Perceptions of risk and coping strategies during the COVID-19 pandemic among women and older adults.

The world's health, economic, and social systems have been adversely impacted by the COVID-19 pandemic. With lockdown measures being a common response strategy in most countries, many individuals were faced with financial and mental health challenges. The current study explored the effect of the COVID-19 pandemic on the psychological well-being, perception of risk factors and coping strategies of two vulnerable groups in Malaysia, namely women and older adults from low-income households (USD592). A purposive sample of 30 women and 30 older adults was interviewed via telephone during Malaysia's Movement Control Order (MCO) regarding the challenges they faced throughout the pandemic. Thematic analysis was subsequently conducted to identify key themes. The themes identified from the thematic analysis indicated a degree of overlap between both groups. For women, seven themes emerged: 1) Psychological challenges due to COVID-19 pandemic, 2) Family violence, 3) Finance and employment related stress and anxiety, 4) Women's inequality and prejudice, 5) Coping strategies, 6) Professional support, and 7) Women's empowerment. Similarly, there were six themes for the older adults: 1) Adverse emotional experiences from COVID-19, 2) Threats to health security, 3) Loss of social connections, 4) Government aid to improve older adults' psychological well-being, 5) Psychological support from family members and pets, and 6) Self-reliance, religion, and spirituality. The findings provide valuable information on the specific burdens faced by these groups, and support psychological interventions and mitigations that would be appropriate to improve well-being during the recovery phase.

A Scoping Review on the Opportunities for Social Engagement and Cognitive Frailty in Older Adults.

Cognitive frailty (CF) is defined as the clinical syndrome of the combination of physical frailty and cognitive impairment, without dementia. Numerous risk factors for CF have been previously identified but this scoping review focusses on the critical need for social engagement and the association with cognition. The focus of this scoping review on the opportunity for social engagement rather than on perception or experience of loneliness. Based on the results of 55 studies were synthesised into four social engagement categories, namely participation, household, network, and habitat. Social engagement is associated with maintaining or improving cognition, particularly through active participation in social roles. Habitat (i.e., rural or urban settings) also influences cognition and the challenge is to enable social participation.

Longitudinal associations of volunteering, grandparenting, and family care with processing speed: A gender perspective on prosocial activity and cognitive aging in the second half of life.

An active lifestyle has been associated with better cognitive performance in many studies. However, most studies have focused on leisure activities or paid work, with less consideration of the kind of prosocial activities, many people engage in, including volunteering, grandparenting, and family care. In the present study, based on four waves of the German Ageing Survey (N = 6,915, aged 40-85 at baseline), we used parallel growth curves to investigate the longitudinal association of level and change in volunteering, grandparenting, and family care with level and change in processing speed. Given the gendered nature of engagement in these activities over the life span, we tested for gender differences in the associations. Only volunteering was reliably associated with higher speed of processing at baseline, no consistent longitudinal associations were found. Our results show that although prosocial activities are of great societal importance, expectations of large rewards in terms of cognitive health may be exaggerated. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Older adults' experiences of taking up a new community-based leisure activity to promote brain health: A focus group study.

INTRODUCTION: An active and engaged lifestyle is supported as being beneficial for brain health. Activities comprising physical, mental and social demands, or combinations of those, are of particular interest, and have been the focus of specific interventions. Exploring how older people engage with such community-based activities, including facilitators and barriers to participation, may help improve the success of future translational activities. The purpose of this study was therefore to identify factors that enabled or hindered activity engagement by conducting focus groups with people who had been supported to take up a new activity as part of an intervention study. MATERIALS AND METHODS: Twenty-seven older adults aged 65-86 (56% female) who had completed an activity-based intervention study participated in three focus groups. Discussions explored their experiences of taking up a new activity, including facilitators and barriers to their engagement, and their perceptions of any benefits. RESULTS: Thematic analysis grouped participants' responses into five themes: positive aspects and facilitators of engagement in a new activity; challenges and barriers to engagement; ageing being a facilitator and a barrier to engagement; differential effects of activities on participants' health and wellbeing; and general project feedback (including opinions on study design). DISCUSSION AND CONCLUSIONS: Participants' experiences and expectations included positive (e.g., enjoyment, socialisation) and negative factors (e.g., lack of confidence, other commitments, class costs and poor structure), consistent with previous research on social participation and engaging with new learning opportunities. Future studies should also consider those who do not readily participate in leisure activities to address earlier barriers. It is important that older adults have access to potentially beneficial activities and local authorities should prioritise increasing their provision.

