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Yoon DH, Kim JH, Lee SU. A study on the development of a fitness age prediction model: the national fitness award cohort study 2017-2021. BMC Public Health 2024; 24:2606. [PMID: 39334055 PMCID: PMC11428858 DOI: 10.1186/s12889-024-19922-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 08/28/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Physical fitness is considered an important indicator of the health of the general public. In particular, the physical fitness of the older adults is an important requirement for determining the possibility of independent living. Therefore, the purpose of this study was to examine the association between chronological age and physical fitness variables in the National Fitness Award Cohort study data and to develop multiple linear regression analyses to predict fitness age using dependent variables. METHODS Data from 501,774 (359,303 adults, 142,471 older adults) individuals who participated in the Korea National Fitness Award Cohort Study from 2017 to 2021 were used. The physical fitness tests consisted of 5 candidate markers for adults and 6 candidate markers for the older adults to measure muscle strength, muscle endurance, cardiopulmonary endurance, flexibility, balance, and agility. Pearson's correlation and stepwise regression analyses were used to analyze the data. RESULTS We obtained a predicted individual fitness age values from physical fitness indicators for adults and older adults individuals, and the mean explanatory power of the fitness age for adults was [100.882 - (0.029 × VO2max) - (1.171 × Relative Grip Strength) - (0.032 × Sit-up) + (0.032 × Sit and reach) + (0.769 × Sex male = 1; female = 2)] was 93.6% (adjusted R2); additionally, the fitness age for older adults individuals was [79.807 - (0.017 × 2-min step test) - (0.203 × Grip Strength) - (0.031 × 30-s chair stand) - (0.052 × Sit and reach) + (0.985 × TUG) - (3.468 × Sex male = 1; female = 2) was 24.3% (adjusted R2). CONCLUSIONS We suggest the use of fitness age as a valid indicator of fitness in adults and older adults as well as a useful motivational tool for undertaking exercise prescription programs along with exercise recommendations at the national level.
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Affiliation(s)
- Dong Hyun Yoon
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute on Aging, Seoul National University, Seoul, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Rehabilitation Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea
| | - Shi-Uk Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Rehabilitation Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea.
- Department of Physical Medicine & Rehabilitation, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Korea.
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Fukuda W, Yoshihisa T, Yamada Y. Effects of muscle quantity, muscle quality, and phase angle on whole-body reaction time in 5164 adults aged 20-91 years. Eur J Appl Physiol 2024:10.1007/s00421-024-05591-3. [PMID: 39244717 DOI: 10.1007/s00421-024-05591-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 08/17/2024] [Indexed: 09/10/2024]
Abstract
PURPOSE Muscle quantity, defined as appendicular lean mass (ALM); muscle quality, defined as the ratio of muscle strength to ALM; and bioelectrical impedance analysis (BIA)-derived phase angle (PhA) are determinants of physical performance. We examined whether muscle quality indices were significant predictors of the whole-body reaction time (WBRT) in healthy female and male adults aged 20-91 years. METHODS Data from 5164 adults (2869 women and 2295 men; mean age ± standard deviation, 60.9 ± 15.6 years) were analyzed. Height and weight were measured, and body mass index was calculated. ALM was estimated using a previously validated 8-electrode multi-frequency BIA. PhA was measured at 50 kHz using a BIA device. Knee extension strength (KES), leg extension power (LEP), and flexibility were examined. The ALM to weight (ALM/weight), KES to ALM (KES/ALM), and LEP to KES (LEP/KES) ratios were calculated. In the WBRT test, participants were asked to stand on a force plate and jump upright as quickly as possible in response to a light stimulus. The WBRT was divided into the response initiation and motion execution phases. RESULTS ALM/weight, KES/ALM, LEP/KES, PhA, and flexibility were significant independent predictors of WBRT and the time of the motion execution phase (p < 0.001). However, PhA was not a significant predictor of the time of response initiation phase. CONCLUSION Muscle quantity (ALM/weight), muscle quality (KES/ALM and LEP/KES), PhA, and flexibility are determinants of WBRT test performance, particularly in the motion execution phase.
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Affiliation(s)
| | | | - Yosuke Yamada
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan.
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senrioka-shinmachi, Settu-city, Osaka, 566-0002, Japan.
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Kim HK, Sagayama H, Yoshida T, Oishi K, Nakayama Y, Kimura M, Ono R, Yamada Y. Predictors of Water Turnover in Older Adults: A Doubly Labeled Water- and Triaxial Accelerometer-Based Study. J Nutr 2024; 154:1750-1757. [PMID: 38649093 DOI: 10.1016/j.tjnut.2024.04.023] [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: 12/22/2023] [Revised: 04/01/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Water is one of the most essential nutrients for life. The water turnover (WT), total body water (TBW), and total energy expenditure (TEE) can be measured using the doubly labeled water (DLW) method. WT and TBW are lower in older adults than in young adults, and the former are susceptible to dehydration, necessitating to identify predictors of the WT in older adults. OBJECTIVES The current study aimed to examine the association between WT and physical activity, physical function, and body composition in Japanese adults aged ≥65 y and identify predictors for WT in this population. METHODS This study enrolled 133 older adults (women, n = 61; men, n = 72) aged 65-88 y. WT, TBW, TEE, fat-free mass (FFM), and percent body fat (%Fat) were determined using the DLW method. The fitness age score (FAS) was obtained from 5 physical fitness tests. Physical activity and the step count were assessed using a previously validated triaxial accelerometer. Multiple regression analyses were performed with WT as the dependent variable. RESULTS WT was positively associated with weight, physical activity level (PAL), moderate-vigorous physical activity, and TEE, and negatively associated with sedentary behavior. We examined potential predictors for WT using age, sex, height, weight, FFM, %Fat, TEE, PAL, and FAS in older Japanese adults. CONCLUSIONS Our results confirmed that age, sex, weight, FFM, TEE, and PAL are the potential predictors of WT in older Japanese adults aged ≥65 y.
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Affiliation(s)
- Hyeon-Ki Kim
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Hiroyuki Sagayama
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tsukasa Yoshida
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Kan Oishi
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan; Graduate School of Health and Sports Science, Doshisha University, Kyoto, Japan; Japan Society for the Promotion of Sciences, Tokyo, Japan
| | - Yui Nakayama
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Rei Ono
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Yosuke Yamada
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan.
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Hirono T, Okudaira M, Takeda R, Ueda S, Nishikawa T, Igawa K, Kunugi S, Yoshimura A, Watanabe K. Association between physical fitness tests and neuromuscular properties. Eur J Appl Physiol 2024; 124:1703-1717. [PMID: 38193907 DOI: 10.1007/s00421-023-05394-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE While various fitness tests have been developed to assess physical performances, it is unclear how these tests are affected by differences, such as, in morphological and neural factors. This study was aimed to investigate associations between individual differences in physical fitness tests and neuromuscular properties. METHODS One hundred and thirty-three young adults participated in various general physical fitness tests and neuromuscular measurements. The appendicular skeletal muscle mass (ASM) was estimated by bioelectrical impedance analysis. Echo intensity (EI) was evaluated from the vastus lateralis. During submaximal knee extension force, high-density surface electromyography of the vastus lateralis was recorded and individual motor unit firings were detected. Y-intercept (i-MU) and slope (s-MU) from the regression line between the recruitment threshold and motor unit firing rate were calculated. RESULTS Stepwise multiple regression analyses revealed that knee extension strength could be explained (adjusted R2 = 0.712) by ASM (β = 0.723), i-MU (0.317), EI (- 0.177), and s-MU (0.210). Five-sec stepping could be explained by ASM (adjusted R2 = 0.212). Grip strength, side-stepping, and standing broad jump could be explained by ASM and echo intensity (adjusted R2 = 0.686, 0.354, and 0.627, respectively). Squat jump could be explained by EI (adjusted R2 = 0.640). Counter-movement jump could be explained by EI and s-MU (adjusted R2 = 0.631). On the other hand, i-MU and s-MU could be explained by five-sec stepping and counter-movement jump, respectively, but the coefficients of determination were low (adjusted R2 = 0.100 and 0.045). CONCLUSION Generally developed physical fitness tests were mainly explained by morphological factors, but were weakly affected by neural factors involved in performance.
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Affiliation(s)
- Tetsuya Hirono
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan.
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Masamichi Okudaira
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
- Faculty of Education, Iwate University, Morioka, Japan
| | - Ryosuke Takeda
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
| | - Saeko Ueda
- Department of Human Nutrition, School of Life Studies, Sugiyama Jogakuen University, Nagoya, Japan
| | - Taichi Nishikawa
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
| | - Kaito Igawa
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
| | - Shun Kunugi
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
- Center for General Education, Aichi Institute of Technology, Toyota, Japan
| | - Akane Yoshimura
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
- Faculty of Education and Integrated Arts and Sciences, Waseda University, Tokyo, Japan
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
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Iwamoto K, Kikuchi Y, Nakano H, Katsurasako T, Mori K, Shiraiwa K, Horie J, Murata S. Relationship between Subjective Grip Strength and Physical Functioning among Community-Dwelling Older Women. Geriatrics (Basel) 2024; 9:68. [PMID: 38920424 PMCID: PMC11202590 DOI: 10.3390/geriatrics9030068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
This study investigated the relationship between subjective grip strength and physical function in community-dwelling older women. Subjective grip strength was assessed using a questionnaire, and physical function and body composition were compared between groups with strong and weak subjective grip strength. Additionally, the two groups were compared in those with mild cognitive impairment (MCI) and those with normal cognitive function, respectively. The results showed significant differences in grip strength (p < 0.001), 30 s chair-stand (CS-30) test (p = 0.039), timed up-and-go (TUG) test (p = 0.027), maximal gait speed (p = 0.029), and skeletal muscle mass (p < 0.001). Older adults with normal cognitive function showed significant differences in grip strength (p < 0.001), quadriceps muscle strength (p < 0.009), one-leg standing time (p = 0.041), CS-30 (p = 0.002), TUG (p = 0.014), gait speed (p = 0.006), and skeletal muscle mass (p = 0.003). Older adults with low subjective grip strength had lower physical function and skeletal muscle mass. However, no items showed significant differences between groups among older adults with MCI. Thus, subjective grip strength is an indicator of an overall decline in physical function and a reduction in skeletal muscle mass in older adults, and cognitive function should be considered when assessing subjective grip strength in older adults.
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Affiliation(s)
- Kohei Iwamoto
- Department of Physical Therapy, Faculty of Rehabilitation Science, Kobe International University, Kobe 658-0032, Japan
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Yuki Kikuchi
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Tsuyoshi Katsurasako
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Koka City Health and Welfare Department, Community Coexistence Promotion Division, Koka 528-8502, Japan
| | - Kohei Mori
- Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, Osaka 582-0026, Japan
| | - Kayoko Shiraiwa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
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Van Criekinge T, Hallemans A, Van de Walle P, Sloot LH. Age- and sex-related differences in trunk kinematics during walking in able-bodied adults. GeroScience 2024; 46:2545-2559. [PMID: 38032420 PMCID: PMC10828227 DOI: 10.1007/s11357-023-01028-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Trunk motion during walking acts as a biomarker for decreased mobility and can differ between sexes. Knowing how age and sex affect trunk motion and energy conservation can help clinicians decide when and in whom to intervene with physiotherapy to prolong functional mobility. METHODS A large sample of 138 able-bodied males and females in the age-categories 20-39 years, 40-59 years, 60-69 years, 70-79 years, and 80-89 years received a full-body 3D gait analysis. A two-factor ANOVA was performed to examine the effect of age and sex and their interaction on 3D trunk kinematics and positive mechanical work of the lower limbs, head-arms-trunk (HAT) segment and whole body. RESULTS A significant decrease in walking speed was only found in those above 80 years (~ .05 nm/s, p < .006), while changes in 3D trunk kinematics were observed earlier. From 60 years on, trunk rotations decreased (~ 2-3°, p < .05), from 70-year frontal pelvic motion (~ 4°, p < .001), and from the age of 80 years sagittal thorax motion (~ 1-6°, p < .05). There were only small aging effects for mechanical energy demands that were more pronounced in females, showing decreased of HAT contributions (p = .020). Furthermore, age-related differences in trunk kinematics are highly dependent on sex whereby age-related changes were observed sooner in females than males in all three planes of motion. CONCLUSIONS Age-related differences in 3D trunk kinematics are observed from 60 years onward and increase with age. Age-related stiffening of the trunk did not seem to affect the body's total mechanical work. Importantly, our data did show a stark contrast between males and females, indicating that training to prolong mobility should be tailored to sex. Future research should include sex-matched data when examining normal age and pathologic gait decline.
