Decline of Functional Capacity in Healthy Aging Workers

Musculoskeletal complaints, physical work demands, and functional capacity in individuals with a brachial plexus injury: An exploratory study

BACKGROUND

Musculoskeletal complaints (MSCs) may be more common in individuals with brachial plexus injury (BPI), whose physical work demands exceed their functional capacity (FC).

OBJECTIVES

(a) To assess the concurrent validity of five methods for measuring upper extremity work demands and the Dictionary of Occupational Titles (DOT). (b) To explore the relations between MSCs, physical work demands, and FC in individuals with BPI.

METHODS

This study had a descriptive correlational design. Physical work demands of 16 individuals with BPI (12 males, 6 one-handed workers) were assessed during work using five assessment methods and the DOT. Spearman correlation coefficients between work demand methods were determined. FC was assessed using the functional capacity evaluation one-handed (FCE-OH). A questionnaire was used to examine MSCs. The relationship between MSCs, physical work demands and FC was analyzed visually, using Spearman correlation coefficients, and by comparing FCE-OH results to FCE reference values.

RESULTS

Spearman correlation coefficients for the DOT and four out of five assessment methods for determining work demands on upper extremities were significant and moderate (four combinations: r = 0.65-0.79) to strong (five combinations: r = 0.81-0.94). Correlations of the fifth method with the other methods were weak to fair. No significant relationships were found between MSCs, physical work demands and FCE-OH results.

CONCLUSION

The relationships between MSCs, physical work demands, and FC are evidently complex and require further investigation. In this small sample the concurrent validity of the DOT and four methods for determining work demands on upper extremities was moderate to good.

Occupational Injuries Among Construction Workers by Age and Related Economic Loss: Findings From Ohio Workers' Compensation, USA: 2007-2017

Background

This study examined age-group differences in the rate, severity, and cost of injuries among construction workers to support evidence-based worker safety and health interventions in the construction industry.

Methods

Ohio workers' compensation claims for construction workers were used to estimate claim rates and costs by age group. We analyzed claims data auto-coded into five event/exposure categories: transportation incidents; slips, trips, and falls (STFs); exposure to harmful substances and environments; contact with objects and equipment (COB); overexertion and bodily reaction. American Community Survey data were used to determine the percentage of workers in each age group.

Results

From 2007-2017, among 72,416 accepted injury claims for ∼166,000 construction full-time equivalent (FTE) per year, nearly half were caused by COB, followed by STFs (20%) and overexertion (20%). Claim rates related to COB and exposure to harmful substances and environments were highest among those 18-24 years old, with claim rates of 313.5 and 25.9 per 10,000 FTE, respectively. STFs increased with age, with the highest claim rates for those 55-64 years old (94.2 claims per 10,000 FTE). Overexertion claim rates increased and then declined with age, with the highest claim rate for those 35-44 years old (87.3 per 10,000 FTE). While younger workers had higher injury rates, older workers had higher proportions of lost-time claims and higher costs per claim. The total cost per FTE was highest for those 45-54 years old ($1,122 per FTE).

Conclusion

The variation in rates of injury types by age suggests that age-specific prevention strategies may be useful.

Personal and Work-Oriented Characteristics Distinguishing Older Nurses' Partial or Complete Actual Retirement Behavior over Three Years

To retain nurses and prevent worsening the nursing shortage, a key opportunity is to better understand the drivers of complete and partial retirement of older nurses. This study investigates the characteristics that distinguish older nurses' partial and complete actual retirement behavior, from those continuing to work, over a three-year period. A quantitative longitudinal design comprising 217 female Australian nurses aged 50 years or over, from two samples working at Time 1 (2012 and 2016), responding three years later (Time 2). Multinomial regression found two different patterns of drivers for each of completely retiring and partly retiring respectively. Age was the only variable distinguishing both partly and completely retired nurses from nurses who were not retired. The further variables distinguishing completely retired nurses were not being prosperous, having impaired work ability, being partnered, not stressed at work and working part-time. The only variable beyond age distinguishing partly retired nurses was having a casual contract. Offering flexible work options in terms of working hours and contracts that suit the nurse's lifestyle and supporting nurses with health impairments to continue working are options that may lessen the number of nurses completely retiring and instead either remaining at work or partly retiring.

Increased physical workload in home care service is associated with reduced recovery from work

OBJECTIVE

This study investigated the physical workload of home care service workers and determined whether the different intensities of physical work strain experienced by home care nurses have different impacts on their recovery from work.

