Investigating dose–response effects of multimodal exercise programs on health-related quality of life in older adults

Navin Kaushal,1,2 Francis Langlois,3 Laurence Desjardins-Crépeau,1,2,4 Martin S Hagger,5,6 Louis Bherer1,2,4 1Department of Medicine, University of Montreal, Montreal, Quebec, Canada; 2Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; 3CIUSSS de l’Estrie, Centre Hospitalier Universitaire de Sherbrooke, Montreal, Quebec, Canada; 4Research Center, Geriatrics Institute, University of Montreal, Montreal, Quebec, Canada; 5School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 6Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland Background: Older adults are at risk of multiple chronic diseases, most of which could be prevented by engaging in regular physical activity. Frailty is a state of increased vulnerability to diseases. Worsening symptoms of frailty, such as decrease in physical functionality, can compromise health-related quality of life (HR-QOL). Previous findings suggest that frailty moderates the relationship between physical activity and HR-QOL, yet intervention findings are limited, particularly in dose–response analyses. Hence, this study was conducted to test if lower-dose physical activity (120 minutes/week) would provide the same benefits in health outcomes (physical functionality and HR-QOL) as higher-dose physical activity (180 minutes/week).Methods: Participants (n=110) were older adults comprising higher-dose, lower-dose, and control groups who were combined from recent randomized controlled trials. Experimental groups participated in a multimodal exercise program in a supervised laboratory setting for 12 weeks.Results: The higher-dose group showed a significant improvement in physical functionality (β=0.23, P=0.03) and in overall HR-QOL (β=0.44, P=0.001) including its subcategories over the control group. A group × frailty interaction revealed that frail individuals significantly improved in capacity HR-QOL when they exercised at a higher dose (F (1, 49)=4.57, P=0.038).Conclusion: This study identifies a positive, predictive relationship between exercise duration and health outcomes (HR-QOL dimensions and frailty) among older adults. Frail individuals in the higher-dose group demonstrated significant recovery of capacity HR-QOL, thus reflecting improvement in their daily activities. Keywords: physical activity, aging, multimodal exercise, frailt