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Affiliation(s)
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy/MOVANT, University of Antwerp, Wilrijk, Belgium
- Multidisciplinary Motor Centre Antwerp (M2Ocean), University of Antwerp, Wilrijk, Belgium
| | - Patricia Van de Walle
- Department of Rehabilitation Sciences and Physiotherapy/MOVANT, University of Antwerp, Wilrijk, Belgium
- Bewegingslab Antwerpen, HederVZW, Antwerp, Belgium
| | - Lizeth H Sloot
- Institut Für Technische Informatik (ZITI), Heidelberg University, Heidelberg, Germany
- Translational and Clinical Research Institute (TCRI), Newcastle University, Newcastle, UK
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Yu J, Ng TKS, Mahendran R. Cognitive and physical age gaps in relation to mild cognitive impairment and behavioral phenotypes. GeroScience 2024; 46:1129-1140. [PMID: 37428365 PMCID: PMC10828169 DOI: 10.1007/s11357-023-00864-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/28/2023] [Indexed: 07/11/2023] Open
Abstract
We can study how fast our biological aging clocks tick by calculating the difference (i.e., age gaps) between machine learning estimations of biological age and chronological age. While this approach has been increasingly used to study various aspects of aging, few had applied this approach to study cognitive and physical age gaps; not much is known about the behavioral and neurocognitive factors associated with these age gaps. In the present study, we examined these age gaps in relation to behavioral phenotypes and mild cognitive impairment (MCI) among community-dwelling older adults. Participants (N = 822, Agemean = 67.6) were partitioned into equally-sized training and testing samples. Cognitive and physical age-prediction models were fitted using nine cognitive and eight physical fitness test scores, respectively, within the training samples, and subsequently used to estimate cognitive and physical age gaps for each subject in the testing sample. These age gaps were then compared among those with and without MCI and correlated with 17 behavioral phenotypes in the domains of lifestyle, well-being, and attitudes. Across 5000 random train-test split iterations, we showed that older cognitive age gaps were significantly associated with MCI (versus cognitively normal) and worse outcomes across several well-being and attitude-related measures. Both age gaps were also significantly correlated with each other. These results suggest accelerated cognitive and physical aging were linked to worse well-being and more negative attitudes about the self and others and reinforce the link between cognitive and physical aging. Importantly, we have also validated the use of cognitive age gaps in the diagnosis of MCI.
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Affiliation(s)
- Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, 639798, Singapore, Singapore.
| | - Ted Kheng Siang Ng
- Department of Internal Medicine, Rush University Medical Center, Illinois, Chicago, USA
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore.
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
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Hidouri S, Driss T, Tagougui S, Kammoun N, Chtourou H, Hammouda O. Sensor-Based Assessment of Time-of-Day-Dependent Physiological Responses and Physical Performances during a Walking Football Match in Higher-Weight Men. SENSORS (BASEL, SWITZERLAND) 2024; 24:909. [PMID: 38339626 PMCID: PMC10856934 DOI: 10.3390/s24030909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024]
Abstract
Monitoring key physiological metrics, including heart rate and heart rate variability, has been shown to be of value in exercise science, disease management, and overall health. The purpose of this study was to investigate the diurnal variation of physiological responses and physical performances using digital biomarkers as a precise measurement tool during a walking football match (WFM) in higher-weight men. Nineteen males (mean age: 42.53 ± 12.18 years; BMI: 33.31 ± 4.31 kg·m-2) were engaged in a WFM at two different times of the day. Comprehensive evaluations of physiological parameters (e.g., cardiac autonomic function, lactate, glycemia, and oxygen saturation), along with physical performance, were assessed before, during, and after the match. Overall, there was a significant interaction (time of day x WFM) for mean blood pressure (MBP) (p = 0.007) and glycemia (p = 0.039). Glycemia decreased exclusively in the evening after WFM (p = 0.001), while mean blood pressure did not significantly change. Rating of perceived exertion was significantly higher in the evening than in the morning (p = 0.04), while the heart rate recovery after 1 min (HRR60s) of the match was lower in the evening than in the morning (p = 0.048). Overall, walking football practice seems to be safe, whatever the time of day. Furthermore, HRR60, glycemia, and (MBP) values were lower in the evening compared to the morning, suggesting that evening exercise practice could be safer for individuals with higher weight. The utilization of digital biomarkers for monitoring health status during WFM has been shown to be efficient.
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Affiliation(s)
- Sami Hidouri
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax 3026, Tunisia; (S.H.); (O.H.)
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, UFR STAPS, Paris Nanterre University, 92001 Nanterre, France
| | - Tarak Driss
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, UFR STAPS, Paris Nanterre University, 92001 Nanterre, France
| | - Sémah Tagougui
- EA7369–URePSSS, Pluridisciplinary Research Unit, “Sport, Health and Society”, University of Lille, University of Artois, University of Littoral Côte d’Opale, 59000 Lille, France;
| | - Noureddine Kammoun
- High Institute of Sport and Physical Education, University of Sfax, Sfax 3000, Tunisia; (N.K.); (H.C.)
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education, University of Sfax, Sfax 3000, Tunisia; (N.K.); (H.C.)
| | - Omar Hammouda
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax 3026, Tunisia; (S.H.); (O.H.)
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, UFR STAPS, Paris Nanterre University, 92001 Nanterre, France
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He Y, Li Z, Niu Y, Duan Y, Wang Q, Liu X, Dong Z, Zheng Y, Chen Y, Wang Y, Zhao D, Sun X, Cai G, Feng Z, Zhang W, Chen X. Progress in the study of aging marker criteria in human populations. Front Public Health 2024; 12:1305303. [PMID: 38327568 PMCID: PMC10847233 DOI: 10.3389/fpubh.2024.1305303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
The use of human aging markers, which are physiological, biochemical and molecular indicators of structural or functional degeneration associated with aging, is the fundamental basis of individualized aging assessments. Identifying methods for selecting markers has become a primary and vital aspect of aging research. However, there is no clear consensus or uniform principle on the criteria for screening aging markers. Therefore, we combine previous research from our center and summarize the criteria for screening aging markers in previous population studies, which are discussed in three aspects: functional perspective, operational implementation perspective and methodological perspective. Finally, an evaluation framework has been established, and the criteria are categorized into three levels based on their importance, which can help assess the extent to which a candidate biomarker may be feasible, valid, and useful for a specific use context.
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Affiliation(s)
- Yan He
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Zhe Li
- The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yue Niu
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Yuting Duan
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Qian Wang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Xiaomin Liu
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Zheyi Dong
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Ying Zheng
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Yizhi Chen
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Hainan Province Academician Team Innovation Center, Sanya, China
| | - Yong Wang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Delong Zhao
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Xuefeng Sun
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Guangyan Cai
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Zhe Feng
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Weiguang Zhang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
| | - Xiangmei Chen
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases Research, Beijing, China
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10
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Phase angle obtained via bioelectrical impedance analysis and objectively measured physical activity or exercise habits. Sci Rep 2022; 12:17274. [PMID: 36241873 PMCID: PMC9568532 DOI: 10.1038/s41598-022-21095-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/22/2022] [Indexed: 02/07/2023] Open
Abstract
The phase angle (PhA), measured via bioelectrical impedance analysis, is considered an indicator of cellular health, where higher values reflect higher cellularity, cell membrane integrity, and better cell function. This study aimed to examine the relationship between PhA and exercise habits or objectively measured physical activity. We included 115 people aged 32-69 years. The body composition and PhA were measured using a bioelectrical impedance device. Physical activity and sedentary behavior (SB) were assessed using a triaxial accelerometer. Exercise habits were also obtained through structured interviews, and participants were categorized into the no exercise habit (No-Ex), resistance training exercise habit (RT), or aerobic training exercise habit (AT) groups. Objectively measured moderate-to-vigorous physical activity or step count significantly correlated with PhA, independent of age, sex, height, percent body fat, body cell mass, and leg muscle power. In contrast, SB was not significant determinants of PhA. People who exercised regularly (RT or AT) had significantly higher PhA values than did those in the No-Ex group. Furthermore, the PhA was not significantly different between the RT and AT groups. Regularly engaging in exercise with moderate-to-vigorous intensity may improve or maintain muscle cellular health and muscle quality.
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11
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The Impact of Physical Activity Levels and Functional Fitness Status on the Quality of Life Perceived by Older Adults Living in Rural and Urban Areas: The Portuguese Inland Case. Healthcare (Basel) 2022; 10:healthcare10071266. [PMID: 35885795 PMCID: PMC9317387 DOI: 10.3390/healthcare10071266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 11/28/2022] Open
Abstract
Health-related quality of life (HRQoL) is influenced by several factors, such as living place, physical activity (PA), and functional fitness levels. Evidence shows that functional fitness and PA levels are strongly associated with positive HRQoL, especially in the older population. However, the impact of the living place has not been investigated as an influencing variable in this context. Therefore, this study aimed to investigate the relationship between the HRQoL, PA, and functional fitness of older adults living in rural and urban areas of Portugal. A cross-sectional study was performed with community-dwelling adults aged 65 years and over (n = 261) living in the city of Guarda. The participants were assessed for sociodemographic, anthropometric, clinical health, HRQoL, PA levels, and functional fitness status. The results showed that rural residents presented higher scores of HRQoL and functional fitness than older individuals living in urban areas. Regression models showed that functional fitness variables influence the HRQoL overall score and mental and physical subcomponents of HRQoL, regardless of the living place. In contrast, PA levels only influenced the HRQoL score in rural residents. The findings suggest that intervention programs to improve the physical health, quality of life, and well-being of the older population need to consider the country’s different geographical areas.
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12
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Kose Y, Hatamoto Y, Tomiga-Takae R, Kimuro Y, Aoyagi R, Kawasaki H, Komiyama T, Ichikawa M, Fujiyama K, Murata Y, Ikenaga M, Higaki Y. Olfaction, ability to identify particular olfactory clusters and odors, and physical performance in community-dwelling older adults: The Yanai Study. Exp Gerontol 2022; 163:111793. [PMID: 35367594 DOI: 10.1016/j.exger.2022.111793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Olfactory dysfunction is associated with poor physical performance in older adults. However, it remains unknown whether the ability to identify particular olfactory clusters and/or odors is associated with physical performance in physically independent community-dwelling older adults. METHODS This cross-sectional study included 130 community-dwelling older adults (70.1 ± 5.5 years). The Odor Stick Identification Test for Japanese people, consisting of 12 odors in four clusters (wood, grass, herb; sweet; spices; foul-smelling), was used to examine olfaction. Participants also completed physical performance tests (one leg standing with open eyes; aerobic capacity; lower muscle function: five-times chair stand [CS] and vertical jump; mobility: star walking and timed up and go [TUG]) and cognitive function tests. RESULTS Worse overall olfaction was not significantly associated with any physical performance measure. Worse performance for identifying sweet odors and an inability to identify some specific odors (menthol and rose) were associated with worse mobility and/or lower muscle function-adjusted covariates. Moreover, an inability to identify menthol and rose was associated with worse TUG (odds ratio [OR]: 0.424; 95% confidence interval [CI]: 0.215-0.836), star walking (OR: 0.714; 95% CI: 0.506-0.976), CS (OR: 0.638; 95% CI: 0.470-0.864), and vertical jump (OR: 1.12; 95% CI: 1.001-1.24) performance, even when the analysis was adjusted to exclude menthol and rose score from the overall olfaction score (p < .05 for all). CONCLUSIONS The current study may help to increase awareness of olfactory and physical dysfunction at an earlier stage among physically independent community-dwelling older adults.
