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Differential exercise effects on quality of life and health-related quality of life in older adults: a randomized controlled trial.

ABSTRACT: Maintaining quality of life (QOL) and physical and mental health status are important outcomes throughout the aging process. Although cross-sectional studies suggest a relationship between global QOL and physical activity, it is unclear whether such a relationship exists as a function of exercise training.We examined the effects of two exercise intervention arms on health-related quality of life (HRQOL) and global QOL. Low-active, older adults (n = 179) were randomly assigned to either a 12-month aerobic walking group or a strengthening and flexibility group. HRQOL and QOL were measured at baseline, 6, and 12 months.There was a significant group by time effect on QOL [F(2,176) = 3.11, p = 0.047, ? (2) = 0.03]. There was also a significant overall group by time effect for HRQOL [F(4,174) = 2.46, p = 0.047, ? (2) = 0.05], which was explained by the significant group by time interaction for mental health status (p = 0.041, ? (2) = 0.02) favoring the walking condition. Further analyses using latent class analysis revealed three classes of individuals with differential patterns of change in QOL and HRQOL across time. These classes reflected no change, declines, and improvements in these constructs across time.Walking appears to enhance the mental aspect of HRQOL and global QOL when compared to a non-aerobic intervention. Additionally, the patterns of change in QOL and HRQOL were not linear over time. Our findings are in contrast to previous reports that these outcomes change a little or not at all in randomized trials.

SUBMITTER: Awick EA

PROVIDER: S-EPMC4312264 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Health-related quality of life (HRQoL) and absence of depressive symptoms are of great importance for older people, which may be achieved through lifestyle interventions, e.g., exercise and nutrition interventions. The aim of this investigation was to analyze the effects of a physical activity program in combination with protein supplementation on HRQoL and depressive symptoms in community-dwelling, mobility-limited older adults. METHODS:In the Vitality, Independence, and Vigor 2 Study (VIVE2), community-dwelling men and women with an average age of 77.5?±?5.4 years, some mobility limitations and low serum vitamin D levels (25(OH)Vit D 22.5-60 nmol/l) from two study sites (Stockholm, Sweden and Boston, USA) were randomized to receive a nutritional supplement or a placebo for 6 months. All took part in a physical activity program 2-3 times/ week. The primary outcome examined in VIVE2 was 400 M walk capacity. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF36), consisting of the Physical Component Summary (PCS) and Mental Component Summary (MCS), and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). In the sensitivity analyses, the sample was divided into sub-groups based on body measures and function (body mass index (BMI), appendicular lean mass index (ALMI), handgrip strength and gait speed). RESULTS:For the whole sample, there was a significant improvement in both MCS, mean (95% CI) 2.68 (0.5, 4.9) (p 0.02), and CES-D -2.7 (-?4.5, -?0.9) (p 0.003) during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in PCS or variation in effects across the sub-categories. CONCLUSIONS:This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected. TRIAL REGISTRATION:Registered at ClinicalTrials.gov, March 2 2012, NCT01542892 .

Project description:BackgroundBy 2030, the number of US adults age ≥65 will exceed 70 million. Their quality of life has been declared a national priority by the US government.ObjectiveAssess effects of an eHealth intervention for older adults on quality of life, independence, and related outcomes.DesignMulti-site, 2-arm (1:1), non-blinded randomized clinical trial. Recruitment November 2013 to May 2015; data collection through November 2016.SettingThree Wisconsin communities (urban, suburban, and rural).ParticipantsPurposive community-based sample, 390 adults age ≥65 with health challenges.Exclusionslong-term care, inability to get out of bed/chair unassisted.InterventionAccess (vs. no access) to interactive website (ElderTree) designed to improve quality of life, social connection, and independence.MeasuresPrimary outcome: quality of life (PROMIS Global Health). Secondary: independence (Instrumental Activities of Daily Living); social support (MOS Social Support); depression (Patient Health Questionnaire-8); falls prevention (Falls Behavioral Scale). Moderation: healthcare use (Medical Services Utilization). Both groups completed all measures at baseline, 6, and 12 months.ResultsThree hundred ten participants (79%) completed the 12-month survey. There were no main effects of ElderTree over time. Moderation analyses indicated that among participants with high primary care use, ElderTree (vs. control) led to better trajectories for mental quality of life (OR=0.32, 95% CI 0.10-0.54, P=0.005), social support received (OR=0.17, 95% CI 0.05-0.29, P=0.007), social support provided (OR=0.29, 95% CI 0.13-0.45, P<0.001), and depression (OR= -0.20, 95% CI -0.39 to -0.01, P=0.034). Supplemental analyses suggested ElderTree may be more effective among people with multiple (vs. 0 or 1) chronic conditions.LimitationsOnce randomized, participants were not blind to the condition; self-reports may be subject to memory bias.ConclusionInterventions like ET may help improve quality of life and socio-emotional outcomes among older adults with more illness burden. Our next study focuses on this population.Trial registrationClinicalTrials.gov ; registration ID number: NCT02128789.

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Differential exercise effects on quality of life and health-related quality of life in older adults: a randomized controlled trial.

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