Effect of Physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study.
OBJECTIVE
To test the hypothesis that a long-term structured, moderate intensity physical activity (PA) program is more effective than a health education (HE) program in reducing the risk of s elf-reported dependency and disability in basic activities of daily living (BADLs), disability in instrumental ADLs (IADL), and mobility disability.


METHODS
The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, single-blinded randomized trial.


METHODS
University-based research clinic.


METHODS
Thousand six hundred and thirty five sedentary men and women aged 70-89 years, who had functional limitations, defined as a score ≤9 on the Short Physical Performance Battery.


METHODS
Participants were randomized to a structured, moderate intensity PA program (n = 818) that included aerobic, resistance, and flexibility exercises or to a HE program (n = 817).


METHODS
All outcomes were derived by self-report using periodic interviews that asked about the degree of difficulty and receipt of help during the past month. Dependency was defined as "receiving assistance" or "unable" to do ≥1 activities. Disability was defined as having "a lot of difficulty" or "unable" doing ≥1 activities. Severe disability was defined as reporting difficulty or being unable to perform ≥3 activities.


RESULTS
Over an average follow-up of 2.6 years, the cumulative incidence of BADL dependency was 15.2% among PA and 15.1% among HE participants (HR = 1.0, 95% CI = 0.78-0.1.3). Intervention groups had similar rates of incident BADL disability, IADL disability and reported mobility disability. Reporting severe mobility disability (HR = 0.78, 95% CI = 0.64-0.96) and ratings of difficulty on mobility tasks were reduced in the PA group.


CONCLUSIONS
A structured physical activity intervention reduces reported severe mobility disability and difficulty on mobility tasks, but not BADL and IADL disability in older adults with functional limitations.
University of Florida, Gainesville, Florida.
Todd M
TM
Manini
Wake Forest University & School of Medicine, Winston-Salem, North Carolina.
Daniel P
DP
Beavers
University of Florida, Gainesville, Florida.
Marco
M
Pahor
University of Florida, Gainesville, Florida.|University of Maryland School of Medicine, Baltimore, Maryland.
Jack M
JM
Guralnik
Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Bonnie
B
Spring
Pennington Biomedical Research Center, Los Angeles, California.
Timothy S
TS
Church
Stanford University, School of Medicine, Stanford, California.
Abby C
AC
King
Tufts University, Boston, Massachusetts.
Sara C
SC
Folta
University of Pittsburgh, Pittsburgh, Pennsylvania.
Nancy W
NW
Glynn
Wake Forest University & School of Medicine, Winston-Salem, North Carolina.
Anthony P
AP
Marsh
Yale School of Medicine, New Haven, Connecticut.
Thomas M
http://orcid.org/0000-0002-6450-0368
TM
Gill
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000534:rehabilitation*; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006266:Health Education; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D057185:Sedentary Behavior; D057566:Self Report; D016037:Single-Blind Method
ambulation; exercise; frailty; rehabilitation