Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial
Kaycee M Sink, Mark A Espeland, Cynthia M Castro, Timothy Church, Ron Cohen, John A Dodson, Jack Guralnik, Hugh C Hendrie, Janine Jennings, Jeffery Katula, Oscar L Lopez, Mary M McDermott, Marco Pahor, Kieran F Reid, Julia Rushing, Joe Verghese, Stephen Rapp, Jeff D Williamson, LIFE Study Investigators, Mary M McDermott, Bonnie Spring, Joshua Hauser, Martha Gulati, Sanjiv Shah, Kathryn Domanchuk, Rex Graff, Kasia Kadela, Alvito Rego, Timothy Church, Steven Blair, Valerie Myers, Ron Monce, Nathan Britt, Melissa Nauta, Ami Parks, Ruben Rodarte, Heidi Millet, Catrine Tudor-Locke, Ben Butitta, Sheletta Donatto, Denise Bonds, Evan C Hadley, Kushang V Patel, Sergei Romashkan, Robert M Kaplan, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Veronica Yank, Leslie A Pruitt, Kathy Berra, Carol Bell, Rosita Thiessen, Kate P Youngman, Selene B Virgen, Kristina N Tarin, Heather Klaftenegger, Carolyn A Prosak, Ines Campero, Dulce M Garcia, José Soto, Linda Chio, David Hoskins, Roger Fielding, Miriam Nelson, Sara Folta, Edward Phillips, Christine Liu, Erica Cifarelli, Kieran Reid, Paige Lacasse, Dylan Kirn, Evan Pasha, Sonnly Ribourg, Karen Ruais, Won Kim, Gregory Cloutier, Todd Manini, Marco Pahor, Stephen Anton, Thomas Buford, Susan Nayfield, Joe Nocera, Michael Marsiske, Bhanu Sandesara, Jocelyn Lee, Deborah Hiatt-Jensen, Mieniecia Black, Kimberly Case, Katherine Herring, Amber Schwier-Delvisco, Bill Burk, Brian Hoover, Jeffrey Knaggs, Allison Martin, Chonglun Xie, Holly Morris, Flo Singletary, Jackie Causer, Susan Yonce, Christine Del Boccio, Charles Gay, Tangerica Peavy Alexander, Marco Pahor, Stephen Anton, Thomas Buford, Christiaan Leeuwenburgh, Susan Nayfield, Todd Manini, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ronald Lester, Ching-ju Lu, Ryan O'Mara, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Jack M Guralnik, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Oscar Lopez, Nancy W Glynn, Janet T Bonk, Jennifer Rush, Piera Kost, Allison Gerger, Pamela Vincent, LaTisha Davis, Mark A Newman, George Grove, Kathy Williams, Erik J Groessl, Stephen B Kritchevsky, Anthony Marsh, Tina Brinkley, Jamehl Demons, Kaycee Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Valerie K Wilson, Michael E Miller, Mark Espeland, Walter Ambrosius, Don Babcock, Daniel Beavers, Robert P Byington, Delilah Cook, Curt Furberg, Candace Goode, Jason Griffin, Lea Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Kathy Joyce, Laura Lovato, Wesley Roberson, Julia Robertson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, Jack Rejeski, Jeff Katula, Peter H Brubaker, Shannon Mihalko, Janine M Jennings, Kathy Lane, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Renekeire, Joanne M McGloin, Raeleen Mautner, Sharon M Huie-White, Luann Bianco, Janice Zocher, Denise M Shepard, Barbara Fennelly, Sean Halpin, Theresa Barnett, Karen C Wu, Lynne P Iannone, Julie A Bugaj, Christine Bailey, Geoffrey Chupp, Gail Flynn, Thomas M Gill, John Hankinson, Carlos A Vaz Fragoso, Kaycee M Sink, Mark A Espeland, Cynthia M Castro, Timothy Church, Ron Cohen, John A Dodson, Jack Guralnik, Hugh C Hendrie, Janine Jennings, Jeffery Katula, Oscar L Lopez, Mary M McDermott, Marco Pahor, Kieran F Reid, Julia Rushing, Joe Verghese, Stephen Rapp, Jeff D Williamson, LIFE Study Investigators, Mary M McDermott, Bonnie Spring, Joshua Hauser, Martha Gulati, Sanjiv Shah, Kathryn Domanchuk, Rex Graff, Kasia Kadela, Alvito Rego, Timothy Church, Steven Blair, Valerie Myers, Ron Monce, Nathan Britt, Melissa Nauta, Ami Parks, Ruben Rodarte, Heidi Millet, Catrine Tudor-Locke, Ben Butitta, Sheletta Donatto, Denise Bonds, Evan C Hadley, Kushang V Patel, Sergei Romashkan, Robert M Kaplan, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Veronica Yank, Leslie A Pruitt, Kathy Berra, Carol Bell, Rosita Thiessen, Kate P Youngman, Selene B Virgen, Kristina N Tarin, Heather Klaftenegger, Carolyn A Prosak, Ines Campero, Dulce M Garcia, José Soto, Linda Chio, David Hoskins, Roger Fielding, Miriam Nelson, Sara Folta, Edward Phillips, Christine Liu, Erica Cifarelli, Kieran Reid, Paige Lacasse, Dylan Kirn, Evan Pasha, Sonnly Ribourg, Karen Ruais, Won Kim, Gregory Cloutier, Todd Manini, Marco Pahor, Stephen Anton, Thomas