METHODS

Physical workload and recovery were measured among 95 home care nurses based on heart rate (HR) and heart rate variability (HRV) recordings during one work shift and the following night. Differences in the physical work strain were compared between younger (≤ 44-year-old) and older (≥ 45-year-old) employees and between morning and evening shifts. To determine the effects of occupational physical activity on recovery, HRV at all time points (during the workday, when awake and asleep, and whole measurement) in relation to the amount of occupational physical activity was examined.

RESULTS

The average physiological strain during the work shift, measured as metabolic equivalent (MET), was 1.8 ± 0.5. Moreover, the occupational physical demands in relation to maximal capacity were higher for the older employees. The results of the study showed that a higher occupational physical workload reduced the HRV of home care workers during the workday, leisure time, and sleep.

CONCLUSIONS

These data indicate that increased occupational physical workload is associated with reduced recovery among home care workers. Therefore, decreasing occupational strain and ensuring sufficient recovery is recommended.

Cumulative Health Drivers of Overnight Hospitalization for Australian Working-Age Adults Living Alone: The Early Warning Potential of Functionality

There is a need to better understand the drivers of hospital utilization for the large and growing number of adults living alone. The cumulative effect of health drivers can be assessed by initially considering clinically advised information, then considering issues that a general practitioner or the person themselves may know. Logistic regression analyses were conducted on longitudinal data from the Household, Income, and Labor Dynamics in Australia (HILDA) survey with three time points over four years (n = 1019). The significant predictors of overnight hospitalization were the presence of a long-term health condition (Time 1), hospitalization severity and comorbidity (Time 1), work ability (Time 2), physical functioning (Time 2), being separated/divorced and having one or more health care cards. Health issues were predictive up to four years before the hospitalization window. That baseline risk of hospitalization was modified as symptoms and relatively salient changes in functionality accumulated. Specific sub-groups of hospital users had access due to insurance or special coverage. The impact of living alone on hospitalization may be able to be partly addressed through interventions such as improving access to primary care and using early warning triggers such as decreasing functionality to seek primary care before seeking hospitalization.

Prospective Drivers of Nurses' Partial or Complete Retirement Seven Years Later: Work Ability and Physical Functioning Going against the Tide of Age

In the context of a nursing shortage in many developed countries, one option for retaining the expertise of older nurses in the workforce is to better manage the retirement of nurses. This study will investigate life course predictors of actual retirement behavior, whether partial or complete, for older working nurses over a seven-year span. Data were analyzed from a quantitative, longitudinal survey of 178 Australian nurses aged 45 years and older working at Time 1 (2012), who responded seven years later (Time 2). Age predicted both forms of retirement behavior, confirming the strength of social normative pressures toward retirement. Moving against this social normative tide toward retirement were the predictors of partial retirement such as job satisfaction, physical functioning and work ability. In turn, working part-time was the only predictor, beyond age, of complete retirement. Nurse and health service managers could support nurses to stand against the tide of social normative pressures (until such social norms change) by managing the nurses' physical functioning and work ability, including by more explicitly managing the impacts of chronic diseases in the workplace, not least so as to retain their nurses in the context of nurse shortages.

The role of work conditions on the functional decline in senior workers in the automotive industry

BACKGROUND: The aging of the workforce is changing, but working conditions have not changed at the same exponential growth rate for senior workers. Such a situation can compromise the worker’s physical and cognitive capability, reducing the ability to perform work activities. OBJECTIVES: This study aims to understand the main functional capacity changes in senior workers in the automotive industry and to determine the contribution of working conditions on the decline of the functional capacity in senior workers. METHODS: To achieve the objectives of the study, a set of questionnaires (Sociodemographic Data, COPSOQ, Nordic Questionnaire, and Par-Q) and a battery of 4 functional capacity tests were used. Results: Work conditions, namely awkward postures, force demands and manual material handling, and age, were statistically associated to the functional decline in workers. Additionally, multiple linear regression showed that height, weight, seniority, and strength have predictive value to the handgrip decline (both positions HG2 and HG5). CONCLUSION: These results suggest that workers’ handgrip assessment should be considered as a future measure as an indicator of strength ability in the occupational field.

