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Physical Activity Guidelines Advisory Committee Report
Part G. Section 6: Functional Health
Table G6.A1. Summary Table of Studies Investigating Whether Regular
Physical Activity Prevents or Delays the Onset of Substantial Functional
Limitations and/or Role Limitations in Middle-Aged and Older Adults Who Do Not
Have Severe Functional or Role Limitations
Author/Year |
Outcome Category |
Name of Measure |
Referent Group OR |
2nd Level of PA |
3rd Level of PA |
4th Level of PA |
5th Level of PA |
Ward et al., 1995 (1) |
Global |
Health Assessment Questionnaire (HAQ) |
1.0 |
0.61; 95% CI (0.40-0.93) |
– |
– |
– |
Strawbridge et al.,1996 (2) |
Global disability |
ADL, IADL, Rosow‑Breslau |
1.0 |
0.59; 95% CI (0.34-1.02)a |
– |
– |
– |
Rantanen et al., 1997 (3) |
Strength change |
– |
Expressed as % strength change in multiple muscle
groups, inconsistent resultsb |
Expressed as % strength change in multiple muscle
groups, inconsistent resultsb |
Expressed as % strength change in multiple muscle
groups, inconsistent resultsb |
Expressed as % strength change in multiple muscle
groups, inconsistent resultsb |
Expressed as % strength change in multiple muscle
groups, inconsistent resultsb |
Schroll et al., 1997 (4) |
Mobility |
Mobility dependency Men |
1.0 |
0.24 (Inverse of 4.14)a,b |
95% CI not provided |
– |
– |
Schroll et al., 1997 (4) |
Mobility |
Mobility dependency Women |
1.0 |
0.23 (Inverse of 4.32)a,b |
95% CI not provided |
– |
– |
Sarna et al., 1997 (5) |
Global |
Occupational role limitations |
Average working life expectancy was higher in
habitually active adults than in the reference group |
Average working life expectancy(LE) was higher in
habitually active adults than in the reference group |
Average working life expectancy was higher in
habitually active adults than in the reference group |
Average working life expectancy was higher in
habitually active adults than in the reference group |
Average working life expectancy was higher in
habitually active adults than in the reference group |
Unger et al., 1997 (6) |
Change in ADL/IADL |
– |
1.0 |
Decreased slope of decline in people doing several
forms of PA |
Decreased slope of decline in people doing several
forms of PA |
Decreased slope of decline in people doing several
forms of PA |
Decreased slope of decline in people doing several
forms of PA |
Huang et al., 1998 (7) |
Functional limitation, Men |
– |
1.0 |
0.7; 95% CI (0.5-0.9)b |
0.5; 95% CI (0.3-0.8)b |
– |
– |
Huang et al., 1998 (7) |
Functional limitation, Women |
– |
1.0 |
0.7; 95% CI (0.5-1.10) |
0.7; 95% CI (0.4-1.20) |
– |
– |
Ferrucci et al., 1999 (8) |
Disabled LE |
ADL |
More years of disabled LE in sedentary |
More years of disabled LE in sedentary |
More years of disabled LE in sedentary |
More years of disabled LE in sedentary |
More years of disabled LE in sedentary |
Kujala et al., 1999 (9) |
Hip disability |
– |
1.0 |
0.46; 95% CI (0.22-0.93) |
– |
– |
– |
Kujala et al., 1999 (9) |
Knee disability |
– |
1.0 |
0.69; 95% CI (0.39-1.21) |
– |
– |
– |
Leveille et al., 1999 (10) |
ADL before death |
– |
1.0 |
0.67; 95% CI (0.47‑0.98)a [Inverse of
1.25 (0.87‑1.82)] |
0.53 95% CI (0.36‑0.80)a [Inverse of
1.86 (1.24‑2.79)] |
– |
– |
Wu et al., 1999 (11) |
ADL |
ADL |
1.0 |
0.52 (0.39-0.68) |
– |
– |
– |
Brill et al., 2000 (12) |
Strength, Men |
– |
1.0 |
0.56 (0.34-0.93)c |
– |
– |
– |
Brill et al., 2000 (12) |
Strength, Women |
– |
1.0 |
0.54 (0.21-1.39)c |
– |
– |
– |
Hirvensalo et al., 2000 (13) |
ADL |
Dependence, Men |
1.0 |
1.10 (0.27-4.55) [Inverse of 0.91
(0.22-3.70)]a |
In adults with no or mild limitation at baseline |
– |
– |
Hirvensalo et al., 2000 (13) |
ADL |
Dependence, Women |
1.0 |
0.85 (0.45-1.59) [Inverse of 1.17
(0.63-2.22)]a |
In adults with no or mild limitation at baseline |
