Weight Loss and Physical Activity Reduces Perceived Physical Fatigability Among Older Adults With Obesity.

Abstract

This study aimed to evaluate the impact of three lifestyle interventions on perceived physical fatigability. Concurrent with a dietary weight loss program (caloric deficit ~400 kcal/day, weekly dietitian support), older adults with obesity (N = 183) were randomized to three groups: aerobic exercise (150-200 min/week of moderate-intensity treadmill walking; n = 60), daylong movement (improving daily activity distribution, progressively increase steps/day; n = 63), or combination (aerobic and daylong movement interventions; n = 60). Perceived physical fatigability (Pittsburgh Fatigability Scale [PFS] Physical score, range 0-50, and Rating of Perceived Exertion [RPE] after a 5-min 0% grade treadmill walk, range 6-20; higher = greater fatigability) was measured at baseline, 6 months (post-intensive intervention), and 18 months (end of maintenance period). Participants (69.6 ± 4.3 years, 77% female, 74% White, 35.6 ± 3.8 kg/m² BMI) had a PFS Physical score 20.6 ± 7.6 and RPE Fatigability 9.6 ± 1.9 at baseline. Clinically relevant improvements were observed in PFS score from baseline to 6 months (-4.4 points, p = 0.002) and were largely maintained at 18 months (-3.0 points, p = 0.03) after adjustment for baseline age, sex, education, intervention group, and time × intervention group (p = 0.83). RPE Fatigability did not improve (p > 0.05). Multiple physical activity strategies in conjunction with weight loss improved perceived physical fatigability over time among older adults with obesity. ClinicalTrials.gov identifier: NCT02923674.