Dataset Information

Effect of Physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study.

ABSTRACT:

Background/objectives

To test the hypothesis that a long-term structured, moderate intensity physical activity (PA) program is more effective than a health education (HE) program in reducing the risk of s elf-reported dependency and disability in basic activities of daily living (BADLs), disability in instrumental ADLs (IADL), and mobility disability.

Design

The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, single-blinded randomized trial.

Setting

University-based research clinic.

Participants

Thousand six hundred and thirty five sedentary men and women aged 70-89 years, who had functional limitations, defined as a score ≤9 on the Short Physical Performance Battery.

Intervention

Participants were randomized to a structured, moderate intensity PA program (n = 818) that included aerobic, resistance, and flexibility exercises or to a HE program (n = 817).

Measurements

All outcomes were derived by self-report using periodic interviews that asked about the degree of difficulty and receipt of help during the past month. Dependency was defined as "receiving assistance" or "unable" to do ≥1 activities. Disability was defined as having "a lot of difficulty" or "unable" doing ≥1 activities. Severe disability was defined as reporting difficulty or being unable to perform ≥3 activities.

Results

Over an average follow-up of 2.6 years, the cumulative incidence of BADL dependency was 15.2% among PA and 15.1% among HE participants (HR = 1.0, 95% CI = 0.78-0.1.3). Intervention groups had similar rates of incident BADL disability, IADL disability and reported mobility disability. Reporting severe mobility disability (HR = 0.78, 95% CI = 0.64-0.96) and ratings of difficulty on mobility tasks were reduced in the PA group.

Conclusion

A structured physical activity intervention reduces reported severe mobility disability and difficulty on mobility tasks, but not BADL and IADL disability in older adults with functional limitations.

SUBMITTER: Manini TM

PROVIDER: S-EPMC5435532 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effect of Physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study.

Manini Todd M TM Beavers Daniel P DP Pahor Marco M Guralnik Jack M JM Spring Bonnie B Church Timothy S TS King Abby C AC Folta Sara C SC Glynn Nancy W NW Marsh Anthony P AP Gill Thomas M TM

Journal of the American Geriatrics Society 20170207 5

<h4>Background/objectives</h4>To test the hypothesis that a long-term structured, moderate intensity physical activity (PA) program is more effective than a health education (HE) program in reducing the risk of s elf-reported dependency and disability in basic activities of daily living (BADLs), disability in instrumental ADLs (IADL), and mobility disability.<h4>Design</h4>The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, single-blinded randomized trial.<h4> ...[more]

PMID: 28168689

Similar Datasets

Project description:Understanding the minimal dose of physical activity required to achieve improvement in physical functioning and reductions in disability risk is necessary to inform public health recommendations. To examine the effect of physical activity dose on changes in physical functioning and the onset of major mobility disability in The Lifestyle Interventions and Independence for Elders (LIFE) Study. We conducted a multicenter single masked randomized controlled trial that enrolled participants in 2010 and 2011 and followed them for an average of 2.6 years. 1,635 sedentary men and women aged 70-89 years who had functional limitations were randomized to a structured moderate intensity walking, resistance, and flexibility physical activity program or a health education program. Physical activity dose was assessed by 7-day accelerometry and self-report at baseline and 24 months. Outcomes included the 400 m walk gait speed, the Short Physical Performance Battery (SPPB), assessed at baseline, 6, 12, and 24 months, and onset of major mobility disability (objectively defined by loss of ability to walk 400 m in 15 min). When the physical activity arm or the entire sample were stratified by change in physical activity from baseline to 24 months, there was a dose-dependent increase in the change in gait speed and SPPB from baseline at 6, 12, and 24 months. In addition, the magnitude of change in physical activity over 24 months was related to the reduction in the onset of major mobility disability (overall P < 0.001) (highest versus the lowest quartile of physical activity change HR 0.23 ((95% CI:0.10-0.52) P = 0.001) in the physical activity arm. We observed a dose-dependent effect of objectively monitored physical activity on physical functioning and onset of major mobility disability. Relatively small increases (> 48 minutes per week) in regular physical activity participation had significant and clinically meaningful effects on these outcomes.Trial registrationClinicalsTrials.gov NCT00116194.

