Physical activity in older adults requiring support for independent living, and those in long-term care. A mixed methods investigation

Lead Research Organisation: University of Exeter
Department Name: Sport and Health Sciences


Daily PA levels in older-adults are low. This is particularly true in older-adults requiring support for independent living (SIL) who are often isolated, have impaired mobility, and have limited social networks, and those in long term care facilities (LTCFs) where residents may be inactive for between 60-90% of waking hours. Interventions, programmes and provision aimed at improving PA and quality of life (QoL) in adults in LTC facilities have report limited success. Effective design of PA interventions, policy and provision to improve wellbeing and QoL for older-adults requiring SIL and those in LTC is contingent on an in-depth and comprehensive understanding of both how PA occurs in these population groups, and how patterns of PA link to health. Both are currently lacking.

PA behaviour is complex, and analysis of its patterns necessitates precise objective measurement. However, in order to completely understand the link between PA and QoL, and inform interventions, policy and provision it is also necessary to understand the environments/context in which these behaviours occur. This critical information is best obtained using rigorous qualitative methods. To date no research has combined advanced quantitative and qualitative approaches to comprehensively describe PA patterns and their influence on health and wellbeing in these populations.

This mixed-methods research brings together advanced quantitative and qualitative methods and data science to provide important high-quality information, which can inform interventions, policy and practice in order to improve the health wellbeing and QoL within a vulnerable and growing population group.

Objectives and proposed methodology
Objective-1. To synthesise existing literature examining PA in older-adults in SIL (who are near the point of transition to LTC), and those already in LTC.

Methods: Systematic reviews of existing observational and qualitative research exploring associations between PA and measures of wellbeing and QoL in older-adults in SIL, and those in LTCFs, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA).

Objective-2. To understand and characterise the amount, type and pattern of PA observed in older-adults in SIL (who are near transition to LTC), and those already in LTC.

Objective-3. To examine the relationship between daily and weekly patterns of PA with wellbeing and QoL.

Methods for achieving objectives 2-3: Precise objective data on PA will be collected using wrist worn accelerometry. Participants will be recruited from two populations; 1) older-adults who are receiving SIL who attend day centres run by Age UK in Exeter, 2) older-adult residents at partner LTCFs. Novel data processing methodology will then be employed to provide the first comprehensive characterisation of daily and weekly volumes of activity and the patterns of distribution of PA across hours days and weeks in these population groups. A detailed analyses of associations between patterns of PA with measures of wellbeing and QoL will then be undertaken.

Objective-4. To understand the environments and contexts of PA in these populations and to identify opportunities

Objective-5. To understand what aspects of future guidance or provision for PA would be considered feasible helpful and valuable for these population groups.

Methods for achieving objectives 4-5: To employ qualitative methods in order to build on findings from objectives 1-3 by exploring with staff, support-workers and older-adults in both SIL, and LTC; precisely where, when and how PA occurs in these settings, and how it could be built upon; and to work with older-adults in these groups to understand what would be useful, valuable and feasible in terms of support or guidance for improving levels of PA.


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Studentship Projects

Project Reference Relationship Related To Start End Student Name
ES/P000630/1 01/10/2017 30/09/2027
2073546 Studentship ES/P000630/1 01/10/2018 30/09/2023 Joshua Culverhouse