The Role of Tourism in Enhancing Domains of Health for Seniors: A Scoping Review

Abstract

Background

Old age is one of the critical stages of human life, encompassing a significant portion of people's lives in society. During this period, the elderly face various challenges, such as health conditions. As one of the important sectors, the tourism industry has gained considerable popularity among the elderly for promoting health. Therefore, this review study was conducted to examine the role of tourism in the health status of the elderly.

Methods

This scoping review was conducted according to Arksey and O'Malley (2005). In this scoping review, a systematic search was conducted for studies with any type of design on the role, impact, and consequences of tourism on the elderly. The search covered studies in both Persian and English languages from 1984 to 2023 across databases and search engines—including PubMed, Scopus, Web of Science, IranMedex, IRANDOC, Google Scholar, MAGIRAN, and SID—using the keywords "tourism, old person, senior, aged, aging, elderly, older adults, old age" and their Persian equivalents.

Results

Out of 7454 studies identified in the initial search, 23 articles on aging and tourism were finally reviewed based on the inclusion criteria. The studies investigated the role and impact of tourism on health in 3 ways: mixed methods, quantitative, and qualitative. In qualitative studies, the experiences of elderly people with tourism were examined, while quantitative studies explored tourism's predictive role as an independent variable and its correlation with various dimensions of health. The results of the quantitative studies showed that tourism improved the physical health of the elderly. The mean scores for cognitive function, daily activities, and vitality were reported to be higher among elderly tourists compared to nontourists. Additionally, the quality of life and well-being scores of elderly individuals who engaged in tourism were significantly higher compared to those who did not. Tourism experiences for the elderly were often associated with better life satisfaction, a sense of peace, and purpose in life.

Conclusion

Based on the results, tourism can improve the health and quality of life of the elderly. Given the importance of tourism, it is recommended that the tourism industry and its marketing for the elderly be prioritized as a target group. Additionally, to promote the tourism industry, special attention should be given to the specific needs and welfare issues of the elderly.

↑What is “already known” in this topic:

Tourism has been recognized as a beneficial activity for the elderly, contributing to improvements in physical health, cognitive function, and overall well-being. Previous studies have shown that elderly individuals who engage in tourism experience higher levels of life satisfaction and spiritual health.

→What this article adds:

This scoping review synthesizes the findings from both qualitative and quantitative studies, providing a comprehensive analysis of how tourism impacts the health of the elderly. The review categorizes the effects into specific domains such as physical health, mental health, spiritual health, increased ability in daily tasks, vitality, and overall well-being.

Introduction

One of the most critical demographic changes in world history is population aging, with its growth outpacing that of other age groups. Therefore, given the rapid growth of this demographic group, it is predicted that the number of elderly individuals will increase from about 1 billion in 2020 to twice that amount (2.1 billion) by 2050 (1). As the elderly population grows, the associated problems will also expand for society, governments, and relevant organizations. (2, 3). Aging represents the gradual accumulation of changes within an individual over time, including physical, psychological, and social transformations. It is a natural part of human and demographic life processes, characterized by a decrease in fertility and birth rates, a rise in life expectancy, and a shift in the age structure of the population from younger to older groups (4).

According to the World Health Organization's definition, any individual over the age of 60 years is considered elderly (5).

As people age, the risk of chronic diseases such as cancer, cardiovascular problems, and neurodegenerative disorders increases, which can lead to higher healthcare costs. Therefore, it is essential to prioritize healthy aging by maintaining the functional abilities of older adults and mitigating pathological changes (6). Given the importance of the aging period, understanding the issues related to it in detail allows for the planning of appropriate interventions. Tourism, as one of the largest and most diverse industries in the world, has been recognized for its connection to health and well-being studies and is widely used as a healthy activity for both physical and mental well-being (7). Many studies confirm that tourism positively impacts physical and mental well-being and improves quality of life. The connection between tourism and health is widely recognized as both positive and significant (8, 9). The term "tourism" comes from "tour," which means travel and sightseeing, and the suffix "ism," which refers to a concept or ideology. Therefore, tourism is fundamentally focused on travel and exploration (10).

