Hospitalizations During a Physical Activity Intervention in Older Adults at Risk of Mobility Disability

Analyses from the Lifestyle Interventions and Independence for Elders Randomized Clinical Trial

the LIFE Study Investigators

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To determine whether moderate-intensity physical activity (PA) and health education (HE) are differentially associated with categories of hospitalizations or subgroups of participants. Design: Multicenter randomized controlled trial in which participants were randomized to a PA or HE program for an average of 2.6 years. Setting: Eight field centers. Participants: Sedentary men and women aged 70–89 with lower extremity physical limitations but able to walk 400-m in 15 minutes or less (N = 1,635). Interventions: Structured, moderate-intensity PA (n = 818) at a center (2×/wk) and at home (3–4×/wk) that included aerobic, strength, balance, and flexibility training or HE (n = 817) of educational workshops and upper extremity stretching exercises. Measurements: All-cause inpatient hospitalizations ascertained at 6-month intervals. Results: There were 1,458 hospitalizations (49.1% of PA, 44.4% of HE; risk difference = 4.68%, 95% confidence interval (CI) = −0.18–9.54; hazard ratio (HR) = 1.16, 95% CI = 1.00–1.34). The intervention effect on incident hospitalization did not differ according to race, sex, Short Physical Performance Battery score, age, or history of cardiovascular disease or diabetes mellitus. PA was associated with higher rates of hospitalization in the middle baseline gait speed category, than HE (<0.8 m/s: HR = 0.93, 95% CI = 0.76–1.14; 0.8–1.0 m/s: HR = 1.54, 95% CI = 1.23–1.94; >1.0 m/s: HR = 1.05, 95% CI = 0.67–1.65; interaction P =.005). Conclusion: A PA program in older adults at risk for mobility disability did not lead to a different risk of specific types of hospitalizations than a HE program overall. Baseline gait speed may be a marker for risk of hospitalization during a PA intervention, because individuals with moderate baseline gait speed in the PA group had slightly higher rates of hospitalization than those in the HE group. Trial Registration: ClinicalTrials.gov identifier: NCT01072500.

Original languageEnglish (US)
Pages (from-to)933-943
Number of pages11
JournalJournal of the American Geriatrics Society
Volume64
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Life Style
Hospitalization
Randomized Controlled Trials
Health Education
Exercise
Physical Education and Training
Confidence Intervals
Upper Extremity
Inpatients
Lower Extremity
Diabetes Mellitus
Cardiovascular Diseases
Education
Walking Speed

Keywords

  • hospitalizations
  • mobility disability
  • older adults
  • physical activity
  • safety

