A Case for Promoting Movement Medicine: Preventing Disability in the LIFE Randomized Controlled Trial

Jason Fanning*, W. Jack Rejeski, Shyh Huei Chen, Barbara J. Nicklas, Michael P. Walkup, Robert S. Axtell, Roger A. Fielding, Nancy W. Glynn, Abby C. King, Todd M. Manini, Mary M. McDermott, Anne B. Newman, Marco Pahor, Catrine Tudor-Locke, Michael E. Miller

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD) - a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD. Methods: Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry. Results: A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53%). Within health education, both baseline LM (HR = 0.74; 95% CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95% CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95% CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p <. 04), whereby risk for MMD was lower among individuals with higher levels of LM. Conclusions: Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD. Trial Registration: clinicaltrials.gov Identifier NCT01072500

Original languageEnglish (US)
Pages (from-to)1821-1827
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume74
Issue number11
DOIs
StatePublished - Oct 4 2019

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Life Style
Randomized Controlled Trials
Medicine
Health Education
Accelerometry
Physical Education and Training
Principal Component Analysis
Posture

Keywords

  • Accelerometry
  • Disability
  • Exercise
  • Physical activity
  • Sedentary

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

Fanning, Jason ; Rejeski, W. Jack ; Chen, Shyh Huei ; Nicklas, Barbara J. ; Walkup, Michael P. ; Axtell, Robert S. ; Fielding, Roger A. ; Glynn, Nancy W. ; King, Abby C. ; Manini, Todd M. ; McDermott, Mary M. ; Newman, Anne B. ; Pahor, Marco ; Tudor-Locke, Catrine ; Miller, Michael E. / A Case for Promoting Movement Medicine : Preventing Disability in the LIFE Randomized Controlled Trial. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2019 ; Vol. 74, No. 11. pp. 1821-1827.
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abstract = "Background: The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD) - a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD. Methods: Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry. Results: A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53{\%}). Within health education, both baseline LM (HR = 0.74; 95{\%} CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95{\%} CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95{\%} CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p <. 04), whereby risk for MMD was lower among individuals with higher levels of LM. Conclusions: Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD. Trial Registration: clinicaltrials.gov Identifier NCT01072500",
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Fanning, J, Rejeski, WJ, Chen, SH, Nicklas, BJ, Walkup, MP, Axtell, RS, Fielding, RA, Glynn, NW, King, AC, Manini, TM, McDermott, MM, Newman, AB, Pahor, M, Tudor-Locke, C & Miller, ME 2019, 'A Case for Promoting Movement Medicine: Preventing Disability in the LIFE Randomized Controlled Trial', Journals of Gerontology - Series A Biological Sciences and Medical Sciences, vol. 74, no. 11, pp. 1821-1827. https://doi.org/10.1093/gerona/glz050

A Case for Promoting Movement Medicine : Preventing Disability in the LIFE Randomized Controlled Trial. / Fanning, Jason; Rejeski, W. Jack; Chen, Shyh Huei; Nicklas, Barbara J.; Walkup, Michael P.; Axtell, Robert S.; Fielding, Roger A.; Glynn, Nancy W.; King, Abby C.; Manini, Todd M.; McDermott, Mary M.; Newman, Anne B.; Pahor, Marco; Tudor-Locke, Catrine; Miller, Michael E.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 74, No. 11, 04.10.2019, p. 1821-1827.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A Case for Promoting Movement Medicine

T2 - Preventing Disability in the LIFE Randomized Controlled Trial

AU - Fanning, Jason

AU - Rejeski, W. Jack

AU - Chen, Shyh Huei

AU - Nicklas, Barbara J.

AU - Walkup, Michael P.

AU - Axtell, Robert S.

AU - Fielding, Roger A.

AU - Glynn, Nancy W.

AU - King, Abby C.

AU - Manini, Todd M.

AU - McDermott, Mary M.

AU - Newman, Anne B.

AU - Pahor, Marco

AU - Tudor-Locke, Catrine

AU - Miller, Michael E.

PY - 2019/10/4

Y1 - 2019/10/4

N2 - Background: The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD) - a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD. Methods: Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry. Results: A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53%). Within health education, both baseline LM (HR = 0.74; 95% CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95% CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95% CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p <. 04), whereby risk for MMD was lower among individuals with higher levels of LM. Conclusions: Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD. Trial Registration: clinicaltrials.gov Identifier NCT01072500

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KW - Disability

KW - Exercise

KW - Physical activity

KW - Sedentary

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