A Decade Later on How to "Use It" So We Don't "Lose It": An Update on the Unanswered Questions about the Influence of Activity Participation on Cognitive Performance in Older Age.

Activity engagement is a modifiable factor that has been widely-cited as being good for the aging brain and cognition and represents a valuable target for reducing dementia risk. However, specific issues about activity engagement (mental, social, and physical) and cognition in older adulthood remain, and Bielak [Gerontology 2010;56: 507-519] reviewed seven major methodological and theoretical questions about this relationship. We present an updated reflection on these key questions, focusing on research published in the last 10 years. For some questions, a significant amount of work has been done and conclusions have become clearer; for others, there have been few additions to the literature and our knowledge remains much the same as it was a decade ago. We review the issues identified in the 2010 paper including the directionality and temporal nature of the relationship; whether specific activity domains offer different benefits to cognition and what domain(s) of cognition are affected; variation in the relation by age, gender, or education; potential mechanisms involved; and how activity engagement is assessed. For each, we present the most up-to-date research, discuss remaining challenges and possible future directions. This formal unifying of the information in the field is intended as a guide to support continued progress by spurring on studies addressing specific questions while reminding researchers of critical issues. We conclude with recommendations that future studies investigating the link between activity engagement and cognitive performance in adulthood should consider.

Assessing Emotional Expressions During a Cycling-Based Initiative for Older Care Home Residents Using Video-Based Recordings.

Objective: Through Cycling Without Age, trained volunteers use specially designed trishaws to provide rides for older adults living in care homes and other supported living environments. Qualitative and quantitative research suggests benefits in terms of improvements in mood and wellbeing. Those studies have predominantly been interviews with participants reflecting on previous rides, or as pre-/post-assessments. The current study assessed emotional experiences using video recordings acquired during participants' rides. Methods: Twelve older adults (50% female; 67-92 years old (M = 81.8, SD = 7.4)) living in care homes or supported living environments were recruited. During a Cycling Without Age ride, participants were filmed using an action camera mounted on the trishaw. Recordings were rated using the Facial Expression Coding System by two researchers to assess the frequency, duration and intensity of positive and negative emotions. Results: On average, 23.7 positive emotional expressions were observed per ride, significantly higher than negative emotions (0.4). As well as more frequent, positive emotions were observed over a longer duration in total (139.5 seconds vs. 1.3) and rated as more intense (1.9 out of 5 vs. 0.3). Conclusion: The study supported the value of directly assessing emotional responses during this cycling-based initiative, including minimising the input required from participants. The predominantly positive emotional expressions observed were consistent with both qualitative and quantitative assessments of Cycling Without Age, and suggests a potential pathway by which those benefits manifest. Future studies might adopt a triangulated approach, using in-activity monitoring, quantitative assessments and participant reflections.

Genes Versus Lifestyles: Exploring Beliefs About the Determinants of Cognitive Ageing.

Genetic and lifestyle factors contribute to cognitive ageing. However, the extent to which the public attribute changes in thinking skills to either genetic or lifestyle factors is largely unknown. This may be important if it impacts engagement in activities deemed beneficial to thinking skills. This study, therefore, explored people's beliefs about determinants of cognitive ageing and whether those beliefs were associated with engagement in potentially beneficial behaviours. Data were collected through a United Kingdom-wide survey of people aged 40 and over. Participants completed questions about their beliefs regarding cognitive ageing, and specifically the extent to which they believed lifestyle or genetic factors influence those changes, and their engagement in specific behaviours that may be cognitively beneficial. Responses from 3,130 individuals (94.0% of the survey sample) were analysed using chi-square tests of independence, principal component analysis and ANCOVAs to investigate whether their attribution of genetic or lifestyle determinants were associated with their beliefs about cognitive ageing and their participation in brain health-related behaviours. Most respondents (62.2%) believed genes and lifestyle contribute equally to age-related changes in cognitive skills. Respondents who believed genetic factors were more influential were less likely to expect cognitive skills might be improved or maintained with age, less sure what behaviours might be associated with brain health, and less likely to engage in behaviours comprising mental challenge/novelty supported as beneficial for brain health. From this United Kingdom-wide survey about beliefs regarding potential determinants of cognitive ageing, some of our respondents' views were not aligned with the findings from ageing research. It is important for the public to know how to keep their brains healthy. Our results indicate a need for clearer messaging highlighting the role of lifestyle factors for brain health.