– |
– |
Miller et al., 2000 (14) |
Mobility |
Ability to walk, climb stairs, stand, and stoop |
1.0 |
0.68 (0.58-0.80) |
– |
– |
– |
Miller et al., 2000 (14) |
IADL/ADL |
Selected IADL and ADL items |
1.0 |
0.74 (0.62-0.89) |
– |
– |
– |
Ostbye et al., 2002 (15) |
Mobility |
Difficulty walking |
1.0 |
0.53 (0.44-0.64) |
0.35 (0.30-0.41) |
0.21 (0.17-0.25) |
– |
Ostbye et al., 2002 (15) |
ADL |
ADL |
1.0 |
0.53 (0.43-0.66) |
0.44 (0.36-0.52) |
0.28 (0.22-0.36) |
– |
Ostbye et al., 2002 (15) |
Mobility |
Difficulty climbing stairs |
1.0 |
0.72 (0.61-0.85) |
0.50 (0.43-0.58) |
0.26 (0.22-0.31) |
– |
Ostbye et al., 2002 (15) |
Global |
Role limitation = inability to do paid work |
1.0 |
0.51 (0.40-0.64) |
0.46 (0.37-0.55) |
0.25 (0.19-0.33) |
– |
Ostbye et al., 2002 (15) |
Other |
Hospitalization |
1.0 |
0.83 (0.70-0.97) |
0.70 (0.61-0.81) |
0.60 (0.51-0.71) |
– |
Stessman et al., 2002 (16) |
ADL |
ADL |
1.0 |
0.23 (0.09-0.56) [Inverse of 4.30
(1.80-10.6)]a |
Subgroup analysis found significant effects in both
men and women |
– |
– |
Stessman et al., 2002 (16) |
IADL |
IADL |
1.0 |
0.43 (0.20-0.91) [Inverse of 2.30
(1.10-5.10)]a |
Subgroup analysis found significant effect in men but
non-significant trend in women |
– |
– |
Wang et al., 2002 (17) |
Global |
Health Assessment Questionnaire (HAQ) |
Non-runners had more worsening of HAQ scores over 13
years than did runners |
Non-runners had more worsening of HAQ scores over 13
years than did runners |
Non-runners had more worsening of HAQ scores over 13
years than did runners |
Non-runners had more worsening of HAQ scores over
13 years than did runners |
Non-runners had more worsening of HAQ scores over
13 years than did runners |
Brach et al., 2003 (18) |
ADL, global, and mobility |
Any ADL difficulty, Physical Performance Test
(PPT), and gait speed |
The higher the level of PA over time (assessed in both
1985 and 1995), the better the functional performance and role performance as
judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across
PA levels were significant)b |
The higher the level of PA over time (assessed in both
1985 and 1995), the better the functional performance and role performance as
judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across
PA levels were significant)b |
The higher the level of PA over time (assessed in both
1985 and 1995), the better the functional performance and role performance as
judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across
PA levels were significant)b |
The higher the level of PA over time (assessed in both
1985 and 1995), the better the functional performance and role performance as
judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across
PA levels were significant)b |
The higher the level of PA over time (assessed in both
1985 and 1995), the better the functional performance and role performance as
judged by gait speed, PPT, and ADL difficulties (i.e., tests for trends across
PA levels were significant)b |
He et al., 2004 (19)
(“Light PA”) |
Mobility |
Difficulty walking/ climbing stairs |
1.0 |
0.89 (0.65-1.16) |
0.78 (0.56-1.03) |
0.69 (0.49-0.92) |
0.75 (0.53-1.01) |
He et al., 2004 (19)
(“Vigorous PA/household chores”) |
Mobility |
Difficulty walking/ climbing stairs |
1.0 |
0.83 (0.69-0.97) |
0.73 (0.59-0.89) |
0.58 (0.48-0.70) |
0.57 (0.43-0.76) |
Haight et al., 2005 (20) |
Functional limitations at any of 4 surveys, Men |
– |
1.0 |
0.63; 95% CI (0.00-0.92) |
– |
– |
– |
Haight et al., 2005 (20) |
Functional limitations at any of 4 surveys, Women |
– |
1.0 |
0.47; 95% CI (0.14-0.92) |
– |
– |
– |
Hillsdon et al., 2005 (21) |
Not having highest SF‑36 |
SF-36 |
1.0 |
0.91; 95% CI (0.74-1.14) |
0.63; 95% CI (0.5-0.77) |
– |
– |
Simonsick et al., 2005 (22) |
LE performance |
– |
1.0 |
Greater decline in walkers > 8 blocks vs.