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Affiliation(s)
- Yujiro Kose
- Faculty of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; Fukuoka University Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Yoichi Hatamoto
- Fukuoka University Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan
| | - Rie Tomiga-Takae
- Fukuoka University Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; Faculty of Nursing and Nutrition, University of Nagasaki, 1-1-1 Manabino, Nagayo-cho, Nishisonogi-gun, Nagasaki 851-2195, Japan
| | - Yukari Kimuro
- Department of Nursing, Fukuoka International University of Health and Welfare, 3-6-40 Momochihama, Sawara-ku, Fukuoka 814-0001, Japan
| | - Ryo Aoyagi
- Graduate School of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Hikaru Kawasaki
- Graduate School of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Takaaki Komiyama
- Center for Education in Liberal Arts and Sciences, Osaka University, 1-17 Machikaneyama-cho, Toyonaka, Osaka 560-0043, Japan
| | - Mamiko Ichikawa
- Department of Sport and Medical Science, Teikyo University, 359 Otsuka, Hachioji, Tokyo 192-0395, Japan
| | | | - Yoshiro Murata
- Emu Kankyo Design System Co., Ltd., 5-28-23 Chayama, Jonan-ku, Fukuoka 814-0111, Japan
| | - Masahiro Ikenaga
- Fukuoka University Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Yasuki Higaki
- Faculty of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; Fukuoka University Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
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13
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Kitamura M, Izawa KP, Ishihara K, Matsuda H, Okamura S, Fujioka K. Physical Activity and Sarcopenia in Community-Dwelling Older Adults with Long-Term Care Insurance. Eur J Investig Health Psychol Educ 2021; 11:1610-1618. [PMID: 34940392 PMCID: PMC8700727 DOI: 10.3390/ejihpe11040114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 12/14/2022] Open
Abstract
The present study aimed to clarify the difference in physical activity (PA) due to sarcopenia in community-dwelling older adults with long-term care insurance (LTCI). This was a cross-sectional study that investigated data of 97 consecutive community-dwelling older Japanese adults with LTCI who underwent rehabilitation at one day care center in Japan from November 2018 to May 2019. Sarcopenia was determined according to criteria of the Asian Working Group for Sarcopenia. Unpaired t-test, Mann-Whitney U test, chi-square test and analysis of covariance were used to compare participant characteristics and clinical parameters between the older adults with and without sarcopenia. A receiver operating characteristic (ROC) curve was constructed to determine the cut-off value of PA for sarcopenia. The sarcopenia group (n = 20) had significantly lower body mass index (BMI), skeletal muscle mass index, gait speed, and PA than those in the no sarcopenia group (n = 28) (p < 0.05). After adjustment for BMI and sex, the sarcopenia group showed significantly lower PA than the no sarcopenia group. Findings showed that the cut-off value of PA indicating sarcopenia by ROC curve analysis was 1494.4 steps/day (p < 0.05); this value may aid in identifying sarcopenia in older adults with LTCI.
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Affiliation(s)
- Masahiro Kitamura
- Department of Physical Therapy, Fukuokawajiro Professional Training College, 2-1-13 Wajirooka, Higashi-ku, Fukuoka 811-0213, Japan;
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
| | - Kazuhiro P. Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Correspondence: ; Tel.: +81-78-796-4566
| | - Kodai Ishihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan;
- Cardiovascular Stroke Renal Project (CRP), Kobe 654-0142, Japan
- Department of Rehabilitation, Sakakibara Heart Institute of Okayama, 5-1 Nakaicho 2-Chome, Kita-ku, Okayama 700-0804, Japan
| | - Hiroaki Matsuda
- Department of Rehabilitation, Rifuru Yukuhashi Day Care Center, 379-1 Takase, Yukuhashi 824-0027, Japan; (H.M.); (S.O.); (K.F.)
| | - Soichiro Okamura
- Department of Rehabilitation, Rifuru Yukuhashi Day Care Center, 379-1 Takase, Yukuhashi 824-0027, Japan; (H.M.); (S.O.); (K.F.)
| | - Koji Fujioka
- Department of Rehabilitation, Rifuru Yukuhashi Day Care Center, 379-1 Takase, Yukuhashi 824-0027, Japan; (H.M.); (S.O.); (K.F.)
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Kato Y, Kikutani T, Sagawa K, Tamura F. Association between masticatory movement and oral and physical function in healthy older women. J Prosthodont Res 2021; 66:416-421. [PMID: 34789608 DOI: 10.2186/jpr.jpr_d_20_00285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study examined the association between masticatory movement and oral and physical function in healthy older women using clinical assessments considering central motor control. METHODS A total of 107 independent older women (mean age, 74.37 ± 4.46 years; age range, 66-84 years) living in the community participated in this cross-sectional study. The subjects selected were those aged 65 years or older with at least 28 teeth and without oral dysfunction, temporomandibular joint (TMJ) disease, cerebrovascular disease, or neuromuscular disease. The following items of oral and physical function were measured: masticatory path pattern, masticatory perfor-mance, oral diadochokinesis (ODK), tongue pressure, single-leg stance with eyes open (SLS), stepping test, and grip strength. Logistic regression analysis adjusting for age was performed to investigate the association between masticatory movement and other items. RESULTS In total, 30.8% of subjects were classified into the abnormal group regarding masticatory path pattern, having a significantly lower value than that of the normal group in masticatory performance (unadjusted p = 0.021). After adjusting for age, the masticatory path pattern was significantly associated with masticatory performance ( p = 0.032); ODK /pa/ ( p < 0.001), /ta/ ( p = 0.022), and /ka/ ( p = 0.016); and stepping test ( p = 0.018). Tongue pressure, SLS, and grip strength were not significantly associated with masticatory path pattern. CONCLUSION Masticatory movement in older women was associated with masticatory performance, tongue and lip motor skills, and physical agility, which might be influenced by central motor control.
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Affiliation(s)
- Yoko Kato
- Division of Clinical Oral Rehabilitation, The Nippon Dental University, Graduate School of Life Dentistry at Tokyo
| | - Takeshi Kikutani
- Division of Clinical Oral Rehabilitation, The Nippon Dental University, Graduate School of Life Dentistry at Tokyo.,Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo
| | - Keiichiro Sagawa
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo
| | - Fumiyo Tamura
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo
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15
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Yoshida M, Hiraoka A, Takeda C, Mori T, Maruyama M, Yoshikawa M, Tsuga K. Oral hypofunction and its relation to frailty and sarcopenia in community-dwelling older people. Gerodontology 2021; 39:26-32. [PMID: 34727388 DOI: 10.1111/ger.12603] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/20/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the frequency of oral hypofunction in community-dwelling older people and determine its relationship with frailty and sarcopenia. BACKGROUND Previous studies have shown that frailty and sarcopenia are associated with decreased oral function. However, these studies have only evaluated frailty or sarcopenia alone and have not evaluated their relationship with each other. MATERIALS AND METHODS The participants were community-dwelling independent older people in Kyoto. Their oral function evaluation included seven items (oral hygiene, oral dryness, occlusal force, tongue-lip motor function, tongue pressure, masticatory function and swallowing function). Oral hypofunction was defined as abnormalities in at least three of these items. The frailty status was classified into three categories (robust, pre-frail and frail) according to the frailty phenotype and deficit-accumulation models. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) Consensus. The relationships between oral function and frailty were analysed using logistic regression analyses, after adjusting for sarcopenia. RESULTS Among the 340 participants that were analysed (69 men, 271 women; average age: 75.0 years), 182 (53.5%) had oral hypofunction (40 men, 142 women; average age: 76.8 years). There was a significant relationship between oral hypofunction and deficit-accumulation model-assessed frailty, after adjusting for sarcopenia. CONCLUSION Almost half of the community-dwelling older people have oral hypofunction, which is significantly related to comprehensive frailty and sarcopenia.
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Affiliation(s)
- Mitsuyoshi Yoshida
- Department of Dentistry & Oral-Maxillofacial Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Chiho Takeda
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Mariko Maruyama
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
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16
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Kato Y, Kikutani T, Tohara T, Takahashi N, Tamura F. Masticatory movements and food textures in older patients with eating difficulties. Gerodontology 2021; 39:90-97. [PMID: 34676589 PMCID: PMC9297966 DOI: 10.1111/ger.12596] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/10/2021] [Accepted: 10/04/2021] [Indexed: 01/10/2023]
Abstract
Objectives To investigate whether masticatory movements in older patients with eating difficulties were associated with oral motor function, physical function, and appropriate food textures. Background There are few reports on the association between masticatory movements and food textures in older patients with eating difficulties. Materials and Methods This cross‐sectional study involved outpatients at a clinic that specialised in eating and swallowing rehabilitation. Masticatory movements were evaluated as normal or abnormal masticatory path patterns. Oral and physical functions were assessed in terms of oral and physical status, muscle strength and motor skills. The appropriate food texture was determined based on fibreoptic endoscopic evaluation of swallowing and a video fluoroscopic swallowing study. The associations between food texture and masticatory organ, muscle strength and motor skills were analysed. Results A total of 126 outpatients (75 men and 51 women; mean age, 78.2 years; SD, 9.6 years) were included in the analysis. 68 participants (54.0%) showed abnormal masticatory movements. Masticatory movement was associated with masticatory performance (odds ratio [OR] = 0.99, 95% confidence interval [CI] = 0.98‐0.99), oral diadochokinesis (OR = 0.55, CI = 0.35‐0.86) and stepping test (OR = 0.92, CI = 0.86‐0.97). Masticatory movement (OR = 2.94, CI = 1.23‐7.01) and the number of natural teeth (OR = 0.94, CI = 0.89‐0.99) were associated with normal food. Conclusion Masticatory movements in older patients with eating difficulties may be associated with appropriate food textures whilst being influenced by individual differences in systemic motor control. Masticatory movements may be as important as teeth to enjoy eating.
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Affiliation(s)
- Yoko Kato
- Division of Clinical Oral Rehabilitation, Graduate School of Life Dentistry, The Nippon Dental University at Tokyo, Japan
| | - Takeshi Kikutani
- Division of Clinical Oral Rehabilitation, Graduate School of Life Dentistry, The Nippon Dental University at Tokyo, Japan.,Division of Rehabilitation for Speech and Swallowing Disorders, Tama Oral Rehabilitation Clinic, The Nippon Dental University at Tokyo, Japan
| | - Takashi Tohara
- Division of Rehabilitation for Speech and Swallowing Disorders, Tama Oral Rehabilitation Clinic, The Nippon Dental University at Tokyo, Japan
| | - Noriaki Takahashi
- Division of Rehabilitation for Speech and Swallowing Disorders, Tama Oral Rehabilitation Clinic, The Nippon Dental University at Tokyo, Japan
| | - Fumiyo Tamura
- Division of Rehabilitation for Speech and Swallowing Disorders, Tama Oral Rehabilitation Clinic, The Nippon Dental University at Tokyo, Japan
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17
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Sloot LH, Malheiros S, Truijen S, Saeys W, Mombaur K, Hallemans A, van Criekinge T. Decline in gait propulsion in older adults over age decades. Gait Posture 2021; 90:475-482. [PMID: 34619614 DOI: 10.1016/j.gaitpost.2021.09.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/26/2021] [Accepted: 09/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite strong evidence that walking speed and forward propulsion decline with increasing age, their relationship is still poorly understood. While changes in the ankle and hip mechanics have been described, few studies have reported the effect of ageing on the whole leg's contribution to propulsion. RESEARCH QUESTION The aim of this study was to investigate age-related changes in the work performed by the leg on the center of mass (COM) push-off power during walking in adults aged 20-86 years. Specifically, we evaluated how deterioration in COM push-off power relates to changes in ankle and hip kinetics as well as age and walking speed. METHODS Motion, ground reaction forces and gastrocnemius muscle activity were recorded in 138 adults during overground walking at self-selected speed. Age-related differences in variables between decades were analyzed with an ANOVA, while the relation between COM push-off power and joint kinetic variables, as well as walking speed and biological age, was evaluated using correlations and multiple regression analysis. RESULTS From the age of 70 years and onwards, COM push-off power was significantly decreased. The decline in COM push-off power was mostly explained by a decline in average ankle push-off power (72 %), and to a lesser extent by peak hip extension moment (3 %). There was no re-distribution of ankle-to-hip push-off power. The decline in COM push-off power seemed more related to walking speed (explaining 54 % of the variance) than biological age (only 4 %). SIGNIFICANCE Findings indicate that age-related decline in COM push-off power in able-bodied adults starts from the age of 70 years, which is before changes have been found in kinematics, but still later than generally presumed. This decrease in push-off power was more related to walking speed than biological age, which emphasizes the need to better understand the reason for speed decline in older adults.
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Affiliation(s)
- Lizeth H Sloot
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany.
| | - Susanne Malheiros
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany.
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium.
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium; RevArte Rehabilitation Hospital, Edegem, Antwerp, Belgium.
| | - Katja Mombaur
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany; Department of Systems Design Engineering & Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Canada.
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Belgium.
| | - Tamaya van Criekinge
- Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Belgium; Department of Rehabilitation Sciences, KU Leuven Campus Bruges, Bruges, Belgium.
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Association between the inability to identify particular odors and physical performance, cognitive function, and/or brain atrophy in community-dwelling older adults from the Fukuoka Island City study. BMC Geriatr 2021; 21:421. [PMID: 34247577 PMCID: PMC8274001 DOI: 10.1186/s12877-021-02363-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background Olfactory dysfunction is associated with severe brain atrophy and cognitive impairment in Parkinson’s disease. However, it remains unknown whether an inability to identify particular odors is associated with physical performance, cognitive function, and/or brain atrophy in community-dwelling older adults. Methods In this cross-sectional study, 44 community-dwelling older adults were included (14 males, 30 females; mean age: 72.4 ± 5.7 years, range: 63–85 years). The Odor Stick Identification Test for Japanese, consisting of 12 odors, was used to examine olfaction. Subjects also completed physical performance (lower limb function, balance, and gait speed) and cognitive function (global cognition, logical memory, and the Trail Making Tests). Additionally, magnetic resonance imaging was used to investigate brain atrophy in the bilateral medial temporal area (MTA) and whole gray matter using the voxel-based specific regional analysis system for Alzheimer’s disease. Results Total olfaction was not significantly associated with physical performance, cognitive function, or brain atrophy. However, MTA atrophy was associated with an inability to identify Japanese orange (B: − 0.293; β: − 0.347; p < .05) after adjusting for age and sex (R2: 0.328; adjusted R2: 0.277). Subjects who were unable to identify Japanese orange (n = 30) had worse MTA atrophy than those who were able to identify Japanese orange (n = 14), even after adjusting for covariates (p < .05). Conclusions Total olfaction was not associated with physical performance, cognitive function, or brain atrophy. However, an inability to identify Japanese orange odor was independently associated with mild MTA atrophy among community-dwelling older adults.
