Activity programs for older adults
Programs for older adults offer educational, social, creative, musical, or physical activities in group settings that encourage personal interactions, regular attendance, and community involvement. Activity programs are a potential means to reduce social isolation; isolation among older adults is associated with poorer health outcomes1, 2.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Improved health outcomes
Improved mental health
Reduced isolation
Improved quality of life
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased activity levels
Reduced falls
What does the research say about effectiveness?
There is strong evidence that educational, social, and physical activity programs for older adults improve mental and physical health outcomes3, 4, 5, 6, 7, reduce loneliness and social isolation8, 9, 10, and improve emotional well-being and quality of life among participants3, 4, 10, 11. Physical activity programs have been shown to improve physical health outcomes among frail older adults6. Program effects have been sustained up to 12 months after participation; additional research is needed to confirm effects after 12 months12.
Evaluations of social engagement and group activity programs (e.g., participatory art activities, museum-based social activities, membership in a community choir or faith-based community, etc.) in the U.S. and the United Kingdom indicate that such programs can benefit cognition, mental health, and emotional well-being for older adults4, 5, 13, 14 and can reduce loneliness10. Studies in the U.S. and South Korea indicate that senior center activities may foster new supportive friendships among older women who live alone15 and reduce cognitive decline among participants16.
Physical activity programs have been shown to reduce falls, improve strength, walking performance, and balance7, 11, 17. Such programs also reduce depression7, 18, 19, social isolation17, 20, and loneliness21, and have other cognitive benefits for older adults22, although effects may vary by the type of exercise23. Available evidence suggests that physical exercise programs can also improve cognitive function and enhance physical function and activity for frail older adults or those with chronic health conditions6, 24, 25.
Physical activity programs can have positive impacts on sleep, which may lead to additional health benefits26. A Canada-based study suggests effective physical activity programs include more group meetings along with coach training that emphasizes and integrates social connectedness strategies27. Activity programs are feasible and low cost initiatives when implemented in existing community and senior centers. Such programs have been shown to be sustainable and replicable in many urban and rural communities28.
How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.
It is unclear what impact activity programs for older adults can have on disparities in health, well-being, and social isolation.
Social isolation and loneliness have been linked to chronic conditions. Older Black and Hispanic adults are more likely to have significantly smaller social networks, limiting opportunities for thoughtful conversations with supportive and trusted companions, which can increase social isolation and loneliness41. Hispanic and Black adults are likely to be less active, especially those with lower education levels42. Adult activities available through senior center-based programs are often open to all older adults from diverse backgrounds, usually at low to minimum cost.
What is the relevant historical background?
The built environment in under-resourced communities is a significant contributor to health inequities for people of color with low incomes43, 44, 45. During the Industrial Revolution, parks were largely developed to allow wealthy residents access to space that was free from unsanitary conditions and the congestion of crowded cities46. Discriminatory housing, lending, and exclusionary zoning policies led to concentrated poverty and entrenched residential segregation47, including segregation of parks and recreation facilities. Between 1930 and the 1970s, while the government invested in parks in wealthier, white neighborhoods, parks and facilities in neighborhoods of color were neglected46. City ordinances outlawed integrated forms of recreation48. Disinvestment in and unequal distribution of recreational facilities, parks, and green space means that communities with low incomes and communities of color have fewer places to engage in outdoor activities, have less access to cooling shade, and experience poorer air quality49, 50.
Today, these formerly redlined, low income neighborhoods are more likely to be considered physical activity deserts, without access to gyms, safe green spaces, and built environments conducive to physical activity51. Urban areas, which are often primarily populated by individuals of color, usually have the least amount of green space available per person, limiting communities’ access to free physical activity. Four of the five cities in the U.S. with the least amount of green space are majority people of color52.
In the U.S., many adults do not meet the recommendations for physical activity. From 2014 data, among adults 50 years and older nearly a quarter were physically inactive and inactivity amongst those with chronic disease was higher42. Historically, support for older adults to improve their physical activity has improved through government programs, community partnerships, and building communities and community spaces that support safe, efficient, and pedestrian-friendly public transit systems and improving walking trails and parks42.