The World Tourism Organization recognizes the development of tourism for older adults as a significant opportunity in the coming decades. This recognition is based on several factors: the large and growing global population of older adults, their increasing numbers, and the fact that they often have more free time and financial resources to engage in tourism activities. Additionally, older adults tend to travel more frequently and stay longer at destinations (11). Recognizing the importance of health during aging, tourism has been seen as a potential solution. Various studies have explored the impact of tourism on the elderly, each reporting findings based on their specific objectives. The study by Tomoko et al found that the interaction between curiosity and participation in tourism activities enhances the subjective well-being of older adults (12). According to the findings of Sie et al, memorable experiences and perceived benefits serve as intermediaries linking travel motivations, tour preferences, and the life satisfaction of senior travelers (13). The literature indicates a clear need for a comprehensive review of studies on the impact of tourism on the health of older adults. A scoping review would be particularly useful for this purpose. This type of study aims to map the existing research on a specific topic, identifying key concepts, theories, sources, and gaps in the current knowledge (14). This article offers a scoping review aimed at assessing how tourism affects the health of older adults, providing a comprehensive overview of current research in this field.

Methods

Study Design

This review study utilized the comprehensive 5-stage framework developed by Arksey and O’Malley for an in-depth examination of various information sources. This approach aimed to explore the quantity, scope, and nature of existing studies on the impact and consequences of tourism on aging. The 6-step methodology involves developing the research question, pinpointing relevant studies, establishing criteria for selecting studies, and recording and organizing key findings, which may include factors such as study location, intervention, comparison, study population, objectives, measurement methods, and outcomes, and summarizing and reporting the findings. Scoping reviews involve a thorough examination of the literature within a specific field to provide an overview of evidence, rather than a qualitative evaluation (15).

To achieve this objective, the study employed a scoping review approach that incorporates both quantitative and qualitative research and analyzes the findings. The primary research question directing this review is as follows: What is the role and effect of tourism on the health of older adults?

Search Strategy and Information Sources

To identify relevant studies, it is essential to search across multiple sources to ensure a comprehensive review. This study used various databases and search engines depending on the language of the texts. For English texts, searches were conducted using PubMed, Web of Science, and Scopus. For texts available in both English and Farsi, Google Scholar was used, while for Farsi texts, MagIran, SID, Doc Iran, and IranMedex were consulted. This approach ensured a thorough and inclusive review of the literature, capturing a broader range of valuable evidence (16).

The search used keywords such as "tourism," "elderly," "senior," "aged," "aging," "older adults," and "old age" to identify relevant studies. The choice of databases and time limits was deliberate to ensure a comprehensive search and capture a broad range of relevant texts. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) chart was used during the review stage to systematically evaluate and present the studies.

Inclusion Criteria

The criteria for including and excluding studies were modified throughout the search and review process in a collaborative manner guided by the researchers, in accordance with the research question and objectives of the review.

Age 55 years and overall health were the inclusion criteria—the age of 55 years was chosen as the cutoff point because some research considers old age as beginning at retirement age. Both English-language and Farsi-language papers were considered, along with studies of all kinds, including reviews, mixed methods, quantitative, and qualitative research.

Exclusion Criteria

The exclusion criteria were studies not related to older adults, as well as sources like books, letters to the editor, nonscientific journals, and newspapers. Table 1 presents the inclusion and exclusion data in detail.

Table 1. Detailed Presentation of Inclusion and Exclusion Data.

Inclusion criteria	Exclusion criteria
Language English and Farsi, Age ≥55, Accessing full text, no limited year of publication, Original studies of quantitative, qualitative, or mixed methods studies, research examining various impacts of tourism(e.g., leisure travel. medical tourism, religious tourism) on different aspectsof elderly health	Theoretical studies, letters to the editor, case reports and conference abstracts, Studies conducted on othergroups or mixed populations where results specific to the elderly are not separated reported, articles published other than English and Farsi

Selection Criteria

The screening of relevant studies was conducted through a 2-step process involving 2 researchers. Initially, both researchers independently reviewed the titles and abstracts to determine which studies were eligible for the next phase. In the second step, the selected studies were independently assessed to confirm their eligibility. Disagreements were resolved through discussions and consensus between the researchers. The reference lists of all qualifying studies were reviewed to identify any additional studies not captured in the electronic database search. The search strategy was recorded and stored in each database, and the results were organized using EndNote Version 8.

