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
Year: 2016
Type: article
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.
Institutions: University College London, Wake Forest University Health Sciences, Wake Forest University, London School of Hygiene & Tropical Medicine, University of Pittsburgh, Tufts University, Jean Mayer Human Nutrition Research Center on Aging, University of Florida, Stanford Medicine, Stanford University, Yale University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,715
Awards: G1044130170, Centre for Longitudinal Studies, Resource Centre 2015-20, G3306042508, G4245087604, Cross-Cohort Research programme: employment, health and wellbeing, G6156310725, G6807676582, G9000183456, G9000267245, University of Florida Older Americans Independence Center (OAIC), Yale Clinical and Translational Science Award, Claude D. Pepper Older Americans Independence Center at Yale
OpenAlex ID: W2330610568