TOPLINE

Older adults with obesity who paired a dietary weight-loss program with structured exercise, more daily movement, or both for 6 months saw fatigue level drop by a clinically meaningful margin — and most of that improvement was maintained at 18 months.

METHODOLOGY

• Perceived physical fatigability is common and burdensome in older adults with obesity. Because physical activity helps preserve or boost aerobic fitness, it may also be an effective way to reduce fatigability in this population.
• Researchers analyzed data from a clinical trial that included 183 older adults with obesity (mean age, 69.6 years; 77% women) who were less active and free from most chronic health conditions.
• As part of the trial, all participants followed an identical weight-loss program — a roughly 400 kcal/d caloric deficit with weekly dietitian support. They were also randomly assigned to aerobic exercise, daylong movement, or both combined for 6 months. This intensive phase was followed by a 3-month transition period and a 9-month maintenance period.
• Perceived physical fatigability was assessed at baseline, 6 months, and 18 months using two complementary tools: the Pittsburgh Fatigability Scale (PFS), which captures fatigue associated with physical, social, and daily living activities, and Rating of Perceived Exertion (RPE) Fatigability, which rates perceived effort right after a short, slow treadmill walk.
• Analysis included 168 participants with complete PFS data and 165 with complete RPE Fatigability data at baseline and 6 months; 137 and 98 participants had data at 18 months, respectively.

TAKEAWAY

• The participants lost an average of 8.4% of their body weight between baseline and 6 months, with no differences between the intervention groups. At baseline, the mean PFS score was 20.6, and the mean RPE Fatigability score was 9.6.
• By 6 months, PFS scores had dropped by 4.4 points on average, a 21% decline (P <.0001); a year later, at the 18-month mark, scores were still down 3.0 points, or 14%, from where participants started (P <.001). At 6 months, 35 participants were no longer in the most severe PFS category, and the proportion in the least severe category increased substantially.
• All three intervention groups — aerobic exercise, daylong movement, and combined — showed significant improvements in PFS score from baseline to 6 months, with no significant differences between groups.
• None of the three intervention groups pulled ahead of the others on RPE Fatigability severity, whether measured early, midway, or at the study's end.

IN PRACTICE

"Assessing and intervening on PFS, therefore, may better translate to a meaningful change in quality of life. Further, implementing the use of PFS in clinical settings could identify at-risk older adults who would benefit from physical activity interventions," the authors wrote.

"As large gaps between lifespan and healthspan still remain, lowering fatigability through physical activity interventions may reduce this gap and improve the quality of life for older adults with obesity," they added.

SOURCE

The study was led by Reagan E. Garcia, University of Pittsburgh School of Public Health, Pittsburgh. It was published online in Obesity.

LIMITATIONS

Because of the study design, the researchers could not isolate the effects of physical activity from those of weight loss. The sample was also relatively healthy and consisted of mostly White and non-Hispanic participants, limiting the generalizability of the findings. Additionally, higher-than-anticipated attrition rates may have reduced the study's power to detect differences between groups.

DISCLOSURES

The study was supported by the National Institutes of Health and National Institute on Aging. Some authors reported receiving support from the Wake Forest University Claude D. Pepper Older Americans Independence Center, the NIA Pittsburgh Claude D. Pepper Older Americans Independence Center, and the T32 Training in Epidemiology of Aging Program. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.