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Interventions focused on lifestyle have demonstrated effectiveness in addressing issues of frailty and mild cognitive impairment in older individuals. However, the optimal methods to instigate lifestyle modifications among older adults facing frailty and Mild Cognitive Impairment (MCI) remain uncertain. We performed searches in online literature databases including PubMed, Scopus, Cochrane Reviews, ProQuest, and grey literature to identify articles published in English from January 2010 to October 2023. This review emphasized research employing a qualitative design. We collected data concerning the publication year, geographic location, study objectives, population demographics, interventions applied, barriers faced, motivating factors, and expressed preferences within the articles. From an initial 5226 articles retrieved, we narrowed this down to 253 after removing duplicates and screening titles and abstracts. Ultimately, fourteen articles were included for comprehensive analysis following the review process. The primary themes identified in this review were intrinsic and extrinsic factors affecting motivation and barriers to lifestyle modification. The most frequently reported motivators included perceived advantages of lifestyle alteration and levels of self-efficacy. Participants encountered obstacles such as perceived negative effects of intervention, gaps in knowledge, existing impairments (both physical and mental), and lack of social support. Motivators and obstacles to lifestyle changes in older adults were predominantly intrinsic, comprising perceived benefits of intervention, self-efficacy, knowledge, family commitments, and ongoing impairments. It is crucial to empower older adults to surmount these barriers with assistance from healthcare providers, community resources, and family support.
Citation: Mohammad Hanipah J, Mat Ludin AF, Singh DKA, Subramaniam P, Shahar S (2025) Motivation, barriers and preferences of lifestyle changes among older adults with frailty and mild cognitive impairments: A scoping review of qualitative analysis. PLoS ONE 20(1):
e0314100.
https://doi.org/10.1371/journal.pone.0314100
Editor: Mario Ulises Pérez-Zepeda, Instituto Nacional de Geriatria, MEXICO
Received: July 28, 2024; Accepted: November 5, 2024; Published: January 20, 2025
Copyright: © 2025 Mohammad Hanipah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction in any format, provided the original author and source are credited.
Data Availability: All pertinent data are included in the article and its Supporting Information files.
Funding: This research is financed by the Ministry of Higher Education under the Long-Term Research Grant Scheme (LRGS/1/2019/UM-UKM/1/4), though the funding agency did not influence the study’s design, data collection, analysis, publication decision, or manuscript preparation. Approval for this study has also been granted by the Research Ethics Committee of the National University of Malaysia (UKM/PPI/111/8/JEP-2020-34).
Competing interests: The authors have asserted that there are no competing interests.
Advancing age is [1] linked to a heightened risk of chronic illnesses, cognitive decline, and physical frailty, all of which substantially affect the quality of life of older individuals [2, 3]. Frailty and cognitive deficiencies represent two of the most widespread and problematic conditions encountered in geriatric populations, frequently occurring together [4]. Cognitive frailty (CF) is a relatively recent clinical concept, characterized by the coexistence of physical frailty and mild cognitive impairment (MCI) in older adults without dementia [5]. The concurrent existence of frailty and cognitive deterioration increases the vulnerability of older adults to unfavorable outcomes, such as functional dependence, institutionalization, and mortality, in comparison to those who experience either condition alone [6–8]. Unlike dementia, cognitive frailty is potentially reversible if addressed promptly with suitable interventions [9].
Lifestyle interventions or modifications have robust evidence-based effectiveness for older adults suffering from physical frailty and cognitive decline [10–12]. Implementations of lifestyle changes have shown beneficial results in reversing or retarding the progression of both physical frailty and mild cognitive decline [13–15]. These interventions encompass various domains such as physical (exercise and activity), nutrition (healthy balanced diet with supplements), cognitive (cognitive stimulation activities), psychosocial (social support), and cardiovascular risk management (cardiovascular health, control of smoking and alcohol use), effectively addressing [16–18] and preventing adverse health scenarios [19]. Nevertheless, participation in these interventions faces multiple intrinsic and extrinsic obstacles [20]. Grasping these barriers alongside the motivators that inspire participation is vital for crafting effective and accessible intervention programs.