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Kimura N, Maeshima E, Tomokane S, Ikeshima A, Maeda M, Takimoto M, Mishima T. A Study of Changes of Physical Functions According to Changes in Cognitive Functions in Community-Dwelling Elderly People Who Participated in an Exercise Program. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:474-481. [PMID: 34267587 DOI: 10.52082/jssm.2021.474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 05/28/2021] [Indexed: 11/24/2022]
Abstract
Although it is known that physical function differs depending on the state of cognitive function, there are no studies that consider changes in cognitive functions when evaluating physical functions of participants before and after an exercise program. In this study, it was observed changes in cognitive function and physical functions of elderly people who participated in a community-based exercise program for 6 months, and examined changes in physical functions that took into account changes in cognitive functions. Forty-nine participants, whose cognitive and physical functions were both measured before and after the exercise program, were included in the analysis. The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was used to assess participants' cognitive function and to determine whether they had mild cognitive impairment (MCI). To assess physical functions, a battery of physical tests was completed. Participants were classified into four groups (before/after; non-MCI/non-MCI, MCI/MCI, non-MCI/MCI, and MCI/non-MCI) according to the changes in cognitive functions after six months. There was no significant difference in the physical functions of the four groups before the start of the program. When changes in physical functions were examined in each group, some changes in physical functions were observed in the groups other than the non-MCI/MCI group. However, there was no significant difference in the physical functions between the four groups after the program. It was suggested that changes in physical functions of elderly people who participated in a community-based exercise program over a 6-month period were not different due to changes in cognitive functions.
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Affiliation(s)
- Noriko Kimura
- Osaka University of Health and Sport Sciences, Department of Health and Sport Management, Sennan, Osaka, Japan
| | - Etsuko Maeshima
- Osaka University of Health and Sport Sciences, Department of Health and Sport Management, Sennan, Osaka, Japan
| | - Sayaka Tomokane
- Osaka University of Health and Sport Sciences, Department of Health and Sport Management, Sennan, Osaka, Japan
| | - Akiko Ikeshima
- Osaka University of Health and Sport Sciences, Department of Health and Sport Management, Sennan, Osaka, Japan
| | - Megumi Maeda
- Kishigawa rehabilitation hospital, Kinokawa, Wakayama, Japan
| | - Masaki Takimoto
- Kyoto University of Advanced and Science, Faculty of Health and Medical Sciences, Department of Health and Sport Sciences, Kameoka, Kyoto, Japan
| | - Takaaki Mishima
- Osaka University of Health and Sport Sciences, Department of Health and Sport Management, Sennan, Osaka, Japan
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20
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Raza GS, Herzig KH, Leppäluoto J. Invited review: Milk fat globule membrane-A possible panacea for neurodevelopment, infections, cardiometabolic diseases, and frailty. J Dairy Sci 2021; 104:7345-7363. [PMID: 33896625 DOI: 10.3168/jds.2020-19649] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/15/2021] [Indexed: 12/23/2022]
Abstract
Milk is an evolutionary benefit for humans. For infants, it offers optimal nutrients for normal growth, neural development, and protection from harmful microbes. Humans are the only mammals who drink milk throughout their life. Lipids in colostrum originate mostly from milk fat globule membrane (MFGM) droplets extruded from the mammary gland. The MFGM gained much interest as a potential nutraceutical, due to their high phospholipid (PL), ganglioside (GD), and protein contents. In this review, we focused on health effects of MFGM ingredients and dairy food across the life span, especially on neurodevelopment, cardiometabolic health, and frailty in older adults. The MFGM supplements to infants and children reduced gastrointestinal and respiratory tract infections and improved neurodevelopment due to the higher content of protein, PL, and GD in MFGM. The MFGM formulas containing PL and GD improved brain myelination and fastened nerve conduction speed, resulting in improved behavioral developments. Administration of MFGM-rich ingredients improved insulin sensitivity and decreased inflammatory markers, LDL-cholesterol, and triglycerides by lowering intestinal absorption of cholesterol and increasing its fecal excretion. The MFGM supplements, together with exercise, improved ambulatory activities, leg muscle mass, and muscle fiber velocity in older adults. There are great variations in the composition of lipids and proteins in MFGM products, which make comparisons of the different studies impossible. In addition, investigations of the individual MFGM components are required to evaluate their specific effects and molecular mechanisms. Although we are currently only beginning to understand the possible health effects of MFGM products, the current MFGM supplementation trials as presented in this review have shown significant clinical health benefits across the human life span, which are worth further investigation.
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Affiliation(s)
- Ghulam Shere Raza
- Research Unit of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland; Oulu University Hospital, 90220 Oulu, Finland; Pediatric Institute, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Juhani Leppäluoto
- Research Unit of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland.
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21
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Yamada Y, Itoi A, Yoshida T, Nakagata T, Yokoyama K, Fujita H, Kimura M, Miyachi M. Association of bioelectrical phase angle with aerobic capacity, complex gait ability and total fitness score in older adults. Exp Gerontol 2021; 150:111350. [PMID: 33872735 DOI: 10.1016/j.exger.2021.111350] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to examine the association between whole-body or segmental phase angle (PhA) based on bioelectrical impedance analysis (BIA) and aerobic capacity (endurance), complex gait ability, and total fitness age score (FAS). METHODS A total of 426 community-dwelling older adults (332 women and 94 men) aged 60 to 93 years participated in this study. PhA and appendicular skeletal mass index (ASMI) were obtained by an eight-electrode standing BIA. Aerobic capacity was assessed using the shuttle stamina walk test (SSTw); complex gait ability, using the timed-up-and-go test (TUG). FAS was obtained using the previously validated multi-dimensional equations based on 7-year longitudinal data. SSTw, TUG, and FAS were compared between the low PhA (<4.4° for women and <5.2° for men) and normal PhA groups. Pearson's correlation between PhA and SSTw, TUG, and FAS was determined. Multiple linear regression analysis was conducted using SSTw, TUG, and FAS as dependent variables. Age, sex, height, body mass index (BMI), ASMI, and PhA were entered into the linear model. RESULTS SSTw and TUG results and FAS were significantly lower in the low PhA group (P < 0.05). PhA was significantly correlated with SSTw, TUG, and FAS (P < 0.001), and leg PhA showed a stronger correlation than whole-body or arm PhA. PhA at 50 kHz had higher correlation coefficients with SSTw, TUG, or FAS compared with PhA at 5 or 250 kHz. Multiple regression analyses indicated that leg PhA at 50 kHz was a significant predictor of SSTw, TUG, and FAS, independent of age, sex, height, BMI, and ASMI. CONCLUSION Our results indicate that leg PhA is associated with multi-dimensional physical fitness in community-dwelling older adults. PhA is a highly informative biomarker of skeletal muscle and exercise physiology in clinical settings.
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Affiliation(s)
- Yosuke Yamada
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
| | - Aya Itoi
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan; Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Hyogo, Japan
| | - Tsukasa Yoshida
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Takashi Nakagata
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Keiichi Yokoyama
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan; Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, Japan
| | - Hiroyuki Fujita
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, Japan
| | - Misaka Kimura
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
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22
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Wagner J, Knaier R, Königstein K, Klenk C, Carrard J, Lichtenstein E, Scharnagl H, März W, Hanssen H, Hinrichs T, Schmidt-Trucksäss A, Arbeev K. Composite Measures of Physical Fitness to Discriminate Between Healthy Aging and Heart Failure: The COmPLETE Study. Front Physiol 2021; 11:596240. [PMID: 33384610 PMCID: PMC7770139 DOI: 10.3389/fphys.2020.596240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background Aging and changing age demographics represent critical problems of our time. Physiological functions decline with age, often ending in a systemic process that contributes to numerous impairments and age-related diseases including heart failure (HF). We aimed to analyze whether differences in composite measures of physiological function [health distance (HD)], specifically physical fitness, between healthy individuals and patients with HF, can be observed. Methods The COmPLETE Project is a cross-sectional study of 526 healthy participants aged 20–91 years and 79 patients with stable HF. Fifty-nine biomarkers characterizing fitness (cardiovascular endurance, muscle strength, and neuromuscular coordination) and general health were assessed. We computed HDs as the Mahalanobis distance for vectors of biomarkers (all and domain-specific subsets) that quantified deviations of individuals’ biomarker profiles from “optimums” in the “reference population” (healthy participants aged <40 years). We fitted linear regressions with HD outcomes and disease status (HF/Healthy) and relevant covariates as predictors and logistic regressions for the disease outcome and sex, age, and age2 as covariates in the base model and the same covariates plus combinations of one or two HDs. Results Nine out of 10 calculated HDs showed evidence for group differences between Healthy and HF (p ≤ 0.002) and most models presented a negative estimate of the interaction term age by group (p < 0.05 for eight HDs). The predictive performance of the base model for HF cases significantly increased by adding HD General health or HD Fitness [areas under the receiver operating characteristic (ROC) curve (AUCs) 0.63, 0.89, and 0.84, respectively]. HD Cardiovascular endurance alone reached an AUC of 0.88. Further, there is evidence that the combination of HDs Cardiovascular endurance and General health shows superior predictive power compared to single HDs. Conclusion HD composed of physical fitness biomarkers differed between healthy individuals and patients with HF, and differences between groups diminished with increasing age. HDs can successfully predict HF cases, and HD Cardiovascular endurance can significantly increase the predictive power beyond classic clinical biomarkers. Applications of HD could strengthen a comprehensive assessment of physical fitness and may present an optimal target for interventions to slow the decline of physical fitness with aging and, therefore, to increase health span.
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Affiliation(s)
- Jonathan Wagner
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Raphael Knaier
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Karsten Königstein
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Christopher Klenk
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Justin Carrard
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Eric Lichtenstein
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Timo Hinrichs
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Konstantin Arbeev
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, United States
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23
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Zhao X, Huang H, Gu Y. Age score for assessing motor function in Chinese community-dwelling older women. J Women Aging 2020; 34:170-180. [PMID: 33319638 DOI: 10.1080/08952841.2020.1859936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study aimed to develop a physical fitness age score to assess motor function in community-dwelling elderly women and verify its validity. Principal component analysis was employed to build a physical fitness age score based on motor function variables. Validation test showed that the physical fitness age in the exercised older women was significantly lower than their chronological age, while no significant difference was observed between the physical fitness age and the chronological age in the normal elderly. The findings suggest that physical fitness age score is a valid approach to evaluate motor function in Chinese community-dwelling elderly women.
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Affiliation(s)
- Xiaoguang Zhao
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Huiming Huang
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Yaodong Gu
- Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
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24
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Miyachi Y, Kaido T, Hirata M, Iwamura S, Yao S, Shirai H, Kamo N, Uozumi R, Yagi S, Uemoto S. The combination of a male donor's high muscle mass and quality is an independent protective factor for graft loss after living donor liver transplantation. Am J Transplant 2020; 20:3401-3412. [PMID: 32243072 DOI: 10.1111/ajt.15884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/11/2020] [Accepted: 03/18/2020] [Indexed: 01/25/2023]
Abstract
We evaluated the hypothesis that grafts from donors with high muscle mass and quality may have a better outcome after living-donor-liver-transplantation (LDLT) than those from usual donors. A total of 376 primary adult-to-adult LDLT cases were enrolled in this study. Donor skeletal muscle mass index (SMI) and intramuscular adipose tissue content (IMAC) were used as markers of muscle mass and quality. In male donor cases (n = 198), those with higher SMI and lower IMAC than age-adjusted values were defined as the "high muscularity donors" (n = 38) and the others were defined as the "control" (n = 160). The high muscularity donor showed better 1-year (97% vs 82%, P = .020) and overall graft survival rate (88% vs 67%, P = .024) than the control group after LDLT. Contrastingly, the influence of the muscularity was not observed in female donor cases. Multivariable analysis including donor age confirmed that a high muscularity donor was an independent protective factor for overall graft survival after LDLT (hazard ratio, 0.337; 95% CI: 0.101-0.838; P = .017). Our study first confirmed that high muscle mass and quality of a male donor is a protective factor of allograft loss after LDLT, independently from donor age.
