Physical activity program did not prevent CV events in older adults

CHICAGO — A structured physical activity program had no effect on CV events in older adults compared with a health education program, according to new data from the LIFE study.

Previous results from the LIFE study demonstrated that a structured moderate-intensity physical activity program reduced major mobility disability by 18% and persistent mobility disability by 28% in older adults compared with a health education program. In a prespecified analysis, the researchers investigated the effect on CV events in participants from the LIFE study based on assignment to the physical activity program or the educational program.

The analysis included 1,635 older participants (mean age, 79 years; 67% women) who followed a sedentary lifestyle but were able to walk 400 m, had no major cognitive impairment and could safely participate in the intervention, Anne B. Newman, MD, MPH, said at the American Heart Association Scientific Sessions.

The physical activity intervention included walking for 3 to 6 days per week, 2 days of which were at a study center; lower-extremity strength exercises three times per week at 10 minutes per session; and balance and flexibility exercises. The educational program included weekly 1.5-hour health workshops for 6 months and monthly after that, stretching and flexibility exercises, and field trips to local cultural institutions.

Newman, professor of epidemiology and medicine at the University of Pittsburgh, and colleagues assessed differences between the groups in total CVD, defined as definite or silent MI, stroke, CV death, hospitalization for congestive HF, coronary revascularization, angina, abdominal aortic aneurysm, peripheral artery disease, and carotid revascularization or transient ischemic attack; limited CVD, defined as definite or silent MI, stroke and CV death; and individual CVD conditions.

The researchers found no difference between the groups in total CVD (physical activity group, 14.7%; educational group, 13.8%; HR=1.09; 95% CI, 0.84-1.41), limited CVD (physical activity group, 8.9%; educational group, 8.7%; HR=1.04; 95% CI, 0.75-1.45) or any of the individual CVD conditions.

There was a trend toward more favorable total CVD outcomes in the physical activity program group in those aged 80 years and older compared with those aged 79 years and younger (P for interaction=.0788). The physical activity program also was linked to more favorable total CVD outcomes for participants with a Short Physical Performance Battery score <8 compared with those with a score ≥8 (P for interaction=.0049), Newman said.

“Overall, we saw no benefit,” she said. “Why is that? Was it the dose of activity, inadequate in duration or intensity? Is it too late in life to start? Many of these individuals were at very high risk, with established prevalent disease, and probably the rest had some clinical disease. Was there not enough of a difference between the groups? Our [educational] group also became more active, and that may have limited our ability to see a difference. Clearly, we had inadequate power, and we’ve had a question of whether there was a potential bias of reporting more events in the physical activity group. Though they reported these to blinded staff, they were seen more frequently.” – by Erik Swain

For more information:

Newman AB. Abstract #20440. Presented at: American Heart Association Scientific Sessions; Nov. 15-19, 2014; Chicago.

Disclosure: The study was funded by the National Institute on Aging and the NHLBI. Newman reports no relevant financial disclosures.