Despite the emergence of recent studies relating to cognitive frailty, they predominantly focus on the effectiveness of various interventions, associated risk factors, predictors, adverse impacts, relevant biomarkers, and the reversibility of the condition [7, 11, 21–24], rather than examining the factors that affect older adults’ readiness and capacity to engage in such interventions. Thus, this review incorporates research conducted onolder individuals experiencing physical frailty or MCI, as these groups are essential for comprehending the two main facets of cognitive frailty. By reviewing research that focuses on both physical frailty and MCI, this examination establishes a basis for enhancing involvement in lifestyle interventions designed specifically for older individuals with cognitive frailty. The process of translating and applying evidence-based interventions within healthcare frameworks requires an understanding of motivations and obstacles that are specific to the population at individual, organizational, and community levels [25].
Consequently, this review intends to ascertain the existing evidence concerning the viewpoints of older adults facing frailty and MCI regarding lifestyle modifications or interventions. More specifically, this scoping review strives to identify and outline the motivations, barriers, and preferences related to lifestyle intervention/modification among older adults experiencing frailty and MCI. This investigation forms part of the AGELESS Trial study conducted under the LRGS initiative, which aims to identify an effective intervention for reversing cognitive frailty among older adults in Malaysia [26].
This scoping review methodology is grounded in the framework established by Arksey and O’Malley [27] along with the updated framework from the Joanna Briggs Institute [28]. Additionally, we adopted the approach proposed by Levac, Colquhoun, and O’Brien for the searching, screening, and reporting phases of the scoping review [29]. The six phases of conducting a scoping review include (1) Identifying the research question; (2) relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting results; (6) stakeholder consultation. The reporting of findings from this scoping review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist [30].
In this review, we seek to address the following inquiries.
A thorough search strategy was formulated and discussed among team members. We employed PCC (Population, Concept, and Context), as displayed in Table 1 below as a reference. Keywords and search terms were extracted from the titles and primary objectives. Synonyms for these keywords were subsequently derived using Medical Subject Headings (MeSH) and online thesaurus searches.
Search strings (Table 2) were constructed utilizing the Boolean Operator to link the synonyms. We conducted searches across electronic databases (PubMed, Scopus, Cochrane Reviews, and ProQuest) as well as gray literature found on Google Scholar. Searches were restricted to studies published from January 2010 to October 2023, full-text articles, human subjects, and the English language. Articles found through hand-searching were also filtered using the same criteria. The latest search took place on 1st November 2023. All gathered articles were uploaded to the Mendeley application, consolidated into a single shared folder, and reviewed for duplicates.
The selection of articles was based on certain inclusion criteria: (1) studies reporting on the motivations, barriers, or preferences of older adults with frailty or MCI concerning lifestyle modification or participation in a lifestyle intervention program, (2) participants aged 60 and above, (3) qualitative and mixed methods study designs, (4) articles published in English, (5) studies released between January 2010 and October 2023. Review articles were excluded from this scoping review.
Lifestyle interventions in this review are defined as organized programs intended to encourage health-related behavior changes across various domains [31]. These interventions encompass physical activity (PA), nutritional or dietary adjustments, cognitive training, and psychosocial interventions. The term “physical activity” used in this review represents a wide array of definitions and is not confined to “planned, structured, repetitive, and purposive” activities [32]. Nutritional interventions refer to planned actions aimed at positively influencing nutrition-related behavior, risk factors, environmental conditions, or health status for individuals, families, caregivers, target groups, or communities [33]. Cognitive training pertains to structured tasks and guided practice incorporated into interventions designed to enhance cognitive function [34]. Lastly, psychosocial interventions are defined as any non-pharmacological strategies aimed at altering cognitive functions and improving an individual’s health symptoms, functioning, and overall well-being [35].
