Relationship Between Physical Functioning and Physical Activity in the Lifestyle Interventions and Independence for Elders Pilot (original) (raw)
Related papers
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2006
Background. The Short Physical Performance Battery (SPPB), which includes walking, balance, and chair stands tests, independently predicts mobility disability and activities of daily living disability. To date, however, there is no definitive evidence from randomized controlled trials that SPPB scores can be improved. Our objective was to assess the effect of a comprehensive physical activity (PA) intervention on the SPPB and other physical performance measures. Methods. A total of 424 sedentary persons at risk for disability (ages 70-89 years) were randomized to a moderateintensity PA intervention or a successful aging (SA) health education intervention and were followed for an average of 1.2 years. Results. The mean baseline SPPB score on a scale of 0-12, with 12 corresponding to highest performance, was 7.5. At 6 and 12 months, the PA versus SA group adjusted SPPB (6 standard error) scores were 8.7 6 0.1 versus 8.0 6 0.1, and 8.5 6 0.1 versus 7.9 6 0.2, respectively (p , .001). The 400-meter walking speed was also significantly improved in the PA group. The PA group had a lower incidence of major mobility disability defined as incapacity to complete a 400-meter walk (hazard ratio ¼ 0.71, 95% confidence interval ¼ 0.44-1.20). Conclusions. A structured PA intervention improved the SPPB score and other measures of physical performance. An intervention that improves the SPPB performance may also offer benefit on more distal health outcomes, such as mobility disability.
Clinical Interventions in Aging, 2013
The Lifestyle Interventions and Independence for Elders (LIFE) Study is a Phase III randomized controlled clinical trial (Clinicaltrials.gov identifier: NCT01072500) that will provide definitive evidence regarding the effect of physical activity (PA) on major mobility disability in older adults (70-89 years old) who have compromised physical function. This paper describes the methods employed in the delivery of the LIFE Study PA intervention, providing insight into how we promoted adherence and monitored the fidelity of treatment. Data are presented on participants' motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training. Prior to the onset of training, 31.4% of participants noted slight conflict with being able to meet the demands of the program and 6.4% indicated that the degree of conflict would be moderate. Accelerometry data collected during PA training revealed that the average intensity -1,555 counts/minute for men and 1,237 counts/minute for women -was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults. Also, a sizable subgroup required one or more rest stops. These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function. Moreover, the concept of what constitutes "moderate" exercise or an appropriate volume of work is dictated by the physical capacities of each individual and the level of comfort/stability in actually executing a specific prescription.
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2007
Background. Clinical trials to assess interventions for mobility disability are critically needed; however, data for efficiently designing such trials are lacking. Methods. Results are described from a pilot clinical trial in which 424 volunteers aged 70-89 years were randomly assigned to one of two interventions-physical activity or a healthy aging education program-and followed for a planned minimum of 12 months. We evaluated the longitudinal distributions of four standardized outcomes to contrast how they may serve as primary outcomes of future clinical trials: ability to walk 400 meters, ability to walk 4 meters in 10 seconds, a physical performance battery, and a questionnaire focused on physical function. Results. Changes in all four outcomes were interrelated over time. The ability to walk 400 meters as a dichotomous outcome provided the smallest sample size projections (i.e., appeared to be the most efficient outcome). It loaded most heavily on the underlying latent variable in structural equation modeling with a weight of 80%. A 4-year trial based on the outcome of the 400-meter walk is projected to require N ¼ 962-2234 to detect an intervention effect of 30%-20% with 90% power. Conclusions. Future clinical trials of interventions designed to influence mobility disability may have greater efficiency if they adopt the ability to complete a 400-meter walk as their primary outcome.
Physical activity as an indicator of predictive functional disability in elderly
2012
To analyze the time spent on physical activity in female and male individuals as a predictor of the absence of functional disability in older adults, a cross-sectional study was conducted with 624 individuals. Receiver Operating Characteristic curves (ROC) were constructed and compared to areas of physical activity by gender and the absence of functional disability. We identified cutoffs of physical activity (minutes / week) to predict the absence of functional disability (CI 95%). It was found that there is a higher area under the ROC curve for the time spent on physical activities in females. It was observed that 280 minutes / week (women) or 410 minutes / week (men) were the best cutoff points for predicting the absence of functional disability. Time spent on physical activity practices can serve as an important indicator to sort priority groups for certain interventions.
