Effect of a 24-month physical activity intervention vs health education on cognitive outcomes in sedentary older adults: The LIFE randomized trial

LIFE Study Investigators

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106 Citations (Scopus)

Abstract

Importance: Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed. Objective: To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program. Design, Setting, and Participants: A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. Participants were sedentary adults aged 70 to 89 years who were at risk for mobility disability but able to walk 400 m. Interventions: A structured, moderate-intensity physical activity program (n = 818) that included walking, resistance training, and flexibility exercises or a health education program (n = 817) of educational workshops and upper-extremity stretching. Main Outcomes and Measures: Prespecified secondary outcomes of the LIFE study included cognitive function measured by the Digit Symbol Coding (DSC) task subtest of the Wechsler Adult Intelligence Scale (score range: 0-133; higher scores indicate better function) and the revised Hopkins Verbal Learning Test (HVLT-R; 12-item word list recall task) assessed in 1476 participants (90.3%). Tertiary outcomes included global and executive cognitive function and incident MCI or dementia at 24 months. Results: At 24 months, DSC task and HVLT-R scores (adjusted for clinic site, sex, and baseline values) were not different between groups. The mean DSC task scores were 46.26 points for the physical activity group vs 46.28 for the health education group (mean difference, -0.01 points [95%CI, -0.80 to 0.77 points], P = .97). The mean HVLT-R delayed recall scores were 7.22 for the physical activity group vs 7.25 for the health education group (mean difference, -0.03 words [95%CI, -0.29 to 0.24 words], P = .84). No differences for any other cognitive or composite measures were observed. Participants in the physical activity group who were 80 years or older (n = 307) and those with poorer baseline physical performance (n = 328) had better changes in executive function composite scores compared with the health education group (P = .01 for interaction for both comparisons). Incident MCI or dementia occurred in 98 participants (13.2%) in the physical activity group and 91 participants (12.1%) in the health education group (odds ratio, 1.08 [95%CI, 0.80 to 1.46]). Conclusions and Relevance: Among sedentary older adults, a 24-month moderate-intensity physical activity program compared with a health education program did not result in improvements in global or domain-specific cognitive function.

Original languageEnglish (US)
Pages (from-to)781-790
Number of pages10
JournalJournal of the American Medical Association
Volume314
Issue number8
DOIs
StatePublished - Aug 25 2015

