1
|
Ponvel P, Murukesu RR, Shahar S, Rivan NFM, Subramaniam P, Singh DKA. Transition of Physical, Psychological, and Cognitive Frailty and Its' Associated Determinants in Malaysian Older Adults: A 5-Year Follow-up Study. Rejuvenation Res 2024. [PMID: 39225151 DOI: 10.1089/rej.2024.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Frailty, a multifaceted syndrome, affects approximately 26% of older adults globally, yet there are limited data on the prevalence and longitudinal impact of frailty subtypes. Therefore, in this study, we aim to determine the prevalence of physical, psychological, and cognitive frailty, transitions between subtypes, and associated health determinants among Malaysian community-dwelling older adults. This study is part of the longitudinal aging study in Malaysia (LRGS Ageless and TUA). We assessed 815 older adults in 2014, with successful follow-up of 402 participants (mean age: 67.08 ± 5.38 years) after 5 years. Frailty subtypes were assessed at baseline, and transitions were evaluated at the 5-year mark. At baseline, the prevalence of older adults categorized as robust, physical frailty, cognitive frailty, and psychological frailty was 26.7%, 36.3%, 12.1%, and 16.7%, respectively, with 8.1% exhibiting concurrent psychological and cognitive frailty. Follow-up results showed that 22.9% remained robust, 46.8% experienced no change, 24.9% deteriorated (adversed), and 5.5% improved (reversed). Logistic regression analysis identified living alone (p < 0.001), increased body fat percentage (p < 0.05), increased waist circumference (p < 0.05), reduced fat-free mass (p < 0.05), decreased lower limb flexibility (p < 0.05), and declined cardiorespiratory fitness (p < 0.05) as significant predictors of frailty deterioration. Higher Mini Mental State Examination (MMSE) scores and improved Timed Up and Go and Chair Stand test results (p < 0.05) were significantly associated with the reversal of frailty subtypes (p < 0.05). Younger older adults (p < 0.001), males (p < 0.05), those with lower WHO Disability Scale scores (p < 0.05), and higher MMSE scores (p < 0.05) were significantly less likely to develop frailty subtypes. Intervention strategies that focus on combined physical, cognitive, and psychosocial functions are crucial for both reversing and preventing the progression of frailty subtypes in older adults.
Collapse
Affiliation(s)
- Pavapriya Ponvel
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Inti International University, Negeri Sembilan, Malaysia
| | | | - Suzana Shahar
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Fatin Malek Rivan
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (HCARE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Boucham M, Salhi A, El Hajji N, Gbenonsi GY, Belyamani L, Khalis M. Factors associated with frailty in older people: an umbrella review. BMC Geriatr 2024; 24:737. [PMID: 39237866 PMCID: PMC11376099 DOI: 10.1186/s12877-024-05288-4] [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: 01/10/2024] [Accepted: 08/07/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND The number of frail older people is increasing worldwide, and all countries will be confronted with their growing needs for healthcare and social support. The aim of this umbrella review was to summarize the evidence on the factors associated with frailty in older people, using a socioecological approach. METHODS PubMed (MEDLINE), Scopus, Web of Science, ScienceDirect, Hinari (research4life), and the Trip database were systematically searched up to April 2023. Systematic reviews of observational studies that explored factors associated with frailty in older adults aged 60 years and over were considered for inclusion. No language, geographical or setting restrictions were applied. However, we excluded systematic reviews that investigated frailty factors in the context of specific diseases. The Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses and the ROBIS tool were used to assess the quality and risk of bias in the included studies. RESULTS Forty-four systematic reviews were included, covering 1,150 primary studies with approximately 2,687,911 participants overall. Several risk factors, protective factors and biomarkers were found to be associated with frailty, especially in community-dwelling older people, including 67 significant associations from meta-analyses. The certainty of the evidence was rated as moderate or reached moderate levels for seven factors relevant to older people. These factors include depression (OR 4.66, 95% CI 4.07 to 5.34), loneliness (OR 3.51, 95% CI 2.70 to 4.56), limitations in activities of daily living (OR 2.59, 95% CI 1.71 to 3.48), risk of malnutrition (OR 3.52, 95% CI 2.96 to 4.17), Dietary Inflammatory Index score (OR 1.24, 95% CI 1.16 to 1.33), maximal walking speed (Standardized Mean Difference (SMD) -0.97, 95% CI -1.25 to -0.68), and self-reported masticatory dysfunction (OR 1.83, 95% CI 1.55 to 2.18). Additionally, only greater adherence to a Mediterranean diet showed a high level of evidence (OR 0.44, 95% CI 0.31 to 0.64). CONCLUSIONS This umbrella review will provide guidance for prevention strategies and clinical practice by promoting healthy lifestyles and addressing all modifiable risk factors associated with frailty. Future systematic reviews should consider heterogeneity and publication bias, as these were the main reasons for downgrading the level of evidence in our review. REGISTRATION PROSPERO 2022, CRD42022328902.
Collapse
Affiliation(s)
- Mouna Boucham
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco.
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco.
| | - Amal Salhi
- National School of Public Health, Rabat, Morocco
| | - Naoual El Hajji
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Gloria Yawavi Gbenonsi
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Lahcen Belyamani
- Mohammed VI Center for Research and Innovation, Mohammed VI University of Sciences and Health, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed Khalis
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
- Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
- Laboratory of Biostatistics, Clinical, and Epidemiological Research, & Laboratory of Community Health (Public Health, Preventive Medicine and Hygiene), Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| |
Collapse
|
3
|
Marques MGDS, Branco BHM, Marques DCDS, Lalucci MPDPS, Perli VAS, do Nascimento JRA, Valdés-Badilla P, de Oliveira DV. Health-Related Physical Fitness and Biochemical Parameters in Overweight Older People during Social Isolation Imposed by the COVID-19 Pandemic: A Longitudinal and Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1161. [PMID: 39338044 PMCID: PMC11430848 DOI: 10.3390/ijerph21091161] [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: 07/17/2024] [Revised: 08/14/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024]
Abstract
With COVID-19, evidence indicates that the elderly will have worse biochemical markers related to health in social isolation. The objective was to analyze the impacts on physical fitness and biochemical parameters of older adults' health during COVID-19 social isolation. Quantitative, longitudinal, and observational study was conducted between 2020, 2021, and 2022. Thirty-three older adults of both sexes were evaluated. A sociodemographic questionnaire, biomarkers, and health-related physical fitness were used. Significant differences were observed for the sum of maximum isometric right and left handgrip strength, with a reduction in 2022 (p = 0.009); getting up and walking (p < 0.001), reduction in 2021 and 2022 (p < 0.05); elbow flexion and extension (p = 0.004), reduction in 2021 (p = 0.006); and sitting and standing (p = 0.002), reduction in 2022 (p = 0.003) and peak oxygen consumption (p < 0.001), reduction in 2021 and 2022 (p < 0.05). Differences were observed in fasting blood glucose (p < 0.001), with increase in 2021 and 2022 (p < 0.05), triglycerides (p < 0.001), with increase in 2021 and 2022 (p < 0.05), triglyceride-glucose index (p < 0.001), with increase in 2021 and 2022 (p < 0.05), triglyceride-glucose index with waist circumference (p < 0.001), with increase in 2021 (p < 0.001); and triglyceride-glucose index with body mass index (p < 0.001), with increase in 2021 (p < 0.001). However, no differences were observed between anthropometric and body composition (p > 0.05). Conclusions: Older people had changes in biochemical and physical fitness parameters related to health during the social isolation of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Marilene Ghiraldi de Souza Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringa 1610, PR, Brazil; (M.G.d.S.M.); (D.C.d.S.M.); (M.P.d.P.S.L.)
- Graduate Program in Health Promotion, Cesumar University, Maringa 1610, PR, Brazil; (V.A.S.P.); (D.V.d.O.)
| | - Braulio Henrique Magnani Branco
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringa 1610, PR, Brazil; (M.G.d.S.M.); (D.C.d.S.M.); (M.P.d.P.S.L.)
- Graduate Program in Health Promotion, Cesumar University, Maringa 1610, PR, Brazil; (V.A.S.P.); (D.V.d.O.)
| | - Déborah Cristina de Souza Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringa 1610, PR, Brazil; (M.G.d.S.M.); (D.C.d.S.M.); (M.P.d.P.S.L.)
- Graduate Program in Health Promotion, Cesumar University, Maringa 1610, PR, Brazil; (V.A.S.P.); (D.V.d.O.)
| | - Marielle Priscila de Paula Silva Lalucci
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringa 1610, PR, Brazil; (M.G.d.S.M.); (D.C.d.S.M.); (M.P.d.P.S.L.)
- Graduate Program in Health Promotion, Cesumar University, Maringa 1610, PR, Brazil; (V.A.S.P.); (D.V.d.O.)
| | | | | | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Educational Sciences, Universidad Católica del Maule, Talca 3530000, Chile;
- Sports Coaching Career, School of Education, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | | |
Collapse
|
4
|
Xu Q, Fan Y, Zhu J, Wang X. The effect of different exercise on physical fitness, cognition, and mental health in healthy older adults. Heliyon 2024; 10:e36510. [PMID: 39253255 PMCID: PMC11382082 DOI: 10.1016/j.heliyon.2024.e36510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/16/2024] [Accepted: 08/16/2024] [Indexed: 09/11/2024] Open
Abstract
Objective This study aimed to examine the effects of different exercise programs on physical fitness, cognition, and mental health in healthy older adults. Methods A randomized controlled study was performed with 89 healthy older adults. They were separated into four groups: the control (Con; n = 20), physical activity (PA; n = 23), cognitive training (CT; n = 23), and physical activity coupled with cognitive training groups (PA + CT; n = 23). The subjects in PA, CT, and PA + CT groups received exercise programs that lasted 40 min daily, conducted at least three days a week for 20 weeks. The PA group received regular aerobic physical activity interventions, the CT group received cognitive training interventions, and the PA + CT group received physical activity combined with cognitive training interventions. Physical fitness (by chair stand, biceps curl, 2-min step, 8-step up and walk, and sit and reach tests), cognitive function (attention, simple reaction time, and spatial memory), and mental health (anxiety and depression status) were evaluated before and after 20 weeks. Results The body composition results reveal no significant effects among the four groups after 20 weeks before and after aerobic exercise interventions (p > 0.05). Compared with Con, the PA, CT, and PA + CT groups significantly improved physical fitness parameters (p < 0.05). The post-hoc analysis demonstrated that the PA and PA + CT groups had higher fitness levels than the CT group. Similarly, a significant difference was observed in the cognitive index among the four groups (p < 0.05). As determined by post-hoc analysis, attention and simple reaction time differed sequentially between the Con, PA, CT, and PA + CT groups. The spatial memory was superior in the PA, CT, and PA + CT groups compared to the Con group (p < 0.05), with the PA + CT group exhibiting the highest level of performance. However, there was no significant difference in the mental health parameters among all the groups (p < 0.05). Conclusion A 20-week intervention involving different exercise methods can enhance physical fitness, cognition, and mental health in older adults. These methods include physical activity, cognitive training, and a combination of physical and cognitive training. The combined physical activity and cognitive training interventions yielded more favorable outcomes than individual physical or cognitive training interventions.
Collapse
Affiliation(s)
- Qiangqiang Xu
- Department of Physical Education, Donghua University, 2999 Renmin North Road, Songjiang District, 201620, Shanghai, China
| | - Yongzhao Fan
- Department of Physical Education, Henan Normal University, 46 East Jianshe Road, Muye District, 453007, Xinxiang, Henan, China
| | - Jianghua Zhu
- Department of Physical Education, Donghua University, 2999 Renmin North Road, Songjiang District, 201620, Shanghai, China
| | - Xing Wang
- School of Physical Education, Shanghai University of Sport, 399, Changhai Road, 200438, Yangpu District, Shanghai, China
| |
Collapse
|
5
|
Dong Q, Bu X, Wang T, Liu M, Zhong F, Liu C. Profiles of physical frailty, social frailty, and cognitive impairment among older adults in rural areas of China: a latent profile analysis. Front Public Health 2024; 12:1424791. [PMID: 39091519 PMCID: PMC11291239 DOI: 10.3389/fpubh.2024.1424791] [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: 04/28/2024] [Accepted: 07/09/2024] [Indexed: 08/04/2024] Open
Abstract
Background As China rapidly ages, it has now become a deeply aging society with the largest number of older individuals in the world. The issue is particularly severe in rural areas. With the aging population growing and the older population expanding, health problems are becoming more prevalent among older individuals, particularly frailty and cognitive impairments. This study aimed to identify the profiles of physical frailty, social frailty, and cognitive impairment among older adults and explore the influencing factors. Methods In this cross-sectional study, participants were recruited from six villages in four cities in Shandong Province, China from July to October 2023 through cluster random sampling. Latent profile analysis was used to determine the profiles of physical frailty, social frailty, and cognitive impairment. Chi-square tests and Mann-Whitney U tests were used for univariate analysis, while binary logistic regression was used to analyze the related factors. Results Seven hundred and sixty-nine older adult care in rural areas showed two profiles: the "high cognitive function and low frailty" group (73.7%, n = 567) and the "low cognitive function and high frailty" group (26.3%, n = 202). A binary logistic regression found that older people were more likely to be aged 80 or older (OR = 2.253, p = 0.029), have a low income level (OR = 1.051, p = 0.007), have one or two (OR = 2.287, p = 0.004), or more than three chronic diseases (OR = 3.092, p = 0.002), and report moderate (OR = 3.406, p = 0.024) or poor health status (OR = 9.085, p < 0.001) in the "low cognitive function and high frailty" group. Meanwhile, older adults who have completed high school (OR = 0.428, p = 0.005) or junior college and above (OR = 0.208, p = 0.009), and engage in adequate physical activity (OR = 0.319, p < 0.001) were more likely to be in the "high cognitive function and low frailty" group. Conclusion In the future, medical professors should increasingly prioritize promptly identifying and intervening in cognitive decline and frailty status in older individuals without delay.
