Research article
Midlife Physical Activity and Mobility in Older Age: The InCHIANTI Study

https://doi.org/10.1016/j.amepre.2006.05.005Get rights and content

Background

Among older adults, loss of mobility represents a critical stage in the disablement process, whereby the risk for disability is significantly increased. Physical activity is a modifiable risk factor that is associated with reduced risk of losing mobility in older adulthood; however, few studies have examined physical activity performed earlier in life in relation to mobility later in life.

Methods

Data from a population-based study of 1155 adults aged 65 years and older living in the Chianti region of Italy in 1998–2000 were analyzed in 2005 and 2006. Participants retrospectively recalled their physical activity levels in midlife and underwent mobility testing and medical examination. Two objective mobility outcomes were examined as a function of past physical activity: the Short Physical Performance Battery (SPPB) and the ability to walk 400 meters.

Results

Older Italian adults (mean age 74.8, standard deviation 7.3) who engaged in higher levels of physical activity in midlife were significantly more likely to perform better on the SPPB than individuals who were less physically active in midlife. In addition, failure to complete the 400-meter walk test was significantly less likely among physically active men (Level II) (odds ratio [OR]=0.37, 95% confidence interval [CI]=0.15–0.93) and very active men (Level III) (OR=0.23, 95% CI=0.09–0.63) when compared to men who were less active (Level I) in the past (p for trend, 0.008). These associations remained after adjustment for demographic factors, medical conditions, and physiologic impairments.

Conclusions

Older adults who reported higher levels of physical activity in midlife had better mobility in old age than less physically active ones.

Introduction

Mobility influences myriad aspects of everyday functioning from performing activities of daily living to facilitating social interaction. Mobility is defined as the ability to walk safely and independently. Loss of mobility in older ages represents a critical stage in the disablement process, whereby the risk for disability and mortality is significantly increased.1, 2 Given the demographic reality of global population aging, it is imperative to investigate modifiable factors that might help preserve mobility in later life.

Physical activity is widely promoted to prevent adverse health outcomes. Indeed, there is growing evidence that older adults who engage in physical activity are more likely to experience better physical function and longer active life expectancy compared to sedentary older adults.3, 4, 5 Even older women with limitations in activities of daily living who walk at least eight blocks per week are better able to maintain their mobility than those who do not get outside their homes to walk.6 Further, sedentary older adults who become physically active have a lower risk of death relative to those who remain sedentary in old age.7, 8 In addition to behavioral practices in old age, physical activity in midlife is associated with reduced risk for morbidities that might affect mobility in late life, such as coronary heart disease, diabetes, and certain cancers.9, 10, 11 However, it is unclear whether physical activity performed in midlife is associated with mobility in older adulthood. Therefore, the aims of the current study were to test associations of past physical activity levels in midlife with objective measures of mobility in old age, to assess the robustness of these associations by adjusting for medical conditions and physiologic impairments, and finally to determine whether midlife physical activity conferred any benefit on current mobility among older adults who had relatively low levels of physical activity over the past year.

Section snippets

Study Population

The InCHIANTI Study is a probability sample of 1155 community-dwelling adults aged ≥65 years living in two Italian communities: Greve in Chianti and Bagno a Ripoli.12 Among those originally sampled between September 1998 and March 2000, 91.6% of older adults agreed to participate in the study. All subjects were interviewed in their homes, and 1026 underwent a comprehensive medical examination and mobility evaluation at a local clinical center. However, 20 subjects were missing data for one of

Results

The characteristics of the study sample are presented in Table 1. Fifty-six percent of the sample was composed of women and, on average, subjects were approximately 74 to 75 years old (range: 65–102 years), had a low level of formal education, and had a BMI of 27.5 kg/m2. Men were more likely to have smoked cigarettes than women, and men smoked with greater intensity and duration than women. The most prevalent (modal) category of physical activity in midlife (ages 20 to 40 and 40 to 60) was

Discussion and Conclusions

The current study finds that physical activity performed in midlife is associated with mobility in older adulthood. Older Italian adults who reported moderate to vigorous physical activity in midlife (Levels II and III) enjoyed better mobility in old age than those who reported less physical activity (Level I). Specifically, subjects reporting Level-III physical activity in midlife scored nearly a full point higher on the SPPB in old age than those who reported Level-I physical activity (Table 2

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