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Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial.
JAMA. 2015 Aug 25; 314(8):781-90.JAMA

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.

Authors+Show Affiliations

Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California.Pennington Biomedical Research Center, Baton Rouge, Louisiana.College of Medicine, University of Florida, Gainesville.Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.Department of Psychiatry and Center for Aging Research, Indiana University, Indianapolis.Department of Psychology, Wake Forest University, Winston-Salem, North Carolina.Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina.Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois13Senior Editor, JAMA.College of Medicine, University of Florida, Gainesville.Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.Departments of Neurology and Medicine, Albert Einstein College of Medicine, Bronx, New York.Department of Psychiatry, Wake Forest University School of Medicine, Winston-Salem, North Carolina.Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

26305648

Citation

Sink, Kaycee M., et al. "Effect of a 24-Month Physical Activity Intervention Vs Health Education On Cognitive Outcomes in Sedentary Older Adults: the LIFE Randomized Trial." JAMA, vol. 314, no. 8, 2015, pp. 781-90.
Sink KM, Espeland MA, Castro CM, et al. Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial. JAMA. 2015;314(8):781-90.
Sink, K. M., Espeland, M. A., Castro, C. M., Church, T., Cohen, R., Dodson, J. A., Guralnik, J., Hendrie, H. C., Jennings, J., Katula, J., Lopez, O. L., McDermott, M. M., Pahor, M., Reid, K. F., Rushing, J., Verghese, J., Rapp, S., & Williamson, J. D. (2015). Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial. JAMA, 314(8), 781-90. https://doi.org/10.1001/jama.2015.9617
Sink KM, et al. Effect of a 24-Month Physical Activity Intervention Vs Health Education On Cognitive Outcomes in Sedentary Older Adults: the LIFE Randomized Trial. JAMA. 2015 Aug 25;314(8):781-90. PubMed PMID: 26305648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial. 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 C, 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 - ,, PY - 2015/8/26/entrez PY - 2015/8/26/pubmed PY - 2015/9/1/medline SP - 781 EP - 90 JF - JAMA JO - JAMA VL - 314 IS - 8 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. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01072500. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/26305648/Effect_of_a_24_Month_Physical_Activity_Intervention_vs_Health_Education_on_Cognitive_Outcomes_in_Sedentary_Older_Adults:_The_LIFE_Randomized_Trial_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2015.9617 DB - PRIME DP - Unbound Medicine ER -