Results

Screening Results

The study selection process is illustrated in Figure 1. Initially, 7454 original articles were identified. After removing 727 duplicates, 6727 articles were left for title and screening review. From these, 6601 articles did not meet the inclusion and exclusion criteria and were excluded. The remaining 126 articles were further evaluated based on titles and abstracts. At this stage, 77 studies were excluded according to the criteria, and 49 full-text articles were thoroughly reviewed for eligibility assessment.

Figure 1.

Identification of Studies via Databases and Registers

Out of the total, 30 cases were excluded based on the criteria: 22 were unrelated to the study's purpose, 3 did not align with the study plan, and 5 had participants who did not meet the entry criteria. Consequently, 21 articles were initially deemed qualified for the review. During the review process, 2 additional studies were identified, increasing the final number to 23 studies selected for a comprehensive analysis. To document and categorize key findings, a data extraction form was created. Two researchers independently assessed 23 selected studies and recorded the extracted information on this form (Figure 1).

Study Characteristics

The form captured the following details: (1) author, (2) year of publication, (3) study title, (4) country of study, (5) study design, (6) mean age of participants, and (7) main results relevant to the research question. The characteristics of the reviewed studies are detailed in Table 2. Among the 23 studies, there were 15 quantitative studies, 6 qualitative studies, and 2 mixed-method studies. The studies were conducted in various countries: 2 in Japan, 3 in China, 2 in France, and additional studies in Belgium, Canada, England, the United States, Malaysia, the Philippines, Poland, Australia, Sweden, Spain, and Turkey. The data collection methods varied by study type. Several studies explored older adults' experiences with travel and tourism qualitatively, while others provided mixed-method results on the impact of tourism on older adults. Some studies presented quantitative findings on how tourism affects the health of older adults.

Table 2. Characteristics of the Mentioned Articles.

Author	Year	Title	Journal	Country	Research		Mean Age
Manuela Vega-Vázquez et al,	2020	The effect of tourism on active and healthy aging: quality of life related to health. (8)	Journal of Policy Research in Tourism, Leisure and Event	Spain	A quantitative field study		65
Linghan Zhang and Junyi Zhang, et al,	2018	Effects of Leisure and Tourism on the Quality of Life in Intimacy for Older Adults: A Comparative Study in Japan. (22)	Sustainability	Japan	online survey applying a structural equation model (SEM) approach		. 65
Marlène Mélona,et al,	2017	The holiday-related predictors of well-being in seniors(18)	Thesis, taylorfrancis.com	Belgium	quantitative analysis		. 60
Fiocco et al	2021	Virtual tourism for older adults residing in care facilities: A mixed-methods investigation. (19)	Plose one	Canada	Mixed method		65
Renuka mahadevanand vanessa sha fan	2020	The connection between tourism spending by seniors and their well-being in China. (20)	Tourism Analysis	China	Longitudinal Study- panel data		between tourism 65
Danan Gu et al,	2016	Tourism experiences and self-evaluated health among seniors in China. (29 )	Journal of Aging and Health	China	Multilevel logistic regression models		60