Buford, Susan Nayfield, Joe Nocera, Michael Marsiske, Bhanu Sandesara, Jocelyn Lee, Deborah Hiatt-Jensen, Mieniecia Black, Kimberly Case, Katherine Herring, Amber Schwier-Delvisco, Bill Burk, Brian Hoover, Jeffrey Knaggs, Allison Martin, Chonglun Xie, Holly Morris, Flo Singletary, Jackie Causer, Susan Yonce, Christine Del Boccio, Charles Gay, Tangerica Peavy Alexander, Marco Pahor, Stephen Anton, Thomas Buford, Christiaan Leeuwenburgh, Susan Nayfield, Todd Manini, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ronald Lester, Ching-ju Lu, Ryan O'Mara, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Jack M Guralnik, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Oscar Lopez, Nancy W Glynn, Janet T Bonk, Jennifer Rush, Piera Kost, Allison Gerger, Pamela Vincent, LaTisha Davis, Mark A Newman, George Grove, Kathy Williams, Erik J Groessl, Stephen B Kritchevsky, Anthony Marsh, Tina Brinkley, Jamehl Demons, Kaycee Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Valerie K Wilson, Michael E Miller, Mark Espeland, Walter Ambrosius, Don Babcock, Daniel Beavers, Robert P Byington, Delilah Cook, Curt Furberg, Candace Goode, Jason Griffin, Lea Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Kathy Joyce, Laura Lovato, Wesley Roberson, Julia Robertson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, Jack Rejeski, Jeff Katula, Peter H Brubaker, Shannon Mihalko, Janine M Jennings, Kathy Lane, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Renekeire, Joanne M McGloin, Raeleen Mautner, Sharon M Huie-White, Luann Bianco, Janice Zocher, Denise M Shepard, Barbara Fennelly, Sean Halpin, Theresa Barnett, Karen C Wu, Lynne P Iannone, Julie A Bugaj, Christine Bailey, Geoffrey Chupp, Gail Flynn, Thomas M Gill, John Hankinson, Carlos A Vaz Fragoso
Abstract
Importance: Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed.
Objective: To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program.
Design, setting, and participants: A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. Participants were sedentary adults aged 70 to 89 years who were at risk for mobility disability but able to walk 400 m.
Interventions: A structured, moderate-intensity physical activity program (n = 818) that included walking, resistance training, and flexibility exercises or a health education program (n = 817) of educational workshops and upper-extremity stretching.
Main outcomes and measures: Prespecified secondary outcomes of the LIFE study included cognitive function measured by the Digit Symbol Coding (DSC) task subtest of the Wechsler Adult Intelligence Scale (score range: 0-133; higher scores indicate better function) and the revised Hopkins Verbal Learning Test (HVLT-R; 12-item word list recall task) assessed in 1476 participants (90.3%). Tertiary outcomes included global and executive cognitive function and incident MCI or dementia at 24 months.
Results: At 24 months, DSC task and HVLT-R scores (adjusted for clinic site, sex, and baseline values) were not different between groups. The mean DSC task scores were 46.26 points for the physical activity group vs 46.28 for the health education group (mean difference, -0.01 points [95% CI, -0.80 to 0.77 points], P = .97). The mean HVLT-R delayed recall scores were 7.22 for the physical activity group vs 7.25 for the health education group (mean difference, -0.03 words [95% CI, -0.29 to 0.24 words], P = .84). No differences for any other cognitive or composite measures were observed. Participants in the physical activity group who were 80 years or older (n = 307) and those with poorer baseline physical performance (n = 328) had better changes in executive function composite scores compared with the health education group (P = .01 for interaction for both comparisons). Incident MCI or dementia occurred in 98 participants (13.2%) in the physical activity group and 91 participants (12.1%) in the health education group (odds ratio, 1.08 [95% CI, 0.80 to 1.46]).
Conclusions and relevance: Among sedentary older adults, a 24-month moderate-intensity physical activity program compared with a health education program did not result in improvements in global or domain-specific cognitive function.
Trial registration: clinicaltrials.gov Identifier: NCT01072500.
Figures
Source: PubMed