Impact of Baseline Fatigue on a Physical Activity Intervention to Prevent Mobility Disability

for the Lifestyle Interventions and Independence for Elders Study Group

doi:10.1111/jgs.16274

Impact of Baseline Fatigue on a Physical Activity Intervention to Prevent Mobility Disability

for the Lifestyle Interventions and Independence for Elders Study Group

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

OBJECTIVES: Our aim was to examine the impacts of baseline fatigue on the effectiveness of a physical activity (PA) intervention to prevent major mobility disability (MMD) and persistent major mobility disability (PMMD) in participants from the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN: Prospective cohort of individuals aged 65 years or older undergoing structured PA intervention or health education (HE) for a mean of 2.6 years. SETTING: LIFE was a multicenter eight-site randomized trial that compared the efficacy of a structured PA intervention with an HE program in reducing the incidence of MMD. PARTICIPANTS: Study participants (N = 1591) at baseline were 78.9 ± 5.2 years of age, with low PA and at risk for mobility impairment. MEASUREMENTS: Self-reported fatigue was assessed using the modified trait version of the Exercise-Induced Feelings Inventory, a six-question scale rating energy levels in the past week. Responses ranged from 0 (none of the time) to 5 (all of the time). Total score was calculated by averaging across questions; baseline fatigue was based on the median split: 2 or higher = more fatigue (N = 856) and lower than 2 = less fatigue (N = 735). Participants performed a usual-paced 400-m walk every 6 months. We defined incident MMD as the inability to walk 400-m at follow-up visits; PMMD was defined as two consecutive walk failures. Cox proportional hazard models quantified the risk of MMD and PMMD in PA vs HE stratified by baseline fatigue adjusted for covariates. RESULTS: Among those with higher baseline fatigue, PA participants had a 29% and 40% lower risk of MMD and PMMD, respectively, over the trial compared with HE (hazard ratio [HR] for MMD =.71; 95% confidence interval [CI] =.57-.90; P =.004) and PMMD (HR =.60; 95% CI =.44-.82; P =.001). For those with lower baseline fatigue, no group differences in MMD (P =.36) or PMMD (P =.82) were found. Results of baseline fatigue by intervention interaction was MMD (P =.18) and PMMD (P =.05). CONCLUSION: A long-term moderate intensity PA intervention was particularly effective at preserving mobility in older adults with higher levels of baseline fatigue. J Am Geriatr Soc 68:619–624, 2020.

Original language	English (US)
Pages (from-to)	619-624
Number of pages	6
Journal	Journal of the American Geriatrics Society
Volume	68
Issue number	3
DOIs	https://doi.org/10.1111/jgs.16274
State	Published - Mar 1 2020

Funding

The Lifestyle Interventions and Independence for Elders study was funded by a National Institutes of Health/National Institute on Aging (NIH/NIA) Cooperative Agreement U01 AG022376 and a supplement from the National Heart, Lung, and Blood Institute (NHLBI) 3U01AG022376-05A2S, and it was sponsored in part by the Intramural Research Program, NIA and NIH. Theresa Gmelin is supported by the Epidemiology of Aging Training Grant at the University of Pittsburgh, NIA T32-AG000181. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (P30 AG028740), Wake Forest University (P30 AG21332), Tufts University (P30 AG031679), University of Pittsburgh (P30 AG024827), and Yale University (P30 AG021342) and the NIH/NCRR CTSA at Stanford University (UL1 RR025744). The authors have declared no conflicts of interest for this article. Nancy W. Glynn, Laura C. Lovato, and Theresa Gmelin had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. All the authors interpreted the data and critically revised the manuscript for important intellectual content. All the authors read and approved the submitted manuscript. The NIH, NIA, NHLBI, and the Claude D. Pepper Older Americans Independence Centers had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The Lifestyle Interventions and Independence for Elders study was funded by a National Institutes of Health/National Institute on Aging (NIH/NIA) Cooperative Agreement U01 AG022376 and a supplement from the National Heart, Lung, and Blood Institute (NHLBI) 3U01AG022376‐05A2S, and it was sponsored in part by the Intramural Research Program, NIA and NIH. Theresa Gmelin is supported by the Epidemiology of Aging Training Grant at the University of Pittsburgh, NIA T32‐AG000181. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (P30 AG028740), Wake Forest University (P30 AG21332), Tufts University (P30 AG031679), University of Pittsburgh (P30 AG024827), and Yale University (P30 AG021342) and the NIH/NCRR CTSA at Stanford University (UL1 RR025744).