sandy c. Chen Michael Gassner	2012	An analysis of the demographic, psychological, psychographic, and behavioral traits of leisure travelers among Chinese seniors. (24)	Journal of China Tourism Research	China	Multivariate analysis of variance		63
Jongsik Yu a, et al	2023	The impact of virtual reality (VR) and augmented reality (AR) on the experiential quality, perceived benefits, enjoyment, and intentions to reuse among senior tourists. (30)	Current Issues in Tourism	Korea	Mixed method	65
Jordi GARCÉS FERRER et al,	2015	Social tourism and promoting healthy aging. (7)	International Journal of Tourism Research	Spain	quantitative analysis	≥65
Hunter-Jones, P. and Blackburn, A. Et al	2007	Exploring the connection between taking vacations and self-reported health: An exploratory study on senior tourism. (25)	International Journal of Consumer Studies	UK	Qualitative study	≥55
Wei, S. and Milman,	2002	The effect of engaging in activities during vacations on the psychological well-being of seniors: An application of a path model. (21)	Journal of Hospitality & Tourism Research	USA	quantitative analysis	≥70
Lee, S.-H. and Tideswell	2005	Gaining insight into the attitudes of senior Koreans regarding leisure travel and the challenges they encounter. (23 )	Journal of Vacation Marketing	Korea	quantitative analysis	≥60
Tomoko Totsune, Izumi Matsudaira & Yasuyuki Taki	2021	The interaction between curiosity and tourism enhances subjective well-being among older adults in Japan. (12)	Humanities and Social Sciences Communications	Japan	quantitative analysis	64.73±2.79 59–69
Ghazali Musa a & Ong Fon Sim, et al	2015	Travel patterns: An examination of older Malaysians. (31)	Current Issues in Tourism	Malaysia	quantitative analysis	≥59
Moal-Ulvous, G. and Taylor, V.	2014	The spiritual advantages of travel for older tourists (32)	Journal of Consumer Behaviour	France-	Qualitative study	≥65
Gaëlle Moal-Ulvoas, et al	2017	Positive feelings and spirituality among older travelers. (26)	Annals of Tourism Research	France	Qualitative study	60-85
Allan B. de Guzman, Trisha Mae C. Cruz, Jeanne. Et al	2019	Who claims that aging is solitary? A phenomenological study of the happiness experiences of Filipino seniors participating in international group tours. (28)	Educational Gerontology	Filipin	phenomenological study	60 years and above
Lintje Sie a,b Shane Pegg b Virginia Phelan.	2021	Self-determined motivations, tour preferences, memorable experiences, and subjective well-being among senior tourists. (13)	Journal of Hospitality and Tourism Management	Australian	hierarchical model	50 years and older
Ferri Sanz; et al	2013	Functional health benefits for older adults associated with the promotion of social tourism policies. (27)	International Journal of Multidisciplinary Social Sciences	Spain.	survey	65 years old
Cagri Bulut, & Murat Nazli	2020	Senior millionaires and their travel habits: A study in Turkey. (33)	Journal of Population Ageing	Turkey	Qualitative study	Over 70
Merril Silverstein and Marti G. Parker	2002	Leisure activities and quality of life among the oldest seniors in Sweden(34).	Research on Aging	Switzerland	survey	Over 60
Tomka et al	2015	Quality of life as a motivating factor for travel among senior tourists: Findings from research in Novi Sad. (17)	Informatologia	Serbia	Qualitative study	Over 60
Kim et al	2015	Tourism experiences and quality of life among older adult travelers. (35)	Applied Research in Quality of Life	Korea	quantitative analysis	Over 60

