Dataset Information

The REtirement in ACTion exercise programme and its effects on elements of long term functionality in older adults.

ABSTRACT:

Background

The prevention of mobility-related disability amongst adults is a global healthcare priority. Cost-effective community-based strategies to improve physical function and independence in older adults with mobility limitations are needed. This study investigated the effectiveness of the REtirement in ACTion (REACT) exercise intervention on individual markers of physical function at 6-and 12-months.

Methods

The REACT multicentre randomised controlled trial assigned 777 older adults (female, 514; male 263) (mean age 77·6 [SD 6·8] years) with reduced lower limb physical functioning (Short Physical Performance Battery [SPPB] score 4-9) to receive brief healthy ageing advice or a 12-month, group-based, multimodal exercise programme delivered in local communities. Estimated differences in the three individual component scores of the SPPB (strength, balance, gait speed) and physical functional outcomes recorded at 6- and 12-months were assessed.

Results

The intervention group demonstrated significant improvements in strength (OR = 1.88, 95% CI = 1.36-2.59, p < 0.001) and balance (OR = 1.96, 95% CI = 1.39-2.67, p < 0.001) at 12-months, but not in gait speed (OR = 1.32, 95% CI = 0.91-1.90, p = 0.139). In comparison to the control group, at six-and 12-months, the intervention group reported statistically significant improvements in Mobility Assessment Tool-Short Form (MAT-SF), physical component score from SF-36 questionnaire, and strength and endurance items of subjectively reported physical activity (PASE 10-item). Greater than 75% adherence (attending ≥48 of the 64 exercise sessions delivered in 12-months) was associated with superior functional outcomes.

Conclusion

The REACT exercise programme provides local, regional and national service providers with an effective solution to increase muscle strength and balance in older adults at risk of mobility disability.

SUBMITTER: Ladlow P

PROVIDER: S-EPMC10420051 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

The REtirement in ACTion exercise programme and its effects on elements of long term functionality in older adults.

Ladlow Peter P Western Max J MJ Greaves Colin J CJ Thompson Janice L JL Withall Janet J de Koning Jolanthe J Bollen Jessica C JC Moorlock Sarah J SJ Guralnik Jack M JM Fox Kenneth R KR Stathi Afroditi A

Frontiers in public health 20230728

<h4>Background</h4>The prevention of mobility-related disability amongst adults is a global healthcare priority. Cost-effective community-based strategies to improve physical function and independence in older adults with mobility limitations are needed. This study investigated the effectiveness of the REtirement in ACTion (REACT) exercise intervention on individual markers of physical function at 6-and 12-months.<h4>Methods</h4>The REACT multicentre randomised controlled trial assigned 777 olde ...[more]

PMID: 37575112

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Project description:BackgroundMobility limitations in old age can greatly reduce quality of life, generate substantial health and social care costs, and increase mortality. Through the Retirement in Action (REACT) trial, we aimed to establish whether a community-based active ageing intervention could prevent decline in lower limb physical functioning in older adults already at increased risk of mobility limitation.MethodsIn this pragmatic, multicentre, two-arm, single-blind, parallel-group, randomised, controlled trial, we recruited older adults (aged 65 years or older and who are not in full-time employment) with reduced lower limb physical functioning (Short Physical Performance Battery [SPPB] score 4-9) from 35 primary care practices across three sites (Bristol and Bath; Birmingham; and Devon) in England. Participants were randomly assigned to receive brief advice (three healthy ageing education sessions) or a 12-month, group-based, multimodal physical activity (64 1-h exercise sessions) and behavioural maintenance (21 45-min sessions) programme delivered by charity and community or leisure centre staff in local communities. Randomisation was stratified by site and adopted a minimisation approach to balance groups by age, sex, and SPPB score, using a centralised, online, randomisation algorithm. Researchers involved in data collection and analysis were masked but participants were not because of the nature of the intervention. The primary outcome was change in SPPB score at 24 months, analysed by intention to treat. This trial is registered with ISRCTN, ISRCTN45627165.FindingsBetween June 20, 2016, and Oct 30, 2017, 777 participants (mean age 77·6 [SD 6·8] years; 66% female; mean SPPB score 7·37 [1·56]) were randomly assigned to the intervention (n=410) and control (n=367) groups. Primary outcome data at 24 months were provided by 628 (81%) participants (294 in the control group and 334 in the intervention group). At the 24-month follow-up, the SPPB score (adjusted for baseline SPPB score, age, sex, study site, and exercise group) was significantly greater in the intervention group (mean 8·08 [SD 2·87]) than in the control group (mean 7·59 [2·61]), with an adjusted mean difference of 0·49 (95% CI 0·06-0·92; p=0·014), which is just below our predefined clinically meaningful difference of 0·50. One adverse event was related to the intervention; the most common unrelated adverse events were heart conditions, strokes, and falls.InterpretationFor older adults at risk of mobility limitations, the REACT intervention showed that a 12-month physical activity and behavioural maintenance programme could help prevent decline in physical function over a 24-month period.FundingNational Institute for Health Research Public Health Research Programme (13/164/51).

Project description:BackgroundResistance training and other forms of physical exercise are commonly suggested to promote brain health, yet the relationship between resistance training and brain structure in aging is poorly understood. We examined the short- and long-term influence of one year of supervised resistance training at two different loadings on brain structure in aging.MethodsIn the LISA (LIve active Successful Ageing) study, well-functioning older adults at retirement age (mean age: 66 ± 2 years) were randomized to one year of heavy resistance training (HRT), moderate intensity training (MIT), or a non-exercising control group (CON). Magnetic resonance imaging (MRI) of the brain was performed at baseline, 1-, 2-, and 4-years follow ups. Trajectories of total grey matter, hippocampus, dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC), and white matter hyperintensities were analyzed in relation to changes in muscle strength.ResultsIndividuals (n = 276) with MRI scans at all 4 timepoints were included (HRT, n = 96; MIT, n = 95; CON, n = 85). Total grey matter volume decreased with time across all groups (F3,819 = 231.549, p < 0.001, η 2 = 0.46), as did hippocampal (F3,819 = 310.07, p < 0.001, η 2 = 0.53), vlPFC (F3,818 = 74.380, p < 0.001, η 2 = 0.21), and dlPFC (F3,818 = 3.640, p = 0.013, η 2 = 0.01) volumes. White matter hyperintensity volumes increased (F3,819 = 101.876, p < 0.001, η 2 = 0.27). There were no significant group x time interactions for any of the brain structures. Additional cortical and subcortical vertex-wise analyses showed no group differences. Change in isometric leg strength was weakly associated with change in white matter hyperintensity volume across all individuals (r2 = 0.01, p = 0.048).ConclusionsOne year of resistance training in well-functioning older adults at retirement age did not influence volume changes in selected brain regions over a 4-year period.Trial registrationThe study was approved by the regional ethics committee and registered on clinicaltrials.gov 2014-04-24 (NCT02123641).

Dataset Information

The REtirement in ACTion exercise programme and its effects on elements of long term functionality in older adults.

Background

Methods

Results

Conclusion

Publications

The REtirement in ACTion exercise programme and its effects on elements of long term functionality in older adults.

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