Format

Send to

Choose Destination
J Epidemiol Community Health. 2016 Sep;70(9):930-3. doi: 10.1136/jech-2016-207321. Epub 2016 Apr 8.

Socioeconomic differences in the benefits of structured physical activity compared with health education on the prevention of major mobility disability in older adults: the LIFE study.

Author information

1
Centre for Longitudinal Studies, UCL Institute of Education, London, UK.
2
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
3
Department of Social and Environmental Health, London School of Hygiene and Tropical, Medicine, UK.
4
Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
5
Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA.
6
Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida, USA.
7
Stanford University School of Medicine, Stanford, California, USA.
8
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA.
9
Yale School of Medicine, New Haven, Connecticut, USA.

Abstract

BACKGROUND:

Evidence is lacking on whether health-benefiting community-based interventions differ in their effectiveness according to socioeconomic characteristics. We evaluated whether the benefit of a structured physical activity intervention on reducing mobility disability in older adults differs by education or income.

METHODS:

The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicentre, randomised trial that compared a structured physical activity programme with a health education programme on the incidence of mobility disability among at-risk community-living older adults (aged 70-89 years; average follow-up of 2.6 years). Education (≤ high school (0-12 years), college (13-17 years) or postgraduate) and annual household income were self-reported (<$24 999, $25 000 to $49 999 and ≥$50 000). The risk of disability (objectively defined as loss of ability to walk 400 m) was compared between the 2 treatment groups using Cox regression, separately by socioeconomic group. Socioeconomic group×intervention interaction terms were tested.

RESULTS:

The effect of reducing the incidence of mobility disability was larger for those with postgraduate education (0.72, 0.51 to 1.03; N=411) compared with lower education (high school or less (0.93, 0.70 to 1.24; N=536). However, the education group×intervention interaction term was not statistically significant (p=0.54). Findings were in the same direction yet less pronounced when household income was used as the socioeconomic indicator.

CONCLUSIONS:

In the largest and longest running trial of physical activity amongst at-risk older adults, intervention effect sizes were largest among those with higher education or income, yet tests of statistical interactions were non-significant, likely due to inadequate power.

TRIAL REGISTRATION NUMBER:

NCT01072500.

KEYWORDS:

AGEING; DISABILITY; PHYSICAL ACTIVITY; SOCIAL INEQUALITIES

PMID:
27060177
PMCID:
PMC5013156
DOI:
10.1136/jech-2016-207321
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center