CA20104 – Ne wo k on e idence-based physical ac i i y
in old age (PhysAgeNe )
Deli e able D4.5.
D4.5. Consensus epo on inal s a e o he a and u he needs
Con ibu o s
Wo king G oup 4
Signe Tomsone (Associa e P o esso /WG4 leade ), Jona han Gómez-Raja (Chie Scien i ic
O ice /WG4 ice-leade ), Da id Paa (Associa e P o esso /WG4 membe )
1. INTRODUCTION
The demog aphic shi owa ds an inc easingly aging popula ion ep esen s one o he g ea es socie al and public
heal h challenges wo ldwide. While li e expec ancy has isen s eadily o e he pas decades, heal hy li e expec ancy
has no inc eased a he same pace, leading o ex ended yea s li ed wi h unc ional limi a ions, ch onic diseases,
and educed quali y o li e. Physical ac i i y is a p o en, cos -e ec i e s a egy o p omo e heal hy aging, p ese e
unc ional capaci y, and mi iga e he bu den o non-communicable diseases in olde adul s. Ne e heless, despi e a
la ge body o esea ch demons a ing he bene i s o physical ac i i y ac oss physical, cogni i e, and psychosocial
domains, subs an ial gaps emain in he ansla ion o scien i ic e idence in o p ac ical, ailo ed, and sus ainable
in e en ions o he e ogeneous olde popula ions.
The COST Ac ion CA20104, Ne wo k on E idence-Based Physical Ac i i y in Old Age (PhysAgeNe ), was es ablished
o add ess hese gaps by os e ing a ansdisciplina y Eu opean esea ch and inno a ion ne wo k. I s o e a ching
goal is o consolida e and ad ance he e idence base on physical ac i i y in old age, and o enhance he in eg a ion
o inno a i e in o ma ion and communica ion echnologies (ICT) and open da a solu ions in o esea ch and p ac ice.
PhysAgeNe b ings oge he expe s om spo s and exe cise sciences, medicine, ge on ology, psychology, public
heal h, and digi al echnologies, he eby c ea ing a unique pla o m o b idge disciplina y bounda ies and o align
basic, clinical, and applied esea ch wi h policy and p ac ice.
Wi hin his amewo k, Wo king G oup 4 (WG4) plays a cen al ole in c i ically syn hesising he e idence ac oss
domains and coo dina ing he de elopmen o consensus-based ou pu s. Speci ically, he asks o WG4 include
conduc ing consensus p ocesses on p og ess beyond he ini ial opical s a us, iden i ying eme ging needs, and
p oducing a inal consensus epo (Deli e able 4.5) on he s a e o he a and u he equi emen s. This epo
e lec s bo h he scien i ic p og ess achie ed du ing he Ac ion and he collec i e ag eemen o he ne wo k on
p io i ies o u u e esea ch, implemen a ion, and policy de elopmen .
By sys ema ically analysing ad ancemen s in he ield and aligning hem wi h eal-wo ld demands, he consensus
p ocess ensu es ha he ou comes o PhysAgeNe ex end beyond academic con ibu ions. The ul ima e aim is o
deli e ac ionable knowledge, clea ecommenda ions, and a obus oadmap ha can guide esea che s,
p ac i ione s, and decision-make s in p omo ing e idence-based physical ac i i y in e en ions o olde adul s
ac oss di e se Eu opean con ex s.
2. RESULTS BY WORKING GROUPS AND DELIVERABLES OF THE PROJECT
2.1. WG1 – Implemen a ion and De elopmen o S anda ds om
EBM
2.1.1. D1.1 - D1.2 – SYSTEMATIC REVIEW USING THE DATABASE OF
REFERENCES AND METADATA RELATED TO PA INTERVENTIONS AND
BASED ON EBM
Baseline and P og ess Du ing COST Ac ion
A he s a o he Ac ion, e idence on physical ac i i y (PA) in olde age was sca e ed and
inconsis en . B ach e al. (2023) iden i ied agmen ed me hods, limi ed inclusion o ail
pa icipan s, and poo s anda disa ion. Lambe i e al. (2023) ad anced his by in oducing a
PRISMA- and PROSPERO-based p o ocol o e alua e PA e ec s on heal h- ela ed quali y o li e
(HRQoL), es ablishing me hodological igou and eplicabili y ac oss di e se popula ions.
Consensus S a emen s
• Sys ema ic e iews a e he backbone o e idence-based physical ac i i y (EB-PA) esea ch.
• HRQoL should be ea ed as a key ou come, alongside physical and physiological measu es.
• T anspa en , p e- egis e ed me hodologies (PRISMA, PICOS, PROSPERO) a e equi ed o
c edibili y.
