Long-term strength and balance training prevents mobility decline among community-dwelling people aged 75 and older

Abstract

High functional capacity of muscle strength and balance in older persons promotes independent mobility and prevents functional decline below the disability threshold. This dissertation explored the effects of strength and balance training (SBT) as part of a multimodal geriatric intervention on physical functioning and health-related factors associated with training participation in a community-dwelling population aged 75 years and over. This study is a part of the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) project conducted from 2004 to 2007 in Kuopio, Finland. Participants were randomized into an intervention (n=339) and control group (n=312). The individualized multimodal intervention was based on comprehensive geriatric assessment, and included physical activity counselling and supervised SBT at the gym once a week for 28 months. Controls took part in the annual assessments but not in the intervention. Measurements of health, muscle strength, balance, and mobility were repeated annually. In total, 54% of the intervention group participants started SBT. These SBT adopters (n=182) were younger and had better cognitive status and physical functioning than non-adopters (n=157). Long-term adherence to group-based training was possible for the older adults, despite hospital admissions, comorbidities and functional impairments. Adherence to SBT was 55% (SD 29, range 1-99%) and better physical functioning predicted higher adherence. Training adopters improved their muscle strength and mobility, and maintained their performance in balance. Among the non-adopters, who received physical activity counselling, muscle strength declined, while their balance and mobility performance remained unchanged during the intervention. Controls showed a decline in all the tested parameters. In addition, poor functional vision was related to weaker balance and poorer mobility performance. In conclusion, the results indicate that supervised strength and balance training is an important component of a comprehensive geriatric intervention to maintain independent mobility.