|Vaz Fragoso, Carlos - Yale University|
|Beavers, Daniel - Wake Forest School Of Medicine|
|Anton, Stephen - University Of Florida|
|Liu, Christine - Boston University|
|Mcdermott, Mary - Northwestern University|
|Newman, Anne - University Of Pittsburgh|
|Pahor, Marco - University Of Florida|
|Stafford, Randall - Stanford University|
|Gill, Thomas - Yale University|
|Reid, Kieran - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Fielding, Roger - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
Submitted to: Journal of American Geriatric Society
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/5/2015
Publication Date: 3/1/2016
Citation: Vaz Fragoso, C.A., Beavers, D.P., Anton, S.D., Liu, C.K., Mcdermott, M.M., Newman, A.B., Pahor, M., Stafford, R.S., Gill, T.M., Reid, K.F., Fielding, R.A. 2016. Effect of structured physical activity on respiratory outcomes in sedentary elderly adults with mobility limitations. Journal of American Geriatric Society. 64(3):501-509. doi: 10.1111/jgs.14013.
Interpretive Summary: This study evaluated the effects of a structured physical activity program on respiratory outcomes in older adults with mobility limitations. Older adults enrolled in the Lifestyle Interventions for Elders (LIFE) study were evaluated for their lung function and hospitalizations related to worsening of breathing symptoms. We found that physical activity had no effect on measures of lung function. However, physical activity was associated with higher likelihood of respiratory hospitalization. These results suggest that in older persons with mobility limitations, physical activity was associated with higher likelihood of respiratory hospitalization than health education, but differences in lung function did not accompany this effect indicating that higher hospital use could be attributable to greater participant contact.
Technical Abstract: OBJECTIVES: To evaluate the effect of structured physical activity on respiratory outcomes in community dwelling elderly adults with mobility limitations. DESIGN: Multicenter, randomized trial of physical activity vs health education, with respiratory variables prespecified as tertiary outcomes over an intervention period of 24-42 months. Physical activity included walking (goal of 150 min/week) and strength, flexibility, and balance training. Health education included workshops on topics relevant to older adults and upper extremity stretching exercises. SETTING: Lifestyle Interventions and Independence in Elders (LIFE) Study. PARTICIPANTS: Community dwelling persons aged 70-89 with Short Physical Performance Battery scores less than 10 (N = 1,635). MEASUREMENTS: Dyspnea severity (defined as moderate to severe according to a Borg index >2 immediately after a 400 m walk), forced expiratory volume in 1 second (FEV1) (<lower limit of normal (LLN) defined low breathing capacity), and maximal inspiratory pressure (MIP) (<LLN defined respiratory muscle weakness) were assessed at baseline and 6, 18, and 30 months. Hospitalization for exacerbation of obstructive airways disease (EOAD) and pneumonia was also ascertained over the 42 month follow up period. RESULTS: The randomized groups were similar in baseline demographics, including mean age (79) and sex (67% female). The effect of physical activity on dyspnea severity, FEV1, and MIP was no different from that of health education but was associated with higher likelihood of respiratory hospitalization, significantly for EOAD (hazard ratio (HR) = 2.34, 95% confidence interval (CI) = 1.19 4.61, P = .01) and marginally for pneumonia (HR = 1.54, 95% CI = 0.98 2.42, P = .06). CONCLUSION: In older persons with mobility limitations, physical activity was associated with higher likelihood of respiratory hospitalization than health education, but differences in dyspnea severity, FEV1, and MIP did not accompany this effect indicating that higher hospital use could be attributable to greater participant contact.