Effects of mobile app interventions on sedentary time, physical activity and fitness in community-dwelling older adults: a systematic review and meta-analysis

Problem

High sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of adverse health outcomes. Mobile-apps, applications that run on mobile platforms, may help promote active living. We aimed to quantify the effect of mobile-app interventions on sedentary time, PA and fitness in older adults. (Prospero protocol CRD42018106195).

Approach

We systematically searched five electronic databases for trials investigating effects of mobile-app interventions on sedentary time, PA and fitness among older adults aged ≥55 years in September 2018. We calculated pooled standardised mean differences (SMD) in these outcomes between intervention and control groups after the intervention period. We performed risk of bias and certainty assessments. Six trials (486 participants, 67% women; 68±6years) were included (five trials in meta-analysis).

Findings

Mobile-app interventions may be associated with decreases in sedentary time (SMD=−0.49, 95% confidence interval [CI] −1.02, 0.03), increases in PA (505 steps/day (95% CI -80.5, 1092) and increases in fitness (SMD=0.31, 95% CI -0.09, 0.70) in trials ≤3 months and with increases in PA (752 steps/day, 95% CI -146, 1652) in trials ≥6 months. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time, and low for fitness.

Consequences

Mobile-app interventions have potential to promote changes in sedentary time and PA over short-term but results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.