Barriers and facilitators to physical activity uptake and adherence among older South Asians: a qualitative systematic review

BACKGROUND: There are high levels of physical inactivity and chronic diseases among older South Asians. Although physical activity (PA) offers substantial health benefits for older adults, engagement and maintenance are low in this population. There are reviews of previous studies on South Asians in general, but very few concentrate on older South Asians and the synthesis of qualitative research to inform intervention design for this group of people.

OBJECTIVE: To comprehensively evaluate the current body of qualitative research on the facilitators and inhibitors of participation in physical activity in older South Asians.

METHODS: This qualitative systematic review was reported in accordance with PRISMA 2020. Six major databases were searched between the inception of the databases and April 2025. The inclusion criteria for this systematic review included English-language primary qualitative studies and mixed-methods studies with extractable qualitative findings relating to South Asians aged 65 years and older. The Joanna Briggs Institute tool was used in addressing issues of quality in qualitative research studies. Deductive synthesis of studies used Theoretical Domains Framework, which was further transformed into Capability, Opportunity, Motivation–Behaviour (COM-B) model.

RESULTS: A total of sixteen studies in six countries satisfied the inclusion criteria. Barriers to physical activity (PA) included the participant's perception of physical restrictions, other family care commitments, a lack of knowledge about physical activity, social norms, and low levels of motivation. Facilitators include social support, participation in supervised group activities, health beliefs, facilitating environments, and professional health advice. All can be related mainly to the domains: physical and psychological capabilities, social and physical opportunities, and reflective motivation in the COM-B model.

CONCLUSION: Engaging in physical activity among the elderly South Asian population is affected by a complex mixture of individual, social, and cultural factors. For South Asians, it is important that interventions be implemented in a manner that meets the needs regarding capability motivation, and support.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-026-07453-3.