Impact of physical activity and exercise training on health-related quality of life in older adults: an umbrella review

Health-related quality of life (HRQoL) is inversely associated with all-cause mortality in older adults and may be improved with physical activity and exercise training. The objective of this umbrella review was to determine the impact of physical activity and exercise training on HRQoL in younger-old (average age ≤ 75 years) and older-old (average age > 75 years) adults. Our umbrella review (CRD42023481145) included 39 systematic reviews (21/39 with meta-analysis) including 113 unique individual studies of 13391 unique participants. Sources were searched in November 2023 and included Scopus, EMBASE, PubMed, CINAHL, and Academic Search Premier. In all older adults, the impact of exercise/physical activity training on overall HRQoL (n = 30/39) demonstrated mixed results with 50% of studies observing an improvement in overall HRQoL following physical activity and exercise training (younger-old adults, 7/14 studies; older-old adults, 8/16 studies). Thirty-six percent and 44% of studies demonstrated no impact on HRQoL in younger-old and older-old adults, respectively. Fourteen percent and 6% of studies demonstrated mixed results in younger-old and older-old adults, respectively. Older-old adults had the greatest improvement in HRQoL following general exercise training (5/6 studies) versus interventions focusing on physical activity (4/8 studies). Younger-old adults had the greatest improvement in HRQoL following physical activity focused interventions (5/6 studies). Based on high-quality evidence and a large sample size, existing literature demonstrates that increasing physical activity in younger-old adults and general exercise training in older-old adults may be useful for improving HRQoL.