Investigating dose-response effects of multimodal exercise programs on health-related quality of life in older adults

Navin Kaushal, Francis Langlois, Laurence Desjardins-Crépeau, Martin S Hagger, Louis Bherer, Navin Kaushal, Francis Langlois, Laurence Desjardins-Crépeau, Martin S Hagger, Louis Bherer

Abstract

Background: Older adults are at risk of multiple chronic diseases, most of which could be prevented by engaging in regular physical activity. Frailty is a state of increased vulnerability to diseases. Worsening symptoms of frailty, such as decrease in physical functionality, can compromise health-related quality of life (HR-QOL). Previous findings suggest that frailty moderates the relationship between physical activity and HR-QOL, yet intervention findings are limited, particularly in dose-response analyses. Hence, this study was conducted to test if lower-dose physical activity (120 minutes/week) would provide the same benefits in health outcomes (physical functionality and HR-QOL) as higher-dose physical activity (180 minutes/week).

Methods: Participants (n=110) were older adults comprising higher-dose, lower-dose, and control groups who were combined from recent randomized controlled trials. Experimental groups participated in a multimodal exercise program in a supervised laboratory setting for 12 weeks.

Results: The higher-dose group showed a significant improvement in physical functionality (β=0.23, P=0.03) and in overall HR-QOL (β=0.44, P=0.001) including its subcategories over the control group. A group × frailty interaction revealed that frail individuals significantly improved in capacity HR-QOL when they exercised at a higher dose (F (1, 49)=4.57, P=0.038).

Conclusion: This study identifies a positive, predictive relationship between exercise duration and health outcomes (HR-QOL dimensions and frailty) among older adults. Frail individuals in the higher-dose group demonstrated significant recovery of capacity HR-QOL, thus reflecting improvement in their daily activities.

Keywords: aging; frailty; multimodal exercise; physical activity.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
CONSORT flow diagram of group selection. Notes: The flowchart presents selection of groups for the present study. CT represents control group, which did not receive any exercise prescription, Ex1 represents higher-dose group, which exercised for 180 minutes/week, and Ex2A and Ex2B represent lower-dose groups, which exercised for 120 minutes/week. Groups Ex2A and Ex2B were combined to create the lower-dose group. The letters “A” and “B” signify different computer tests administered to these groups; however, the outcomes were not relevant in the present study. Groups ST1 and ST2 were stretching interventions that were not used in the study. Asterisks (*) denote groups that were included in the analysis. Reprinted by permission from Springer Nature: Int J Behav Med. Kaushal N, Desjardins-Crépeau L, Langlois F, Bherer L. The effects of multi-component exercise training on cognitive functioning and health-related quality of life in older adults. Copyright 2018.45.
Figure 2
Figure 2
Relationship between exercise dose and change in HR-QOL. Note: Effect size changes of HR-QOL outcomes when each exercise dose was compared with the control group. Abbreviation: HR-QOL, health-related quality of life.
Figure 3
Figure 3
Exercise dose and frailty interaction. Note: Group (higher dose vs control) interacts with frailty to predict change in capacity HR-QOL. Abbreviation: HR-QOL, health-related quality of life.

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