Keywords

exercise
fatigability
health education
older adults

ASJC Scopus subject areas

Geriatrics and Gerontology

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10.1111/jgs.16274

Cite this

@article{47a6a50eb0d940ea95c033f3e1e833a4,

title = "Impact of Baseline Fatigue on a Physical Activity Intervention to Prevent Mobility Disability",

abstract = "OBJECTIVES: Our aim was to examine the impacts of baseline fatigue on the effectiveness of a physical activity (PA) intervention to prevent major mobility disability (MMD) and persistent major mobility disability (PMMD) in participants from the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN: Prospective cohort of individuals aged 65 years or older undergoing structured PA intervention or health education (HE) for a mean of 2.6 years. SETTING: LIFE was a multicenter eight-site randomized trial that compared the efficacy of a structured PA intervention with an HE program in reducing the incidence of MMD. PARTICIPANTS: Study participants (N = 1591) at baseline were 78.9 ± 5.2 years of age, with low PA and at risk for mobility impairment. MEASUREMENTS: Self-reported fatigue was assessed using the modified trait version of the Exercise-Induced Feelings Inventory, a six-question scale rating energy levels in the past week. Responses ranged from 0 (none of the time) to 5 (all of the time). Total score was calculated by averaging across questions; baseline fatigue was based on the median split: 2 or higher = more fatigue (N = 856) and lower than 2 = less fatigue (N = 735). Participants performed a usual-paced 400-m walk every 6 months. We defined incident MMD as the inability to walk 400-m at follow-up visits; PMMD was defined as two consecutive walk failures. Cox proportional hazard models quantified the risk of MMD and PMMD in PA vs HE stratified by baseline fatigue adjusted for covariates. RESULTS: Among those with higher baseline fatigue, PA participants had a 29% and 40% lower risk of MMD and PMMD, respectively, over the trial compared with HE (hazard ratio [HR] for MMD =.71; 95% confidence interval [CI] =.57-.90; P =.004) and PMMD (HR =.60; 95% CI =.44-.82; P =.001). For those with lower baseline fatigue, no group differences in MMD (P =.36) or PMMD (P =.82) were found. Results of baseline fatigue by intervention interaction was MMD (P =.18) and PMMD (P =.05). CONCLUSION: A long-term moderate intensity PA intervention was particularly effective at preserving mobility in older adults with higher levels of baseline fatigue. J Am Geriatr Soc 68:619–624, 2020.",

keywords = "exercise, fatigability, health education, older adults",

author = "{for the Lifestyle Interventions and Independence for Elders Study Group} and Glynn, {Nancy W.} and Theresa Gmelin and Santanasto, {Adam J.} and Lovato, {Laura C.} and Lange-Maia, {Brittney S.} and Nicklas, {Barbara J.} and Fielding, {Roger A.} and Manini, {Todd M.} and Myers, {Valerie H.} and {de Rekeneire}, Nathalie and Spring, {Bonnie J.} and Marco Pahor and King, {Abby C.} and Rejeski, {W. Jack} and Newman, {Anne B.} and Guralnik, {Jack M.} and Anton, {Stephen D.} and Buford, {Thomas W.} and Christiaan Leeuwenburgh and Nayfield, {Susan G.} 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 Hsu, {Fang Chi} and Kathy Joyce and Laura Lovato and Juan Pierce and Wesley Roberson and Julia Robertson and Julia Rushing and Scott Rushing and Stowe, {Cynthia L.} and Walkup, {Michael P.} and Don Hire and Katula, {Jeffrey A.} and McDermott, {Mary M.} and Joshua Hauser",

note = "Publisher Copyright: {\textcopyright} 2019 The American Geriatrics Society",

year = "2020",

month = mar,

day = "1",

doi = "10.1111/jgs.16274",

language = "English (US)",

volume = "68",

pages = "619--624",

journal = "Journal of the American Geriatrics Society",

issn = "0002-8614",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "3",

}

TY - JOUR

T1 - Impact of Baseline Fatigue on a Physical Activity Intervention to Prevent Mobility Disability

AU - for the Lifestyle Interventions and Independence for Elders Study Group

AU - Glynn, Nancy W.

AU - Gmelin, Theresa

AU - Santanasto, Adam J.

AU - Lovato, Laura C.

AU - Lange-Maia, Brittney S.

AU - Nicklas, Barbara J.

AU - Fielding, Roger A.

AU - Manini, Todd M.

AU - Myers, Valerie H.

AU - de Rekeneire, Nathalie

AU - Spring, Bonnie J.

AU - Pahor, Marco

AU - King, Abby C.

AU - Rejeski, W. Jack

AU - Newman, Anne B.

AU - Guralnik, Jack M.

AU - Anton, Stephen D.

AU - Buford, Thomas W.

AU - Leeuwenburgh, Christiaan

AU - Nayfield, Susan G.

