Co-designing physical activity interventions for older adults with frailty: Insights from a qualitative study in retirement village

Introduction: The UK’s ageing population presents growing challenges for health and social care.1 Age-related impairments in mobility, strength, cognition, and endurance contribute to the development of frailty and decreased physical activity in older adults.2 Despite the World Health Organization’s recommendations for regular physical activity among older adults, participation remains low due to physical, psychological, and social barriers.3 This study is aimed to explore these barriers and understand older adults’ preferences regarding physical activity to inform the co-development of interventions for promoting physical activity in older adults with frailty.

Methods: A qualitative study was conducted using semi-structured interviews with residents of a retirement village in Bristol. Participants were purposively sampled to include diversity in physical activity levels, physical impairments, frailty level4, gender and age. The interview topic guide was co-developed with the research team and two Public Involvement members. All interviews were conducted in-person by the primary investigator in the village meeting room, after obtaining the informed consent. Interviews were audio-recorded with participants’ permission, and reflexive notes were taken after each session to capture immediate impressions and address potential researcher bias. Data are being analysed using a reflexive thematic analysis. Ethical approval was obtained from UWE ethics committee, Bristol.

Results: To date, six residents (aged 76-84; two males, four females; clinical frailty score ranged from 3 to 5) have participated. Interviews ranged from 60 to 90 minutes. All participants reported at least one physical condition, including impaired mobility, hearing loss, or joint-related problems. Preliminary inductive thematic analysis revealed the emerging themes: (a) Adaptation to age-related functional decline; (b) Self-determination and exercise self- regulation; (c) Emotional resilience and positive coping mechanisms; (d) Environmental facilitators and barriers to physical activity; and (e) Social dynamics and community engagement. The study is ongoing, with a target of at least 12 participants.

Conclusion: These findings will inform the next phase of the research, contributing to the co-development of a comprehensive intervention model aimed at facilitating physical activity and exercise participation among older adults with frailty residing in retirement homes.

References:

1. Reeves C, Islam A, Gentry T (2023). The state of Health and Care of Older People in England 2023. Age UK [online]. Available from: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/age_uk_briefing_state_of_health_and_care_of_older_people_july2023.pdf [Accessed 2 Oct 2024]
2. Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: Clinical, research, and policy implications of a core geriatric concept. Journal of the American Geriatrics Society, 55(5), 780–791. https://doi.org/10.1111/j.1532-5415.2007.01156.x
3. Nilstomt, A., Gustavsson, J., Beckman, L., Bäccman, C., Nilson, F., Wagnsson, S., & Wästlund, E. (2024). Physical activity from the perspective of older adults: A convergent mixed-method study. BMC Geriatrics, 24(1), 768. https://doi.org/10.1186/s12877-024-05362-x
4. Rockwood, K., Song, X., MacKnight, C., Bergman, H., Hogan, D. B., McDowell, I., & Mitnitski, A. (2005). A global clinical measure of fitness and frailty in elderly people. CMAJ : Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 173(5), 489–495. https://doi.org/10.1503/cmaj.050051