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Background <p>Adherence to 24-h movement guidelines that include physical activity (PA), sedentary behaviour (SB), and sleep is linked to improved health outcomes, yet its impact on health-related quality of life (HRQoL) in older adults remains underexplored.</p> Objective <p>This study investigated the relationship between adherence to guidelines for 24-h movement behaviours and HRQoL in older adults.</p> Methods <p>A systematic search of four databases was conducted to identify studies published from the date of inception to January 2025. The Appraisal Tool for Cross-Sectional Studies was used to assess the risk of bias among the included studies. Random-effects models were used to conduct a meta-analysis involving the extracted proportions and odds ratios (OR) from each study. The Freeman–Tukey transformation was applied to stabilise the variance of proportional data before meta-analysis, and pooled proportions were back-transformed to their original scale for reporting.&#xa0;Heterogeneity was assessed using the I<sup>2</sup> statistic. Publication bias was evaluated using Begg’s test. A sensitivity analysis was conducted, which included changing the random-effects model to a fixed-effects model and adopting a leave-one-out analysis.</p> Results <p>Twenty-five cross-sectional articles were included, covering a total of 170,670 older adults aged ≥ 60&#xa0;years.&#xa0;We found that 24.3% (95% confidence interval [CI]: 22.1%–26.5%, <i>p</i> &lt; 0.01) of older adults adhered to at least one movement guideline, among whom 23.0% (95% CI: 20.8%–25.2%, <i>p</i> &lt; 0.01, <i>n</i> = 18) adhered to PA guidelines, 18.5% (95% CI: 15.3%–21.7%, <i>p</i> &lt; 0.01, <i>n</i> = 7) to SB guidelines, and 40.0% (95% CI: 37.5%–42.5%, <i>p</i> &lt; 0.01, <i>n</i> = 7) to sleep guidelines. Our meta-analysis suggests that compared with non-compliance, adherence to at least one 24-h movement guideline was associated with higher HRQoL among older adults (OR = 1.65, 95% CI: 1.44–1.89,&#xa0;<i>p</i> &lt; 0.01,&#xa0;I^2 = 95.5%, <i>n</i> = 15). Small-study effects were examined with Begg’s test; all subgroup analyses of individual guidelines were underpowered due to a small number of included studies (<i>n</i> &lt; 10: PA <i>n</i> = 7, SB <i>n</i> = 5 and SL <i>n</i> = 4).</p> Conclusion <p>Adherence to at least one 24-h movement guideline is associated with better HRQoL in older adults. However, the lack of available research—primarily due to an insufficient number of studies reporting data on multi-component adherence—limits our ability to conduct further analyses on the association between adherence to a combination of two to three movement guidelines and HRQoL.</p>

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Associations between meeting 24-hour movement guidelines and health-related quality of life in older adults: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月22日

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  • Wei Tuo,
  • Poyong Yan,
  • Weijie Qin,
  • Liang Li,
  • Zhou Zhou,
  • Tiantian Zhang,
  • Lu Chen,
  • Yagang Song,
  • Aiwei Wang

摘要

Background

Adherence to 24-h movement guidelines that include physical activity (PA), sedentary behaviour (SB), and sleep is linked to improved health outcomes, yet its impact on health-related quality of life (HRQoL) in older adults remains underexplored.

Objective

This study investigated the relationship between adherence to guidelines for 24-h movement behaviours and HRQoL in older adults.

Methods

A systematic search of four databases was conducted to identify studies published from the date of inception to January 2025. The Appraisal Tool for Cross-Sectional Studies was used to assess the risk of bias among the included studies. Random-effects models were used to conduct a meta-analysis involving the extracted proportions and odds ratios (OR) from each study. The Freeman–Tukey transformation was applied to stabilise the variance of proportional data before meta-analysis, and pooled proportions were back-transformed to their original scale for reporting. Heterogeneity was assessed using the I2 statistic. Publication bias was evaluated using Begg’s test. A sensitivity analysis was conducted, which included changing the random-effects model to a fixed-effects model and adopting a leave-one-out analysis.

Results

Twenty-five cross-sectional articles were included, covering a total of 170,670 older adults aged ≥ 60 years. We found that 24.3% (95% confidence interval [CI]: 22.1%–26.5%, p < 0.01) of older adults adhered to at least one movement guideline, among whom 23.0% (95% CI: 20.8%–25.2%, p < 0.01, n = 18) adhered to PA guidelines, 18.5% (95% CI: 15.3%–21.7%, p < 0.01, n = 7) to SB guidelines, and 40.0% (95% CI: 37.5%–42.5%, p < 0.01, n = 7) to sleep guidelines. Our meta-analysis suggests that compared with non-compliance, adherence to at least one 24-h movement guideline was associated with higher HRQoL among older adults (OR = 1.65, 95% CI: 1.44–1.89, p < 0.01, I^2 = 95.5%, n = 15). Small-study effects were examined with Begg’s test; all subgroup analyses of individual guidelines were underpowered due to a small number of included studies (n < 10: PA n = 7, SB n = 5 and SL n = 4).

Conclusion

Adherence to at least one 24-h movement guideline is associated with better HRQoL in older adults. However, the lack of available research—primarily due to an insufficient number of studies reporting data on multi-component adherence—limits our ability to conduct further analyses on the association between adherence to a combination of two to three movement guidelines and HRQoL.