Use of wearable sensors to assess patterns of trunk flexion in young and old workers in the Metalworking Industry

Workers exposed to repeated trunk flexions are at risk of onset of low-back disorders and in individuals aged over 50 this issue is exacerbated by the physiologic decline of the musculoskeletal system and longer lifetime occupational exposure. In this study, we investigated the existence of possible age-related differences in patterns of trunk flexion of workers in the metalworking industry. Thirty-three subjects were monitored during an actual shift using a wearable Inertial Measurement Unit (IMU) to assess trunk flexion angles (i.e. between 30° and 60°, 60°-90° and > 90°). Results show that older workers spent less time with their trunk flexed, regardless of the class of flexion considered, with respect to their younger colleagues. Although further studies are necessary to clarify the existence of strategies aimed at optimising trunk movements during ageing, the IMU-based approach appears useful in highlighting potentially harmful conditions, especially in workers with marked signs of decline in their physical capacities. Practitioner summary: Wearable sensors, which are well tolerated and minimally intrusive, represent a valid option to continuously monitor trunk posture in workers employed in metalworking industry. The results of this study show that they provide valuable information about the patterns of flexion of young and old individuals engaged in physically demanding tasks.

Regression model for predicting low work ability among sedentary aging workers

BACKGROUND

Work ability is the physical and psychological capacity of workers to meet the demands of a job; it declines with age, and the effect is multiplied in a sedentary job. Early detection of workers at risk would help to improve their functional capacity and work efficiency.

OBJECTIVE

To identify factors and develop a prediction model for low work ability among sedentary aging office workers.

METHODS

In this case-control study, work ability among sedentary aging workers was evaluated using a Work Ability Questionnaire (WAQ). The worker's age, gender, BMI, marital status, years at work, diabetes, hypertension, diagnosed medical condition, musculoskeletal problems, medicine intake, menopause, physical activity, sedentary work behaviour and six job-related tasks were recorded. Multiple logistic regression was performed, and the odds ratio was calculated for the variables assessed.

RESULTS

One hundred and fifty seven sedentary aging workers were assessed for 19 independent factors. BMI and years at work in the demographic domain, diagnosed medical condition and intake of medicine in the health-related domain and handgrip strength in the task domain were found to have a statistically significant odds ratio for poor work ability.

CONCLUSIONS

The study identified factors influencing work ability among sedentary aging workers and a prediction model was developed.

Health-related physical fitness in patients with complaints of hand, wrist, forearm and elbow: an exploratory study

Objectives

Little is known about the physical fitness of patients with complaints of hand, wrist, forearm and/or elbow and its possible determinants. Aims were to assess health-related physical fitness (HRPF) in these patients, to compare HRPF with reference values of healthy persons, and to explore whether HRPF was correlated with symptom severity, upper limb function (ULF) and physical activity (PA).

Methods

Cardiorespiratory fitness, handgrip strength and body composition, self-reported symptom severity, ULF and PA were assessed in adult outpatients with complaints of hand, wrist, forearm and/or elbow diagnosed as CANS.

Results

Measurements were completed in 25 subjects (8 males) aged 46.1±14.5 years, of which 44% had specific CANS and 56% had non-specific CANS.

Peak oxygen consumption (VO₂peak) of men was 2978±983 mL/min and of women was 1978±265 mL/min. Handgrip strength of men was 47.0±11.1 kgf and of women was 32.4±6.3 kgf. Body mass index (BMI) of men was 24.2±2.6 kg/m² and of women was 27.4±6.1 kg/m².

VO₂peak of the study sample was lower than that of healthy adults (−414±510 mL/min, p<0.001). Handgrip strength and BMI were similar to reference values.

VO₂peak was correlated with PA (r=0.58, p=0.004); BMI was correlated with disability (r=0.48, p=0.022). Other correlations between HRPF and symptom severity and ULF were non-significant.

Conclusions

Patients with CANS have lower cardiorespiratory fitness, but similar handgrip strength and body composition, compared with the healthy population. Cardiorespiratory fitness was correlated with PA and BMI was correlated with disability, no other correlations were observed with symptom severity and ULF.

Forces: A Motion Capture-Based Ergonomic Method for the Today's World

Approximately three of every five workers are affected by musculoskeletal disorders, especially in production environments. In this regard, workstation ergonomic evaluations are especially beneficial for conducting preventive actions. Nevertheless, today's context demonstrates that traditional ergonomic methods should lead to smart ergonomic methods. This document introduces the Forces ergonomic method, designed considering the possibilities of inertial motion capture technology and its applicability to evaluating actual workstations. This method calculates the joint risks for each posture and provides the total risk for the assessed workstation. In this calculation, Forces uses postural measurement and a kinetic estimation of all forces and torques that the joints support during movement. This paper details the method's fundamentals to achieve structural validity, demonstrating that all parts that compose it are logical and well-founded. This method aims to aid prevention technicians in focusing on what matters: making decisions to improve workers' health. Likewise, it aims to answer the current industry needs and reduce musculoskeletal disorders caused by repetitive tasks and lower the social, economic, and productivity losses that such disorders entail.

