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

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) were randomized to receive a structured physical activity (PA) intervention or health education control (HE). 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 HE, both baseline LM (HR=0.74; 95% CI 0.62-0.88) and MVPA (HR=0.69; 95% CI 0.54-0.87) were associated with MMD, while only LM was associated with MMD within PA (HR=0.74; 95% CI 0.61-0.89). There were similar non-linear relationships present for LM in both PA and HE (p < .04), whereby risk for MMD was lower among individuals with higher levels of LM.

CONCLUSIONS: Both LM and MVPA should be central in treatment regimens for older adults at risk for MMD.