• Ha monized epo ing (FITT pa ame e s) enables da a syn hesis and c oss-s udy compa ison.
Knowledge Gaps and Fu he Needs
• Lack o uni o m HRQoL measu emen ools and ou come compa abili y.
• Unde ep esen a ion o ail and mul imo bid popula ions.
• Insu icien open-da a s uc u es o cumula i e e idence analysis.
Recommenda ions
• Adop uni ied epo ing empla es o exe cise in e en ions.
• Include HRQoL as a s anda d a iable in u u e e iews.
• De elop open-access Eu opean PA e idence da abases o suppo con inuous me a-analysis.
2.1.2. D1.3 – DESCRIPTION TOOL FOR PA INTERVENTIONS BASED
ON EBM STANDARDS
Baseline and P og ess Du ing COST Ac ion
The deli e able es ablished he ounda ion o a sha ed in e en ion-desc ip ion ool. Lambe i e al.
(2023) demons a ed how de ailed epo ing o exe cise cha ac e is ics (FITT), supe ision, and
adhe ence enhances s udy compa abili y and eplica ion.
Consensus S a emen s
• Comp ehensi e documen a ion o exe cise equency, in ensi y, ime, and ype is essen ial.
• Clea p og ession and supe ision de ails de e mine bo h sa e y and eplicabili y.
• S anda dized empla es suppo anspa ency and u u e e idence syn hesis.
Knowledge Gaps and Fu he Needs
• He e ogenei y in in e en ion documen a ion and adhe ence acking.
• Weak linkage be ween exe cise dose and obse ed ou comes.
Recommenda ions
• Apply he COST empla e o in e en ion desc ip ion ac oss all u u e s udies.
• Combine s anda dized documen a ion wi h digi al adhe ence moni o ing sys ems.
2.1.3. D1.5 – CONSENSUS PAPER AND ROADMAP ON EBM FOR PA
INTERVENTIONS SUBMITTED FOR PUBLICATIONS
Baseline and P og ess Du ing COST Ac ion
B ach e al. (2023) emphasized he need o ha monized EBM p ac ices and in e disciplina y
collabo a ion o ansla e PA esea ch in o policy and p ac ice. This oadmap unde pins
PhysAgeNe ’s c oss-domain e idence in eg a ion s a egy.
Consensus S a emen s
• EBM should guide all s ages o PA esea ch, om design o dissemina ion.
• In e disciplina y ne wo ks a e i al o educe duplica ion and agmen a ion.
• Me hodological anspa ency is he ounda ion o ansla ion in o clinical and policy con ex s.
Knowledge Gaps and Fu he Needs
• Low adop ion o EBM amewo ks in non-clinical exe cise esea ch.
• F agmen ed communica ion be ween disciplines.
Recommenda ions
• Deli e s uc u ed EBM aining o exe cise scien is s and p ac i ione s.
• Encou age open-access, ep oducible p o ocols and c oss-disciplina y collabo a ion.
2.2. WG2 – Da a o u ilising bioma ke s and beha iou al ma ke s
as well as en i onmen al ac o s
2.2.1. D2.2 – ROADMAP FOR BIOMARKERS AND ENVIRONMENTAL
FACTORS
Baseline and P og ess Du ing COST Ac ion
PhysAgeNe expanded i s biological and ecological e idence base. Vin s e al. (2023) explo ed
myokines (BDNF, i isin, IL-6, IGF-1) as media o s o exe cise–cogni ion in e ac ion. Oniszczuk e
al. (2022) iden i ied scle os in as a bone-heal h bioma ke . Oli ei a e al. (2022) alida ed phase
angle (PhA) as a non-in asi e unc ional bioma ke . Jansen e al. (2025) highligh ed
en i onmen al and digi al condi ions a ec ing echnology-assis ed PA adhe ence.
Consensus S a emen s
• Biological ma ke s (myokines, scle os in, PhA) p o ide measu able insigh in o physiological
adap a ion.
• En i onmen al and con ex ual ac o s shape accessibili y, adhe ence, and eal-wo ld impac .
• In eg a ion o molecula and en i onmen al da a enables pe sonalized, con ex -sensi i e PA
in e en ions.
Knowledge Gaps and Fu he Needs
• Lack o longi udinal bioma ke da a and s anda dized sampling.
• Limi ed linkage be ween bioma ke esponses and en i onmen al me ics.
• Digi al inequi ies hinde equi able access o echnology-assis ed p og ams.
Recommenda ions
• De elop ha monized bioma ke p o ocols and e e ence anges.