The most significant findings from the studies are summarized in Table 3. Based on the extracted results, the impact of tourism on the elderly is as follows.

Table 3. The Summary of Extracted Article Findings.

Author	Sample	Main Results
Vega-Vázquez et al	363	The study results indicated that the mean scores for physical functions, physical role, vitality, and general health were significantly higher in the elderly tourism group compared to the reference group. Also, the mean scores of Anxiety were less than the reference group significantly. The mean scores EQ5D-5L instrument dimensions (self-care, Mobility, Daily Activities, Self-care) are higher in the tourism group than the refernces group.
Linghan Zhang and Junyi Zhang, et al	1114	Tourism Behavior has a Direct Effect on theQOL during leisure time(ß = 0.155). Tourism Behavior has an Indirect Effect on theQOL in intimacy(ß = 0.138).
Marlène Mélona, et al	4130	Senior tourists reported higher well-being scores (M = 3.78, SD = .61) compared to senior non-tourists (M = 3.31, SD = .77), even when controlling for other variables.
Alexandra J. Fiocco et al	2021	Engagement in VR tourism resulted in immediate decreases in anxiety and fatigue, along with enhanced social interaction and quality of life after 6 weeks.
Mahadevan and shafan	744	The results indicated that tourism spending has a notable effect on seniors' life satisfaction, even after two years.
Danan Gu et al	11,717	The final regression model revealed that individuals who had a tourism experience in the past two years were 20% less likely to report poor health (odds ratio = .80, P < .01), after accounting for demographics, socioeconomic status (SES), family/social support, leisure activities, health behaviors, and self-rated health before the tourism experience.
sandy c. Chen Michael Gassner	505	The elderly heavy travelers reported their health status as good/excellent at a significantly higher rate (50%) compared to medium travelers (34.6%) and light travelers (24%). This difference was statistically significant, as determined by a chi-square analysis.
Jongsik Yu a, et al	412	Perceived advantages (β = .782, p < .01) and perceived enjoyment (β = .914, P < .01) had a statistically significant positive impact on the intention to reuse. The findings indicated that the features of VR/AR in senior tourism create meaningful experiences and positively influence emotional benefits, enjoyment, and the intention to reuse.
Jordi GARCÉS FERRER et al	198	The results showed that the mean scores for physical health, mental health, role-emotional, and social functioning from the self-perceived health questionnaire were significantly higher among elderly tourists compared to other elderly individuals.
Hunter-Jones, P.and Blackburn, A. Et al	2007	The benefit of health: travel makes you happier and, in turn, healthier. Physical health improvements.
Wei, S. and Milman, A	300	Two correlation coefficients were found to be significant at the .05 level: one was the correlation between respondents’ participation levels in activities during their vacations and their overall satisfaction with their vacation experiences (.236), and the other was the correlation between participation levels and their psychological well-being (.363). Senior travelers’ engagement in activities while on vacation was positively and significantly associated with their psychological well-being levels (P = .358, significance = .01).
Lee, S.-H. and Tideswell	2005	Over 90% of the respondents agreed that travel improved their QOL as it created new interests in their lives.
Tomoko Totsune, Izumi Matsudaira & Yasuyuki Taki	835	The results indicated that the mean score on the Subjective happiness scale(SHS) is higher among elderly individuals who travel more frequently. In particular, the mean SHS score was 4.55 for those who traveled ˃ 10 times per year,4.43 (5-9 times per year),4.33 (3 to 4 times per year), and 4.13 for those who traveled one year per year.
Ghazali Musa a & Ong Fon Sim, et al	1365	The primary travel motivations were "spending time with friends or family" and "relaxation."
Moal-Ulvous, G. and Taylor, V.	16	Traveling provides meaning for older adults, helps them discover their identities, promotes a deeper understanding of others, and enhances their connection to nature.
Gaëlle Moal-Ulvoas, et al	16	Content analysis indicates that traveling evokes three types of self-transcendent positive emotions: appreciation for the beauty of nature and humanity's harmonious connection with it, admiration for manmade heritage and artistic creations, and respect for other individuals along with gratitude for their kindness. Participants also express that travel positively impacts their spirituality by providing meaningful experiences and fostering reflection on the essence of life.
Allan B. de Guzman, et al	15	This phenomenological study explores the happiness of aging Filipino tourists participating in international group tours, which encompasses treasured experiences (Shared Moments), valued joy (Shared Culture), cherished memories (Shared Memories), and a deep sense of happiness (Shared Transcendence).
Lintje Sie a,b Shane Pegg b Virginia Phelan.	361	The study findings indicated that many individuals experienced various psychological benefits that persisted well beyond the completion of their trips. It was found that memorable experiences and perceived advantages acted as mediators between motivations or tour preferences and the life satisfaction of senior travelers.
Ferri Sanz, et al	367	The results from the SF-36 indicated that older adults who traveled in the past year had an average physical health score of 76.5 (S.D. = 16.4) and a mental health score of 78.8 (SD = 15.8). In contrast, seniors who did not travel during the same period had an average physical health score of 67.0 (SD = 21.7) and a mental health score of 74.7 (SD = 12.3). Furthermore, when examining the eight health dimensions of the SF-36, significant differences (P < 0.05) were observed in two areas: physical functioning and vitality.
Cagri Bulut, & Murat Nazli	27	The interview results highlighted travel preferences, which included: (1) relaxation and (2) socializing with others while discovering new destinations.
Merril Silverstein and Marti G. Parker	324	Those who increased their participation in various activities generally felt that their life circumstances had improved.
Tomka et al	14	The results of this qualitative study indicated that most respondents reported experiencing satisfaction and emotional fulfillment while traveling. They found that trips allowed them to relax and break away from their daily routines, helping to alleviate the stress they encountered in their work and everyday lives.
Kim et al	208	The findings indicate that the involvement of elderly tourists significantly impacts their perceived value (t = 3.88, P < .001) and demonstrates a noteworthy relationship between involvement and satisfaction with their travel experience (t = 2.86, P < .05). Additionally, the results show that perceived value positively influences satisfaction with the travel experience (t = 6.15, P < .001). Furthermore, Hypothesis 4 suggests that satisfaction with the travel experience affects leisure life satisfaction (t = 7.03, P < .001). Both leisure life satisfaction and travel experience satisfaction are significant predictors of quality of life.

