Research Study Abstract

Effect of Structured Physical Activity on Prevention of Major Mobility Disability in Older Adults The LIFE Study Randomized Clinical Trial

  • Published on June 18, 2014

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

Author(s)

  • Marco Pahor, MD 1
  • Jack M. Guralnik, MD, PHD 1,2
  • Walter T. Ambrosius, PhD 3
  • Steven Blair, PED 4
  • Denise E. Bonds, MD 5
  • Timothy S. Church, MD, PhD, MPH 6
  • Mark A. Espeland, PhD 3
  • Roger A. Fielding, PhD 7
  • Thomas M. Gill, MD 8
  • Erik J. Groessl, PhD 9,10
  • Abby C. King, PhD 11
  • Stephen B. Kritchevsky, PhD 3
  • Todd M. Manini, PhD 1
  • Mary M. McDermott, MD 12
  • Michael E. Miller, PhD 3
  • Anne B. Newman, MD, MPH 13
  • W. Jack Rejeski, PhD 3
  • Kaycee M. Sink, MD, MAS 3
  • Jeff D. Williamson, MD, MHS 3

Institution(s)

  • 1

    Department of Aging and Geriatric Research,University of Florida, Gainesville

  • 2

    Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore

  • 3

    Department of Internal Medicine, Wake Forest University and School of Medicine, Winston-Salem, North Carolina

  • 4

    Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia

  • 5

    Division of Cardiac Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland

  • 6

    Department of Preventative Medicine, Pennington Biomedical Research Center, Louisiana

  • 7

    Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts

  • 8

    Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut

  • 9

    Veterans Affairs San Diego Healthcare System, San Diego, California

  • 10

    Department of Family and Preventive Medicine, University of California, San Diego, San Diego

  • 11

    Department of Health Research and Policy and Department of Medicine, Stanford University, School of Medicine, Stanford, California

  • 12

    Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois

  • 13

    Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania

Journal

JAMA

Categories

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