Equity Considerations
- Are there a variety of adult activities, such as educational, social, and creative activities, in your community? What activities are older adults in your community interested in?
- What adult activities exist in neighborhoods with low incomes? What activities are available in racially/ethnically diverse communities?
- Are these programs affordable and accessible? How can they be tailored to encourage participation by different communities?
- What barriers exist to participation in adult activity programs? Do some groups face more barriers than others? What can you do to eliminate or reduce the impact of those barriers?
Implementation Examples
Community and senior centers across the country offer educational, social, and physical activity programs for older adults29, 30, 31. The National Council on Aging (NCOA) supports senior center programs and promotes outstanding practices through its annual National Institute of Senior Centers (NISC) Programs of Excellence Awards32.
Many states also have aging services departments or programs that consolidate information about potential activity programs, senior centers, and social services available for older adults, for example: North Carolina33, Florida34, Kentucky35, and Wisconsin36.
SilverSneakers is a nationwide fitness program available for adults over 65 who are enrolled in Medicare Advantage Plans (Medicare Part C) at over 17,000 locations from national gyms to community centers across the country; it also offers online workout videos for seniors who prefer to workout at home or are homebound37. Choose to Move is another example of a physical activity program in British Columbia, Canada that provides older adults with a tailored physical activity plan at no cost and helps them meet a group of other seniors38. StrongPeople programs exist in urban, suburban, and rural settings across the U.S. and are designed for midlife and older adults. Programs include community-based strength training, fitness and nutrition education, and guidance in making community-led changes to the local food and physical activity environments39.
Individuals with chronic conditions or those that have a disability can work with their doctor to develop a plan to participate in physical activity programs40.
Implementation Resources
‡ Resources with a focus on equity.
EnhanceFitness - Project Enhance. EnhanceFitness. Seattle, WA.
CDC-Older adult activity - Centers for Disease Control and Prevention (CDC). (2023). Physical activity basics. Older adult activity: An overview. Retrieved April 16, 2025.
CDC-Physical activity - Centers for Disease Control and Prevention (CDC). (2023). Physical activity basics. What counts as physical activity for older adults. Retrieved April 16, 2025.
NCOA-Evidence-based programs - National Council on Aging (NCOA). Evidence-based programs for professionals: About evidence-based programs. 2022.
Footnotes
* Journal subscription may be required for access.
1 Coyle 2012 - Coyle CE, Dugan E. Social isolation, loneliness and health among older adults. Journal of Aging and Health. 2012;24(8):1346-1363.
2 Clifford 2023 - Clifford, A. M., Shanahan, J., McKee, J., Cleary, T., O’Neill, A., O’Gorman, M., Louw, Q., & Ní Bhriain, O. (2023). The effect of dance on physical health and cognition in community dwelling older adults: A systematic review and meta-analysis. Arts & Health, 15(2), 200–228.
3 Leung 2015 - Leung P, Orwell M, Orgeta V. Social support group interventions in people with dementia and mild cognitive impairment: A systematic review of the literature. International Journal of Geriatric Psychiatry. 2015;30(1):1-9.
4 Noice 2014 - Noice T, Noice H, Kramer AF. Participatory arts for older adults: A review of benefits and challenges. The Gerontologist. 2014;54(5):741-753.
5 Hertzog 2009 - Hertzog C, Kramer AF, Wilson RS, Lindenberger U. Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychological Science in the Public Interest. 2009;9(1):1–65.
6 Cadore 2013 - Cadore EL, Rodriguez-Manas L, Sinclair A, Izquidero M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: A systematic review. Rejuvenation Research. 2013;16(2):105-114.
7 RAND-Shekelle 2003 - Shekelle P, Maglione M, Mojica W, et al. Exercise programs for older adults: A systematic review and meta-analysis. Santa Monica: RAND Corporation; 2003.
8 Cattan 2005 - Cattan M, White M, Bond J, Learmouth A. Preventing social isolation and loneliness among older people: A systematic review of health promotion interventions. Ageing and Society. 2005;25(1):41-67.
