Effect of physical activity on frailty: Secondary analysis of a randomized controlled trial

Life Study Investigators

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Limited evidence suggests that physical activity may prevent frailty and associated negative outcomes in older adults. Definitive data from large long-term randomized trials are lacking. Objective: To determine whether a long-term, structured, moderate-intensity physical activity program is associated with a lower risk for frailty and whether frailty status alters the effect of physical activity on the reduction in major mobility disability (MMD) risk. Design: Multicenter, single-blind, randomized trial. Setting: 8 centers in the United States. Participants: 1635 community-dwelling adults, aged 70 to 89 years, with functional limitations. Intervention: A structured, moderate-intensity physical activity program incorporating aerobic, resistance, and flexibility activities or a health education program consisting of workshops and stretching exercises. Measurements: Frailty, as defined by the SOF (Study of Osteoporotic Fractures) index, at baseline and 6, 12, and 24 months, and MMD, defined as the inability to walk 400 m, for up to 3.5 years. Results: Over 24 months of follow-up, the risk for frailty (n = 1623) was not statistically significantly different in the physical activity versus the health education group (adjusted prevalence difference, -0.021 [95% CI, -0.049 to 0.007]). Among the 3 criteria of the SOF index, the physical activity intervention was associated with improvement in the inability to rise from a chair (adjusted prevalence difference, -0.050 [CI, -0.081 to -0.020]). Baseline frailty status did not modify the effect of physical activity on reducing incident MMD (P for interaction = 0.91). Limitation: Frailty status was neither an entry criterion nor a randomization stratum. Conclusion: A structured, moderate-intensity physical activity program was not associated with a reduced risk for frailty over 2 years among sedentary, community-dwelling older adults. The beneficial effect of physical activity on the incidence of MMD did not differ between frail and nonfrail participants.

Original languageEnglish (US)
Pages (from-to)309-316
Number of pages8
JournalAnnals of internal medicine
Volume168
Issue number5
DOIs
StatePublished - Mar 6 2018

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Randomized Controlled Trials
Independent Living
Osteoporotic Fractures
Health Education
Random Allocation
Education
Incidence

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{03fd50ffeb894ff4b58e2799d49e6801,
title = "Effect of physical activity on frailty: Secondary analysis of a randomized controlled trial",
abstract = "Background: Limited evidence suggests that physical activity may prevent frailty and associated negative outcomes in older adults. Definitive data from large long-term randomized trials are lacking. Objective: To determine whether a long-term, structured, moderate-intensity physical activity program is associated with a lower risk for frailty and whether frailty status alters the effect of physical activity on the reduction in major mobility disability (MMD) risk. Design: Multicenter, single-blind, randomized trial. Setting: 8 centers in the United States. Participants: 1635 community-dwelling adults, aged 70 to 89 years, with functional limitations. Intervention: A structured, moderate-intensity physical activity program incorporating aerobic, resistance, and flexibility activities or a health education program consisting of workshops and stretching exercises. Measurements: Frailty, as defined by the SOF (Study of Osteoporotic Fractures) index, at baseline and 6, 12, and 24 months, and MMD, defined as the inability to walk 400 m, for up to 3.5 years. Results: Over 24 months of follow-up, the risk for frailty (n = 1623) was not statistically significantly different in the physical activity versus the health education group (adjusted prevalence difference, -0.021 [95{\%} CI, -0.049 to 0.007]). Among the 3 criteria of the SOF index, the physical activity intervention was associated with improvement in the inability to rise from a chair (adjusted prevalence difference, -0.050 [CI, -0.081 to -0.020]). Baseline frailty status did not modify the effect of physical activity on reducing incident MMD (P for interaction = 0.91). Limitation: Frailty status was neither an entry criterion nor a randomization stratum. Conclusion: A structured, moderate-intensity physical activity program was not associated with a reduced risk for frailty over 2 years among sedentary, community-dwelling older adults. The beneficial effect of physical activity on the incidence of MMD did not differ between frail and nonfrail participants.",
author = "{Life Study Investigators} and Andrea Trombetti and M{\'e}lany Hars and Hsu, {Fang Chi} and Reid, {Kieran F.} and Church, {Timothy S.} and Gill, {Thomas M.} and King, {Abby C.} and Liu, {Christine K.} and Manini, {Todd M.} and McDermott, {Mary McGrae} and Newman, {Anne B.} and Rejeski, {W. Jack} and Guralnik, {Jack M.} and Marco Pahor and Fielding, {Roger A.} and Christiaan Leeuwenburgh and Connie Caudle and Lauren Crump and Latonia Holmes and Jocelyn Lee and Lu, {Ching Ju} and Miller, {Michael E.} and Espeland, {Mark A.} and Ambrosius, {Walter T.} and William Applegate and Beavers, {Daniel P.} and Byington, {Robert P.} and Delilah Cook and Furberg, {Curt D.} and Harvin, {Lea N.} and Leora Henkin and John Hepler and Laura Lovato and Wesley Roberson and Julia Rushing and Scott Rushing and Stowe, {Cynthia L.} and Walkup, {Michael P.} and Don Hire and Katula, {Jeffrey A.} and Brubaker, {Peter H.} and Mihalko, {Shannon L.} and Jennings, {Janine M.} and Hadley, {Evan C.} and Sergei Romashkan and Patel, {Kushang V.} and Denise Bonds and Bonnie Spring and Hauser, {Joshua M} and Diana Kerwin",
year = "2018",
month = "3",
day = "6",
doi = "10.7326/M16-2011",
language = "English (US)",
volume = "168",
pages = "309--316",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
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Effect of physical activity on frailty : Secondary analysis of a randomized controlled trial. / Life Study Investigators.

