867. Cluster randomized controlled trial of a multilevel physical activity intervention for older adults
Source: International Journal of Behavioral Nutrition and Physical Activity
Commentary by Steve Gilbert, GlobalPANet Executive/ University of Sydney
The benefits of engaging in a physically active lifestyle can be of particular importance for older adults, where age-related declines in physical function can be an outcome of increased sedentary behaviours and can go hand-in-hand with the onset of chronic disability and disease. Older adults with higher levels of physical activity have been shown to have improved cognitive function, reduced risk factors for chronic diseases and greater longevity. However, despite the benefits of maintaining a physically active lifestyle in old age, few older adults are regularly active.
Kerr et al. have recently published their study investigating the effects of a 12 month multi-level intervention on the physical activity levels of older adults living in retirement communities in San Diego, United States. Retirement communities were randomly allocated to receive the intervention or to a control group. Participants in the intervention group were encouraged to increase their daily step count by 3000 steps from their baseline values over a 12 week period, and then maintain this for the remainder of the trial. Individual support, group sessions and community levels projects were all provided as part of the intervention to encourage greater activity participation.
After 3-months, participation in both light intensity and moderate-vigorous intensity physical activity were found to be increased in the intervention group, with no change in the controls. Through the following assessments at 6, 9 and 12 months, participants in the intervention group completed less activity than achieved at the 3 month time-point, but still remained higher than baseline, and still maintained a statistically significant difference from controls. A statistically significant difference in both systolic and diastolic blood pressure was also reported after 6 months, with participants in the intervention group showing reductions from baseline levels. These differences between groups were not maintained at 12 months.
The findings of this study show that a 12 month multi-level intervention can result in increases in physical activity levels amongst older adults. It is notable however that the greatest increase in activity was observed in the first three months of the intervention, with a steady decline observed at each of the time-points thereafter. This finding could be attributed to the withdrawal of the goal-setting and personal counselling phone calls participants received through the first 3 months of the trial. It would be of interest for future studies to explore whether efforts to maintain this level of participant support for longer durations could provide more sustained increases in activity levels.
This study demonstrates that physical activity interventions based in retirement communities can be an effective means of encouraging greater physical activity participation amongst this age group. With the rapid increase of the older population, such means of promoting and maintaining good health into older age are greatly needed and must be promoted to reduce the growing costs of disability and ill-health in this age-group.
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