The role of high-intensity physical exercise in the prevention of disability among community-dwelling older people.
BACKGROUND
Moderate to vigorous physical activity (MVPA) is considered important to prevent disability among community-dwelling older people. To develop MVPA programs aimed at reducing or preventing disability more insight is needed in the contributions of exercise duration and intensity and the interplay between the two.


METHODS
Longitudinal data of 276 Dutch community-dwelling persons aged 65 years and older participating in the Elderly And their Neighbourhood (ELANE) study were used. MVPA exercise (yes/no), duration (hours per two weeks), intensity (Metabolic Equivalent of Task; METs), and energy expenditure (MET-hours per two weeks), and disability in instrumental activities of daily living (range 0-8) were measured twice within 9 months to account for fluctuations over time. Associations between the four exercise measures and disability were tested with longitudinal tobit regression analyses.


RESULTS
MVPA exercise was associated with fewer disabilities. While exercise duration was not associated with disability, whereas an increase of one MET in exercise intensity was associated with 0.14 fewer disabilities (95 % CI: -0.26 to -0.02). For exercise energy expenditure, an increase of one MET-hour exercise per two weeks was associated with 0.03 fewer disabilities (95 % CI: -0.05 to -0.01).


CONCLUSIONS
Higher-intensity exercise may help to prevent disability among community-dwelling older people. Further investigation is needed to explore the preventive effects in more detail.
Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Astrid
A
Etman
Department of Urban Environment and Safety, TNO, Utrecht, The Netherlands.
Frank H
FH
Pierik
Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands.
Carlijn B M
CB
Kamphuis
Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Alex
A
Burdorf
Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands. frank.vanlenthe@erasmusmc.nl.
Frank J
FJ
van Lenthe
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D004734:Energy Metabolism; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration; D012111:Residence Characteristics; D013223:Statistics as Topic
Disability; Elderly; Physical activity; Sports