Researchers compared the effects of three treatment approaches, "successful aging" education, physical activity, and weight loss plus physical activity, on mobility in a population of older, overweight or obese adults at risk for or having cardiovascular compromise. The study sample comprised 288 community-dwelling subjects between 60 and 79 years of age who had a body mass index (BMI) higher than 28. Patients had an impaired ability to exercise and performed less than one hour of physical activity per week. All had a recent history of heart disease or metabolic syndrome.

The successful aging arm, designed as a control, received instructional lessons in healthful aging practices. The physical activity arm aimed to engage in a minimum of 2.5 hours of moderate-to-vigorous activity per week. The combined arm added the goal of a 7%-to-10% reduction in BMI through calorie reduction. The effects of each intervention were evaluated using the 400-m walk test-the time in seconds it takes to walk this distance-and measured at baseline and at six, 12, and 18 months.

An overall benefit in each group was realized from baseline 400-m walk test times. The combined group, however, was found to have the most improved mobility throughout the 18-month study period; the benefit the physical activity group showed over the control group at six months was gone by 18 months. The combined group had an 18-second adjusted mean difference over the control arm and a 13-second advantage over the physical activity arm. The subjects with the worst mobility at the start of the study had progressed the most at 18 months. The researchers concluded that weight loss is crucial to successfully increasing mobility in this population, and the combination of weight loss and physical activity can be successfully applied in a community setting.-AK

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