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Activity Adherence and Physical Function in Older Adults with Functional Limitations

FIELDING, ROGER A.1; KATULA, JEFFREY2; MILLER, MICHAEL E.3; ABBOTT-PILLOLA, KARI4; JORDAN, ALEXANDER5; GLYNN, NANCY W.6; GOODPASTER, BRETT6; WALKUP, MICHAEL P.3; KING, ABBY C.4; REJESKI, W. JACK2and for the LIFE STUDY INVESTIGATORS

Medicine & Science in Sports & Exercise: November 2007 - Volume 39 - Issue 11 - p 1997-2004
doi: 10.1249/mss.0b013e318145348d
BASIC SCIENCES: Original Investigations

Purpose: Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) was a trial to examine the effects of a physical activity intervention (PA) compared with a health education control (SA) on measures of disability risk in sedentary older adults (N = 424). We examined adherence to the LIFE-P PA intervention for the first 12 months of the trial.

Methods: The PA intervention consisted of walking, strength, flexibility, and balance training supplemented with behavioral skills training modules, and it used a phased, center-based schedule of adoption (3× wk−1, weeks 1-8), transition (2× wk−1, weeks 9-24), and maintenance (1× wk−1, weeks 25 to end of trial) while transitioning to primarily home-based physical activity. SA consisted of weekly (weeks 1-26) transitioning to monthly health education workshops.

Results: Participation in moderate-intensity physical activity increased from baseline to months 6 and 12 in PA compared with SA (P < 0.001). At 12 months, PA participants who reported ≥ 150 min·wk−1 of moderate activity demonstrated a significantly greater improvement in their Short Physical Performance Battery score compared with participants who reported < 150 min·wk−1 of moderate activity (P < 0.017). For the PA arm, center-based attendance was 76.3 ± 24.5, 65.4 ± 28.6, and 49.8 ± 35.8% in the adoption, transition, and maintenance phases, respectively.

Conclusions: Adherence to physical activity in LIFE-P was associated with greater improvement in SPPB score and was consistent with adherence in physical activity trials of shorter duration in this subgroup of older adults. Older individuals at risk for disability can adhere to a regular program of physical activity in a long-term randomized trial.

1Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA; 2Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC; 3Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC; 4Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA; 5The Cooper Institute, Dallas, TX; and 6Healthy Aging Research Program, University of Pittsburgh, Pittsburgh, PA

Address for correspondence: Roger A. Fielding, Ph.D., Director and Senior Scientist, Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St., Boston, MA 02111; E-mail: roger.fielding@tufts.edu.

Submitted for publication February 2007.

Accepted for publication June 2007.

©2007The American College of Sports Medicine