Effects of intergenerational exercise-based interventions on activity levels and physical performance in older adults: a systematic review

Abstract Background Older adults (OA) are the most sedentary population segment, emphasizing the need for sustainable interventions to promote lasting behavioural change in this group. Intergenerational (IG) exercise programmes may improve adherence and support lasting benefits. This systematic review evaluated the effects of IG exercise interventions on reducing sedentary behaviour (SB) and/or increasing physical activity (PA) and/or improving physical performance (PP) in OA. Methods A systematic search was conducted from database inception to October 31, 2025, in PubMed, Scopus, Web of Science, and Cochrane. Eligible studies included experimental and quasi-experimental exercise-based interventions targeting OA (adults ≥ 60 years) without severe dementia, involving younger participants, incorporating IG connections, and measuring PA, PP, and/or SB at least at pre- and post-intervention time points. Risk of bias in the included studies was assessed using RoB 2 and RoBANS 2. This systematic review adhered to the PRISMA 2020 guidelines and was registered in PROSPERO under reference number CRD42024521977. Results Seven of the 299 identified non-duplicate studies met the inclusion criteria (1 clinical trial, 4 quasi-experimental studies, 1 pilot crossover study, and 1 pilot randomized clinical study), comprising 248 OA aged 67.6–83.6 years. The interventions in the included studies were conducted in high-income countries. The settings varied, as they did not all represent traditional physical activity environments, and the outcomes were assessed using different measurement approaches across studies. Nonetheless, all interventions were delivered face-to-face and were community-based. Overall, these interventions were associated with improvements in PA, PP, and psychosocial outcomes (e.g., life satisfaction and loneliness), although some effects—particularly those related to motor skills and mobility—were small or not statistically significant. Due to the heterogeneity of the included studies, strong conclusions cannot be drawn. Conclusions Although IG exercise-based interventions appear valuable for improving activity levels and even more promising for improving secondary outcomes in OA, the available evidence is limited by the predominance of low-quality studies and the high risk of bias in most trials. Therefore, the findings should be interpreted with caution and confirmed in future high-quality studies.