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Conti A, Concina D, Opizzi A, Sanguedolce A, Rinaldi C, Russotto S, Grossini E, Gramaglia CM, Zeppegno P, Panella M. Effectiveness of a combined lifestyle intervention for older people in long-term care: A randomized controlled trial. Arch Gerontol Geriatr 2024; 120:105340. [PMID: 38295616 DOI: 10.1016/j.archger.2024.105340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE Lifestyle medicine interventions combining physical, nutritional, and psychological components have been found effective in general older population. However, evidence from the long-term care (LTC) is scarce. METHODS We conducted a pragmatic, two-arm, parallel group, superiority randomized controlled trial. Residents living in a LTC facility for one or more years, able to discern and to express informed consent, and requiring nursing care were considered eligible. The three-months intervention combined bi-weekly physical exercise groups, a healthy diet, and weekly psychological wellbeing sessions. Patients of the control group were subjected to routine care. At the end of the study participants were assessed using Barthel Index, Katz Activities of Daily Living, and Tinetti scales. RESULTS A total of 54 patients with a mean age of 84 years took part to the study. Physical exercise and psychological wellbeing sessions were mostly attended by all the subjects of the intervention group. Both groups took less calories than planned in the diets; in addition, the intervention group showed a lower energy and carbohydrates intake than the control group. At the end of the study, the intervention group showed a significant improvement in the total scores of all the scales. CONCLUSIONS This intervention was effective in improving functionality in older people living in the LTC setting. Results were achieved in a short timeframe, likely due to synergistic interactions between components. However, a further exploration of underlying factors is needed, to better understand the barriers that hampered a complete intervention delivery in this context.
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Affiliation(s)
- Andrea Conti
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Doctoral Program in Food, Health, and Longevity, Università del Piemonte Orientale, Novara, Italy.
| | - Diego Concina
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Doctoral Program in Food, Health, and Longevity, Università del Piemonte Orientale, Novara, Italy; Anteo Impresa Sociale, Biella, Italy
| | - Annalisa Opizzi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Doctoral Program in Food, Health, and Longevity, Università del Piemonte Orientale, Novara, Italy; Anteo Impresa Sociale, Biella, Italy
| | - Agatino Sanguedolce
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Carmela Rinaldi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Education and Research area, Health Professions' Direction, Maggiore Della Carità Hospital, Novara, Italy
| | - Sophia Russotto
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Doctoral Program in Sports and Health - Patient Safety line, Universitas Miguel Hernandez, Alicante, Spain; Residency Program of Psychiatry, Università del Piemonte Orientale, Novara, Italy
| | - Elena Grossini
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Carla Maria Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Massimiliano Panella
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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Wang K, Gao H, Sijbrands EJ, Kavousi M, Ahmadizar F. Associations of baseline glycemic status and its transitions with cognitive and physical functioning decline. Maturitas 2023; 171:25-32. [PMID: 36990054 DOI: 10.1016/j.maturitas.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/03/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE Evidence about the decline of cognition and physical function across glycemic status (normoglycemia, prediabetes, and diabetes) is inconsistent. We evaluated longitudinal changes in cognition and physical function according to glycemic status and also different glycemic transitions. STUDY DESIGN Population-based cohort study. METHODS 9307 participants (mean age 59.7 years, 53.7 % women) were included from the China Health and Retirement Longitudinal Study (2011-2018). Global cognition (assessed by orientation, memory, and executive function) and physical function (calculated as the sum of impaired basic and instrumental activities of daily living) were assessed in each wave. The glycemic status was assessed in waves 2011 and 2015. Diabetes was defined as fasting blood glucose ≥7.0 mmol/L, HbA1c ≥6.5 %, self-reported diabetes, or glucose-lowering medication use. Prediabetes was defined as fasting blood glucose 5.6-6.9 mmol/L or an HbA1c of 5.7-6.4 %. RESULTS Compared with normoglycemia, baseline diabetes was associated with a faster decline in orientation (-0.018 SD/year, 95%CI -0.032, -0.004) and a faster increase in physical function score (0.082 /year, 95%CI 0.038, 0.126). We did not observe any effect of prediabetes on the changing rate of cognition and physical function. Progression from normoglycemia to diabetes between waves 2011 and 2015 was associated with a significantly faster decline in global cognition, memory, executive function, and physical function compared with stable normoglycemia. CONCLUSIONS Baseline diabetes was associated with accelerated decline of cognition and physical function. Associations with prediabetes were not observed, suggesting an important short diagnostic window when diabetes presents de novo.
