Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Jun;16(3):e13870.
doi: 10.1002/jcsm.13870.

Adherence to Physical Activity and Incident Mobility Disability in Older Adults With Mobility Limitations

Alejandro Álvarez-Bustos  1   2   3 , Helio José Coelho-Junior  1   2   4 , Riccardo Calvani  2   4 , Leocadio Rodriguez-Mañas  1   3   5 , Matteo Tosato  4 , Matteo Cesari  6 , Antonio Cherubini  7   8 , Alfonso J Cruz-Jentoft  9 , Pálmi V Jónsson  10 , Fabrizia Lattanzio  7 , Marcello Maggio  11   12 , Regina Roller-Wirnsberger  13 , Ingrid Rýznarová  14 , Annemie M W J Schols  15 , Cornel C Sieber  16 , Alan J Sinclair  17 , Anna Skalska  18 , Timo Strandberg  19   20 , Achille Tchalla  21 , Eva Topinková  22   23 , Bruno Vellas  24   25 , Stephan von Haehling  26   27 , Francesco Landi  2   4 , Emanuele Marzetti  2   4 ; SPRINTT consortium
Affiliations
Randomized Controlled Trial

Adherence to Physical Activity and Incident Mobility Disability in Older Adults With Mobility Limitations

Alejandro Álvarez-Bustos et al. J Cachexia Sarcopenia Muscle. 2025 Jun.

Abstract

Background: Preservation of mobility independence is a primary goal in older adults with physical frailty and sarcopenia (PF&S). Interventions based on the combination of physical activity (PA) and nutritional counselling have been indicated as strategies for the management of this condition, although their effectiveness is not confirmed in all investigations. A possible explanation for this uncertain scenario relies in the impact of the adherence to PA interventions. Hence, the present study investigated the impact of the adherence to PA sessions on the incidence of mobility disability in older adults with PF&S.

Methods: This is a secondary analysis of an evaluator blinded, randomised controlled trial, developed in 16 clinical sites across 11 European countries, from January 2016 to 31 October 2019. Participants were community-dwelling older adults (70+ years) with PF&S enrolled in the SPRINTT trial (NCT02582138). PF&S was operationalised as having a total score from 3 to 9 on the short physical performance battery (SPPB), low appendicular lean mass and ability to complete the 400-m walk test in < 15 min. Data from participants allocated to a multicomponent intervention (PA with technological support plus nutritional counselling) and a healthy ageing lifestyle education programme (control group) were analysed. Adherence to PA was assessed based on the number of weekly sessions attended. According to recommendations of the American College of Sports Medicine, adherence was categorised as below recommendations (< 2 sessions/week, BR), meeting recommendations (2-3 sessions/week, MR), and above recommendations (> 3 sessions/week, AR). The primary outcome was incident mobility disability, operationalised as incident inability to complete the 400-m walk test in < 15 min during up to 36 months of follow-up.

Results: Data of 1444 participants (mean age 79.3 years, 72.6% women) were analysed. In those with SPPB scores of 3-7, MR and AR groups had lower risk of mobility disability compared with controls [MR HR (95% CI): 0.57 (0.41-0.78), p = 0.001; AR HR (95% CI): 0.33 (0.23-0.46), p < 0.001] and BR groups [MR: HR (95% CI): 0.48 (0.34-0.69), p < 0.001; AR: HR (95% CI): 0.27 (0.18-0.38), p < 0.001] in a dose-dependent manner. In those with SPPB scores of 8 or 9, the BR group had a higher risk of mobility disability than controls. MR and AR groups had a lower risk of mobility disability than the BR group.

Conclusions: In older adults with PF&S, adherence to PA recommendations is associated with lower incidence of mobility disability. This benefit depends on the degree of adherence as well as baseline physical performance.

Trial registration: ClinicalTrials.gov NCT02582138.

Keywords: disability; frailty; frequency; physical activity; sarcopenia.