Measuring activity engagement in old age: An exploratory factor analysis.

A growing body of literature suggests that higher engagement in a range of activities can be beneficial for cognitive health in old age. Such studies typically rely on self-report questionnaires to assess level of engagement. These questionnaires are highly heterogeneous across studies, limiting generalisability. In particular, the most appropriate domains of activity engagement remain unclear. The Victoria Longitudinal Study-Activity Lifestyle Questionnaire comprises one of the broadest and most diverse collections of activity items, but different studies report different domain structures. This study aimed to help establish a generalisable domain structure of the Victoria Longitudinal Study-Activity Lifestyle Questionnaire. The questionnaire was adapted for use in a sample of UK-based older adults (336 community-dwelling adults aged 65-92 with no diagnosed cognitive impairment). An exploratory factor analysis was conducted on 29 items. The final model retained 22 of these items in a six-factor structure. Activity domains were: Manual (e.g., household repairs), Intellectual (e.g., attending a public lecture), Games (e.g., card games), Religious (e.g., attending religious services), Exercise (e.g., aerobics) and Social (e.g., going out with friends). Given that beneficial activities have the potential to be adapted into interventions, it is essential that future studies consider the most appropriate measurement of activity engagement across domains. The factor structure reported here offers a parsimonious and potentially useful way for future studies to assess engagement in different kinds of activities.

Using Theories of Behavior Change to Develop Interventions for Healthy Aging.

Healthy aging requires people to adopt and maintain beneficial behaviors in all stages of the life span. Supporting behavior change, including via the motivation to make and maintain those changes, is therefore important for the promotion of healthy aging. The aim of this overview is to introduce theoretical frameworks from the psychology of motivation that lend themselves to the development of effective interventions promoting behavior change conducive to healthy aging. We discuss theoretical frameworks referring to the determinants, properties, and functionality of goals aimed at behavior change, and consider the implications of the various theories for designing interventions to support healthy aging. We first consider theories that focus on beliefs and attitudes as determinants of goals, then we address theories that focus on the structure and content as important properties of goals, and, finally, we examine theories drawing on conscious and nonconscious processes underlying the functionality of these goals. We will present if-then planning and mental contrasting, as well as nudging and boosting, that is, novel strategies of behavior change that support the creation of scalable interventions for healthy aging across the life span. Against this background, new perspectives emerge for modern, state-of-the-art, and individually tailored interventions with the aim of enhancing older people's healthy living.

A systematic review of the impacts of intergenerational engagement on older adults' cognitive, social, and health outcomes.

BACKGROUND: Intergenerational engagement could benefit health and wellbeing within an ageing population. This systematic review evaluated the impacts of intergenerational engagement on cognitive, social, and health outcomes in healthy older adults and older adults with mild cognitive impairment. RESEARCH DESIGN AND METHODS: Comprehensive literature searches were undertaken, with records filtered according to pre-registered criteria. Study quality was formally assessed, and a narrative synthesis of the findings produced. RESULTS: Forty-four studies were reviewed. Regarding quantitative evidence, 4 out of 8 studies found significant intergenerational engagement effects on cognitive outcomes, 15 of 24 on social outcomes, and 21 of 31 on health-related outcomes. Qualitative evidence was also important for understanding perceived impacts and experiences of intergenerational programmes. Only 11 studies fully met criteria for high quality research, of which the majority focused on social outcomes. DISCUSSION AND IMPLICATIONS: There are a range of potential benefits of intergenerational engagement, most notably regarding anxiety, generativity, cross-age attitudes, and physical activity. However, heterogeneity in programme context, sample design, dosage, and duration indicate that more research is required to enable wider implementation and generalisability. Scientific rigour in both quantitative and qualitative research should also be employed as far as possible, to provide the highest quality evidence.

Towards an active and happy retirement? Changes in leisure activity and depressive symptoms during the retirement transition.

Objectives: Retirement is a major life transition in the second half of life, and it can be associated with changes in leisure activity engagement. Although theories of retirement adjustment have emphasized the need to find meaningful activities in retirement, little is known about the nature of changes in leisure activity during the retirement transition and their association with mental health.Methods: Based on four annual waves of the 'Health, Aging and Retirement Transitions in Sweden' study, we investigated the longitudinal association of leisure activity engagement and depressive symptoms using bivariate dual change score models. We distinguished intellectual, social, and physical activity engagement.Results: We found increases in all three domains of activity engagement after retirement. Although level and change of activity and depressive symptoms were negatively associated, the coupling parameters were not significant, thus the direction of effects remains unclear.Conclusion: The results highlight the need to consider the role of lifestyle changes for retirement adjustment and mental health.

