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Impact of Baseline Fatigue on a Physical Activity Intervention to Prevent Mobility Disability
Author(s) -
Glynn Nancy W.,
Gmelin Theresa,
Santanasto Adam J.,
Lovato Laura C.,
LangeMaia Brittney S.,
Nicklas Barbara J.,
Fielding Roger A.,
Manini Todd M.,
Myers Valerie H.,
Rekeneire Nathalie,
Spring Bonnie J.,
Pahor Marco,
King Abby C.,
Rejeski W. Jack,
Newman Anne B.
Publication year - 2020
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16274
Subject(s) - medicine , baseline (sea) , intervention (counseling) , physical therapy , physical activity , gerontology , physical medicine and rehabilitation , psychiatry , oceanography , geology
OBJECTIVES Our aim was to examine the impacts of baseline fatigue on the effectiveness of a physical activity (PA) intervention to prevent major mobility disability (MMD) and persistent major mobility disability (PMMD) in participants from the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN Prospective cohort of individuals aged 65 years or older undergoing structured PA intervention or health education (HE) for a mean of 2.6 years. SETTING LIFE was a multicenter eight‐site randomized trial that compared the efficacy of a structured PA intervention with an HE program in reducing the incidence of MMD. PARTICIPANTS Study participants (N = 1591) at baseline were 78.9 ± 5.2 years of age, with low PA and at risk for mobility impairment. MEASUREMENTS Self‐reported fatigue was assessed using the modified trait version of the Exercise‐Induced Feelings Inventory, a six‐question scale rating energy levels in the past week. Responses ranged from 0 (none of the time) to 5 (all of the time). Total score was calculated by averaging across questions; baseline fatigue was based on the median split: 2 or higher = more fatigue (N = 856) and lower than 2 = less fatigue (N = 735). Participants performed a usual‐paced 400‐m walk every 6 months. We defined incident MMD as the inability to walk 400‐m at follow‐up visits; PMMD was defined as two consecutive walk failures. Cox proportional hazard models quantified the risk of MMD and PMMD in PA vs HE stratified by baseline fatigue adjusted for covariates. RESULTS Among those with higher baseline fatigue, PA participants had a 29% and 40% lower risk of MMD and PMMD, respectively, over the trial compared with HE (hazard ratio [HR] for MMD = .71; 95% confidence interval [CI] = .57‐.90; P = .004) and PMMD (HR = .60; 95% CI = .44‐.82; P = .001). For those with lower baseline fatigue, no group differences in MMD ( P = .36) or PMMD ( P = .82) were found. Results of baseline fatigue by intervention interaction was MMD ( P = .18) and PMMD ( P = .05). CONCLUSION A long‐term moderate intensity PA intervention was particularly effective at preserving mobility in older adults with higher levels of baseline fatigue. J Am Geriatr Soc 68:619–624, 2020