PubMed Disclaimer

Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: The present work was funded by a grant from the Innovative Medicines Initiative Joint Undertaking: R.C., L.R.‐M., M.T., M.C., A.C., A.J.C.‐J., P.V.J., M.M., Fa.L., R.R.‐W., I.R., A.M.W.J.S., C.C.S., A.J.S., A.S., T.S., A.T., E.T., B.V., S.v.H., Fr.L. and E.M. received in‐kind support from the European Federation of Pharmaceutical Industries and Associations as part of the Innovative Medicines Initiative Joint Undertaking for the submitted work; A.Á.‐B. and H.J.C.J. have no conflicts of interest to declare; R.C. received personal fees from Abbott Nutrition outside the submitted work; A.C. received grants or contracts from Pfizer and Bristol Myers Squibb outside the submitted work; A.J.C.J. received personal fees from Abbott nutrition and Nutricia for lectures and from Nestlé Health Science Honoraria for lectures and manuscript writing outside the submitted work; R.R.‐W. received public funding from the EU (paid to university), personal fees from AstraZeneca, GSK, Nestlè, Nutricia/Danone, VAMED and Fresenius, support for attending meetings and/or travel from GSK and stock from Actimed, all outside the submitted work; C.C.S. declares to be EuGMS Past President, EICA President elect and Board of Directors Felix Platter Spital (Basel, Switzerland); A.T. received support from the CHU Limoges (France) outside the submitted work; T.S. declares to be the Chairperson of the National Dyslipidemia Guideline Group; received support from the University of Helsinki (Finland), Kela, Sohlberg Foundation; and personal payments from Nutricia advisory board: Valio and support for attending meetings and/or travel from EuGMS; E.T. received support from the Charles University in Prague and personal fees from Nestlè and Pfizer for lectures outside the submitted work; B.V. declares to be a leadership or fiduciary role in the ICFSR; S.v.H. received grants or contracts from Amgen, AstraZeneca, Boehringer Ingelheim, Pharmacosmos, IMI and the German Center for Cardiovascular Research (DZHK); personal payments from Amomed, AstraZeneca, Bayer, Boehringer Ingelheim, BRAHMS, Edwards Lifesciences, MSD, Novo Nordisk, Novartis, Pfizer, Pharmacosmos, Respicardia, Roche, Servier and Vifor; and stock from Actimed, all outside the submitted work; F.L. received personal fees from Abbott outside the submitted work; E.M. received personal fees from Pfizer outside the submitted work; no other relationships or activities that could appear to have influenced the submitted work.

Figures

FIGURE 1
FIGURE 1
Flow of participants through the study. aThe sum of individual items is higher than the number of ineligible participants because the screening process was not always stopped at the first unmet eligibility criterion. bSome entries are different from those previous published [18] because of data updates following database cleaning.
FIGURE 2
FIGURE 2
Changes in physical performance and appendicular lean mass based on adherence to physical activity sessions over 24 months. < 2, 2–3, > 3 = multicomponent intervention group categorisation according to weekly physical activity adherence; 4‐m GS = 4‐m gait speed, aLM = appendicular lean mass, BMI = body mass index, CST = chair stand test, HALE = healthy ageing lifestyle education, HS = handgrip strength, SPPB = short physical performance battery.
FIGURE 3
FIGURE 3
Changes in physical performance and appendicular lean mass based on adherence to physical activity sessions over 36 months. < 2, 2–3, > 3 = multicomponent intervention group categorisation according to weekly physical activity adherence; 4‐m GS = 4‐m gait speed, aLM = appendicular lean mass, BMI = body mass index, CST = chair stand test, HALE = healthy ageing lifestyle education, HS = handgrip strength, SPPB = short physical performance battery.
See this image and copyright information in PMC

References

    1. Crimmins E. M., Zhang Y., and Saito Y., “Trends Over 4 Decades in Disability‐Free Life Expectancy in the United States,” American Journal of Public Health 106 (2016): 1287–1293. - PMC - PubMed
    1. Ferrari A. J., Santomauro D. F., Aali A., et al., “Global Incidence, Prevalence, Years Lived With Disability (YLDs), Disability‐Adjusted Life‐Years (DALYs), and Healthy Life Expectancy (HALE) for 371 Diseases and Injuries in 204 Countries and Territories and 811 Subnational Locations, 1990‐2021: A Systematic Analysis for the Global Burden of Disease Study 2021,” Lancet 403 (2024): 2133–2161. - PMC - PubMed
    1. Seals D. R., Justice J. N., and Larocca T. J., “Physiological Geroscience: Targeting Function to Increase Healthspan and Achieve Optimal Longevity,” Journal of Physiology 594 (2016): 2001–2024. - PMC - PubMed
    1. The Lancet Healthy Longevity , “The Decade of Healthy Ageing: Progress and Challenges Ahead,” Lancet Healthy Longevity 5 (2024): e1. - PubMed
    1. LIFE Study Investigators , Pahor M., Blair S. N., et al., “Effects of a Physical Activity Intervention on Measures of Physical Performance: Results of the Lifestyle Interventions and Independence for Elders Pilot (LIFE‐P) Study,” Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 61 (2006): 1157–1165. - PubMed

Publication types

Associated data