Aging Clinical Trial
Official title:
The LIFE Study - Lifestyle Interventions and Independence for Elders
Based upon promising results from a pilot study among 424 sedentary older adults who were
randomized to a physical activity intervention or a successful aging health education
intervention, a Phase 3 multi-center randomized controlled trial is being conducted to
compare a moderate-intensity physical activity program to a successful aging health education
program in 1,600 sedentary older adults who are followed for an average of 2.7 years.
The primary aim was to assess the long-term effects of the proposed interventions on the
primary outcome of major mobility disability, defined as inability to walk 400 m.
As life expectancy in the United States continues to rise, the maintenance of physical
independence among older Americans has emerged as a major clinical and public health
priority. Efficient and reliable locomotion, or the ability to move without assistance, is a
fundamental feature of human functioning. Older people who lose mobility are less likely to
remain in the community, have higher rates of morbidity, mortality, and hospitalizations and
experience a poorer quality of life. Several studies have shown that regular physical
activity improves physical performance, but definitive evidence showing that mobility
disability can be prevented was lacking. A Phase 3 randomized controlled trial was needed to
fill this evidence gap.
The LIFE Study was a Phase 3, multicenter randomized controlled trial (RCT) designed to
compare a moderate-intensity physical activity program to a successful aging health education
program in 1,600 sedentary older persons who are followed for an average of 2.7 years. The
primary outcome was major mobility disability, defined as inability to walk 400 m. Secondary
outcomes include cognitive function based on the Digit Symbol Substitution Test (DSST) and
the Hopkins Verbal Learning Test (HVLT); serious fall injuries; persistent mobility
disability; the combined outcome of major mobility disability or death; disability in
activities of daily living; and cost-effectiveness. Tertiary outcomes include the combined
outcome of mild cognitive impairment or dementia, a composite measure of the cognitive
assessment battery, physical performance within pre-specified subgroups defined on the basis
of race, gender and baseline physical performance, sleep-wake disturbances, dyspnea,
ventilatory capacity, cardiopulmonary events, and cardiovascular events.
The physical activity intervention consists primarily of walking at moderate intensity, lower
extremity resistance exercises, balance exercises, stretching and behavioral counseling. The
successful aging intervention consists of health education seminars regarding health-related
matters and upper extremity stretching exercises. This trial provides definitive evidence
regarding whether physical activity is effective and practical for preventing major mobility
disability. These results will have crucial implications for public health prevention in a
rapidly aging society, and will fill an important gap in knowledge for practicing
evidence-based geriatric medicine. The study will also yield valuable information concerning
the efficacy and effectiveness of physical activity across a broad spectrum of important
health outcomes. The study will impact both clinical practice and public health policy, and
will, therefore, benefit individuals and society.
The Coordinating Center was at the University of Florida and the Data Management Analysis and
Quality Control Center (DMAQC) was at Wake Forest University School of Medicine. The 8 field
sites participating in the LIFE Study are University of Florida, Gainesville, Florida;
Northwestern University, Chicago, Illinois; Pennington Biomedical Research Center, Baton
Rouge, Louisiana; University of Pittsburgh, Pittsburgh, Pennsylvania; Stanford University,
Palo Alto, California; Tufts University, Boston, Massachusetts; Wake Forest University,
Winston-Salem, North Carolina; and Yale University, New Haven, Connecticut.
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