Apolipoprotein E Genotype Moderation of the Association Between Physical Activity and Brain Health. A Systematic Review and Meta-Analysis.

INTRODUCTION: Possession of one or two e4 alleles of the apolipoprotein E (APOE) gene is associated with cognitive decline and dementia risk. Some evidence suggests that physical activity may benefit carriers of the e4 allele differently. METHOD: We conducted a systematic review and meta-analysis of studies which assessed APOE differences in the association between physical activity and: lipid profile, Alzheimer's disease pathology, brain structure and brain function in healthy adults. Searches were carried out in PubMed, SCOPUS, Web of Science and PsycInfo. RESULTS: Thirty studies were included from 4,896 papers screened. Carriers of the e4 allele gained the same benefit from physical activity as non-carriers on most outcomes. For brain activation, e4 carriers appeared to gain a greater benefit from physical activity on task-related and resting-state activation and resting-state functional connectivity compared to non-carriers. Post-hoc analysis identified possible compensatory mechanisms allowing e4 carriers to maintain cognitive function. DISCUSSION: Though there is evidence suggesting physical activity may benefit e4 carriers differently compared to non-carriers, this may vary by the specific brain health outcome, perhaps limited to brain activation. Further research is required to confirm these findings and elucidate the mechanisms.

Cycling Without Age: Assessing the Impact of a Cycling-Based Initiative on Mood and Wellbeing.

Objective: Cycling Without Age is a global initiative in which trained volunteers take adults living in care homes or supported housing environments out on specially designed trishaws. Despite its global success, there is limited research on the effect the initiative has on the older adults taking part. The current study therefore assessed changes in mood and wellbeing to determine whether there were short-term benefits of participation. Methods: Forty-nine older adults (69% female; 67-100 years old (M = 84.1, SD = 7.6)) living in care homes and supported housing environments were recruited; 35 participants completed all measures and comprise the analytical sample. Participants completed the Warwick-Edinburgh Mental Wellbeing Scale and UWIST Mood Adjective Checklist immediately before a ride (baseline); they repeated the measures on completion of the ride (follow-up). Participants also completed baseline and follow-up measures on a day in which they did not go on a ride. Mixed ANOVA compared differences in baseline and follow-up mood and wellbeing scores on ride and no ride days. Results: For all mood and wellbeing measures, there were significant interactions between day (ride or no ride) and measurement occasion (baseline or follow-up). Analyses revealed significant improvement in mood and wellbeing at follow-up on ride days versus no ride days. Conclusion: Short-term positive changes in mood and wellbeing were reported as a result of participation in the Cycling Without Age initiative for older adults in care home and supported living environments. Further research is needed to explore the longevity of benefits and longer-term changes.

Computational quantification of brain perivascular space morphologies: Associations with vascular risk factors and white matter hyperintensities. A study in the Lothian Birth Cohort 1936.

