Restricted access

Purchase article

USD $24.95

Student 1 year subscription

USD $76.00

1 year subscription

USD $101.00

Student 2 year subscription

USD $144.00

2 year subscription

USD $189.00

Veterans represent a unique population of older adults, as they are more likely to self-report a disability and be overweight or obese compared with the general population. We sought to compare changes in mobility function across the obesity spectrum in older veterans participating in 6 months of Gerofit, a clinical exercise program. A total of 270 veterans (mean age: 74 years) completed baseline, 3-, and 6-month mobility assessments and were divided post hoc into groups: normal weight, overweight, and obese. The mobility assessments included 10-m walk time, 6-min walk distance, 30-s chair stands, and 8-foot up-and-go time. No significant weight × time interactions were found for any measure. However, clinically significant improvements of 7–20% were found for all mobility measures from baseline to 3 months and maintained at 6 months (all ps < .05). Six months of participation in Gerofit, if enacted nationwide, appears to be one way to improve mobility in older veterans at high risk for disability, regardless of weight status.

Addison, Katzel, and Giffuni are with Geriatric Research, Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD. Addison and Katzel are with the University of Maryland School of Medicine, Baltimore, MD. Serra is with Atlanta VA Medical Center, Atlanta, GA; and the School of Medicine, Emory University, Atlanta, GA. Lee and Castle are with the Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA; and the David Geffen School of Medicine at UCLA, Los Angeles, CA. Valencia is with the Geriatric Research, Education, and Clinical Center, Miami Healthcare System, Miami, FL; and the Miller School of Medicine, University of Miami, Miami, FL. Kopp and Cammarata are with the VA Medical Center, Canandaigua, NY. McDonald is with the Geriatric Rehabilitation and Clinical Center, VA Pacific Health Care System, Honolulu, HI. Oursler and Jain are with the Geriatric Research, Education, and Clinical Center, VA Medical Center, Salem, VA. Bettger is with the Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC. Pearson, Manning, and Morey are with Geriatric Research, Education, and Clinical Center, VA Health Care System, Durham, NC. Sloane and Morey are with the Center for the Study of Aging/Claude D. Pepper Older Americans Independence Center, Department of Medicine, Duke University Medical Center, Durham, NC. Intrator, Veazie, and Li are with Geriatrics and Extended Care Data and Analyses Center, VA Medical Center, Canandaigua, NY; the University of Rochester, Medical Center, Rochester, NY.

Addison (oaddison@som.umaryland.edu) is corresponding author.
Journal of Aging and Physical Activity
Article Sections
References
  • AngelR. & FriscoM. (2001). Self-assessments of health and functional capacity among older adults. Journal of Mental Health and Aging 7(1) 119135.

    • Search Google Scholar
    • Export Citation
  • ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. (2002). ATS statement: Guidelines for the six-minute walk test. American Journal of Respiratory and Critical Care Medicines 166(1) 111117. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • BlackwellD. & LucasJ. (2014). Participation in leisure-time aerobic and muscle-strengthening activities that meet the 2008 federal physical activity guidelines among adults aged 18 and over, by selected characteristics. Retrieved from https://ftp.cdc.gov/pub/health_Statistics/nchs/NHIS/SHS/2014_SHS_Table_A-14.pdf

    • Export Citation
  • BohannonR.W. & CrouchR. (2017). Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: A systematic review. Journal of Evaluation in Clinical Practice 23(2) 377381. PubMed ID: 27592691 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • FlegalK.M.CarrollM.D.OgdenC.L. & CurtinL.R. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303(3) 235241. PubMed ID: 20071471 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • HardyS.E.PereraS.RoumaniY.F.ChandlerJ.M. & StudenskiS.A. (2007). Improvement in usual gait speed predicts better survival in older adults. Journal of the American Geriatrics Society 55(11) 17271734. PubMed ID: 17916121 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KosterA.PenninxB.W.NewmanA.B.VisserM.van GoolC.H.HarrisT.B. . . . KritchevskyS.B. (2007). Lifestyle factors and incident mobility limitation in obese and non-obese older adults. Obesity 15(12) 31223132. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KritchevskyS.B.LovatoL.HandingE.P.BlairS.BotoseneanuA.GuralnikJ.M. . . . ManiniT. (2017). Exercise’s effect on mobility disability in older adults with and without obesity: The LIFE study randomized clinical trial. Obesity 25(7) 11991205. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • LiG.TaljaardM.Van den HeuvelE.R.LevineM.A.CookD.J.WellsG.A. . . . ThabaneL. (2017). An introduction to multiplicity issues in clinical trials: The what, why, when and how. International Journal of Epidemiology 46(2) 746755. PubMed ID: 28025257 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • LittmanA.J.ForsbergC.W. & KoepsellT.D. (2009). Physical activity in a national sample of veterans. Medicines & Science in Sports & Exercise 41(5) 10061013. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • ManiniT.M.NewmanA.B.FieldingR.BlairS.N.PerriM.G.AntonS.D. . . . GroupL.R. (2010). Effects of exercise on mobility in obese and nonobese older adults. Obesity 18(6) 11681175. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MiddletonA.FritzS.L. & LusardiM. (2015). Walking speed: The functional vital sign. Journal of Aging and Physical Activity 23(2) 314322. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MiznerR.L.PettersonS.C.ClementsK.E.ZeniJ.A.Jr.IrrgangJ.J. & Snyder-MacklerL. (2011). Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: A longitudinal analysis of outcomes. Journal of Arthroplasty 26(5) 728737. PubMed ID: 20851566 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MoreyM.C.CrowleyG.M.RobbinsM.S.CowperP.A. & SullivanR.J.Jr. (1994). The Gerofit program: A VA innovation. Southern Medical Journal 87(5) 8387. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MoreyM.C.LeeC.C.CastleS.ValenciaW.M.KatzelL.GiffuniJ. . . . ParkerD.C. (2018). Should structured exercise be promoted as a model of care? Dissemination of the department of veterans affairs Gerofit program. Journal of the American Geriatrics Society 66(5) 10091016. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • NelsonK.M. (2006). The burden of obesity among a national probability sample of veterans. Journal of General Internal Medicine 21(9) 915919. PubMed ID: 16918734 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • PeetersA.BonneuxL.NusselderW.J.De LaetC. & BarendregtJ.J. (2004). Adult obesity and the burden of disability throughout life. Obesity Research 12(7) 11451151. PubMed ID: 15292479 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • PereraS.ModyS.H.WoodmanR.C. & StudenskiS.A. (2006). Meaningful change and responsiveness in common physical performance measures in older adults. Journal of the American Geriatrics Society 54(5) 743749. PubMed ID: 16696738 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • RejeskiW.J.BrubakerP.H.GoffD.C.Jr.BearonL.B.McClellandJ.W.PerriM.G. & AmbrosiusW.T. (2011). Translating weight loss and physical activity programs into the community to preserve mobility in older, obese adults in poor cardiovascular health. Archives of Internal Medicine 171(10) 880886. PubMed ID: 21263080 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • RikliR. & JonesC. (2013). Senior fitness test manual. (2nd ed.). Campaign, IL: Human Kinetics.

