title: Cardiovascular Events in a Physical Activity Intervention Compared With a Successful Aging Intervention: The LIFE Study Randomized Trial.
abstract: Whether sustained physical activity prevents cardiovascular disease (CVD) events in older adults is uncertain.
  
  
  
  To test the hypothesis that cardiovascular morbidity and mortality would be reduced in participants in a long-term physical activity program.
  
  
  
  The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, randomized trial. Participants were recruited at 8 centers in the United States. We randomized 1635 sedentary men and women aged 70 to 89 years with a Short Physical Performance Battery (SPPB) score of 9 or less but able to walk 400 m.
  
  
  
  The physcial activity (PA) intervention was a structured moderate-intensity program, predominantly walking 2 times per week on site for 2.6 years on average. The successful aging intervention consisted of weekly health education sessions for 6 months, then monthly.
  
  
  
  Total CVD events, including fatal and nonfatal myocardial infarction, angina, stroke, transient ischemic attack, and peripheral artery disease, were adjudicated by committee, and silent myocardial infarction was assessed by serial electrocardiograms. A limited outcome of myocardial infarction, stroke, and CVD death was also studied. Outcome assessors and adjudicators were blinded to intervention assignment.
  
  
  
  The 1635 LIFE study participants were predominantly women (67%), with a mean (SD) age of 78.7 (5.2) years; 20% were African-American, 6% were Hispanic or other race or ethnic group, and 74% were non-Latino white. New CVD events occurred in 121 of 818 PA participants (14.8%) and 113 of 817 successful aging participants (13.8%) (HR, 1.10; 95% CI, 0.85-1.42). For the more focused combined outcome of myocardial infarction, stroke, or cardiovascular death, rates were 4.6% in PA and 4.5% in the successful aging group (HR, 1.05; 95% CI, 0.67-1.66). Among frailer participants with an SPPB score less than 8, total CVD rates were 14.2% in PA vs 17.7% in successful aging (HR, 0.76; 95% CI, 0.52-1.10), compared with 15.3% vs 10.5% among those with an SPPB score of 8 or 9 (HR, 1.59; 95% CI, 1.09-2.30) (P for interaction = .006). With the limited end point, the interaction was not significant (P = .59), with an HR of 0.94 (95% CI, 0.50-1.75) for an SPPB score less than 8 and an HR of 1.20 (95% CI, 0.62-2.34) for an SBBP score of 8 or 9.
  
  
  
  Among participants in the LIFE Study, an aerobically based, moderately intensive PA program was not associated with reduced cardiovascular events in spite of the intervention's previously documented ability to prevent mobility disability.
  
  
  
  clinicaltrials.gov Identifier: NCT00116194.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.affiliation: New York University School of Medicine, New York.
authors.forename: John A
authors.initials: JA
authors.lastname: Dodson
authors.affiliation: Department of Preventative Medicine, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.affiliation: University of Florida, Gainesville.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Buford
authors.affiliation: Tufts University, Boston, Massachusetts.
authors.forename: Roger A
authors.initials: RA
authors.lastname: Fielding
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kritchevsky
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Beavers
authors.affiliation: University of Florida, Gainesville.
authors.forename: Marco
authors.initials: M
authors.lastname: Pahor
authors.affiliation: Stanford University, Palo Alto, California.
authors.forename: Randall S
authors.initials: RS
authors.lastname: Stafford
authors.affiliation: University of Florida, Gainesville.
authors.forename: Anita D
authors.initials: AD
authors.lastname: Szady
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Walter T
authors.initials: WT
authors.lastname: Ambrosius
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Mary M
authors.initials: MM
authors.lastname: McDermott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006266:Health Education; D000073656:Healthy Aging; D006801:Humans; D008019:Life Style; D008297:Male; D057185:Sedentary Behavior; D016138:Walking