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The LIFE Study - Lifestyle Interventions and Independence for Elders

The LIFE Study - Lifestyle Interventions and Independence for Elders

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01072500
Acronym
LIFE
Enrollment
1635
Registered
2010-02-22
Start date
2010-02-28
Completion date
2014-12-31
Last updated
2018-05-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Sedentary Lifestyle, Risk of Disability, Aging

Keywords

Aging, Physical Activity, Exercise, Sedentary Lifestyle, Mobility, Disability, Falls, Cost effectiveness, Behavioral counseling

Brief summary

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.

Detailed description

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.

Interventions

BEHAVIORALPhysical Activity

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.

Sponsors

National Institute on Aging (NIA)
CollaboratorNIH
National Heart, Lung, and Blood Institute (NHLBI)
CollaboratorNIH
University of Florida
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
70 Years to 89 Years
Healthy volunteers
No

Inclusion criteria

1. age 70 to 89 years; (2) summary score \<10 on the short physical performance battery (SPPB) (45% are \<8);90 (3) sedentary lifestyle; (4) ability to complete the 400 m walk test without an assistive device; and (5) willingness to be randomized to either intervention group.

Design outcomes

Primary

MeasureTime frameDescription
Major Mobility Disability, Defined as Incapacity to Walk 400 MetersMedian 2.7 years/Average 2.6 yearsThe primary outcome of major mobility disability was defined as the inability to complete a 400-m walk test within 15 minutes without sitting and without the help of another person or walker. Use of a cane was acceptable. Participants were asked to walk 400 m at their usual pace, without overexerting, on a 20 meter course for 10 laps (40 meters/lap). Participants were allowed to stop for up to 1 minute for fatigue or related symptoms. When major mobility disability could not be objectively measured because of the inability of the participant to come to the clinic and absence of a suitable walking course at the participant's home, institution, or hospital, an alternative adjudication of the outcome was based on objective inability to walk 4 meters in less than 10 seconds, or self-, proxy-, or medical record-reported inability to walk across a room. If participants met these alternative criteria, they would not be able to complete the 400 meter walk within 15 minutes.

Secondary

MeasureTime frameDescription
Persistent Mobility Disability (Assessed Every 6 Months)Median 2.7 years/Average 2.6 yearsThe assessment of major mobility disability (the inability to complete a 400-m walk test within 15 minutes without sitting and without the help of another person or walker. Use of a cane was acceptable. Participants were asked to walk 400m at their usual pace, without overexerting, on a 20 meter course for 10 laps (40 meters/lap). Participants were allowed to stop for up to 1 minute for fatigue or related symptoms. When MMD could not be objectively measured because of the inability of the participant to come to the clinic and absence of a suitable walking course at the participant's home, institution, or hospital, an alternative adjudication of the outcome was based on objective inability to walk 4 meters in less than 10 seconds, or self-, proxy-, or medical record-reported inability to walk across a room. If participants met these alternative criteria, they would not be able to complete the 400 m walk within 15 minutes.) at two consecutive time points or MMD followed by death.

Countries

United States

Participant flow

Recruitment details

1,635 participants were randomized over 21-months, with the target of 1,600 reached late Nov 2011. The 1st randomization occurred 3/12/10, and the final randomization on 12/27/11. Participants in the recruitment pipeline completed screening and testing visits and were randomized; hence, the total randomized exceeded the target.

Participants by arm

ArmCount
Physical Activity
The physical activity intervention consists primarily of walking at moderate intensity, lower extremity resistance exercises, balance exercises, stretching and behavioral counseling.
818
Successful Aging
The successful aging intervention consists of health education seminars regarding health-related matters and upper extremity stretching exercises.
817
Total1,635

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath22
Overall StudyLost to Follow-up52
Overall StudyWithdrawal by Subject1710