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Chatterjee R, Kwee LC, Pagidipati N, Koweek LH, Mettu PS, Haddad F, Maron DJ, Rodriguez F, Mega JL, Hernandez A, Mahaffey K, Palaniappan L, Shah SH. Multi-dimensional characterization of prediabetes in the Project Baseline Health Study. Cardiovasc Diabetol 2022; 21:134. [PMID: 35850765 PMCID: PMC9295520 DOI: 10.1186/s12933-022-01565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background We examined multi-dimensional clinical and laboratory data in participants with normoglycemia, prediabetes, and diabetes to identify characteristics of prediabetes and predictors of progression from prediabetes to diabetes or reversion to no diabetes. Methods The Project Baseline Health Study (PBHS) is a multi-site prospective cohort study of 2502 adults that conducted deep clinical phenotyping through imaging, laboratory tests, clinical assessments, medical history, personal devices, and surveys. Participants were classified by diabetes status (diabetes [DM], prediabetes [preDM], or no diabetes [noDM]) at each visit based on glucose, HbA1c, medications, and self-report. Principal component analysis (PCA) was performed to create factors that were compared across groups cross-sectionally using linear models. Logistic regression was used to identify factors associated with progression from preDM to DM and for reversion from preDM to noDM. Results At enrollment, 1605 participants had noDM; 544 had preDM; and 352 had DM. Over 4 years of follow-up, 52 participants with preDM developed DM and 153 participants reverted to noDM. PCA identified 33 factors composed of clusters of clinical variables; these were tested along with eight individual variables identified a priori as being of interest. Six PCA factors and six a priori variables significantly differed between noDM and both preDM and DM after false discovery rate adjustment for multiple comparisons (q < 0.05). Of these, two factors (one comprising glucose measures and one of anthropometry and physical function) demonstrated monotonic/graded relationships across the groups, as did three a priori variables: ASCVD risk, coronary artery calcium, and triglycerides (q < 10–21 for all). Four factors were significantly different between preDM and noDM, but concordant or similar between DM and preDM: red blood cell indices (q = 8 × 10-10), lung function (q = 2 × 10-6), risks of chronic diseases (q = 7 × 10-4), and cardiac function (q = 0.001), along with a priori variables of diastolic function (q = 1 × 10-10), sleep efficiency (q = 9 × 10-6) and sleep time (q = 6 × 10-5). Two factors were associated with progression from prediabetes to DM: anthropometry and physical function (OR [95% CI]: 0.6 [0.5, 0.9], q = 0.04), and heart failure and c-reactive protein (OR [95% CI]: 1.4 [1.1, 1.7], q = 0.02). The anthropometry and physical function factor was also associated with reversion from prediabetes to noDM: (OR [95% CI]: 1.9 [1.4, 2.7], q = 0.02) along with a factor of white blood cell indices (OR [95% CI]: 0.6 [0.4, 0.8], q = 0.02), and the a priori variables ASCVD risk score (OR [95% CI]: 0.7 [0.6, 0.9] for each 0.1 increase in ASCVD score, q = 0.02) and triglycerides (OR [95% CI]: 0.9 [0.8, 1.0] for each 25 mg/dl increase, q = 0.05). Conclusions PBHS participants with preDM demonstrated pathophysiologic changes in cardiac, pulmonary, and hematology measures and declines in physical function and sleep measures that precede DM; some changes predicted an increased risk of progression to DM. A factor with measures of anthropometry and physical function was the most important factor associated with progression to DM and reversion to noDM. Future studies may determine whether these changes elucidate pathways of progression to DM and related complications and whether they can be used to identify individuals at higher risk of progression to DM for targeted preventive interventions. Trial registration ClinicalTrials.gov NCT03154346 Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01565-x.
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Affiliation(s)
- Ranee Chatterjee
- Department of Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, NC, 27701, Durham, USA.
