Factors affecting the acceptability of Mindfulness-based Interventions among older adults: A systematic literature review

Objectives: Mindfulness-based interventions (MBIs) are increasingly implemented to promote psychological wellbeing in later life. Although growing evidence suggests benefits, less is known about the acceptability of MBIs to older adults. Acceptability is often inferred from users’ attendance or adherence, which may overlook the cognitive and emotional factors shaping it. This review investigates the factors shaping older adults’ acceptability of MBIs to understand what enables or limits their engagement. Methods: Following PRISMA-2000 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 then analysed using the lens of the Theoretical Framework of Acceptability, a model for assessing how appropriate people view new healthcare interventions based on anticipated or experienced cognitive and emotional responses to the intervention. 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.