The screening process involves two phases: title screening and abstract screening. The online systematic article management software Rayyan Ai was utilized to facilitate the screening process [36]. Rayyan AI software was employed to streamline the organization and screening methodology to handle duplicates and aid in title and abstract screening. In the initial stage of the literature search, we identified 5042 articles and added 245 more articles through reference tracking. Following this, JMH and AFML independently assessed the titles and abstracts of the articles. By the conclusion of the first phase, 5143 articles were dismissed. JHM and AFML then reviewed 144 full reports, analyzing each in detail to gauge individual articles’ relevance. Any differences were reconciled during regular consensus meetings amongall the contributors. Fig 1 illustrates the flowchart of search and study selection, modified from the PRISMA group [30]. Ultimately, 14 articles were incorporated into the final evaluation [21, 37–49].
The first and second authors independently reviewed the included articles and extracted any motivation, barriers, or preferences mentioned in each document based on the aforementioned definitions. After data extraction, the studies were organized and tabulated according to the following aspects:
“Barriers” were characterized as any physiological, psychological, or socio-ecological factors reported to hinder or negatively impact an individual’s involvement in any lifestyle intervention. “Motivation” encompasses a broad term that includes both internal motivators (such as personal goals, acknowledged benefits, and psychological readiness) and external influences (like social support, accessibility, and environmental factors [50–52]. Preferences pertain to attributes or features of any lifestyle interventions that participants indicated as enjoyable. The final agreement to include in the analysis was reached during the regular gathering of all the contributors (SS, DKAS, or PS).
Subsequently, the selected articles were archived in NVivo 12 Plus, qualitative data analysis software, for extraction and thematic analysis of data [53]. Initially, JMH reviewed the data and familiarized themselves with it to aid in creating the initial codes. The initial codes were generated, and the excerpts were sorted according to the suitable themes. Following that, JMH organized the themes to determine the connections between them. The sorted themes were classified and named after discussions with AFML. The finalized themes were confirmed during the census meeting with all authors.
Among 5287 unique references discovered through searches, 14 studies were incorporated into this review (Fig 1), all of which investigated participants’ insights and experiences concerning lifestyle interventions or modifications. These studies evaluated various facets of lifestyle interventions, incorporating participants’ opinions on the feasibility, acceptability, and perceived efficacy of programs aimed at enhancing physical or cognitive health results. Two studies detailed the perceptions of older individuals with MCI regarding PA [42, 43]. One study outlined the barriers and preferences of older adults with MCI in engaging with computer-based cognitive training [37]. Another study illustrated the motivation and barriers of older adults with MCI concerning digitized multicomponent lifestyle intervention strategies [45]. Furthermore, one selected study discussed barriers and preferences of older adults with MCI towards psychosocial approaches (public square dance) [44], while two studies highlighted motivation, barriers, and preferences of older adults with MCI regarding multi-component lifestyle interventions to avert cognitive decline and cardiovascular risk factors [21, 46]. For the participants with frailty, three of the selected studies reported on their motivation, barriers, and preferences relating to PA [38, 40, 47]. Four studies involving participants with frailty focused on the perceptions of older adults regarding multi-component interventions [39, 41, 48, 49]. The features of the selected studies are summarized in Table 3.
Within this review, we identified several overarching themes that encompassed both intrinsic and extrinsic factors. Aligning with Mohamed Nor et al. [54], we categorize the motivations and barriers into intrinsic and extrinsic elements as the main theme. The sub-themes stemming from the primary themes were classified as either motivations or barriers to engagement in lifestyle interventions.
The motivations recognized under intrinsic factors were the perceived advantages of the intervention, self-efficacy, awareness, and diagnosis of the condition.The influences examined under external factors included the information source, community support, component related to intervention, and availability. Table 4 presents a summary of themes pertaining to motivational factors.
