Effectiveness of Interventions for Reducing Sedentary Behavior in Older Adults Living in Long-Term Care Facilities: A Systematic Review and Meta-Analysis

Abstract

Objectives: To evaluate the effectiveness of interventions aimed at reducing sedentary behavior (SB) and/or increasing physical activity (PA) among adults aged _60 years residing in long-term care facilities (LTCFs). Design: Systematic review of randomized controlled trials (RCTs) and pre-post interventional studies targeting SB reduction and/or increase in PA, following PRISMA guidelines. Setting and Participants: Six studies conducted in LTCFs across Europe and North America, involving 403 participants aged ≥60 years. Methods: We searched 7 databases (Cochrane Library, PubMed, Scopus, PEDro, ScienceDirect, ClinicalTrials.gov, and Google Scholar) up until January 2025 and screened reference lists for additional articles. Two independent reviewers screened titles, abstracts, and full texts, resulting in the inclusion of 6 studies: 3 prepost interventional studies and 3 RCTs. The primary outcome was time spent in SB, measured via device or self-report, whereas secondary outcomes included quality of life, depression, physical health (physical function, cardiovascular and metabolic health, adverse events), and social isolation. Results: One RCT found that the intervention reduced SB compared to usual care, whereas the other studies reported nonsignificant improvements. Notably, interventions focused on SB rather than PA showed potential positive effects on reducing sedentary time. However, limitations such as small sample sizes, heterogeneity, and risk of bias were common, highlighting the need for further research. Conclusions and Implications: In conclusion, this review emphasizes the uncertainty surrounding the effectiveness of SB reduction interventions in LTCFs. Future research should refine methodologies, standardize interventions and outcome measures, and build a stronger evidence base to guide intervention development and improve well-being in LTCF residents. Findings also suggest that SB-focused strategies may be more effective than PA-based ones alone and could inform policy and practice development in LTCFs.