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Affiliation(s)
- Yosuke Miyachi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshimi Kaido
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaaki Hirata
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sena Iwamura
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Siyuan Yao
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hisaya Shirai
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoko Kamo
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shintaro Yagi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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25
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Shahid M, Kim J. Exercise May Affect Metabolism in Cancer-Related Cognitive Impairment. Metabolites 2020; 10:E377. [PMID: 32962184 PMCID: PMC7570125 DOI: 10.3390/metabo10090377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 01/14/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI) is a significant comorbidity for cancer patients and survivors. Physical activity (PA) has been found to be a strong gene modulator that can induce structural and functional changes in the brain. PA and exercise reduce the risk of cancer development and progression and has been shown to help in overcoming post-treatment syndromes. Exercise plays a role in controlling cancer progression through direct effects on cancer metabolism. In this review, we highlight several priorities for improving studies on CRCI in patients and its underlying potential metabolic mechanisms.
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Affiliation(s)
- Muhammad Shahid
- Departments of Surgery and Biomedical Sciences, Cedars-Sinai Medical Center, Davis 5071, 8700 Beverly Blvd., Los Angeles, CA 90048, USA;
| | - Jayoung Kim
- Departments of Surgery and Biomedical Sciences, Cedars-Sinai Medical Center, Davis 5071, 8700 Beverly Blvd., Los Angeles, CA 90048, USA;
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
- Department of Urology, Ga Cheon University College of Medicine, Incheon 461-701, Korea
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26
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Yapici F, Aykut US, Coskun M, Arslan MC, Merder-Coskun D, Kocabiyik A, Ulu E, Bayhan AI, Kaygusuz MA. Complications, Additional Surgery, and Joint Survival Analysis After Medial Open-Wedge High Tibial Osteotomy. Orthopedics 2020; 43:303-314. [PMID: 32931590 DOI: 10.3928/01477447-20200819-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/11/2019] [Indexed: 02/03/2023]
Abstract
The reported incidence of complications following medial open-wedge high tibial osteotomy (MOWHTO) varies. The authors sought to assess the complications, additional surgeries, and joint survival following MOWHTO in patients with isolated medial compartment arthrosis during a mean follow-up of 10 years. This retrospective study involved patients implanted with spacer plates, angle adjustable plates, or inverse L-type plates with wedges between 2000 and 2010. A total of 504 knees from 441 patients were examined. Mean age of the study population was 52.6±7.0 years, with 56 (11.1%) knees from men and 448 (88.9%) from women. The 10-year Kaplan-Meier joint survival rate was 94.8%. Overall complication rate for MOWHTO was 63.7%, with complications in 20.3% of treated knees requiring additional surgery. In this population, although the overall complication rate and the need for additional surgery were high, the need for additional surgery resulting from serious complications was low (2.6%). The high joint survival rate and low rate of additional surgery for serious complications indicate that MOWHTO can be safely applied in patients with isolated medial gonarthrosis. [Orthopedics. 2020;43(5):303-314.].
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27
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Takae R, Hatamoto Y, Yasukata J, Kose Y, Komiyama T, Ikenaga M, Yoshimura E, Yamada Y, Ebine N, Higaki Y, Tanaka H. Association of Lower-Extremity Muscle Performance and Physical Activity Level and Intensity in Middle-Aged and Older Adults: A Doubly Labeled Water and Accelerometer Study. J Nutr Health Aging 2020. [DOI: 10.1007/s12603-020-1514-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Higa C, Mori T, Hiraoka A, Takeda C, Kuroki A, Yoshikawa M, Yoshida M, Tsuga K. Five-year change in maximum tongue pressure and physical function in community-dwelling elderly adults. J Dent Sci 2020; 15:265-269. [PMID: 32952883 PMCID: PMC7486543 DOI: 10.1016/j.jds.2020.05.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/27/2020] [Indexed: 12/01/2022] Open
Abstract
Background/purpose To identify age-related changes in maximum tongue pressure (MTP), it is necessary to determine individual biological age. The fitness age score (FAS) is used to calculate the biological age, based on the one-leg standing time with eyes open, vertical jump height, grip strength, functional reach, and 10-m walk time. Materials and methods The study included 112 community-dwelling elderly adults (42 males and 70 females). We investigated MTP, FAS, and body mass index (BMI) at baseline and 5 years later. MTP was determined with a pressure measurement device. Results A significant reduction in MTP, FAS, and BMI in both male and female subjects was observed at 5 years. A negative correlation between change in MTP and baseline MTP was observed, but there was no correlation between MTP change and baseline FAS, BMI, and change in FAS and BMI. Conclusion Age-related decline in MTP might be associated with high MTP, reflecting decreased reserve. Additionally, age-related decline in tongue function might be different from that of physical function.
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Affiliation(s)
- Chiaki Higa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Chiho Takeda
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Azusa Kuroki
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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29
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Rashid MH, Zahid MF, Zain S, Kabir A, Hassan SU. The Neuroprotective Effects of Exercise on Cognitive Decline: A Preventive Approach to Alzheimer Disease. Cureus 2020; 12:e6958. [PMID: 32190507 PMCID: PMC7067577 DOI: 10.7759/cureus.6958] [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] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive disorder that causes brain cells to slowly degenerate and die. This leads to a continuous decline in thinking, behavioral and social skills that disrupts a person's ability to function independently. AD is the most common cause of dementia globally. Neuroinflammation caused by intracellular neurofibrillary tangles and extracellular amyloid deposits leads to atrophy of brain cells especially the hippocampus, which is associated with memory formation. This atrophy leads to dementia and cognitive decline. Among the many preventive factors being studied, exercise is thought to play a vital role in not only preventing the pre-clinical stage of AD but also slowing the clinical progression of AD. It is also deployed as a treatment option for late-stage AD along with pharmacological treatment options. Various studies and clinical trials in both human and animal models are of the opinion that exercise slows the onset and progression of cognitive decline in AD patients. Some studies suggest that this effect is due to a decrease in neurofibrillary tangles and amyloid deposits in brain parenchyma. Others suggest that exercise causes an increase in angiogenesis, neurogenesis, and synaptogenesis mainly due to an increase in blood flow, brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1), hormones, and second messengers.
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Affiliation(s)
| | | | - Sarmad Zain
- Internal Medicine, Nishtar Hospital, Nishtar Medical University, Multan, PAK
| | - Ahmad Kabir
- Pathology, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Sibt Ul Hassan
- Internal Medicine, Bakhtawar Amin Memorial Hospital, Multan, PAK
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30
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Watanabe Y, Yamada Y, Yoshida T, Yokoyama K, Miyake M, Yamagata E, Yamada M, Yoshinaka Y, Kimura M. Comprehensive geriatric intervention in community-dwelling older adults: a cluster-randomized controlled trial. J Cachexia Sarcopenia Muscle 2020; 11:26-37. [PMID: 31997543 PMCID: PMC7015250 DOI: 10.1002/jcsm.12504] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/01/2019] [Accepted: 09/09/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self-monitoring comprehensive geriatric intervention programme (CGIP) on physical function and muscle size in community-dwelling older adults. We compared the effects of a CGIP using weekly class-styled (CS) sessions and a home-based (HB) programme. METHODS The 526 participants were randomized into one of two groups (CS 251, HB 275) based on their residential districts. We conducted a 12 week CGIP, which consisted of low-load resistance exercise, physical activity increments, oral function improvements, and a nutritional guide. All participants were encouraged to attend two 90 min lectures that included instructions on the CGIP. They were provided with exercise materials (triaxial-accelerometers/pedometers, ankle weights, and elastic bands) and diary logs. The CS group attended 90 min weekly sessions and independently executed the programme on other days, whereas the HB group only received instructions on how to execute the programme. Physical functions, such as knee extension strength (KES), normal and maximum walking speed, the timed up-and-go test, and anterior thigh muscle thickness (MT), were measured and analysed using intention-to-treat analysis before and after the 12 week intervention. RESULTS Of the 526 participants identified, 517 (CS 243 age 74.0 ± 5.4 women 57.2%, HB 274 age 74.0 ± 5.6 women 58.8%) were enrolled. Nine (CS 8, HB 1) were excluded from the analysis because they did not participate in the pre-intervention measurements. Both interventions significantly improved KES (CS 18.5%, HB 10.6%), normal walking speed (CS 3.7%, HB 2.8%), and MT (CS 3.2%, HB 3.5%). Greater improvement of KES was observed in the CS group (P = 0.003). Maximum walking speed (CS 4.7%, HB 1.8%; P = 0.001) and timed up-and-go (CS -4.7%, HB -0.2%; P < 0.001) significantly improved in the CS group only. CONCLUSIONS The intervention was effective in preventing sarcopenia and/or frailty. Most physical functions and MT improved after both interventions. The HB intervention is cost-effective and may help prevent sarcopenia and/or frailty in the large older population.
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Affiliation(s)
- Yuya Watanabe
- Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yosuke Yamada
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Tsukasa Yoshida
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, Kameoka, Japan
| | - Keiichi Yokoyama
- Non-profit Organization Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Motoko Miyake
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyotanabe, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yasuko Yoshinaka
- Non-profit Organization Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Misaka Kimura
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
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31
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Yokoyama K, Yamada Y, Akamatsu Y, Yoshinaka Y, Yamamoto A, Koizumi T, Ohyama K, Suzuki K, Hashimoto M, Sato H, Kimura M. Effects of Capsinoids on Daily Physical Activity, Body Composition and Cold Hypersensitivity in Middle-Aged and Older Adults: A Randomized Study. Nutrients 2020; 12:nu12010212. [PMID: 31947529 PMCID: PMC7019503 DOI: 10.3390/nu12010212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/05/2020] [Accepted: 01/09/2020] [Indexed: 01/15/2023] Open
Abstract
Sedentary/inactive lifestyle leads middle-aged and older adults to metabolic syndrome and frailty. Capsinoids from nonpungent chili pepper cultivar have been reported to reduce body fat mass, promote metabolism, and improve unidentified complaints of chills. Additionally, they have an anti-inflammation effect; therefore, we hypothesized that continuous oral ingestion of capsinoids alleviates age-related inflammation in the brain and improves the physical activity (PA) in middle-aged and older adults. In our double-blind human study, 69 participants (17 male, 52 female; mean age: 74.1 ± 7.7 years; range: 52–87 years) were administered either 9 mg of capsinoids which were extracted from pepper fruit variety CH-19 Sweet (Capsicum anuum L.) (CP group), or a placebo (PL group) daily over a 3 month period. In an animal study, PA and inflammation-related mRNA expression in the brain were examined in 5-week (young) and 53-week (old) aged mice fed a diet with or without 0.3% dihydrocapsiate, a type of capsinoids, for 12 weeks. In a human study, capsinoids intake did not increase the amount of light-to-moderate PA less than 6.0 metabolic equivalents (METs) (CP: 103.0 ± 28.2 at baseline to 108.2 ± 28.3 at 12 weeks; PL: 104.6 ± 19.8 at baseline to 115.2 ± 23.6 at 12 weeks, METs × hour/week); however, in participants exhibiting an inactive lifestyle, it showed significant increase (CP: 84.5 ± 17.2 at baseline to 99.2 ± 24.9 at 12 weeks; PL: 99.7 ± 23.3 at baseline to 103.8 ± 21.9 at 12 weeks). The energy expenditure in physical activity also improved in the inactive CP group (CP: 481.2 ± 96.3 at baseline to 562.5 ± 145.5 at 12 weeks; PL: 536.8 ± 112.2 at baseline to 598.6 ± 127.6 at 12 weeks; kcal/day). In all participants, CP showed reduced waist circumference, percent body fat, and visceral fat volume; in addition, chills were eased in subjects aged 80 years and older. The older mice fed capsinoids showed increased locomotion activity, decreased inflammation, and oxidative stress in the brain. The results suggest that the continuous oral ingestion of capsinoids gains PA through anti-inflammation effect in the brain as well as reduces fat accumulation and chills in inactive and older humans.
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Affiliation(s)
- Keiichi Yokoyama
- Institute for Active Health, Institutes of Interdisciplinary Research, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; (Y.Y.); (M.K.)
- Nonprofit Organization Genki-up AGE Project, Kameoka-city, Kyoto 621-8555, Japan;
- Correspondence: ; Tel.: +81-90-3700-9086; Fax: +81-771-29-2354
| | - Yosuke Yamada
- Institute for Active Health, Institutes of Interdisciplinary Research, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; (Y.Y.); (M.K.)
