학술논문
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
Document Type
Report
Author
Marsh, Anthony P.; Applegate, William B.; Guralnik, Jack M.; Jack Rejeski, W.; Church, Timothy S.; Fielding, Roger A.; Gill, Thomas M.; King, Abby C.; Kritchevsky, Stephen B.; Manini, Todd M.; McDermott, Mary M.; Newman, Anne B.; Stowe, Cynthia L.; Walkup, Michael P.; Pahor, Marco; Miller, Michael E.; Leeuwenburgh, Christiaan; Caudle, Connie; Crump, Lauren; Holmes, Latonia; Lee, Jocelyn; Lu, Ching-ju; Espeland, Mark A.; Ambrosius, Walter T.; Beavers, Daniel P.; Byington, Robert P.; Cook, Delilah; Furberg, Curt D.; Harvin, Lea N.; Henkin, Leora; Hepler, John; Hsu, Fang-Chi; Lovato, Laura; Roberson, Wesley; Rushing, Julia; Rushing, Scott; Hire, Don; Katula, Jeffrey A.; Brubaker, Peter H.; Mihalko, Shannon L.; Jennings, Janine M.; Hadley, Evan C.; Romashkan, Sergei; Patel, Kushang V.; Bonds, Denise; Spring, Bonnie; Hauser, Joshua; Kerwin, Diana; Domanchuk, Kathryn; Graff, Rex; Rego, Alvito; Blair, Steven N.; Myers, Valerie H.; Monce, Ron; Britt, Nathan E.; Harris, Melissa Nauta; McGucken, Ami Parks; Rodarte, Ruben; Millet, Heidi K.; Tudor-Locke, Catrine; Butitta, Ben P.; Donatto, Sheletta G.; Cocreham, Shannon H.; Castro, Cynthia M.; Haskell, William L.; Stafford, Randall S.; Pruitt, Leslie A.; Berra, Kathy; Yank, Veronica; Nelson, Miriam E.; Folta, Sara C.; Phillips, Edward M.; Liu, Christine K.; McDavitt, Erica C.; Reid, Kieran F.; Kim, Won S.; Beard, Vince E.; Anton, Stephen D.; Nayfield, Susan; Buford, Thomas W.; Marsiske, Michael; Sandesara, Bhanuprasad D.; Knaggs, Jeffrey D.; Lorow, Megan S.; Marena, William C.; Korytov, Irina; Morris, Holly L.; Fitch, Margo; Singletary, Floris F.; Causer, Jackie; Radcliff, Katie A.; Studenski, Stephanie A.; Goodpaster, Bret H.; Glynn, Nancy W.; Lopez, Oscar; Nadkarni, Neelesh K.; Williams, Kathy; Newman, Mark A.; Grove, George; Bonk, Janet T.; Rush, Jennifer; Kost, Piera; Ives, Diane G.; Brinkley, Tina E.; Demons, Jamehl S.; Sink, Kaycee M.; Kennedy, Kimberly; Shertzer-Skinner, Rachel; Wrights, Abbie; Fries, Rose; Barr, Deborah; Axtell, Robert S.; Kashaf, Susan S.; Rekeneire, Nathalie; McGloin, Joanne M.; Wu, Karen C.; Shepard, Denise M.; Fennelly, Barbara; Iannone, Lynne P.; Mautner, Raeleen; Barnett, Theresa Sweeney; Halpin, Sean N.; Brennan, Matthew J.; Bugaj, Julie A.; Zenoni, Maria A.; Mignosa, Bridget M.; Williamson, Jeff; Sink, Kaycee M; Hendrie, Hugh C.; Rapp, Stephen R.; Verghese, Joe; Espeland, Mark; Jennings, Janine; Pepine, Carl J.; Ariet, Mario; Handberg, Eileen; Deluca, Daniel; Hill, James; Szady, Anita; Chupp, Geoffrey L.; Flynn, Gail M.; Hankinson, John L.; Vaz Fragoso, Carlos A.