Baseline characteristics

CharacteristicPhysical ActivitySuccessful AgingTotal
3MSE Score, 0-100 scale, mean91.5 units on a scale
STANDARD_DEVIATION 5.6
91.6 units on a scale
STANDARD_DEVIATION 5.5
91.5 units on a scale
STANDARD_DEVIATION 5.5
Age, Continuous78.7 years
STANDARD_DEVIATION 5.2
79.1 years
STANDARD_DEVIATION 5.2
78.9 years
STANDARD_DEVIATION 5.2
Body Mass Index, mean30.1 kg/m^2
STANDARD_DEVIATION 5.9
30.3 kg/m^2
STANDARD_DEVIATION 6.2
30.2 kg/m^2
STANDARD_DEVIATION 6.1
Cancer178 participants192 participants370 participants
CHAMPS 18 Total Score15.9 hours/week
STANDARD_DEVIATION 32.1
18.2 hours/week
STANDARD_DEVIATION 33.8
17.0 hours/week
STANDARD_DEVIATION 33
Chronic lung disease130 participants123 participants253 participants
Diabetes/High Blood Sugar198 participants216 participants414 participants
Diastolic Blood Pressure68.7 mmHg
STANDARD_DEVIATION 10.3
67.7 mmHg
STANDARD_DEVIATION 10.1
68.2 mmHg
STANDARD_DEVIATION 10.2
Education
College (13-17)
321 participants320 participants641 participants
Education
Elementary School (k-8)
15 participants17 participants32 participants
Education
High school/equivalent (9-12)
248 participants236 participants484 participants
Education
No formal eduction
7 participants6 participants13 participants
Education
Other
32 participants26 participants58 participants
Education
Post Graduate
194 participants208 participants402 participants
Education
Unknown
1 participants4 participants5 participants
Heart Attack/Coronary/MI60 participants69 participants129 participants
Heart failure/congestive heart failure26 participants45 participants71 participants
High blood pressure/hypertension573 participants578 participants1151 participants
Pacemaker33 participants33 participants66 participants
Race/Ethnicity, Customized
African American
163 participants125 participants288 participants
Race/Ethnicity, Customized
Asian
7 participants8 participants15 participants
Race/Ethnicity, Customized
Hispanic
31 participants30 participants61 participants
Race/Ethnicity, Customized
Other/Mixed
10 participants17 participants27 participants
Race/Ethnicity, Customized
Refused/Missing
3 participants2 participants5 participants
Race/Ethnicity, Customized
White
604 participants635 participants1239 participants
Sex: Female, Male
Female
547 Participants551 Participants1098 Participants
Sex: Female, Male
Male
271 Participants266 Participants537 Participants
Stroke57 participants52 participants109 participants
Systolic Blood Pressure127.9 mmHg
STANDARD_DEVIATION 18.1
127.0 mmHg
STANDARD_DEVIATION 17.8
127.4 mmHg
STANDARD_DEVIATION 18
Total Cholesterol179.3 mg/dL
STANDARD_DEVIATION 39.6
178.5 mg/dL
STANDARD_DEVIATION 39.9
178.9 mg/dL
STANDARD_DEVIATION 39.8
Total SPPB Score7.4 units on a scale
STANDARD_DEVIATION 1.6
7.3 units on a scale
STANDARD_DEVIATION 1.6
7.4 units on a scale
STANDARD_DEVIATION 1.6
Weight (kg)81.9 kg
STANDARD_DEVIATION 18.4
82.0 kg
STANDARD_DEVIATION 19.3
81.9 kg
STANDARD_DEVIATION 18.8

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
181 / 81888 / 817
serious
Total, serious adverse events
404 / 818373 / 817

Outcome results

Primary

Major Mobility Disability, Defined as Incapacity to Walk 400 Meters

The primary outcome of major mobility disability was defined as the inability to complete a 400-m walk test within 15 minutes without sitting and without the help of another person or walker. Use of a cane was acceptable. Participants were asked to walk 400 m at their usual pace, without overexerting, on a 20 meter course for 10 laps (40 meters/lap). Participants were allowed to stop for up to 1 minute for fatigue or related symptoms. When major mobility disability could not be objectively measured because of the inability of the participant to come to the clinic and absence of a suitable walking course at the participant's home, institution, or hospital, an alternative adjudication of the outcome was based on objective inability to walk 4 meters in less than 10 seconds, or self-, proxy-, or medical record-reported inability to walk across a room. If participants met these alternative criteria, they would not be able to complete the 400 meter walk within 15 minutes.

Time frame: Median 2.7 years/Average 2.6 years

ArmMeasureValue (NUMBER)
Physical ActivityMajor Mobility Disability, Defined as Incapacity to Walk 400 Meters246 participants
Successful AgingMajor Mobility Disability, Defined as Incapacity to Walk 400 Meters290 participants
p-value: 0.0395% CI: [0.69, 0.98]Regression, Cox
Secondary

Persistent Mobility Disability (Assessed Every 6 Months)

The assessment of major mobility disability (the inability to complete a 400-m walk test within 15 minutes without sitting and without the help of another person or walker. Use of a cane was acceptable. Participants were asked to walk 400m at their usual pace, without overexerting, on a 20 meter course for 10 laps (40 meters/lap). Participants were allowed to stop for up to 1 minute for fatigue or related symptoms. When MMD could not be objectively measured because of the inability of the participant to come to the clinic and absence of a suitable walking course at the participant's home, institution, or hospital, an alternative adjudication of the outcome was based on objective inability to walk 4 meters in less than 10 seconds, or self-, proxy-, or medical record-reported inability to walk across a room. If participants met these alternative criteria, they would not be able to complete the 400 m walk within 15 minutes.) at two consecutive time points or MMD followed by death.

Time frame: Median 2.7 years/Average 2.6 years

ArmMeasureValue (NUMBER)
Physical ActivityPersistent Mobility Disability (Assessed Every 6 Months)120 participants
Successful AgingPersistent Mobility Disability (Assessed Every 6 Months)162 participants
p-value: 0.00695% CI: [0.57, 0.91]Regression, Cox

Source: ClinicalTrials.gov · Data processed: Mar 14, 2026