- Nonprofit Organization Genki-up AGE Project, Kameoka-city, Kyoto 621-8555, Japan;
| | - Yasunori Akamatsu
- Center for Faculty Development, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan;
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto City, Kyoto 612-8555, Japan
| | - Yasuko Yoshinaka
- Nonprofit Organization Genki-up AGE Project, Kameoka-city, Kyoto 621-8555, Japan;
- Center for Faculty Development, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan;
| | - Akiko Yamamoto
- Ajinomoto Co., Inc., Institute of Food Sciences & Technologies, 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki City, Kanagawa 210-8681, Japan; (A.Y.); (T.K.); (K.S.)
| | - Tomonori Koizumi
- Ajinomoto Co., Inc., Institute of Food Sciences & Technologies, 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki City, Kanagawa 210-8681, Japan; (A.Y.); (T.K.); (K.S.)
| | - Kana Ohyama
- Ajinomoto Co., Inc., Task Force for Nutrition Strategy, 15-1, Kyobashi 1-chome, Chuo-ku, Tokyo 104-8315, Japan;
| | - Katsuya Suzuki
- Ajinomoto Co., Inc., Institute of Food Sciences & Technologies, 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki City, Kanagawa 210-8681, Japan; (A.Y.); (T.K.); (K.S.)
| | - Masaki Hashimoto
- Ajinomoto Co., Inc., Direct Marketing Department, 15-1, Kyobashi 1-chome, Chuo-ku, Tokyo 104-8315, Japan;
| | - Hitoshi Sato
- Ajinomoto Co., Inc., Quality Assurance Department, 15-1, Kyobashi 1-chome, Chuo-ku, Tokyo 104-8315, Japan;
| | - Misaka Kimura
- Institute for Active Health, Institutes of Interdisciplinary Research, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto 621-8555, Japan; (Y.Y.); (M.K.)
- Nonprofit Organization Genki-up AGE Project, Kameoka-city, Kyoto 621-8555, Japan;
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Gomeñuka NA, Oliveira HB, da Silva ES, Passos-Monteiro E, da Rosa RG, Carvalho AR, Costa RR, Rodríguez Paz MC, Pellegrini B, Peyré-Tartaruga LA. Nordic walking training in elderly, a randomized clinical trial. Part II: Biomechanical and metabolic adaptations. SPORTS MEDICINE-OPEN 2020; 6:3. [PMID: 31932999 PMCID: PMC6957599 DOI: 10.1186/s40798-019-0228-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/20/2019] [Indexed: 12/04/2022]
Abstract
Background Nordic walking is an attractive method of endurance training. Nevertheless, the biomechanic response due to the additional contribution of using poles in relation to free walking training has been less explored in the elderly. Purpose: This randomized parallel controlled trial aimed to assess the effects of 8 weeks of Nordic walking and free walking training on the walking economy, mechanical work, metabolically optimal speed, and electromyographic activation in elderly. Methods Thirty-three sedentary elderly were randomized into Nordic walking (n = 16) and free walking group (n = 17) with equalized loads. Submaximal walking tests were performed from 1 to 5 km h−1 on the treadmill. Results Walking economy was improved in both free and Nordic walking groups (x2 4.91, p = 0.014) and the metabolically optimal speed was increased by approximately 0.5 km h−1 changing the speed-cost profile. The electromyographic activation in lower and upper limbs, pendular recovery, and total, external, and internal mechanical work remained unchanged (p > 0.05). Interestingly, the internal mechanical work associated with arm movement was higher in the Nordic walking group than in the free walking group after training, while the co-contraction from upper limb muscles was reduced similarly to both groups. Conclusions Eight weeks of Nordic walking training effectively improved the walking economy and functionality as well as maintained the gait mechanics, similar to free walking training in elderly people. This enhancement in the metabolic economy may have been mediated by a reduction in the co-contraction from upper limb muscles. Trial registration ClinicalTrails.gov NCT03096964
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Affiliation(s)
- Natalia Andrea Gomeñuka
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil.,Departamento de Investigación de la Facultad de Ciencias de la Salud, (UCAMI) Universidad Católica de las Misiones, Posadas, Argentina
| | - Henrique Bianchi Oliveira
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | - Edson Soares da Silva
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | - Elren Passos-Monteiro
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil.,Post-Graduate Program in Health Sciences, Federal University of Health Sciences, Porto Alegre, Brazil
| | - Rodrigo Gomes da Rosa
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | - Alberito Rodrigo Carvalho
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil.,Physical Therapy College, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil
| | - Rochelle Rocha Costa
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | | | - Barbara Pellegrini
- CeRiSM (Research Centre of Mountain Sport and Health), University of Verona, Rovereto, Italy
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Watanabe Y, Yamada Y, Yoshida T, Matsui T, Seo K, Azuma Y, Hiramoto M, Miura Y, Fukushima H, Shimazu A, Eto T, Saotome H, Kida N, Morihara T. Relationship Between Physical Fitness at the End of Preseason and the Inseason Game Performance in Japanese Female Professional Baseball Players. J Strength Cond Res 2019; 33:1580-1588. [PMID: 28759535 DOI: 10.1519/jsc.0000000000002024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Watanabe, Y, Yamada, Y, Yoshida, T, Matsui, T, Seo, K, Azuma, Y, Hiramoto, M, Miura, Y, Fukushima, H, Shimazu, A, Eto, T, Saotome, H, Kida, N, and Morihara, T. Relationship between physical fitness at the end of preseason and the inseason game performance in Japanese female professional baseball players. J Strength Cond Res 33(6): 1580-1588, 2019-This study examined anthropometric and fitness profiles of Japanese female professional baseball players and investigated the relationship between players' physical fitness and inseason game performance. Fifty-seven players who were registered in the Japan Women's Baseball League (JWBL) participated. Height, body mass, grip strength, back strength, knee extension and flexion strength, hamstring extensibility, vertical jump height, and horizontal jump distance were measured at preseason (February and March) in 2013. Game performance during the 2013 season (March-November) was obtained from official JWBL statistics. Vertical jump height showed significant positive correlations with individual performance records (e.g., total bases [r = 0.551], slugging percentage [r = 0.459], and stolen bases [r = 0.442]). Similar relationships were observed between horizontal jump distance and performance statistics in most cases. By contrast, grip, back, and lower-limb strength, as well as hamstring extensibility were not significantly correlated with game performance. Stepwise regression analysis selected vertical jump height as an independent variable, significantly correlating with several game performance measures (e.g., total bases: adjusted R = 0.257). Also, vertical jump height and body mass index were identified as independent variables significantly associated with stolen bases (adjusted R = 0.251). Maximal jump performance, rather than simple isometric muscle strength or flexibility, is a good performance test that can be used at the end of preseason to predict inseason batting and stolen base performance. Our findings demonstrate the importance of constructing preseason training programs to enhance lower-limb muscular power that is linked to successful inseason performance in female baseball players.
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Affiliation(s)
- Yuya Watanabe
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Japan
| | - Yosuke Yamada
- Department of Nutritional Science, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Tsukasa Yoshida
- Department of Biotechnology, Graduate School of Science and Technology, Kyoto Institute of Technology, Kyoto, Japan
| | | | - Kazuya Seo
- Rehabilitation Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | | | - Yuichiro Miura
- Department of Rehabilitation, Fushimi Okamoto Hospital, Kyoto, Japan
| | - Hideaki Fukushima
- Department of Rehabilitation, Fushimi Okamoto Hospital, Kyoto, Japan
| | - Akito Shimazu
- Department of Rehabilitation, Fushimi Okamoto Hospital, Kyoto, Japan
| | - Toshiaki Eto
- Department of Rehabilitation, Fushimi Okamoto Hospital, Kyoto, Japan
| | - Homare Saotome
- Faculty of Business, Hannan University, Matsubara, Japan
| | - Noriyuki Kida
- Department of Biotechnology, Graduate School of Science and Technology, Kyoto Institute of Technology, Kyoto, Japan
| | - Toru Morihara
- Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Latorre-Rojas EJ, Prat-Subirana JA, Peirau-Terés X, Mas-Alòs S, Beltrán-Garrido JV, Planas-Anzano A. Determination of functional fitness age in women aged 50 and older. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:267-272. [PMID: 31193284 PMCID: PMC6523037 DOI: 10.1016/j.jshs.2017.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 10/07/2016] [Accepted: 11/13/2016] [Indexed: 06/09/2023]
Abstract
BACKGROUND The construction of useful and attainable indicators of fitness assessment deserves special attention in clinical practice. We aimed to construct an indicator of the functional fitness age (FFA) of women aged 50 and older by an equation using fitness outcomes and its correlation with chronological age (CA) and to analyze the external validity of our results by comparing our sample to others. METHODS Participants (n = 459, age: 70.3 ± 7.9 years, mean ± SD) were evaluated using the Senior Fitness Test battery. We applied a multiple regression and a subsequent Holt's exponential smoothing to analyze the outcomes. RESULTS We obtained a statistically significant expression of F(6, 452) = 328.384; p < 0.0005 in which the coefficients of the equation explain 81% of variability (R 2 corrected = 0.813). The equation correlates fitness assessment in women aged 50 and over with regards to CA: FFA = 40.146 + 0.350 × CS (stand) - 0.714 × AC (rep) - 0.110 × ST (step) - 0.177 × CSR (cm) - 0.101 × BS (cm) + 8.835 × FUG (s) where CS means chair stand test, AC means arm curl test, ST means 2-min step test, CSR means chair sit-and-reach test, BS means back scratch test, FUG means 8-foot up-and-go test. We compared this index with percentiles distribution from our sample and from other studies. CONCLUSION We suggest the use of FFA as a valid indicator of fitness in adult and senior women as well as a useful motivational tool to undertake exercise programs.
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Affiliation(s)
- Edgar Johani Latorre-Rojas
- National Institute of Physical Education of Catalonia, University of Lleida, Lleida, Catalonia E-25192, Spain
- Physical Fitness, Sport and Recreation Department, Floridablanca Campus, University Santo Tomás Aquino, Kilómetro 7 vía Floridablanca, Bucaramanga, Colombia
| | - Joan Antoni Prat-Subirana
- National Institute of Physical Education of Catalonia, University of Lleida, Lleida, Catalonia E-25192, Spain
| | - Xavier Peirau-Terés
- National Institute of Physical Education of Catalonia, University of Lleida, Lleida, Catalonia E-25192, Spain
| | - Sebastià Mas-Alòs
- National Institute of Physical Education of Catalonia, University of Lleida, Lleida, Catalonia E-25192, Spain
- Department of Nursery and Physiotherapy, University of Lleida, Lleida, Catalonia E-25198, Spain
| | - José Vicente Beltrán-Garrido
- National Institute of Physical Education of Catalonia, University of Lleida, Lleida, Catalonia E-25192, Spain
- EUSES TE, Health and Sport Science School, Rovira i Virgili University, Amposta, Catalonia E-43870, Spain
| | - Antoni Planas-Anzano
- National Institute of Physical Education of Catalonia, University of Lleida, Lleida, Catalonia E-25192, Spain
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Aparicio-Ugarriza R, Díaz ÁE, Palacios G, Bibiloni MDM, Julibert A, Tur JA, González-Gross M. Association between blood marker analyses regarding physical fitness levels in Spanish older adults: A cross-sectional study from the PHYSMED project. PLoS One 2018; 13:e0206307. [PMID: 30356331 PMCID: PMC6200257 DOI: 10.1371/journal.pone.0206307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 10/10/2018] [Indexed: 11/19/2022] Open
Abstract
Biomarkers have been postulated as essential variables to measure the effects of exercise on the human body. To investigate the relationship between physical fitness (PF) and blood biomarkers that are associated with disease risk in Spanish older adults, four hundred and twenty-nine adults (57% females) aged older than 55 years from a cross-sectional study were included. A battery of PF test was performed, and participants were divided into 3 groups: low, medium and high fitness. Blood samples were collected, and subjects were also grouped based on a particular biomarker being within its reference range. Furthermore, drug intake and dietary intake were considered for each participant. Higher concentrations out of the reference range were observed for vitamin 25(OH)D (67.9%) and total cholesterol (TC) (58.6%). Participants from the low PF group presented lower significant concentrations out of the reference range for vitamin B12 and triglycerides; however, participants in the low PF group showed higher significant concentrations out of the reference range for total homocysteine, creatinine, TC, HDL-cholesterol and LDL-cholesterol (LDL-c) than those in the high PF group (all p<0.05). Considering drugs related to blood lipid modifications, subjects who regularly consumed lipid reducers presented higher significant concentrations out of the reference range for TC and LDL-c than participants who did not take these drugs (p<0.01). Participants from the high PF group presented better blood marker profiles, namely, lower blood markers related to disease risk out of the reference range. These blood markers could be used as a routine method for considering PF groups in older adults.