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

@article{56cbdcaa97254336acec4eda82a8fc37,
title = "Hospitalizations During a Physical Activity Intervention in Older Adults at Risk of Mobility Disability: Analyses from the Lifestyle Interventions and Independence for Elders Randomized Clinical Trial",
abstract = "Objectives: To determine whether moderate-intensity physical activity (PA) and health education (HE) are differentially associated with categories of hospitalizations or subgroups of participants. Design: Multicenter randomized controlled trial in which participants were randomized to a PA or HE program for an average of 2.6 years. Setting: Eight field centers. Participants: Sedentary men and women aged 70–89 with lower extremity physical limitations but able to walk 400-m in 15 minutes or less (N = 1,635). Interventions: Structured, moderate-intensity PA (n = 818) at a center (2×/wk) and at home (3–4×/wk) that included aerobic, strength, balance, and flexibility training or HE (n = 817) of educational workshops and upper extremity stretching exercises. Measurements: All-cause inpatient hospitalizations ascertained at 6-month intervals. Results: There were 1,458 hospitalizations (49.1{\%} of PA, 44.4{\%} of HE; risk difference = 4.68{\%}, 95{\%} confidence interval (CI) = −0.18–9.54; hazard ratio (HR) = 1.16, 95{\%} CI = 1.00–1.34). The intervention effect on incident hospitalization did not differ according to race, sex, Short Physical Performance Battery score, age, or history of cardiovascular disease or diabetes mellitus. PA was associated with higher rates of hospitalization in the middle baseline gait speed category, than HE (<0.8 m/s: HR = 0.93, 95{\%} CI = 0.76–1.14; 0.8–1.0 m/s: HR = 1.54, 95{\%} CI = 1.23–1.94; >1.0 m/s: HR = 1.05, 95{\%} CI = 0.67–1.65; interaction P =.005). Conclusion: A PA program in older adults at risk for mobility disability did not lead to a different risk of specific types of hospitalizations than a HE program overall. Baseline gait speed may be a marker for risk of hospitalization during a PA intervention, because individuals with moderate baseline gait speed in the PA group had slightly higher rates of hospitalization than those in the HE group. Trial Registration: ClinicalTrials.gov identifier: NCT01072500.",
keywords = "hospitalizations, mobility disability, older adults, physical activity, safety",
author = "{the LIFE Study Investigators} and Marsh, {Anthony P.} and Applegate, {William B.} and Guralnik, {Jack M.} and {Jack Rejeski}, W. and Church, {Timothy S.} and Fielding, {Roger A.} and Gill, {Thomas M.} and King, {Abby C.} and Kritchevsky, {Stephen B.} and Manini, {Todd M.} and McDermott, {Mary M.} and Newman, {Anne B.} and Stowe, {Cynthia L.} and Walkup, {Michael P.} and Marco Pahor and Miller, {Michael E.} and Christiaan Leeuwenburgh and Connie Caudle and Lauren Crump and Latonia Holmes and Jocelyn Lee and Lu, {Ching ju} and Espeland, {Mark A.} and Ambrosius, {Walter T.} and Beavers, {Daniel P.} and Byington, {Robert P.} and Delilah Cook and Furberg, {Curt D.} and Harvin, {Lea N.} and Leora Henkin and John Hepler and Hsu, {Fang Chi} and Laura Lovato and Wesley Roberson and Julia Rushing and Scott Rushing and Don Hire and Katula, {Jeffrey A.} and Brubaker, {Peter H.} and Mihalko, {Shannon L.} and Jennings, {Janine M.} and Hadley, {Evan C.} and Sergei Romashkan and Patel, {Kushang V.} and Denise Bonds and Bonnie Spring and Joshua Hauser and Diana Kerwin and Kathryn Domanchuk and Rex Graff",
year = "2016",
month = "5",
day = "1",
doi = "10.1111/jgs.14114",
language = "English (US)",
volume = "64",
pages = "933--943",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Hospitalizations During a Physical Activity Intervention in Older Adults at Risk of Mobility Disability

T2 - Analyses from the Lifestyle Interventions and Independence for Elders Randomized Clinical Trial

AU - the LIFE Study Investigators

AU - Marsh, Anthony P.

AU - Applegate, William B.

AU - Guralnik, Jack M.

AU - Jack Rejeski, W.

AU - Church, Timothy S.

AU - Fielding, Roger A.

AU - Gill, Thomas M.

AU - King, Abby C.

AU - Kritchevsky, Stephen B.

AU - Manini, Todd M.

AU - McDermott, Mary M.

AU - Newman, Anne B.

AU - Stowe, Cynthia L.

AU - Walkup, Michael P.

AU - Pahor, Marco

AU - Miller, Michael E.

AU - Leeuwenburgh, Christiaan

AU - Caudle, Connie

AU - Crump, Lauren

AU - Holmes, Latonia

AU - Lee, Jocelyn

AU - Lu, Ching ju

AU - Espeland, Mark A.

AU - Ambrosius, Walter T.

AU - Beavers, Daniel P.

AU - Byington, Robert P.

AU - Cook, Delilah

AU - Furberg, Curt D.

AU - Harvin, Lea N.

AU - Henkin, Leora

AU - Hepler, John

AU - Hsu, Fang Chi

AU - Lovato, Laura

AU - Roberson, Wesley

AU - Rushing, Julia

AU - Rushing, Scott

AU - Hire, Don

AU - Katula, Jeffrey A.

AU - Brubaker, Peter H.

AU - Mihalko, Shannon L.

AU - Jennings, Janine M.

AU - Hadley, Evan C.

AU - Romashkan, Sergei

AU - Patel, Kushang V.

