December 6 — 7, 2007 Advisory Committee Meeting
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,
Through the sub-committee's work, three questions were formulated:
What is the evidence that physical activity prevents or
postpones functional limitations and/or disability with aging?
What is the evidence that physical activity improves or
maintains functional performance with aging?
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
While the studies in this area seem consistent it is the feeling
of the subcommittee that more data is needed to strengthen possible conclusions.