A new study of more than 1,600 inactive older men and women has found that those who became active over the course of the 2.6-year study were far less likely to lose their ability to walk without assistance. This is perhaps the single most important factor in whether vulnerable older people can maintain their independence.
The Life Interventions and Independence for Elders (LIFE) trial included 1,635 sedentary men and women aged 70-89 who were at risk of disability because of factors such as poor mobility, decreased muscle tone and poor cardiovascular health. They were randomly assigned to a program of structured, moderate-intensity physical activity or to a health education program focused on topics related to successful aging. Participants were of diverse backgrounds and lived in urban, suburban and rural areas throughout the country.
Older people who lose their mobility have higher rates of disease, disability, and death. Although there is a lot of research on the benefits of regular physical activity for populations including the elderly, none has found a specific intervention to prevent disability from immobility.
In the LIFE study, researchers found that a “regular, balanced, and moderate physical activity program followed for an average of 2.6 years reduced the risk of major mobility disability by 18 percent” in an elderly group who previously did not exercise, according to materials issued by the National Institutes of Health’s National Institute on Aging (NIA). The NIH supported and funded the study.
The exercise program consisted of aerobic, resistance, and flexibility training. The results were that participants who received the exercise program were better able to maintain their ability to walk without assistance for 400 meters, or about a quarter of a mile, which was the primary measure of the study.
“We are gratified by these findings,” said Richard J. Hodes, M.D., director of the NIA, which was the primary sponsor of the trial. “They show that participating in a specific, balanced program of aerobic, resistance, and flexibility training activities can have substantial positive benefits for reducing risk of mobility disability. These are actionable results that can be applied today to make a difference for many frail older people and their families.”
Participation in the study averaged 2.6 years. The physical activity group of 818 people gradually worked up to the goal of 150 minutes of weekly activity, including 30 minutes of brisk walking, 10 minutes of lower extremity strength training, 10 minutes of balance training, and large muscle flexibility exercises. Their programs took place at a clinic twice a week and at home three or four times a week.
The 817 people in the comparison group participated in weekly health education workshops for the first 26 weeks, followed by monthly sessions thereafter. They also performed five to 10 minutes of upper body stretching and flexibility exercises in each session. Participants in both groups were assessed every six months at clinic visits.
Adherence to the program was measured by attendance at sessions and by questionnaires in which participants recorded the number of hours per week that they were physically active. In addition, participants’ activity was recorded for one week during each year of the trial through an accelerometer, a small belt device that measures physical activity.
“At the beginning of this trial, all the participants were at high risk for mobility disability,” said Evan Hadley, M.D., director of the NIA Division of Geriatrics and Clinical Gerontology. “At the start, they were able to walk about a quarter of a mile without a cane, walker, or help of another person. But they did have sedentary lifestyles and low scores on some standard physical tests that measure risk for disability. The study shows it is never too late for exercise to have a positive effect for a significant portion of frail older people.”
A previous national exercise and physical activity campaign launched in 2011 by NIA, “Go4Life,” showed similar results as the LIFE study, which found that older people at risk of disability also gain physical benefits from regular exercise.
In 2011, NIA launched Go4Life, a national exercise and physical activity campaign, based on benefits of exercise (especially walking) for adults age 50 and older. The LIFE study adds to that evidence with findings that older people vulnerable to disability can also be included among those who could reap rewards from regular physical activity.