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Health Education
Life Style
Exercise
Cognition
Dementia
Executive Function
Verbal Learning
Resistance Training
Intelligence
Upper Extremity
Walking
Randomized Controlled Trials
Odds Ratio
Outcome Assessment (Health Care)
Education
Cognitive Dysfunction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{753c4277cf2f42b1b14a9d23ad33bbff,
title = "Effect of a 24-month physical activity intervention vs health education on cognitive outcomes in sedentary older adults: The LIFE randomized trial",
abstract = "Importance: Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed. Objective: To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program. Design, Setting, and Participants: A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. Participants were sedentary adults aged 70 to 89 years who were at risk for mobility disability but able to walk 400 m. Interventions: A structured, moderate-intensity physical activity program (n = 818) that included walking, resistance training, and flexibility exercises or a health education program (n = 817) of educational workshops and upper-extremity stretching. Main Outcomes and Measures: Prespecified secondary outcomes of the LIFE study included cognitive function measured by the Digit Symbol Coding (DSC) task subtest of the Wechsler Adult Intelligence Scale (score range: 0-133; higher scores indicate better function) and the revised Hopkins Verbal Learning Test (HVLT-R; 12-item word list recall task) assessed in 1476 participants (90.3{\%}). Tertiary outcomes included global and executive cognitive function and incident MCI or dementia at 24 months. Results: At 24 months, DSC task and HVLT-R scores (adjusted for clinic site, sex, and baseline values) were not different between groups. The mean DSC task scores were 46.26 points for the physical activity group vs 46.28 for the health education group (mean difference, -0.01 points [95{\%}CI, -0.80 to 0.77 points], P = .97). The mean HVLT-R delayed recall scores were 7.22 for the physical activity group vs 7.25 for the health education group (mean difference, -0.03 words [95{\%}CI, -0.29 to 0.24 words], P = .84). No differences for any other cognitive or composite measures were observed. Participants in the physical activity group who were 80 years or older (n = 307) and those with poorer baseline physical performance (n = 328) had better changes in executive function composite scores compared with the health education group (P = .01 for interaction for both comparisons). Incident MCI or dementia occurred in 98 participants (13.2{\%}) in the physical activity group and 91 participants (12.1{\%}) in the health education group (odds ratio, 1.08 [95{\%}CI, 0.80 to 1.46]). Conclusions and Relevance: Among sedentary older adults, a 24-month moderate-intensity physical activity program compared with a health education program did not result in improvements in global or domain-specific cognitive function.",
author = "{LIFE Study Investigators} and Sink, {Kaycee M.} and Espeland, {Mark A.} and Castro, {Cynthia M.} and Timothy Church and Ron Cohen and Dodson, {John A.} and Jack Guralnik and Hugh Hendrie and Janine Jennings and Jeffery Katula and Lopez, {Oscar L.} and McDermott, {Mary M.} and Marco Pahor and Reid, {Kieran F.} and Julia Rushing and Joe Verghese and Stephen Rapp and Williamson, {Jeff D.} and Bonnie Spring and Joshua Hauser and Martha Gulati and Sanjiv Shah and Kathryn Domanchuk and Rex Graff and Kasia Kadela and Alvito Rego and Steven Blair and Valerie Myers and Ron Monce and Nathan Britt and Melissa Nauta and Ami Parks and Ruben Rodarte and Heidi Millet and Catrine Tudor-Locke and Ben Butitta and Sheletta Donatto and Denise Bonds and Hadley, {Evan C.} and Patel, {Kushang V.} and Sergei Romashkan and Kaplan, {Robert M.} and King, {Abby C.} and Haskell, {William L.} and Stafford, {Randall S.} and Veronica Yank and Pruitt, {Leslie A.} and Kathy Berra and Carol Bell and Rosita Thiessen",
year = "2015",
month = "8",
day = "25",
doi = "10.1001/jama.2015.9617",
language = "English (US)",
volume = "314",
pages = "781--790",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "8",

}

TY - JOUR

T1 - Effect of a 24-month physical activity intervention vs health education on cognitive outcomes in sedentary older adults

T2 - The LIFE randomized trial

AU - LIFE Study Investigators

AU - Sink, Kaycee M.

AU - Espeland, Mark A.

AU - Castro, Cynthia M.

AU - Church, Timothy

AU - Cohen, Ron

AU - Dodson, John A.

AU - Guralnik, Jack

AU - Hendrie, Hugh

AU - Jennings, Janine

AU - Katula, Jeffery

AU - Lopez, Oscar L.

AU - McDermott, Mary M.

AU - Pahor, Marco

AU - Reid, Kieran F.

AU - Rushing, Julia

AU - Verghese, Joe

AU - Rapp, Stephen

AU - Williamson, Jeff D.

AU - Spring, Bonnie

AU - Hauser, Joshua

AU - Gulati, Martha

AU - Shah, Sanjiv

AU - Domanchuk, Kathryn

AU - Graff, Rex

AU - Kadela, Kasia

AU - Rego, Alvito

AU - Blair, Steven

AU - Myers, Valerie

AU - Monce, Ron

AU - Britt, Nathan

AU - Nauta, Melissa

AU - Parks, Ami

AU - Rodarte, Ruben

AU - Millet, Heidi

AU - Tudor-Locke, Catrine

AU - Butitta, Ben

AU - Donatto, Sheletta

AU - Bonds, Denise

AU - Hadley, Evan C.

AU - Patel, Kushang V.

AU - Romashkan, Sergei

AU - Kaplan, Robert M.

AU - King, Abby C.

AU - Haskell, William L.

AU - Stafford, Randall S.

AU - Yank, Veronica

AU - Pruitt, Leslie A.

