Effects of Digital Health Interventions on Multidimensional Physical Activity in Older Adults: A Systematic Review, Meta-analysis, and Meta-regression of Randomized Controlled Trials (Preprint)
Year: 2026
Type: preprint
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND Digital health interventions (DHIs) offer new pathways for promoting active living in older adults, but their comprehensive effects on multidimensional physical activity indicators and sedentary behavior remain controversial. OBJECTIVE This study aims to systematically evaluate the impact of DHIs on daily steps, moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LPA), total physical activity, and sedentary behavior (SB) in older adults, and to explore the key regulatory factors influencing intervention outcomes. METHODS Databases including PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for randomized controlled trials (RCTs) regarding DHIs for promoting physical activity in older adults, from inception to December 25, 2025. Literature screening, data extraction, and risk of bias assessment were performed independently by two researchers. Meta-analysis and random-effects meta-regression analysis were conducted using RevMan 5.4 and R software. RESULTS A total of 26 RCTs involving older participants and various digital technology carriers were included. Meta-analysis results showed that DHIs significantly increased daily steps (MD = 0.62 × 1000 steps/d, 95% CI: [0.26, 0.98], P = 0.0008) and weekly MVPA time (MD = 42.08 min/wk, 95% CI: [24.38, 59.78], P < 0.00001) , and significantly reduced sedentary time (MD = -208.15 min/wk, 95% CI: [-320.48, -95.81], P = 0.0003). However, improvements in LPA and total physical activity were not significant (both P > 0.05). Subgroup analysis revealed that standalone wearable devices were significantly more effective in increasing step counts than mobile applications. Meta-regression analysis found that the effect on improving MVPA significantly weakened as participant age increased and intervention duration was extended (both P < 0.05). CONCLUSIONS DHIs are effective means of improving core physical activity indicators and reducing sedentary behavior in older adults. Standalone wearable devices demonstrate superior intervention efficacy compared to mobile applications. Future intervention designs should fully consider the risk of effect attenuation in older populations and long-term interventions to formulate more precise intervention strategies. CLINICALTRIAL [www.crd.york.ac.uk/prospero], identifier [CRD420261284322].
Authors: Jiayi Yao, Haozhe Wang, Shiguan Jia, Hao Chen, Junhao He, Juncheng Long, Shengxian Chen
Topic: Physical Activity and Health
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7124155502