1. Well-being and Life Quality of the Older adults Tourists

Engaging in travel experiences can significantly enhance the well-being of older adults. These experiences offer a sense of adventure, novelty, and improved overall performance, which can lead to greater life satisfaction and enjoyment. Exploring new environments and cultures fosters personal growth and strengthens self-concept. Tomka et al's study emphasizes that such travel experiences contribute to emotional satisfaction and relaxation (17).

Studies assessing well-being frequently examine factors such as life satisfaction and happiness. Marlène et al's research found that older adult tourists had significantly higher well-being scores (M, 3.78; SD, 0.61) compared to nontourists (M, 3.18; SD, 0.77), indicating a notable difference (18). Additionally, older adults mean scores for happiness and excitement increased after engaging in virtual tourism (19). Another study found that older adults who spend money on tourism report greater life satisfaction (20). Ferrer et al reported that life satisfaction levels were significantly higher among older adult tourists compared to other groups (7). Wei and Milman’s research demonstrated a positive and significant relationship between participation in tourism activities and well-being (r = 0.36; P < 0.001). Furthermore, participating in tourism was a 43% predictor of increased well-being among older adults (21). In Totsune et al's study, people who had traveled 5 times in 2 years had a higher mean mental well-being score than people who had traveled twice in the last 2 years (12). Additionally, relaxation, which contributes to well-being, has been identified as a key motivator for older adults to travel. Sie et al found that positive travel experiences significantly influenced life satisfaction and mental well-being (13). Another important concept related to well-being in the literature is vitality. In Ferrer et al's study, the mean vitality score for tourists was 63.99, compared to 55.93 for older adults who had not traveled in recent years, indicating a significant difference (7).

Quality of life is an important outcome of tourism for older adults, as shown by various studies examining the link between tourism and quality of life. Zhang et al found that tourism behaviors account for 15% of the variance in quality of life. Additionally, both tourism and recreational behaviors together predicted 28% of the variance in quality of life (22).

In Fiocco et al's study, the mean quality of life score for older adults improved with the implementation of virtual tourism (19). Additionally, older adults who participated in Lee and Carmen's study reported that tourism enhanced their quality of life and led to a more positive attitude toward life (23).

2. Health Status of Older adults Tourists

The studies examined the health status of older adult tourists. In a study conducted in China, it was found that 50% of frequent travelers rated their health as excellent, compared to only 24% of infrequent travelers. This difference between the 2 groups was statistically significant (24). Additionally, another study found that older adult tourists rated their health more positively compared to nontourist older adults and reported fewer disease symptoms (18).

Research on the impact of virtual tourism on older adults in care revealed significant findings. The mean level of tiredness among these individuals was notably reduced after participating in virtual tourism, showing a significant improvement. Furthermore, a study showed that, even after accounting for demographic variables, having tourism experience in the past 2 years lowered the likelihood of self-reporting poor health by 37% (25). Ferrer’s study found that older adult tourists had a significantly higher mean physical health score compared to other older adults (7). Qualitative studies revealed that older adults reported improvements in their health conditions, including asthma, better eyesight, and increased physical activity (23). Various studies also explored the health status of tourists, examining different aspects or dimensions of their health, as detailed below:

3. Mental Health and Mental Performance

Several studies have also examined mental performance. Ferrer et al found that tourists had a higher average mental performance score compared to other older adults (7). Additionally, Mélona et al reported fewer symptoms of memory impairment among older adult tourists compared to other older adults (18).

Regarding mental health, the focus has been on depression and anxiety. Older adult tourists reported only 1.65% mild depression, while the rate was 8.22% for other older adults. Furthermore, Fiocco et al found that even virtual tourism helped reduce levels of anxiety and depression in older adults (19). The reported decrease in depression among older adults led qualitative studies to identify a theme of increased positive emotions (19).

Additionally, some older adults shared positive experiences from tourism, such as reduced distress and improved sleep quality. Activities like learning new things, exploring new places, sharing cultures, and engaging with others fostered happiness and joy, helped diminish negative mental states (26). Ferri et al's study also highlighted a link between tourism and improved mental health (27). Moreover, a major reason older adults travel is to seek peace, escape from daily routines, and meet new people (17, 28). Therefore, the sense of peace and distance from everyday worries was emphasized as a key factor motivating older adults to travel again.