Collapse
Affiliation(s)
- Qian Dong
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Xiaolong Bu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Ting Wang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Man Liu
- School of Public Health, Qingdao University, Qingdao, China
| | - Feng Zhong
- School of Public Health, Qingdao University, Qingdao, China
| | - Cuiping Liu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| |
Collapse
|
6
|
Rodrigues F, Monteiro D, Matos R, Jacinto M, Antunes R, Gomes P, Amaro N. Physical Fitness of the Older Adult Community Living in Leiria, Portugal. EPIDEMIOLOGIA 2024; 5:330-339. [PMID: 39051203 PMCID: PMC11270434 DOI: 10.3390/epidemiologia5030023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024] Open
Abstract
This study aimed to achieve two primary objectives. Firstly, to compare physical fitness levels based on sex, age groups, and body composition. Secondly, to examine physical fitness of the older adults against criterion-referenced fitness standard values using a representative sample from the district of Leiria in Portugal, a region undergoing exponential population growth, including a rise in the elderly population. Data from cross-sectional assessments of the Portuguese older adult community living in the Municipality of Leiria from 2014 to 2022 were collected. This study comprised a sample of 664 community-dwelling older adults (female = 480; male = 184) aged between 60 and 90 years (M = 70.34; SD = 12.67). Participants had a body mass ranging from 45 kg to 122 kg (M = 71.48; SD = 12.34) and a height ranging from 1.30 m to 1.89 m (M = 1.59; SD = 0.08). The Senior Fitness Test battery was used to evaluate parameters of physical fitness, body mass index was calculated, and abdominal circumference was measured. Females displayed a tendency to greater physical fitness compared to males, specifically in terms of lower and upper body flexibility compared to older male adults (p < 0.05). In addition, sexagenarian and older adults with normal weight tended to display greater physical fitness compared to septuagenarian and octogenarian, and overweight adults and those with obesity (p < 0.05), respectively. Information concerning physical fitness is crucial for guiding policymakers and other stakeholders in Leiria for the promotion of healthy aging among the older adult community. Furthermore, this study has established the preliminary reference standards for physical fitness, serving as a tool to promote healthy aging among Portuguese older adults residing in Leiria.
Collapse
Affiliation(s)
- Filipe Rodrigues
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (D.M.); (R.M.); (M.J.); (R.A.); (N.A.)
- Research Center in Sport, Health and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Diogo Monteiro
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (D.M.); (R.M.); (M.J.); (R.A.); (N.A.)
- Research Center in Sport, Health and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Rui Matos
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (D.M.); (R.M.); (M.J.); (R.A.); (N.A.)
- Research Center in Sport, Health and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Miguel Jacinto
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (D.M.); (R.M.); (M.J.); (R.A.); (N.A.)
- Research Center in Sport, Health and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Raúl Antunes
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (D.M.); (R.M.); (M.J.); (R.A.); (N.A.)
- Research Center in Sport, Health and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| | - Paulo Gomes
- Municipality of Leiria, 2414-006 Leiria, Portugal;
| | - Nuno Amaro
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal; (D.M.); (R.M.); (M.J.); (R.A.); (N.A.)
- Research Center in Sport, Health and Human Development (CIDESD), 5000-558 Vila Real, Portugal
| |
Collapse
|
7
|
Mejdouli H, Baali A, Amor H, Ouzennou N. Prevalence and determinants of frailty among the elderly in the province of Essaouira, Morocco. Pan Afr Med J 2024; 48:43. [PMID: 39280821 PMCID: PMC11399447 DOI: 10.11604/pamj.2024.48.43.41695] [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: 09/09/2023] [Accepted: 02/25/2024] [Indexed: 09/18/2024] Open
Abstract
Introduction Morocco is no exception to the global phenomenon of an ageing population. The number of people aged 60 and over rose from one million to 4.5 million between 1970 and 2022. In terms of health, 64.4% of Moroccan seniors are affected by at least one chronic disease, and almost a third suffer from disability. We aimed to estimate the prevalence and identify the factors associated with frailty among the elderly in the Essaouira province of Morocco. Methods a descriptive and analytical cross-sectional survey of 384 people aged 65 and over attending health centres in Essaouira province was conducted between March 2022 and January 2023. Data were collected using a self-administered questionnaire. The Fried phenotype was used to assess frailty in the participants. Results according to Fried's phenotype, 46.4% of the elderly were frail. Multivariate analyses showed that frailty was associated with family type [OR=1.9; 95% CI 1.4-2.6], professional activity [OR=2.2; 95% CI 1.2-3.9], financial difficulties [OR=1.7; 95% CI 1.1-2.8] and undernutrition [OR=2.9; 95% CI 1.7-4.8]. Conclusion implementing a screening strategy and speeding up the process of generalising social protection are actions that will make it possible to reduce the prevalence of frailty among the elderly, prevent its complications and act on its main determinants in Morocco.
Collapse
Affiliation(s)
- Hicham Mejdouli
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, Environment and Behaviour, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Abdellatif Baali
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, Environment and Behaviour, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Hakima Amor
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, Environment and Behaviour, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Nadia Ouzennou
- Higher Institute of Nursing and Technical Health Professions, Ministry of Health and Social Protection, Marrakech, Morocco
| |
Collapse
|
8
|
Benhammou S, Mourot L, Clemente FM, Coquart J, Belkadi A. Is test specificity the issue in assessing aerobic fitness and performance of runners? A systematic review. J Sports Med Phys Fitness 2024; 64:539-549. [PMID: 38324270 DOI: 10.23736/s0022-4707.23.15619-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Various tests have been developed to evaluate aerobic fitness and performance of runners. However, a systematic understanding of which methods are more accurate is necessary to provide coaches and the sports sciences community with useful and confident outcomes. This study aims to summarize the evidence regarding the validity, reliability and sensitivity of tests for measuring aerobic fitness and performance in runners of several background of training. EVIDENCE ACQUISITION A systematic search was conducted of Web of Science, PubMed and Scopus up to 31st December 2022 according to PRISMA statement guidelines. Studies that reported findings about tests covering maximal aerobic speed, final velocity achieved during the test, average running speed or other method of evaluating the reference speed during the test were included. We evaluated the risk of bias in the included articles using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). The tests were categorized into continuous incremental tests, intermittent tests and time-trial test. EVIDENCE SYNTHESIS A total of 23 studies met eligibility criteria. These studies contained three background of training: track and road runners (N.=15), trail runners (N.=7) and inexperienced runners (N.=1). Criterion validity was assessed in 73% of the studies, while only 41% of studies examined convergent validity. The majority of the reviewed studies (87%) ignored test-retest reliability. Test sensitivity was not reported in any study. CONCLUSIONS At least one aerobic fitness and performance test was identified for each types of background of training. However, some methodological aspects were not provided in the included articles. Most studies examined at least one aspect of validity (i.e., criterion or convergent-related validity), whilst few studies investigated test-retest reliability. Researchers and practitioners can use the information provided in this systematic review to select appropriate tests.
Collapse
Affiliation(s)
- Saddek Benhammou
- Platform Exercise Performance Health Innovation (Plateforme EPSI), Paris, France -
- Laboratory of Optimizing Research Programs on Physical and Sports Activities, Institute of Physical Education and Sport, University of Abdelhamid Ibn Badis, Mostaganem, Algeria -
| | - Laurent Mourot
- Platform Exercise Performance Health Innovation (Plateforme EPSI), Paris, France
- Unit of Prognostic Markers and Regulatory Factors of Cardiac and Vascular Pathologies (MPFRPV), University of Franche-Comté, Besançon, France
| | - Filipe M Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Gdansk University of Physical Education and Sport, Gdańsk, Poland
- Sport Physical Activity and Health Research & Innovation Center (SPRINT), Viana do Castelo, Portugal
| | - Jeremy Coquart
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Sante Société, Lille, France
| | - Adel Belkadi
- Laboratory of Optimizing Research Programs on Physical and Sports Activities, Institute of Physical Education and Sport, University of Abdelhamid Ibn Badis, Mostaganem, Algeria
| |
Collapse
|
9
|
Chen X, Zheng R, Xu X, Wang Z, Huang G, Wu R, Hong J. Frailty and Health-Related Quality of Life in Elderly Patients Undergoing Esophageal Cancer Surgery: A Longitudinal Study. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:125-133. [PMID: 38677471 DOI: 10.1016/j.anr.2024.04.004] [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: 02/05/2024] [Revised: 03/20/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE This study aims to elucidate the longitudinal alterations in frailty and health-related quality of life experienced by elderly patients undergoing surgical treatment for esophageal cancer. Additionally, it seeks to ascertain the impact of preoperative frailty on postoperative health-related quality of life over time. METHODS 131 patients were included in the prospective study. Patients' frailty and health-related quality-of-life were assessed utilizing the Tilburg and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at preoperative, 1 week, 1 month, and 3 months, postoperatively. Statistical analyses were performed using generalized estimating equations, repeated-measures analysis of variance, and linear mixed models (LMMs). RESULTS Out of 131 patients, 28.2% had frailty before surgery, and the prevalence of frailty consistently higher after surgery compared with baseline (67.9%, 51.9%, and 39.7%). There was no significant change in frailty scores in preoperative frail patients within 3 months following surgery (p = .496, p < .999, p < .999); whereas in preoperative non-frail patients, the frailty scores increased at 1 week (p < .001) and then decreased at 1 month (p = .014), followed by no change at 3 months. In addition, preoperative frail patients had significantly worse global quality-of-life (β = -4.24 (-8.31; -.18), p = .041), physical functioning (β = -9.87 (-14.59; -5.16), p < .001), role functioning (β = -10.04 (-15.76; -4.33), p = .001), and social functioning (β = -8.58 (-15.49; -1.68), p = .015), compared with non-frail patients. CONCLUSIONS A significant proportion of participants exhibited a high prevalence of preoperative frailty. These patients, who were preoperatively frail, exhibited a marked reduction in health-related quality-of-life, a more gradual recovery across various functional domains, and an increased symptom burden during the follow-up period. Therefore, it is crucial to meticulously identify and closely monitor patients with preoperative frailty for any changes in their postoperative physiology, role, and social functioning.
Collapse
Affiliation(s)
- Xi Chen
- School of Nursing, Anhui Medical University, Hefei, China
| | - Rong Zheng
- School of Nursing, Anhui Medical University, Hefei, China
| | - Xiuzhi Xu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Zhuzhu Wang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Guohong Huang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Rongrong Wu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, China.
| |
Collapse
|
10
|
Snigdha A, Majumdar V, Manjunath NK, Jose A. Yoga-based lifestyle intervention for healthy ageing in older adults: a two-armed, waitlist randomized controlled trial with multiple primary outcomes. GeroScience 2024:10.1007/s11357-024-01149-5. [PMID: 38583114 DOI: 10.1007/s11357-024-01149-5] [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: 07/18/2023] [Accepted: 03/22/2024] [Indexed: 04/08/2024] Open
Abstract
Yoga-based clinical research has shown considerable promise in varied ageing-related health outcomes in older adults. However, robust frameworks have yet to be used in intervention research to endorse yoga as a healthy ageing intervention to test the multidimensional construct of healthy ageing. This was an assessor-masked, randomized controlled trial conducted among 258 sedentary, community-dwelling older adults aged 60-80 years, randomly allocated to 26-week yoga-based intervention (YBI) (n = 132) or waitlist control (WLC) (n = 126). The effectiveness of YBI was assessed through two separate global statistical tests, generalized estimating equations and rank sum-based test, against a comprehensive healthy aging panel comprised of ten markers representing the domains of physiological and metabolic, cognitive, physical capability, psychological, and social well-being. The secondary outcomes were individual primary marker scores, Klotho, inflammatory markers, and auxiliary blood markers. We could establish the healthy aging effect of the 26-week YBI over WLC using two models of global statistical test (GEE, β = 0.29; 95% CI = 0.20 to 0.38, p < 0.001), and rank sum-based test (β = 0.28, 95% CI = 0.19 to 0.36, p < 0.001). There were also significant improvements in direction of benefit at individual levels of all the aging markers. Exploratory evaluation with adopted indices from contemporary clinical trials also validated the potential of YBI for healthy aging; HATICE adapted composite score (mean difference = - 0.18; 95% CI = - 0.26 to - 0.09, p < 0.001) and healthy ageing index (mean difference = - 0.33; 95% CI = - 0.63 to - 0.02, p = 0.03). The global effect of YBI across multiple ageing-related outcomes provides a proof of concept for further large-scale validation. The findings hold a great translational value given the accelerated pace of population aging across the globe. Trial registration: CTRI/2021/02/031373.
