Older Adults With Chronic Conditions Still Gained From a Year of Training

The findings come from the European Journal of Applied Physiology. According to the published article page, the work is an exploratory secondary analysis of a randomised controlled trial, a study design in which people are assigned by chance to different programmes. It enrolled 314 community-dwelling older adults with an average age of 74.5. Because this analysis looks at who responded, not at what was assigned, its links are associations, not proof of cause.

Participants were randomised to physical training or to physical plus cognitive training. The physical programme included resistance, walking, balance and flexibility training. The cognitive part consisted of executive function tasks. It ran for 12 months. The responder analysis included 288 people who attended both the baseline and the final measurements, regardless of which group they were in.

According to the published article page, on average grip strength, knee extension strength, walking speed and walking distance all improved significantly (all p < 0.01). Appendicular lean mass, a measure that covers the muscle and other soft tissue of the arms and legs, showed no significant average change. Averages hide differences between people. The researchers labelled each person a high or low responder for each outcome. A high responder's change was larger than the smallest worthwhile change, defined as 0.2 times the group's baseline standard deviation. By that measure, the article page reports that 27% were high responders for grip strength, 46% for knee extension strength, 30% for walking speed and 44% for walking distance. For lean mass, 17% were. Overall, 46% were high responders in two to five of the outcomes.

The team then asked which health-related factors tracked with that broader response. Four did, according to the article page. Multimorbidity, meaning more than one chronic condition, was linked to higher odds of responding well (odds ratio 2.60, 95% confidence interval 1.47–4.59). Lower body mass index was also linked to higher odds (0.94, 0.88–0.99). So was higher adherence to the resistance training (1.03, 1.01–1.04). Younger age was linked to a stronger response too (0.90, 0.84–0.96). An odds ratio compares the chances of an outcome between groups.

The article page states that the authors had hypothesised that people in better health would gain more, so the multimorbidity result runs against that starting expectation. This is the weakest part of the argument. The analysis also does not show that adherence caused better results, since people who attend more sessions may differ in other ways. Nor does it rank the four factors, so it cannot show which mattered most.

A related piece on October 14 covered a different trial of interval training, in which lean mass changes were small. This study is separate. It also found no significant average change in lean mass, though it measured a different outcome set in a different programme. Whether other trials confirm that multimorbidity predicts a stronger response, and whether the same factors hold up in larger and more varied groups of older adults.

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