4. Health and Physical Performance

Several studies have examined physical function in the context of tourism. A study by Vega-Vلzquez et al in Spain investigated the impact of tourism on activity and health, with a focus on quality of life. The study found that older adult tourists had a significantly higher mean score in physical performance compared to those who had not traveled in the past 6 months. Moreover, the tourism group showed significantly better results in social performance and mobility than the reference group of older adults (8). Additionally, studies by Mélon et al and Ferrer reported higher levels of physical activity and social interaction among older adult tourists compared to other older adults (7, 18). Qualitative research also supported these findings, highlighting the improvement in physical activity among older adults as a key benefit (17).

Furthermore, the study by Vega-Vلzquez et al examined body pain in relation to physical health. It found that tourists had a significantly lower mean score for body pain (8). Ferrer's study also observed lower mean body pain among older adult tourists, although the difference was not statistically significant (7). In terms of daily activities, a higher proportion of older adults who experienced no issues with their daily activities were those who enjoyed traveling (22). Notably, older adult tourists reported significantly higher levels of self-care without problems compared to other older adults (25). This contributes to improvements in both physical and mental health.

5. Health and Social Performance

Marlène et al's study assessed the state and quality of communication among participants. The results showed that older adult tourists reported better communication quality and had more social interactions than other older adults (18). In Ferrer et al's study, older adult tourists had significantly higher social performance scores compared to other older adult groups (7). Some studies, such as Fiocco et al's, explore virtual tourism. In their study, the mean score for participation in social activities increased after engaging in virtual tourism (19).

Better connections with family members during travel, enhanced interactions with others, increased emotional well-being, and a greater sense of participation in activities contribute to feelings of worthiness and self-sufficiency among older adults. Both qualitative and quantitative studies provide insights into these topics.

The feelings of comfort, excitement, and emotional connection also impacted daily activities during travel. In a study exploring older adults' experiences in tour groups, participants expressed emotions such as happiness, togetherness, cultural exchange, learning from others, and shared moments. These experiences fostered a sense of satisfaction and reduced feelings of loneliness (36).

Morley et al's study evaluated communication with others, revealing that older adult tourists had a higher mean quality of communication and more frequent contact compared to other older adults, showing a significant difference. Ferri et al found that older adult tourists scored significantly higher in social performance than other groups of older adults (27). Fiocco et al noted an increase in mean scores for participation in social activities after virtual experiences (19).

6. Spiritual Health

Many qualitative studies have highlighted themes such as spiritual health, the value of life, and its purpose. Some studies emphasized an enhanced appreciation for the preciousness of life. Moal-Ulvoas and Taylor examined the impact of tourism on spirituality, uncovering themes such as self-understanding, comprehension of the environment and nature, and understanding of others (37).

Discussion

The main goal of this review was to examine the impact of tourism on the health of older adults. Previous research shows that tourism has positive effects—such as reducing chronic diseases and improving mental health within communities (34). As people age, there is often a decline in overall well-being, especially mental well-being, which includes having a positive attitude, satisfaction, and happiness. According to Diener's definition, mental well-being consists of life satisfaction and a balance between positive and negative emotions (38, 39). This study's findings suggest that tourism enhances the well-being of older adults. This improvement is due to travel satisfaction, positive social interactions, and the joy experienced during trips. In conclusion, travel and tourism play a role in enhancing the overall well-being of older adults in society. Research by Sweet and Kanaroglou supports this, emphasizing the positive impact of travel on mental well-being (39).

A key finding of this study is that tourism positively influences the physical well-being of older adults. With aging, individuals frequently experience physiological changes and diminished bodily functions, resulting in a range of physical challenges. The World Health Organization characterizes health as a condition of total physical, mental, and spiritual well-being, emphasizing that it is more than merely the lack of illness.Considering the many factors affecting health, the tourism industry is recognized globally as a "happy industry" with the potential to positively influence physical health. Results from cohort studies show that tourism can help reduce the risk of chronic diseases such as cardiovascular disease and cancer (38). The study's findings demonstrate that tourism has a positive effect on the physical health of older adults. During trips, participants experienced relief from issues like asthma, muscle pain, and digestive discomfort. The interaction between tourism and aging is strongly influenced by individual characteristics, such as health status. Research in tourism highlights a significant link between health, well-being, and various aspects of physical, mental, and psychological health in older adults (40).