Collapse
Affiliation(s)
- Atmakur Snigdha
- Division of Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, 560105, Bengaluru, Karnataka, India
| | - Vijaya Majumdar
- Division of Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, 560105, Bengaluru, Karnataka, India.
| | - N K Manjunath
- Division of Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, 560105, Bengaluru, Karnataka, India
| | - Amrutha Jose
- ICMR-National Institute of Immunohematology, 400012, Mumbai, India
| |
Collapse
|
11
|
Chad T, Koulouroudias M, Layton GR, Fashina O, Sze S, Roman M, Murphy GJ. Frailty in acute coronary syndromes. A systematic review and narrative synthesis of frailty assessment tools and interventions from randomised controlled trials. Int J Cardiol 2024; 399:131764. [PMID: 38211672 DOI: 10.1016/j.ijcard.2024.131764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 01/13/2024]
Abstract
AIM We aimed to review all randomised controlled trial (RCT) data to explore optimal identification and treatment strategies of frail patients with Acute Coronary Syndromes (ACS). METHODS The protocol was preregistered (PROSPERO - CRD42021250235). We performed a systematic review including RCT's that 1; used at least one frailty assessment tool to assess frailty and its impact on outcomes in patients diagnosed with ACS and 2; used at least one intervention where change in frailty was measured in patients diagnosed with ACS. The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched on the 1st April 2021 and updated on 4th July 2023. Owing to low search output results are presented as a narrative synthesis of available evidence. RESULTS A single RCT used a frailty assessment tool. A single RCT specifically targeted frailty with their intervention. This precluded further quantitative analysis. There was indication of selection bias against frail participants, and a signal of value for physical activity measurement in frail ACS patients. There was a high level of uncertainty and low level of robustness of this evidence. CONCLUSIONS Data from RCT's alone is inadequate in answering the reviews question. Future RCT's need to address ways to incorporate frail participants, whilst mitigating selection biases. Physical performance aspects of the frailty syndrome appear to be high yield modifiable targets that improve outcomes. Intervention trials should consider using change in frailty status as an outcome measure. Any trials that include frail participants should present data specifically attributable to this group.
Collapse
Affiliation(s)
- Thomas Chad
- Department of Cardiovascular Sciences, University of Leicester, UK.
| | | | - Georgia R Layton
- Department of Cardiac Surgery, University Hospitals of Leicester NHS trust, UK
| | | | - Shirley Sze
- Department of Cardiovascular Sciences, University of Leicester, UK
| | - Marius Roman
- Department of Cardiovascular Sciences, University of Leicester, UK
| | - Gavin J Murphy
- Department of Cardiovascular Sciences, University of Leicester, UK
| |
Collapse
|
12
|
Schwonke I, Freitag N, Aschendorf P, Wucharz K, Thieme J, Appelmann I, Schumann M, Elsner F. Feasibility of a physical exercise intervention for patients on a palliative care unit: a critical analysis. BMC Palliat Care 2024; 23:58. [PMID: 38418974 PMCID: PMC10900709 DOI: 10.1186/s12904-024-01388-5] [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: 03/30/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Recent exercise intervention studies have shown promising results in improving quality of life (QoL) and physical function (PF) in diverse chronic disease and advanced cancer patients. However, the effects of structured exercise in palliative care patients, having different therapeutic needs, lower life expectancies and PFs remain unknown. This study primarily aimed to assess the feasibility of an exercise intervention with follow-up by analysing recruitment numbers, screening procedures, acceptability, preferences, and safety of the exercise intervention as well as retention in follow-up. Our secondary aims related to changes in QoL and PF. METHODS This study comprised of a one-arm design without a control group. Over 6 months, every in-hospital palliative care unit (PCU) patient was screened for eligibility. Eligible patients were asked to participate in a 2-week exercise intervention consisting of resistance training and/or endurance training with moderate or high intensity based on personal preferences and a 4-week follow-up. Before and after the exercise intervention, QoL and PF were assessed and a qualitative interview after the intervention addressed expectations and experiences of the exercise intervention. For follow-up, patients were provided with information on independent training and after 1 and 4 weeks a QoL assessment and qualitative interview were conducted. RESULTS Of 124 patients screened, 10 completed the intervention with an adherence rate of (80 ± 25%), of which 6 patients completed follow-up. Endurance training was the most performed training type and only a few minor adverse events occurred in certain or likely connection to the exercise intervention. While physical QoL and PF measured by arm curl strength and time up and go performance improved, mental QoL and the other PF tests remained unchanged. CONCLUSION Despite the challenges that were faced in our screening and testing process, that are specific to the palliative patient population with their unique therapeutic requirements and varying mental-/ physical capabilities, we discovered the 2-week exercise intervention to be feasible, safe, and well tolerated by palliative care patients. Moreover, it seems that short-term improvements in QoL and PF are possible. Further full scale studies are required to confirm our findings. TRIAL REGISTRATION The study was retrospectively registered on 25.01.2022 in the German Clinical Trials Register (DRKS00027861).
Collapse
Affiliation(s)
- Inken Schwonke
- Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Nils Freitag
- Olympic Training Centre Berlin, Berlin, Germany
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Paula Aschendorf
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Kerstin Wucharz
- Department of Physiotherapy, Franziska-Schervier Educational Center, Bethlehem Hospital, Stolberg, Germany
- Department of Physiotherapy, RWTH Aachen University Hospital, Aachen, Germany
| | - Johanna Thieme
- Pro Sanum Health and Therapy Center Eifel, Nettersheim, Germany
- Department of Physiotherapy, RWTH Aachen University Hospital, Aachen, Germany
| | - Iris Appelmann
- Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Moritz Schumann
- Department of Sports Medicine and Exercise Therapy, Chemnitz University of Technology, Chemnitz, Germany
| | - Frank Elsner
- Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| |
Collapse
|
13
|
Bunch PM, Rigdon J, Niazi MKK, Barnard RT, Boutin RD, Houston DK, Lenchik L. Association of CT-Derived Skeletal Muscle and Adipose Tissue Metrics with Frailty in Older Adults. Acad Radiol 2024; 31:596-604. [PMID: 37479618 PMCID: PMC10796847 DOI: 10.1016/j.acra.2023.06.003] [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: 03/25/2023] [Revised: 05/18/2023] [Accepted: 06/02/2023] [Indexed: 07/23/2023]
Abstract
RATIONALE AND OBJECTIVES Tools are needed for frailty screening of older adults. Opportunistic analysis of body composition could play a role. We aim to determine whether computed tomography (CT)-derived measurements of muscle and adipose tissue are associated with frailty. MATERIALS AND METHODS Outpatients aged ≥ 55 years consecutively imaged with contrast-enhanced abdominopelvic CT over a 3-month interval were included. Frailty was determined from the electronic health record using a previously validated electronic frailty index (eFI). CT images at the level of the L3 vertebra were automatically segmented to derive muscle metrics (skeletal muscle area [SMA], skeletal muscle density [SMD], intermuscular adipose tissue [IMAT]) and adipose tissue metrics (visceral adipose tissue [VAT], subcutaneous adipose tissue [SAT]). Distributions of demographic and CT-derived variables were compared between sexes. Sex-specific associations of muscle and adipose tissue metrics with eFI were characterized by linear regressions adjusted for age, race, ethnicity, duration between imaging and eFI measurements, and imaging parameters. RESULTS The cohort comprised 886 patients (449 women, 437 men, mean age 67.9 years), of whom 382 (43%) met the criteria for pre-frailty (ie, 0.10 < eFI ≤ 0.21) and 138 (16%) for frailty (eFI > 0.21). In men, 1 standard deviation changes in SMD (β = -0.01, 95% confidence interval [CI], -0.02 to -0.001, P = .02) and VAT area (β = 0.008, 95% CI, 0.0005-0.02, P = .04), but not SMA, IMAT, or SAT, were associated with higher frailty. In women, none of the CT-derived muscle or adipose tissue metrics were associated with frailty. CONCLUSION We observed a positive association between frailty and CT-derived biomarkers of myosteatosis and visceral adiposity in a sex-dependent manner.
Collapse
Affiliation(s)
- Paul M Bunch
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, NC 27157 (P.M.B., L.L.).
| | - Joseph Rigdon
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (J.R., R.T.B.)
| | - Muhammad Khalid Khan Niazi
- Center for Biomedical Informatics, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (M.K.K.N.)
| | - Ryan T Barnard
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (J.R., R.T.B.)
| | - Robert D Boutin
- Department of Radiology, Stanford University School of Medicine, Stanford, California (R.D.B.)
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, North Carolina (D.K.H.)
| | - Leon Lenchik
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard,Winston-Salem, NC 27157 (P.M.B., L.L.)
| |
Collapse
|
14
|
Wang XM, Fan L, Meng CC, Wang YJ, Deng LE, Yuan Z, Zhang JP, Li YY, Lv SC. Gut microbiota influence frailty syndrome in older adults: mechanisms and therapeutic strategies. Biogerontology 2024; 25:107-129. [PMID: 38150088 DOI: 10.1007/s10522-023-10082-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023]
Abstract
Frailty syndrome denotes a decreased capacity of the body to maintain the homeostasis and stress of the internal environment, which simultaneously increases the risk of adverse health outcomes in older adults, including disability, hospitalization, falls, and death. To promote healthy aging, we should find strategies to cope with frailty. However, the pathogenesis of frailty syndrome is not yet clear. Recent studies have shown that the diversity, composition, and metabolites of gut microbiota significantly changed in older adults with frailty. In addition, several frailty symptoms were alleviated by adjusting gut microbiota with prebiotics, probiotics, and symbiosis. Therefore, we attempt to explore the pathogenesis of frailty syndrome in older people from gut microbiota and summarize the existing interventions for frailty syndrome targeting gut microbiota, with the aim of providing timely and necessary interventions and assistance for older adults with frailty.
Collapse
Affiliation(s)
- Xiao-Ming Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300193, China
- School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lu Fan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300193, China
- School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chen-Chen Meng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300193, China
- School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yun-Jiao Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300193, China
- School of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Li-E Deng
- Nephrology department, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, China
| | - Zhuo Yuan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300193, China
| | - Jun-Ping Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300193, China
| | - Yan-Yang Li
- Department of Integrated Chinese and Western Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Shi-Chao Lv
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300193, China.
- Tianjin Key Laboratory of Traditional Research of TCM Prescription and Syndrome, Tianjin, China.
| |
Collapse
|
15
|
Mojas E, Santisteban A, Muñoz-Pérez I, Larrinaga-Undabarrena A, Arietaleanizbeaskoa MS, Mendizabal-Gallastegui N, Grandes G, Cacicedo J, Río X. Differences in Functional Capacity between Oncologic and Non-Oncologic Populations: Reference Values. Healthcare (Basel) 2024; 12:318. [PMID: 38338203 PMCID: PMC10855221 DOI: 10.3390/healthcare12030318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
This study is focused on the fact that in the context of increasing global aging and cancer diagnoses, additional challenges arise in clinical care. Adequate functionality and body composition are key to coping with antineoplastic treatment, which can lead to better treatment tolerance, survival, and quality of life. This is a cross-sectional comparative study focused on the assessment and comparison of body composition and functionality between cancer patients and a reference population, with the aim of establishing meaningful baseline values. Techniques such as manual dynamometry, the Five-Times Sit-to-Stand test, and bioimpedance were used to collect data from 374 oncologic patients and 1244 reference individuals. The results reveal significant disparities in functionality and body composition among participants, and provide age group-specific adjusted baseline values for those diagnosed with cancer. These findings may have crucial clinical implications for applying particular cut-off points designed for this population group, which makes the assessment process faster and more accurate, enhances the capacity of medical personnel to act quickly, and improves the management of frailty in cancer patients.
