Barriers and facilitators to resistance and aerobic exercise among older adults with sarcopenic obesity: a...

Sarcopenic obesity (SO), characterized by the coexistence of excess adiposity and diminished muscle mass and function, represents an increasing health concern among the older adults. Resistance and aerobic exercises are effective strategies for managing this condition. However, due to low exercise adherence among older adults, the current state of prevention and control of SO remains challenging. Moreover, qualitative insights into the specific exercise experiences of this population, particularly in the Chinese context, are lacking. This study seeks to elucidate the barriers and facilitators to exercise adherence among elderly individuals affected by SO through the application of the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation-Behavior (COM-B) model.

This study employed a descriptive qualitative research methodology. From March to September 2024, 21 community-dwelling older adults with SO were recruited in Southwest China to participate in face-to-face, semi-structured interviews. Participants were aged 60 years or older and diagnosed with SO. The interview outline was developed based on the TDF, and interviews were audio-recorded and transcribed verbatim. Data were analyzed using both deductive and inductive approaches, and the identified themes were mapped onto the TDF and the COM-B model.

This study analyzed a total of 488 utterances, which comprehensively covered 12 domains of the TDF and the 3 core components of the COM-B model. Six barrier themes and three facilitator themes were identified. The main barriers included inadequate capability (e.g., lack of knowledge, insufficient exercise confidence, poor self-control), limited opportunity (e.g., unsafe environments, body image pressure), and insufficient motivation (e.g., lack of security). The facilitators included motivation (e.g., perceived benefits of exercise, perceived disease threat) and opportunity (e.g., multidimensional social support).

This study revealed that exercise adherence among geriatric individuals with SO is influenced by a complex interplay of factors. The key barriers identified were insufficient exercise confidence and lack of security. Future research should incorporate targeted behavioral intervention strategies, such as demonstration of the behavior, verbal persuasion about capability, pros and cons, and restructuring the physical environment, to effectively address the multifaceted challenges associated with SO in older adults. These strategies should be central to the development of effective intervention programs aimed at promoting physical activity among this cohort.