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 - Hsu, Fang Chi

AU - Joyce, Kathy

AU - Lovato, Laura

AU - Pierce, Juan

AU - Roberson, Wesley

AU - Robertson, Julia

AU - Rushing, Julia

AU - Rushing, Scott

AU - Stowe, Cynthia L.

AU - Walkup, Michael P.

AU - Hire, Don

AU - Katula, Jeffrey A.

AU - McDermott, Mary M.

AU - Hauser, Joshua

PY - 2020/3/1

Y1 - 2020/3/1

N2 - OBJECTIVES: Our aim was to examine the impacts of baseline fatigue on the effectiveness of a physical activity (PA) intervention to prevent major mobility disability (MMD) and persistent major mobility disability (PMMD) in participants from the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN: Prospective cohort of individuals aged 65 years or older undergoing structured PA intervention or health education (HE) for a mean of 2.6 years. SETTING: LIFE was a multicenter eight-site randomized trial that compared the efficacy of a structured PA intervention with an HE program in reducing the incidence of MMD. PARTICIPANTS: Study participants (N = 1591) at baseline were 78.9 ± 5.2 years of age, with low PA and at risk for mobility impairment. MEASUREMENTS: Self-reported fatigue was assessed using the modified trait version of the Exercise-Induced Feelings Inventory, a six-question scale rating energy levels in the past week. Responses ranged from 0 (none of the time) to 5 (all of the time). Total score was calculated by averaging across questions; baseline fatigue was based on the median split: 2 or higher = more fatigue (N = 856) and lower than 2 = less fatigue (N = 735). Participants performed a usual-paced 400-m walk every 6 months. We defined incident MMD as the inability to walk 400-m at follow-up visits; PMMD was defined as two consecutive walk failures. Cox proportional hazard models quantified the risk of MMD and PMMD in PA vs HE stratified by baseline fatigue adjusted for covariates. RESULTS: Among those with higher baseline fatigue, PA participants had a 29% and 40% lower risk of MMD and PMMD, respectively, over the trial compared with HE (hazard ratio [HR] for MMD =.71; 95% confidence interval [CI] =.57-.90; P =.004) and PMMD (HR =.60; 95% CI =.44-.82; P =.001). For those with lower baseline fatigue, no group differences in MMD (P =.36) or PMMD (P =.82) were found. Results of baseline fatigue by intervention interaction was MMD (P =.18) and PMMD (P =.05). CONCLUSION: A long-term moderate intensity PA intervention was particularly effective at preserving mobility in older adults with higher levels of baseline fatigue. J Am Geriatr Soc 68:619–624, 2020.

AB - OBJECTIVES: Our aim was to examine the impacts of baseline fatigue on the effectiveness of a physical activity (PA) intervention to prevent major mobility disability (MMD) and persistent major mobility disability (PMMD) in participants from the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN: Prospective cohort of individuals aged 65 years or older undergoing structured PA intervention or health education (HE) for a mean of 2.6 years. SETTING: LIFE was a multicenter eight-site randomized trial that compared the efficacy of a structured PA intervention with an HE program in reducing the incidence of MMD. PARTICIPANTS: Study participants (N = 1591) at baseline were 78.9 ± 5.2 years of age, with low PA and at risk for mobility impairment. MEASUREMENTS: Self-reported fatigue was assessed using the modified trait version of the Exercise-Induced Feelings Inventory, a six-question scale rating energy levels in the past week. Responses ranged from 0 (none of the time) to 5 (all of the time). Total score was calculated by averaging across questions; baseline fatigue was based on the median split: 2 or higher = more fatigue (N = 856) and lower than 2 = less fatigue (N = 735). Participants performed a usual-paced 400-m walk every 6 months. We defined incident MMD as the inability to walk 400-m at follow-up visits; PMMD was defined as two consecutive walk failures. Cox proportional hazard models quantified the risk of MMD and PMMD in PA vs HE stratified by baseline fatigue adjusted for covariates. RESULTS: Among those with higher baseline fatigue, PA participants had a 29% and 40% lower risk of MMD and PMMD, respectively, over the trial compared with HE (hazard ratio [HR] for MMD =.71; 95% confidence interval [CI] =.57-.90; P =.004) and PMMD (HR =.60; 95% CI =.44-.82; P =.001). For those with lower baseline fatigue, no group differences in MMD (P =.36) or PMMD (P =.82) were found. Results of baseline fatigue by intervention interaction was MMD (P =.18) and PMMD (P =.05). CONCLUSION: A long-term moderate intensity PA intervention was particularly effective at preserving mobility in older adults with higher levels of baseline fatigue. J Am Geriatr Soc 68:619–624, 2020.

KW - exercise

KW - fatigability

KW - health education

KW - older adults

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JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

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Impact of Baseline Fatigue on a Physical Activity Intervention to Prevent Mobility Disability

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