An Older Adult Well-rounded Exercise Program (WellREP) - Medically Underserved And Well-served

The health benefits of older adult physical activity are well established. Regrettably, the number of physically active US older adults (OA) declines with age. Only 7% of OA 80+ yrs and 17% of OA aged 65-69 meet ACSM guidelines for aerobic, strength and balance activities. Within these, medically underserved (MU) OA 65+ are 2 times less likely than their well-served (WS) peers to meet ACSM recommendations (16% vs 32%, respectively). PURPOSE: To compare MU and WS OA functional fitness before and after a WellREP intervention. METHOD: MU (N = 18) and WS (N = 18) groups completed a 12 wk, 50 min, 2d•wk multi-component training program (flexibility, strength, balance, and aerobic). A WS waitlist (N = 15) was the control (C). The Senior Fitness Test (Chair Stand, Arm Curl, Sit and Reach, Up & Go, Scratch Test, 12-min Walk) was used to assess program effectiveness. RESULTS: No age difference was observed between groups (M = 77 + 3 yrs). BASELINE. A one-way ANOVA revealed significant baseline differences (p < 0.05) between groups for all measures except flexibility. Follow-up multiple comparisons indicated differences between MU and both WS and C. No difference existed between WS and C. Baseline pairwise comparisons of MU and WS groups indicated WS performed significantly more chair stands (16%) and arm curls (13%); and completed the Up-&-Go (10%) and 12-min Walk (23%) more quickly. INTERVENTION. Repeated measures ANOVAs revealed group x time interactions (p < 0.05) on all measures except flexibility. Significant improvements were observed between MU and C: Chair Stand 42%, Arm Curl 31%, Up-&-Go 13%, 12-min Walk 9%; and WS and C: Chair Stand 35%, Arm Curl 26%; Up-&-Go 8%; 12-min Walk 14%. Post-intervention differences between MU and WS were reduced to one measure, 12-min Walk (16%). C did not change. CONCLUSION: Similar to the physical activity literature, lower baseline functional fitness was observed in MU OA as compared to WS OA. However, following a WellREP intervention, MU OA outperformed the C and reduced initial WS between group differences on all measures except the 12-min walk. The promotion of physical activity to older adults is a public health priority. This study suggests that, given the opportunity, medically underserved older adults can reach fitness levels comparable to their well-served peers.