• Combine biological, beha io al, and en i onmen al da ase s wi hin open eposi o ies.
• P omo e digi al inclusion and use -cen e ed en i onmen al design.
2.2.2. D2.3 – OPEN DATA FRAMEWORK INCLUDING PA INTERVENTION
AND MULTIPLE DATA SOURCES AND BIOMARKERS
Baseline and P og ess Du ing COST Ac ion
This deli e able consolida es open-da a p ac ices linking physiological and bioma ke da ase s. Vin s
e al. (2023) p oposed s anda diza ion o biological da a in eg a ion, while Oli ei a e al. (2022)
alida ed bioelec ical impedance a iables as scalable, non-in asi e inpu s o open da abases.
Consensus S a emen s
• Open-da a in eg a ion accele a es ep oducibili y and anspa ency.
• Bioma ke s and physiological a iables en ich unde s anding o indi idual exe cise esponse.
• E hical da a go e nance is c ucial o biospecimen sha ing and euse.
Knowledge Gaps and Fu he Needs
• Missing in e ope abili y among biological and pe o mance da ase s.
• Une en da a quali y s anda ds ac oss ins i u ions.
Recommenda ions
• Build in e ope able, FAIR-complian open eposi o ies.
• S anda dize da a anno a ion o bioma ke and BIA a iables.
• De elop e hical guidelines o da a access and euse in PA esea ch.
2.2.3. D2.4 – DEMONSTRATOR (PROTOTYPE) OF THE REPOSITORY
INCLUDING REAL DATA FROM TECHNOLOGY-ASSISTED PA
INTERVENTIONS
Baseline and P og ess Du ing COST Ac ion
Jansen e al. (2025) iden i ied key en i onmen al and con ex ual a iables (social suppo , usabili y,
accessibili y) necessa y o accompany TA-PA da ase s. This in o ms he design o a
demons a o eposi o y ha in eg a es con ex ual me ada a.
Consensus S a emen s
• En i onmen al me ada a (social, digi al, in as uc u al) a e essen ial o unde s anding
ou comes.
• Con ex ual alignmen imp o es sus ainabili y and equi y o in e en ions.
Knowledge Gaps and Fu he Needs
• Lack o ha monized con ex ual desc ip o s.
• Insu icien linkage be ween en i onmen al da a and beha io al ou comes.
Recommenda ions
• Manda e en i onmen al me ada a in TA-PA da a eposi o ies.
• Use open amewo ks o connec en i onmen –beha io –heal h da ase s.
2.3. WG3 – Resea ch me hodology o echnology-assis ed PA
and exe cise in e en ions in old age
2.3.1. D3.1 – GUIDELINES ON REQUIREMENTS AND STRATEGICAL
IMPROVEMENT OF RECRUITMENT AND SAMPLING FOR DIFFERENT
TARGET GROUPS, USING A FORMAL CONSENSUS PROCEDURE
Baseline and P og ess Du ing COST Ac ion
These s udies add essed pa icipan ec ui men and ep esen a i eness. Gomes Ciolac e al. (2024)
emphasized sex-balanced ca dio ascula aging esea ch, while Lee e al. (2025) es ablished 34
in e na ional ecommenda ions o inclusi e, e hical ec ui men .
Consensus S a emen s
• Rec ui men s a egies mus ensu e gende , heal h-s a us, and socioeconomic di e si y.
• E hical inclusion and anspa en consen p ocesses a e undamen al.
• Balanced ep esen a ion enhances ex e nal alidi y.
Knowledge Gaps and Fu he Needs
• Unde ep esen a ion o e y old, ail, and emale pa icipan s.
• Limi ed empi ical alida ion o ec ui men amewo ks.
Recommenda ions
• Apply he COST ec ui men consensus amewo k.
• Repo de ailed ec ui men me ics.
• Engage communi y and heal hca e ne wo ks o inclusi e pa icipan sou cing.
2.3.2. D3.2 – GUIDELINES AND FRAMEWORK FOR DESIGNING
TECHNOLOGY-ASSISTED PA INTERVENTIONS INCLUDING
APPROPRIATE ASSESSMENT STANDARDS
Baseline and P og ess Du ing COST Ac ion
This deli e able uni es me hodological ad ances in digi al, physiological, and men al heal h
in e en ion design. The s udies collec i ely es ablished amewo ks o cogni i e,
ca dio ascula , a ec i e, and neu omuscula ou comes, ancho ed by Wollesen e al.’s (2024)
Delphi consensus on exe cise in ensi y.
Consensus S a emen s
• S anda dized in ensi y (Delphi axonomy) is essen ial o ep oducibili y.