In: Annals of internal medicine, Vol. 168, No. 5, 06.03.2018, p. 309-316.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of physical activity on frailty

T2 - Secondary analysis of a randomized controlled trial

AU - Life Study Investigators

AU - Trombetti, Andrea

AU - Hars, Mélany

AU - Hsu, Fang Chi

AU - Reid, Kieran F.

AU - Church, Timothy S.

AU - Gill, Thomas M.

AU - King, Abby C.

AU - Liu, Christine K.

AU - Manini, Todd M.

AU - McDermott, Mary McGrae

AU - Newman, Anne B.

AU - Rejeski, W. Jack

AU - Guralnik, Jack M.

AU - Pahor, Marco

AU - Fielding, Roger A.

AU - Leeuwenburgh, Christiaan

AU - Caudle, Connie

AU - Crump, Lauren

AU - Holmes, Latonia

AU - Lee, Jocelyn

AU - Lu, Ching Ju

AU - Miller, Michael E.

AU - Espeland, Mark A.

AU - Ambrosius, Walter T.

AU - Applegate, William

AU - Beavers, Daniel P.

AU - Byington, Robert P.

AU - Cook, Delilah

AU - Furberg, Curt D.

AU - Harvin, Lea N.

AU - Henkin, Leora

AU - Hepler, John

AU - Lovato, Laura

AU - Roberson, Wesley

AU - Rushing, Julia

AU - Rushing, Scott

AU - Stowe, Cynthia L.

AU - Walkup, Michael P.

AU - Hire, Don

AU - Katula, Jeffrey A.

AU - Brubaker, Peter H.

AU - Mihalko, Shannon L.

AU - Jennings, Janine M.

AU - Hadley, Evan C.

AU - Romashkan, Sergei

AU - Patel, Kushang V.

AU - Bonds, Denise

AU - Spring, Bonnie

AU - Hauser, Joshua M

AU - Kerwin, Diana

PY - 2018/3/6

Y1 - 2018/3/6

N2 - Background: Limited evidence suggests that physical activity may prevent frailty and associated negative outcomes in older adults. Definitive data from large long-term randomized trials are lacking. Objective: To determine whether a long-term, structured, moderate-intensity physical activity program is associated with a lower risk for frailty and whether frailty status alters the effect of physical activity on the reduction in major mobility disability (MMD) risk. Design: Multicenter, single-blind, randomized trial. Setting: 8 centers in the United States. Participants: 1635 community-dwelling adults, aged 70 to 89 years, with functional limitations. Intervention: A structured, moderate-intensity physical activity program incorporating aerobic, resistance, and flexibility activities or a health education program consisting of workshops and stretching exercises. Measurements: Frailty, as defined by the SOF (Study of Osteoporotic Fractures) index, at baseline and 6, 12, and 24 months, and MMD, defined as the inability to walk 400 m, for up to 3.5 years. Results: Over 24 months of follow-up, the risk for frailty (n = 1623) was not statistically significantly different in the physical activity versus the health education group (adjusted prevalence difference, -0.021 [95% CI, -0.049 to 0.007]). Among the 3 criteria of the SOF index, the physical activity intervention was associated with improvement in the inability to rise from a chair (adjusted prevalence difference, -0.050 [CI, -0.081 to -0.020]). Baseline frailty status did not modify the effect of physical activity on reducing incident MMD (P for interaction = 0.91). Limitation: Frailty status was neither an entry criterion nor a randomization stratum. Conclusion: A structured, moderate-intensity physical activity program was not associated with a reduced risk for frailty over 2 years among sedentary, community-dwelling older adults. The beneficial effect of physical activity on the incidence of MMD did not differ between frail and nonfrail participants.

AB - Background: Limited evidence suggests that physical activity may prevent frailty and associated negative outcomes in older adults. Definitive data from large long-term randomized trials are lacking. Objective: To determine whether a long-term, structured, moderate-intensity physical activity program is associated with a lower risk for frailty and whether frailty status alters the effect of physical activity on the reduction in major mobility disability (MMD) risk. Design: Multicenter, single-blind, randomized trial. Setting: 8 centers in the United States. Participants: 1635 community-dwelling adults, aged 70 to 89 years, with functional limitations. Intervention: A structured, moderate-intensity physical activity program incorporating aerobic, resistance, and flexibility activities or a health education program consisting of workshops and stretching exercises. Measurements: Frailty, as defined by the SOF (Study of Osteoporotic Fractures) index, at baseline and 6, 12, and 24 months, and MMD, defined as the inability to walk 400 m, for up to 3.5 years. Results: Over 24 months of follow-up, the risk for frailty (n = 1623) was not statistically significantly different in the physical activity versus the health education group (adjusted prevalence difference, -0.021 [95% CI, -0.049 to 0.007]). Among the 3 criteria of the SOF index, the physical activity intervention was associated with improvement in the inability to rise from a chair (adjusted prevalence difference, -0.050 [CI, -0.081 to -0.020]). Baseline frailty status did not modify the effect of physical activity on reducing incident MMD (P for interaction = 0.91). Limitation: Frailty status was neither an entry criterion nor a randomization stratum. Conclusion: A structured, moderate-intensity physical activity program was not associated with a reduced risk for frailty over 2 years among sedentary, community-dwelling older adults. The beneficial effect of physical activity on the incidence of MMD did not differ between frail and nonfrail participants.

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