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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:1154-1156 (2006)
© 2006 The Gerontological Society of America

GUEST EDITORIAL

A Little Exercise

Luigi Ferrucci and Eleanor M. Simonsick

Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.

Address correspondence to Luigi Ferrucci, MD, PhD, NIA-ASTRA Unit at Harbor Hospital, 3001 S. Hanover St., NM540, Baltimore, MD 21225. E-mail: ferruccilu{at}grc.nia.nih.gov

All parts of the body which have a function if used in moderation and exercised in labors in which each is accustomed, become thereby healthy, well developed and age more slowly; but if unused and left idle they become liable to disease, defective in growth and age quickly.

—Hippocrates, c. 450 B.C.

TALK about wisdom! Nearly 2500 years later, the debate about exercise and aging continues with little understanding of the topic beyond Hippocrates' words.

The report by the LIFE Study investigators on the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study that appears in this issue of the Journal adds to the growing number of reports demonstrating that well-designed and supervised training programs encompassing strength, balance, and/or endurance-promoting activities in the very old and/or debilitated can improve performance on low-level functional tasks. Somewhat imbedded in the findings is another increasingly well-documented principle—performance-based tests can identify individuals on the brink of severe loss or decline in health and functional independence, some of whom will benefit from performance training and attention to the underlying functional deficits.

The LIFE-P study adds pivotal information to the substantial and multifaceted literature on the benefits of physical activity in older persons (1–13), and provides important evidence that increased physical exercise in older persons with functional limitations improves lower extremity performance, one of the most important risk factors for late-life disability (14). Although large observational studies supported the role of exercise in late life as a means to improve or slow down age-related decline in physical performance, it remained uncertain whether this association was causal or whether physical activity just served as a proxy measure for "life engagement or health behaviors" associated with better health. Further, although considerable data in the literature suggests that tests of lower extremity performance, such as the Short Physical Performance Battery (SPPB), are quick and effective tools for identifying older persons at high risk of disability (15,16), evidence that SPPB score can be successfully modified was limited to small studies.

We compliment the authors for the scientific rigor of the LIFE-P study. No doubt they have broken new ground and provided further justification and preliminary data critical to an improved design and conduct of a clinical trial to determine whether increasing physical activity prevents or delays disability in older persons.

In the spirit of full disclosure, we should state that both authors of this editorial were involved in early discussions about the design of the LIFE study. Below we offer the perspectives and sometimes differing opinions of a geriatrician (L.F.) and social scientist (E.M.S.) on the findings and future direction of the LIFE study.

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