Predictors of Change in Physical Function in Older Adults in Response to Long-Term, Structured Physical Activity: The LIFE Study

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• 作者：Andrew S. Layne ; MA^a ; Fang-Chi Hsu ; PhD^c ; Steven N. Blair ; PED^e ; Shyh-Huei Chen ; PhD^c ; Jennifer Dungan ; PhD^f ; Roger A. Fielding ; PhD^g ; Nancy W. Glynn ; PhD^h ; Alexandra M. Hajduk ; PhDⁱ ; Abby C. King ; PhD^j ; Todd M. Manini ; PhD^b ; Anthony P. Marsh ; PhD^d ; Marco Pahor ; MD^b ; Christine A. Pellegrini ; PhD^k ; Thomas W. Buford ; PhD^b ; ^{tbuford@ufl.edu} ; for the LIFE Study InvestigatorsMarco Pahor ; MD ; Jack M. Guralnik ; MD ; PhD (Co-Investigator of the LIFE Study) ; Christiaan Leeuwenburgh ; PhD ; Connie Caudle ; Lauren Crump ; MPH ; Latonia Holmes ; Jocelyn Lee ; PhD ; Ching-ju Lu ; MPH ; Michael E. Miller ; PhD (DMAQC Principal Investigator) ; Mark A. Espeland ; PhD (DMAQC Co-Investigator) ; Walter T. Ambrosius ; PhD ; William Applegate ; MD ; Daniel P. Beavers ; PhD ; MS ; Robert P. Byington ; PhD ; MPH ; FAHA ; Delilah Cook ; CCRP ; Curt D. Furberg ; MD ; PhD ; Lea N. Harvin ; BS ; Leora Henkin ; MPH ; Med ; John Hepler ; MA ; Fang-Chi Hsu ; PhD ; Laura Lovato ; MS ; Wesley Roberson ; BSBA ; Julia Rushing ; BSPH ; MStat ; Scott Rushing ; BS ; Cynthia L. Stowe ; MPM ; Michael P. Walkup ; MS ; Don Hire ; BS ; W. Jack Rejeski ; PhD ; Jeffrey A. Katula ; PhD ; MA ; Peter H. Brubaker ; PhD ; Shannon L. Mihalko ; PhD ; Janine M. Jennings ; PhD ; Evan C. Hadley ; MD ; Sergei Romashkan ; MD ; PhD ; Kushang V. Patel ; PhD ; Denise Bonds ; MD ; MPH ; Mary M. McDermott ; MD (Field Center Principal Investigator) ; Bonnie Spring ; PhD (Field Center Co-Investigator) ; Joshua Hauser ; MD (Field Center Co-Investigator) ; Diana Kerwin ; MD (Field Center Co-Investigator) ; Kathryn Domanchuk ; BS ; Rex Graff ; MS ; Alvito Rego ; MA ; Timothy S. Church ; MD ; PhD ; MPH (Field Center Principal Investigator) ; Steven N. Blair ; PED ; Valerie H. Myers ; PhD ; Ron Monce ; PA-C ; Nathan E. Britt ; NP ; Melissa Nauta Harris ; BS ; Ami Parks McGucken ; MPA ; BS ; Ruben Rodarte ; MBA ; MS ; BS ; Heidi K. Millet ; MPA ; BS ; Catrine Tudor-Locke ; PhD ; FACSM ; Ben P. Butitta ; BS ; Sheletta G. Donatto ; MS ; RD ; LDN ; CDE ; Shannon H. Cocreham ; BS ; Abby C. King ; PhD (Field Center Principal Investigator) ; Cynthia M. Castro ; PhD ; William L. Haskell ; PhD ; Randall S. Stafford ; MD ; PhD ; Leslie A. Pruitt ; PhD ; Kathy Berra ; MSN ; NP-C ; FAAN ; Veronica Yank ; MD ; Roger A. Fielding ; PhD (Field Center Principal Investigator) ; Miriam E. Nelson ; PhD (Field Center Co-Investigator) ; Sara C. Folta ; PhD (Field Center Co-Investigator) ; Edward M. Phillips ; MD ; Christine K. Liu ; MD ; Erica C. McDavitt ; MS ; Kieran F. Reid ; PhD ; MPH ; Won S. Kim ; BS ; Vince E. Beard ; BS ; Todd M. Manini ; PhD (Field Center Principal Investigator) ; Marco Pahor ; MD (Field Center Co-Investigator) ; Stephen D. Anton ; PhD ; Susan Nayfield ; MD ; Thomas W. Buford ; PhD ; Michael Marsiske ; PhD ; Bhanuprasad D. Sandesara ; MD ; Jeffrey D. Knaggs ; BS ; Megan S. Lorow ; BS ; William C. Marena ; MT ; CCRC ; Irina Korytov ; MD ; Holly L. Morris ; MSN ; RN ; CCRC ; Margo Fitch ; PT ; Floris F. Singletary ; MS ; CCC-SLP ; Jackie Causer ; BSH ; RN ; Katie A. Radcliff ; MA ; Anne B. Newman ; MD ; MPH (Field Center Principal Investigator) ; Stephanie A. Studenski ; MD ; MPH (Field Center Co-Investigator) ; Bret H. Goodpaster ; PhD ; Nancy W. Glynn ; PhD ; Oscar Lopez ; MD ; Neelesh K. Nadkarni ; MD ; PhD ; Kathy Williams ; RN ; BSEd ; MHSA ; Mark A. Newman ; PhD ; George Grove ; MS ; Janet T. Bonk ; MPH ; RN ; Jennifer Rush ; MPH ; Piera Kost ; BA (deceased) ; Diane G. Ives ; MPH ; Stephen B. Kritchevsky ; PhD (Field Center Principal Investigator) ; Anthony P. Marsh ; PhD (Field Center Co-Investigator) ; Tina E. Brinkley ; PhD ; Jamehl S. Demons ; MD ; Kaycee M. Sink ; MD ; MAS ; Kimberly Kennedy ; BA ; CCRC ; Rachel Shertzer-Skinner ; MA ; CCRC ; Abbie Wrights ; MS ; Rose Fries ; RN ; CCRC ; Deborah Barr ; MA ; RHEd ; CHES ; Thomas M. Gill ; MD (Field Center Principal Investigator) ; Robert S. Axtell ; PhD ; FACSM (Field Center Co-Investigator) ; Susan S. Kashaf ; MD ; MPH ; Nathalie de Rekeneire ; MD ; MS ; Joanne M. McGloin ; MDiv ; MS ; MBA ; Karen C. Wu ; RN ; Denise M. Shepard ; RN ; MBA ; Barbara Fennelly ; MA ; RN ; Lynne P. Iannone ; MS ; CCRP ; Raeleen Mautner ; PhD ; Theresa Sweeney Barnett ; MS ; APRN ; Sean N. Halpin ; MA ; Matthew J. Brennan ; MA ; Julie A. Bugaj ; MS ; Maria A. Zenoni ; MS ; Bridget M. Mignosa ; Jeff Williamson ; MD ; MHS (Center Principal Investigator) ; Kaycee M. Sink ; MD ; MAS (Center Co-Investigator) ; Hugh C. Hendrie ; MB ; ChB ; DSc ; Stephen R. Rapp ; PhD ; Joe Verghese ; MB ; BS ; Nancy Woolard ; Mark Espeland ; PhD ; Janine Jennings ; PhD ; Carl J. Pepine ; MD ; MACC ; Mario Ariet ; PhD ; Eileen Handberg ; PhD ; ARNP ; Daniel Deluca ; BS ; James Hill ; MD ; MS ; FACC ; Anita Szady ; MD ; Geoffrey L. Chupp ; MD ; Gail M. Flynn ; RCP ; CRFT ; Thomas M. Gill ; MD ; John L. Hankinson ; PhD ; Carlos A. Vaz Fragoso ; MD ; Erik J. Groessl ; PhD ; Robert M. Kaplan ; PhD
• 关键词：Aging ; Exercise ; Individuality ; Rehabilitation ; Resistance training ; Walking
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：98
• 期：1
• 页码：11-24.e3
• 全文大小：803 K
• 卷排序：98

