Projects per year
Abstract
Background
Mobility limitations in older age greatly reduce quality of life, generate substantial health and social care costs and increase mortality. The Retirement in Action (REACT) trial aimed to establish whether a community-based active ageing intervention could prevent decline in physical functioning in older adults already at increased risk of mobility limitation.
Methods
We recruited older adults with reduced lower limb physical functioning (65 years and older; Short Physical Performance Battery (SPPB) score 4-9) into a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial (RCT). Recruitment was largely via 35 primary care practices in urban and semi-rural locations across three sites in England. Participants were randomly assigned to receive brief advice (three healthy ageing education sessions) or a 12-month, group-based, multimodal physical activity and behavioural maintenance programme delivered by charity and community /leisure centre staff in local communities. Randomisation was stratified by site and adopted a minimisation approach to balance age, gender and SPPB score, using a centralised online randomisation algorithm. Data collection and analyses were blinded. The primary outcome was change in lower limb physical function (SPPB score) at 24 months analysed by intention-to-treat. Trial registration number is ISRCTN45627165.
Findings
Between June 2016 and October 2017, 777 participants (mean age 77.6, SD 6.8; 66% female; mean SPPB score 7.37, SD 1.56) were randomised to the intervention (410) and control (367) arms. Primary outcome data at 24 months were provided by 628 (81%) participants. At 24-month follow-up, SPPB score was significantly greater in the intervention arm (mean 8.08, SD 2.87) compared with controls (mean 7.59, SD 2.61), with an adjusted mean difference of 0.49 (95%CI: 0.06 to 0.92).The difference in lower limb function between intervention and control participants was clinically meaningful at 6, 12 and 24 months. One adverse event was related to the intervention.
Interpretation
For older adults at risk of mobility limitations, the REACT intervention prevented decline in physical function over a 24-month period.
Funding: National Institute for Health Research Public Health Research Programme (13/164/ 51).
Trial Registration: ISRCTN45627165
Mobility limitations in older age greatly reduce quality of life, generate substantial health and social care costs and increase mortality. The Retirement in Action (REACT) trial aimed to establish whether a community-based active ageing intervention could prevent decline in physical functioning in older adults already at increased risk of mobility limitation.
Methods
We recruited older adults with reduced lower limb physical functioning (65 years and older; Short Physical Performance Battery (SPPB) score 4-9) into a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial (RCT). Recruitment was largely via 35 primary care practices in urban and semi-rural locations across three sites in England. Participants were randomly assigned to receive brief advice (three healthy ageing education sessions) or a 12-month, group-based, multimodal physical activity and behavioural maintenance programme delivered by charity and community /leisure centre staff in local communities. Randomisation was stratified by site and adopted a minimisation approach to balance age, gender and SPPB score, using a centralised online randomisation algorithm. Data collection and analyses were blinded. The primary outcome was change in lower limb physical function (SPPB score) at 24 months analysed by intention-to-treat. Trial registration number is ISRCTN45627165.
Findings
Between June 2016 and October 2017, 777 participants (mean age 77.6, SD 6.8; 66% female; mean SPPB score 7.37, SD 1.56) were randomised to the intervention (410) and control (367) arms. Primary outcome data at 24 months were provided by 628 (81%) participants. At 24-month follow-up, SPPB score was significantly greater in the intervention arm (mean 8.08, SD 2.87) compared with controls (mean 7.59, SD 2.61), with an adjusted mean difference of 0.49 (95%CI: 0.06 to 0.92).The difference in lower limb function between intervention and control participants was clinically meaningful at 6, 12 and 24 months. One adverse event was related to the intervention.
Interpretation
For older adults at risk of mobility limitations, the REACT intervention prevented decline in physical function over a 24-month period.
Funding: National Institute for Health Research Public Health Research Programme (13/164/ 51).
Trial Registration: ISRCTN45627165
| Original language | English |
|---|---|
| Pages (from-to) | E316-E326 |
| Journal | The Lancet Public Health |
| Volume | 7 |
| Issue number | 4 |
| Early online date | 21 Mar 2022 |
| DOIs | |
| Publication status | Published - 30 Apr 2022 |
Bibliographical note
Data sharingAll source data used in this study are publicly available. The trial dataset can be accessed by contacting the corresponding author. All project documentation is available at https://www.fundingawards.nihr.ac.uk/award/13/164/51.
This work was supported by the NIHR Public Health Research Programme (13/164/51). HJ-B is funded by the Wellcome Trust (110027/Z/15/Z) and the Oxford NIHR Biomedical Research Centre. CES was supported by the NIHR Oxford Health Biomedical Research Centre, and is now a full-time employee of the Alzheimer's Association. We wish to express our thanks to the entire REACT research team, the Clinical Research Networks at each REACT site, and all the GP practices and community organisations who supported REACT recruitment. Delivery of the REACT programme was only possible due to the support of our partners: Bath and North East Somerset Council; Exeter and Solihull City Councils; Westbank Charity; St Monica Trust, Bristol; Bristol Ageing Better; St John's Hospital, Bath; Age UK Birmingham; Agewell, West Midlands; Sandwell and West Birmingham Hospitals NHS Trust; and the Portway Lifestyle Centre and Solihull Borough Council, Birmingham. We would also like to express our gratitude to our Trial Steering Committee, chaired by Yoav Ben-Shlomo; the Data Management and Ethics Committee, chaired by Dawn Skelton; independent statistician Peter Thomas, who provided hugely valuable expert guidance and support; and Andrew F Hayes, who provided valuable advice on the conduct and interpretation of the moderation and subgroup analyses. Finally, we would like to thank the participants, without whom this research would not have been possible. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health.
Access to Document
Embargoed Document
Fingerprint
Dive into the research topics of 'Effect of a physical activity and behaviour maintenance programme on functional mobility decline in older adults: The REACT (REtirement in ACTion) randomised controlled trial'. Together they form a unique fingerprint.-
Centre for the Analysis of Motion, Entertainment Research and Applications (CAMERA) - 2.0
Campbell, N. (PI), Cosker, D. (PI), Bilzon, J. (CoI), Campbell, N. (CoI), Cazzola, D. (CoI), Colyer, S. (CoI), Cosker, D. (CoI), Lutteroth, C. (CoI), McGuigan, P. (CoI), O'Neill, E. (CoI), Petrini, K. (CoI), Proulx, M. (CoI) & Yang, Y. (CoI)
Engineering and Physical Sciences Research Council
1/11/20 → 31/10/25
Project: Research council
-
Centre for the Analysis of Motion, Entertainment Research and Applications (CAMERA)
Cosker, D. (PI), Bilzon, J. (CoI), Campbell, N. (CoI), Cazzola, D. (CoI), Colyer, S. (CoI), Fincham Haines, T. (CoI), Hall, P. (CoI), Kim, K. I. (CoI), Lutteroth, C. (CoI), McGuigan, P. (CoI), O'Neill, E. (CoI), Richardt, C. (CoI), Salo, A. (CoI), Seminati, E. (CoI), Tabor, A. (CoI) & Yang, Y. (CoI)
Engineering and Physical Sciences Research Council
1/09/15 → 28/02/21
Project: Research council
-
The REACT Study
Bilzon, J. (PI), Stathi, A. (CoI) & Taylor, G. (CoI)
National Institute for Health Research
1/09/15 → 31/05/21
Project: Central government, health and local authorities