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Effect of Structured Physical Activity on Respiratory Outcomes in Sedentary Elderly Adults with Mobility Limitations.

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27000324
10.1111/jgs.14013
PMC4806401
Journal of the American Geriatrics Society
March 1, 2016
Carlos A Vaz Fragoso8 5, Daniel P Beavers2, Stephen D Anton1, Christine K Liu4, Mary M McDermott6, Anne B Newman3, Marco Pahor1, Randall S Stafford7, Thomas M Gill5, Lifestyle Interventions and Independence in Elders Investigators
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  • 1
    Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida.
  • 2
    Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
  • 3
    Department of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • 4
    Department of Medicine, School of Medicine, Boston University, Boston, Massachusetts.
  • 5
    Department of Medicine, School of Medicine, Yale University, New Haven, Connecticut.
  • 6
    Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
  • 7
    Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California.
  • 8
    Veterans Affairs Connecticut, West Haven, Connecticut.
Pneumonia, Hospitalization, Upper Extremity, Forced Expiratory Volume, Dyspnea, Sedentary Behavior, Exercise Therapy, Mobility Limitation, Health Education, Walking, Treatment Outcome, Male, Exercise, Humans, Female, Aged, Aged, 80 and over
K24 HL086703, U54RR025208, UL1 TR000142, UL1 TR001085, K07AG3587, UL1 RR025744, 1R24HD065688-01A1, R24 HD065688, 1 P30 AG028740, P30 AG021342, P30AG021342, 1P30AG031679, P30 AG031679, UO1 AG22376, P30 AG024827, P30 AG028740, U01 AG022376
Vaz Fragoso CA, Beavers DP, Anton SD, Liu CK, McDermott MM, Newman AB, Pahor M, Stafford RS, Gill TM, Lifestyle Interventions and Independence in Elders Investigators. Effect of Structured Physical Activity on Respiratory Outcomes in Sedentary Elderly Adults with Mobility Limitations. Journal of the American Geriatrics Society 2016 Mar.

Abstract

OBJECTIVE: To evaluate the effect of structured physical activity on respiratory outcomes in community-dwelling elderly adults with mobility limitations. METHODS: Multicenter, randomized trial of physical activity vs health education, with respiratory variables prespecified as tertiary outcomes over an intervention period of 24-42 months. Physical activity included walking (goal of 150 min/week) and strength, flexibility, and balance training. Health education included workshops on topics relevant to older adults and upper extremity stretching exercises. METHODS: Lifestyle Interventions and Independence in Elders (LIFE) Study. METHODS: Community-dwelling persons aged 70-89 with Short Physical Performance Battery scores less than 10 (N = 1,635). METHODS: Dyspnea severity (defined as moderate to severe according to a Borg index >2 immediately after a 400-m walk), forced expiratory volume in 1 second (FEV1) (<lower limit of normal (LLN) defined low breathing capacity), and maximal inspiratory pressure (MIP) (<LLN defined respiratory muscle weakness) were assessed at baseline and 6, 18, and 30 months. Hospitalization for exacerbation of obstructive airways disease (EOAD) and pneumonia was also ascertained over the 42-month follow-up period. RESULTS: The randomized groups were similar in baseline demographics, including mean age (79) and sex (67% female). The effect of physical activity on dyspnea severity, FEV1, and MIP was no different from that of health education but was associated with higher likelihood of respiratory hospitalization, significantly for EOAD (hazard ratio (HR) = 2.34, 95% confidence interval (CI) = 1.19-4.61, P = .01) and marginally for pneumonia (HR = 1.54, 95% CI = 0.98-2.42, P = .06). CONCLUSIONS: In older persons with mobility limitations, physical activity was associated with higher likelihood of respiratory hospitalization than health education, but differences in dyspnea severity, FEV1, and MIP did not accompany this effect-indicating that higher hospital use could be attributable to greater participant contact.