The Impact of Social Vulnerability on Exercise Outcomes: A Longitudinal Study of Physical Function in Older People...

ObjectivesTo examine whether the Social Vulnerability Index (SVI) moderated changes in physical function during supervised and unsupervised phases of an exercise intervention in older adults with HIV.MethodsThis exploratory analysis used data from the High Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV. Participants completed 16 weeks of supervised high- or moderate-intensity exercise, followed by 12 weeks of unsupervised support (personalized coaching or educational text messages). Linear mixed-effects models assessed SVI moderation effects on 400-meter walk time (400-MWT) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF).ResultsAmong 117 participants, SVI did not moderate 400-MWT in either phase or PROMIS-PF during supervised exercise; however, higher SVI was associated with declines in self-reported physical function during the unsupervised phase (P = .03), robust to adjustment and sensitivity analyses.ConclusionsFindings suggest supervised exercise benefits participants across vulnerability levels, but sustained support may be needed to prevent disparities.Parent Trial InformationThe High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV trial, ClinicalTrials.gov: NCT04550676.