BACKGROUND AND PURPOSE: Perivascular Spaces (PVS), also known as Virchow-Robin spaces, seen on structural brain MRI, are important fluid drainage conduits and are associated with small vessel disease (SVD). Computational quantification of visible PVS may enable efficient analyses in large datasets and increase sensitivity to detect associations with brain disorders. We assessed the associations of computationally-derived PVS parameters with vascular factors and white matter hyperintensities (WMH), a marker of SVD. PARTICIPANTS: Community dwelling individuals (n = 700) from the Lothian Birth Cohort 1936 who had multimodal brain MRI at age 72.6 years (SD = 0.7). METHODS: We assessed PVS computationally in the centrum semiovale and deep corona radiata on T2-weighted images. The computationally calculated measures were the total PVS volume and count per subject, and the mean individual PVS length, width and size, per subject. We assessed WMH by volume and visual Fazekas scores. We compared PVS visual rating to PVS computational metrics, and tested associations between each PVS measure and vascular risk factors (hypertension, diabetes, cholesterol), vascular history (cardiovascular disease and stroke), and WMH burden, using generalized linear models, which we compared using coefficients, confidence intervals and model fit. RESULTS: In 533 subjects, the computational PVS measures correlated positively with visual PVS ratings (PVS count r = 0.59; PVS volume r = 0.61; PVS mean length r = 0.55; PVS mean width r = 0.52; PVS mean size r = 0.47). PVS size and width were associated with hypertension (OR 1.22, 95% CI [1.03 to 1.46] and 1.20, 95% CI [1.01 to 1.43], respectively), and stroke (OR 1.34, 95% CI [1.08 to 1.65] and 1.36, 95% CI [1.08 to 1.71], respectively). We found no association between other PVS measures and diabetes, hypercholesterolemia or cardiovascular disease history. Computational PVS volume, length, width and size were more strongly associated with WMH (PVS mean size versus WMH Fazekas score ß = 0.66, 95% CI [0.59 to 0.74] and versus WMH volume ß = 0.43, 95% CI [0.38 to 0.48]) than computational PVS count (WMH Fazekas score ß = 0.21, 95% CI [0.11 to 0.3]; WMH volume ß = 0.14, 95% CI [0.09 to 0.19]) or visual score. Individual PVS size showed the strongest association with WMH. CONCLUSIONS: Computational measures reflecting individual PVS size, length and width were more strongly associated with WMH, stroke and hypertension than computational count or visual PVS score. Multidimensional computational PVS metrics may increase sensitivity to detect associations of PVS with risk exposures, brain lesions and neurological disease, provide greater anatomic detail and accelerate understanding of disorders of brain fluid and waste clearance.

Perivascular spaces in the centrum semiovale at the beginning of the 8th decade of life: effect on cognition and associations with mineral deposition.

Brain iron deposits (IDs) are indicative of microvessel dysfunction which may predispose to small vessel disease (SVD) brain damage and worsen cognition later in life. Visible perivascular spaces in the centrum semiovale (CSO-PVS) are SVD features linked with microvessel dysfunction. We examined possible associations of CSO-PVS volume and count with brain IDs and cognitive abilities in 700 community-dwelling individuals from the Lothian Birth Cohort 1936 who underwent detailed cognitive testing and multimodal brain MRI at mean age 72.7 years. Brain IDs were assessed automatically followed by manual editing. PVS were automatically assessed in the centrum semiovale and deep corona radiata supraventricular. General factors of overall cognitive function (g), processing speed (g-speed) and memory (g-memory) were used in the analyses. Median (IQR) volumes of IDs and CSO-PVS expressed as a percentage of intracranial volume were 0.0021 (0.011) and 0.22 (0.13)% respectively. Median count of CSO-PVS was 410 (IQR = 201). Total volumes of CSO-PVS and ID, adjusted for head size, were correlated (Spearman ρ = 0.13, p < 0.001). CSO-PVS volume, despite being correlated with all three cognitive measures, was only associated with g-memory (B = -114.5, SE = 48.35, p = 0.018) in general linear models, adjusting for age, sex, vascular risk factors, childhood intelligence and white matter hyperintensity volume. The interaction of CSO-PVS count with diabetes (B = -0.0019, SE = 0.00093, p = 0.041) and volume with age (B = 1.57, SE = 0.67, p = 0.019) were also associated with g-memory. Linear regression models did not replicate these associations. Therefore, it does not seem that CSO-PVS burden is directly associated with general cognitive ability in older age.

How is musical activity associated with cognitive ability in later life?

Research has suggested that individuals who play a musical instrument throughout adulthood have better preserved executive function. However, mixed results have been found for associations between musical activity and visuo-spatial abilities, and less is known about associations with fluid intelligence. We explored differences between musicians (N = 30) and non-musicians (N = 30) aged 60-93 years old across a range of neuropsychological measures of cognitive function. Musicians performed significantly better than non-musicians on all domains, which remained after adjusting for age, gender, educational history, languages spoken and physical activity. As a cross-sectional comparison, the results should not be overstated; however, they are consistent with findings suggesting learning a musical instrument throughout the life course may be associated with cognitive benefits. Identifying potential lifestyle factors that have cognitive benefits in later life, such as musical experience, is an important step in developing intervention strategies for cognitive aging.

Investigating associations between personality and the efficacy of interventions for cognitive ageing: A systematic review.

