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Title: Effect of statin use on mobility disability and its prevention in at-risk older adults: the LIFE study

Author
item HENDERSON, REBECCA - Wake Forest University
item LOVATO, LAURA - Wake Forest University
item MILLER, MICHAEL - Wake Forest University
item FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item CHURCH, TIM - Pennington Biomedical Research Center
item NEWMAN, ANNE - University Of Pittsburgh
item BUFORD, THOMAS - University Of Florida
item PAHOR, MARCO - Northwestern University
item MCDERMOTT, MARY - Northwestern University
item STAFFORD, RANDALL - Stanford University
item LEE, DAVID - Oregon State University
item KRITCHEVSKY, STEPHEN - Wake Forest University

Submitted to: Journal of Gerontology Medical Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/1/2016
Publication Date: 3/17/2016
Citation: Henderson, R.M., Lovato, L., Miller, M.E., Fielding, R.A., Church, T.S., Newman, A.B., Buford, T.W., Pahor, M., McDermott, M.M., Stafford, R.S., Lee, D.S., Kritchevsky, S.B. 2016. Effect of statin use on mobility disability and its prevention in at-risk older adults: the LIFE study. Journal of Gerontology Medical Science. https://doi.org/10.1093/gerona/glw057.

Interpretive Summary: Lipid lowering medications (statins) may affect muscle function and impair exercise capacity. This subgroup analysis of the Lifestyle Intervention and Independence for Elders trial evaluated the impact of a long-term physical activity (PA) intervention on development of the inability to walk among older adults according to lipid lowering (statin) medication use. Lifestyle Intervention and Independence for Elders study participants were randomized to center-based PA or health education for a median of 2.7 years. Participants were sedentary men and women aged 70-89 years with objectively measured physical limitations. The effects of long-term PA on the incidence of inability to walk 400 M was similar among subgroups of older adults stratified by their statin medication use. Several findings may warrant future study in other cohorts given the post hoc nature of this study.

Technical Abstract: BACKGROUND: HMG-CoA reductase inhibitors (statins) are among the most commonly prescribed classes of medications. Although their cardiovascular benefits and myalgia risks are well documented, their effects on older adults initiating an exercise training program are less understood. METHODS: 1,635 sedentary men and women aged 70-89 years with Short Physical Performance Battery (SPPB) score of 9 or below and were able to walk 400 m were randomized to a structured, moderate-intensity physical activity (PA) program consisting of both center-based (twice/wk) and home-based (3-4 times/wk) aerobic, resistance, and flexibility training or to a health education (HE) program combined with upper extremity stretching. RESULTS: Overall, the PA intervention was associated with lower risk of major mobility disability (hazard ratio [HR] = 0.82; 95% confidence interval [CI] = 0.69-0.98). The effect was similar (p value for interaction = .62) in both statin users (PA n = 415, HE n = 412; HR = 0.86, 95% CI = 0.67-1.1) and nonusers (PA n = 402, HE n = 404; HR = 0.78, 95% CI = 0.61-1.01). Attendance was similar for statin users (65%) and nonusers (63%). SPPB at 12 months was slightly greater for PA (8.35+/-0.10) than for HE (7.94+/-0.10) in statin users but not in nonusers (PA 8.25+/-0.10, HE 8.16+/-0.10), though the interaction effect was not statistically significant. Self-reported PA levels were not different between statin users and nonusers. CONCLUSIONS: Although statins have been associated with adverse effects on muscle, data from the LIFE Study show that statin users and nonusers both benefit from PA interventions. Older adults who require statin medications to manage chronic medical conditions and are sedentary will be able to benefit from interventions to increase PA.