Factors Affecting the Acceptability of Mindfulness-Based Interventions Among Older Adults: A Systematic Literature Review

Abstract

Abstract Background Mindfulness-based interventions (MBIs) are increasingly implemented to promote psychological wellbeing in later life. Although emerging evidence suggests that MBIs may improve wellbeing among older adults, fewer studies have examined the factors influencing their acceptability. Acceptability is often inferred from attendance or adherence, which may overlook the cognitive and emotional factors shaping it. Objective This review investigated the factors shaping older adults’ acceptability of MBIs and identifies what enables or limits engagement. Methods Following PRISMA 2020 guidelines, a systematic review was conducted across the databases MEDLINE, PsycINFO, CINAHL, Embase, and Scopus. Studies involving older adults and examining the acceptability of MBIs were identified and analysed using the lens of the theoretical framework of acceptability, a model for assessing how appropriate people view healthcare interventions based on anticipated or experienced cognitive and emotional responses. This framework encompasses seven constructs: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. Results Twenty-two studies met the inclusion criteria. Acceptability was shaped by affective attitudes , calm and social connection; perceived effectiveness , improved mood and sleep; and ethicality , alignment with values and purpose. MBIs were associated with mechanisms for coping and regulating emotions and perceived as requiring manageable effort. Conclusions MBIs are acceptable to older adults when tailored to their cognitive, physical, and social capacities. As non-pharmacological approaches, they promote wellbeing and align with positive ageing principles by improving connection, meaning, and resilience. The TFA offers a robust framework for exploring acceptability of MBIs in this population. Preregistration This study is not preregistered.