1.1 Internal motivators for participation in the lifestyle intervention. a. Perceived advantages of lifestyle intervention: Ten articles emphasized the gains from lifestyle interventions as driving forces for engagement to implement changes [38, 40–43]. Participants noted experiencing improvements in physical and mental health through involvement in interventions [43]. Sustaining physical condition alleviated the stress and burden for care partners and family members [40, 42, 46]. Furthermore, social interaction during interventions was also recognized as a perceived advantage [40, 41, 43, 46].
b. Self-efficacy: Self-efficacy serves as a motivator for involvement in lifestyle interventions. It plays a pivotal role in executing lifestyle modifications, as it indicates the determination to initiate or refrain from lifestyle alterations [55]. Participants from one study expressed that behaviors linked with autonomy and lifelong self-improvement were drivers for them to adopt lifestyle changes. They also recognized that these behavioral modifications positively impacted brain health [45]. A favorable mood facilitates their participation in lifestyle change intervention programs [43]. Individuals with MCI aimed to sustain or boost their existing physical status, which influenced their engagement in PA. The self-efficacy attributes of strong internal drive, commitment to exercise, time management proficiency, and adaptability to shifting schedules determine their involvement in interventions [42].
c. Knowledge: Comprehending the illness aids older adults in shaping their perspectives towards cognitive impairments and preventative measures, while moderating their anticipations and motivations for participating in preventive trials [21]. Awareness of local services and the ability to utilize them (e.g., completing forms) also encouraged older adults to engage or modify their lifestyles [38]. Moreover, the intention to enhance scientific understanding of MCI and its prevention has been identified as a motivating factor for their involvement in such initiatives [46].
d. Condition diagnosis: Participants in one investigation indicated that being diagnosed with MCI or early dementia motivated them to increase their exercise [43]. A few studies suggest that family history or indirect exposures to cognitive disorders could encourage some older adults to seek medical guidance and information regarding health and preventive strategies. Anxiety and familial history of cognitive disorders were cited as significant influences towards lifestyle alterations and prevention engagement [45]. Those diagnosed with cognitive disorders feel compelled to participate as they aspire to lessen the burden on their family and caregivers [46]. Participants shared that their encounters with affected individuals made them more inclined to join lifestyle intervention programs [21].
1.2 External motivations for joining the lifestyle intervention. a. Information source: Endorsements from healthcare professionals [doctors or therapists] produce urgency and anxiety, propelling them to begin and uphold exercise routines [43]. For many participants, knowledge or guidance from their providers was perceived as essential to cultivate their confidence to instigate changes [42].
b. Community support: Seven of the reviewed studies highlighted community support as a facilitator for engaging in lifestyle interventions. Motivation to exercise and influence on health behaviors were found from the encouragement and aid of others [43, 45–47]. Care partners significantly impacted participation in the PA among individuals with MCI [42]. A support network offers assistance, freedom, and opportunities to socialize and engage with the community [39]. Formulating action plans with others, holding oneself accountable, and sharing motivation and new ideas also encourage participation in lifestyle modifications [45].
c. Availability: Accessibility to the intervention program was identified as a motivating aspect for frail participants to engage and adhere to the lifestyle intervention. The nearness of community resources, access to exercise tools, and supportive care constituted a favorable physical environment that encouraged and enabled participants [42]. Additionally, the provision of assistive devices to ease PA also improved their access to the intervention program [40].
Numerous hurdles to commencing or sustaining lifestyle changes exceed the motivations. These challenges can be further classified into intrinsic and extrinsic factors. The intrinsic barriers identified encompassed perceived negative experiences with the intervention, insufficient knowledge, family obligations, and absent internal motivation. The examined extrinsic barriers included care partner support and availability, accessibility issues, societal stigma, and components related to the intervention (Table5).