Insights into the Sustainable Return to Work of Aging Workers with a Work Disability: An Interpretative Description Study

Purpose A sustainable return to work (S-RTW) following prolonged work disability poses particular challenges as workers age. This article provides a synthesis of the factors and issues involved in a S-RTW process for aging workers following such a disability. Methods Using interpretive description methods, a critical review was conducted of the literature specifying return-to-work factors and issues for aging workers with regard to four major causes of work disability (musculoskeletal disorders, common mental disorders, cancer or other chronic diseases). The initial review concerned the 2000-2016 literature, and was subsequently updated for November 2016-December 2018. To further explore and contextualise the results of this literature review, four focus groups were held with stakeholders, representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. Results Fifty-five articles were reviewed and 35 stakeholders participated in the focus groups. Returning to work and staying at work appear to be particularly challenging for aging workers, who face notable issues and stigma concerning their ability to meet work demands, as well as their mobilisation and engagement in these processes. Such findings echo in many ways the main assertions of the literature on aging at work, except those regarding the transformation of capacities with aging, which is not mentioned in relation to workers with a work disability. The influence of healthcare and compensation systems on the S-RTW of aging work-disabled workers has also received little attention to date. Conclusions The results underscore that aging workers with a disability are frequently vulnerable in terms of their health or their jobs. Intersectoral efforts are needed to remedy this situation to keep them at work.

Mediterranean Diet In Healthy Aging

The World elderly population is expected to double before 2050. Unhealthy habits and unhealthy lifestyles are commonly associated with age-related diseases or their worsening. Modification in daily lifestyle and diet may help preventing age-related diseases onset and efficiently affecting their evolution, thus promoting the Healthy Aging process, concept recently coined to describe the disease-free aging process. This review highlights the role of nutrition science in promoting healthy aging. Since the Mediterranean Model demonstrated to be a useful style in supporting healthy aging, promotion of this correct lifestyle by health policies seems to be the best approach to achieve this target.

The association between changes in functional capacity and work ability among unemployed individuals

PURPOSE

Unemployment has multidimensional effects. This study investigated how the changes in functioning are associated with the changes in perceived work ability among unemployed people.

METHODS

The participants were clients in projects funded by the European Social Fund (ESF) targeted for unemployed individuals. They answered a questionnaire covering work ability (Work Ability Score) and functioning (cognitive, psychological and social functioning, physical condition and everyday activities) and perceived health at the beginning and at the end of the project (mean follow-up 173 days). The study included data from unemployed respondents (N = 502) aged 19-64 years.

RESULTS

Overall, during the follow-up, both work ability and different aspects of functioning improved, excluding physical condition. Changes in cognitive and psychological functioning, physical condition and everyday activities were significantly associated with the changes in work ability. The physical condition had the strongest association with the changes in work ability. Short unemployment time and especially good perceived health improved WAS over time. Age, gender and follow-up time were not associated with changes in work ability.

CONCLUSIONS

Maintaining or improving health and functioning and shortening the length of unemployment appeared to be important issues in enhancing work ability and thus increasing re-employability potential.

Trajectories of Physical Work Capacity in Early Symptomatic Osteoarthritis of Hip and Knee: Results from the Cohort Hip and Cohort Knee (CHECK) Study

Purpose To evaluate the 5-year course of physical work capacity of participants with early symptomatic osteoarthritis (OA) of the hip and/or the knee; to identify trajectories and explore the relationship between trajectories and covariates. Methods In a prospective cohort study, physical work capacity was measured at baseline, using a test protocol (functional capacity evaluation) consisting of work-related physical activities. Participants were invited to participate in 1, 2 and 5 year follow-up measurements. Multilevel analysis and latent classes analysis were performed, in models with test performances as dependent variables and age, sex, work status, self-reported function (Western Ontario McMasters Arthritis Scale-WOMAC), body mass index (BMI) and time as independent variables. Multiple imputation was used to control for the influence of missing data. Results At baseline and after 1, 2 and 5 years there were 96, 64, 61 and 35 participants. Mean (SD) age at baseline was 56 (4.9) years, 84% were females. There was no statistically significant change in test performances (lifting low and high, carrying, static overhead work, repetitive bending, repetitive rotations) between the 4 measurements. Male sex, younger age and better self-reported function were statistically significant (p < 0.05) determinants of higher performance on most of the tests; having a paid job, BMI and progression of time were not. Three trajectories were identified: 'weak giving way', 'stable and able', and 'strong with decline'. Discussion In subgroups of participants with early symptomatic OA, determined by age, sex and self-reported function, physical work capacity seems to be a stable characteristic over 5 years.

