Background

In the EU, 19% of the EU population is 65 years or older (Eurostat, 2020). By 2100, it is expected that there will be a 15% increase in people 80+ years of age. As ageing advances, the risk of physical and cognitive decline increases, along with greater incidence of chronic diseases and comorbidities (Kirkland, 2013).

As there is an increasing pressure to deal with additional health and social care costs associated with an ageing population and chronic disease burden, careful planning of preventive and sustainable programmes is warranted.

Physical activity (PA) is considered one of the most powerful non-pharmacological treatment for noncommunicable diseases (Santanasto, 2018), and higher levels of PA are associated with better trajectories of healthy ageing (Daskalopoulou, 2017).

Nevertheless, older adults are the least active group, with only about 11% meeting the current PA recommendations (Gomes, 2017). It has also been documented that sedentary individuals will benefit from short activity periods throughout the day, roughly as long as 1-10 minutes (McPhee, 2016; Powell, 2011; Healy, 2008).

Sedentary behaviour (SB) defined as any waking activity in a sitting, reclining, or lying posture where energy expenditure is <1.5 metabolic equivalents) (Tremblay, 2017) seems to have an independent but negative effect on trajectories. SB has been associated with increased risk of obesity, cardiovascular disease, cancer, diabetes, overall mortality as well as reduced mobility and social interactions (Copeland, Ashe, Biddle, et al, 2017).

In western Europe in 2015, a lack of PA was the fourth leading risk factor for mortality, leading to about 3 million deaths (Kahlmeier, 2015). SB has increased substantially over the last three decades and it is consistently reported to increase with age (Van Ballegooijen, 2019).

PA and exercise programmes are often conducted in a group format and are a good opportunity for participants to have social interactions, establish support relationships and be socially integrated.

Moreover, PA improves psychological and emotional well-being leading to direct health benefits based on the so-called feel-good effect of exercise identified in the literature (Hyde, 2011).

According to broaden-and-build theory of positive emotions, enjoyable forms of PA generate happiness and bring positive emotions, which in turn could be associated with loneliness reduction (Newall, 2013).

Despite growing evidence that enjoyment may be a key element for adherence and maintenance of PA programs, such component has been seldom the focus of PA programmes targeting older adults. Since the content of the programmes has been determined by the focus on the functional benefits of PA to prevent age-related disability.

Insufficiently PA and sedentary behavior among older people are linked to social, cultural, economic, educational barriers, as well as barriers related to disability, health problems and discrimination for different reasons. Specifically, older women, people with low socio-economic levels, caregivers and older people from ethnic minorities are among those with less opportunities to access PA programmes and have been seldom a specific target of PA programmes.

Sex-specific differences are also reported with women in Europe being less physically active than men (Van Tuyckom et al. 2012; Van Tuyckom and Scheerder, 2010; Hovermann and Wicker, 2009; Hartmann-Tews, 2006; Van Bottenburg et al. 2005; Rütten and Abdu-Omar, 2004).