTRP, and ClinicalTrials.gov up to 18 January 2021. We also screened the reference lists of included articles and contacted authors to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and cluster-RCTs. We included interventions purposefully designed to reduce sedentary time in older adults (aged 60 or over) living independently in the community. We included studies if some of the participants had multiple comorbidities, but excluded interventions that recruited clinical populations specifically (e.g. stroke survivors). DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts and full-text articles to determine study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. Any disagreements in study screening or data extraction were settled by a third review author. MAIN RESULTS: We included seven studies in the review, six RCTs and one cluster-RCT, with a total of 397 participants. The majority of participants were female (n = 284), white, and highly educated. All trials were conducted in high-income countries. All studies evaluated individually based behaviour change interventions using a combination of behaviour change techniques such as goal setting, education, and behaviour monitoring or feedback. Four of the seven studies also measured secondary outcomes. The main sources of bias were related to selection bias (N = 2), performance bias (N = 6), blinding of outcome assessment (N = 2), and incomplete outcome data (N = 2) and selective reporting (N=1). The overall risk of bias was judged as unclear. PRIMARY OUTCOMES: The evidence suggests that interventions to change sedentary behaviour in community-dwelling older adults may reduce sedentary time (mean difference (MD) -44.91 min/day, 95% confidence interval (CI) -93.13 to 3.32; 397 participants; 7 studies; I(2) = 73%; low-certainty evidence). We could not pool evidence on the effect of interventions on breaks in sedentary behaviour or time spent in specific domains such as TV time, as data from only one study were available for these outcomes. SECONDARY OUTCOMES: We are uncertain whether interventions to reduce sedentary behaviour have any impact on the physical or mental health outcomes of community-dwelling older adults. We were able to pool change data for the following outcomes. * Physical function (MD 0.14 Short Physical Performance Battery (SPPB) score, 95% CI -0.38 to 0.66; higher score is favourable; 98 participants; 2 studies; I(2) = 26%; low-certainty evidence). * Waist circumference (MD 1.14 cm, 95% CI -1.64 to 3.93; 100 participants; 2 studies; I(2) = 0%; low-certainty evidence). * Fitness (MD -5.16 m in the 6-minute walk test, 95% CI -36.49 to 26.17; higher score is favourable; 80 participants; 2 studies; I(2) = 29%; low-certainty evidence). * Blood pressure: systolic (MD -3.91 mmHg, 95% CI -10.95 to 3.13; 138 participants; 3 studies; I(2) = 73%; very low-certainty evidence) and diastolic (MD -0.06 mmHg, 95% CI -5.72 to 5.60; 138 participants; 3 studies; I(2) = 97%; very low-certainty evidence). * Glucose blood levels (MD 2.20 mg/dL, 95% CI -6.46 to 10.86; 100 participants; 2 studies; I(2) = 0%; low-certainty evidence). No data were available on cognitive function, cost-effectiveness or adverse effects. AUTHORS' CONCLUSIONS: It is not clear whether interventions to reduce sedentary behaviour are effective at reducing sedentary time in community-dwelling older adults. We are uncertain if these interventions have any impact on the physical or mental health of community-dwelling older adults. There were few studies, and the certainty of the evidence is very low to low, mainly due to inconsistency in findings and imprecision. Future studies should consider interventions aimed at modifying the environment, policy, and social and cultural norms. Future studies should also use device-based measures of sedentary time, recruit larger samples, and gather information about quality of life, cost-effectiveness, and adverse event data. |
Keywords | Aged; Behavior; Bias; Blood Glucose/analysis; Blood Pressure; Female; Goals; Humans; *Independent Living; Male; Middle Aged; Randomized Controlled Trials as Topic; *Sedentary Behavior; Selection Bias; Sitting Position; Time Factors; Waist Circumference; Walk Test |
ANZSRC Field of Research 2020 | 420603. Health promotion |
320210. Geriatrics and gerontology | |
420799. Sports science and exercise not elsewhere classified | |
Public Notes | Files associated with this item cannot be displayed due to copyright restrictions. |
Byline Affiliations | Glasgow Caledonian University, United Kingdom |
School of Health and Wellbeing | |
Aberdeen City Health and Social Care Partnership, United Kingdom | |
University of Vic - Central University of Catalonia, Spain | |
Kaiser Permanente Washington Health Research Institute, United States | |
University of British Columbia, Canada | |
Norwegian University of Science and Technology, Norway | |
Institution of Origin | University of Southern Queensland |
https://research.usq.edu.au/item/q6q3x/interventions-for-reducing-sedentary-behaviour-in-community-dwelling-older-adults
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