| | | | - Neha Pagidipati
- Department of Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, NC, 27701, Durham, USA
| | - Lynne H Koweek
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Priyatham S Mettu
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - Francois Haddad
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - David J Maron
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | | | | | - Adrian Hernandez
- Department of Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, NC, 27701, Durham, USA.,Duke Clinical Research Institute, Duke University School of Medicine, NC, Durham, USA
| | | | | | - Svati H Shah
- Department of Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, NC, 27701, Durham, USA.,Duke Molecular Physiology Institute, Durham, NC, USA.,Duke Clinical Research Institute, Duke University School of Medicine, NC, Durham, USA
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Vrátná E, Husáková J, Jarošíková R, Dubský M, Wosková V, Bém R, Jirkovská A, Králová K, Pyšková B, Lánská V, Fejfarová V. Effects of a 12-Week Interventional Exercise Programme on Muscle Strength, Mobility and Fitness in Patients With Diabetic Foot in Remission: Results From BIONEDIAN Randomised Controlled Trial. Front Endocrinol (Lausanne) 2022; 13:869128. [PMID: 35865313 PMCID: PMC9294221 DOI: 10.3389/fendo.2022.869128] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Diabetic foot syndrome (DFS) is a serious late diabetic complication characterised by limited joint mobility and other biomechanical and muscle abnormalities. Aim To evaluate the effect of an interventional exercise programme on anthropometric parameters, muscle strength, mobility and fitness in patients with diabetic foot in remission. Data Sources and Study Selection Thirty-eight patients with type 2 diabetes and DFS without active lesions (mean age 65 ± 6.9 years, BMI 32 ± 4.7 kg.m-2, waist-hip ratio (WHR)1.02 ± 0.06) were enrolled in our randomised controlled trial. All subjects were randomised into two groups: an intervention group (I; n=19) and a control group (C; n=19). The 12-week exercise intervention focused on ankle and small-joint mobility in the foot, strengthening and stretching of the lower extremity muscles, and improvements in fitness. Changes (Δ=final minus initial results) in physical activity were assessed using the International Physical Activity Questionnaire (IPAQ), with joint mobility detected by goniometry, muscle strength by dynamometry, and fitness using the Senior Fitness Test (SFT). Data extraction Due to reulceration, 15.8% of patients from group I (3/19) and 15.8% of patients from group C were excluded. Based on the IPAQ, group I was more active when it came to heavy (p=0.03) and moderate physical activity (p=0.06) after intervention compared to group C. Group I improved significantly in larger-joint flexibility (p=0.012) compared to controls. In group I, dynamometric parameters increased significantly in both lower limbs (left leg; p=0.013, right leg; p=0.043) compared to group C. We observed a positive trend in the improvement of fitness in group I compared to group C. We also confirmed positive correlations between heavy physical activity and selected parameters of flexibility (r=0.47; p=0.007), SFT (r=0.453; p=0.011) and dynamometry (r=0.58; p<0.0025). Anthropometric parameters, such as BMI and WHR, were not significantly influenced by the intervention programme. Conclusion Our 12-week interventional exercise programme proved relatively safe, resulting in improved body flexibility and increased muscle strength in DF patients in remission.
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Affiliation(s)
- Eliška Vrátná
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
- Clinical Rehabilitation Division, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Jitka Husáková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Radka Jarošíková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
- Second Faculty of Medicine, Charles University, Prague, Czechia
| | - Michal Dubský
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Veronika Wosková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Robert Bém
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Alexandra Jirkovská
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Kateřina Králová
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Bára Pyšková
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Věra Lánská
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Vladimíra Fejfarová
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
- Second Faculty of Medicine, Charles University, Prague, Czechia
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Lin CC, Ou HY, Hsu HY, Cheng KP, Hsieh TJ, Yeh CH, Su FC, Kuo LC. Beyond Sarcopenia: older adults with type II diabetes mellitus tend to experience an elevated risk of poor dynamic balance-a case-control study. BMC Geriatr 2022; 22:138. [PMID: 35177026 PMCID: PMC8855561 DOI: 10.1186/s12877-022-02826-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background People with type 2 diabetes mellitus (T2DM) tend to be vulnerable to geriatric syndromes such as sarcopenia and frailty. Reduced physical activity also accompanies sarcopenia and frailty, which is generally typical of patients with T2DM. However, a comprehensive assessment of physical fitness in patients with T2DM has seldom been carried out and verified. This study is thus an attempt to determine the associations among sarcopenia, frailty, and the SFT in diabetic patients and non-diabetic controls to provide a more comprehensive understanding of such associations in future evaluations of T2DM in older individuals. Methods Sarcopenia, frailty, and the senior fitness test (SFT) were compared between 78 older men with T2DM (66.5 ± 9.0 years) and 48 age-matched normoglycemic controls (65.8 ± 5.3 years) in this case–control study. The skeletal muscle index (SMI), grip strength, and 4-m walk test were employed to assess for sarcopenia. Frailty was evaluated using the Study of Osteoporotic Fractures index (SOF). The SFT comprises five components, including body composition, muscle strength, flexibility, balance, and aerobic endurance. Results The risk level of sarcopenia was significantly higher (p < 0.05) in the T2DM group as compared to the control group. No significant difference between-group differences were found in SMI and grip strength in the T2DM and control groups. However, the T2DM group showed a significant decrease in gait speed (p < 0.01) in comparison with the control group, as well as significant increases in frailty (p < 0.01) and depression (p < 0.05). With respect to the SFT, obvious elevation in BMI, significant declines in extremity muscle strength (elbow extensor, knee flexor, hip abductor, hip flexor, sit to stand), static/dynamic balance (single leg stand: p < 0.05; up-and-go: p < 0.01) and aerobic endurance (2-min step: p < 0.01; 6-min walk: p < 0.01) were found in the T2DM group. Furthermore, the SOF (OR = 2.638, 95% CI = 1.333–5.221), BMI (OR = 1.193, 95% CI = 1.041–1.368) and up-and-go (OR = 2.089, 95% CI = 1.400–3.117) were found to be positively and significantly associated with T2DM. Conclusions The findings of this study indicated the importance of countering frailty and maintaining physical fitness, especially dynamic balance, during the early physical deterioration taking place in diabetic patients.
