Prevention of onset and progression of basic ADL disability in community dwelling older adults: A meta-analysis

Abstract

Purpose Physical activity (PA) is an important behavior when it comes to preventing or slowing down disablement caused by aging and chronic diseases. It remains unclear whether PA can directly prevent or reduce disability in activities of daily living (ADL). This article presents a meta-analysis of the association between PA and the incidence and progression of basic ADL disability (BADL). Methods Electronic literature search and cross-referencing of prospective longitudinal studies of PA and BADL in community dwelling older adults (50+) with baseline and follow-up measurements, multivariate analysis and reporting a point estimate for the association. Results Compared with a low PA, a medium/high PA level reduced the risk of incident BADL disability by 0.51 (95% CI: 0.38, 0.68; p < 001), based on nine longitudinal studies involving 17,000 participants followed up for 3–10 years. This result was independent of age, length of follow-up, study quality, and differences in demographics, health status, functional limitations, and lifestyle. The risk of progression of BADL disability in older adults with a medium/high PA level compared with those with a low PA level was 0.55 (95% CI: 0.42, 0.71; p < 001), based on four studies involving 8500 participants. Discussion This is the first meta-analysis to show that being physically active prevents and slows down the disablement process in aging or diseased populations, positioning PA as the most effective preventive strategy in preventing and reducing disability, independence and health care cost in aging societies.