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运动预防失能的生活方式干预和老年人独立(LIFE)临床试验的影响和经验教训。

Impact and Lessons From the Lifestyle Interventions and Independence for Elders (LIFE) Clinical Trials of Physical Activity to Prevent Mobility Disability.

机构信息

Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida.

Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.

出版信息

J Am Geriatr Soc. 2020 Apr;68(4):872-881. doi: 10.1111/jgs.16365. Epub 2020 Feb 27.

Abstract

BACKGROUND

Walking independently is basic to human functioning. The Lifestyle Interventions and Independence for Elders (LIFE) studies were developed to assess whether initiating physical activity could prevent major mobility disability (MMD) in sedentary older adults.

METHODS

We review the development and selected findings of the LIFE studies from 2000 through 2019, including the planning phase, the LIFE-Pilot Study, and the LIFE Study.

RESULTS

The planning phase and the LIFE-Pilot provided key information for the successful implementation of the LIFE Study. The LIFE Study, involving 1635 participants randomized at eight sites throughout the United States, showed that compared with health education, the physical activity program reduced the risk of the primary outcome of MMD (inability to walk 400 m: hazard ratio = 0.82; 95% confidence interval = 0.69-0.98; P = .03), and that the intervention was cost-effective. There were no significant effects on cognitive outcomes, cardiovascular events, or serious fall injuries. In addition, the LIFE studies provided relevant findings on a broad range of other outcomes, including health, frailty, behavioral outcomes, biomarkers, and imaging. To date, the LIFE studies have generated a legacy of 109 peer-reviewed publications, 19 ancillary studies, and 38 independently funded grants and clinical trials, and advanced the development of 59 early career scientists. Data and biological samples of the LIFE Study are now publicly available from a repository sponsored by the National Institute on Aging (https://agingresearchbiobank.nia.nih.gov).

CONCLUSIONS

The LIFE studies generated a wealth of important scientific findings and accelerated research in geriatrics and gerontology, benefiting the research community, trainees, clinicians, policy makers, and the general public. J Am Geriatr Soc 68:872-881, 2020.

摘要

背景

独立行走是人类基本的活动能力。生活方式干预和老年人独立(LIFE)研究旨在评估启动身体活动是否可以预防久坐老年人的主要移动障碍(MMD)。

方法

我们回顾了 LIFE 研究从 2000 年到 2019 年的发展和部分研究结果,包括规划阶段、LIFE 先导研究和 LIFE 研究。

结果

规划阶段和 LIFE 先导研究为 LIFE 研究的成功实施提供了关键信息。涉及美国各地 8 个地点的 1635 名参与者随机分组的 LIFE 研究表明,与健康教育相比,身体活动方案降低了 MMD 主要结局(无法行走 400 米:风险比=0.82;95%置信区间=0.69-0.98;P=0.03)的发生风险,而且该干预措施具有成本效益。该研究对认知结果、心血管事件或严重跌倒伤害没有显著影响。此外,LIFE 研究还提供了广泛的其他结果相关的发现,包括健康、虚弱、行为结果、生物标志物和影像学。迄今为止,LIFE 研究已经产生了 109 篇同行评审出版物、19 项辅助研究以及 38 项独立资助的赠款和临床试验,并促进了 59 名早期职业科学家的发展。LIFE 研究的数据和生物样本现已从美国国立卫生研究院(National Institute on Aging)赞助的存储库(https://agingresearchbiobank.nia.nih.gov)中公开获取。

结论

LIFE 研究产生了丰富的重要科学发现,并加速了老年医学和老年学的研究,使研究界、受训者、临床医生、政策制定者和广大公众受益。J Am Geriatr Soc 68:872-881,2020。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82e2/7187344/5c2ce303ba2c/JGS-68-872-g001.jpg

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