UF Health MedMatters

The Legacy of a Landmark Study of Exercise in Sedentary Older Adults

One of the most consequential geriatric projects not just at the University of Florida Health but in the nation marked its 20th anniversary in 2020. And the final chapter is not yet written for the Lifestyle Interventions and Independence for Elders, or LIFE, study.

It was 2000 when Marco Pahor, MD, then a researcher at Wake Forest University, conceived the idea of a big project to determine the benefits of exercise in frail older adults. He didn’t realize he was beginning a 20-year odyssey.

Seniors working out

Pahor, director of the UF Institute on Aging, would eventually lead a consortium of eight universities or research centers that concluded in 2014 that moderate physical activity helped sedentary adults ages 70 to 89 maintain their ability to walk and stave off major mobility disability.

The LIFE studies generated a wealth of important scientific findings and accelerated research in geriatrics and gerontology, benefiting the research community, trainees, clinicians, policy makers and the general public.

LIFE also showed the benefit of physical activity was especially notable for participants who were more physically impaired at baseline.

The study’s findings were far-reaching and provided evidence that informs public health guidelines affecting millions of Americans.

“We wanted to provide definitive evidence that exercise can keep older adults independent and able to perform the activities that make life enjoyable and meaningful,” said Pahor. “We accomplished that.”

Those 2014 findings, however, weren’t the end of it.

To date, the LIFE study has involved more than 870 scientists, staff members and trainees at 18 institutions throughout the United States. It has generated at least 115 peer-reviewed studies, 19 ancillary studies and 38 independently funded grants and clinical trials. Scientists today continue to draw on the data the study generated.

Just as important to Pahor are the lives LIFE has improved, and the scientists whose careers were enhanced by the research. Pahor estimates 59 early-career scientists have benefited from the study.

“It shows that persistence pays,” Pahor said. “It took a lot of energy to keep the team together. And the study is still paying dividends. It’s made a huge difference in public health.”

Pahor and colleagues reviewed some of the lessons learned from this landmark investigation in a paper published last year in the Journal of the American Geriatrics Society.

“The LIFE studies support the view that thorough planning, secondary analyses of data from existing studies, extensive pilot testing, and persistence are of pivotal importance to secure the success of a large multicenter phase 3 clinical trial,” the paper noted. “The LIFE studies have shown that older persons who are at high risk of disability and are traditionally excluded from large clinical trials can be successfully recruited, can be retained and will adhere to behavioral interventions and physical and cognitive assessment protocols.”

The journal recognized the hard work of Pahor and his collaborators.

“Those of us who glimpsed at the dedication, commitment and tenacity of Pahor and colleagues over these years can only be moved, humbled in fact, by the efforts that it took to get here,” the journal said in an editorial. “How many of us would be willing to devote 20 years of our lives to seeing a trial through?”

The journal noted the LIFE study “was a historic and ambitious undertaking that succeeded in reducing the onset and persistence of (major mobility disability) in high-risk older men and women aged 70 to 89 years.”

The journal said “we owe a huge debt” to the LIFE investigators.

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University of Florida Health Shands Hospital has been recognized among the nation’s best hospitals in seven adult medical specialties. Overall, UF Health Shands Hospital was recognized as one of the best hospitals in Florida. In addition to being ranked among the nation’s top 50 hospitals in seven specialties, UF Health Shands Hospital also was listed as “high performing” in seven specialties, including abdominal aortic aneurysm repair, colon cancer surgery, COPD, heart failure, lung cancer surgery, neurology & neurosurgery and orthopaedics.