Patterns of Sedentary Behavior among Older Adults in Care Facilities: A Scoping Review

Abstract

Understanding the sedentary patterns can guide the design of strategies to engage older adults in physical activity. This scoping review aimed to synthesize available evidence on sedentary behaviors in care facilities. We searched PubMed/MEDLINE and Web of Science for studies published from inception through October 2020. Eighteen studies were included and reviewed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data obtained were analyzed based on levels of care provided. Overall, daily sedentary time was higher among residents in high level care facilities (e.g., nursing homes) (11.6 h/day) than intermediate/mixed level care facilities (e.g., assisted living) (9.5 h/day). In intermediate/mixed level care facilities, television (TV) viewing was the most common sedentary activity (2.5-2.9 h/day; 26% of daily sedentary time), while napping was the most favorite sedentary activity (4.7 h/day; 36% of waking hours) in high level care facilities. Sex differences in daily patterns of sedentary behavior (sedentary time, uninterrupted bouts, and bout durations) were commonly observed in intermediate/mixed level care facilities, as exemplified by men being more sedentary by 0.7-1.1 h/day. In summary, this study highlights distinctive sedentary patterns among older adults residing in different levels of care facilities, addressing a pressing need for customized interventions to engage care facility residents in physical activity.

Keywords: care homes; elderly; inactivity; institutional; lying; mobility; residential aged care; retirement communities; sedentariness; sitting.

Figure 1

Flow chart of the publication selection process.

Figure 2

Daily sedentary time measured by accelerometers and naturalistic observations in care facilities.

Figure 3

Sex differences in daily sedentary time in care facilities. In intermediate/mixed level care facilities, Marshall et al. (2015) and Leung et al. (2017) consistently showed that, as measured by accelerometers, men were more sedentary than women by 0.7 h/day. Similarly, Sebastião et al. (2019) found that a self-report of daily sedentary time was higher in men than women by 1.1 h/day. However, in high level care facilities, there was no significant difference in daily sedentary time measured by self-reported questionnaires between older men and women.