People in their 70s and 80s who took part in a moderate-intensity exercise program over several years were more likely to retain their ability to get around independently, according to a new study.

The results add to a growing body of evidence that regular physical activity may help to keep older adults moving as they age, said the study’s lead author.

“The key issue is that we did not have until now definitive evidence where physical activity could prevent a major outcome such as (loss of) mobility in adults,” Dr. Marco Pahor, director of the Institute on Aging at the University of Florida, Gainesville, said.

A person’s ability to walk without assistance is often used as a measure of independence and quality of life, Pahor and his coauthors write in JAMA – the Journal of the American Medical Association.

People who lose their mobility have higher rates of disability and illnesses and are more likely to die, they note.

The study was published online on Tuesday to coincide with its presentation at the American College of Sports Medicine annual meeting in Orlando, Florida.

To test the longterm benefits of regular exercise, the researchers recruited 1,635 men and women from across the U.S. in 2010 and 2011. At the start of the study, they were all between the ages of 70 and 89 years old and were able to walk about a quarter mile without assistance.

Half the participants were randomly assigned to a structured exercise program and the other half to a health education group. The 818 people assigned to exercise walked and took part in strength, flexibility and balance training during three to four home sessions and two visits to medical centers each week.

The 817 people assigned to the health education group attended weekly meetings about healthy aging during the study’s first 26 weeks and monthly meetings after that.

Everyone’s ability to walk a quarter mile without assistance was tested every six months. After being enrolled in the study for about two and a half years, about 30 percent of the participants in the physical activity group and about 36 percent of the health education group were no longer able to walk the quarter mile.

All the participants kept trying, however, and only after being unable to complete the course in two consecutive tests was an individual considered to have “persistent mobility disability.” About 15 percent of people in the exercise group fell into that category during the study compared to 20 percent of the education group.

Those in the physical activity group did have more “adverse events” during the study, such as being sent to the hospital, compared to those in the health education group. But the difference was small, and in most cases the problem was not related to the exercise program, the authors say.

Pahor told Reuters Health the additional adverse events in the physical activity group might have been due to the fact they were being more intensively monitored by doctors, so more problems got reported.

Ursula M. Staudinger, who directs the Robert N. Butler Columbia University Aging Center in New York City, said the apparent benefit from physical activity seen in the study only applied to mobility, but there might be other health benefits over a longer time.

“One has to realize mobility effects on health in general probably take a longer term intervention (to identify),” Staudinger, who was not involved in the new research, said.

Pahor said a structured physical activity program, such as the one used in this study is not widely available. He and his colleagues estimated the cost of the exercise program, including transportation, at about $1,815 per year.

“I think it’s important to lobby for reimbursement of a program like this,” Pahor said.

“I would assume the kind of intensity and combination of training they had here is not so easy to find for free,” Staudinger said. “Obviously you can sign up for a gym, but you have to go there and you have to be able to afford it.”

Stressing that the workouts should be tailored to a person’s individual needs, she said that people should invest in a heart rate monitor and talk with their doctor about the best program for them.

“It’s important to push yourself, but not too much,” Staudinger said.

SOURCE: JAMA, online May 27, 2014

###

Effect of Structured Physical Activity on Prevention of Major Mobility Disability in Older Adults

In older adults reduced mobility is common and is an independent risk factor for morbidity, hospitalization, disability, and mortality. Limited evidence suggests that physical activity may help prevent mobility disability; however, there are no definitive clinical trials examining whether physical activity prevents or delays mobility disability.

Objective To test the hypothesis that a long-term structured physical activity program is more effective than a health education program (also referred to as a successful aging program) in reducing the risk of major mobility disability.

###
Marco Pahor, MD; Jack M. Guralnik, MD, PHD; Walter T. Ambrosius, PhD; Steven Blair, PED; Denise E. Bonds, MD; Timothy S. Church, MD, PhD, MPH; Mark A. Espeland, PhD; Roger A. Fielding, PhD; Thomas M. Gill, MD; Erik J. Groessl, PhD; Abby C. King, PhD; Stephen B. Kritchevsky, PhD; Todd M. Manini, PhD; Mary M. McDermott, MD; Michael E. Miller, PhD; Anne B. Newman, MD, MPH; W Jack Rejeski, PhD; Kaycee M. Sink, MD, MAS; Jeff D. Williamson, MD, MHS ; for the LIFE study investigators