A case for promoting movement medicine: preventing disability in the LIFE randomized controlled trial

A case for promoting movement medicine: preventing disability in the LIFE randomized controlled trial. Fanning, J., Rejeski, W J., 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., Tudorlocke, C., & Miller, M. I Journals of Gerontology Series A-biological Sciences and Medical Sciences, 74(11):1821–1827, 2019. Citation Key Alias: ISI:000491242600017, lens.org/077-007-606-131-474 tex.type: [object Object]

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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.

@article{pop00036,
	title = {A case for promoting movement medicine: preventing disability in the {LIFE} randomized controlled trial},
	volume = {74},
	issn = {1079-5006},
	url = {https://academic.oup.com/biomedgerontology/advance-article-abstract/doi/10.1093/gerona/glz050/5335754},
	doi = {10.1093/gerona/glz050},
	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.},
	number = {11},
	journal = {Journals of Gerontology Series A-biological Sciences and Medical Sciences},
	author = {Fanning, Jason and Rejeski, W Jack and Chen, Shyhhuei and Nicklas, Barbara J and Walkup, Michael P and Axtell, Robert S and Fielding, Roger A and Glynn, Nancy W and King, Abby C and Manini, Todd M and Mcdermott, Mary Mcgrae and Newman, Anne B and Pahor, Marco and Tudorlocke, Catrine and Miller, Michael I},
	year = {2019},
	note = {Citation Key Alias: ISI:000491242600017, lens.org/077-007-606-131-474
tex.type: [object Object]},
	keywords = {Accelerometry, Disability, Exercise, Physical activity, Sedentary, dept.hms},
	pages = {1821--1827},
}

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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. 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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. 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