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Randomized Controlled Trial
. 2018 Oct 10;73(8):1501-1513.
doi: 10.1093/geronb/gbx051.

Social Participation Modifies the Effect of a Structured Physical Activity Program on Major Mobility Disability Among Older Adults: Results From the LIFE Study

Duane B Corbett  1 , W Jack Rejeski  2 , Catrine Tudor-Locke  3 , Nancy W Glynn  4 , Stephen B Kritchevsky  5 , Mary M McDermott  6 , Timothy S Church  7 , Roger A Fielding  8 , Thomas M Gill  9 , Abby C King  10 , Michael E Miller  11 , Haiying Chen  11 , Marco Pahor  1 , Todd M Manini  1 ; LIFE Study Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Social Participation Modifies the Effect of a Structured Physical Activity Program on Major Mobility Disability Among Older Adults: Results From the LIFE Study

Duane B Corbett et al. J Gerontol B Psychol Sci Soc Sci. .

Abstract

Objectives: To investigate whether baseline social participation modifies the effect of a long-term structured physical activity (PA) program on major mobility disability (MMD).

Methods: 1,635 sedentary adults (70-89 years) with physical limitations were randomized to either a structured PA or health education (HE) intervention. Social participation was defined categorically at baseline. High social participation was defined as attending organized group functions at least once per week and visiting with noncohabitating friends and family ≥7 hr per week. Anything less was considered limited social participation. Participants performed a standardized walking test at baseline and every 6 months for up to 42 months. MMD was defined as the loss in the ability to walk 400 m.

Results: There was a significant intervention by social participation interaction (p = .003). Among individuals with high levels of social participation, those randomized to PA had significantly lower incidence of MMD (hazard ratio [HR], 0.43 [95% confidence interval (CI), 0.27-0.68]; p < .01) than those randomized to HE. Individuals with limited social participation showed no mobility benefit of the PA intervention when compared with their HE counterparts (HR, 0.92 [95% CI, 0.77-1.11]; p = .40).

Discussion: Our findings suggest that baseline social participation is an important factor for the success of a PA intervention aimed at delaying mobility disability.

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Figures

Figure 1.
Figure 1.
Moderating effect of continuously measured social participation on a long-term moderate physical activity intervention to delay the onset of major mobility disability (A) and persistent mobility disability (B). Solid line indicates log-hazard ratio, dotted lines indicate 95% confidence intervals. There was a stronger intervention effect for higher social participation for both major (p = .05) and persistent (p = .16) mobility disability. HE = health education; PA = physical activity.
Figure 2.
Figure 2.
Moderating effect of categorically measured social participation on a long-term moderate physical activity intervention to delay the onset of major (A) and persistent (B) mobility disability. There was no effect of baseline social participation on the incidence of major mobility disability (MMD) (p > .40) but there was a significant intervention by social participation interaction (p = .003). Highly social participants randomized to PA had significantly lower incidence of MMD (hazards ratio [HR], 0.43 [95% confidence interval (CI), 0.27–0.68]; p < .01) compared with their highly social HE counterparts. Individuals who had limited social participation showed no benefit of the PA intervention (HR, 0.92 [95% CI, 0.77–1.11]; p = .40). There was also a modification of social participation on persistent MMD (p = .038). Individuals with high levels of social participation randomized to PA had significantly lower incidence of persistent MMD compared to those randomized to HE (HR, 0.37 [95% CI, 0.19–0.74]; p < .01). The results of the intervention on individuals with limited social participation showed no effect of PA on persistent MMD compared to those randomized to HE (HR, 0.80 [95% CI, 0.62–1.03]; p = .09). HE = health education; PA = physical activity.
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