Small Steps in Fitness Can Lead to Major Leaps in Health

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Journal of Applied Research in Intellectual Disabilities





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Background: Cut-off values are available for the minimum physical fitness levels required to generate health benefits as decreased morbidity and longer survival. However, these cut-off values may be impossible to reach for extremely unfit populations, such as older adults with intellectual disabilities. We want to propose a novel hypothesis that even among very unfit, older adults with intellectual disabilities, small changes in fitness can lead to major leaps in health. Methods: Data collected in the Healthy Ageing and Intellectual Disabilities (HA-ID) study was used to support this hypothesis. Physical fitness (cardiorespiratory fitness, gait speed, grip strength) was measured in 900 older adults with intellectual disabilities (50 years and older). Mortality was collected 5 years after baseline. The relationships between fitness and survival were analysed with multiple linear regression models and Cox proportional hazard models. Results: Looking at cardiorespiratory fitness, 100% of the older adults with intellectual disabilities scored below the average reference range of the general population. For gait speed this was 43% of the men and 54% of the women, and for grip strength 77% of the men and 67% of the women scored below the average reference range of the general population. Within these extremely low fitness levels, better baseline fitness was still associated with better survival (cardiorespiratory fitness HR = 0.997 [0.995–0.999], comfortable gait speed HR = 0.65 [0.54–0.78], grip strength HR = 0.97 [0.94–0.99]). Conclusions: Our study is the first to support our hypothesis that even small differences at the lower end of the physical fitness spectrum are associated with health benefits. Improving physical fitness is important to improve outcomes even in extremely unfit populations scoring well under the cut-off values for the general population. This supports a stronger focus on improving fitness amongst these unfit adults with intellectual disabilities.


Movement and Mind-Body Therapies | Psychology of Movement



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