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Affiliation(s)
- Chih-Chun Lin
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Horng-Yih Ou
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Yun Hsu
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kai-Pi Cheng
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tai-Jung Hsieh
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan
| | - Chien-Hsien Yeh
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.,Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan. .,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan.
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Chabot K, Gillis C, Minnella EM, Ferreira V, Awasthi R, Baldini G, Carli F. Functional capacity of prediabetic patients: effect of multimodal prehabilitation in patients undergoing colorectal cancer resection. Acta Oncol 2021; 60:1025-1031. [PMID: 34102947 DOI: 10.1080/0284186x.2021.1937307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Prehabilitation is the process of increasing functional capacity (FC) before surgery. Poor glycemic control is associated with worse outcomes in patients undergoing surgery. Therefore, prediabetic patients could particularly benefit from prehabilitation. METHODS This is a pooled analysis of individual patient data from three multimodal prehabilitation trials in colorectal cancer surgery. Following a baseline assessment using the 6-minute walking test (6MWT), subjects were randomized to multimodal prehabilitation or to a control group. Participants were reassessed 24 h before surgery and 4 weeks after surgery. Prediabetes (PreDM) was defined as HbA1c 5.7%-6.4%. Multivariable logistic regression was used to adjust for potentially confounding variables. RESULTS Participation in a prehabilitation program was the most important predictive factor of clinical improvement in FC prior to surgery (Adjusted OR 2.42, 95% CI 1.18, 4.94); prediabetes was not a statistically significant predictor of improvement in FC after adjustments for covariates. Prehabilitation attenuated the loss of FC in unadjusted analyses after surgery in prediabetic patients (PreDM Control: median change -6 m [IQR -50-20] vs PreDM Prehab: median change +25 m [IQR -20-53], p = 0.045). Adjusted analyses also suggested the protective effect against loss of FC after surgery was stronger in prediabetic patients (PreDM Prehab vs PreDM Control: OR 5.5, 95% CI: 1.2-25.8; Normo Prehab vs Normo Control: OR 1.5, 95% CI: 0.53-4.52). CONCLUSIONS Multimodal prehabilitation favored clinical recovery of FC after surgery in CRC patients, especially prediabetic patients.
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Affiliation(s)
| | - Chelsia Gillis
- Department of Anesthesia, McGill University, Montreal, Canada
| | - Enrico Maria Minnella
- Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy
| | - Vanessa Ferreira
- Department of Kinesiology and Physical Education, McGill University, Montreal, Canada
| | - Rashami Awasthi
- Department of Anesthesia, McGill University, Montreal, Canada
| | | | - Francesco Carli
- Department of Anesthesia, McGill University, Montreal, Canada
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Åström MJ, von Bonsdorff MB, Haanpää M, Salonen MK, Kautiainen H, Eriksson JG. Glucose regulation and pain in older people-The Helsinki Birth Cohort Study. Prim Care Diabetes 2021; 15:561-566. [PMID: 33579570 DOI: 10.1016/j.pcd.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 11/21/2022]
Abstract
AIMS To assess if individuals with diabetes or prediabetes report more pain or have increased use of pain medication compared to normoglycaemic individuals. METHODS Using cross-sectional data, we studied 928 men and 1075 women from the Helsinki Birth Cohort Study in 2001-2004 at a mean age of 61.5 years. Glucose regulation was assessed with a 2-h 75 g oral glucose tolerance test, and applying World Health Organization criteria, participants were defined as having normoglycaemia, prediabetes (impaired fasting glucose or impaired glucose tolerance), newly diagnosed diabetes or previously diagnosed diabetes. Self-reported pain intensity and interference during the previous 4 weeks was estimated using the RAND 36-Item Health Survey 1.0. Information on use of pain medication during the past 12 months was obtained from the Social Insurance Institution of Finland. RESULTS There was no difference in pain intensity or interference between glucose regulation groups for neither men nor women after adjusting for covariates (age, body mass index, education years, Beck Depression Inventory and physical activity). In addition, use of pain medication was similar between glucose regulation groups. CONCLUSIONS Although pain is a common symptom in the general population, impairments in glucose regulation alone does not seem to increase pain among older individuals.
