Physical activity as a determinant of change in mobility performance: the Longitudinal Aging Study Amsterdam.
ABSTRACT This study examined the association of (change in) physical activity and decline in mobility performance in older men and women.
A 3-year prospective study using data of the Longitudinal Aging Study.
Two thousand one hundred nine men and women aged 55 to 85.
Total physical activity (expressed as hours per day and kilocalories per day) and sports participation were measured using a validated, interviewer-administered questionnaire. Mobility performance was assessed using two timed tests: 6-meter walk and repeated chair stands.
Mobility performance declined for 45.6% of the sample. At baseline, the mean time +/- standard deviation spent on total physical activity was 3.0 +/- 2.1 h/d or 719 +/- 543 kcal/d, and 56.6% of the sample participated in sports. Sports participation and a higher level of total physical activity, walking, or household activity were associated with a smaller mobility decline. After 3 years, total physical activity declined, and only 53.4% of those reporting sports at baseline continued doing so. Continuation of physical activity over time was associated with the smallest decline in mobility. The observed associations were similar for those with and without chronic disease (P> 0.3). The conclusions did not change after adjustment for potential confounders, including demographic and lifestyle variables, depression, and cognitive status.
Physical activity, and especially a regularly active lifestyle, may slow the decline in mobility performance. A beneficial effect was observed for sports and nonsports activities, independent of the presence of chronic disease.
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ABSTRACT: A validated physical activity questionnaire for young adults was adapted and validated for use in free living, apparently healthy people, aged 63-80 yr. Test-retest reliability of the questionnaire on 29 participants was 0.89 as determined by Spearman's correlation coefficient. Further classification by tertiles of activity resulted in 72% of the participants being correctly classified and 0% grossly misclassified on two separate occasions. In a similar group of 31 subjects, classifications based on questionnaire activity scores were compared with classifications obtained by repeated 24-h activity recalls and pedometer measurements, showing Spearman's correlations of 0.78 and 0.73, for both methods, respectively. Seventy-one and 67% of the subjects, respectively, were classified in the same activity tertile for both methods. It is concluded that the questionnaire provides a reliable and valid method for classifying elderly subjects into categories of high, medium, and low physical activity.Medicine & Science in Sports & Exercise 09/1991; 23(8):974-9. · 4.48 Impact Factor
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ABSTRACT: Functional assessment is an important part of the evaluation of elderly persons. We conducted this study to determine whether objective measures of physical function can predict subsequent disability in older persons. This prospective cohort study included men and women 71 years of age or older who were living in the community, who reported no disability in the activities of daily living, and who reported that they were able to walk one-half mile (0.8 km) and climb stairs without assistance. The subjects completed a short battery of physical-performance tests and participated in a follow-up interview four years later. The tests included an assessment of standing balance, a timed 8-ft (2.4-m) walk at a normal pace, and a timed test of five repetitions of rising from a chair and sitting down. Among the 1122 subjects who were not disabled at base line and who participated in the four-year follow-up, lower scores on the base-line performance tests were associated with a statistically significant, graduated increase in the frequency of disability in the activities of daily living and mobility-related disability at follow-up. After adjustment for age, sex, and the presence of chronic disease, those with the lowest scores on the performance tests were 4.2 to 4.9 times as likely to have disability at four years as those with the highest performance scores, and those with intermediate performance scores were 1.6 to 1.8 times as likely to have disability. Among nondisabled older persons living in the community, objective measures of lower-extremity function were highly predictive of subsequent disability. Measures of physical performance may identify older persons with a preclinical stage of disability who may benefit from interventions to prevent the development of frank disability.New England Journal of Medicine 04/1995; 332(9):556-61. · 51.66 Impact Factor
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ABSTRACT: OBJECTIVE: In older people, mobility impairments and physical inactivity are risk factors for further disability and death. We studied the interaction of physical activity and mobility impairment as a predictor of dependence and mortality. DESIGN: A population-based, prospective study. The data were collected in structured interviews in the year 1988 and 8 years later in the year 1996 as part of the Evergreen Project. PARTICIPANTS: Subjects were 1109 independently living, at baseline 65- to 84-year-old people in the city of Jyvaskyla, in central Finland. METHODS: Participants were ranked into four groups: (1) Intact mobility and physically active (Mobile-Active), (2) Intact mobility and sedentary (Mobile-Sedentary), (3) Impaired mobility and physically active (Impaired-Active), and (4) Impaired mobility and sedentary (Impaired-Sedentary). The confounders adjusted for in the models included age, marital status, education, chronic conditions, smoking, and physical exercise earlier in life. RESULTS: In men and women, the relative risk of death was two times greater in Impaired-Active and three times greater in Impaired-Sedentary groups than the risk of death in Mobile-Active groups. However, the risk of death did not differ between Mobile-Active and Mobile-Sedentary groups. The odds ratio for dependency (95% confidence interval) in Impaired-Sedentary men was 5.21 (1.44-18.70) and in Impaired-Sedentary women was 2.92 (1.52-5.60) compared to Mobile-Active groups. The risk of dependence did not differ significantly between Mobile-Active, Mobile-Sedentary, and Impaired-Active groups. CONCLUSIONS: Mobility impairments predicted mortality and dependence. However, among people with impaired mobility, physical activity was associated with lower risks, whereas the risk did not differ according to activity level among those with intact mobility. Despite of their overall greater risk, mobility-impaired people may be able to prevent further disability and mortality by physical exercise.Journal of the American Geriatrics Society 05/2000; 48(5):493-498. · 3.98 Impact Factor