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Randomized Controlled Trial
. 2017 Jan;98(1):11-24.e3.
doi: 10.1016/j.apmr.2016.07.019. Epub 2016 Aug 25.

Predictors of Change in Physical Function in Older Adults in Response to Long-Term, Structured Physical Activity: The LIFE Study

Andrew S Layne  1 , Fang-Chi Hsu  2 , Steven N Blair  3 , Shyh-Huei Chen  2 , Jennifer Dungan  4 , Roger A Fielding  5 , Nancy W Glynn  6 , Alexandra M Hajduk  7 , Abby C King  8 , Todd M Manini  9 , Anthony P Marsh  10 , Marco Pahor  9 , Christine A Pellegrini  11 , Thomas W Buford  12 ; LIFE Study Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Predictors of Change in Physical Function in Older Adults in Response to Long-Term, Structured Physical Activity: The LIFE Study

Andrew S Layne et al. Arch Phys Med Rehabil. 2017 Jan.

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Arch Phys Med Rehabil. 2017 Mar;98(3):604. doi: 10.1016/j.apmr.2017.01.001. Arch Phys Med Rehabil. 2017. PMID: 28232001 No abstract available.

Abstract

Objectives: To evaluate the extent of variability in functional responses in participants in the Lifestyle Interventions and Independence for Elders (LIFE) study and to identify the relative contributions of intervention adherence, physical activity, and demographic and health characteristics to this variability.

Design: Secondary analysis.

Setting: Multicenter institutions.

Participants: A volunteer sample (N=1635) of sedentary men and women aged 70 to 89 years who were able to walk 400m but had physical limitations, defined as a Short Physical Performance Battery (SPPB) score of ≤9.

Interventions: Moderate-intensity physical activity (n=818) consisting of aerobic, resistance, and flexibility exercises performed both center-based (2times/wk) and home-based (3-4times/wk) sessions or health education program (n=817) consisting of weekly to monthly workshops covering relevant health information.

Main outcome measures: Physical function (gait speed over 400m) and lower extremity function (SPPB score) assessed at baseline and 6, 12, and 24 months.

Results: Greater baseline physical function (gait speed, SPPB score) was negatively associated with change in gait speed (regression coefficient β=-.185; P<.001) and change in SPPB score (β=-.365; P<.001), whereas higher number of steps per day measured by accelerometry was positively associated with change in gait speed (β=.035; P<.001) and change in SPPB score (β=.525; P<.001). Other baseline factors associated with positive change in gait speed and/or SPPB score include younger age (P<.001), lower body mass index (P<.001), and higher self-reported physical activity (P=.002).

Conclusions: Several demographic and physical activity-related factors were associated with the extent of change in functional outcomes in participants in the LIFE study. These factors should be considered when designing interventions for improving physical function in older adults with limited mobility.

Keywords: Aging; Exercise; Individuality; Rehabilitation; Resistance training; Walking.

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Figures

Figure 1
Figure 1
24-month Δ gait speed (top) and short physical performance battery (SPPB) performance (bottom) among participants in the physical activity (left) and health education (right) intervention group. Data for gait speed indicate individual responses to the interventions, while SPPB data reflect the proportion of individuals with a respective Δ SPPB score following treatment.
Figure 2
Figure 2
Forest plot of the hazard ratio (HR) and 95% confidence interval (CI) of each risk factor for development of major mobility disability (MMD) according to Cox regression modeling stratified by sex. MMD was defined as inability to complete a 400m walk test within 15 minutes without sitting or help of another person or walker. Persistent MMD (PMMD) was defined by two consecutive major mobility disability assessments or major mobility disability followed by death. SPPB=Short Physical Performance Battery; BMI= body mass index; BP=blood pressure. *0=No and 1=Yes.
Figure 3
Figure 3
Percentage of individuals obtaining poor (≤ −0.05 m/s or ≤ −1 point), modest (−0.049 to 0.049 m/s or 0-1 point) or strong (≥ 0.05 m/s or >1 point) responses to the PA intervention, dichotomized by adherence, for gait speed and SPPB score at 24 months. Minutes walked per week includes total center- and home-based walking over the course of the intervention.
Figure 4
Figure 4
Forest plot of the hazard ratio (HR) and 95% confidence interval (CI) of each risk factor for development of major mobility disability (MMD) among participants in the PA intervention alone according to Cox regression modeling stratified by sex. MMD was defined as inability to complete a 400m walk test within 15 minutes without sitting or help of another person or walker. Persistent MMD (PMMD) was defined by two consecutive major mobility disability assessments or major mobility disability followed by death. SPPB=Short Physical Performance Battery; BP=blood pressure; 3MSE=modified mini-mental state examination; CHAMPS=community health activities model program for seniors. *0=No and 1=Yes.
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References

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