As people get older, they often find that walking, climbing stairs and doing their normal daily activities become more difficult. The REtirement in ACTion (REACT) study tested whether or not a group exercise programme run in local communities could reduce this decline in older adults, and whether or not it provided good value for money. The programme encouraged social interaction and fun and provided support to find out about and get involved in other physical activities.
A multicentre, pragmatic, two-arm, parallel-group randomised controlled trial, for physically frail or pre-frail older adults aged ≥ 65 years. Recruitment was primarily via 35 primary care practices. Participants were randomly assigned to receive three healthy ageing education sessions or a 12-month, group-based exercise programme delivered in fitness and community centres. The primary outcome was improved lower limb function at 24 months, this was measured using the – Short Physical Performance Battery score.
Between June 2016 and October 2017, 777 participants (mean age 77.6 years, 66% female) were randomised to the intervention arm (n = 410) or the control arm (n = 367). Data collection was completed in October 2019. Primary outcome data at 24 months were provided by 628 (80.8%) participants.
At the 24-month follow-up, participants mobility was significantly greater in the intervention arm than in the control arm). The difference in lower limb function between intervention and control participants was clinically meaningful at both 12 and 24 months. Self-reported physical activity significantly increased in the intervention arm compared with the control arm.
Dropout rates were low (19% at 24 months) and adherence was high. Engagement with the REACT intervention was associated with positive changes in exercise competence, relatedness and enjoyment and perceived physical, social and mental well-being benefits. The intervention plus usual care was cost-effective compared with care alone over the 2 years of REACT. The intervention saved £103 per participant within the 2-year trial window. Lifetime horizon modelling estimated that further cost savings and quality-adjusted life-year gains were accrued up to 15 years post randomisation.
People that took part in the REACT intervention reported better mobility throughout the study. This most importantly included the final assessment which took place 24 months after the programme had started, 12 months after REACT sessions had finished.
The REACT intervention deliver enhanced mobility, and also proved to be a cost effective means of delivering such health benefits.
This CRN Portfolio study was sponsored by University of Bath and funded by the NIHR Public Health Research Programme.