Experimental Gerontology, 2018
Background: Older adults have twice as many disabilities and four times as many physical limitations as people < 60 years of age. Positive influence of physical activity to prevent these limitations has been presented in some studies. However, the indispensable combination of physical abilities and body composition parameters to maintain independence in later life and their relationship with physical activity has not been studied thoroughly. Objective: The main aim of this study was to determine possible differences in body composition and mobility parameters among older women with various levels of engagement in physical activity. In addition, the relationships between mobility and distinct levels of physical activity were evaluated in healthy older women. Methods: Eighty-one healthy older women aged from 65 to 91 years participated in this study and were allocated to three groups according to weekly moderate-to-vigorous physical activity (MVPA) time in 10 min bouts: highest MVPA (H-MVPA) (n = 27), middle MVPA (M-MVPA) (n = 40) and lowest MVPA (L-MVPA) (n = 14). Body composition (fat mass [FM] and fat free mass [FFM]) variables were assessed with dual-energy X-ray absorptiometry (DXA), objective physical activity data were collected with accelerometers and mobility tests were carried out to assess static and dynamic balance, lower limbs strength and aerobic capacity. Results: No differences in body composition parameters were observed between studied groups (p > 0.0025). Women in L-MVPA covered significantly shorter distance during the six-minute walk test (6MWT) compared to H-MVPA (p = 0.000) and M-MVPA (p = 0.003) groups, performed timed-up-and-go (TUG) slower compared to H-MVPA group (p = 0.003) and five-times-sit-to-stand (FTSTS) test slower compared to H-MVPA (p = 0.006) and M-MVPA (p = 0.009) groups. There were no differences in body composition and mobility parameters between women in H-MVPA and M-MVPA groups. Regardless of bout duration, MVPA was correlated with mobility (TUG r = −0.47; FTSTS r = −0.37; 6MWT r = 0.53) parameters, whereas no relationships was observed with light physical activity (LPA). Conclusion: MVPA is associated with body composition and mobility parameters, while LPA is not related to any measured body composition nor mobility parameters. Accordingly, healthy older women could benefit from MVPA to maintain body composition and mobility parameters to preserve independence in later life.
Clinical Rehabilitation, 2012
Objective: To investigate the predictive value of self-reported decline in weight, exhaustion, walking difficulty, grip strength and physical activity on development of disabilities in community-dwelling elderly people. Design: A one-year follow-up study. Setting: Participants were recruited via four Dutch general practitioners. Participants: Community-dwelling elderly people aged 70 years or older. Methods: A total of 687 participants received a questionnaire at baseline regarding weight loss, exhaustion, walking difficulty, grip strength, physical activity and disability. The same questionnaire was sent to them after one year follow-up. Disability was operationalized in two ways: as increased dependence and as increased difficulty in daily activities. Univariate and multivariate logistic regression analyses were used to determine whether self-reported decline in five physical indicators at baseline predicted development of dependence or increased difficulty in daily activities after one year. The analyses were controlled for age, gender and baseline disability. Results: Four hundred and one participants with a mean age of 76.9 years (SD 5.2) were included in the analyses. Eighty-four of them reported increased dependence (21%) and 76 reported increased difficulty (19%) in daily activities at one-year follow-up. All physical indicators, except weight loss, were significant univariate predictors of disability. Multivariate analyses revealed that self-reported decrease in physical activity (e.g. walking, cycling, gardening) was a significant predictor of development of dependence (odds ratio (OR) = 1.89, 95% confidence interval (CI) = 1.02-3.51) and development of difficulty (OR = 1.98, 95% CI = 1.05-3.71) in daily activities. Conclusion: Community-dwelling elderly people who report decreased physical activity have a higher risk to develop disability at one-year follow-up.
Should physical activity programs be tailored when older adults have compromised function?
Journal of aging and physical activity, 2009
The purpose of this study was to determine whether a walking program supplemented by tasks designed to challenge balance and mobility (WALK+) could improve physical function more than a traditional walking program (WALK) in older adults at risk for mobility disability. 31 community-dwelling older adults (M +/- SD age = 76 +/- 5 yr; Short Physical Performance Battery [SPPB] score = 8.4 +/- 1.7) were randomized to treatment. Both interventions were 18 sessions (1 hr, 3x/wk) and progressive in intensity and duration. Physical function was assessed using the SPPB and the 400-m-walk time. A subset of participants in the WALK group who had relatively lower baseline function showed only small improvement in their SPPB scores after the intervention (0.3 +/- 0.5), whereas a subset of participants in the WALK+ group with low baseline function showed substantial improvement in their SPPB scores (2.2 +/- 0.7). These preliminary data underscore the potential importance of tailoring interventions...
BMC Geriatrics, 2012
Background: Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods: Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL). The odds ratio and 95% Confidence Interval (CI) were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results: In 870 participants, the mean total daily physical activity was 2. 9 × 10 5 counts/day (range in 10 5 counts/ day = 0.16, 13. 6) and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6). At baseline, 718 (82.5%) participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 10 5 counts/day difference = 0.55; 95% CI = 0.47, 0.65). Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 10 5 counts/day additional total daily physical activity was associated with reduced hazard of developing disability by 25% (HR = 0.75, 95% CI = 0.66, 0.84). The results were unchanged after controlling for important covariates including cognition, depressive symptoms, and chronic health conditions. Conclusions: Greater total daily physical activity is independently associated with less disability even after controlling for self-reported physical activity.