Exploring the impact of community-based interventions on healthy older adults' physical health, psychological wellbeing, and social connections: A systematic review.

Abstract

Background: Given trends towards greater life expectancy, there is an increasing need to promote healthy ageing and add quality and value to older adults' lives, however the evidence regarding the effects on overall health and wellbeing has not been synthesised. Active lifestyles may provide diverse health and wellbeing benefits for older adults in terms of maintaining or improving their physical, psychological, and social functions. This systematic review evaluates whether and how different types of interventions within community-based settings could benefit specific aspects of older adults' health and wellbeing.

Methods: PubMed, PsycINFO, Scopus and Web of Science were systematically searched in January 2022 for experimental studies (including randomised controlled trials, non-randomised controlled trials, and quasi-experimental studies) exploring health and wellbeing benefits of community-based activities in older adults. A total of 12,707 sources were identified through database searches with 183 retained for full screening. Final inclusion was based on the following eligibility criteria: (1) participants were generally healthy and predominantly independent community-dwelling older adults aged 60 and above; (2) interventions were based in real-world settings, e.g., dance, art and technology classes, etc. held in publicly-accessible facilities; (3) pre-/post-interventions assessed at least one outcome in physical health, psychological wellbeing or social connections; (4) control groups were used, including passive and active control groups or groups that received a different type of intervention; (5) experimental studies followed a quantitative research design. Study quality was systematically assessed, and a comprehensive narrative synthesis of the findings was conducted.

Results: Of the 183 studies screened, 56 were included in the final review. Among the 33 predominantly physical interventions, 31 demonstrated positive effects. Of the 16 predominantly mental interventions, 14 reported benefits. All seven predominantly social interventions reported positive effects.

Discussion: The benefits of real-world interventions were reported across a range of outcomes, particularly in terms of reducing depression or anxiety, or improving physical functioning, sleep quality and social participation. However, heterogeneity in interventions, sample design, duration and dosage suggest that more research is needed to support the effects of duration and dosage of intervention exposure. As real-world interventions more closely resemble the way in which older people engage in activities, evidence of their effectiveness in promoting health and wellbeing should inform preventative healthcare provision and policymaking.