2.1 Innate obstacles to engaging in lifestyle interventions. a. Perceived adverse experiences in intervention: Participants noted unfavorable encounters during PA (e.g., disliking the sensation of perspiration or being in water while swimming), post-PA (e.g., muscle soreness, tiredness), as a major hurdle to participating in interventions [43]. Another research indicated that participants lacked comprehension of the advantages of exercise, viewing it as difficult and possibly ineffective for older adults [40]. Experiences and discrepancies between their own encounters and what they had heard regarding prevention were also highlighted as obstacles to joining lifestyle interventions [21].
b. Insufficient knowledge: A deficiency in knowledge acts as a barrier to participation in lifestyle interventions, impeding the ability of participants to engage in activities and obtain relevant information [40]. In initiatives employing digital technology, participants may disengage due to inadequate skills with devices [46, 49]. Individuals diagnosed with MCI may feel fearful and embarrassed about their condition, resulting in hesitance to educate themselves regarding their diagnosis [21].
c. Family obligations: Family obligations as a barrier were primarily reported by female participants. Their duties towards family members often cause their role as a caregiver to supersede their self-care, hobbies, and other pursuits [38, 49].
d. Physical and cognitive impairments: Participants indicated that their physical limitations [mobility restrictions, pain and arthritis, vision impairment, and other physiological changes] restricted their ability to exercise, particularly walking [45, 48]. Cognitive issues and disorientation also obstructed participation in the intervention, notably exercise at home [43]. Physical disabilities were consistently recognized as barriers to engagement [38].
e. Lack of inherent motivation: Motivation is vital for lifestyle alterations. With sufficient motivation, the majority of participants managed to implement necessary changes. Participants who exhibited a lack of motivation faced challenges in making essential changes, like increasing their exercise levels [43]. Some felt too aged to walk or exercise, which discouraged their willingness to participate [47]. Frail older adults conveyed a lack of drive to exercise independently without supervision, affecting the program [49].
2.2 External barriers to participating in lifestyle interventions. a. Support and availability of care partners: Due to aging and disease processes, individuals experiencing cognitive decline may depend more on their care partners for companionship and assistance with exercise. Furthermore, participants require their caregivers to co-participate as they may need help or guidance throughout the intervention or regarding transportation. However, caregivers may not always be accessible because of other obligations. The health condition of caregivers may also influence their capacity to join the program [42, 43].
b. Accessibility issues: Three selected studies highlighted accessibility as a barrier to engaging in lifestyle interventions. Various aspects of accessibility were discussed, including environmental accessibility, transportation, the availability of specific programs, and climate considerations. Transportation emerged as a significant obstacle for older adults to reach intervention or program locations since some cannot drive or utilize public transport [43]. Another accessibility barrier involved the availability of specific programs corresponding to their mental or physical condition. Many programs necessitated a care partner’s presence, which was unfeasible for all individuals living with MCI or early dementia [42]. Individuals living with MCI or early dementia did not qualify for community-assisted transport for persons with disabilities as this condition was not recognized as a disability [38].
c. Social stigma implications: Perceived societal stigma was stated to adversely impact participation in exercise. They sensed that others viewed them as afflicted rather than as individuals [43]. Insufficient awareness from peers and fitness professionals regarding cognitive impairment also created awkward situations, dissuading some participants from engaging in PA [43].
d. Aspects related to the intervention: Participants in one study noted that the tasks assigned in the computerized cognitive training were overly complex and demotivated them to persist in their participation. When tasks are too challenging for individuals with MCI, they may hesitate to interact online with unfamiliar individuals [37]. Moreover, an intervention not customized to a participant’s abilities and conditions often leads to demotivation for them to participate [21]. Conversely, factors related to service providers were also discussed in one study, highlighting that the consistency of service providers (therapists/trainers) impacts motivation to remain engaged in intervention programs. Frequent alterations or reliance on temporary staff can indirectly diminish the interpersonal relationships between participants and service providers, dissuading them from continuing with the program [47].
We identified two sub-themes emerging fromthe primary theme choices (Table 6). Initially, preferences pertain to qualities or elements of any lifestyle modifications that participants recognized as appealing or motivating.