Collapse
Affiliation(s)
- Egoitz Mojas
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Aitor Santisteban
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Iker Muñoz-Pérez
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Arkaitz Larrinaga-Undabarrena
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Maria Soledad Arietaleanizbeaskoa
- Comprehensive Care Group for Patients with Chronic Diseases, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Spain; (M.S.A.); (N.M.-G.); (G.G.)
| | - Nere Mendizabal-Gallastegui
- Comprehensive Care Group for Patients with Chronic Diseases, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Spain; (M.S.A.); (N.M.-G.); (G.G.)
| | - Gonzalo Grandes
- Comprehensive Care Group for Patients with Chronic Diseases, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Spain; (M.S.A.); (N.M.-G.); (G.G.)
| | - Jon Cacicedo
- Radiation Oncology Department, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Osakidetza, 48903 Barakaldo, Spain;
- Department of Surgery, Radiology and Physical Medicine, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Xabier Río
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| |
Collapse
|
16
|
Zhang H, Wang J, Xi J, Xu J, Wang L. Functional fitness and risk factors of older patients with diabetes combined with sarcopenia and/or frailty: A cross-sectional study. Nurs Open 2024; 11:e2042. [PMID: 38214433 PMCID: PMC10697117 DOI: 10.1002/nop2.2042] [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: 10/11/2022] [Revised: 09/19/2023] [Accepted: 10/19/2023] [Indexed: 01/13/2024] Open
Abstract
AIM To learn the functional fitness levels in older adults with diabetes combined with sarcopenia and/or frailty. DESIGN A cross-sectional investigation study. METHODS A total of 205 participants with type 2 diabetes were recruited from September 2019 to August 2020. All patients underwent diagnostic screening for sarcopenia and frailty, and were divided into combined group (the patients who had sarcopenia and/or frailty) and non-combined group (the patient who had no sarcopenia and/or frailty). The diagnostic criteria for sarcopenia applied was proposed by the Asian Working Group on Sarcopenia in 2019 and frailty status was assessed using FRAIL Scale. Functional fitness was measured using the Senior Fitness Test and compared between combined and non-combined groups. Biochemical data of blood routine, glycolipid, and hepatorenal function tests were acquired from medical records. Logistic regression analysis was applied to explore the factors associated with the sarcopenia and/or frailty in the older adults with diabetes. RESULTS Compared with non-combined group, the participants in combined group exhibited shorter 6-min walk distance, fewer repetitions of arm curls and chair stands, smaller back scratch and chair sit-and-reach values, and longer time in the 8-ft up-and-go test. The patients in the combined group had significantly lower level of red blood cell, haemoglobin, haematocrit, and higher level of platelet and blood urea nitrogen. Apart from calf circumference, physical activity, and insulin injection treatment, 6-min walk distance was the factor associated with diabetes combined with sarcopenia and/or frailty.
Collapse
Affiliation(s)
- Hui Zhang
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
- School of NursingSuzhou Vocational Health CollegeSuzhouChina
| | - Jinping Wang
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
- Department of EndocrinologySubei People's Hospital of Jiangsu ProvinceYangzhouChina
| | - Jing Xi
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
| | - Jing Xu
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
| | - Li Wang
- School of NursingSuzhou Medical College of Soochow UniversitySuzhouChina
| |
Collapse
|
17
|
Pan Y, Feng ZQ, Yuan Y, Hu GM, Jiang Y, Dong JC. Bidirectional Relationship Between Circadian Rhythm and Frailty. Nat Sci Sleep 2023; 15:949-953. [PMID: 38021211 PMCID: PMC10676114 DOI: 10.2147/nss.s436488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Coupled with the ageing population, frailty, characterized by high prevalence and difficult treatment, has progressively evolved into a significant public health concern. Frail individuals can often observe serious metabolic disorders and sleep-wake cycle disruption, which may be caused by the decline in physiological reserve and increased vulnerability. Moreover, sleep-wake cycle disruptions and metabolic dysfunctions associated with circadian rhythm disorders are considered to be a central part of the disorder. Previous studies have documented a correlation between frailty and sleep-wake disruptions; nevertheless, the association between circadian rhythm disorders and frailty has not yet been definitively established. Hence, we hypothesize a bidirectional link between circadian rhythm disorders and frailty, with each condition exerting a significant influence on the progression of the other's disease trajectory.
Collapse
Affiliation(s)
- Yu Pan
- Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Zhu Qing Feng
- Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Yan Yuan
- Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Gui Ming Hu
- Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Yi Jiang
- Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Jiang Chuan Dong
- Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| |
Collapse
|
18
|
Agbangla NF, Caby I, Albinet CT. The interest to expand group-based studies with single-case experimental design studies in the investigation of the effects of physical exercise in frail older adults: an opinion article. Front Public Health 2023; 11:1256645. [PMID: 38026373 PMCID: PMC10654972 DOI: 10.3389/fpubh.2023.1256645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Nounagnon Frutueux Agbangla
- Univ. Artois, Univ. Lille, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Liévin, France
| | - Isabelle Caby
- Univ. Artois, Univ. Lille, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Liévin, France
| | - Cédric T. Albinet
- Laboratoire Sciences de la Cognition, Technologie, Ergonomie (SCoTE-EA7420), Université de Toulouse, INU Champollion, Albi, France
| |
Collapse
|
19
|
Orlando JF, Beard M, Guerin M, Kumar S. Systematic review of predictors of hospitalisation for non-specific low back pain with or without referred leg pain. PLoS One 2023; 18:e0292648. [PMID: 37816006 PMCID: PMC10564130 DOI: 10.1371/journal.pone.0292648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Significant costs and utilisation of healthcare resources are associated with hospitalisations for non-specific low back pain despite clinical guidelines recommending community-based care. The aim of this systematic review was to investigate the predictors of hospitalisation for low back pain. A protocol was registered with PROSPERO international prospective register of systematic reviews (#CRD42021281827) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Database search of Ovid Medline, Emcare, Embase, PsycINFO, Cochrane Library, PEDro and OTSeeker was conducted. Studies were included if they examined a predictor of hospitalisation for non-specific low back pain with or without referred leg pain. Data was extracted and descriptively synthesised. Risk of bias of included studies was assessed using the Critical Appraisal Skills Programme Checklists. There were 23 studies published over 29 articles which identified 52 predictor variables of hospitalisation for low back pain. The risk of hospitalisation was grouped into themes: personal, health and lifestyle, psychology, socioeconomic, occupational, clinical, and health systems and processes. There was moderate level evidence that arrival to an emergency department via ambulance with low back pain, and older age increase the risk of hospitalisations for low back pain. There was low level evidence that high pain intensity, past history of low back pain, opioid use, and occupation type increase the risk of hospitalisation for low back pain. Further research into psychological and social factors is warranted given the paucity of available studies. Hospital avoidance strategies, improved patient screening and resource utilisation in emergency departments are considerations for practice.
Collapse
Affiliation(s)
- Joseph F. Orlando
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
- Central Adelaide Local Health Network, Adelaide, Australia
| | - Matthew Beard
- Central Adelaide Local Health Network, Adelaide, Australia
| | - Michelle Guerin
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Saravana Kumar
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| |
Collapse
|
20
|
Delaire L, Courtay A, Humblot J, Aubertin-Leheudre M, Mourey F, Racine AN, Gilbert T, Niasse-Sy Z, Bonnefoy M. Implementation and Core Components of a Multimodal Program including Exercise and Nutrition in Prevention and Treatment of Frailty in Community-Dwelling Older Adults: A Narrative Review. Nutrients 2023; 15:4100. [PMID: 37836384 PMCID: PMC10574358 DOI: 10.3390/nu15194100] [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: 07/31/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.
Collapse
Affiliation(s)
- Leo Delaire
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Aymeric Courtay
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Joannès Humblot
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Mylène Aubertin-Leheudre
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W5, Canada;
- Groupe de Recherche en Activité Physique Adaptée, Département des Sciences de l’Activité Physique, Université du Québec à Montréal (UQÀM), Montréal, QC H2L 2C4, Canada
| | - France Mourey
- Laboratoire CAPS (Cognition, Action, et Plasticité Sensorimotrice), Inserm U1093, UFR STAPS, Université de Bourgogne, Campus Universitaire, BP 27877, 21078 Dijon, France;
| | | | - Thomas Gilbert
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- RESHAPE Research on Healthcare Professionals and Performance, Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Zeinabou Niasse-Sy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
| | - Marc Bonnefoy
- Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; (A.C.); (J.H.); (T.G.); (Z.N.-S.); (M.B.)
- Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
- Inserm U1060-CarMeN, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| |
Collapse
|
21
|
Lee YH, Lin CH, Wu WR, Chiu HY, Huang HC. Virtual reality exercise programs ameliorate frailty and fall risks in older adults: A meta-analysis. J Am Geriatr Soc 2023; 71:2946-2955. [PMID: 37165743 DOI: 10.1111/jgs.18398] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/23/2023] [Accepted: 04/08/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Virtual reality (VR) technology constitutes a promising rehabilitation strategy, but its effect on frailty in older adults remains inconclusive. This study examined the effects of interactive VR training programs on lower-limb muscle strength, walking speed, balance, and fall risks in older adults with frailty. METHODS Various electronic databases comprising PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, Embase, the Chinese Electronic Periodical Service, the Chinese National Knowledge Infrastructure, and gray literature were searched from their inception through December 31, 2022 for relevant studies. Randomized controlled trials that examined the effects of interactive VR training programs on lower-limb muscle strength, balance, walking speed, and fall risks as measured by validated scales or methods. in older adults aged 65 years and older with frailty were included. A random-effects model was employed to examine the overall effect size, and the trim-and-fill method was adopted to examine publication bias. RESULTS For those studies that defined frailty using fall risks, substantial evidence demonstrated that interactive VR training interventions increased lower-limb muscle strength (Hedges' g = 0.35, p = 0.015), walking speed (Hedges' g = 0.29, p = 0.003), balance (Hedges' g = 0.62, p = 0.011), and fall risks (Hedges' g = -0.61, p < 0.001). Studies that defined frailty in accordance with the Fried frailty phenotype criteria indicated that interactive VR training interventions only increased walking speed (Hedges' g = 0.28, p = 0.023) and balance (Hedges' g = 0.27, p = 0.049). CONCLUSIONS Interactive VR training programs may benefit older adults with frailty with respect to walking speed and balance. More studies with good study quality are required to validate the effects of interactive VR exercise training on these frailty-related parameters in older adults.
Collapse
Affiliation(s)
- Yueh-Hua Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Chueh-Ho Lin
- International Ph.D. Program in Gerontology and Long-Term Care, Taipei Medical University, Taipei City, Taiwan
- Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Wan-Ru Wu
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei City, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| |
Collapse
|
22
|
Singh SK, Jaiswal AK, Verma M. Is there a ubiquitous association between sleep disorder and frailty? findings from LASI (2017-18). BMC Geriatr 2023; 23:429. [PMID: 37438687 DOI: 10.1186/s12877-023-04148-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Relatively little is known about how sleep disorders affect frailty of seniors. The study uses Fried's frailty index, to investigate the relationship between sleep disorder and frailty among older Indian adults. METHODS The study analysed Longitudinal Ageing Study in India (2017-18) data which uses a multistage stratified area probability cluster sampling design. The association between frailty was studied for which the total sample size was 31,902. The principal dependent variable was frailty. Descriptive statistics and cross-tabulation were presented in the study. A binary logistic regression analysis was used to fulfil the study objectives to find the possible association. RESULTS The prevalence of frailty in India was 21.3 percent. Older adults with sleep disorder had 66 percent higher likelihood to be frail than their counterparts. The benefits of physical activity in containing frailty is huge, the association were quite high. Poor Self-rated health was significantly associated with higher frailty (OR = 1.73; CI = 1.47-2.04). CONCLUSIONS Frailty is an enormously growing public health issue and has bi-directional relation with sleep disorders. The study has clinical relevance since sleep complaints offer a means for identifying those who are vulnerable to frailty and through appropriate intervention, the causes of sleep disorder would help to delay and in some cases reverse frailty.
