Facilitators and Barriers to Physical Activity Participation in Older Adults With Mild Cognitive Impairment or Dementia: A Systematic Review Based on the COM-B Model

BackgroundPhysical activity is crucial for preventing cognitive decline in elders with mild cognitive impairment (MCI) or dementia, but increasing it in this group poses challenges.ObjectiveTo summarize and update barriers and facilitators to physical activity using the COM-B (Capability-Opportunity-Motivation-Behavior) model, and examine variations across settings, cognitive levels, and stakeholders' perspectives.MethodsEight databases (PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, China National Knowledge Network, Wanfang Data and VIP) were searched from inception to January 20, 2024. Barriers and facilitators were analyzed using directed content analysis based on the COM-B model.ResultsFrom 33 studies, 18 barriers and 15 facilitators were identified, spanning all COM-B domains, with variations across settings, cognitive levels, and stakeholders' perspectives.ConclusionThe findings provide a foundation for developing tailored physical activity promotion strategies for older adults with MCI/dementia, which should be differentiated based on residential settings, cognitive impairment levels, and stakeholders involved.