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Exercise's effect on mobility disability in older adults with and without obesity: The LIFE study randomized clinical trial
Author(s) -
Kritchevsky Stephen B.,
Lovato Laura,
Handing Elizabeth P.,
Blair Steven,
Botoseneanu Anda,
Guralnik Jack M.,
Liu Christine,
King Abby,
Marsh Anthony P.,
Pahor Marco,
Rejeski W. Jack,
Spring Bonnie,
Manini Todd
Publication year - 2017
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21860
Subject(s) - medicine , obesity , waist , hazard ratio , confidence interval , randomized controlled trial , gerontology , physical therapy , body mass index , demography , sociology
Objective Some data suggest that obesity blunts the benefits of exercise on mobility in older adults. This study tested the homogeneity of the effect of a physical activity intervention on major mobility disability (MMD) across baseline obesity classifications in the Lifestyle Interventions and Independence for Elders (LIFE) Study. LIFE randomized 1,635 sedentary men and women aged 70 to 89 years to a moderate‐intensity physical activity (PA) or health education program. Methods MMD, defined as the inability to walk 400 m, was determined over an average follow‐up of 2.6 years. Participants were divided into four subgroups: (1) nonobese (BMI < 30 kg/m 2 ; n = 437); (2) nonobese with high waist circumference (WC > 102 cm [men], > 88 cm [women]; n = 434); (3) class 1 obesity (30 kg/m 2 ≤ BMI < 35 kg/m 2 ; n = 430); and (4) class 2 + obesity (BMI ≥ 35 kg/m 2 ; n = 312). Cox proportional hazard modeling was used to test an obesity by intervention interaction. Results The PA intervention had the largest benefit in participants with class 2 + obesity (hazard ratio 0.69, 95% confidence interval 0.48, 0.98). However, there was no statistically significant difference in benefit across obesity categories. Conclusions A structured PA program reduced the risk of MMD even in older adults with extreme obesity.