@article{79d2c077f0bf488e99de7f008e522f05,
title = "Effect of physical activity on frailty: Secondary analysis of a randomized controlled trial",
abstract = "Background: Limited evidence suggests that physical activity may prevent frailty and associated negative outcomes in older adults. Definitive data from large long-term randomized trials are lacking. Objective: To determine whether a long-term, structured, moderate-intensity physical activity program is associated with a lower risk for frailty and whether frailty status alters the effect of physical activity on the reduction in major mobility disability (MMD) risk. Design: Multicenter, single-blind, randomized trial. Setting: 8 centers in the United States. Participants: 1635 community-dwelling adults, aged 70 to 89 years, with functional limitations. Intervention: A structured, moderate-intensity physical activity program incorporating aerobic, resistance, and flexibility activities or a health education program consisting of workshops and stretching exercises. Measurements: Frailty, as defined by the SOF (Study of Osteoporotic Fractures) index, at baseline and 6, 12, and 24 months, and MMD, defined as the inability to walk 400 m, for up to 3.5 years. Results: Over 24 months of follow-up, the risk for frailty (n = 1623) was not statistically significantly different in the physical activity versus the health education group (adjusted prevalence difference, -0.021 [95% CI, -0.049 to 0.007]). Among the 3 criteria of the SOF index, the physical activity intervention was associated with improvement in the inability to rise from a chair (adjusted prevalence difference, -0.050 [CI, -0.081 to -0.020]). Baseline frailty status did not modify the effect of physical activity on reducing incident MMD (P for interaction = 0.91). Limitation: Frailty status was neither an entry criterion nor a randomization stratum. Conclusion: A structured, moderate-intensity physical activity program was not associated with a reduced risk for frailty over 2 years among sedentary, community-dwelling older adults. The beneficial effect of physical activity on the incidence of MMD did not differ between frail and nonfrail participants.",
author = "{LIFE Study Investigators} and Andrea Trombetti and M{\'e}lany Hars and Hsu, {Fang Chi} and Reid, {Kieran F.} and Church, {Timothy S.} and Gill, {Thomas M.} and King, {Abby C.} and Liu, {Christine K.} and Manini, {Todd M.} and McDermott, {Mary M.} and Newman, {Anne B.} and Rejeski, {W. Jack} and Guralnik, {Jack M.} and Marco Pahor and Fielding, {Roger A.} and Christiaan Leeuwenburgh and Connie Caudle and Lauren Crump and Latonia Holmes and Jocelyn Lee and Lu, {Ching Ju} and Miller, {Michael E.} and Espeland, {Mark A.} and Ambrosius, {Walter T.} and William Applegate 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 Laura Lovato and Wesley Roberson and Julia Rushing and Scott Rushing and Stowe, {Cynthia L.} and Walkup, {Michael P.} 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 Joe Verghese",
note = "Funding Information: Cost-Effectiveness Analysis Center: Erik J. Groessl, PhD (University of California, San Diego, and VA San Diego Healthcare System); and Robert M. Kaplan, PhD (Office of Behavioral and Social Sciences Research, NIH). * Dr. Vaz Fragoso is the recipient of a Career Development Award from the Department of Veterans Affairs. Funding Information: Grant Support: The LIFE study was funded by cooperative agreement UO1AG22376 from the NIH and National Institute on Aging (NIA) and supplement 3U01AG022376-05A2S from the National Heart, Lung, and Blood Institute (NHLBI), and was sponsored in part by the Intramural Research Program. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (1 P30 AG028740), Wake Forest University (1 P30 AG21332), Tufts University (1P30AG031679), University of Pittsburgh (P30 AG024827), and Yale University (P30AG021342), and is supported by the NIH/National Center for Research Resources Clinical and Translational Science Award program at Stanford University (UL1 RR025744), University of Florida (U54RR025208), and Yale University (UL1 TR000142). Tufts University is also supported by the Boston Rehabilitation Outcomes Center (1R24HD065688-01A1). The following LIFE investigators also are partially supported: Dr. Gill (Yale University) is the recipient of an Academic Leadership Award (K07AG3587) from the NIA. Dr. Fielding (Tufts University) is partially supported by the U.S. Department of Agriculture under agreement 58-1950-4-003. Funding Information: Disclosures: Dr. McDermott reports grants from the NHLBI during the conduct of the study, and donations of study medication from ReserveAge, grants from Novartis and the Patient-Centered Outcomes Research Institute, and donations of study intervention from Hershey's, outside the submitted work. Dr. Fielding reports grants from the NIH (NIA) during the conduct of the study and grants, personal fees, and equity stock options from Axcella Health; equity stock options from InsideTracker; grants and personal fees from Biophytis, Astel-las, and Nestl{\'e}; and personal fees from Cytokinetics, Amazen-tis, and GlaxoSmithKline, outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje /ConflictOfInterestForms.do?msNum=M16-2011. Publisher Copyright: {\textcopyright} 2018 American College of Physicians.",
year = "2018",
month = mar,
day = "6",
doi = "10.7326/M16-2011",
language = "English (US)",
volume = "168",
pages = "309--316",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "5",
}