This university news release describes results of a study of sedentary elderly Americans enrolled in a federally funded study designed to document and improve their physical mobility and function. The release does a good job of describing the study methods and the conclusion that a modest increase of at least 48 minutes a week of moderately intense walking and walking-based strengthening exercises achieved significant, if not dramatic, decreases in average overall risk of major mobility disability over a two-year-plus period of time.
It also paid appropriate attention to the “dose-dependent” benefits of the exercise regimen as compared to the control group’s health education classes. That is, the greater the increase in minutes of exercise, the greater the benefits on average overall. It also noted the researchers’ conclusion that although 150 minutes of exercise a week was the goal, seeing benefits at just 48 minutes does have implications for exercise compliance rates and the likelihood that even elderly couch potatoes might devote 15 minutes or so a few days a week to stay healthier.
The release didn’t include any numbers summarizing and putting the results in context. It also would have been strengthened by including a more detailed description of what “sedentary” referred to. One notable inclusion was a paragraph devoted to weaknesses in the study. Bravo for that.
As the U.S. population ages, increasing numbers of elderly signal their desire to live independently, and evidence for the benefits of consistent and persistent exercise grows, researchers, geriatricians and the public are clearly interested in identifying optimal and safe exercise regimens that people can do on their own, that don’t require gym memberships or expensive equipment, and that — most of all– that people will stick to over the long haul. For many over 70 or 75 years of age, even half an hour a day can seem overwhelming. Thus, research suggesting that 20 minutes a day of moderately intense walking (with or without ankle weights), stretching, and balance exercises is a reasonable goal. Studies designed to demonstrate with some confidence that even moderate exercise can contribute to reduced risk of disability are likely to attract interest among caregivers and the public.
Although there could be modest costs to those who participate in the kinds of exercise used in this study (e.g. a good pair of walking shoes, a set of ankle weights), it’s clear to the reader that walking at a fairly modest clip, and performing some stretches and balance exercises, can be done at home, in malls, in hallways, in public parks and at very little, if any, cost beyond one’s time.
However, the exercise intervention described here included a twice-weekly supervised program. Although many senior centers offer similar programs for free, there may well be costs associated with participation outside the research program.
The release provided only bare-bones results. We’d have liked to see some indication of the changes in mobility — from what to what — following the exercise program.
The release says “Changes in activity were significantly greater in the physical activity intervention group than the health education group from baseline through 24 months.” What does that mean exactly? How much improved were those who took part in physical activity compared to those who didn’t?
In addition, the headline and text refer often to reduced risks, but we’re never told exactly what those risk factors are.
There is no mention of harms. The release could have noted that harm scores were pretty even among all of the study participants, regardless of the duration of their physical activity, and that the protocol was designed to keep the regimen safe for older, sedentary people.
The release noted some of the study limitations and we give them kudos for that. There was another limitation we wish they had highlighted: 14,831 elders were screened for participation with 13,196 excluded due to a variety of factors (health related as well as relocations). This suggests that the generalizability of the study conclusions to the general population should be tempered. It’s not clear that the interventions are widely applicable in the elderly population.
More information about the study group and the control group would have added context and clarity to the release.
The release is clear that the research was supported by the National Institutes of Health.
While some of the researchers disclosed pharma funding in the published study, that funding wasn’t relevant to this research and we agree with the decision not to include it in the release.
The release doesn’t mention any alternatives to walking as a physical exercise. Multiple studies have shown benefits to the elderly from resistance training, cardiovascular endurance training, balance and flexibility training.
The program of exercise training used in the study is not well described but is presumably within the scope of many senior centers and exercise programs designed for the elderly population. The release would ideally have made it clear that the program was not unique and is likely widely available.
The release noted what was novel about the research’s endpoint/conclusion: the “dose” response and the search for a “minimum” level of activity that would confer benefit.
None here.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
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