In what its authors call "the largest and longest duration randomized trial of physical activity in older persons," a new study asserts that a carefully structured, moderate physical activity program can reduce risk of losing the ability to walk without assistance.
The Lifestyle Interventions and Independence for Elders (LIFE) trial included 1,635 sedentary men and women aged 70-89 at risk of disability. Participants were randomly assigned to a program of structured, moderate-intensity physical activity or to a health education program focused on topics related to successful aging, and then monitored for 2.6 years. The diverse participants were recruited from urban, suburban, and rural communities across the US. Results are available for free in the May 27 issue of JAMA, the Journal of the American Medical Association.
The physical activity intervention involved walking as well as strength, flexibility, and balance training. Participants in this group attended 2 center-based visits a week in individualized sessions that worked toward a goal of 30 minutes of walking daily at moderate intensity, 10 minutes of primarily lower extremity strength training by means of ankle weights (2 sets of 10 repetitions), 10 minutes of balance training, and large muscle group flexibility exercises.
Participants in the health education program attended weekly education sessions on healthy aging for the first 26 weeks of the intervention, and then monthly sessions. According to the study's authors, the workshops "included topics relevant to older adults," but did not address physical activity. Participants did receive "a 5 to 10-minute instructor-led program of gentle upper extremity stretching or flexibility exercises."
Participants were assessed every 6 months at clinic visits over 2.6 years. Clinicians performing the assessments were not aware of which participants were in which groups.
Results showed that the incidence of major mobility disability (defined in this study as the inability to complete a 400-m walk test within 15 minutes without sitting and without the help of another person or walker) was markedly higher among the education group, with 35.5% of that group experiencing the disability compared with 30.1% of the physical activity group. Additionally, persistent mobility disability was experienced by 19.8% of the education group and 14.7% of the physical activity group. Authors also write that participants who began the study with lower baseline levels of activity received "considerable benefit" from the activity intervention.
"These results suggest the potential for structured physical activity as a feasible and effective intervention to reduce the burden of disability among vulnerable older persons, in spite of functional decline in late life," authors write. The researchers were supported by the National Institute on Aging (NIA) and the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
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