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Weight
loss plus walking essential for older, obese
adults
January 25, 2011--Walking more and losing
weight can improve mobility as much as 20
percent in older, obese adults with poor
cardiovascular health, according to a new
Wake Forest University study.
The results from the five-year study of 288
participants appear online Jan. 24 in
the Archives of Internal Medicine.
The combination of weight loss and physical
activity is what works best. These findings
run counter to the commonly held belief that
it is unhealthy for older adults to lose
weight.
"To improve mobility, physical activity has
to be coupled with weight loss," said Jack
Rejeski, Thurman D. Kitchin Professor of
Health and Exercise Science. "This is one of
the first large studies to show that weight
loss improves the functional health of older
people with cardiovascular disease."
The study addresses what to do to help
seniors with poor mobility, but it also
proves existing community agencies can be
used effectively to get seniors the help
they need.
"With 60 percent of adults over age 65
walking less than one mile per week and a
rapidly growing population of older adults,
the need for cost-effective community-based
intervention programs to improve the
mobility of seniors is critical," said
Rejeski, principal investigator for the
Cooperative Lifestyle Intervention Program
(CLIP).
Key co-investigators included Dr. David C.
Goff and Walter T. Ambrosius from Wake
Forest University School of Medicine, Peter
Brubaker, professor of health and exercise
science at Wake Forest, Lucille Bearon and
Jacquelyn McClelland from North Carolina
State University, and Michael Perri from the
University of Florida.
"Community-based preventative programs are
extremely important," Rejeski said.
The researchers partnered with the North
Carolina Cooperative Extension and trained
health care professionals at centers in
three counties (Davidson, Forsyth and
Guilford) to lead the programs along with an
intervention team from Wake Forest.
The participants, ranging in age from 60 to
79, were tracked over an 18-month period.
The study divided participants into three
groups: a control group who received
education on successful aging, a physical
activity only group, and a physical activity
and weight loss group.
The physical activity group did well, but
the most dramatic effect was found in the
participants who combined an increase in
physical activity with weight loss.
On average, they improved their mobility by
5 percent as measured by the time it took
them to walk 400 meters. Those with the most
limited mobility improved by as much as 20
percent.
The 400-meter walk is a widely used measure
of mobility disability in older adults
because for those who cannot walk this
distance the likelihood of losing their
independence increases dramatically.
Rejeski uses this analogy for the loss of
mobility in seniors who often don't realize
its seriousness. "It is like being in a
canoe paddling down a river and being
completely unaware that a waterfall is only
a short distance away. Once your canoe
starts down the waterfall of disability, the
consequences are severe."
The waterfall is the cascade of adverse
outcomes including hospitalizations,
worsening disability, institutionalization,
and death that are more likely when seniors
lose the basic ability to get around.
Seniors with limited mobility require
significantly more high-cost medical care.
"Clearly the ability to walk without
assistance is a critical factor in an older
person's capacity to function independently
in the community," he said. "The next step
is to develop a model that can be replicated
at similar sites across the state and the
country and we look forward to working with
our colleagues from North Carolina to
achieve this goal."
###
Rejeski is also one of the lead behavioral
scientists on the national Lifestyle
Interventions and Independence for Elders
(LIFE) Study, a six-year project funded by
the National Institutes of Health designed
to determine the effects of physical
activity and successful aging interventions
on major mobility disability.
He also serves on the intervention committee
for the Look AHEAD Study, a 20-site trial
funded by the National Institutes of Health
that is evaluating the effects of weight
loss on cardiovascular events in adults with
Type 2 diabetes. He is associate director of
the Translational Science Center on the
Reynolda campus of Wake Forest University.
