CLOSING THE KNOW-DO GAP: A SOCIO- ECOLOGICAL AND BEHAVIOURAL REVIEW OF PHYSICAL ACTIVITY ADHERENCE IN COMMUNITY-DWELLING OLDER ADULTS

Abstract

Despite robust clinical evidence demonstrating that regular exercise preserves functional independence and mitigates chronic disease burden in late life, a profound "know–do gap" persists between global physical activity recommendations and real-world behavioral adherence among community-dwelling older adults. This short review examines the multifaceted reasons underlying this widespread behavioral drop-off, shifting the focus from idealized clinical prescription to complex real-world determinants. Utilizing the Socio-Ecological Model and behavioral frameworks like the COM-B model, we synthesize how intrapersonal psychological barriers such as a cyclical fear of falling, low self efficacy, and subclinical depression are actively amplified by interpersonal social isolation, hostile built environments, and fragmented healthcare referral pathways. The review highlights that passive family encouragement often proves insufficient, underscoring the critical necessity for active, structured community interpersonal support. We argue that sustainable behavioral change cannot be achieved through isolated medical directives; instead, healthcare systems must integrate with local social infrastructures through multi-component community volunteer frameworks and peer companionship models. Finally, we identify a profound geographic gap in current literature, calling for targeted socio ecological research in low- and middle-income countries (LMICs) where rapid population aging collides with unique structural and economic challenges. Ultimately, resolving late-life physical inactivity requires transitioning from individual-focused clinical mandates toward community-anchored, sustainable support networks.