Collapse
Affiliation(s)
- S K Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Ajit K Jaiswal
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
| | - Madhur Verma
- Assistant Professor of Community/Family Medicine, All India Institute of Medical Sciences Bathinda (Punjab), Punjab, India
| |
Collapse
|
23
|
Lusardi MM. 2023 Carol B. Lewis Distinguished Lecture Address to the APTA Geriatrics Membership Combined Sections Meeting, February 23, 2023 Key Words & Challenges: Defining Our Role in Caring for Older Adults. J Geriatr Phys Ther 2023; 46:93-102. [PMID: 36935462 DOI: 10.1519/jpt.0000000000000378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
|
24
|
Albrecht BM, Stalling I, Recke C, Doerwald F, Bammann K. Associations between older adults' physical fitness level and their engagement in different types of physical activity: cross-sectional results from the OUTDOOR ACTIVE study. BMJ Open 2023; 13:e068105. [PMID: 36990489 PMCID: PMC10069498 DOI: 10.1136/bmjopen-2022-068105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES To describe the prevalence of different types of physical activities and to explore the association between engagement in these physical activities and performance in the physical fitness dimensions among older adults living in Bremen, Germany. DESIGN Cross-sectional study. SETTING Twelve subdistricts in Bremen, Germany. PARTICIPANTS 1583 non-institutionalised adults aged 65-75 years residing in one of the 12 subdistricts in Bremen, Germany (53.1% female). PRIMARY OUTCOME MEASURES Level of physical fitness in five dimensions: handgrip strength (hand dynamometry), lower muscle strength (30 s-chair stand test), aerobic endurance (2 min-step test), lower body flexibility (sit-and-reach test), and upper body flexibility (back scratch test); classified using normative values. RESULTS In this study population, home-based activities (housework, gardening) and activities for transport (walking, cycling) were performed by nearly all the participants, while leisure activities were less prevalent. Logistic regression revealed a positive association between being in or over norm in handgrip strength with cycling (OR: 1.56, 95% CI: 1.13 to 2.15), hiking/running (OR: 1.50, 95% CI: 1.05 to 2.16) and other sports (OR: 3.22, 95% CI: 1.37 to 7.56). Lower muscle strength was positively related to cycling (OR: 1.91, 95% CI: 1.37 to 2.65), gym training (OR: 1.62, 95% CI: 1.16 to 2.26) and dancing (OR: 2.15, 95% CI: 1.00 to 4.61). Aerobic endurance was positively associated with cycling (OR: 1.90, 95% CI: 1.37 to 2.65), gym training (OR: 1.68, 95% CI: 1.20 to 2.36), aerobics (OR: 1.64, 95% CI: 1.19 to 2.26), dancing (OR: 2.62, 95% CI: 1.10 to 6.22) and ball sports (OR: 2.07, 95% CI: 1.30 to 3.29). Apart from housework and upper body flexibility (OR: 0.39, 95% CI: 0.19 to 0.78), flexibility dimensions did not show any significant associations. CONCLUSIONS While muscle strength dimensions and aerobic endurance were associated with several physical activities, flexibility dimensions were associated with none of the investigated activities apart from housework. Especially cycling and leisure activities (eg, hiking/ running, gym training, aerobics, dancing) showed great potential for sustaining and increasing physical fitness in older age.
Collapse
Affiliation(s)
- Birte Marie Albrecht
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Imke Stalling
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Carina Recke
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Friederike Doerwald
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Karin Bammann
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| |
Collapse
|
25
|
Concha-Cisternas Y, Castro-Piñero J, Leiva-Ordóñez AM, Valdés-Badilla P, Celis-Morales C, Guzmán-Muñoz E. Effects of Neuromuscular Training on Physical Performance in Older People: A Systematic Review. Life (Basel) 2023; 13:life13040869. [PMID: 37109398 PMCID: PMC10147025 DOI: 10.3390/life13040869] [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: 02/01/2023] [Revised: 03/04/2023] [Accepted: 03/18/2023] [Indexed: 04/29/2023] Open
Abstract
This systematic review aimed to assess the available evidence on the effects of neuromuscular training on physical performance in older adults. A literature search was conducted across four databases (Psychology and Behavioral (EBSCO), Scopus, Web of Science and PubMed). The PRISMA guidelines were followed. The PEDro scale and Cochrane risk of bias tool were used to assess the quality of and risk of bias in the studies, respectively. The protocol was registered in PROSPERO (code: CRD42022319239). The outcomes were muscle strength, cardiorespiratory fitness, postural balance and gait speed. From 610 records initially found, 10 were finally included in the systematic review, involving 354 older people with a mean age of 67.3 years. Nine of them reported significant changes in at least one variable related to physical performance in the intervention compared to the control groups. The neuromuscular training caused significant improvements in postural balance, flexibility, cardiorespiratory fitness, strength power of the upper and lower limbs and autonomy. The available evidence indicates that neuromuscular training has a positive effect on some variables of physical performance, especially in postural balance; however, the methodological quality and certainty of the evidence in the available literature are limited. Therefore, a greater number of high-quality studies are required to draw definitive conclusions.
Collapse
Affiliation(s)
- Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca 3460000, Chile
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Ana María Leiva-Ordóñez
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3460000, Chile
- Carrera de Entrenador Deportivo, Escuela de Educación, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca 3460000, Chile
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile
| |
Collapse
|
26
|
Liao CD, Chen HC, Huang MH, Liou TH, Lin CL, Huang SW. Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Int J Mol Sci 2023; 24:ijms24076078. [PMID: 37047058 PMCID: PMC10094194 DOI: 10.3390/ijms24076078] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 04/14/2023] Open
Abstract
Knee osteoarthritis (KOA) is associated with a high risk of sarcopenia. Both intra-articular injections (IAIs) and physical therapy (PT) exert benefits in KOA. This network meta-analysis (NMA) study aimed to identify comparative efficacy among the combined treatments (IAI+PT) in patients with KOA. Seven electronic databases were systematically searched from inception until January 2023 for randomized controlled trials (RCTs) reporting the effects of IAI+PT vs. IAI or PT alone in patients with KOA. All RCTs which had treatment arms of IAI agents (autologous conditioned serum, botulinum neurotoxin type A, corticosteroids, dextrose prolotherapy (DxTP), hyaluronic acid, mesenchymal stem cells (MSC), ozone, platelet-rich plasma, plasma rich in growth factor, and stromal vascular fraction of adipose tissue) in combination with PT (exercise therapy, physical agent modalities (electrotherapy, shockwave therapy, thermal therapy), and physical activity training) were included in this NMA. A control arm receiving placebo IAI or usual care, without any other IAI or PT, was used as the reference group. The selected RCTs were analyzed through a frequentist method of NMA. The main outcomes included pain, global function (GF), and walking capability (WC). Meta-regression analyses were performed to explore potential moderators of the treatment efficacy. We included 80 RCTs (6934 patients) for analyses. Among the ten identified IAI+PT regimens, DxTP plus PT was the most optimal treatment for pain reduction (standard mean difference (SMD) = -2.54) and global function restoration (SMD = 2.28), whereas MSC plus PT was the most effective for enhancing WC recovery (SMD = 2.54). More severe KOA was associated with greater changes in pain (β = -2.52) and WC (β = 2.16) scores. Combined IAI+PT treatments afford more benefits than do their corresponding monotherapies in patients with KOA; however, treatment efficacy is moderated by disease severity.
Collapse
Affiliation(s)
- Chun-De Liao
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110301, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Mao-Hua Huang
- Department of Biochemistry, University of Washington, Seattle, WA 98015, USA
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Che-Li Lin
- Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| |
Collapse
|
27
|
[Levels of physical activity and sitting time in elderly people with fragility: results of the 2016-2017 National Health Survey]. NUTR HOSP 2023; 40:28-34. [PMID: 36537317 DOI: 10.20960/nh.04335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction Background: fragility is characterized by loss of biological reserves and vulnerability to adverse outcomes. An intervention with beneficial effects on the prevention and management of frailty is the regular practice of physical activity (PA). Objective: to determine the association between levels of PA, sedentary time and frailty in older Chileans by sex. Methodology: 232 people over 60 years of age from the metropolitan region participating in the National Health Survey 2016-2017 were included. Frailty was assessed based on the Fried Phenotype Scale criteria and PA level and sedentary time with the Global Physical Activity Questionnaire (GPAQ v2). The association between levels of PA with the different states of frailty was investigated with linear regression analysis. Results and conclusion: elderly people with frailty have less total PA (β = -292.6 min/day [95 % CI: 399.5; -185.7], p = 0.001), occupational PA (β = -5821.8 min/day [95 % CI: 8680.8, -2962.8], p = 0.001), transportation (β = -68.0 min/day [95 % CI: -105.4, -30.62], p = 0.001). A lower amount of moderate AF was also found (β = -137.7 min/day [95 % CI: -202.0, -73.5], p = 0.001); vigorous (β = -43.4 min/day [95 % CI: -81.6; -5.20], p = 0.026) and longer time seated (β = 3.55 hours/day [95 % CI: - 1.97, 5.14], p = 0.001). Frail older people have lower PA levels compared to their peers without frailty. Considering that the Chilean population will experience an increase in the number of older people, it is essential to implement preventive measures to delay the onset of frailty, such as promoting the practice of PA at all levels.
Collapse
|
28
|
Corral-Pérez J, Ávila-Cabeza-de-Vaca L, González-Mariscal A, Espinar-Toledo M, Ponce-González JG, Casals C, Vázquez-Sánchez MÁ. Risk and Protective Factors for Frailty in Pre-Frail and Frail Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3123. [PMID: 36833817 PMCID: PMC9961851 DOI: 10.3390/ijerph20043123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
This study aims to evaluate the differences in body composition, physical function, and physical activity between pre-frail/frail older adults and to detect risk and protective factors against frailty and physical frailty. Fried's criteria for frailty and physical frailty using the short-performance physical battery (SPPB) were measured in 179 older participants (75.3 ± 6.4 years old). Body weight, height, and waist, arm, and leg circumferences were obtained as body composition variables. Daily accelerometer outcomes (physical activity and inactivity) were obtained. Pre-frail participants showed overall better physical function and spent more time in physical activity and less time in long inactivity periods than frail participants (p < 0.05). Risk frailty factors were higher waist perimeter (Odds Ratio [OR]: 1.032, 95%CI: 1.003-1.062), low leg performance (OR: 1.025, 95%CI: 1.008-1.043), and inactivity periods longer than 30 min (OR:1.002, 95%CI: 1.000-1.005). Protective factors were standing balance (OR:0.908, 95%CI: 0.831-0.992) and SPPB score (OR: 0.908, 95%CI: 0.831-0.992) for frailty, handgrip strength (OR: 0.902, 95%CI: 0.844-0.964) for physical frailty, and light (OR: 0.986, 95%CI: 0.976-0.996) and moderate-to-vigorous (OR: 0.983, 95%CI: 0.972-0.996) physical activity for both. Our findings suggest that handgrip strength, balance, and physical activity are protective frailty factors and can be monitored in pre-frail older adults. Moreover, poor lower body performance and long inactivity periods are frailty risk factors, which highlights their importance in frailty assessment.
Collapse
Affiliation(s)
- Juan Corral-Pérez
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Laura Ávila-Cabeza-de-Vaca
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Andrea González-Mariscal
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Milagrosa Espinar-Toledo
- Clinical Management Unit, Malaga-Guadalhorce Health District, Rincón de la Victoria, 29730 Malaga, Spain
| | - Jesús G. Ponce-González
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Cristina Casals
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Puerto Real, 11519 Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA) Research Unit, Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - María Ángeles Vázquez-Sánchez
- Department of Nursing, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- PASOS Research Group, UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, 29071 Malaga, Spain
| |
Collapse
|
29
|
Qin Y, Hao X, Lv M, Zhao X, Wu S, Li K. A global perspective on risk factors for frailty in community-dwelling older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 105:104844. [PMID: 36335672 DOI: 10.1016/j.archger.2022.104844] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Frailty has become an important determinant of a series of adverse health outcomes. We explored the risk factors for frailty in older adults in the community from a global perspective and explore whether there are ethnic differences in these risk factors. METHODS The systematic review and meta-analysis (PROSPERO registration number: CRD42022323342) was searched using six electronic databases, including PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO (EBSCO) and CINAHL (EBSCO) from inception to October 2021. We assessed study eligibility by inclusion and excluded criteria. Cohort studies included were assessed according to the Newcastle-Ottawa Scale. Cross-sectional studies were assessed by the bias risk evaluation standard recommended by the Agency for Health care Research and Quality. The results were reported by a narrative synthesis and pooled analyses. Statistical analyses were performed in Review Manager 5.3 software. RESULTS We reviewed 10870 studies, and 62 studies were included. The results showed a significant association between multidomain risk factors and the frailty of global older adults, including demographic factors, health-related factors, and physical factors. Marital status, depression, risk of malnutrition, history of falls and disease-related symptoms are also risk factors for frailty among older people in Asia. CONCLUSION Multiple domain factors were associated with frailty among older people around the world. Compared with the rest of the world, Asian populations are exposed to more risk factors for frailty. Therefore, health care providers should consider the characteristics of risk factors for frailty in this region when formulating intervention measures related to frailty.
