Jason Fanning1,2, W Jack Rejeski1, Shyh-Huei Chen3, Barbara J Nicklas2, Michael P Walkup3, Robert S Axtell4, Roger A Fielding5, Nancy W Glynn6, Abby C King7, Todd M Manini8, Mary M McDermott9, Anne B Newman10, Marco Pahor8, Catrine Tudor-Locke11, Michael E Miller3. 1. Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina. 2. Department of internal medicine, section on gerontology and geriatric medicine, Winston-Salem, North Carolina. 3. Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina. 4. Department of Exercise Science, Southern Connecticut State University, New Haven. 5. Jean Mayer USDA Human Nutrition Research Center on Aging, Nutrition, Exercise Physiology and Sarcopenia Laboratory, Tufts University, Boston, Massachusetts. 6. Department of epidemiology, University of Pittsburgh, Pennsylvania. 7. Department of Health Research and Policy and Stanford Prevention Research Center, Palo Alto, California. 8. Department of Aging and Geriatric Research, University of Florida, Gainesville. 9. Devision of General Internal medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 10. Department Epidemiology and Medicine, University of Pittsburgh, Pennsylvania. 11. Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts.
Abstract
BACKGROUND: The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD)-a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD. METHODS:Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry. RESULTS: A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53%). Within health education, both baseline LM (HR = 0.74; 95% CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95% CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95% CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p < .04), whereby risk for MMD was lower among individuals with higher levels of LM. CONCLUSIONS: Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD. TRIAL REGISTRATION: clinicaltrials.gov Identifier NCT01072500.
RCT Entities:
BACKGROUND: The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD)-a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD. METHODS: Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry. RESULTS: A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53%). Within health education, both baseline LM (HR = 0.74; 95% CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95% CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95% CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p < .04), whereby risk for MMD was lower among individuals with higher levels of LM. CONCLUSIONS: Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD. TRIAL REGISTRATION: clinicaltrials.gov Identifier NCT01072500.
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