Are Mobile Apps Effective at Targeting Physical Activity or Malnutrition in Community-Dwelling Older Adults? A Systematic Review and Meta-Analysis.

Abstract

This systematic review aims to identify the effectiveness of digital health applications (apps) to increase physical activity (PA) or prevent malnutrition in community-dwelling older adults. Searches were conducted in June 2023 across seven electronic databases (MEDLINE, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica database, Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials), and grey literature were searched via google scholar. Data from studies that met the inclusion criteria were extracted. Risk of bias was assessed, and the quality of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation. Meta-analyses were undertaken where appropriate using DerSimonian and Laird random-effects model (Stata version 16.1), or data were described narratively. Twenty-seven studies met the eligibility criteria, although 23 of these had low or unclear risk of bias. Twelve studies considered PA outcomes only, two studies considered nutritional outcomes only, and three studies considered both PA and nutritional components. A meta-analysis comprising six studies (818 participants) showed that those using a digital health app had a higher step count compared with participants in the control group (mean difference = 799, 95% CI [48.76, 1550.08]). Studies looking at nutritional outcomes aimed to increase protein intake or adherence to dietary patterns with mixed findings. Digital health apps have the potential to increase PA in community-dwelling older adults. Digital health app interventions that aim to reduce the risk of malnutrition in older adults is a relatively unexplored area with mixed findings, so more high-quality studies should be prioritized.