Article

OBJECTIVES: To evaluate the extent of variability in functional responses in
participants in the Lifestyle Interventions and Independence for Elders (LIFE)
study and to identify the relative contributions of intervention adherence,
physical activity, and demographic and health characteristics to this
variability. DESIGN: Secondary analysis. SETTING: Multicenter institutions.
PARTICIPANTS: A volunteer sample (N=1635) of sedentary men and women aged 70 to
89 years who were able to walk 400m but had physical limitations, defined as a
Short Physical Performance Battery (SPPB) score of </=9. INTERVENTIONS:
Moderate-intensity physical activity (n=818) consisting of aerobic, resistance,
and flexibility exercises performed both center-based (2times/wk) and home-based
(3-4times/wk) sessions or health education program (n=817) consisting of weekly
to monthly workshops covering relevant health information.
MAIN OUTCOME MEASURES:
Physical function (gait speed over 400m) and lower extremity function (SPPB
score) assessed at baseline and 6, 12, and 24 months. RESULTS: Greater baseline
physical function (gait speed, SPPB score) was negatively associated with change
in gait speed (regression coefficient beta=-.185; P<.001) and change in SPPB
score (beta=-.365; P<.001), whereas higher number of steps per day measured by
accelerometry was positively associated with change in gait speed (beta=.035;
P<.001) and change in SPPB score (beta=.525; P<.001). Other baseline factors
associated with positive change in gait speed and/or SPPB score include younger
age (P<.001), lower body mass index (P<.001), and higher self-reported physical
activity (P=.002). CONCLUSIONS: Several demographic and physical activity-related
factors were associated with the extent of change in functional outcomes in
participants in the LIFE study. These factors should be considered when designing
interventions for improving physical function in older adults with limited mobility.
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