AU - Bonds, Denise

AU - Spring, Bonnie

AU - Hauser, Joshua

AU - Kerwin, Diana

AU - Domanchuk, Kathryn

AU - Graff, Rex

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objectives: To determine whether moderate-intensity physical activity (PA) and health education (HE) are differentially associated with categories of hospitalizations or subgroups of participants. Design: Multicenter randomized controlled trial in which participants were randomized to a PA or HE program for an average of 2.6 years. Setting: Eight field centers. Participants: Sedentary men and women aged 70–89 with lower extremity physical limitations but able to walk 400-m in 15 minutes or less (N = 1,635). Interventions: Structured, moderate-intensity PA (n = 818) at a center (2×/wk) and at home (3–4×/wk) that included aerobic, strength, balance, and flexibility training or HE (n = 817) of educational workshops and upper extremity stretching exercises. Measurements: All-cause inpatient hospitalizations ascertained at 6-month intervals. Results: There were 1,458 hospitalizations (49.1% of PA, 44.4% of HE; risk difference = 4.68%, 95% confidence interval (CI) = −0.18–9.54; hazard ratio (HR) = 1.16, 95% CI = 1.00–1.34). The intervention effect on incident hospitalization did not differ according to race, sex, Short Physical Performance Battery score, age, or history of cardiovascular disease or diabetes mellitus. PA was associated with higher rates of hospitalization in the middle baseline gait speed category, than HE (<0.8 m/s: HR = 0.93, 95% CI = 0.76–1.14; 0.8–1.0 m/s: HR = 1.54, 95% CI = 1.23–1.94; >1.0 m/s: HR = 1.05, 95% CI = 0.67–1.65; interaction P =.005). Conclusion: A PA program in older adults at risk for mobility disability did not lead to a different risk of specific types of hospitalizations than a HE program overall. Baseline gait speed may be a marker for risk of hospitalization during a PA intervention, because individuals with moderate baseline gait speed in the PA group had slightly higher rates of hospitalization than those in the HE group. Trial Registration: ClinicalTrials.gov identifier: NCT01072500.

AB - Objectives: To determine whether moderate-intensity physical activity (PA) and health education (HE) are differentially associated with categories of hospitalizations or subgroups of participants. Design: Multicenter randomized controlled trial in which participants were randomized to a PA or HE program for an average of 2.6 years. Setting: Eight field centers. Participants: Sedentary men and women aged 70–89 with lower extremity physical limitations but able to walk 400-m in 15 minutes or less (N = 1,635). Interventions: Structured, moderate-intensity PA (n = 818) at a center (2×/wk) and at home (3–4×/wk) that included aerobic, strength, balance, and flexibility training or HE (n = 817) of educational workshops and upper extremity stretching exercises. Measurements: All-cause inpatient hospitalizations ascertained at 6-month intervals. Results: There were 1,458 hospitalizations (49.1% of PA, 44.4% of HE; risk difference = 4.68%, 95% confidence interval (CI) = −0.18–9.54; hazard ratio (HR) = 1.16, 95% CI = 1.00–1.34). The intervention effect on incident hospitalization did not differ according to race, sex, Short Physical Performance Battery score, age, or history of cardiovascular disease or diabetes mellitus. PA was associated with higher rates of hospitalization in the middle baseline gait speed category, than HE (<0.8 m/s: HR = 0.93, 95% CI = 0.76–1.14; 0.8–1.0 m/s: HR = 1.54, 95% CI = 1.23–1.94; >1.0 m/s: HR = 1.05, 95% CI = 0.67–1.65; interaction P =.005). Conclusion: A PA program in older adults at risk for mobility disability did not lead to a different risk of specific types of hospitalizations than a HE program overall. Baseline gait speed may be a marker for risk of hospitalization during a PA intervention, because individuals with moderate baseline gait speed in the PA group had slightly higher rates of hospitalization than those in the HE group. Trial Registration: ClinicalTrials.gov identifier: NCT01072500.

KW - hospitalizations

KW - mobility disability

KW - older adults

KW - physical activity

KW - safety

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U2 - 10.1111/jgs.14114

DO - 10.1111/jgs.14114

M3 - Article

VL - 64

SP - 933

EP - 943

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 5

ER -