AU - Berra, Kathy

AU - Bell, Carol

AU - Thiessen, Rosita

PY - 2015/8/25

Y1 - 2015/8/25

N2 - Importance: Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed. Objective: To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program. Design, Setting, and Participants: A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. Participants were sedentary adults aged 70 to 89 years who were at risk for mobility disability but able to walk 400 m. Interventions: A structured, moderate-intensity physical activity program (n = 818) that included walking, resistance training, and flexibility exercises or a health education program (n = 817) of educational workshops and upper-extremity stretching. Main Outcomes and Measures: Prespecified secondary outcomes of the LIFE study included cognitive function measured by the Digit Symbol Coding (DSC) task subtest of the Wechsler Adult Intelligence Scale (score range: 0-133; higher scores indicate better function) and the revised Hopkins Verbal Learning Test (HVLT-R; 12-item word list recall task) assessed in 1476 participants (90.3%). Tertiary outcomes included global and executive cognitive function and incident MCI or dementia at 24 months. Results: At 24 months, DSC task and HVLT-R scores (adjusted for clinic site, sex, and baseline values) were not different between groups. The mean DSC task scores were 46.26 points for the physical activity group vs 46.28 for the health education group (mean difference, -0.01 points [95%CI, -0.80 to 0.77 points], P = .97). The mean HVLT-R delayed recall scores were 7.22 for the physical activity group vs 7.25 for the health education group (mean difference, -0.03 words [95%CI, -0.29 to 0.24 words], P = .84). No differences for any other cognitive or composite measures were observed. Participants in the physical activity group who were 80 years or older (n = 307) and those with poorer baseline physical performance (n = 328) had better changes in executive function composite scores compared with the health education group (P = .01 for interaction for both comparisons). Incident MCI or dementia occurred in 98 participants (13.2%) in the physical activity group and 91 participants (12.1%) in the health education group (odds ratio, 1.08 [95%CI, 0.80 to 1.46]). Conclusions and Relevance: Among sedentary older adults, a 24-month moderate-intensity physical activity program compared with a health education program did not result in improvements in global or domain-specific cognitive function.

AB - Importance: Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed. Objective: To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program. Design, Setting, and Participants: A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. Participants were sedentary adults aged 70 to 89 years who were at risk for mobility disability but able to walk 400 m. Interventions: A structured, moderate-intensity physical activity program (n = 818) that included walking, resistance training, and flexibility exercises or a health education program (n = 817) of educational workshops and upper-extremity stretching. Main Outcomes and Measures: Prespecified secondary outcomes of the LIFE study included cognitive function measured by the Digit Symbol Coding (DSC) task subtest of the Wechsler Adult Intelligence Scale (score range: 0-133; higher scores indicate better function) and the revised Hopkins Verbal Learning Test (HVLT-R; 12-item word list recall task) assessed in 1476 participants (90.3%). Tertiary outcomes included global and executive cognitive function and incident MCI or dementia at 24 months. Results: At 24 months, DSC task and HVLT-R scores (adjusted for clinic site, sex, and baseline values) were not different between groups. The mean DSC task scores were 46.26 points for the physical activity group vs 46.28 for the health education group (mean difference, -0.01 points [95%CI, -0.80 to 0.77 points], P = .97). The mean HVLT-R delayed recall scores were 7.22 for the physical activity group vs 7.25 for the health education group (mean difference, -0.03 words [95%CI, -0.29 to 0.24 words], P = .84). No differences for any other cognitive or composite measures were observed. Participants in the physical activity group who were 80 years or older (n = 307) and those with poorer baseline physical performance (n = 328) had better changes in executive function composite scores compared with the health education group (P = .01 for interaction for both comparisons). Incident MCI or dementia occurred in 98 participants (13.2%) in the physical activity group and 91 participants (12.1%) in the health education group (odds ratio, 1.08 [95%CI, 0.80 to 1.46]). Conclusions and Relevance: Among sedentary older adults, a 24-month moderate-intensity physical activity program compared with a health education program did not result in improvements in global or domain-specific cognitive function.

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U2 - 10.1001/jama.2015.9617

DO - 10.1001/jama.2015.9617

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