Collapse
Affiliation(s)
- Yuan Qin
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Xiaonan Hao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Miaohua Lv
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Xuetong Zhao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Shuang Wu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Kun Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
| |
Collapse
|
30
|
Roxburgh BH, Cotter JD, Campbell HA, Reymann U, Wilson LC, Gwynne-Jones D, van Rij AM, Thomas KN. Physiological relationship between cardiorespiratory fitness and fitness for surgery: a narrative review. Br J Anaesth 2023; 130:122-132. [PMID: 36529576 DOI: 10.1016/j.bja.2022.10.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/11/2022] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Epidemiological evidence has highlighted a strong relationship between cardiorespiratory fitness and surgical outcomes; specifically, fitter patients possess heightened resilience to withstand the surgical stress response. This narrative review draws on exercise and surgical physiology research to discuss and hypothesise the potential mechanisms by which higher fitness affords perioperative benefit. A higher fitness, as indicated by higher peak rate of oxygen consumption and ability to sustain metabolic homeostasis (i.e. higher anaerobic threshold) is beneficial postoperatively when metabolic demands are increased. However, the associated adaptations with higher fitness, and the related participation in regular exercise or physical activity, might also underpin the observed perioperative benefit through a process of hormesis, a protective adaptive response to the moderate and intermittent stress of exercise. Potential mediators discussed include greater antioxidant capacity, metabolic flexibility, glycaemic control, lean body mass, and improved mood.
Collapse
Affiliation(s)
- Brendon H Roxburgh
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; School of Physical Education, Sport and Exercise Sciences, Dunedin, University of Otago, New Zealand.
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, Dunedin, University of Otago, New Zealand
| | - Holly A Campbell
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Ulla Reymann
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Luke C Wilson
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - David Gwynne-Jones
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Department of Orthopaedic Surgery, Southern District Health Board, Dunedin, New Zealand
| | - Andre M van Rij
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Kate N Thomas
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
31
|
Rulleau T, Planche L, Dorion A, Soldani G, Blain C, Chapeleau C, Bleher Y, Da Silva C, Launeau N, Joguet E, Fevrier R, Decours R. Evaluation of the impact of non-slip socks on the motor recovery of elderly people in acute care hospitals: Protocol for a randomized, controlled trial study. PLoS One 2023; 18:e0283226. [PMID: 37126507 PMCID: PMC10150981 DOI: 10.1371/journal.pone.0283226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/21/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Older patients often arrive in acute care wards with inappropriate footwear. Hospitals may provide non-slip socks to improve the patients' safety. However, few studies have been conducted on the benefits of non-slip socks. A recent literature review found only two randomized controlled studies that evaluated non-slip socks, but the socks were not the primary focus of the studies. The aim of this study is therefore to specifically evaluate the benefits of non-slip socks on gait in hospitalized older people. METHODS This open, randomized, controlled trial will include patients aged 75 years and over, hospitalized in an acute medical unit. Patients will be randomized to either remain barefoot or wear non-slip socks throughout their stay. The primary outcome is gait speed, assessed on Day 1 and Day 8. DISCUSSION This randomized controlled trial should provide clinicians with a scientific rational for the recommendation, or not, of the use of non-slip socks for older patients in acute care hospitals. TRIAL REGISTRATION https://clinicaltrials.gov/ on May 12, 2021 under the reference: NCT04882696 https://clinicaltrials.gov/ct2/show/NCT04882696.
Collapse
Affiliation(s)
- Thomas Rulleau
- Unité de recherche clinique, CHD-Vendée, La Roche Sur Yon, France
- Service de rééducation, CHD-Vendée, La Roche Sur Yon, France
- Service de court séjour gériatrique, CHD-Vendée, La Roche Sur Yon, France
| | - Lucie Planche
- Unité de recherche clinique, CHD-Vendée, La Roche Sur Yon, France
| | - Agnès Dorion
- Unité de recherche clinique, CHD-Vendée, La Roche Sur Yon, France
| | - Girolamo Soldani
- Service de rééducation, CHD-Vendée, La Roche Sur Yon, France
- Service de court séjour gériatrique, CHD-Vendée, La Roche Sur Yon, France
- Service de médecine post-urgence CHD-Vendée, La Roche Sur Yon, France
| | - Cécile Blain
- Service de rééducation, CHD-Vendée, La Roche Sur Yon, France
- Service de médecine post-urgence CHD-Vendée, La Roche Sur Yon, France
| | | | - Yves Bleher
- Service de médecine post-urgence CHD-Vendée, La Roche Sur Yon, France
| | - Cécile Da Silva
- Service de médecine post-urgence CHD-Vendée, La Roche Sur Yon, France
| | - Nathalie Launeau
- Service de médecine post-urgence CHD-Vendée, La Roche Sur Yon, France
| | | | - Ronan Fevrier
- Service de rééducation, CHD-Vendée, La Roche Sur Yon, France
| | - Romain Decours
- Service de rééducation, CHD-Vendée, La Roche Sur Yon, France
| |
Collapse
|
32
|
Tay L, Tay EL, Mah SM, Latib A, Koh C, Ng YS. Association of Intrinsic Capacity with Frailty, Physical Fitness and Adverse Health Outcomes in Community-Dwelling Older Adults. J Frailty Aging 2023; 12:7-15. [PMID: 36629078 PMCID: PMC8966852 DOI: 10.14283/jfa.2022.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/21/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Intrinsic capacity (IC) and frailty are complementary in advancing disability prevention through maintaining functionality. OBJECTIVES We examined the relationship between IC and frailty status at baseline and 1-year, and evaluated if IC decline predicts frailty onset among robust older adults. The secondary objectives investigated associations between IC, physical fitness and health-related outcomes. DESIGN Prospective cohort study. SETTING Community-based assessments. PARTICIPANTS Older adults aged>55 years, who were independent in ambulation (walking aids permitted). MEASUREMENTS 5 domains of IC were assessed at baseline: locomotion (Short Physical Performance Battery, 6-minute walk test), vitality (nutritional status, muscle mass), sensory (self-reported hearing and vision), cognition (self-reported memory, age- and education adjusted cognitive performance), psychological (Geriatric Depression Scale-15, self-reported anxiety/ depression). Composite IC (0-10) was calculated, with higher scores representing greater IC. Frailty status was based on modified Fried criteria, with frailty progression defined as incremental Fried score at 1-year. RESULTS 809 participants (67.6+6.8 years) had complete data for all 5 IC domains. 489 (60.4%) participants were robust but only 213 (26.3%) had no decline in any IC domain. Pre-frail and frail participants were more likely to exhibit decline in all 5 IC domains (p<0.05), with decremental composite IC [9 (8-9), 8 (6-9), 5.5 (4-7.5), p<0.001] across robust, prefrail and frail. IC was significantly associated with fitness performance, independent of age and gender. Higher composite IC reduced risk for frailty progression (OR=0.62, 95% CI 0.48-0.80), and reduced frailty onset among robust older adults (OR=0.53, 95% CI 0.37-0.77), independent of age, comorbidities and social vulnerability. Participants with higher IC were less likely to experience health deterioration (OR=0.70, 95% CI 0.58-0.83), falls (OR=0.76, 95% CI 0.65-0.90) and functional decline (OR=0.64, 95% CI 0.50-0.83) at 1-year. CONCLUSION Declining IC may present before frailty becomes clinically manifest, increasing risk for poor outcomes. Monitoring of IC domains potentially facilitates personalized interventions to avoid progressive frailty.
Collapse
Affiliation(s)
- L Tay
- Dr Laura Tay, Geriatric Medicine, Department of General Medicine, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Phone: +65-69302910,
| | | | | | | | | | | |
Collapse
|
33
|
Kamimoto T, Kawakami M, Morita T, Miyazaki Y, Hijikata N, Akimoto T, Tsujikawa M, Honaga K, Suzuki K, Kondo K, Tsuji T. Effects of the COVID-19 Pandemic on Physical Function of Community-Dwelling People with Disabilities in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12599. [PMID: 36231898 PMCID: PMC9566647 DOI: 10.3390/ijerph191912599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
In 2020, COVID-19 spread throughout the world, and international measures such as travel bans, quarantines, and increased social distancing were implemented. In Japan, the number of infected people increased, and a state of emergency was declared from 16 April to 25 May 2020. Such a change in physical activity could lead to a decline in physical function in people with disabilities. A retrospective study was conducted to determine the impact of the pandemic on the physical function of disabled persons living in the community. Data were collected at four points in time: two points before the declaration of the state of emergency was issued and two points after the declaration period had ended. Time series data of physical function at four points in time were compared for 241 people with disabilities. The mean age was 72.39 years; 157 had stroke, 59 musculoskeletal disease, and 26 other diseases. Overall, there was a long-term decrease in walking speed (p < 0.001) and a worsening of the Timed Up-and-Go (TUG) score (p < 0.001) after the period of the state of emergency. The TUG score worsened only in the group with a walking speed of 1.0 m/s or less before the state of emergency (p = 0.064), suggesting that this group was more susceptible.
Collapse
Affiliation(s)
- Takayuki Kamimoto
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
| | - Towa Morita
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
| | - Yuta Miyazaki
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
- Department of Physical Rehabilitation, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Nanako Hijikata
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, Chiba 277-8577, Japan
| | - Tomonori Akimoto
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
| | - Masahiro Tsujikawa
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
| | - Kaoru Honaga
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | - Kanjiro Suzuki
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
- Department of Rehabilitation Medicine, Waseda Clinic, Miyazaki 880-0933, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba 275-0026, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| |
Collapse
|
34
|
Osuka Y, Kojima N, Sugie M, Omura T, Motokawa K, Ueda T, Maruo K, Ono R, Aoyama T, Inoue S, Kim H, Sasai H. Effects of a home-based Radio-Taiso exercise programme on health-related quality of life in older adults with frailty: protocol for an assessor-blind randomised controlled trial. BMJ Open 2022; 12:e063201. [PMID: 36137626 PMCID: PMC9511584 DOI: 10.1136/bmjopen-2022-063201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Few clinical trials have examined the effects of home-based exercise programmes on health-related quality of life (HR-QoL) in older adults with frailty. Radio-Taiso is the most famous exercise programme in Japan. A home-based Radio-Taiso exercise programme may serve as an accessible, scalable and sustainable care intervention for older adults with frailty. The primary aim of this trial is to test whether older adults with frailty who are prescribed our home-based Radio-Taiso exercise programme will receive greater benefits for HR-QoL compared with those who are not prescribed the exercise programme. Potential mechanisms underlying the effectiveness of the programme and the effects of the programme on daily lifestyle will also be investigated. METHODS AND ANALYSIS This assessor-blind randomised controlled trial will be conducted at the Tokyo Metropolitan Institute of Gerontology (TMIG) in Itabashi-ku, Tokyo, Japan. From April to May 2022, 226 older adults with prefrailty or frailty according to the revised Japanese version of the Cardiovascular Health Study criteria will be included from a large database. After a baseline assessment in June 2022, participants will be randomly assigned to the intervention (home-based Radio-Taiso exercise and nutrition programme) or control (nutrition programme) groups at a 1:1 ratio. After intervention completion, a follow-up assessment will be conducted in September 2022. The primary outcome is the change in the mental domain of HR-QoL assessed using SF-36. Secondary outcomes include physical and role/social domains and subscales of HR-QoL, frailty phenotype, physical fitness, posture, cognition, exercise self-efficacy, depressive symptoms, brain-derived neurotrophic factor, social network, habitual energy intake, physical activity and sleep conditions. ETHICS AND DISSEMINATION The Research Ethics Committee of TMIG has approved the research protocol. This trial will be conducted in accordance with the principles of the Declaration of Helsinki. The findings will be presented at international academic conferences and published in peer-reviewed international journals. TRIAL REGISTRATION NUMBER UMIN000047229.
