Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial
Marco Pahor, Jack M Guralnik, Walter T Ambrosius, Steven Blair, Denise E Bonds, Timothy S Church, Mark A Espeland, Roger A Fielding, Thomas M Gill, Erik J Groessl, Abby C King, Stephen B Kritchevsky, Todd M Manini, Mary M McDermott, Michael E Miller, Anne B Newman, W Jack Rejeski, Kaycee M Sink, Jeff D Williamson, LIFE study investigators, Marco Pahor, Jack M Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E Miller, Mark A Espeland, Walter T Ambrosius, William Applegate, Daniel P Beavers, Robert P Byington, Delilah Cook, Curt D Furberg, Lea N Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, W Jack Rejeski, Jeffrey A Katula, Peter H Brubaker, Shannon L Mihalko, Janine M Jennings, Evan C Hadley, Sergei Romashkan, Kushang V Patel, Denise Bonds, Mary M McDermott, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S Church, Steven N Blair, Valerie H Myers, Ron Monce, Nathan E Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K Millet, Catrine Tudor-Locke, Ben P Butitta, Sheletta G Donatto, Shannon H Cocreham, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Leslie A Pruitt, Kathy Berra, Veronica Yank, Roger A Fielding, Miriam E Nelson, Sara C Folta, Edward M Phillips, Christine K Liu, Erica C McDavitt, Kieran F Reid, Won S Kim, Vince E Beard, Todd M Manini, Marco Pahor, Stephen D Anton, Susan Nayfield, Thomas W Buford, Michael Marsiske, Bhanuprasad D Sandesara, Jeffrey D Knaggs, Megan S Lorow, William C Marena, Irina Korytov, Holly L Morris, Margo Fitch, Floris F Singletary, Jackie Causer, Katie A Radcliff, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Nancy W Glynn, Oscar Lopez, Neelesh K Nadkarni, Kathy Williams, Mark A Newman, George Grove, Janet T Bonk, Jennifer Rush, Piera Kost, Diane G Ives, Stephen B Kritchevsky, Anthony P Marsh, Tina E Brinkley, Jamehl S Demons, Kaycee M Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Rekeneire, Joanne M McGloin, Karen C Wu, Denise M Shepard, Barbara Fennelly, Lynne P Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N Halpin, Matthew J Brennan, Julie A Bugaj, Maria A Zenoni, Bridget M Mignosa, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L Chupp, Gail M Flynn, Thomas M Gill, John L Hankinson, Carlos A Vaz Fragoso, Erik J Groessl, Robert M Kaplan, Marco Pahor, Jack M Guralnik, Walter T Ambrosius, Steven Blair, Denise E Bonds, Timothy S Church, Mark A Espeland, Roger A Fielding, Thomas M Gill, Erik J Groessl, Abby C King, Stephen B Kritchevsky, Todd M Manini, Mary M McDermott, Michael E Miller, Anne B Newman, W Jack Rejeski, Kaycee M Sink, Jeff D Williamson, LIFE study investigators, Marco Pahor, Jack M Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E Miller, Mark A Espeland, Walter T Ambrosius, William Applegate, Daniel P Beavers, Robert P Byington, Delilah Cook, Curt D Furberg, Lea N Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, W Jack Rejeski, Jeffrey A Katula, Peter H Brubaker, Shannon L Mihalko, Janine M Jennings, Evan C Hadley, Sergei Romashkan, Kushang V Patel, Denise Bonds, Mary M McDermott, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S Church, Steven N Blair, Valerie H Myers, Ron Monce, Nathan E Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K Millet, Catrine Tudor-Locke, Ben P Butitta, Sheletta G Donatto, Shannon H Cocreham, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Leslie A Pruitt, Kathy Berra, Veronica Yank, Roger A Fielding, Miriam E Nelson, Sara C Folta, Edward M Phillips, Christine K Liu, Erica C McDavitt, Kieran F Reid, Won S Kim, Vince E Beard, Todd M Manini, Marco Pahor, Stephen D Anton, Susan Nayfield, Thomas W Buford, Michael Marsiske, Bhanuprasad D Sandesara, Jeffrey D Knaggs, Megan S Lorow, William C Marena, Irina Korytov, Holly L Morris, Margo Fitch, Floris F Singletary, Jackie Causer, Katie A Radcliff, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Nancy W Glynn, Oscar Lopez, Neelesh K Nadkarni, Kathy Williams, Mark A Newman, George Grove, Janet T Bonk, Jennifer Rush, Piera Kost, Diane G Ives, Stephen B Kritchevsky, Anthony P Marsh, Tina E Brinkley, Jamehl S Demons, Kaycee M Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Rekeneire, Joanne M McGloin, Karen C Wu, Denise M Shepard, Barbara Fennelly, Lynne P Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N Halpin, Matthew J Brennan, Julie A Bugaj, Maria A Zenoni, Bridget M Mignosa, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L Chupp, Gail M Flynn, Thomas M Gill, John L Hankinson, Carlos A Vaz Fragoso, Erik J Groessl, Robert M Kaplan
Abstract
Importance: In older adults reduced mobility is common and is an independent risk factor for morbidity, hospitalization, disability, and mortality. Limited evidence suggests that physical activity may help prevent mobility disability; however, there are no definitive clinical trials examining whether physical activity prevents or delays mobility disability.
Objective: To test the hypothesis that a long-term structured physical activity program is more effective than a health education program (also referred to as a successful aging program) in reducing the risk of major mobility disability.
Design, setting, and participants: The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, randomized trial that enrolled participants between February 2010 and December 2011, who participated for an average of 2.6 years. Follow-up ended in December 2013. Outcome assessors were blinded to the intervention assignment. Participants were recruited from urban, suburban, and rural communities at 8 centers throughout the United States. We randomized a volunteer sample of 1635 sedentary men and women aged 70 to 89 years who had physical limitations, defined as a score on the Short Physical Performance Battery of 9 or below, but were able to walk 400 m.
Interventions: Participants were randomized to a structured, moderate-intensity physical activity program (n = 818) conducted in a center (twice/wk) and at home (3-4 times/wk) that included aerobic, resistance, and flexibility training activities or to a health education program (n = 817) consisting of workshops on topics relevant to older adults and upper extremity stretching exercises.
Main outcomes and measures: The primary outcome was major mobility disability objectively defined by loss of ability to walk 400 m.
Results: Incident major mobility disability occurred in 30.1% (246 participants) of the physical activity group and 35.5% (290 participants) of the health education group (hazard ratio [HR], 0.82 [95% CI, 0.69-0.98], P = .03).Persistent mobility disability was experienced by 120 participants (14.7%) in the physical activity group and 162 participants (19.8%) in the health education group (HR, 0.72 [95% CI, 0.57-0.91]; P = .006). Serious adverse events were reported by 404 participants (49.4%) in the physical activity group and 373 participants (45.7%) in the health education group (risk ratio, 1.08 [95% CI, 0.98-1.20]).
Conclusions and relevance: A structured, moderate-intensity physical activity program compared with a health education program reduced major mobility disability over 2.6 years among older adults at risk for disability. These findings suggest mobility benefit from such a program in vulnerable older adults.
Trial registration: clinicaltrials.gov Identifier: NCT01072500.
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Source: PubMed