3.1 Preferences specific to interventions. Seven of the chosen studies documented participants’ preferences for various lifestyle modifications. Participants expressed a preference for a tailored group exercise program with individuals who have similar challenges. Such involvement fostered feelings of comfort and pleasure, along with a sense of self-esteem [43]. Furthermore, participants indicated that interventions should be customized to align with their physical and mental requirements to enhance fun and enjoyment [40, 43, 47]. In another study, participants favored interventions arranged into different groups according to their skill levels [41]. In research regarding older adults’ perspectives on computer-based cognitive training, participants conveyed a preference for consistent training sessions explicitly intended to enhance cognitive abilities rather than infrequent ones [37].
Participants conveyed a desire for a progressive intervention program featuring a feedback mechanism to inform them about their progress and performance, which would serve as a motivating factor [37]. They also suggested shorter initial assessments and advocated for feedback sessions between service providers and participants to enhance coordination and their understanding of progress [49].
Moreover, the intervention program (computer-based cognitive training) should involve daily activities. Participants favored activities conducted in small groups with a mix of light, yet challenging exercises [43, 46, 48]. Additionally, participants preferred the training site to be easily accessible within the community or that transportation be provided [38].
Furthermore, participants from one study indicated a preference for face-to-face interventions/programs rather than online delivery methods. Face-to-face interactions are valued as they facilitate social interaction and support during the intervention program [48]. Participants also recommended extending the program period to maintain the benefits achieved [49].
Preferences concerning the intervention were also highlighted regarding the service providers. Participants leaned towards instructors who are knowledgeable and amiable, as this encourages greater engagement [39, 47]. This, in turn, could enhance adherence among older adults, particularly those with MCI or frailty. It was suggested that religious, governmental organizations or medical service providers oversee the intervention. Some participants expressed a desire for the program to continue at an affordable price. Delivering free or low-cost frailty prevention programs would serve as a critical strategy for mitigating frailty [21, 37, 38, 44].
3.2 Information. In one study, participants remarked that local authorities should play a greater role in promoting physical activity programs for older individuals [40]. Additionally, there should be a collaborative effort between healthcare providers and clients to enhance knowledge sharing. Participants expressed a preference for brochures containing information, such as the health benefits of exercise for seniors and available physical activity programs in the community [43]. They preferred intervention-related materials to be presented in written form, as they found it more comprehensible and helpful for memorization [46].
This review assessed the current literature regarding motivation, obstacles, and preferences related to lifestyle interventions among older adults experiencing MCI or frailty.
It was found that intrinsic factors presented a more considerable concern compared to extrinsic factors. Additionally, the findings denote that participants reported more obstacles than motivations concerning lifestyle changes. The most frequently mentioned sub-themes under barriers included the presumed adverse effects of interventions and insufficient knowledge. Conversely, the perceived advantages of the intervention were the most frequently cited sub-themes under motivation. Furthermore, adequate knowledge, social support, and motivation facilitated participation in lifestyle modifications.
Among the obstacles and motivations recognized by this review, many are frequently acknowledged as determinants of lifestyle/behavior modifications among older adults. However, a select few factors are specific to the population studied. Older adults, particularly those affected by MCI/dementia, often encounter co-occurring conditions and functional limitations that complicate the initiation and maintenance of regular exercise [56]. To empower older adults with or at risk for dementia to remain physically active, it is crucial to identify and mitigate barriers while enhancing motivators for exercise. Most barriers to physical activity and exercise prevalent among older adults are likely to be pertinent to individuals with MCI/dementia, often to a more significant extent [57]. Furthermore, progressive cognitive decline may intensify previously existing obstacles over time.
While intrinsic elements are fundamental, it is vital to recognize that extrinsic factors can greatly affect behavior change. For instance, alterations in environmental aspects, such as accessible facilities and community programs, can motivate older adults with MCI or frailty to engage in physical activities [58]. Furthermore, an individual’s economic position and cultural heritage may interrelate with internal motivations, emphasizing the necessity for customized interventions that take various contexts into account [59]. Acknowledging the link between internal and external factors offers a thorough framework for comprehending and tackling barriers to lifestyle changes within these demographics.