Collapse
Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Masamitsu Sugie
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Japan
| | - Takuya Omura
- Department of Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Takuya Ueda
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Risa Ono
- Japan Radio-Taiso Federation, Chiyoda-ku, Japan
| | | | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjyuku-ku, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| |
Collapse
|
35
|
Andrew MK, Matthews S, Kim JH, Riley ME, Curran D. An Easy-to-Implement Clinical-Trial Frailty Index Based on Accumulation of Deficits: Validation in Zoster Vaccine Clinical Trials. Clin Interv Aging 2022; 17:1261-1274. [PMID: 36017192 PMCID: PMC9397533 DOI: 10.2147/cia.s364997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/02/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Despite being among those most in need of protection, frail older adults are often not well represented in clinical trials. Although frailty likely influences responses to treatments and vaccines, frailty may not be explicitly considered in trials even when frail participants are enrolled due to the perception that frailty is difficult to measure effectively and efficiently without adding to participant or data collection burden. We developed an easy-to-implement frailty index, the Clinical Trial-Frailty Index (CT-FI), based on baseline medical history and standard patient-reported outcomes using data from clinical trials of recombinant Zoster vaccine (the ZOE-50 and ZOE-70 studies). Our objective was to demonstrate that the CT-FI is a robust measure that may be used retrospectively or prospectively in clinical trials where sufficient patient data have been collected. Methods The CT-FI was based on baseline medical history and Quality of Life questionnaires (SF-36 and EQ-5D). Items meeting criteria for inclusion were scored from 0 to 1, then summed for each participant and divided by the total number of deficits considered. Validation analyses included descriptive verification of distribution and age- and sex-associations in relation to usual patterns of the frailty index, regressions in relation to outcomes hypothesized to be related to frailty, and resampling methods within the index. Results The CT-FI distribution was well represented by a gamma distribution with a range of 0–0.70. Deficit accumulation increased with chronological age and was higher for females. Multivariate Cox regression survival analysis showed that the CT-FI, age, and sex were significant predictors of mortality. Jackknife and Bootstrap resampling methods highlighted the robustness of the CT-FI, which was not sensitive to inclusion/exclusion of specific individual or groups of variables. Conclusion We have developed a reliable, robust and easy-to-implement CT-FI with potential retrospective or prospective application in other clinical trials. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/VbOCDZYBxwI
Collapse
Affiliation(s)
- Melissa K Andrew
- Department of Medicine (Division of Geriatric Medicine), Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | |
Collapse
|
36
|
Cuenca-Zaldivar JN, Monroy Acevedo Á, Fernández-Carnero J, Sánchez-Romero EA, Villafañe JH, Barragán Carballar C. Effects of a Multicomponent Exercise Program on Improving Frailty in Post-COVID-19 Older Adults after Intensive Care Units: A Single-Group Retrospective Cohort Study. BIOLOGY 2022; 11:biology11071084. [PMID: 36101461 PMCID: PMC9313031 DOI: 10.3390/biology11071084] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 12/21/2022]
Abstract
Background: Older adult patients with post-COVID-19 syndrome present greater physical impairment accompanied by frailty than younger patients, which is why multicomponent exercise programs (MEP) are recommended for their positive effects on improving frailty and physical capacity. The aim of this study was to evaluate the effects of a short MEP (Vivifrail; <4 weeks) on improving frailty in post-COVID-19 older adults after intensive care units. Methods: To develop a retrospective cohort study, data were collected from the functional gait training program based on selected Vivifrail MEP in a single-group and applied to patients admitted with a diagnosis of post-COVID-19 functional impairment. The MEP was carried out for 3 weeks, with daily sessions lasting 40 min. Patients included were assessed at the beginning and at the end of the protocol by using the Short Performance Physical Battery (SPPB), the number of falls in the last year, the number of falls with medical attention, the Timed Up and Go (TUG) test, the presence of dementia, the Trunk Control Test (TCT), the Tinetti balance and gait test, Barthel Index, Medical Research Council Sum Score (MRCSS) and handgrip strength dynamometry. Results: The results of this study show statistically significant improvements in physical fitness and frailty with increases in the Short Physical Performance Battery (Z = 9.12, p < 0.001) by means of the MET applied in its short version (<4 weeks) showing even clinically relevant improvements (>2.5 points). Statistically significant improvements were also found in Medical Research Council Sum Score (Z = 12.345, p < 0.001), Barthel Index Score (Z = 12.272, p < 0.001), Trunk Control Test (Z = 12. 36, p < 0.001), Tinetti−POMA (Z = 12.293, p < 0.001) including the balance (Z = 12.11, p < 0.001), gait (Z = 12.164, p < 0.001) subscales and in the hand dynamometry (Z = 12.172, p < 0.001). Conclusions: The selected Vivifrail MEP is effective and safe for improving frailty in post-COVID-19 older adult’s patients.
Collapse
Affiliation(s)
- Juan Nicolás Cuenca-Zaldivar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute—Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain; (J.N.C.-Z.); (Á.M.A.)
- Rehabilitation Service, Guadarrama Hospital, 28440 Madrid, Spain
| | - Álvaro Monroy Acevedo
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute—Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain; (J.N.C.-Z.); (Á.M.A.)
- Rehabilitation Service, Guadarrama Hospital, 28440 Madrid, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Correspondence: (J.F.-C.); (E.A.S.-R.); Tel.: +34-659-70-67-22 (J.F.-C.); +34-617-12-35-63 (E.A.S.-R.); Fax: +34-633-11-53-28 (E.A.S.-R.)
| | - Eleuterio A. Sánchez-Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Correspondence: (J.F.-C.); (E.A.S.-R.); Tel.: +34-659-70-67-22 (J.F.-C.); +34-617-12-35-63 (E.A.S.-R.); Fax: +34-633-11-53-28 (E.A.S.-R.)
| | | | - Carlos Barragán Carballar
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- OnelifeCenter, Multidisciplinary Center for the Prevention and Treatment of Pain, 28924 Alcorcón, Spain
| |
Collapse
|
37
|
Hellec J, Hayotte M, Chorin F, Colson SS, d'Arripe-Longueville F. Applying the UTAUT2 model to smart eyeglasses to detect and prevent falls among older adults and examination of associations with fall-related functional physical capacities: Survey Study (Preprint). J Med Internet Res 2022; 25:e41220. [PMID: 37171835 DOI: 10.2196/41220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/08/2023] [Accepted: 03/12/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND As people age, their physical capacities (eg, walking and balance) decline and the risk of falling rises. Yet, classic fall detection devices are poorly accepted by older adults. Because they often wear eyeglasses as they go about their daily activities, daily monitoring to detect and prevent falls with smart eyeglasses might be more easily accepted. OBJECTIVE On the basis of the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), this study evaluated (1) the acceptability of smart eyeglasses for the detection and prevention of falls by older adults and (2) the associations with selected fall-related functional physical capacities. METHODS A total of 142 volunteer older adults (mean age 74.9 years, SD 6.5 years) completed the UTAUT2 questionnaire adapted for smart eyeglasses and then performed several physical tests: a unipodal balance test with eyes open and closed, a 10-m walk test, and a 6-minute walk test. An unsupervised analysis classified the participants into physical performance groups. Multivariate ANOVAs were performed to identify differences in acceptability constructs according to the performance group. RESULTS The UTAUT2 questionnaire adapted for eyeglasses presented good psychometric properties. Performance expectancy (β=.21, P=.005), social influence (β=.18, P=.007), facilitating conditions (β=.17, P=.04), and habit (β=.40, P<.001) were significant contributors to the behavioral intention to use smart eyeglasses (R²=0.73). The unsupervised analysis based on fall-related functional physical capacities created 3 groups of physical performance: low, intermediate, and high. Effort expectancy in the low performance group (mean 3.99, SD 1.46) was lower than that in the other 2 groups (ie, intermediate: mean 4.68, SD 1.23; high: mean 5.09, SD 1.41). Facilitating conditions in the high performance group (mean 5.39, SD 1.39) were higher than those in the other 2 groups (ie, low: mean 4.31, SD 1.68; intermediate: mean 4.66, SD 1.51). CONCLUSIONS To our knowledge, this study is the first to examine the acceptability of smart eyeglasses in the context of fall detection and prevention in older adults and to associate acceptability with fall-related functional physical capacities. The older adults with higher physical performances, and possibly lower risks of falling, reported greater acceptability of smart eyeglasses for fall prevention and detection than their counterparts exhibiting low physical performances.
Collapse
|
38
|
Chiu TY, Yu HW. Associations of multicomponent exercise and aspects of physical performance with frailty trajectory in older adults. BMC Geriatr 2022; 22:559. [PMID: 35790911 PMCID: PMC9258123 DOI: 10.1186/s12877-022-03246-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has shown that frailty leads to falls, institutionalization, hospitalization, and the loss of functional capacity. While numerous intervention methods aim to reverse frailty, the most effective in older adults is multicomponent exercise. Physical performance has been highlighted as a key factor in mobility, independence, and the burden of chronic disease. Several studies have demonstrated an association between physical performance and frailty; however, the relation between the two over the long term has not yet been fully investigated. Therefore, the current study aims to examine how aspects of physical performance are associated with frailty in the long run for older adults in Taiwan. METHODS This nine-month longitudinal study employed the generalized estimating equation (GEE) modeling to identify measures associated with frailty trajectory. A sample of 159 community-dwelling older adults was recruited through purposive sampling in 12 community care centers in Taiwan. A quasi-experimental approach was adopted in which participants were assigned to the control group or to receive a multicomponent exercise intervention and examined sociodemographic, physical performance, and other factors at the baseline, post intervention (3 months), and follow up (6 months) levels. The multicomponent exercise program was designed based on the principles of the American College of Sports Medicine and comprised aerobic exercise, muscle-strengthening activities, balance training, and stretching exercises once per week for 2 h per session for 12 weeks. RESULTS After intervention, we found that the multicomponent exercise group exhibited better performance in the 2-minute step test than the control group (p < 0.05). Regarding long-term effects on frailty trajectories, the study finds that age progression, being female, and longer completion time in the timed up and go test increase the probability of frailty (p < 0.05). Conversely, more steps in the 2-minute step test and undertaking the multicomponent exercise program reduced the long-term probability of frailty (p < 0.05). CONCLUSIONS This study is the first to explore the relation between indicators of physical performance and frailty trajectory among older adults in Taiwan. Furthermore, we provided support for the efficacy of the multicomponent exercise program in improving frailty status.
Collapse
Affiliation(s)
- Tzu-Ying Chiu
- Department of Health and Welfare, College of City Management, University of Taipei, Taipei City, Taiwan
| | - Hsiao-Wei Yu
- Department of Gerontological Care and Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
- Department of Family Medicine, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan
- Geriatric and Long-term Care Research Center, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| |
Collapse
|
39
|
Arrieta H, Rezola-Pardo C, Sanz B, Virgala J, Lacunza-Zumeta M, Rodriguez-Larrad A, Irazusta J. Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study. Biol Res Nurs 2022; 24:530-540. [PMID: 35574636 DOI: 10.1177/10998004221100797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To compare the capacity of blood myostatin concentration and physical, cognitive, and affective function tests to predict frailty among long-term care (LTC) residents. METHODS This cross-sectional analysis used baseline data from three randomized controlled trials involving 260 older adults in 14 LTC centers. Serum myostatin levels were analyzed by enzyme-linked immunosorbent assay. Frailty, physical fitness, cognitive and affective functions were assessed using validated tests and scales. RESULTS The Timed Up and Go, gait speed, 6-minute walk, and Berg Balance Scale had excellent capabilities in identifying frail individuals in accordance with Fried's Frailty Phenotype (FFP). The best tests for identifying frailty in accordance with the Clinical Frailty Scale (CFS) were Timed Up and Go and Berg Balance Scale. For the Tilburg Frailty Indicator (TFI), the best tests were Quality of Life in Alzheimer's Disease (QoL-AD) and Goldberg Anxiety. Myostatin, along with physical, cognitive, and affective function tests, improved the capability of the hand grip, arm-curl, Montreal Cognitive Assessment, Goldberg Anxiety, Goldberg Depression, and QoL-AD to identify frailty according to FFP, while myostatin improved CFS-defined frailty identification by the hand grip, arm-curl, 6-minute walk test, Berg Balance Scale, 30-second chair-stand, gait speed, Montreal Cognitive Assessment, Goldberg Anxiety, and De Jong-Gierveld Loneliness Scale. CONCLUSION Among LTC residents, serum myostatin was associated with being frail according to FFP and CFS. However, this measure was less discriminating of frailty than physical fitness tests (for FFP and CFS) and affective function parameters (for TFI). However, evaluated concurrently with physical, cognitive, and affective parameters, myostatin improved the capabilities of these measures to predict CFS-defined frailty.
Collapse
Affiliation(s)
- Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Gipuzkoa, Spain
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Janire Virgala
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| |
Collapse
|
40
|
Liu Z, Bu T, Akpinar S, Jabucanin B. The Association Between the China's Economic Development and the Passing Rate of National Physical Fitness Standards for Elderly People Aged 60–69 From 2000 to 2020. Front Public Health 2022; 10:857691. [PMID: 35359759 PMCID: PMC8961805 DOI: 10.3389/fpubh.2022.857691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/11/2022] [Indexed: 11/25/2022] Open
Abstract
Objective According to the seventh demographic census, China's elderly population reached 260 million, accounting for 18.7% of the total population, indicating that China is on the verge of transitioning from a relatively mild aging to a moderately aging society, and an aging society inevitably brings concerns about the elderly people's health. The purpose of this study was to better understand the effect of economic development on the physical fitness of the elderly people aged 60–69 in China during the first two decades of the twenty-first century, as well as to establish a correlation between China's gross domestic product (GDP) and changes in the elderly people's passing rate of national physical fitness standards. Methods A linear regression analysis was performed on the data of GDP and the passing rate of national physical fitness standards of Chinese elderly people aged 60–69 in 2000, 2005, 2010, 2014, and 2020. Results The passing rate of national physical fitness standards for elderly people aged 60–69 increased linearly (R2 = 80.56%, p < 0.05), indicating that the physical fitness of the elderly tends to increase steadily with GDP expansion. Conclusions Between 2000 and 2020, the annual improvement in the physical fitness of the elderly people in China is inextricably linked to rapid economic development. Increased financial investments in public sports services and a corresponding national fitness plan all contribute to an overall improvement in the physical fitness of the elderly people. This outcome is the effect of fiscal and policy coordination, which may represent a distinctive Chinese model and contribution to the global effort to manage and improve population physical fitness.