The personal and societal impact of age-related cognitive decline supports the development of effective interventions. While some strategies, such as cognitive training, exercise or socio-intellectual engagement, appear beneficial, few studies have examined the association between personality and intervention efficacy. A systematic review was therefore conducted to summarise and synthesise the literature regarding the influence of personality traits on the effectiveness of non-pharmacological interventions for cognitive ageing. A systematic search of PubMed, PsycINFO and Web of Science was carried out. Of the 2100 papers identified by the search strategy, 10 studies were retained that met the relevant criteria (e.g., intervention studies with one or more cognitive outcomes and a measure of personality). Of these, two studies reported that higher levels of Openness to Experience were associated with greater improvement in memory performance after cognitive training interventions. Another found a positive association between Openness and improvement in divergent thinking following a novel group-based problem solving programme. One social intervention study reported positive moderating effects of Conscientiousness and Agreeableness, and mixed effects of Extraversion. Mixed evidence was also found regarding Need for Cognition, with one study reporting a positive association with memory improvement and another reporting less improvement in divergent thinking. Others found no evidence of personality influencing intervention outcomes. Due to the relatively small and heterogeneous sample of studies identified, any conclusions should currently be considered preliminary. These findings highlight the need for further research exploring the role of personality in intervention efficacy, so that interventions might be better tailored to individuals.

Reaction time variability and brain white matter integrity.

OBJECTIVE: Mean speed of responding is the most commonly used measure in the assessment of reaction time (RT). An alternative measure is intraindividual variability (IIV): the inconsistency of responding across multiple trials of a test. IIV has been suggested as an important indicator of central nervous system functioning, and as such, there has been increasing interest in the associations between IIV and brain imaging metrics. Results however, have been inconsistent. The present seeks to provide a comprehensive evaluation of the associations between a variety of measures of brain white matter integrity and individual differences in choice RT (CRT) IIV. METHOD: MRI brain scans of members of the Lothian Birth Cohort 1936 were assessed to obtain measures of the volume and severity of white matter hyperintensities, and the integrity of brain white matter tracts. CRT was assessed with a 4 CRT task on a separate occasion. Data were analyzed using multiple regression (N range = 358-670). RESULTS: Greater volume of hyperintensities and more severe hyperintensities in frontal regions were associated with higher CRT IIV. White matter tract integrity, as assessed by both fractional anisotropy and mean diffusivity, showed the smallest effect sizes in associations with CRT IIV. Associations with hyperintensities were attenuated and no longer significant after controlling for M CRT. CONCLUSIONS: Taken together, the results of the present study suggested that IIV was not incrementally predictive of white matter integrity over mean speed. This is in contrast to previous reports, and highlights the need for further study. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Copenhagen Consensus statement 2019: physical activity and ageing.

From 19th to 22nd November 2018, 26 researchers representing nine countries and a variety of academic disciplines met in Snekkersten, Denmark, to reach evidence-based consensus about physical activity and older adults. It was recognised that the term 'older adults' represents a highly heterogeneous population. It encompasses those that remain highly active and healthy throughout the life-course with a high intrinsic capacity to the very old and frail with low intrinsic capacity. The consensus is drawn from a wide range of research methodologies within epidemiology, medicine, physiology, neuroscience, psychology and sociology, recognising the strength and limitations of each of the methods. Much of the evidence presented in the statements is based on longitudinal associations from observational and randomised controlled intervention studies, as well as quantitative and qualitative social studies in relatively healthy community-dwelling older adults. Nevertheless, we also considered research with frail older adults and those with age-associated neurodegenerative diseases, such as Alzheimer's and Parkinson's disease, and in a few cases molecular and cellular outcome measures from animal studies. The consensus statements distinguish between physical activity and exercise. Physical activity is used as an umbrella term that includes both structured and unstructured forms of leisure, transport, domestic and work-related activities. Physical activity entails body movement that increases energy expenditure relative to rest, and is often characterised in terms of intensity from light, to moderate to vigorous. Exercise is defined as a subset of structured physical activities that are more specifically designed to improve cardiorespiratory fitness, cognitive function, flexibility balance, strength and/or power. This statement presents the consensus on the effects of physical activity on older adults' fitness, health, cognitive functioning, functional capacity, engagement, motivation, psychological well-being and social inclusion. It also covers the consensus on physical activity implementation strategies. While it is recognised that adverse events can occur during exercise, the risk can be minimised by carefully choosing the type of activity undertaken and by consultation with the individual's physician when warranted, for example, when the individual is frail, has a number of co-morbidities, or has exercise-related symptoms, such as chest pain, heart arrhythmia or dizziness. The consensus was obtained through an iterative process that began with the presentation of the state-of-the-science in each domain, followed by group and plenary discussions. Ultimately, the participants reached agreement on the 30-item consensus statements.