December 6 — 7, 2007 Advisory Committee Meeting Minutes

Functional Health Subcommittee Report

Miriam Nelson, Ph.D., presented the subcommittee report on functional health. Dr. Nelson thanked her fellow subcommittee members, Dr. Kohrt, Dr. Rimmer as well as their consultants, Dave Buchner, Jack Guralnick and John Campbell as well as administrative help from Dr. Nelson's graduate assistant, Mary Kennedy.

Through the sub-committee's work, three questions were formulated:

1. What is the evidence that physical activity prevents or postpones functional limitations and/or disability with aging?

2. What is the evidence that physical activity improves or maintains functional performance with aging?

3. What is the evidence that physical activity reduces falls or risks of falls in older adults?

Addressing question number 1, there were approximately 23 studies that were identified that were relevant to the question. While there appears to be more studies that can be reviewed the initial findings seem to be clear and consistent in that physical activity reduces the risk of developing functional limitations. While there may be a dose-response effect it is not conclusive at this point. It may be important to pay close attention to studies that include older adults as those studies point towards benefits to all ages.

Reviewing whether there is evidence that physical activity improves or maintains functional performance with aging the group looked at 39 studies (mostly randomized control studies) consisting of participants from age 35 to 65 (as the emphasis in this area has focusing more on older adults now the group may need to reconsider the age groups in the studies they review). Again, the preliminary findings, no matter how one defines physical activity, show benefits to improving or maintaining functional health. While there are only a small number of studies that show a dose-response effect there may be evidence linking increased activity to better results. However, more data is needed.

Dr. Nelson next discussed the conclusions of physical activity with regards to balance. In this area there were 13 papers available, most of which were randomized controls with participants aged 45 or older. The findings indicate physical activity reduces the risk of falling in older adults. While a variety of activities show benefit, strength and balance training seem most effective.

While the studies in this area seem consistent it is the feeling of the subcommittee that more data is needed to strengthen possible conclusions.