Exercise Program for Aging

Overseen By Joseph Mikels, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: DePaul University

Disqualifiers: Joint injections, Recent surgery, Arthritis, Uncontrolled diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

240 Participants Needed

Trial Summary

What is the purpose of this trial?

Exercise is routinely recommended because of its benefits for physical, cognitive, and mental health. It is especially beneficial for older adults due to its potential buffering effects against Alzheimer's disease and related dementias (Luck et al., 2014). However, little is known about how to best encourage older adults to exercise. Based on behavior change theory, different intrapersonal and interpersonal motivational factors are likely to be relevant during the contemplation, action, and maintenance stages of behavior change. Generally, as a result of motivational shifts toward prioritizing positivity and socially meaningful goals with advancing age (Carstensen, 2006), socioemotional aspects of decision making may become more salient and influential for older adults (Mikels et al., 2015; Peter et al., 2011). Our previous work has demonstrated that positive affect (Mikels et al., 2020) and social goals (Steltenpohl et al., 2019) play a critical role in older adults' motivation to exercise, but these two lines of research have not been integrated to date. Recent work indicates that positive affect is particularly beneficial for health when shared in social connections (Fredrickson, 2016; Major et al., 2018), and the proposed work will, for the first time, examine how shared interpersonal positivity may impact exercise decision making and behavior, especially during the contemplation and action/maintenance stages of behavior change. But who are the older adults that benefit the most from exercise in terms of physical, cognitive, and mental health (and should be hence be targeted with messages)? Not all older adults reap the benefits of exercise (Sparks, 2014) and, conversely, sedentary older adults have the most to gain. Overall, the current proposed research program is innovative in its (a) translational application of insights from affective, cognitive, and aging theory and research to understand the antecedents and outcomes of exercise decision making in younger and older adults, (b) conceptualization of both the social and emotional aspects of decision making, (c) development of novel methods for health messaging that incorporate social influences, and (d) novel assessments of the exercise-health link.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It mentions that your physician will be contacted for clearance if you have certain health conditions, but it doesn't say anything about stopping medications.

What data supports the effectiveness of the treatment Fit and Strong in the Exercise Program for Aging?

Research shows that exercise programs similar to Fit and Strong can improve strength, balance, and flexibility in older adults, which are important for reducing the risk of falls and improving overall physical health. ^{1 2 3 4 5}

Is the exercise program for aging, including Fit and Strong, safe for humans?

Exercise programs, including muscle-strengthening activities, are generally safe for older adults and can lower the risk of death from all causes, heart disease, and cancer. They also help improve muscle strength and walking speed, which are important for maintaining independence and quality of life. ^{6 7 8 9 10}

How does the Fit and Strong exercise program differ from other treatments for aging-related muscle decline?

The Fit and Strong exercise program is unique because it focuses on individualized, goal-oriented exercise routines that are low to moderate in intensity, making it a cost-effective way to maintain muscle strength and improve quality of life in older adults. Unlike other treatments, it emphasizes flexibility, strength, and mobility, and can be adapted to suit varying levels of physical impairment. ^{11 12 13 14 15}

Eligibility Criteria

This trial is for older adults who can potentially benefit from exercise to improve physical, cognitive, and mental health. Participants must have previously joined Experiment 4A and meet the Fit & Strong! study criteria. They need physician clearance if they have high blood pressure or experience certain symptoms during physical activity.

Inclusion Criteria

Participants must comply with the exclusion protocol implemented in earlier Fit & Strong! studies, and their physician will be contacted for further health clearance if they report having high blood pressure or experiences of dizziness, lightheadedness, chest pain/pressure while physically active

To be eligible for Experiment 4B, you must have already taken part in Experiment 4A.

Exclusion Criteria

Experiment 4B: Participants who did not participate in Experiment 4A are not eligible to participate in Experiment 4B.

Experiment 4A: Participants will be excluded for joint steroid injections within 3 months, knee or hip surgery within the previous 6 months or next year, rheumatoid arthritis or other systemic inflammatory arthritis, or uncontrolled diabetes. The participant's physician will be contacted for clearance if they have a history of high blood pressure, or experience dizziness, lightheadedness, or chest pain or pressure during physical activities. Physicians will also be contacted if participants indicate that they fall, feel unsteady, or use an assistive walking or standing device.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Experiment 1

Laboratory-based experiment examining affective reactions, evaluations, and behavioral intentions in response to framed messages

4-6 weeks

Experiment 2

Field-based experiment examining affective reactions, evaluations, and behavioral intentions when people exercise alone or with another person

4-6 weeks

Experiment 4A & 4B

Participants attend 3 sessions/week for 8 weeks in an evidence-based fitness program, Fit & Strong!, focusing on flexibility, aerobics, strengthening, and physical activity logs

8 weeks

3 sessions per week

Follow-up

Participants are monitored for continued physical activity and social and emotional influences one year after the program ends

1 year

Treatment Details

Interventions

• Fit and Strong

Trial Overview The 'Fit and Strong' intervention is being tested to see how shared interpersonal positivity affects decision-making in exercising among older adults. The study explores motivational factors relevant at different stages of behavior change.

