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Effect of a Structured Exercise Program on the Overall Burden of Major Mobility Disability Among Older Adults

What is the problem and what is known about it so far? Being able to walk independentlythat is, 400 meters (one quarter mile) without help from another person or using a walkeris an important health goal for older adults. Older adults who cannot walk independently have an increased risk for depression and other serious illnesses and are less likely to be able to live in the community. Studies suggest that the amount of time that an older adult spends being unable to walk independently has a big effect on his or her quality of life. Why did the researchers do this particular study? The investigators wanted to compare the effect of a long-term exercise program with that of a health education program on the proportion of measurements (or amount of time) in which the study participants could not walk independently. They also compared the participants' risks for changing from being able to walk independently to not being able to walk, and vice versa. Who was studied? 1635 older adults, aged 70 to 89 years, who were not physically active and had functional limitations. To participate in the study, they had to be able to walk a quarter mile (400 meters) without the help of another person or using a walker. How was the study done? The researchers analyzed data from a trial that was completed in 2013. In the trial, the participants were randomly assigned to either a structured exercise program or a health education program for about 3 years. The researchers saw the participants every 6 months to measure their ability to walk independently. Major mobility disability was defined as not being able to independently walk a quarter mile in 15 minutes. What did the researchers find? During the follow-up, the proportion of measurements showing that the study participants had major mobility disability (or were unable to walk independently) was lower in the group that exercised than in the group that received health education. Compared with the health education group, the exercise group also had a lower risk for going from a state of being able to walk to a state of not being able to walk. The participants in the exercise group also were more likely to change from a state of not being able to walk to a state of being able to walk. What were the limitations of the study? The original trial was not designed to answer this question. What are the implications of the study? A structured exercise program was associated with a decreased burden of major mobility disabilitythat is, the amount of time that older adults spent not being able to walk independently.