Adherence to Physical Activity and Incident Mobility Disability in Older Adults With Mobility Limitations

IF 9.4 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-06-18 DOI:10.1002/jcsm.13870

Alejandro Álvarez-Bustos, Helio José Coelho-Junior, Riccardo Calvani, Leocadio Rodriguez-Mañas, Matteo Tosato, Matteo Cesari, Antonio Cherubini, Alfonso J. Cruz-Jentoft, Pálmi V. Jónsson, Fabrizia Lattanzio, Marcello Maggio, Regina Roller-Wirnsberger, Ingrid Rýznarová, Annemie M. W. J. Schols, Cornel C. Sieber, Alan J. Sinclair, Anna Skalska, Timo Strandberg, Achille Tchalla, Eva Topinková, Bruno Vellas, Stephan von Haehling, Francesco Landi, Emanuele Marzetti, for the SPRINTT consortium

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引用次数: 0

Abstract

Background

Preservation of mobility independence is a primary goal in older adults with physical frailty and sarcopenia (PF&S). Interventions based on the combination of physical activity (PA) and nutritional counselling have been indicated as strategies for the management of this condition, although their effectiveness is not confirmed in all investigations. A possible explanation for this uncertain scenario relies in the impact of the adherence to PA interventions. Hence, the present study investigated the impact of the adherence to PA sessions on the incidence of mobility disability in older adults with PF&S.

Methods

This is a secondary analysis of an evaluator blinded, randomised controlled trial, developed in 16 clinical sites across 11 European countries, from January 2016 to 31 October 2019. Participants were community-dwelling older adults (70+ years) with PF&S enrolled in the SPRINTT trial (NCT02582138). PF&S was operationalised as having a total score from 3 to 9 on the short physical performance battery (SPPB), low appendicular lean mass and ability to complete the 400-m walk test in < 15 min. Data from participants allocated to a multicomponent intervention (PA with technological support plus nutritional counselling) and a healthy ageing lifestyle education programme (control group) were analysed. Adherence to PA was assessed based on the number of weekly sessions attended. According to recommendations of the American College of Sports Medicine, adherence was categorised as below recommendations (< 2 sessions/week, BR), meeting recommendations (2–3 sessions/week, MR), and above recommendations (> 3 sessions/week, AR). The primary outcome was incident mobility disability, operationalised as incident inability to complete the 400-m walk test in < 15 min during up to 36 months of follow-up.

Results

Data of 1444 participants (mean age 79.3 years, 72.6% women) were analysed. In those with SPPB scores of 3–7, MR and AR groups had lower risk of mobility disability compared with controls [MR HR (95% CI): 0.57 (0.41–0.78), p = 0.001; AR HR (95% CI): 0.33 (0.23–0.46), p < 0.001] and BR groups [MR: HR (95% CI): 0.48 (0.34–0.69), p < 0.001; AR: HR (95% CI): 0.27 (0.18–0.38), p < 0.001] in a dose-dependent manner. In those with SPPB scores of 8 or 9, the BR group had a higher risk of mobility disability than controls. MR and AR groups had a lower risk of mobility disability than the BR group.

Conclusions

In older adults with PF&S, adherence to PA recommendations is associated with lower incidence of mobility disability. This benefit depends on the degree of adherence as well as baseline physical performance.

Trial Registration: ClinicalTrials.gov NCT02582138

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活动受限的老年人坚持体力活动和偶发性活动障碍

背景：保持活动独立性是老年人身体虚弱和肌肉减少症（PF&；S）的主要目标。基于身体活动（PA）和营养咨询相结合的干预措施已被认为是治疗这种疾病的策略，尽管其有效性并未在所有调查中得到证实。对于这种不确定的情况，一个可能的解释依赖于坚持PA干预措施的影响。因此，本研究调查了坚持PA课程对老年PF&；S患者行动障碍发生率的影响。这是对一项评估者盲法随机对照试验的二次分析，该试验于2016年1月至2019年10月31日在11个欧洲国家的16个临床点开展。参与者是SPRINTT试验（NCT02582138）中患有PF&；S的社区居住老年人（70岁以上）。PF&；S在短物理性能电池（SPPB）上的总分为3到9分，阑尾瘦质量低，能够在15分钟内完成400米步行测试。研究人员分析了被分配到多组分干预（PA与技术支持加营养咨询）和健康老龄化生活方式教育计划（对照组）的参与者的数据。对PA的依从性是根据每周参加会议的次数来评估的。根据美国运动医学学院的建议，依从性分为以下建议（2次/周，BR），会议建议（2 - 3次/周，MR）和以上建议（3次/周，AR）。主要结果为偶发性行动障碍，在长达36个月的随访中，以偶发性无法在15分钟内完成400米步行测试为操作指标。结果共纳入1444名参与者，平均年龄79.3岁，女性72.6%。在SPPB评分为3-7分的患者中，MR组和AR组的行动障碍风险较对照组低[MR HR (95% CI): 0.57 (0.41-0.78), p = 0.001；基于“增大化现实”技术的人力资源(95% CI): 0.33 (0.23 - -0.46), p & lt; 0.001]和BR组[先生:人力资源(95% CI): 0.48 (0.34 - -0.69), p & lt; 0.001;AR: HR (95% CI): 0.27 (0.18-0.38), p <； 0.001]呈剂量依赖性。在SPPB得分为8或9分的人群中，BR组比对照组有更高的行动障碍风险。MR和AR组的行动障碍风险低于BR组。结论：在患有PF&；S的老年人中，遵守PA建议可降低行动障碍的发生率。这种益处取决于坚持的程度以及基线的身体表现。试验注册：ClinicalTrials.gov NCT02582138

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.