Effect of spironolactone on physical performance in older people with self-reported physical disability

Louise A. Burton (Lead / Corresponding author), Deepa Sumukadas, Miles D. Witham, Allan D. Struthers, Marion E. T. McMurdo

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    Background

    Interventions that improve muscle function may slow decline in physical function and disability in later life. Recent evidence suggests that inhibition of the renin-angiotensin-aldosterone system may maintain muscle function. We evaluated the effect of aldosterone blockade on physical performance in functionally impaired older people without heart failure.
    Methods

    In this parallel-group, double-blind, randomized, placebo-controlled trial, community-dwelling participants aged =65 years with self-reported problems with activities of daily living were randomized to receive 25 mg spironolactone or identical placebo daily for 20 weeks. The primary outcome was change in 6-minute walking distance over 20 weeks. Secondary outcomes were changes in Timed Up and Go test, Incremental Shuttle Walk Test, Functional Limitation Profile, EuroQol EQ-5D, and Hospital Anxiety and Depression Scale over 20 weeks.
    Results

    Participants’ mean (standard deviation) age was 75 (6) years. Of the 93% of participants (112/120) who completed the study, 106 remained on medication at 20 weeks. There was no significant difference in change in 6-minute walking distance at 20 weeks between the spironolactone and placebo groups (mean change, -3.2 m; 95% confidence interval, -28.9 to 22.5; P = .81). Quality of life improved significantly at 20 weeks, with an increase in EuroQol EQ-5D score of 0.10 (95% confidence interval, 0.03-0.18; P < .01) in the spironolactone group relative to the placebo group. There were no significant differences in between-group change for other secondary outcomes.
    Conclusions

    Spironolactone was well tolerated but did not improve physical function in older people without heart failure. Quality of life improved significantly, and the possible mechanisms for this require further study.
    Original languageEnglish
    Pages (from-to)590-597
    Number of pages8
    JournalAmerican Journal of Medicine
    Volume126
    Issue number7
    DOIs
    Publication statusPublished - Jul 2013

    Fingerprint

    Spironolactone
    Placebos
    Walking
    Heart Failure
    Quality of Life
    Confidence Intervals
    Independent Living
    Muscles
    Renin-Angiotensin System
    Activities of Daily Living
    Aldosterone
    Anxiety
    Randomized Controlled Trials
    Depression

    Cite this

    @article{cb9c801000cc47c3a8e39fae1c113aaf,
    title = "Effect of spironolactone on physical performance in older people with self-reported physical disability",
    abstract = "BackgroundInterventions that improve muscle function may slow decline in physical function and disability in later life. Recent evidence suggests that inhibition of the renin-angiotensin-aldosterone system may maintain muscle function. We evaluated the effect of aldosterone blockade on physical performance in functionally impaired older people without heart failure.MethodsIn this parallel-group, double-blind, randomized, placebo-controlled trial, community-dwelling participants aged =65 years with self-reported problems with activities of daily living were randomized to receive 25 mg spironolactone or identical placebo daily for 20 weeks. The primary outcome was change in 6-minute walking distance over 20 weeks. Secondary outcomes were changes in Timed Up and Go test, Incremental Shuttle Walk Test, Functional Limitation Profile, EuroQol EQ-5D, and Hospital Anxiety and Depression Scale over 20 weeks.ResultsParticipants’ mean (standard deviation) age was 75 (6) years. Of the 93{\%} of participants (112/120) who completed the study, 106 remained on medication at 20 weeks. There was no significant difference in change in 6-minute walking distance at 20 weeks between the spironolactone and placebo groups (mean change, -3.2 m; 95{\%} confidence interval, -28.9 to 22.5; P = .81). Quality of life improved significantly at 20 weeks, with an increase in EuroQol EQ-5D score of 0.10 (95{\%} confidence interval, 0.03-0.18; P < .01) in the spironolactone group relative to the placebo group. There were no significant differences in between-group change for other secondary outcomes.ConclusionsSpironolactone was well tolerated but did not improve physical function in older people without heart failure. Quality of life improved significantly, and the possible mechanisms for this require further study.",
    author = "Burton, {Louise A.} and Deepa Sumukadas and Witham, {Miles D.} and Struthers, {Allan D.} and McMurdo, {Marion E. T.}",
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    Effect of spironolactone on physical performance in older people with self-reported physical disability. / Burton, Louise A. (Lead / Corresponding author); Sumukadas, Deepa; Witham, Miles D.; Struthers, Allan D.; McMurdo, Marion E. T.