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Affiliation(s)
- Max J Åström
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Vaasa Central Hospital, Vaasa, Finland.
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland; Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Maija Haanpää
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland; Ilmarinen Mutual Pension Insurance Company, Vantaa, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland; Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore; Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
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Liang X, Jiang CQ, Zhang WS, Zhu F, Jin YL, Cheng KK, Lam TH, Xu L. Glycaemia and hand grip strength in aging people: Guangzhou biobank cohort study. BMC Geriatr 2020; 20:399. [PMID: 33046005 PMCID: PMC7552450 DOI: 10.1186/s12877-020-01808-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/30/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is a link between hyperglycemia and mechanical functions of muscle. However, existing evidence of the association between hyperglycemia and weaker muscle strength is limited and inconsistent. We examined whether glycemic status was associated with relative grip strength (RGS) in older Chinese. METHODS In 2008-2012, 9180 participants (2516 men and 6664 women) from the Guangzhou Biobank Cohort Study had fasting and 2-h post-load glucose measured. Glycemic status was categorized as normoglycaemia, prediabetes (i.e., impaired fasting glucose and/or impaired glucose tolerance) and diabetes. RGS was assessed using a Jamar Hydraulic Hand Dynamometer divided by body mass index. General linear model was used to assess the association of glycemic status with RGS. RESULTS After adjusting for age, smoking status, alcohol use, physical activity, health status, body fat percentage and waist circumference, in men, hyperglycemia was associated with a lower RGS, with the RGS being 1.38 (95% confidence interval (CI) = 1.34, 1.42) in normoglycaemia, 1.35 (95% CI = 1.30, 1.39) in prediabetes, 1.33 (95% CI = 1.29, 1.38) in newly diagnosed diabetes and 1.32 (95% CI = 1.27, 1.37) in known diabetes (P for trend < 0.001). The association of glycemic status with RGS was non-significant in women. Among the normoglycaemic group, no association was found between fasting glucose and RGS in men, whereas a significantly inverse association was found in women, with adjusted β for RGS per mmol/l increase in fasting glucose being - 0.05 to - 0.04 (P values from 0.002 to 0.03). CONCLUSIONS Higher fasting glucose was associated with reduced grip strength in a dose-response manner, and the association was significant even in women with normoglycaemia. Our findings suggest that lowering glucose across the whole range might be important in preserving muscle strength, especially in aging women.
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Affiliation(s)
- Xue Liang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | | | | | - Feng Zhu
- Guangzhou No.12 Hospital, Guangzhou, 510620, China
| | - Ya Li Jin
- Guangzhou No.12 Hospital, Guangzhou, 510620, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- Guangzhou No.12 Hospital, Guangzhou, 510620, China. .,School of Public Health, the University of Hong Kong, Hong Kong, China.
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China. .,School of Public Health, the University of Hong Kong, Hong Kong, China.
