Evidence for the positive association of physical activity and healthy ageing in longitudinal observational studies

Summary of Daskalopoulou, C., Stubbs, B., Kralj, C., Koukounari, A., Prince, M. & Prina, A. M. ( 2017). Physical activity and healthy ageing: A systematic review and meta‐analysis of longitudinal cohort studies. Ageing Research Reviews, 38, 6– 17.Objective: To establish the evidence for the association between physical activity and healthy ageing in longitudinal cohorts of community based adults.Design: Systematic review.Search strategies: A search was conducted of databases including Medline, Embase, Psycinfo and Cochrane Central Register of Controlled Trials to January 2017. Reference lists were examined. Search strategy is provided.Selection criteria: Published in an electronic journal; an original peer‐reviewed longitudinal study; report an association between physical activity and healthy ageing. Outcomes: Measures of physical activity or exercise through self‐reported questionnaires or objective tools, and health status measured by healthy ageing or other related terms including successful ageing, active ageing and healthy survival.Methods of review: Data were independently extracted by two reviewers and a quality assessment was performed using the Quality in Prognosis Studies (QUIP) tool. Tables were constructed detailing the characteristics of each study and associations between physical activity and healthy ageing. A random effect meta‐analysis was performed to calculate a pooled effect size (ES) and 95% confidence intervals (CI).Results: Search terms and reference list searches identified 5792 titles and abstracts. Following exclusions, 73 full‐text articles were assessed and a further 42 were excluded. Twenty‐three studies were included, with 174,114 participants (30% men) with age ranges from 20 to 87 years old. Two studies were assessed as being at a high risk of bias, five assessed as moderate and 16 assessed as low. There was much heterogeneity in the measurement of healthy ageing (19 studies included physical performance to define healthy ageing) and physical activity with 16 studies reporting a significant positive association. The results of the meta‐analysis demonstrated that physical activity is positively associated with healthy ageing (ES: 1.39, 95% CI = 1.23–1.57, n = 17 studies). Subgroup analyses found that when physical activity was a binary variable, which did not factor in level or intensity of exercise, the associations were smaller in comparison to those that did include these factors. Baseline age and the definition of the measurement of healthy ageing were found to be significant modifiers.Conclusions: There is consistent evidence, despite varying definitions and methods of measurement, from longitudinal observational studies that physical activity is positively associated with healthy ageing.