Robert T Mankowski1, Stephen D Anton1, Robert Axtell2, Shyh-Huei Chen3, Roger A Fielding4, Nancy W Glynn5, Fang-Chi Hsu3, Abby C King6,7, Andrew S Layne1, Christiaan Leeuwenburgh1, Todd M Manini1, Anthony P Marsh8, Marco Pahor1, Catrine Tudor-Locke9, David E Conroy10, Thomas W Buford11. 1. Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida. 2. Department of Exercise Science, Southern Connecticut State University, New Haven, Connecticut. 3. Department of Biostatistics, School of Medicine, Wake Forest University, Winston-Salem, North Carolina. 4. Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts. 5. Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania. 6. Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California. 7. Stanford Prevention Research Center, Department of Medicine, School of Medicine, Stanford University, Stanford, California. 8. Department of Health and Exercise Science, School of Medicine, Wake Forest University, Winston-Salem, North Carolina. 9. Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts. 10. Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania. 11. Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Abstract
OBJECTIVES: To examine associations between objectively measured physical activity (PA) and incidence of major mobility disability (MMD) and persistent MMD (PMMD) in older adults in the Lifestyle Interventions and Independence for Elders (LIFE) Study. DESIGN: Prospective cohort of individuals aged 65 and older undergoing structured PA intervention or health education. SETTING: The LIFE Study was a multicenter (eight sites) randomized controlled trial designed to compare the efficacy of a long-term structured PA intervention with that of a health education (HE) program in reducing the incidence of MMD in mobility-limited older adults. PARTICIPANTS: LIFE Study participants (n = 1,590) had a mean age±standard deviation of 78.9 ± 5.2, low levels of PA, and measured mobility-relevant functional impairment at baseline. MEASUREMENTS: Activity data were collected using hip-worn 7-day accelerometers at baseline and 6, 12, and 24 months after randomization to test for associations with incident MMD and PMMD (≥2 consecutive instances of MMD). RESULTS: At baseline, every 30 minutes spent being sedentary (<100 accelerometry counts per minute) was associated with higher rate of subsequent MMD (10%) and PMMD (11%) events. Every 500 steps taken was associated with lower rate of MMD (15%) and PMMD (18%). Similar associations were observed when fitting accelerometry-based PA as a time-dependent variable. CONCLUSION:Accelerometry-based PA levels were strongly associated with MMD and PMMD events in older adults with limited mobility. These results support the importance of daily PA and lower amounts of sedentary time levels in this population and suggest that accelerometry may be a useful tool for assessing risk of mobility disability.
RCT Entities:
OBJECTIVES: To examine associations between objectively measured physical activity (PA) and incidence of major mobility disability (MMD) and persistent MMD (PMMD) in older adults in the Lifestyle Interventions and Independence for Elders (LIFE) Study. DESIGN: Prospective cohort of individuals aged 65 and older undergoing structured PA intervention or health education. SETTING: The LIFE Study was a multicenter (eight sites) randomized controlled trial designed to compare the efficacy of a long-term structured PA intervention with that of a health education (HE) program in reducing the incidence of MMD in mobility-limited older adults. PARTICIPANTS: LIFE Study participants (n = 1,590) had a mean age±standard deviation of 78.9 ± 5.2, low levels of PA, and measured mobility-relevant functional impairment at baseline. MEASUREMENTS: Activity data were collected using hip-worn 7-day accelerometers at baseline and 6, 12, and 24 months after randomization to test for associations with incident MMD and PMMD (≥2 consecutive instances of MMD). RESULTS: At baseline, every 30 minutes spent being sedentary (<100 accelerometry counts per minute) was associated with higher rate of subsequent MMD (10%) and PMMD (11%) events. Every 500 steps taken was associated with lower rate of MMD (15%) and PMMD (18%). Similar associations were observed when fitting accelerometry-based PA as a time-dependent variable. CONCLUSION: Accelerometry-based PA levels were strongly associated with MMD and PMMD events in older adults with limited mobility. These results support the importance of daily PA and lower amounts of sedentary time levels in this population and suggest that accelerometry may be a useful tool for assessing risk of mobility disability.
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