文摘

To evaluate the extent of variability in functional responses in participants in the Lifestyle Interventions and Independence for Elders (LIFE) study and to identify the relative contributions of intervention adherence, physical activity, and demographic and health characteristics to this variability.DesignSecondary analysis.SettingMulticenter institutions.ParticipantsA volunteer sample (N=1635) of sedentary men and women aged 70 to 89 years who were able to walk 400m but had physical limitations, defined as a Short Physical Performance Battery (SPPB) score of ≤9.InterventionsModerate-intensity physical activity (n=818) consisting of aerobic, resistance, and flexibility exercises performed both center-based (2times/wk) and home-based (3–4times/wk) sessions or health education program (n=817) consisting of weekly to monthly workshops covering relevant health information.Main Outcome MeasuresPhysical function (gait speed over 400m) and lower extremity function (SPPB score) assessed at baseline and 6, 12, and 24 months.ResultsGreater baseline physical function (gait speed, SPPB score) was negatively associated with change in gait speed (regression coefficient β=−.185; P<.001) and change in SPPB score (β=−.365; P<.001), whereas higher number of steps per day measured by accelerometry was positively associated with change in gait speed (β=.035; P<.001) and change in SPPB score (β=.525; P<.001). Other baseline factors associated with positive change in gait speed and/or SPPB score include younger age (P<.001), lower body mass index (P<.001), and higher self-reported physical activity (P=.002).ConclusionsSeveral demographic and physical activity–related factors were associated with the extent of change in functional outcomes in participants in the LIFE study. These factors should be considered when designing interventions for improving physical function in older adults with limited mobility.