UGA Study: Regular Walking Nearly Halves Elderly Disability Risk

Older adults can decrease their risk of disability and increase their likelihood of maintaining independence by 41 percent by participating in a walking exercise program, according to a new University of Georgia study.

The study, which appears in the current issue of the Journal of Geriatric Physical Therapy, also found that walking program participants increased their peak aerobic capacity by 19 percent when compared to a control group and increased their physical function by 25 percent.

“In the past decade, researchers have focused on the benefits of strength training in maintaining independence, but until now we didn’t have good evidence using an objective performance measure that a walking program would improve physical functioning,” said study co-author M. Elaine Cress, professor of kinesiology and researcher in the UGA Institute of Gerontology. “Our study found that walking offers tremendous health benefits that can help older adults stay independent.”

The researchers randomly assigned 26 low-income adults aged 60 and older to either a walking exercise group, which met three times a week for four months, or a nutrition education control group. Initially, the group would walk for 10 minutes continually. As the weeks progressed, they increased their walking time to 40 continuous minutes. Each session began with a 10-minute warm-up and ended with a 10-minute cool-down that included balance and flexibility exercises.

Trudy Moore-Harrison, the lead author of the study and a former UGA doctoral student, explained that the researchers focused their study on low-income individuals because people with fewer financial resources are less likely to be physically active and are more likely to have chronic health conditions and lack health care coverage. Moore-Harrison added that walking doesn’t require any special equipment other than a pair of comfortable shoes, which makes it a simple and low-cost way for people to become active. Moore-Harrison supervised the group, but the researchers said that motivated community members could lead similar groups across the country.

Getting people to stick with exercise programs can be notoriously difficult, but the researchers found that every single member of the group stayed with the program for its four-month duration. “People really enjoyed the program,” said Moore-Harrison, now a post-doctoral fellow at the University of North Carolina Charlotte. “It gave them an opportunity to make new friends and get to know their neighbors.”

The researchers measured the aerobic capacity of the participants using a treadmill test and found that while the control group saw an 9 percent decline in aerobic capacity over the four-month study period, the aerobic capacity of the walking group increased by 19 percent over the same time period.

“Aerobic capacity is really the engine that we draw upon for doing the things we want to do, whether it’s cleaning up around the house or running a marathon,” Cress said. “By increasing their aerobic capacity, the walking group was better able to perform their daily tasks and had more energy left over for recreational activities, like going out dancing.”

The researchers assessed health status and bodily pain through questionnaires and examined disability by measuring performance on factors such as balance and walking. Physical functioning was measured through both questionnaires and through tests that measured how well the volunteers performed daily activities such as climbing a flight of stairs and putting on and removing a jacket.

The researchers found that physical function increased by 25 percent in the walking exercise group, compared to a decrease of 1 percent in the control group. And while the control group saw their risk of disability increase over the four-month period, the walking exercise group saw their disability risk go from 66 percent to 25 percent – a decrease of 41 percent in just four months.

“We know that walking is good for you, but too many people still aren’t doing it,” Moore-Harrison said. “This study shows that just walking on a regular basis can make a huge impact on quality of life.”

The research was supported by the UGA Institute of Gerontology Seed Grant, the Northeast Georgia Area Agency on Aging and the Georgia Gerontology Consortium Seed Grant. The research was done in cooperation with the Athens Housing Authority.

By Sam Fahmy

Georgia to Offer More Community Living Alternatives for Individuals With Disabilities

PRNewswire--- More than 2,300 individuals with disabilities currently institutionalized in Georgia's eight public psychiatric hospitals and mental retardation facilities will have the opportunity to live in their communities with appropriate supports tailored to meet their individualized needs as a result of a settlement agreement between the state of Georgia and the HHS Office for Civil Rights (OCR).

Under the settlement, signed Tuesday, Georgia also will involve consumers and advocates in planning how best to provide adequate community services to meet the needs of all Georgians with disabilities who are either living in institutions or at risk of institutionalization without community supports.

"Georgia's commitment to improve its community services through this settlement furthers the President's New Freedom Initiative by supporting independent living and individual choice," HHS Secretary Mike Leavitt said. "This agreement provides persons with disabilities greater opportunities to live within their home communities and have full access to community life."

By enhancing community alternatives to institutionalization under the settlement, Georgia will promote individuals' rights under the United States Supreme Court's 1999 ruling in Olmstead v. L.C. that the unnecessary institutionalization of individuals with disabilities constitutes discrimination under the Americans with Disabilities Act (ADA).

"Every Georgian who faces mental illness or developmental disabilities has the right to be treated in a way that not only ensures the best outcome, but allows for the highest quality of life," said Georgia Governor Sonny Perdue. "We've worked hard to make this agreement work, and the state of Georgia is committed to completing this effort."

The agreement settles statewide complaints filed with OCR by the Georgia Advocacy Office, Atlanta Legal Aid Society, Georgia Legal Services Program, and the Disability Law and Policy Center of Georgia. The complaints alleged that, in violation of the ADA, Georgia has failed to treat individuals with developmental disabilities and mental health disabilities in the most integrated setting appropriate to their needs -- the setting that enables persons with disabilities to interact with people without disabilities to the fullest extent possible. "In this voluntary compliance agreement with the Federal Government, Georgia promises a serious effort to end the illegal segregation of its citizens with disabilities and to provide appropriate community alternatives," said Sue Jamieson, the attorney with the Atlanta Legal Aid Society, who originally filed the Olmstead case, which arose in Georgia. "If the agreement results in long overdue residential supports and other needed community services, it could finally begin to heal the wounds we have all suffered from institutionalizing people who should be our neighbors."

Georgia's implementation of the settlement agreement will rely, in part, on a $44 million dollar Money Follows the Person Rebalancing Demonstration Grant, which was awarded to the state by the HHS Centers for Medicare & Medicaid Services on June 30, 2008. This grant will allow Georgia to "rebalance" its Medicaid program away from long-term institutional care to one that offers individuals the option to live in the community. Experts from HHS' Substance Abuse and Mental Health Services Administration will also work with Georgia officials to develop its community mental health system to carry out the requirements of the agreement.

"This settlement is a model for states in meeting their ADA obligations to eliminate unlawful institutionalization and provide adequate community alternatives," said OCR Director Winston Wilkinson. "To combat ongoing disability discrimination, the HHS Office for Civil Rights will continue its enforcement efforts, along with promoting voluntary compliance and technical assistance to ensure states comply with the ADA and Olmstead decision."