Abstract
Background/Objectives: To test the hypothesis that a long-term structured, moderate intensity physical activity (PA) program is more effective than a health education (HE) program in reducing the risk of s elf-reported dependency and disability in basic activities of daily living (BADLs), disability in instrumental ADLs (IADL), and mobility disability. Design: The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, single-blinded randomized trial. Setting: University-based research clinic. Participants: Thousand six hundred and thirty five sedentary men and women aged 70–89 years, who had functional limitations, defined as a score ≤9 on the Short Physical Performance Battery. Intervention: Participants were randomized to a structured, moderate intensity PA program (n = 818) that included aerobic, resistance, and flexibility exercises or to a HE program (n = 817). Measurements: All outcomes were derived by self-report using periodic interviews that asked about the degree of difficulty and receipt of help during the past month. Dependency was defined as “receiving assistance” or “unable” to do ≥1 activities. Disability was defined as having “a lot of difficulty” or “unable” doing ≥1 activities. Severe disability was defined as reporting difficulty or being unable to perform ≥3 activities. Results: Over an average follow-up of 2.6 years, the cumulative incidence of BADL dependency was 15.2% among PA and 15.1% among HE participants (HR = 1.0, 95% CI = 0.78–0.1.3). Intervention groups had similar rates of incident BADL disability, IADL disability and reported mobility disability. Reporting severe mobility disability (HR = 0.78, 95% CI = 0.64–0.96) and ratings of difficulty on mobility tasks were reduced in the PA group. Conclusion: A structured physical activity intervention reduces reported severe mobility disability and difficulty on mobility tasks, but not BADL and IADL disability in older adults with functional limitations.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 980-988 |
| Number of pages | 9 |
| Journal | Journal of the American Geriatrics Society |
| Volume | 65 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2017 |
Funding
Financial Disclosure: The Lifestyle Interventions and Independence for Elders Study is funded by a National Institutes of Health/National Institute on Aging Cooperative Agreement #UO1 AG22376 and a supplement from the National Heart, Lung and Blood Institute 3U01AG022376-05A2S, and sponsored in part by the Intramural Research Program, National Institute on Aging, NIH. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (1 P30 AG028740), Wake Forest University (1 P30 AG21332), Tufts University (1P30AG031679), University of Pittsburgh (P30 AG024827), and Yale University (P30AG021342) and the NIH/NCRR CTSA at Stanford University (UL1 RR025744). Tufts University is also supported by the Boston Rehabilitation Outcomes Center (1R24HD065688-01A1). Brief explanation for Manini: $1000 Honorarium provided for ACCME to the Texas Health, Research & Education Institute. LIFE data was presented at this event. Brief explanation for Spring: Service on Actigraph Scientific Advisory Board. Author Contributions: All authors: study concept, data collection critical revisions of content and approval of final version for publication; TMM: initial draft of manuscript and results; DPB: statistical analyses; MP: PI of the LIFE study and obtained funding. DPB had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. Sponsors Role: LIFE investigators are also partially supported by the following: Dr. Manini is partially supported by R01AG042525, R01HL121023, SBIR HHSN261201500014C and P30AG028740. Dr. Thomas Gill (Yale University) is the recipient of an Academic Leadership Award (K07AG3587) from the National Institute on Aging. Dr. Carlos Fragoso (Spirometry Reading Center, Yale University) is the recipient of a Career Development Award from the Department of Veterans Affairs. Dr. Roger Fielding (Tufts University) is partially supported by the U.S. Department of Agriculture, under agreement No. 58-1950-0-014. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Dept of Agriculture. Dr. Bonnie Spring is partially supported by NIH DK097364, HL075451, U54EB020404, and AHA 14SFRN20740001.
Keywords
- ambulation
- exercise
- frailty
- rehabilitation
ASJC Scopus subject areas
- Geriatrics and Gerontology