9 Wick 2012 - Wick J. Senior centers: Traditional and evolving roles. Consultant Pharmacist. 2012;27(9):664-667.
10 Johnson 2020 - Johnson JK, Stewart AL, Acree M, et al. A community choir intervention to promote well-being among diverse older adults: Results from the Community of Voices trial. Journals of Gerontology - Series B Psychological Sciences and Social Sciences. 2020;75(3):549-559.
11 Bullo 2015 - Bullo V, Bergamin M, Gobbo S, et al. The effects of pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription. Preventive Medicine. 2015;75:1-11.
12 Hobbs 2013 - Hobbs N, Godfrey A, Lara J, et al. Are behavioral interventions effective in increasing physical activity at 12 to 36 months in adults aged 55 to 70 years: A systematic review and meta-analysis. BMC Medicine. 2013;11:75.
13 Thomson 2018 - Thomson LJ, Lockyer B, Camic PM, Chatterjee HJ. Effects of a museum-based social prescription intervention on quantitative measures of psychological wellbeing in older adults. Perspectives in Public Health. 2018;138(1):28-38.
14 Fancourt 2018 - Fancourt D, Steptoe A. Community group membership and multidimensional subjective well-being in older age. Journal of Epidemiology and Community Health. 2018;72(5):376-382.
15 Aday 2006 - Aday RH, Kehoe GC, Farney LA. Impact of senior center friendships on aging women who live alone. Journal of Women & Aging. 2006;18(1):57-73.
16 Lee 2016b - Lee SH, Kim YB. Which type of social activities may reduce cognitive decline in the elderly?: A longitudinal population-based study. BMC Geriatrics. 2016;16(1):1-9.
17 Brady 2020 - Brady S, D’Ambrosio LA, Felts A, et al. Reducing isolation and loneliness through membership in a fitness program for older adults: Implications for health. Journal of Applied Gerontology. 2020;39(3):301-310.
18 Mammen 2013 - Mammen G, Faulkner G. Physical activity and the prevention of depression: A systematic review of prospective studies. American Journal of Preventive Medicine. 2013;45(5):649-657.
19 Bridle 2012 - Bridle C, Spanjers K, Patel S, Atherton NM, Lamb SE. Effect of exercise on depression severity in older people: Systematic review and meta-analysis of randomised controlled trials. The British Journal of Psychiatry. 2012;201(3):180-5.
20 Choi 2020b - Choi, N. G., Pepin, R., Marti, C. N., Stevens, C. J., & Bruce, M. L. (2020). Improving social connectedness for homebound older adults: Randomized controlled trial of tele-delivered behavioral activation versus tele-delivered friendly visits. The American Journal of Geriatric Psychiatry, 28(7), 698–708.
21 Shekelle 2024 - Shekelle, P. G., Miake-Lye, I. M., Begashaw, M. M., Booth, M. S., Myers, B., Lowery, N., & Shrank, W. H. (2024). Interventions to reduce loneliness in community-living older adults: A systematic review and meta-analysis. Journal of General Internal Medicine, 39(6), 1015–1028.
22 Kelly 2014 - Kelly ME, Loughrey D, Lawlor BA, et al. The impact of exercise on the cognitive functioning of healthy older adults: A systematic review and meta-analysis. Ageing Research Reviews. 2014;16:12-31.
23 Cochrane-Young 2015 - Young J, Angevaren M, Rusted J, Tabet N. Aerobic exercise to improve function in older people without known cognitive impairment. Cochrane Database of Systematic Reviews. 2015;(4):CD005381.
24 Gine-Garriag 2014 - Giné-Garriag M, Roqué-Fíguls M, Coll-Planas L, Sitjà-Rabert M, Salvà A. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation. 2014;95(4):753-769.
25 Guzman-Garcia 2013 - Guzmán-García A, Hughes JC, James IA, Rochester L. Dancing as a psychosocial intervention in care homes: A systematic review of the literature. International Journal of Geriatric Psychiatry. 2013;28(9):914-924.
