Systematic literature review of determinants of sedentary behaviour in older adults: a DEDIPAC study

Background: Older adults are the most sedentary segment of society and high sedentary time is associated withpoor health and wellbeing outcomes in this population. Identifying determinants of sedentary behaviour is anecessary step to develop interventions to reduce sedentary time.Methods: A systematic literature review was conducted to identify factors associated with sedentary behaviourin older adults. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles publishedbetween 2000 and May 2014. The search strategy was based on four key elements: (a) sedentary behaviour andits synonyms; (b) determinants and its synonyms (e.g. correlates, factors); (c) types of sedentary behaviour (e.g. TVviewing, sitting, gaming) and (d) types of determinants (e.g. environmental, behavioural). Articles were included inthe review if specific information about sedentary behaviour in older adults was reported. Studies on samplesidentified by disease were excluded. Study quality was rated by means of QUALSYST. The full review protocol isavailable from PROSPERO (PROSPERO 2014: CRD42014009823). The analysis was guided by the socio-ecologicalmodel framework.Results: Twenty-two original studies were identified out of 4472 returned by the systematic search. These included19 cross-sectional, 2 longitudinal and 1 qualitative studies, all published after 2011. Half of the studies wereEuropean. The study quality was generally high with a median of 82 % (IQR 69–96 %) using Qualsyst tool. Personalfactors were the most frequently investigated with consistent positive association for age, negative for retirement,obesity and health status. Only four studies considered environmental determinants suggesting possible associationwith mode of transport, type of housing, cultural opportunities and neighbourhood safety and availability of placesto rest. Only two studies investigated mediating factors. Very limited information was available on contexts andsub-domains of sedentary behaviours.Conclusion: Few studies have investigated determinants of sedentary behaviour in older adults and these have todate mostly focussed on personal factors, and qualitative studies were mostly lacking. More longitudinal studies areneeded as well as inclusion of a broader range of personal and contextual potential determinants towards asystems-based approach, and future studies should be more informed by qualitative work.