Participant Groups

Group I: Experiment 4A & 4B Experimental Treatment 1 Intervention

Participants will attend for 3 sessions/week for 8 weeks. Instructors will conduct classes and maintain participant attendance records. Exercise components include flexibility, aerobics, strengthening, and physical activity logs. Classes begin and end with 10-minute warmups and cool downs. Participants are taught low-impact aerobic routines to maximize self-efficacy for physical activity maintenance after the program. This will include fitness walking that will progress from each participant's maximum capacity to the goal of 20 minutes of sustained walking. Participants will be instructed on how to gauge their exercise intensity and physical exertion. The strengthening focus of the program will improve independent functioning by targeting lower extremity strength with a graded, task-specific approach. Resistance will be progressively increased over the course of the program by adding weight. At the end of each exercise session, participants will log physical activity.

Who Is Running the Clinical Trial?

DePaul University

Lead Sponsor

Trials

9

Recruited

8,500+

Findings from Research

In a study involving 71 older hospitalized patients, those who participated in progressive resistance strength training showed significant improvements in walking speed and mobility tasks compared to the control group, indicating potential benefits of this training method.

While both groups improved in various functional measures, the treatment group demonstrated greater overall improvements, suggesting that adding strength training to standard care may enhance rehabilitation outcomes for older patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients? A single-blinded randomized controlled trial. Tibaek, S., Andersen, CW., Pedersen, SF., et al.[2019]

Resistance training (RT) is the only non-drug method proven to effectively counteract age-related declines in muscle mass, strength, and power, while also reducing risks of various health issues like cardiovascular disease and depression.

Minimal-dose RT strategies, which involve lower training volumes and can be performed with minimal equipment, are effective in improving strength and functional ability, making it easier for more people to participate and potentially enhancing overall health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Minimal-Dose Resistance Training for Improving Muscle Mass, Strength, and Function: A Narrative Review of Current Evidence and Practical Considerations. Fyfe, JJ., Hamilton, DL., Daly, RM.[2022]

Strength-training exercises, performed regularly (2 to 3 days per week), can effectively combat sarcopenia in older adults by building muscle strength and mass, preserving bone density, and enhancing overall vitality.

These exercises not only reduce the risk of osteoporosis but also alleviate symptoms of chronic diseases like heart disease and type 2 diabetes, while improving sleep and reducing depression, highlighting their broad health benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The benefits of strength training for older adults. Seguin, R., Nelson, ME.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

A home-based multidimensional exercise program reduced physical impairment and fear of falling. [2016]

2. United States pubmed.ncbi.nlm.nih.gov

Physical Exercise Improves Function in Acutely Hospitalized Older Patients: Secondary Analysis of a Randomized Clinical Trial. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients? A single-blinded randomized controlled trial. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of Advanced Stay Strong, Stay Healthy in Community Settings. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Home-Based Exercise Supported by General Practitioner Practices: Ineffective in a Sample of Chronically Ill, Mobility-Limited Older Adults (the HOMEfit Randomized Controlled Trial). [2019]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Engagement in Muscle-Strengthening Activities Lowers Sarcopenia Risk in Older Adults Already Adhering to the Aerobic Physical Activity Guidelines. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Independent and Joint Associations Between Leisure Time Physical Activity and Strength Activities With Mortality Outcomes in Older Adults At least 65 Years of Age: A Prospective Cohort Study. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Sarcopenia and age-related changes in body composition and functional capacity. [2022]

9. New Zealand pubmed.ncbi.nlm.nih.gov

Minimal-Dose Resistance Training for Improving Muscle Mass, Strength, and Function: A Narrative Review of Current Evidence and Practical Considerations. [2022]

10. Switzerland pubmed.ncbi.nlm.nih.gov

A Systematic Review and Meta-Analysis of Exercise Beneficial for Locomotion in Community-Dwelling Elderly People with Sarcopenia. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Effect of exercise on muscle function decline with aging. [2018]

12. United States pubmed.ncbi.nlm.nih.gov

Exercise and aging. Issues for the practitioner. [2022]

13. United States pubmed.ncbi.nlm.nih.gov

Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone. [2019]

14. United States pubmed.ncbi.nlm.nih.gov

The role of progressive resistance training and nutrition in the preservation of lean body mass in the elderly. [2019]

15. Netherlands pubmed.ncbi.nlm.nih.gov

The benefits of strength training for older adults. [2022]