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Affiliation(s)
- Raquel Aparicio-Ugarriza
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | - Ángel Enrique Díaz
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
- Clinical Laboratory Unit, Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | - Gonzalo Palacios
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Madrid, Spain
| | - María del Mar Bibiloni
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress (NUCOX), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Alicia Julibert
- Research Group on Community Nutrition and Oxidative Stress (NUCOX), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Josep Antoni Tur
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress (NUCOX), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Madrid, Spain
- * E-mail:
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Oh SL, Yoon SH, Lim JY. Age- and sex-related differences in myosin heavy chain isoforms and muscle strength, function, and quality: a cross sectional study. J Exerc Nutrition Biochem 2018; 22:43-50. [PMID: 30149426 PMCID: PMC6058071 DOI: 10.20463/jenb.2018.0016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 06/28/2018] [Indexed: 11/22/2022] Open
Abstract
[Purpose] Declining muscle strength and function are hallmarks of the aging process. This study aimed to determine sex-related differences in myosin heavy chain (MHC) isoforms and muscle mass, strength, and quality with aging. [Methods] This cross-sectional study recruited 53 healthy participants (32 men, 21 women) aged 20–85 years who were divided into four groups: young men (n=17, YM, 29.23±4.51), older men (n=15, OM, 71.87±3.42), young women (n=11, YW, 29.64±4.88), and older women (n=10, OW, 68.1±1.91). Body composition and muscle strength and quality were analyzed. Muscle specimens were obtained from the vastus lateralis in all participants to analyze the type of MHC isoforms. [Results] Men showed a greater age-related decline in skeletal muscle mass (18.6%, p<0.01), lean body mass (10.1%, p<0.05), grip strength (35.3%, p<0.001), isometric strength (29.6%, p<0.001), isotonic power (42.5%, p<0.001), isokinetic strength (up to 44.3%, p<0.001), and muscle quality (up to 24.8%, p<0.01). In contrast, women had significantly lower isometric strength (24.2%, p<0.05), isotonic power (36.5%, p<0.01), and upper-body muscle quality (24.7%, p<0.001) with aging. In addition, the proportion of MHC IIa was significantly lower in OM (p<0.05) and OW (p<0.05) than in YM and YW, respectively. However, the proportion of MHC I was significantly higher in OM (p<0.01) than in YM but was high in both YW and OW. MHC I and MHC IIa negatively and positively correlated, respectively, with muscle strength and function. [Conclusion] These results indicate the existence of sex-related differences in muscle mass, strength, and quality and MHC isoform composition with increasing age. The effects on muscle strength and function with aging were significant in men, but not in women. Higher and lower proportions of MHC I and MHC IIa fibers, respectively, were inversely associated with muscle strength and quality. In particular, Korean YW showed lower muscle strength and quality, and the proportion of MHC isoforms was similar to that in the muscles of OW.
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Watanabe Y, Yamada Y, Yokoyama K, Yoshida T, Yoshinaka Y, Yoshimoto M, Tanaka Y, Itoi A, Yamagata E, Ebine N, Ishikawa-Takata K, Kimura M. Comprehensive geriatric intervention program with and without weekly class-style exercise: research protocol of a cluster randomized controlled trial in Kyoto-Kameoka Study. Clin Interv Aging 2018; 13:1019-1033. [PMID: 29872280 PMCID: PMC5973472 DOI: 10.2147/cia.s151427] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The number of long-term care (LTC) users and the associated expenditures in Japan are increasing dramatically. The national government recommends LTC prevention through activation of communities. However, there is no clear evidence of the effect of population-based comprehensive geriatric intervention program (CGIP) for restraints of LTC users and the associated expenditures in the future. The aims of the current paper are to describe the study protocol and progress of a cluster randomized controlled trial (RCT) with a CGIP in Kameoka City. Methods The cluster RCT involved random allocation of regions as intervention (n=4,859) and nonintervention (n=7,195). Participants were elderly persons aged ≥65 years without LTC certification who had responded to a mailing survey. The residents living in intervention regions were invited to a physical check-up, and 1,463 people participated (30.3%). These individuals were invited to the CGIP, and 526 accepted. The CGIP comprised instructions on: 1) low-load resistance training using bodyweight, ankle weights, and elastic bands; 2) increasing daily physical activity; 3) oral motor exercise and care; and 4) a well-balanced diet based on a program from Ministry of Health, Labour and Welfare. We allocated the intervention regions randomly into home-based self-care program alone (HB group, 5 regions, n=275) and home-based program+weekly class-style session (CS group, 5 regions, n=251). We evaluated the effects of the CGIP at 12 weeks and at 12 or 15 months on physical function, and are conducting follow-up data collection for an indefinite period regarding LTC certification, medical costs, and mortality. Results and discussion The study was launched with good response rates in each phase. Participants of both groups significantly increased their step counts by ~1,000 per day from the baseline during the CGIP. This RCT will provide valuable information and evidence about effectiveness of a community-based CGIP.
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Affiliation(s)
- Yuya Watanabe
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yosuke Yamada
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Keiichi Yokoyama
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Specified Non-profit Corporation Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kyoto, Japan
| | - Tsukasa Yoshida
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, Kameoka, Japan
| | - Yasuko Yoshinaka
- Specified Non-profit Corporation Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kyoto, Japan
| | - Mie Yoshimoto
- Corporation of Japan Dental Hygienists' Association, Kyoto, Japan
| | | | - Aya Itoi
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Japan
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyotanabe, Japan
| | - Naoyuki Ebine
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Japan
| | - Kazuko Ishikawa-Takata
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Misaka Kimura
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
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Yoshinaka Y, Soga S, Ota N, Yokoyama K, Yamada Y, Kimura M. Light rhythmic exercise with dietary milk fat globule membrane improves physical fitness in an elderly Japanese population: a double-blind randomized placebo-controlled trial. Biosci Biotechnol Biochem 2018; 82:677-682. [DOI: 10.1080/09168451.2017.1412248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
This study aimed to investigate the efficacy of home-based, light gymnastic exercise plus dietary milk fat globule membrane (MFGM) intake on physical fitness of an elderly Japanese sample in a pilot, double-blind, randomized, placebo-controlled trial. Seventy-one subjects (male, n = 13; female, n = 58) were randomly assigned into two groups: placebo (n = 35 [male, n = 6; female, n = 29]) and MFGM group (n = 36 [male, n = 7; female, n = 29]). The intervention was eight weeks. Subjects ingested either MFGM (1 g/day) or placebo tablets daily and engaged in an exercise program daily. Physical function tests were performed at baseline and after four and eight weeks. Foot tapping and open–close stepping scores significantly increased from baseline to eight weeks in the MFGM group. Study results suggest daily MFGM ingestion might further enhance the effects of light-intensity exercise in healthy elderly people.
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Affiliation(s)
- Yasuko Yoshinaka
- Faculty of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Satoko Soga
- Biological Science Research, Kao Corporation, Ichikai-machi, Japan
| | - Noriyasu Ota
- Biological Science Research, Kao Corporation, Ichikai-machi, Japan
| | - Keiichi Yokoyama
- Faculty of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Yosuke Yamada
- Faculty of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Misaka Kimura
- Faculty of Health and Medical Sciences, Kyoto Gakuen University, Kameoka, Japan
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Kang YG, Suh E, Lee JW, Kim DW, Cho KH, Bae CY. Biological age as a health index for mortality and major age-related disease incidence in Koreans: National Health Insurance Service - Health screening 11-year follow-up study. Clin Interv Aging 2018; 13:429-436. [PMID: 29593385 PMCID: PMC5865564 DOI: 10.2147/cia.s157014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose A comprehensive health index is needed to measure an individual's overall health and aging status and predict the risk of death and age-related disease incidence, and evaluate the effect of a health management program. The purpose of this study is to demonstrate the validity of estimated biological age (BA) in relation to all-cause mortality and age-related disease incidence based on National Sample Cohort database. Patients and methods This study was based on National Sample Cohort database of the National Health Insurance Service - Eligibility database and the National Health Insurance Service - Medical and Health Examination database of the year 2002 through 2013. BA model was developed based on the National Health Insurance Service - National Sample Cohort (NHIS - NSC) database and Cox proportional hazard analysis was done for mortality and major age-related disease incidence. Results For every 1 year increase of the calculated BA and chronological age difference, the hazard ratio for mortality significantly increased by 1.6% (1.5% in men and 2.0% in women) and also for hypertension, diabetes mellitus, heart disease, stroke, and cancer incidence by 2.5%, 4.2%, 1.3%, 1.6%, and 0.4%, respectively (p<0.001). Conclusion Estimated BA by the developed BA model based on NHIS - NSC database is expected to be used not only as an index for assessing health and aging status and predicting mortality and major age-related disease incidence, but can also be applied to various health care fields.
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Affiliation(s)
- Young Gon Kang
- Department of R&D, MediAge Research Center, Seongnam, Republic of South Korea
| | - Eunkyung Suh
- Department of Family Medicine, College of Medicine, CHA University, Chaum, Seoul, Republic of South Korea
| | - Jae-Woo Lee
- Department of Family Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of South Korea
| | - Dong Wook Kim
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Republic of South Korea
| | - Kyung Hee Cho
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of South Korea
| | - Chul-Young Bae
- Department of R&D, MediAge Research Center, Seongnam, Republic of South Korea
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Morita K, Mori T, Maruyama M, Hiraoka A, Higa C, Kuroki A, Yoshida M, Tsuga K. Association between buccal mucosa ridging and oral or occlusal status among older people. Oral Dis 2018; 24:778-783. [PMID: 29316022 DOI: 10.1111/odi.12828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 12/20/2017] [Accepted: 01/05/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES This study aimed to evaluate the association between buccal mucosa ridging and oral or occlusal statuses among older people. SUBJECTS AND METHODS This cross-sectional study examined 262 independent older people (mean age, 74.2 ± 5.9 years) who participated in the Kyoto Elderly Physical Fitness Measurement Research Project. The predictor variables were oral statuses (number of present teeth and torus palatinus, torus mandibularis, temporomandibular joint noise, clenching, or grinding) and oral functions (occlusal pressure, cheek pressure, oral diadochokinesis, and tongue pressure). The outcome variable was the buccal mucosa ridging status (presence or absence). Additional variables were age, sex, body mass index, grip strength, and wearing dentures. We compared these variables between participants with and without buccal mucosa ridging using a univariate analysis and multiple logistic regression analysis. RESULTS Buccal mucosa ridging was present in 177 (67.6%) people. Multiple logistic regression analysis revealed a close association of buccal mucosa ridging with torus mandibularis, tooth clenching and grinding and occlusal pressure, and cheek pressure. CONCLUSIONS Over 50% of the participants showed buccal mucosa ridging; this was significantly associated with higher cheek pressure, lower occlusal pressure, torus mandibularis, and tooth clenching and grinding.
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Affiliation(s)
- Koji Morita
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takahiro Mori
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mariko Maruyama
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chiaki Higa
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Azusa Kuroki
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Valiani V, Sourdet S, Schoeller DA, Mackey DC, Bauer DC, Glynn NW, Yamada Y, Harris TB, Manini TM. Surveying predictors of late-life longitudinal change in daily activity energy expenditure. PLoS One 2017; 12:e0186289. [PMID: 29040301 PMCID: PMC5645098 DOI: 10.1371/journal.pone.0186289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 09/23/2017] [Indexed: 12/21/2022] Open
Abstract
Background Total daily energy expenditure (TEE) is composed of resting metabolic rate (RMR), post-prandial thermogenesis and activity energy expenditure (AEE). Higher AEE is strongly associated with lower mortality and physical limitations among older adults, but factors that predict changes in AEE in septu and octogenarians are not clearly understood. Objective To identify factors associated with late-life longitudinal change in AEE. Design Energy expenditure was re-assessed in 83 participants (average age at baseline, 74.4±3.2 years)—an average of 7.5±0.54 years since the baseline measure. RMR was measured using indirect calorimetry and the thermic effect of meals was estimated at 10% of TEE. AEE was calculated as: TEE(0.9)-RMR. Participants were categorized into two groups according to the estimated day-to-day precision of the doubly-labeled water technique. Those who were within 10% or increased relative to their initial AEE measurement were categorized as having preserved AEE. Participants who declined greater than 10% of their initial measurement were categorized as having reduced AEE. A variety of socio-demographic, functional and mental factors, body composition, community and personal behaviors, blood measurements and health conditions were evaluated between groups at baseline and changes during follow-up. Results Daily AEE declined 106.61±293.25 kcal, which equated to a 14.63±40.57 kcal/d decrease per year. Fifty-nine percent (n = 49) preserved their AEE and 41% (n = 34) declined. Those who demonstrated a decline in AEE were older, had lower walking speed at baseline and showed a higher lean mass loss during follow up. Otherwise, groups were similar for socio-demographic characteristics, body composition, mental and physical function, health conditions and community and personal behaviors at baseline and change in these factors during follow-up. Conclusions This study demonstrates that AEE declines through the 8th decade of life and is associated with age, lower walking speed at baseline and lean mass loss. Additionally, there are a significant number of individuals who appear to be resilient to these declines despite having health events that are expected to have a negative impact on their physical activity.