26 Vanderlinden 2020 - Vanderlinden, J., Boen, F., & Van Uffelen, J. G. Z. (2020). Effects of physical activity programs on sleep outcomes in older adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 11.
27 Gray 2020 - Gray SM, McKay HA, Hoy CL, et al. Getting ready for scale-up of an effective older adult physical activity program: Characterizing the adaptation process. Prevention Science. 2020;21(3):355-365.
28 EnhanceFitness - Project Enhance. EnhanceFitness. Seattle, WA.
29 YMCA-Healthy living - Young Men’s Christian Association (YMCA). (n.d.). Healthy living. Retrieved April 22, 2025.
30 JCC-Fitness - Jewish Community Center Association (JCC), DiscoverJCC.com. Programs and services at JCCs of North America: Health & fitness.
31 LBFE - Little Brothers-Friends of the Elderly (LBFE). Flowers before bread: Little Brothers Friends of the Elderly.
32 NCOA-Excellence - National Council on Aging (NCOA). Programs of Excellence.
33 NCDHHS-DAAS - North Carolina Department of Health and Human Services (NCDHHS). North Carolina Division of Aging and Adult Services (DAAS).
34 FL-Elder affairs - State of Florida Department of Elder Affairs. Latest news & topics.
35 KY-Aging programs and services - Kentucky Cabinet for Health and Family Services (CHFS). Department of Aging and Independent Living programs and services.
36 WI DHS-Older adults services - Wisconsin Department of Health Services (DHS). Services for older adults.
37 SilverSneakers - SilverSneakers. Get active, feel great.
38 CTM - Choose to Move (CTM). Being active.
39 StrongPeople - StrongPeople. Lifting people and communities to better health.
40 CDC-Older adults - Centers for Disease Control and Prevention (CDC). (2024). Older adults: Adding activity recommendations. Retrieved April 16, 2025.
41 Adepoju 2024 - Adepoju, O. E., Ojinnaka, C. O., Pieratt, J., & Dobbins, J. (2024). Racial and ethnic differences in predictors of participation in an intergenerational social connectedness intervention for older adults. BMC Geriatrics, 24(1), 70.
42 CDC-Physical activity 50 and older - Centers for Disease Control and Prevention (CDC). (2024). Physical activity. Report: Adults 50 and older need more physical activity. Retrieved April 16, 2025.
43 Prochnow 2022 - Prochnow T, Valdez D, Curran LS, et al. Multifaceted scoping review of Black/African American transportation and land use expert recommendations on activity-friendly routes to everyday destinations. Health Promotion Practice. 2022.
44 McAndrews 2022 - McAndrews C, Schneider RJ, Yang Y, et al. Toward a gender-inclusive Complete Streets movement. Journal of Planning Literature. 2022;38(1):3-18.
45 Brookings-Semmelroth 2020 - Semmelroth L. How Wilmington, Del. is revitalizing vacant land to rebuild community trust. Washington, D.C.: Brookings Institution; 2020.
46 NRPA-Equity 2021 - National Recreation and Park Association (NRPA). Equity in parks and recreation: A historical perspective.
47 Kaplan 2007 - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.
48 NRPA-Fleming 2021 - Fleming K. Observing from a lens of equity. National Recreation and Park Association (NRPA). 2021.
49 CAP-Rowland-Shea 2020 - Rowland-Shea J, Doshi S, Edberg S, Fanger R. The nature gap: Confronting racial and economic disparities in the destruction and protection of nature in America. Washington, D.C.: Center for American Progress (CAP); 2020.
50 TPL-Chapman 2021 - Chapman R, Foderaro L, Hwang L, et al. Parks and an equitable recovery. San Francisco, CA: The Trust for Public Land (TPL); 2021.
51 VWH-Brown 2022 - Brown S. Do you live in an ‘exercise desert’? Verywell Health (VWH). 2022.
52 MH-Lawrence 2020 - Lawrence A. How race, class, and geography keep some people from great workouts. Men’s Health (MH). 2020.
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