Nudge-Based Interventions Can Improve Activity and Outcomes in Older Adults

March 2, 2023

March 2, 2023

Contact: Ellen Mullally

Social distancing due to the COVID pandemic exacerbated inactivity in many older adults. Novel approaches can help improve activity and outcomes; and according to a new study in the March issue of JAMDA, nudge-based interventions show promise in this regard, especially for older men.

In Nudge-Based Interventions on Health Promotion Activity Among Very Old People: A Pragmatic, Two-Arm, Participant-Blinded Randomized Controlled Trial, the authors enrolled participants from a retirement community in Japan. Tablet computers were installed in a common area for participants to receive information about their health. The intervention group received a one-time loss-emphasized nudge, followed by asking questions about when they planned to use it again. The control group used the tablets without being asked those questions.

The findings indicated that a two-step behavioral intervention, which involved a loss-emphasized nudge and a commitment nudge, made a difference by increasing older adults’ health promotion activities in the following 12 weeks.

The authors noted that an initial large effect of nudges in the intervention group disappeared quickly, yet the intervention group experienced a subtle but consistent increase in their activities after a few weeks, and the increase persisted for at least eight weeks. They also noted that the nudges were more effective in men and observed that the exact element of intervention that prompted older men to promote their activity could not be determined. However, they suggested this may be at least partly because women were more likely than men to engage in social/physical activity, especially at an older age.

Such interventions will help improve the health outcomes of older adults, the authors concluded. They stressed, “Promoting older adults’ activities is the key to designing health services.” They also suggested that future studies could be conducted using a wearable device to assess the effect of nudge-based interventions directly on physical activity in older adults.

The study was conducted by researchers at the Fukuma Research Group, Human Health Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan; Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan; Department of Health Data Science, Tokyo Medical University, Shinjuku-ku, Tokyo; Kyoto University Museum, Yoshida Nonmachi, Sakyo-ku, Kyoto, Japan; and Center for Data Science Education and Research, Shiga University, Siga, Japan.

Get more information on the findings above and more details about the study. To contact the researchers or JAMDA editors for an interview, please email





JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit for more information.


About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.