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Affiliation(s)
- Vincenzo Valiani
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Forida, United States of America
- Dipartimento Interdisciplinare di Medicina, Clinica Medica Cesare Frugoni, University of Bari Aldo Moro, Bari, Italy
- * E-mail: ,
| | | | - Dale A. Schoeller
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Dawn C. Mackey
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
| | - Douglas C. Bauer
- Division of General Internal Medicine, University of California, San Francisco, California, United States of America
| | - Nancy W. Glynn
- Department of Epidemiology, Center for Aging and Population Health, Univeristy of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Yosuke Yamada
- Deparment of Nutritional Science, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Sciences, IRP, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Todd M. Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Forida, United States of America
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A Novel Physical Activity and Sedentary Behavior Classification and Its Relationship With Physical Fitness in Spanish Older Adults: The PHYSMED Study. J Phys Act Health 2017; 14:815-822. [PMID: 28556668 DOI: 10.1123/jpah.2016-0263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND As there is no gold-standard methodology to classify older people in relation to physical activity (PA) and sedentary behavior (SB), this paper aimed to propose a classification combining PA and SB. METHODS Within a broader study, 433 subjects, aged 55 years and older (57% females) from Madrid and Majorca, were evaluated for PA and SB by means of validated questionnaires. Physical fitness was analyzed objectively using the EXERNET test battery. Cluster analyses were used to establish behavioral patterns, combining PA and SB. RESULTS Males spent more time doing regular PA but less time walking and working at home than females (P < .001). Comparing the groups (inactive and high sedentary, inactive and low sedentary, active and high sedentary, and active and low sedentary), the worst aerobic endurance (P < .001) and lower body strength (P < .05) were obtained in males from both inactive groups. Agility was highest in the active and low sedentary group (P < .05). No significant differences were observed in females. CONCLUSIONS The proposed classification is valid, as it classifies subjects according to their PA and SB, and outcomes are related to objectively measured fitness. It could facilitate the work of public health authorities, researchers, and physicians.
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Mitnitski A, Howlett SE, Rockwood K. Heterogeneity of Human Aging and Its Assessment. J Gerontol A Biol Sci Med Sci 2017; 72:877-884. [PMID: 27216811 DOI: 10.1093/gerona/glw089] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/27/2016] [Indexed: 01/15/2023] Open
Abstract
Understanding the heterogeneity in health of older adults is a compelling question in the biology of aging. We analyzed the performance of five measures of health heterogeneity, judging them by their ability to predict mortality. Using clinical and biomarker data on 1,013 participants of the Canadian Study of Health and Aging who were followed for up to 6 years, we calculated two indices of biological age using the Klemera and Doubal method, which controversially includes using chronological age as a "biomarker," and three frailty indices (FIs) that do not include chronological age: a standard clinical FI, an FI from standard laboratory blood tests and blood pressure, and their combination (FI-combined). Predictive validity was tested using Cox proportional hazards analysis and discriminative ability by the area under the receiver-operating characteristic curves. All five measures showed moderate performance that was improved by combining measures to evaluate larger numbers of items. The greatest addition in explanatory power came from the FI-combined that showed the best mortality prediction in an age-adjusted model. More extensive comparisons across different databases are required, but these results do not support including chronological age as a biomarker.
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Affiliation(s)
| | - Susan E Howlett
- Department of Medicine and.,Department of Pharmacology (Division of Geriatric Medicine), Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Physiology, Institute of Cardiovascular Sciences and
| | - Kenneth Rockwood
- Department of Medicine and.,Department of Geriatric Medicine and Institute of Brain, Behaviour and Neurosciences, University of Manchester, UK
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Yamada Y, Yoshida T, Yokoyama K, Watanabe Y, Miyake M, Yamagata E, Yamada M, Kimura M. The Extracellular to Intracellular Water Ratio in Upper Legs is Negatively Associated With Skeletal Muscle Strength and Gait Speed in Older People. J Gerontol A Biol Sci Med Sci 2017; 72:293-298. [PMID: 27422438 DOI: 10.1093/gerona/glw125] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/16/2016] [Indexed: 12/25/2022] Open
Abstract
Skeletal muscles contain a large volume of water that is classified into intracellular (ICW) and extracellular (ECW) water fractions. Nuclear magnetic resonance-based biomarkers suggest that increased water T2 heterogeneities, as well as elevated water T2 relaxation in the quadriceps occurs in the elderly when compared with young adults. However, nuclear magnetic resonance is difficult to apply to a large-scale study or a clinical setting for sarcopenia and frailty screening. Segmental bioelectrical impedance spectroscopy is a unique tool used to assess the segmental ratio of ECW/ICW in the limbs. We evaluated 405 community-living people aged between 65 and 90 years. ECW and ICW in the upper legs were assessed by segmental bioelectrical impedance spectroscopy. Isometric knee extension strength, gait speed, and skeletal muscle mass were measured. Thigh ECW/ICW was negatively correlated with knee extension strength and gait speed (r = -.617 and -.431, respectively, p < .001) and increased with age (p < .001). Thigh ECW/ICW was a significant predictor of knee extension strength and gait speed independent of age, sex, body mass index, and skeletal muscle mass. Relative expansion of ECW against ICW in the thigh muscles is a factor in decreased muscle quality and a biomarker of muscle aging.
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Affiliation(s)
- Yosuke Yamada
- Department of Nutritional Science, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Tsukasa Yoshida
- Graduate School of Science and Technology, Kyoto Institute of Technology, Kyoto, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, Kameoka, Japan
| | | | - Yuya Watanabe
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
| | - Motoko Miyake
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyotanabe, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Misaka Kimura
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
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Yu R, Ong S, Cheung O, Leung J, Woo J. Reference Values of Grip Strength, Prevalence of Low Grip Strength, and Factors Affecting Grip Strength Values in Chinese Adults. J Am Med Dir Assoc 2017; 18:551.e9-551.e16. [DOI: 10.1016/j.jamda.2017.03.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 12/25/2022]
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Furtado G, Patrício M, Loureiro M, Teixeira AM, Ferreira JP. Physical Fitness and Frailty Syndrome in Institutionalized Older Women. Percept Mot Skills 2017; 124:754-776. [DOI: 10.1177/0031512517709915] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Guilherme Furtado
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
| | - Miguel Patrício
- Laboratory of Biostatistics and Medical Informatics and IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Marisa Loureiro
- Laboratory of Biostatistics and Medical Informatics and IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Maria Teixeira
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
| | - José Pedro Ferreira
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
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Ignasiak Z, Sławinska T, Skrzek A, Rożek K, Kozieł S, Posłuszny P, Malina RM. Functional capacities of Polish adults of 60-87 years and risk of losing functional independence. Ann Hum Biol 2017; 44:502-509. [PMID: 28539050 DOI: 10.1080/03014460.2017.1328071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM To characterise the functional capacities of Polish men and women aged 60-87 years and evaluate their status relative to criteria for functional independence. SUBJECTS AND METHODS Four hundred and thirty-one women and 125 men, aged 60-87 years, who were residents of Wrocław, southwestern Poland, were recruited. Height and weight were measured and BMI was calculated. The Fullerton Functional Fitness Test was administered to test upper and lower body strength, upper and lower body flexibility, agility-dynamic balance and aerobic endurance. The Paffenbarger physical activity questionnaire was completed. Characteristics of individuals classified by the number of tests which equalled or exceeded criterion-referenced standards for functional independence (excluding flexibility) were compared. RESULTS Polish older adults compared favourably to American reference values. Percentages meeting the criteria for all four, for two or three and for one or no tests were, respectively, 21%, 54% and 25% in women and 37%, 45% and 18% in men. Adults meeting the criteria for all four tests were lighter, with a lower BMI and more physically active than those meeting the criteria on two or three tests and on one or no tests. CONCLUSION The majority of Polish older adults were not at risk for loss of physical independence. The most functionally independent adults of both sexes had a lower BMI and less obesity, and were physically more active; the converse was true for those not meeting the criteria.
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Affiliation(s)
- Zofia Ignasiak
- a Faculty of Physical Education , University School of Physical Education , Wrocław , Poland
| | - Teresa Sławinska
- a Faculty of Physical Education , University School of Physical Education , Wrocław , Poland
| | - Anna Skrzek
- b Faculty of Physiotherapy , University School of Physical Education , Wrocław , Poland
| | - Krystyna Rożek
- b Faculty of Physiotherapy , University School of Physical Education , Wrocław , Poland
| | - Sławomir Kozieł
- c Department of Anthropology , Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences , Wrocław , Poland
| | - Pawel Posłuszny
- a Faculty of Physical Education , University School of Physical Education , Wrocław , Poland
| | - Robert M Malina
- d Department of Kinesiology and Health Education , University of Texas , Austin , TX , USA
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Abstract
At present, no single indicator could be used as a golden index to estimate aging process. The biological age (BA), which combines several important biomarkers with mathematical modeling, has been proposed for >50 years as an aging estimation method to replace chronological age (CA). The common methods used for BA estimation include the multiple linear regression (MLR), the principal component analysis (PCA), the Hochschild's method, and the Klemera and Doubal's method (KDM). The fundamental differences in these four methods are the roles of CA and the selection criteria of aging biomarkers. In MLR and PCA, CA is treated as the selection criterion and an independent index. The Hochschild's method and KDM share a similar concept, making CA an independent variable. Previous studies have either simply constructed the BA model by one or compared the four methods together. However, reviews have yet to illustrate and compare the four methods systematically. Since the BA model is a potential estimation of aging for clinical use, such as predicting onset and prognosis of diseases, improving the elderly's living qualities, and realizing successful aging, here we summarize previous BA studies, illustrate the basic statistical steps, and thoroughly discuss the comparisons among the four common BA estimation methods.
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Affiliation(s)
- Linpei Jia
- Department of Nephrology, Second Hospital of Jilin University, Changchun, Jilin Province
- Department of Nephrology, Chinese People’s Liberation Army General Hospital, Beijing
- State Key Laboratory of Kidney Disease, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
| | - Weiguang Zhang
- Department of Nephrology, Chinese People’s Liberation Army General Hospital, Beijing
- State Key Laboratory of Kidney Disease, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
| | - Xiangmei Chen
- Department of Nephrology, Second Hospital of Jilin University, Changchun, Jilin Province
- Department of Nephrology, Chinese People’s Liberation Army General Hospital, Beijing
- State Key Laboratory of Kidney Disease, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
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Jee H, Park J. Selection of an optimal set of biomarkers and comparative analyses of biological age estimation models in Korean females. Arch Gerontol Geriatr 2017; 70:84-91. [DOI: 10.1016/j.archger.2017.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/04/2016] [Accepted: 01/09/2017] [Indexed: 12/20/2022]
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Yoo J, Kim Y, Cho ER, Jee SH. Biological age as a useful index to predict seventeen-year survival and mortality in Koreans. BMC Geriatr 2017; 17:7. [PMID: 28056846 PMCID: PMC5217268 DOI: 10.1186/s12877-016-0407-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 12/22/2016] [Indexed: 11/28/2022] Open
Abstract
Background Many studies have been conducted to quantitatively estimate biological age using measurable biomarkers. Biological age should function as a valid proxy for aging, which is closely related with future work ability, frailty, physical fitness, and/or mortality. A validation study using cohort data found biological age to be a superior index for disease-related mortality than chronological age. The purpose of this study is to demonstrate the validity of biological age as a useful index to predict a person’s risk of death in the future. Methods The data consists of 13,106 cases of death from 557,940 Koreans at 20–93 years old, surveyed from 1994 to 2011. Biological ages were computed using 15 biomarkers measured in general health check-ups using an algorithm based on principal component analysis. The influence of biological age on future mortality was analyzed using Cox proportional hazards regression considering gender, chronological age, and event type. Results In the living subjects, the average biological age was almost the same as the average chronological age. In the deceased, the biological age was larger than the chronological age: largest increment of biological age over chronological age was observed when their baseline chronological age was within 50–59 years. The death rate significantly increased as biological age became larger than chronological age (linear trend test, p value < 0.0001). The largest hazard ratio was observed in subjects whose baseline chronological age was within 50–59 years when the cause was death from non-cancerous diseases (HR = 1.30, 95% confidence intervals = 1.26 - 1.34). The survival probability, over the 17 year term of the study, was significantly decreased in the people whose biological age was larger than chronological age (log rank test, p value < 0.001). Conclusions Biological age could be used to predict future risk of death, and its effect size varied according to gender, chronological age, and cause of death. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0407-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jinho Yoo
- Bioage Medical Research Institute, Bio-Age Inc., Seoul, Republic of Korea
| | - Yangseok Kim
- Bioage Medical Research Institute, Bio-Age Inc., Seoul, Republic of Korea.,College of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Eo Rin Cho
- Department of Epidemiology and Health Promotion, Institute for Health promotion, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health promotion, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea.
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