A Case for Promoting Movement Medicine: Preventing Disability in the LIFE Randomized Controlled Trial

J Gerontol A Biol Sci Med Sci. 2019 Oct 4;74(11):1821-1827. doi: 10.1093/gerona/glz050.


Background: The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD)-a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD.

Methods: Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry.

Results: A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53%). Within health education, both baseline LM (HR = 0.74; 95% CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95% CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95% CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p < .04), whereby risk for MMD was lower among individuals with higher levels of LM.

Conclusions: Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD.

Trial registration: clinicaltrials.gov Identifier NCT01072500.

Keywords: Accelerometry; Disability; Exercise; Physical activity; Sedentary.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acceleration
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Confidence Intervals
  • Disability Evaluation*
  • Female
  • Geriatric Assessment / methods
  • Humans
  • Linear Models
  • Male
  • Mobility Limitation*
  • Physical Fitness*
  • Prognosis
  • Sex Factors
  • Single-Blind Method
  • Walking Speed

Associated data

  • ClinicalTrials.gov/NCT01072500