non-walkers |
Greater decline in walkers > 8 blocks vs.
non-walkers |
Greater decline in walkers > 8 blocks vs.
non-walkers |
Greater decline in walkers > 8 blocks vs.
non-walkers |
Visser et al., 2005 (23) |
Mobility, Men |
– |
1.0 |
0.70; 95% CI (0.54-0.85)[Inverse of 1.47
(0.56‑0.89)]a |
0.48; 95% CI (0.30-0.63)[Inverse of 2.08
(1.60‑2.70)]a |
– |
– |
Visser et al., 2005 (23) |
Mobility, Women |
– |
1.0 |
0.73; 95% CI (0.57-0.93) [Inverse of 1.44
(1.12‑1.84)]a |
0.51; 95% CI (0.38‑0.66) [Inverse of
1.98 (1.51‑2.60)]a |
– |
– |
Wannamethee et al., 2005 (24) |
Mobility |
Any of 3 mobility problems |
1.0 |
0.90 (0.68-1.19) |
0.88 (0.64-1.21) |
0.77 (0.58-1.03) |
– |
Backmand et al., 2006 (25) |
Daily activities |
– |
1.0 |
0.89; 95% CI (0.83-0.95) Risk per MET |
– |
– |
– |
Berk et al., 2006 (26) |
Global |
Health Assessment Questionnaire |
“Sedentary” and “Exercise
Decreasers” had more worsening of HAQ scores over 16 years compared to
“Exercisers” and “Exercise Increasers” |
“Sedentary” and “Exercise
Decreasers” had more worsening of HAQ scores over 16 years compared to
“Exercisers” and “Exercise Increasers” |
“Sedentary” and “Exercise
Decreasers” had more worsening of HAQ scores over 16 years compared
to “Exercisers” and “Exercise Increasers” |
“Sedentary” and “Exercise
Decreasers” had more worsening of HAQ scores over 16 years compared to
“Exercisers” and “Exercise Increasers” |
“Sedentary” and “Exercise
Decreasers” had more worsening of HAQ scores over 16 years compared
to “Exercisers” and “Exercise Increasers” |
Christensen et al., 2006 (27) |
Mobility |
Mobility-Tiredness Scale |
1.0 |
0.18; 95% CI (0.05-0.60) [Inverse of 5.65
(1.66-19.28)]a |
– |
– |
– |
Patel et al., 2006 (28) |
Mobility, Men |
400-meter walk |
1.0 |
0.37; 95% CI (0.15-0.93) |
0.23; 95% CI (0.09‑0.63) |
– |
– |
Patel et al., 2006 (28) |
Mobility, Women |
400-meter walk |
1.0 |
0.69; 95% CI (0.37-1.28) |
0.70; 95% CI (0.31‑1.59) |
– |
– |
Tessier et al., 2007 (29) |
Physical Function |
SF-36 |
Modest but significant association between change in
PA and change in physical function domain |
Modest but significant association between change in
PA and change in physical function domain |
Modest but significant association between change in
PA and change in physical function domain |
Modest but significant association between change in
PA and change in physical function domain |
Modest but significant association between change in
PA and change in physical function domain |
ADL, activities of daily living; CI, confidence
interval; HAQ, health assessment questionnaire; IADL, instrumental activities
of daily living; LE, life expectancy; MET, metabolic equivalent; PA, physical
activity; PPT, physical performance test; SF-36, short form health survey with
36 questions a Odd ratios (ORs) were recalculated to use the
least active group as the reference category. b Both physical
activity and fitness were measured. c The study by Brill et al.,
2000 (12) was not included in the review for the overall conclusions because it
did not include any measure of physical activity. It was considered in the
limitations section because it provided information about muscle strength and
function.
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Last revised: June 11, 2008
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