Maintenance of physical function 1 year after exercise intervention in at-risk older adults: follow-up from the LIFE study

Authors: HENDERSON, REBECCA - Wake Forest University; MILLER, MICHAEL - Wake Forest University; FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; GILL, THOMAS - Yale University; GLYNN, NANCY - University Of Pittsburgh; GURALNIK, JACK - University Of Maryland; KING, ABBY - Stanford University; NEWMAN, ANNE - University Of Pittsburgh; MANINI, TODD - University Of Pittsburgh; MARSH, ANTHONY - Wake Forest University; PAHOR, MARCO - University Of Florida; MCDERMOTT, MARY - Northwestern University; REJESKI, JACK - Wake Forest University; TUDOR-LOCKE, CATRINE - University Of Massachusetts; KRITCHEVSKY, STEPHEN - Wake Forest University

Submitted to: Journal of Gerontology Medical Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/3/2017
Publication Date: 2/27/2018
Citation: Henderson, R.M., Miller, M.E., Fielding, R.A., Gill, T.M., Glynn, N.W., Guralnik, J.M., King, A., Newman, A.B., Manini, T.M., Marsh, A.P., Pahor, M., McDermott, M.M., Rejeski, J., Tudor-Locke, C., Kritchevsky, S. 2018. Maintenance of physical function 1 year after exercise intervention in at-risk older adults: follow-up from the LIFE study. Journal of Gerontology Medical Science. 73(5):688-694. https://doi.org/10.1093/gerona/glx231.
DOI: https://doi.org/10.1093/gerona/glx231

Interpretive Summary: Using data from the Lifestyle Interventions for Elders (LIFE) study, we examined whether older adults who were randomized to a structured program of physical activity for an average of 2 years sustained this physical activity once the formal intervention stopped. We examined all participants one year after the intervention ended. Although sedentary at-risk older adults increased their physical activity during the structured physical activity intervention, they did not continue at this level following the cessation of the study intervention. Future exercise interventions need to include novel methods to support older adults in continued physical activity following structured interventions.

Technical Abstract: Background: Structured physical activity interventions delay the onset of disability for at-risk older adults. However, it is not known if at-risk older adults continue to participate in physical activity or maintain mobility benefits after cessation of structured intervention. Methods: One thousand six hundred and thirty-five sedentary men and women aged 70-89 years with Short Physical Performance Battery (SPPB) scores of 9 or less and able to walk 400 m were randomized to a structured, moderate-intensity physical activity (PA) program consisting of center-based (twice/week) and home-based (three to four times per week) aerobic, resistance, and flexibility training or a health education (HE) program combined with upper extremity stretching. Results: Most of the participants (88% of HE and 87% of PA) returned for a follow-up visit (POST) 1 year after cessation of formal intervention. The HE group reported about 1-hour less activity per week than the PA group at end of intervention (LAST TRIAL; -68.9; 95% confidence interval [CI] = -86.5 to -51.3) but similar weekly activity at POST (-13.5; 95% CI = -29.5 to 2.47). SPPB did not differ between the two groups at LAST TRIAL (-0.06; 95% CI = -0.31 to 0.19) nor POST (-0.18; 95% CI = -0.45 to 0.088). Conclusions: Although sedentary at-risk older adults increased their physical activity during a structured physical activity intervention, they did not continue at this level following the cessation of intervention. Future exercise interventions need to include novel methods to support older adults in continued physical activity following structured interventions.