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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #364086
Title: A case for promoting movement medicine: preventing disability in the LIFE Randomized Controlled Trial

Author
item FANNING, JASON - Wake Forest University
item REJESKI, W. JACK - Wake Forest University
item CHEN, SHYH-HUEI - Wake Forest University
item NICKLAS, BARBARA - Wake Forest University
item WALKUP, MICHAEL - Wake Forest University
item AXTELL, ROBERT - Southern Connecticut State University
item FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item GLYNN, NANCY - University Of Pittsburgh
item KING, ABBY - Stanford University
item MANINI, TODD - University Of Florida
item MCDERMOTT, MARY - Northwestern University
item NEWMAN, ANNE - University Of Pittsburgh
item PAHOR, MARCO - University Of Florida
item TUDOR-LOCKE, CATRINE - University Of Massachusetts
item MILLER, MICHAEL - Wake Forest University

Submitted to: Journal of Gerontology Medical Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/10/2019
Publication Date: 2/19/2019
Citation: Fanning, J., Rejeski, W., Chen, S., Nicklas, B.J., Walkup, M.P., Axtell, R.S., Fielding, R.A., Glynn, N.W., King, A.C., Manini, T.M., McDermott, M.M., Newman, A.B., Pahor, M., Tudor-Locke, C., Miller, M.E. 2019. A case for promoting movement medicine: preventing disability in the LIFE Randomized Controlled Trial. Journal of Gerontology Medical Science. https://doi.org/10.1093/gerona/glz050.
DOI: https://doi.org/10.1093/gerona/glz050

Interpretive Summary: The pattern of movement of older adults with compromised function is unknown, as is the relationship between movement patterns and the development of disability. In this paper, we attempted to describe the dimensions of movement in older adults with compromised function and examine whether these dimensions are related to the development of disability. Over one thousand older adults at risk for becoming disabled were randomized to receive a structured physical activity program or health education program. Using a waist worn activity monitor we found three components or patterns of movement that were associated with most physical activity during the day: lifestyle movement (normal activities of daily living), extended bouts of moderate-to-vigorous physical activity (moderate to vigorous physical activity), and stationary body posture (standing). We found that lifestyle movement and moderate-to-vigorous physical activity were associated with development of disability. Both lifestyle movement and moderate-to-vigorous physical activity should be key components of treatment for older adults at risk of disability.

Technical 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.