Collapse
Affiliation(s)
- Zeyong Liu
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Te Bu
- College of Physical Education, Hunan Normal University, Changsha, China
- Te Bu
| | - Selcuk Akpinar
- Faculty of Sports Science, Nevşehir Haci Bektaş Veli University, Nevşehir, Turkey
| | | |
Collapse
|
41
|
Kinematic characteristics during gait in frail older women identified by principal component analysis. Sci Rep 2022; 12:1676. [PMID: 35102162 PMCID: PMC8803892 DOI: 10.1038/s41598-022-04801-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/23/2021] [Indexed: 12/20/2022] Open
Abstract
Frailty is associated with gait variability in several quantitative parameters, including high stride time variability. However, the associations between joint kinematics during walking and increased gait variability with frailty remain unclear. In the current study, principal component analysis was used to identify the key joint kinematics characteristics of gait related to frailty. We analyzed whole kinematic waveforms during the entire gait cycle obtained from the pelvis and lower limb joint angle in 30 older women (frail/prefrail: 15 participants; non-frail: 15 participants). Principal component analysis was conducted using a 60 × 1224 input matrix constructed from participants’ time-normalized pelvic and lower-limb-joint angles along three axes (each leg of 30 participants, 51 time points, four angles, three axes, and two variables). Statistical analyses revealed that only principal component vectors 6 and 9 were related to frailty. Recombining the joint kinematics corresponding to these principal component vectors revealed that frail older women tended to exhibit greater variability of knee- and ankle-joint angles in the sagittal plane while walking compared with non-frail older women. We concluded that greater variability of knee- and ankle-joint angles in the sagittal plane are joint kinematic characteristics of gait related to frailty.
Collapse
|
42
|
Effectiveness of Blood Flow Restriction Training on Muscle Strength and Physical Performance in Older Adults: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2022; 103:1848-1857. [DOI: 10.1016/j.apmr.2021.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/03/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022]
|
43
|
A Sensor-Based mHealth Platform for Remote Monitoring and Intervention of Frailty Patients at Home. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111730. [PMID: 34770244 PMCID: PMC8583636 DOI: 10.3390/ijerph182111730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022]
Abstract
Frailty syndrome is an independent risk factor for serious health episodes, disability, hospitalization, falls, loss of mobility, and cardiovascular disease. Its high reversibility demands personalized interventions among which exercise programs are highly efficient to contribute to its delay. Information technology-based solutions to support frailty have been recently approached, but most of them are focused on assessment and not on intervention. This paper describes a sensor-based mHealth platform integrated in a service-based architecture inside the FRAIL project towards the remote monitoring and intervention of pre-frail and frail patients at home. The aim of this platform is constituting an efficient and scalable system for reducing both the impact of aging and the advance of frailty syndrome. Among the results of this work are: (1) the development of elderly-focused sensors and platform; (2) a technical validation process of the sensor devices and the mHealth platform with young adults; and (3) an assessment of usability and acceptability of the devices with a set of pre-frail and frail patients. After the promising results obtained, future steps of this work involve performing a clinical validation in order to quantify the impact of the platform on health outcomes of frail patients.
Collapse
|
44
|
Soltani A, Abolhassani N, Marques-Vidal P, Aminian K, Vollenweider P, Paraschiv-Ionescu A. Real-world gait speed estimation, frailty and handgrip strength: a cohort-based study. Sci Rep 2021; 11:18966. [PMID: 34556721 PMCID: PMC8460744 DOI: 10.1038/s41598-021-98359-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 08/24/2021] [Indexed: 02/08/2023] Open
Abstract
Gait speed is a reliable outcome measure across multiple diagnoses, recognized as the 6th vital sign. The focus of the present study was on assessment of gait speed in long-term real-life settings with the aim to: (1) demonstrate feasibility in large cohort studies, using data recorded with a wrist-worn accelerometer device; (2) investigate whether the walking speed assessed in the real-world is consistent with expected trends, and associated with clinical scores such as frailty/handgrip strength. This cross-sectional study included n = 2809 participants (1508 women, 1301 men, [45-75] years old), monitored with a wrist-worn device for 13 consecutive days. Validated algorithms were used to detect the gait bouts and estimate speed. A set of metrics were derived from the statistical distribution of speed of gait bouts categorized by duration (short, medium, long). The estimated usual gait speed (1-1.6 m/s) appears consistent with normative values and expected trends with age, gender, BMI and physical activity levels. Speed metrics significantly improved detection of frailty: AUC increase from 0.763 (no speed metrics) to 0.798, 0.800 and 0.793 for the 95th percentile of individual's gait speed for bout durations < 30, 30-120 and > 120 s, respectively (all p < 0.001). Similarly, speed metrics also improved the prediction of handgrip strength: AUC increase from 0.669 (no speed metrics) to 0.696, 0.696 and 0.691 for the 95th percentile of individual's gait speed for bout durations < 30, 30-120 and > 120 s, respectively (all p < 0.001). Forward stepwise regression showed that the 95th percentile speed of gait bouts with medium duration (30-120 s) to be the best predictor for both conditions. The study provides evidence that real-world gait speed can be estimated using a wrist-worn wearable system, and can be used as reliable indicator of age-related functional decline.
Collapse
Affiliation(s)
- Abolfazl Soltani
- grid.5333.60000000121839049Laboratory of Movement Analysis and Measurement (LMAM)
, Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland
| | - Nazanin Abolhassani
- grid.8515.90000 0001 0423 4662Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Pedro Marques-Vidal
- grid.8515.90000 0001 0423 4662Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Kamiar Aminian
- grid.5333.60000000121839049Laboratory of Movement Analysis and Measurement (LMAM)
, Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland
| | - Peter Vollenweider
- grid.8515.90000 0001 0423 4662Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Anisoara Paraschiv-Ionescu
- grid.5333.60000000121839049Laboratory of Movement Analysis and Measurement (LMAM)
, Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland
| |
Collapse
|
45
|
Patrick RP, Johnson TL. Sauna use as a lifestyle practice to extend healthspan. Exp Gerontol 2021; 154:111509. [PMID: 34363927 DOI: 10.1016/j.exger.2021.111509] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Sauna use, sometimes referred to as "sauna bathing," is characterized by short-term passive exposure to high temperatures, typically ranging from 45 °C to 100 °C (113 °F to 212 °F), depending on modality. This exposure elicits mild hyperthermia, inducing a thermoregulatory response involving neuroendocrine, cardiovascular, and cytoprotective mechanisms that work in a synergistic fashion in an attempt to maintain homeostasis. Repeated sauna use acclimates the body to heat and optimizes the body's response to future exposures, likely due to the biological phenomenon known as hormesis. In recent decades, sauna bathing has emerged as a probable means to extend healthspan, based on compelling data from observational, interventional, and mechanistic studies. Of particular interest are the findings from large, prospective, population-based cohort studies of health outcomes among sauna users that identified strong dose-dependent links between sauna use and reduced morbidity and mortality. This review presents an overview of sauna practices; elucidates the body's physiological response to heat stress and the molecular mechanisms that drive the response; enumerates the myriad health benefits associated with sauna use; and describes sauna use concerns.
Collapse
Affiliation(s)
| | - Teresa L Johnson
- TLJ Communications, LLC, 36 Creek Harbour Blvd., Freeport, FL 32439, USA.
| |
Collapse
|
46
|
Howlett SE, Rutenberg AD, Rockwood K. The degree of frailty as a translational measure of health in aging. NATURE AGING 2021; 1:651-665. [PMID: 37117769 DOI: 10.1038/s43587-021-00099-3] [Citation(s) in RCA: 111] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 07/06/2021] [Indexed: 04/30/2023]
Abstract
Frailty is a multiply determined, age-related state of increased risk for adverse health outcomes. We review how the degree of frailty conditions the development of late-life diseases and modifies their expression. The risks for frailty range from subcellular damage to social determinants. These risks are often synergistic-circumstances that favor damage also make repair less likely. We explore how age-related damage and decline in repair result in cellular and molecular deficits that scale up to tissue, organ and system levels, where they are jointly expressed as frailty. The degree of frailty can help to explain the distinction between carrying damage and expressing its usual clinical manifestations. Studying people-and animals-who live with frailty, including them in clinical trials and measuring the impact of the degree of frailty are ways to better understand the diseases of old age and to establish best practices for the care of older adults.
Collapse
Affiliation(s)
- Susan E Howlett
- Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrew D Rutenberg
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kenneth Rockwood
- Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada.
| |
Collapse
|
47
|
Erlandson KM, Piggott DA. Frailty and HIV: Moving from Characterization to Intervention. Curr HIV/AIDS Rep 2021; 18:157-175. [PMID: 33817767 PMCID: PMC8193917 DOI: 10.1007/s11904-021-00554-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW While the characteristics associated with frailty in people with HIV (PWH) have been well described, little is known regarding interventions to slow or reverse frailty. Here we review interventions to prevent or treat frailty in the general population and in people with HIV (PWH). RECENT FINDINGS Frailty interventions have primarily relied on nonpharmacologic interventions (e.g., exercise and nutrition). Although few have addressed frailty, many of these therapies have shown benefit on components of frailty including gait speed, strength, and low activity among PWH. When nonpharmacologic interventions are insufficient, pharmacologic interventions may be necessary. Many interventions have been tested in preclinical models, but few have been tested or shown benefit among older adults with or without HIV. Ultimately, pharmacologic and nonpharmacologic interventions have the potential to improve vulnerability that underlies frailty in PWH, though clinical data is currently sparse.
Collapse
Affiliation(s)
- Kristine M Erlandson
- Department of Medicine, Division of Infectious Diseases, University of Colorado-Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO, 80045, USA.
- Department of Epidemiology, Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA.
| | - Damani A Piggott
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| |
Collapse
|
48
|
Ramírez-Vélez R, Rincón-Pabón D, Correa-Bautista JE, García-Hermoso A, Izquierdo M. Handgrip strength: Normative reference values in males and females aged 6-64 Years old in a Colombian population. Clin Nutr ESPEN 2021; 44:379-386. [PMID: 34330493 DOI: 10.1016/j.clnesp.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Handgrip strength (HGS) is an indicator of overall strength; therefore, individual HGS measurements should be interpreted using geographic region and ethnic group references. AIMS The aim of this study was to develop new normative values for absolute and relative HGS in the Colombian population after stratification by sex, age, and body mass using the large National Representative Nutrition Survey 2015. METHODS This cross-sectional study included 3803 subjects aged 6-64 years. Absolute HGS was measured using a hand dynamometer with an adjustable grip, and normalized HGS was calculated by dividing the HGS by body mass. Smoothed centile tables for the P3, P10, P25, P50, P75, P90, and P97 centiles were calculated using Cole's lambda-mu-sigma (LMS) method. This study used a cutoff at 2 standard deviations (SDs) below the sex-specific peak mean value across the life course to define weak, absolute and relative HGS. RESULTS In men, HGS peaked at 26-33 years of age (~43.0 kg in P50), especially in the upper centiles, and fell away quickly. The pattern was different in females, where this value peaked at ages 25-33 (~26.0 kg in P50). We found a curvilinear pattern for HGS that declined with age in both sexes. There was significant variation in the slope for HGS in men and women around the age of 25 and 35 years, respectively. CONCLUSION The normative values presented here are a valuable source of information for the clinical assessment of HGS and for comparison with studies from other countries.
Collapse
Affiliation(s)
- Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, 31008, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
| | - David Rincón-Pabón
- ZIPATEFI (Zona de Investigaciones de Posgrados, Terapia Respiratoria y Fisioterapia de Areandina), Fundación Universitaria del Área Andina, Pereira, 110231, Colombia.
| | - Jorge E Correa-Bautista
- Grupo Rendimiento Físico Militar "RENFIMIL", Escuela Militar de Cadetes "General José María Córdova", Bogotá, 111211, Colombia.
| | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, 31008, Spain; Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, 7500618, Chile.
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, 31008, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|