• Mul idimensional ou come amewo ks mus include physical, cogni i e, and psychological
measu es.
• Technology-assis ed p og ams enhance accessibili y and engagemen .
• Sex and heal h-s a us s a i ica ion imp o e in e en ion sa e y and ele ance.
Knowledge Gaps and Fu he Needs
• Limi ed adop ion o he Delphi amewo k.
• Weak da a in eg a ion be ween digi al adhe ence me ics and physiological da a.
• Lack o ha monized ou come se s ac oss esea ch domains.
Recommenda ions
• Embed he Delphi in ensi y de ini ions in all s udies.
• Use s anda dized cogni i e and men al-heal h assessmen s.
• Calib a e wea able senso s o in ensi y le els.
• Apply in e disciplina y co-design in digi al in e en ion de elopmen .
3. CONCLUSIONS
O e he ou yea s o COST Ac ion CA20104 – Ne wo k on E idence-Based Physical Ac i i y in Old Age (PhysAgeNe )
– he pa icipa ing expe s ied o ans o m a agmen ed and discipline-bound esea ch ield in o a cohe en ,
s anda dized, and ansdisciplina y e idence base on physical ac i i y (PA) and aging. Th ough he combined e o s
o he ou wo king g oups, PhysAgeNe has buil me hodological and en i onmen al b idges linking physiology,
psychology, medicine, and echnology wi h public heal h and social sciences.
WG1 laid he concep ual and me hodological ounda ions o e idence-based p ac ice.
By p omo ing sys ema ic e iews and s anda dized in e en ion epo ing (PRISMA, PROSPERO, FITT), i ad anced
he in eg a ion o quali y-o -li e indica o s in o PA e alua ion and c ea ed he ools equi ed o anspa en ,
ep oducible esea ch.
WG2 connec ed he biological and con ex ual dimensions o heal hy aging.
I iden i ied key bioma ke s – such as myokines, scle os in, and bioelec ical impedance-de i ed a iables – while
also highligh ing he decisi e ole o en i onmen al, social, and digi al con ex s in suppo ing echnology-assis ed
physical ac i i y.
Toge he , hese indings pa e he way o pe sonalized, da a-d i en heal h p omo ion s a egies.
WG3 add essed he me hodological challenges o echnology-assis ed in e en ions.
I s deli e ables p oduced s anda dized amewo ks o exe cise in ensi y (Delphi consensus), ec ui men (inclusi e
and sex-balanced sampling), and design o mul imodal in e en ions a ge ing cogni i e, ca dio ascula , and
psychological ou comes.
These me hodological ad ances ensu e ha u u e s udies will be bo h scien i ically igo ous and e hically inclusi e.
WG4 syn hesized all e idence s ands in o consensus s a emen s and ac ionable ecommenda ions.
I s wo k demons a es ha exe cise ac s as a sys emic in e en ion – simul aneously enhancing physical capaci y,
cogni i e pe o mance, ca dio ascula in eg i y, molecula adap a ion, and men al wellbeing – and ha sus ainable
implemen a ion depends on suppo i e en i onmen al and echnological in as uc u es.
Ac oss all deli e ables, se e al o e a ching conclusions eme ge:
• Physical ac i i y is a co ne s one o heal hy aging, p o iding mul idimensional bene i s ac oss
physiological, cogni i e, and psychosocial domains.
• S anda diza ion and anspa ency a e essen ial o e idence accumula ion and in e na ional compa abili y.
• Pe sonaliza ion and inclusi i y mus guide esea ch design, ensu ing ha ail, mul imo bid, and socially
disad an aged olde adul s a e ep esen ed.
• Technology and digi aliza ion can d ama ically ex end access o indi idualized in e en ions when guided
by e hical, use -cen e ed p inciples.
• In e disciplina y and open science collabo a ion is i al o b idging mechanis ic disco e y wi h eal-wo ld
policy and p ac ice.
Looking ahead, he PhysAgeNe ne wo k lea es a sus ainable legacy:
a communi y o esea che s, clinicians, and p ac i ione s uni ed by sha ed s anda ds and a commi men o ad ancing
heal hy longe i y h ough e idence-based physical ac i i y.
Fu u e Eu opean ini ia i es – whe he unde Ho izon Eu ope, E asmus+, o WHO Heal hy Aging amewo ks – should
build upon hese achie emen s by de eloping in eg a ed, da a- ich, and en i onmen ally esponsi e sys ems ha
u n e idence in o ac ion.
By main aining and expanding his collabo a ion, Eu ope can ensu e ha e e y olde ci izen has he oppo uni y o
emain ac i e, au onomous, and connec ed ac oss he li espan.
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