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Fernandes SGG, Pirkle CM, Sentell T, Costa JV, Maciel ACC, da Câmara SMA. Association between self-rated health and physical performance in middle-aged and older women from Northeast Brazil. PeerJ 2020; 8:e8876. [PMID: 32309044 PMCID: PMC7153554 DOI: 10.7717/peerj.8876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/09/2020] [Indexed: 11/20/2022] Open
Abstract
Background Self-rated Health (SRH) is regarded as a simple and valid measure of a person’s health status, given its association to adverse health outcomes, including low physical performance in older populations. However, studies investigating these associations in low- and middle-income settings are scarce, especially for middle-aged populations. Understanding the validity of SRH in relation to objective health measures in low-income populations could assist in decision making about health policy and strategies, especially in under-resourced settings. Objective Assess the relationship between SRH and physical performance measures in middle-aged and older women in a low-income setting of Brazil. Methods This is a cross-sectional study of 571 middle-aged (40–59 years old) and older (60–80 years old) women living in Parnamirim and Santa Cruz in the Northeast region of Brazil. Participants reported their health status and were allocated to the “SRH good” or “SRH poor” groups. The physical performance evaluation included: handgrip strength, one-legged balance with eyes open and closed and chair stand test. The relationship between SRH and physical performance for middle-aged and older women was assessed by quantile regression (modeling medians) adjusted for potential confounders (age, socioeconomic variables, body mass index, menopause status, age at first birth, parity, chronic conditions and physical activity). Results Middle-aged women from the “SRH good” group presented better physical performance with 1.75 kgf stronger handgrip strength (95% CI [0.47–3.02]; p = 0.004), 1.31 s longer balance with eyes closed ([0.00–2.61]; p = 0.030), and they were 0.56 s faster in the chair stand test ([0.18–0.94]; p = 0.009) than those who reported “SRH poor”. No association was found for balance with eyes open. For older women, there was no evidence of associations between physical performance and SRH. Conclusion This study showed that SRH is significantly associated with objective measures of physical performance in a sample of low-income middle-aged women. SRH can be an important tool to indicate the need for further evaluation of physical performance among middle-aged women and can be particularly useful for low-income communities.
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Affiliation(s)
- Sabrina Gabrielle Gomes Fernandes
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Tetine Sentell
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - José Vilton Costa
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Saionara Maria Aires da Câmara
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
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10
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Kim J, Shin JH, Ryu JK, Jung JH, Kim CH, Lee HB, Kim DH, Lee SK, Roh D. Association of Depression With Functional Mobility in Schizophrenia. Front Psychiatry 2020; 11:854. [PMID: 32973589 PMCID: PMC7472778 DOI: 10.3389/fpsyt.2020.00854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 08/05/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Functional immobility can cause functional disability in patients with schizophrenia and has been linked to prognosis and mortality. Although depression might be a barrier for physical activity engagement, scarce data are present on the relationship between depression and functional mobility (FM) in schizophrenia. Thus, we aimed to investigate the associations among FM, depression, and other clinical correlates in individuals with schizophrenia. METHODS FM was evaluated by the pedometer-assessed daily steps and Timed Up-and-Go (TUG) test in the daily-living and clinical settings, respectively. Psychiatric symptoms were assessed using the Beck Depression Inventory, Brief Psychiatric Rating Scale (BPRS), and State-Trait Anxiety Inventory. Cognitive function was evaluated using the Sternberg Working Memory (SWM) Task. Multiple regression analyses were performed to identify predictive factors associated with FM, with adjustment for relevant covariates. RESULTS Sixty patients were enrolled in this study. Depression was the most consistent explanatory variable for both pedometer (β = -0.34, p = 0.011) and TUG time (β = 0.32, p = 0.018). Additionally, SWM accuracy (β = -0.29, p = 0.018), BPRS-Withdrawal (β = 0.19, p = 0.139), and fasting blood sugar (β = 0.34, p = 0.008) were associated with TUG time. However, psychotic symptoms and anxiety were not associated with pedometer and TUG. CONCLUSIONS We identified an association between depression and FM after adjusting for other disorder-related correlates in schizophrenia. Since the intervention goal is functional recovery, improving FM by treating depression may have considerable therapeutic value.
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Affiliation(s)
- Jiheon Kim
- Mind-Neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Ji-Hyeon Shin
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
| | - Jeh-Kwang Ryu
- Department of Physical Education, College of Education, Dongguk University, Seoul, South Korea
| | - Jae Hoon Jung
- Mind-Neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Chan-Hyung Kim
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hwa-Bock Lee
- Gwangmyeong Mental Health Welfare Center, Gwangmyeong, South Korea
| | - Do Hoon Kim
- Mind-Neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Sang-Kyu Lee
- Mind-Neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
| | - Daeyoung Roh
- Mind-Neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea
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Åström MJ, von Bonsdorff MB, Perälä MM, Salonen MK, Rantanen T, Kajantie E, Simonen M, Pohjolainen P, Haapanen MJ, Guzzardi MA, Iozzo P, Kautiainen H, Eriksson JG. Telomere length and physical performance among older people—The Helsinki Birth Cohort Study. Mech Ageing Dev 2019; 183:111145. [DOI: 10.1016/j.mad.2019.111145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 12/17/2022]
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