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American Journal of Epidemiology Advance Access originally published online on April 21, 2009
American Journal of Epidemiology 2009 169(12):1507-1516; doi:10.1093/aje/kwp069
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Activity Energy Expenditure and Mobility Limitation in Older Adults: Differential Associations by Sex

Todd M. Manini, James E. Everhart, Kushang V. Patel, Dale A. Schoeller, Steve Cummings, Dawn C. Mackey, Douglas C. Bauer, Eleanor M. Simonsick, Lisa H. Colbert, Marjolein Visser, Frances Tylavsky, Anne B. Newman, Tamara B. Harris and for the Health, Aging and Body Composition Study

Correspondence to Dr. Todd M. Manini, 210 East Mowry Road, PO Box 112610, Gainesville, FL 32611-2610 (e-mail: tmanini{at}aging.ufl.edu).

Received for publication June 17, 2008. Accepted for publication March 4, 2009.

In this study, the authors aimed to determine whether higher activity energy expenditure, assessed by using doubly labeled water, was associated with a reduced decline in mobility limitation among 248 older community-dwelling US adults aged 70–82 years enrolled in 1998–1999. Activity energy expenditure was calculated as total energy expenditure (assessed over 2 weeks by using doubly labeled water) minus resting metabolic rate (measured with indirect calorimetry), with adjustment for the thermic effect of food. Across sex-specific tertiles of activity energy expenditure, men in the lowest activity group experienced twice the rate of mobility limitation as men in the highest activity group (41% (n = 18) vs. 18% (n = 8)). Conversely, women in the lowest and highest activity groups exhibited similarly high rates of mobility limitation (40% (n = 16) vs. 38% (n = 15)). After adjustment for potential confounders, men with higher activity energy expenditure levels continued to show reduced risk of mobility limitation (per standard deviation (284 kcal/day): hazard ratio = 0.61, 95% confidence interval: 0.41, 0.92). Women showed no association (per standard deviation (226 kcal/day): hazard ratio = 1.34, 95% confidence interval: 0.98, 1.85). Greater energy expenditure from any and all physical activity was significantly associated with reduced risk of developing mobility limitation among men, but not among women.

aging; disability evaluation; energy metabolism; exercise; mobility limitation; motor activity; sex

Abbreviations: AEE, activity energy expenditure; Health ABC, Health, Aging and Body Composition


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