a prescription of regular structured exercise, sedentary elderly are
able to safely improve their physical function and may reduce the
likelihood they will experience difficulty walking a quarter mile,
according to findings from a multicenter pilot study led by the
University of Florida Institute on Aging.
announced the results of the Lifestyle Interventions and Independence
For Elders pilot study, or LIFE, today (Nov. 17) at the Gerontological
Society of America's annual meeting in Dallas. The study also appears in
the November issue of the Journal of Gerontology: Medical Sciences
accompanied by an editorial.
The findings confirm
the feasibility of a full-scale clinical trial using physical activity
in older people, said Marco Pahor, director of the UF Institute on Aging
and the study's principal investigator.
demonstrates that the physical activity was extremely safe for the study
participants - elderly people at a high risk of becoming disabled,"
The pilot study was
the first to gather evidence that physical activity can improve the
score on a standardized test of lower extremity physical mobility called
the Short Physical Performance Battery, or SPPB, the researchers said.
Previous research has
found that the score on this performance test is highly predictive of
future health problems. People with lower scores on the SPPB assessment
are more likely than others to die earlier, have health problems, be
institutionalized and become less able to get around.
"I think the result
is promising for a full-scale study," said Pahor, a professor and
chairman of the department of aging and geriatric research in UF's
College of Medicine. "(Previously) we had no definitive empirical
evidence that the score on the SPPB test could be modified. We were able
to show this is possible, and it is promising that, once tested in a
full-scale clinical trial, this intervention may also be shown to modify
other health outcomes, such as mobility disability."
Even a small
improvement of a half point on the test score's scale of 0 to 12 may
translate as a major improvement in an elder person's ability to perform
activities of daily living, such as walking across a room, dressing,
eating or bathing. A low score, between 0 and 4, is a strong risk factor
for disability and death. The LIFE study looked at people with
intermediate scores from 4 to 9 to see if exercise could improve or
prevent a decline in their scores.
424 sedentary elderly participants aged 70 to 89 from the community.
Participants first took the SPPB test to establish a baseline score and
then were divided into two groups. One group was given a structured
physical activity consisting primarily of walking at a moderate
intensity for at least 150 minutes a week, coupled with leg stretches,
balance exercises and leg-strengthening exercises. The second group was
given "successful aging" instruction on good living practices, including
information on nutrition, medications, foot care and preventive
services. Participants were re-tested twice over an average of 1.2
During the testing
period, participants in the physical activity group increased their
score from a baseline average of about 7.5 to about 8.5. Participants in
the physical activity group also improved their performance on a second
assessment, the 400-meter walking test, and had a lower incidence of a
major mobility disability, defined as an inability to walk a quarter
mile, than did those in the "successful aging" intervention group.
"This analysis showed
that, compared with those who received health education, participants in
the physical activity group had a 29 percent lower risk of being unable
to walk 400 meters," Pahor said.
The LIFE study was
conducted at four centers - the Cooper Institute, Stanford University,
the University of Pittsburgh and Wake Forest University - and was funded
by the National Institute on Aging. The coordinating center was based at
UF and the data management, analysis and quality control center was
based at Wake Forest University. Investigators from Tufts University,
Yale University, the University of California San Diego, UCLA and the
NIA also contributed to the study.
functioning is a good reflection of overall functioning and disability
in older adults. We are encouraged by these results, which demonstrate
that a well-designed program combining aerobic, strength, balance and
flexibility exercises can make a difference for those who are at high
risk of losing mobility function," said Jack M. Guralnik, M.D., Ph.D.,
co-principal investigator for the study and chief of the NIA's
Laboratory of Epidemiology, Demography and Biometry.
The LIFE study
researchers are planning to conduct a full-scale study, testing 2,500
adults at 10 sites over four years - the longest study to date to assess
whether structured exercise can delay the inability to walk 400 meters,
a quarter mile.