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JAMA. 2015 Aug 25;314(8):781-90. doi: 10.1001/jama.2015.9617.

Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial.

Collaborators (187)

McDermott MM, Spring B, Hauser J, Gulati M, Shah S, Domanchuk K, Graff R, Kadela K, Rego A, Church T, Blair S, Myers V, Monce R, Britt N, Nauta M, Parks A, Rodarte R, Millet H, Tudor-Locke C, Butitta B, Donatto S, Bonds D, Hadley EC, Patel KV, Romashkan S, Kaplan RM, King AC, Castro CM, Haskell WL, Stafford RS, Yank V, Pruitt LA, Berra K, Bell C, Thiessen R, Youngman KP, Virgen SB, Tarin KN, Klaftenegger H, Prosak CA, Campero I, Garcia DM, Soto J, Chio L, Hoskins D, Fielding R, Nelson M, Folta S, Phillips E, Liu C, Cifarelli E, Reid K, Lacasse P, Kirn D, Pasha E, Ribourg S, Ruais K, Kim W, Cloutier G, Manini T, Pahor M, Anton S, Buford T, Nayfield S, Nocera J, Marsiske M, Sandesara B, Lee J, Hiatt-Jensen D, Black M, Case K, Herring K, Schwier-Delvisco A, Burk B, Hoover B, Knaggs J, Martin A, Xie C, Morris H, Singletary F, Causer J, Yonce S, Del Boccio C, Gay C, Alexander TP, Pahor M, Anton S, Buford T, Leeuwenburgh C, Nayfield S, Manini T, Caudle C, Crump L, Holmes L, Lee J, Lester R, Lu CJ, O'Mara R, Pepine CJ, Ariet M, Handberg E, Deluca D, Hill J, Guralnik JM, Newman AB, Studenski SA, Goodpaster BH, Lopez O, Glynn NW, Bonk JT, Rush J, Kost P, Gerger A, Vincent P, Davis L, Newman MA, Grove G, Williams K, Groessl EJ, Kritchevsky SB, Marsh A, Brinkley T, Demons J, Sink K, Kennedy K, Shertzer-Skinner R, Wrights A, Fries R, Barr D, Williamson J, Sink KM, Hendrie HC, Rapp SR, Verghese J, Woolard N, Wilson VK, Miller ME, Espeland M, Ambrosius W, Babcock D, Beavers D, Byington RP, Cook D, Furberg C, Goode C, Griffin J, Harvin L, Henkin L, Hepler J, Hsu FC, Joyce K, Lovato L, Roberson W, Robertson J, Rushing J, Rushing S, Stowe CL, Walkup MP, Hire D, Rejeski J, Katula J, Brubaker PH, Mihalko S, Jennings JM, Lane K, Gill TM, Axtell RS, Kashaf SS, de Renekeire N, McGloin JM, Mautner R, Huie-White SM, Bianco L, Zocher J, Shepard DM, Fennelly B, Halpin S, Barnett T, Wu KC, Iannone LP, Bugaj JA, Bailey C, Chupp G, Flynn G, Gill TM, Hankinson J, Fragoso CA.

Author information

1
Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
2
Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
3
Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California.
4
Pennington Biomedical Research Center, Baton Rouge, Louisiana.
5
College of Medicine, University of Florida, Gainesville.
6
Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
7
Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.
8
Department of Psychiatry and Center for Aging Research, Indiana University, Indianapolis.
9
Department of Psychology, Wake Forest University, Winston-Salem, North Carolina.
10
Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina.
11
Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
12
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois13Senior Editor, JAMA.
13
Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
14
Departments of Neurology and Medicine, Albert Einstein College of Medicine, Bronx, New York.
15
Department of Psychiatry, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

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.

TRIAL REGISTRATION:

clinicaltrials.gov Identifier: NCT01072500.

PMID:
26305648
PMCID:
PMC4698980
DOI:
10.1001/jama.2015.9617
[Indexed for MEDLINE]
Free PMC Article

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