    In: American Journal of Medicine, Vol. 126, No. 7, 07.2013, p. 590-597.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Effect of spironolactone on physical performance in older people with self-reported physical disability

    AU - Burton, Louise A.

    AU - Sumukadas, Deepa

    AU - Witham, Miles D.

    AU - Struthers, Allan D.

    AU - McMurdo, Marion E. T.

    PY - 2013/7

    Y1 - 2013/7

    N2 - BackgroundInterventions that improve muscle function may slow decline in physical function and disability in later life. Recent evidence suggests that inhibition of the renin-angiotensin-aldosterone system may maintain muscle function. We evaluated the effect of aldosterone blockade on physical performance in functionally impaired older people without heart failure.MethodsIn this parallel-group, double-blind, randomized, placebo-controlled trial, community-dwelling participants aged =65 years with self-reported problems with activities of daily living were randomized to receive 25 mg spironolactone or identical placebo daily for 20 weeks. The primary outcome was change in 6-minute walking distance over 20 weeks. Secondary outcomes were changes in Timed Up and Go test, Incremental Shuttle Walk Test, Functional Limitation Profile, EuroQol EQ-5D, and Hospital Anxiety and Depression Scale over 20 weeks.ResultsParticipants’ mean (standard deviation) age was 75 (6) years. Of the 93% of participants (112/120) who completed the study, 106 remained on medication at 20 weeks. There was no significant difference in change in 6-minute walking distance at 20 weeks between the spironolactone and placebo groups (mean change, -3.2 m; 95% confidence interval, -28.9 to 22.5; P = .81). Quality of life improved significantly at 20 weeks, with an increase in EuroQol EQ-5D score of 0.10 (95% confidence interval, 0.03-0.18; P < .01) in the spironolactone group relative to the placebo group. There were no significant differences in between-group change for other secondary outcomes.ConclusionsSpironolactone was well tolerated but did not improve physical function in older people without heart failure. Quality of life improved significantly, and the possible mechanisms for this require further study.

    AB - BackgroundInterventions that improve muscle function may slow decline in physical function and disability in later life. Recent evidence suggests that inhibition of the renin-angiotensin-aldosterone system may maintain muscle function. We evaluated the effect of aldosterone blockade on physical performance in functionally impaired older people without heart failure.MethodsIn this parallel-group, double-blind, randomized, placebo-controlled trial, community-dwelling participants aged =65 years with self-reported problems with activities of daily living were randomized to receive 25 mg spironolactone or identical placebo daily for 20 weeks. The primary outcome was change in 6-minute walking distance over 20 weeks. Secondary outcomes were changes in Timed Up and Go test, Incremental Shuttle Walk Test, Functional Limitation Profile, EuroQol EQ-5D, and Hospital Anxiety and Depression Scale over 20 weeks.ResultsParticipants’ mean (standard deviation) age was 75 (6) years. Of the 93% of participants (112/120) who completed the study, 106 remained on medication at 20 weeks. There was no significant difference in change in 6-minute walking distance at 20 weeks between the spironolactone and placebo groups (mean change, -3.2 m; 95% confidence interval, -28.9 to 22.5; P = .81). Quality of life improved significantly at 20 weeks, with an increase in EuroQol EQ-5D score of 0.10 (95% confidence interval, 0.03-0.18; P < .01) in the spironolactone group relative to the placebo group. There were no significant differences in between-group change for other secondary outcomes.ConclusionsSpironolactone was well tolerated but did not improve physical function in older people without heart failure. Quality of life improved significantly, and the possible mechanisms for this require further study.

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