title: Effect of Metabolic Syndrome on the Mobility Benefit of a Structured Physical Activity Intervention-The Lifestyle Interventions and Independence for Elders Randomized Clinical Trial.
abstract: OBJECTIVE
  To test whether structured physical activity (PA) is associated with a greater reduction in major mobility disability (MMD) in older persons with metabolic syndrome (MetS) than in those without.
  
  
  METHODS
  Data from the Lifestyle Interventions and Independence for Elders (LIFE) Study, a multicenter randomized trial of 1,635 persons with assessments every 6 months (average 2.7 years).
  
  
  METHODS
  Eight U.S. centers.
  
  
  METHODS
  Sedentary men and women aged 70 to 89 with functional limitations (N = 1,535); 100 participants were excluded because of missing MetS data.
  
  
  METHODS
  Participants were randomized to a moderate-intensity PA program (n = 766) or a health education program (n = 769).
  
  
  METHODS
  MetS was defined according to the 2009 multiagency harmonized criteria. Outcomes included incident MMD (loss of ability to walk 400 m) and persistent MMD (two consecutive MMD diagnoses or one MMD diagnosis followed by death).
  
  
  RESULTS
  Seven hundred sixty-three (49.7%) participants met criteria for MetS. PA reduced incident MMD more than health education did in participants with MetS (hazard ratio (HR) = 0.72, 95% confidence interval (CI) = 0.57-0.91, P = .007) but not in those without MetS (HR = 0.96, 95% CI = 0.73-1.25, P = .75); the test for statistical interaction was not significant (P = .13). PA reduced the risk of persistent MMD in participants with MetS (HR = 0.57, 95% CI = 0.41-0.79, P < .001) but not in those without MetS (HR = 0.97, 95% CI = 0.67-1.41, P = .87). The test for statistical interaction was significant (P = .04).
  
  
  CONCLUSIONS
  Moderate-intensity PA substantially reduces the risk of persistent MMD in older persons with functional limitations with MetS but not in those without MetS. Comparable results were observed for incident MMD. The LIFE PA program may be an effective strategy for reducing mobility disability in vulnerable older persons with MetS.
authors.affiliation: Department of Health and Human Services, University of Michigan, Ann Arbor and Dearborn, Michigan.|Institute of Gerontology, University of Michigan, Ann Arbor and Dearborn, Michigan.
authors.forename: Anda
authors.initials: A
authors.lastname: Botoseneanu
authors.affiliation: Department of Biostatistical Sciences, Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Biostatistical Sciences, Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Walter T
authors.initials: WT
authors.lastname: Ambrosius
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Yale University, New Haven, Connecticut.
authors.forename: Heather G
authors.initials: HG
authors.lastname: Allore
authors.affiliation: Institute on Aging, Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida.
authors.forename: Stephen
authors.initials: S
authors.lastname: Anton
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Folta
authors.affiliation: Department of Health Research and Policy, Department of Medicine, School of Medicine, Stanford University, Stanford, California.|Stanford Prevention Research Center, Department of Medicine, School of Medicine, Stanford University, Stanford, California.
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
authors.affiliation: J. Paul Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Nicklas
authors.affiliation: Department of Preventive Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Spring
authors.affiliation: Department of Epidemiology, Center for Aging and Population Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Elsa S
authors.initials: ES
authors.lastname: Strotmeyer
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Yale University, New Haven, Connecticut.
authors.forename: Thomas M
authors.identifier: http://orcid.org/0000-0002-6450-0368
authors.initials: TM
authors.lastname: Gill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D051346:Mobility Limitation; D057185:Sedentary Behavior; D016037:Single-Blind Method; D014481:United States / Q000453:epidemiology
keywords: Intervention trial; Metabolic syndrome; Mobility disability; Physical activity