Trajectories of physical function changes for older veterans with serious mental illness in a clinical exercise program

Abstract

Background and aims

Older persons with serious mental illness (SMI) have compromised physical function (endurance, strength, mobility). Multicomponent exercise is effective at improving function in older adults but has been minimally examined in older people with SMI. The purpose of this study was to evaluate changes in physical function for older adults with SMI enrolled in a clinical exercise program.

Methods

This study was a retrospective analysis of Veterans Health Administration (VHA) electronic health record and national clinical exercise program (“Gerofit”) data. One hundred fifty older veterans with SMI and 1264 older veterans without SMI enrolled in eight Gerofit sites between 2010 and 2019. Veterans completed five objective measures of physical function assessing endurance (6-min walk test), strength (arm curl, chair stand), and mobility (10-m walk, 8-foot-up-and-go) at Gerofit enrollment and at three, six, and 12 months. Demographic and health information were obtained from VHA electronic health records. Propensity-score matching (1:3) was conducted followed by linear mixed modeling analyses to evaluate differences in trajectories of functional changes between groups.

Results

Results showed significant improvements in all function measures over time adjusting for SMI status and control variables; however, there were no significant differences in physical function changes between SMI and non-SMI groups.

Conclusion

These findings suggest that multicomponent exercise can improve physical function in older veterans with SMI.