  • Rillamas-SunE.LaCroixA.Z.WaringM.E.KroenkeC.H.LaMonteM.J.VitolinsM.Z. . . . WallaceR.B. (2014). Obesity and late-age survival without major disease or disability in older women. JAMA Internal Medicine 174(1) 98106. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • RoseD.J.JonesC.J. & LuccheseN. (2002). Predicting the probability of falls in community-residing older adults using the 8-foot up-and-go: A new measure of functional mobility. Journal of Aging and Physical Activity 10(4) 466475. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Samper-TernentR. & Al SnihS. (2012). Obesity in older adults: Epidemiology and implications for disability and disease. Reviews in Clinical Gerontology 22(1) 1034. PubMed ID: 22345902 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • ThomasD.R.MarrenK.BanksW. & MorleyJ. (2007). Do objective measurements of physical function in ambulatory nursing home women improve assessment of functional status? Journal of the American Medical Directors Association 8(7) 469476. PubMed ID: 17845951 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • van den BusscheH.KollerD.KolonkoT.HansenH.WegscheiderK.GlaeskeG. . . . SchonG. (2011). Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health 11101. PubMed ID: 21320345 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • VillarealD.T.ApovianC.M.KushnerR.F.KleinS.American Society for Nutrition and NAASO The Obesity Society. (2005). Obesity in older adults: Technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obesity Research 13(11) 18491863. PubMed ID: 16339115 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • VillarealD.T.BanksM.SienerC.SinacoreD.R. & KleinS. (2004). Physical frailty and body composition in obese elderly men and women. Obesity Research 12(6) 913920. PubMed ID: 15229329 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • VillarealD.T.BanksM.SinacoreD.R.SienerC. & KleinS. (2006). Effect of weight loss and exercise on frailty in obese older adults. Archives of Internal Medicine 166(8) 860866. PubMed ID: 16636211 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • VillarealD.T.ChodeS.ParimiN.SinacoreD.R.HiltonT.Armamento-VillarealR. . . . ShahK. (2011). Weight loss, exercise, or both and physical function in obese older adults. New England Journal of Medicine 364(13) 12181229. PubMed ID: 21449785 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • WareJ.E.Jr. & SherbourneC.D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care 30(6) 473483. PubMed ID: 1593914 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • WestcottW.L.WinettR.A.AnnesiJ.J.WojcikJ.R.AndersonE.S. & MaddenP.J. (2009). Prescribing physical activity: Applying the ACSM protocols for exercise type, intensity, and duration across 3 training frequencies. The Physician and Sportsmedicine 37(2) 5158. PubMed ID: 20048509 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • WrightA.A.CookC.E.BaxterG.D.DockertyJ.D. & AbbottJ.H. (2011). A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis. Journal of Orthopaedic and Sports Physical Therapy 41(5) 319327. PubMed ID: 21335930 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • ZaniniA.CrisafulliE.D’AndriaM.GregoriniC.CherubinoF.ZampognaE. . . . ChettaA. (2018). Minimal clinically important difference in 30 second sit-to-stand test after pulmonary rehabilitation in patients with COPD. European Respiratory Journal 52(Suppl. 62) OA5199. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
Article Metrics
All Time Past Year Past 30 Days
Abstract Views 135 135 59
Full Text Views 23 23 10
PDF Downloads 15 15 4
Altmetric Badge
PubMed
Google Scholar