Project description:Physical activity (PA) has a substantial impact on health and mortality. Besides questionnaires that rely on subjective assessment of activity levels, accelerometers can help to objectify an individual's PA. In this study, variables estimating PA and sleep time obtained through the wGT3X-BT activity monitor (ActiGraph LLC, USA) in 797 participants of the Berlin Aging Study II (BASE-II) were analyzed. Self-reports of PA and sleep time were recorded with Rapid Assessment of Physical Activity (RAPA) and the Pittsburgh Sleep Quality Index sleep questionnaire (PSQI). Total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), fasting glucose, and hemoglobin A1c (HbA1c) were determined in an accredited standard laboratory. Of all participants, 760 fulfilled the PA wear-time criteria. In this sample mean age was 75.6 years (SD: 3.8 years, range 66.0-94.1 years) and 53% of the included participants were women. Average wear time was 23.2 h/day (SD 1.3 h/day). Statistically significant differences between RAPA groups were found for all accelerometric variables except energy expenditure. Post-hoc analysis, however, suggested low agreement between subjective and device-based assessment of physical activity. TC, HDL-C, LDL-C, TG, fasting glucose and HbA1c were weakly correlated with accelerometric variables (Pearson's r ≤ 0.25). Device-based average sleep time per night (mean sleep time = 6.91 h, SD = 1.3, n = 720) and self-reported average sleep time per night (mean sleep time = 7.1 h, SD = 1.15 h, n = 410) were in a comparable range and moderately correlated (Pearson's r = 0.31, p < 0.001, n = 410). Results from this study suggest that self-reported PA obtained through the RAPA and device-based measures assessed by accelerometers are partially inconsistent in terms of the physical activity level of the participants. Self-reported and device-based measures of average sleep time per night, however, were comparable.

Project description:ImportanceIn 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.ObjectiveTo 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 participantsThe 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.InterventionsParticipants 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 measuresThe primary outcome was major mobility disability objectively defined by loss of ability to walk 400 m.ResultsIncident 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 relevanceA 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 registrationclinicaltrials.gov Identifier: NCT01072500.

Project description:Background and aimsPhysical activity (PA) is associated with higher gait speed. We aimed to examine the associations between PA and change in spatial and temporal gait measures as well as fall risk in community-dwelling individuals free of dementia.MethodsLongitudinal study among 4173 individuals aged ≥50 years (mean age 71 years; 2078 males; median follow-up 4 years) enrolled in the Mayo Clinic Study of Aging. Self-reported late-life PA was used to calculate overall PA and moderate-vigorous PA (MVPA) scores. Gait was assessed using GAITRite® and Zeno™ systems. Incident falls information was based on diagnostic codes retrieved from medical records. We ran linear mixed effects models to examine associations between z-scored PA variables and longitudinal gait parameters, adjusted for age, sex, education, body mass index (BMI), medical comorbidities, and including interactions between PA and time since baseline. In secondary analyses, we calculated Cox Proportional hazard models with age as time scale predicting incident falls by PA, adjusting for sex, education, BMI, medical comorbidities, and falls history.ResultsAt baseline, higher PA was associated with higher velocity (overall PA: estimate 2.9935; MVPA: 2.2961; p < 0.001), higher cadence (overall PA: 1.0665; MVPA: 0.9073; p < 0.001), greater stride length (overall PA: 2.0805; MVPA: 1.4726; p < 0.001), shorter double support time (overall PA: -0.0257; MVPA: -0.0205; p < 0.001), and lower stance time variability (overall PA: -0.0204, p < 0.001; MVPA: -0.0152; p = 0.006). Overall PA was longitudinally associated with less decline in cadence, and MVPA with less increase in intraindividual stance time variability. Overall PA (Hazard ratio 0.892, 95% confidence interval 0.828-0.961, p = 0.003) and MVPA (HR 0.901; 95% CI 0.835-0.973, p = 0.008) were associated with a decreased risk of incident falls.ConclusionLate-life PA was associated with favorable gait outcomes and decreased risk of incident falls. Thus, late-life PA may help to maintain gait performance and decrease fall risk in old age.

Project description:Background and objectiveMaintaining the life satisfaction of frail middle-aged and older adults when they experience physical disability, lower activity status, or complex conditions that are related to each other is now an urgent issue. Therefore, the purpose of this study was to provide evidence for the impact of frailty in middle-aged and older adults on life satisfaction under the simultaneous occurrence and correlation of physical disability and physical activity status.MethodsData from the 2015 Taiwan Longitudinal Study in Ageing (TLSA) were analyzed by PROCESS in SPSS to explore three different mediation models (N = 4,421). The first was a parallel mediation model for exploring life satisfaction in middle-aged and older adults with frailty through physical disability or physical activity. The second was a serial mediation model for examining physical disability and physical activity in causal chains linked with a specific direction of flow and to test all combinations. The third was a moderated mediation model for testing whether the indirect effect of frailty status on life satisfaction through physical disability or physical activity was moderated by age stratification.ResultsPhysical disability and physical activity partially mediated the relationship between frailty status and life satisfaction (IEOVERALL = -0.196, 95% CI: -0.255 to -0.139). The causal path with the highest indirect effect was found to be that between frailty and physical disability; increased frailty led to higher physical disability, which in turn affected physical activity, leading to lower life satisfaction (IE = 0.013, 95% CI: 0.008 to 0.019). The different stratifications by age significantly increased the mediating effect of physical activity (Index of Moderated Mediation = -0.107, SE = 0.052, 95% CI: -0.208 to -0.005) but did not reduce the mediating effect of physical disability.ConclusionThis study provides evidence that physical activity and physical disability influence the development of frailty. It also has a significant impact on the life satisfaction of middle-aged and older adults.

Dataset Information

Effect of Physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study.

Background/objectives

Design

Setting

Participants

Intervention

Measurements

Results

Conclusion

Publications

Effect of Physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study.

Similar Datasets

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