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Sedentary behavior and health outcomes in older adults: A systematic review

1 Institute for the Medical Humanities, Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, TX, USA
2 Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Austin, TX, USA
3 Department of Graduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
4 Department of Community Medicine and Population Health, Institute for Rural Health Research, University of Alabama, Tuscaloosa, AL, USA

Introduction: Older adults (≥ 60 years old) report prolonged periods of sedentary behavior. Sedentary behavior is a potential health hazard for this priority population. Therefore, we systematically reviewed the published literature to document the relationships among sedentary behaviors and twelve health outcomes ranging from mental health to mortality. Methods: Major databases were searched from 2013 to 2019; 27 relevant articles were found and evaluated. In addition, we compared our findings to a previously published review. Results: Higher levels of sedentary behavior were related to an increased risk of all-cause mortality and adversely associated with metabolic syndrome, triglycerides/high density lipoprotein cholesterol/blood glucose, HBA1C/glucose intolerance, waist circumference, and obesity/overweight when compared to those with lower levels of sedentary behavior. Findings for blood pressure, cancer, and mental health (e.g., dementia, mild cognitive impairment, psychological well-being) were insufficient to draw conclusions or had inconsistent results. Because some sedentary behaviors were protective for mental health, we recommend a taxonomy of sedentary behaviors for older adults to provide insights into these seemingly discrepant findings. Some of our findings were similar to a prior review while other findings were different. Conclusion: This systematic review identified the health outcomes that were sufficiently, insufficiently, or not affected by sedentary behavior. To advance the field, we recommend better methodological quality. To improve the overall health and wellbeing of older adults, future studies should evaluate interventions to decrease health-compromising and increase health-promoting sedentary behaviors among older adults.
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