Therefore, it can be concluded that tourism positively affects the physical health of older adults. Isa et al's review study also identified health as a major outcome of tourism, which supports the findings of the current study (41).

For older adults and individuals with multiple chronic diseases, following precautions and care standards while traveling is essential to prevent health issues from worsening. This is supported by the study's findings, where most older adult participants had travel experience and did not suffer from debilitating chronic illnesses. However, conclusions about older adults and those with severe chronic conditions may need to be considered on a case-by-case basis.

The study revealed that improved physical performance and increased social engagement were outcomes of tourism. It showed that older adults' physical activity levels rose during their travels, with more significant benefits observed after the trip compared to those who did not travel. Additionally, older adult tourists were more involved in social activities. Therefore, tourism appears to help older adults reconnect with activities similar to those from their preretirement or early retirement years, thereby enhancing their physical performance, social engagement, and self-efficacy (42). Improving the social engagement of older adults reduces negative effects like loneliness, which in turn enhances their overall quality of life. The study also found that tourism positively affects social health among older adults. Traveling offers benefits at every stage of life. As people age and become more isolated from their communities, they can experience increased feelings of loneliness and depression. However, traveling and meeting new people can lead to significant improvements in mental well-being for many older adults by enhancing their social interactions (40). Tourism positively affects older adults by improving their quality of life through various factors. Quality of life, which includes physical and psychological health, relationships, and social environments, is crucial for older adults. Therefore, participating in tourism and travel can enhance their overall quality of life. Studies that examine physical health, mental health, and social engagement individually help to illustrate how tourism contributes to a better quality of life overall. Since improving quality of life is a key responsibility of healthcare organizations, it follows that they should prioritize tourism programs within their initiatives (Figure 2).

Figure 2.

The Role of Tourism in the Health of the Older adults

Spiritual health is a significant outcome when assessing the impact of tourism on older adults, as emphasized in qualitative research. These studies highlight how tourism enhances older adults' sense of life's value and meaning. In societies struggling with a sense of purpose, travel experiences become crucial for providing this sense of significance (43). Experiences with nature, visits to historical sites, and interactions with diverse cultures can deeply change a person's outlook on life. Discovering new places, reflecting on nature, and engaging with different cultures can renew one's sense of purpose and vision. This transformative effect also applies to older adults, highlighting the important role of tourism in their lives (44). Recognizing its significance, there has been a focus on regional tourism and exploring natural areas close to home. This highlights the broader importance of this approach (45).

Limitations

One limitation of this review is that it relied solely on cross-sectional data and qualitative studies to assess the impact of tourism on health, and no long-term cohort studies were identified that specifically examined the effects of tourism on the health of the elderly. Therefore, it is recommended that longitudinal cohort studies be conducted in this area. Additionally, the inclusion of travel frequency as a predictor in life satisfaction questionnaires could enhance the understanding of tourism's influence on well-being. Regarding quality of life, the use of a single, standardized questionnaire across studies would have provided more accurate predictions and higher validity of the results.

Conclusion

The study shows that tourism positively impacts older adults in terms of physical and functional health, mental performance, mental health, social well-being, and spiritual health. With these benefits and the increasing older adult population, tourism proves to be an effective way to improve quality of life, well-being, and vitality. The tourism industry, supported by governments and healthcare authorities, should focus on this important group, leading to benefits for both older adults and the industry’s growth and innovation. This study aimed to thoroughly explore the link between tourism and older adults' health by reviewing various research methods. However, a key limitation is the lack of analysis of the standardization and psychometric qualities of the tools used to measure health in these studies. Future research should focus on standardized tools that align with relevant conceptual frameworks. Moreover, to better understand tourism's effects on aspects of aging, such as functional status and Alzheimer's reduction, more extensive experimental and longitudinal studies are needed.

Ethical Considerations

Ethical approval is not necessary for this type of study.

Conflict of Interests

The authors declare that they have no competing interests.

Cite this article as: Bahrevar V, Zanjari N, Hosseini S, Fattahi Ardakani M, Kazemi S. The Role of Tourism in Enhancing Domains of Health for Seniors: A Scoping Review. Med J Islam Repub Iran. 2025 (13 mar);39:40. https://doi.org/10.47176/mjiri.39.40