The elements of intrinsic motivation can also be amplified by social support and elements of intervention. For instance, social encouragement enhanced compliance with exercise, involving oversight and motivation from service providers and caregivers. This facilitated the establishment of exercise as a routine habit for senior individuals with MCI [60, 61]. Family relationships and caregiver involvement are pivotal in nurturing motivation and surmounting obstacles faced by seniors with MCI and frailty. By integrating input from family members or caregivers within intervention plans, healthcare practitioners can boost the effectiveness and longevity of lifestyle strategies for this group [62].
Beyond motivation and obstacles, we gathered insights on the preferences regarding lifestyle interventions among older adults with frailty and MCI. Interventions specifically adapted to physical or cognitive capabilities were the most frequently cited criteria. Insufficient focus was given to individual differences and their inclinations. Custom-tailored interventions addressing their needs and skills, along with group activities and integrating interventions into everyday routines were highlighted as their preferences. Engaging in forms of social interaction generated feelings of comfort, joy, and a sense of self-worth among older adults with MCI. Involving them in the collaborative design of intervention programs ensures the prioritization of their preferences and needs, cultivating a sense of empowerment and responsibility for their health [63].
Factors pertaining to service providers were highlighted in both the barriers and preferences themes. Expanding on this, recognizing the influence of healthcare providers and systemic factors is crucial in shaping the experiences of older adults facing MCI and frailty. For example, the availability and reach of geriatric care services, which include specialized rehabilitation initiatives and interdisciplinary care teams, can significantly affect an individual’s capacity to engage in lifestyle adjustments [64]. Additionally, regulations regarding reimbursements for preventive services and community-based support initiatives may affect the implementation and continuity of lifestyle changes [65]. By tackling systemic impediments and advocating for policy reforms, healthcare providers can foster a more supportive environment enabling older adults to adopt healthier habits amidst cognitive and physical hurdles.
The main strength of this research lies in the systematic aggregation of qualitative studies aimed at gathering insights on older adults’ views regarding lifestyle interventions. Qualitative techniques are ideal for obtaining a profound understanding of related subjects. We acknowledge that the selected articles are not plentiful, even after conducting extensive and thorough searches. We believe this results from our specific focus on factors relevant to lifestyle-changing behaviors in a multidisciplinary lifestyle initiative targeting older adults experiencing MCI and frailty. A limitation of this study is that it encompasses studies from various nations with distinct social and environmental variations that may differ from our local context. Furthermore, the severity of both MCI and the frailty of study participants was not considered during the analysis of findings.
Grasping the specific hurdles encountered by older adults, especially those with MCI and frailty, is crucial for developing targeted interventions aimed at improving their cognitive and physical health. The identified intrinsic elements such as pre-existing impairments, lack of awareness, and motivation aggravate their cognitive and physical decline and highlight the urgency for preventive actions. The intrinsic and extrinsic factors affecting lifestyle changes highlighted in this review hold direct implications for promoting healthier lifestyles among older adults. By acknowledging the influence of social support and personalized interventions, our findings can contribute to the broader objective of enhancing overall well-being in the aging populace.
The expressed preferences for personalized interventions based on physical or cognitive ability levels, along with the integration of activities into daily routines, resonate with initiatives designed to promote sustained lifestyle changes. This comprehensive understanding is particularly pertinent to ongoing public health endeavors to design and implement initiatives that not only avert cognitive decline and frailty but also elevate the overall health and quality of life for older individuals. As the landscape of preventive healthcare evolves, our research offers significant insights that can guide the formulation of comprehensive approaches for encouraging healthy aging and averting dementia.
This review offers insight into the motivations, challenges, and inclinations toward lifestyle transformations among older adults with MCI and physical frailty. The most significant motivating factors can be categorized within the intrinsic motivation theme. Thus, promoting lifestyle modifications should be encouraged for all older adults, especially for those with impairments such as frailty and MCI.
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