Healthy Lifestyle Adherence

Healthy lifestyle adherence should not be treated merely as a matter of personal choice or willingness. Diet and alcohol abstinence adherence were much less frequently assessed than medication, smoking cessation, LDL-C, or exercise adherence. Smoking cessation was nearly as frequently assessed as medication adherence. Validated PROMs were not used for smoking cessation, exercise, diet, alcohol, or rehabilitation adherence. Lifestyle and rehabilitation adherence were less comprehensively assessed, especially in PAD and stroke. Smoking cessation adherence became the predominant adherence domain from 2021 to 2024. Barriers to healthy lifestyle adherence reflected structural, social, economic, physical, cultural, and environmental constraints rather than only lack of motivation. The study examined why older adults in Kalutara district, Sri Lanka, did not follow healthy lifestyle recommendations. Lifestyle programmes for older adults need to address contextual realities beyond individual behaviour change.