Source
Journal of the American Geriatrics Society. May, 2016, Vol. 64 Issue 5, p933, 11 p.
Subject
Language
English
ISSN
0002-8614
Abstract
Byline: Anthony P. Marsh, William B. Applegate, Jack M. Guralnik, W. Jack Rejeski, Timothy S. Church, Roger A. Fielding, Thomas M. Gill, Abby C. King, Stephen B. Kritchevsky, Todd M. Manini, Mary M. McDermott, Anne B. Newman, Cynthia L. Stowe, Michael P. Walkup, Marco Pahor, Michael E. Miller, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Mark A. Espeland, Walter T. Ambrosius, Daniel P. Beavers, Robert P. Byington, Delilah Cook, Curt D. Furberg, Lea N. Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Don Hire, Jeffrey A. Katula, Peter H. Brubaker, Shannon L. Mihalko, Janine M. Jennings, Evan C. Hadley, Sergei Romashkan, Kushang V. Patel, Denise Bonds, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Steven N. Blair, Valerie H. Myers, Ron Monce, Nathan E. Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K. Millet, Catrine Tudor-Locke, Ben P. Butitta, Sheletta G. Donatto, Shannon H. Cocreham, Cynthia M. Castro, William L. Haskell, Randall S. Stafford, Leslie A. Pruitt, Kathy Berra, Veronica Yank, Miriam E. Nelson, Sara C. Folta, Edward M. Phillips, Christine K. Liu, Erica C. McDavitt, Kieran F. Reid, Won S. Kim, Vince E. Beard, Stephen D. Anton, Susan Nayfield, Thomas W. Buford, Michael Marsiske, Bhanuprasad D. Sandesara, Jeffrey D. Knaggs, Megan S. Lorow, William C. Marena, Irina Korytov, Holly L. Morris, Margo Fitch, Floris F. Singletary, Jackie Causer, Katie A. Radcliff, Stephanie A. Studenski, Bret H. Goodpaster, Nancy W. Glynn, Oscar Lopez, Neelesh K. Nadkarni, Kathy Williams, Mark A. Newman, George Grove, Janet T. Bonk, Jennifer Rush, Piera Kost, Diane G. Ives, Tina E. Brinkley, Jamehl S. Demons, Kaycee M. Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Robert S. Axtell, Susan S. Kashaf, Nathalie Rekeneire, Joanne M. McGloin, Karen C. Wu, Denise M. Shepard, Barbara Fennelly, Lynne P. Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N. Halpin, Matthew J. Brennan, Julie A. Bugaj, Maria A. Zenoni, Bridget M. Mignosa, Jeff Williamson, Kaycee M Sink, Hugh C. Hendrie, Stephen R. Rapp, Joe Verghese, Mark Espeland, Janine Jennings, Carl J. Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L. Chupp, Gail M. Flynn, John L. Hankinson, Carlos A. Vaz Fragoso Keywords: physical activity; older adults; mobility disability; safety; hospitalizations 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 (2x/wk) and at home (3-4x/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 (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. Article Note: The LIFE investigators are listed in Appendix 1. CAPTION(S): Data S1. Exploration of Baseline Gait Speed by Intervention Interaction Effect. Table S1. Subject Characteristics at Baseline According to Intervention Group. Table S2. Hospitalizations Reported to Masked Staff According to Medical Dictionary for Regulatory Activities (MedDRA) System Organ Class (SOC): Overall and According to Category of Baseline 400-m-Walk Speed. Table S3. Hospitalizations Reported to Masked Staff According to Field Center: Overall and According to Category of Baseline 400-m-Walk Speed. Figure S1. Hospitalizations according to 400-m walk speed category at each of the eight field centers. Figure S2. Self-reported minutes of walking and resistance training activities per week. Figure S3. Hazard functions for any hospitalization according to baseline gait speed category.