Setting-related influences on physical inactivity of older adults in residential care settings: a review

Abstract

BackgroundDespite the detrimental effects of physical inactivity for older adults, especially aged residents of residential care settings may spend much time in inactive behavior. This may be partly due to their poorer physical condition; however, there may also be other, setting-related factors that influence the amount of inactivity. The aim of this review was to review setting-related factors (including the social and physical environment) that may contribute to the amount of older adults’ physical inactivity in a wide range of residential care settings (e.g., nursing homes, assisted care facilities).MethodsFive databases were systematically searched for eligible studies, using the key words ‘inactivity’, ‘care facilities’, and ‘older adults’, including their synonyms and MeSH terms. Additional studies were selected from references used in articles included from the search. Based on specific eligibility criteria, a total of 12 studies were included. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT).ResultsBased on studies using different methodologies (e.g., interviews and observations), and of different quality (assessed quality range: 25-100%), we report several aspects related to the physical environment and caregivers. Factors of the physical environment that may be related to physical inactivity included, among others, the environment’s compatibility with the abilities of a resident, the presence of equipment, the accessibility, security, comfort, and aesthetics of the environment/corridors, and possibly the presence of some specific areas. Caregiver-related factors included staffing levels, the available time, and the amount and type of care being provided.ConclusionsInactivity levels in residential care settings may be reduced by improving several features of the physical environment and with the help of caregivers. Intervention studies could be performed in order to gain more insight into causal effects of improving setting-related factors on physical inactivity of aged residents.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0487-3) contains supplementary material, which is available to authorized users.

Effects of Protein Supplementation Combined with Exercise Intervention on Frailty Indices, Body Composition, and Physical Function in Frail Older Adults

“…The results of this study further indicated that an additional PS may have effects on improvement of frailty status and body composition among frail older individuals undergoing exercise training sessions, regardless of the supplementation dose and exercise training type. In agreement with previous reviews [63,64] and following the recommendations from the European Society for Clinical Nutrition and Metabolism Expert Group [65], the results of the current meta-analysis supported the urgent necessity for prefrail or frail older adults to incorporate protein-based nutrition intervention plus exercise training to prevent functional decline, especially for institutionalized residents who are at a high risk of insufficient protein intake and physical inactivity [66,67,68,69].…”

Nutritional Status Plays More Important Role in Determining Functional State in Older People Living in the Community than in Nursing Home Residents

“…Therefore, active seniors tend to display lower R and higher PhA [ 47 , 48 , 49 ]. Older people living in institutions are usually characterized by a lower level of PA in comparison with CD subjects [ 50 ]. What is more, institutionalization influences not only leisure PA but also usual daily living activities.…”

The Best Day of the Week: New Technology Enhancing Quality of Life in a Care Home

“…Existing literature suggests that social and physical inactivity in RACFs can be explained by a range of interdependent factors including: patient-related, such as immobility; organisational, such as lack of meaningful activities; environmental, concerning the facilities in the ward; and caregiver-related, including staffing levels, time constraints and type of care given [9,46]. In addition, we found that social and physical inactivity is to a large extent influenced by management- & government-related factors that shape and influence the other factors.…”