Increased Physical Activity and Fitness above the 50th Percentile Avoid the Threat of Older Adults Becoming Institutionalized: A Cross-sectional Pilot Study

The objective of this study was to analyze the impact of physical fitness and physical activity on the threat of older adults without cognitive impairment becoming institutionalized. This cross-sectional study involved 195 non-institutionalized (80.1 +/- 4.4 years) and 186 institutionalized (83.8 +/- 5.2years) participants. Cognitive impairment was assessed using Mini-Mental State Examination, measures of physical fitness were determined by the Senior Fitness Test, and physical activity was assessed using the International Physical Activity Questionnaire. Multivariate binary logistic analysis selected four main determinants of institutionalization in both genders: The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, whereas it decreased by -24.8% by each fewer kg/m(2) in body mass index (BMI), by -0.9% for each additional meter performed in the aerobic endurance test, and by -2.0% for each additional 100 metabolic equivalent of task (MET)-min/week of physical activity expenditure (p<0.05). Values 50(th) percentile (age 81 years, BMI 26.7kg/m(2), aerobic endurance 367.6 meters, and physical activity 693 MET-min/week) were computed using receiver operating characteristics analysis as cutoffs discriminating institutionalized from non-institutionalized older adults. The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance), may avoid the threat of institutionalization of older adults without cognitive impairment only if they are above the 50(th) percentile. The following parameters are highly recommended: Expending 693 MET-min/week on physical activity, having a BMI 26.7kg/m(2), and being able to walk 367.6 meters in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cutoffs in old and very old adults.