Implementing sensor technology applications for workplace health promotion: a needs assessment among workers with physically demanding work

Background

Workers with physically demanding work may be at risk for injury, illness or other adverse health outcomes due to exposure to different occupational hazards, especially at higher age. Sensor technology applications may be useful in the workplace to unobtrusively measure and monitor work exposures and provide workers with real-time feedback or access to data on demand. Many aspects might impede the implementation of sensor technology applications in the workplace, which should be taken into consideration for a successful implementation. Moreover, needs and preferences of workers regarding the use of sensor technology applications during work performance need to be identified. Therefore, the aim of this study was to identify worker needs and preferences regarding the use of sensor technology applications in the workplace.

Methods

Four on-site focus group sessions were conducted in four different companies among workers with physically demanding work (n = 30). Semi-structured interview schedules were used to identify which work exposures should be measured, by which kind of sensor technology applications, under which (pre)conditions, how to motivate long-term use of sensor technology applications, and which type of feedback is preferred. For data analysis, a content-analysis with an inductive approach was performed.

Results

Participants mentioned that they want to use wearable sensor technology applications to measure and monitor physical job demands, occupational heat stress, noise and fatigue. Factors associated with quality, comfort and perceived ease of use were identified as potential barriers for implementation in the workplace. Long-term motivation was attributed to the ability to manage and monitor work exposures, positive feedback and data ownership. Participants indicated a need to both receive real-time feedback and access to data on demand.

Conclusions

Sensor technology applications may support workers with physically demanding work to measure and monitor their work exposures. Potential barriers for implementation such as privacy aspects and quality, comfort and perceived ease of use of sensor technology applications need to be well considered to ensure successful implementation of sensor technology applications in the workplace.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7364-2) contains supplementary material, which is available to authorized users.

Physical capacity, occupational physical demands, and relative physical strain of older employees in construction and healthcare

Purpose

To assess age-related differences in physical capacity, occupational physical demands, and relative physical strain at a group level, and the balance between capacity and demands at an individual level, for construction and healthcare workers.

Methods

Shoulder strength, back strength, and aerobic capacity were assessed among construction (n = 62) and healthcare workers (n = 64). During a full working day, accelerometers estimated upper-arm elevation, trunk flexion, and occupational physical activity as indicators of occupational physical demands. Simultaneously, normalised surface electromyography (%sEMG_max) of the upper trapezius and erector spinae muscles, and normalised electrocardiography (percentage heart rate reserve (%HRR)) estimated relative physical strain. Differences between younger (≤ 44 years) and older (≥ 45 years) workers, as well as the moderating effect of age on the associations between capacity and demands, were analysed per sector.

Results

Compared to younger workers, older workers had similar strength and lower aerobic capacity; older construction workers had similar demands while older healthcare workers had higher demands. Compared to younger workers, older employees had unfavourable muscle activity patterns; %HRR had a tendency to be lower for older construction workers and higher for older healthcare workers. Among construction workers, age moderated the associations between shoulder strength and arm elevation (p = 0.021), and between aerobic capacity and occupational physical activity (p = 0.040). Age did not moderate these associations among healthcare workers.

Conclusions

In both sectors, the level of occupational physical demands and the higher relative physical strain in older employees require addressing to promote sustainable work participation among an aging population.

Electronic supplementary material

The online version of this article (10.1007/s00420-018-1377-5) contains supplementary material, which is available to authorized users.

Fatores associados à ótima capacidade para o trabalho em servidores idosos de uma universidade no Sul do Brasil

Resumo Objetivo: investigar a associação entre o índice de capacidade para o trabalho e os fatores sociodemográficos, ocupacionais, estilo de vida e saúde em idosos. Métodos: estudo transversal, com amostra de servidores idosos de uma instituição de ensino superior. Foram coletadas informações sociodemográficas e dados referentes a comportamento social, saúde, e trabalho. Utilizou-se análise uni e multivariada pelo Modelo de Regressão Logística para determinar os fatores associados à ótima capacidade para o trabalho. Resultados: na amostra prevaleceram os homens (57,8%), entre 60 e 64 anos (75,6%), com ensino superior (57,8%). A maioria declarou ser sedentária (89,1%) e com exigência mental de trabalho (62,8%). Mais da metade da amostra era de idosos em sobrepeso (53%), que relataram quedas (21,3%) e uso regular de múltiplos medicamentos (25,6%). As variáveis associadas à menor chance de ótima capacidade para o trabalho foram sexo feminino (OR=0,39; IC95%=0,18-0,83); cor não branca (OR=0,37; IC95%=0,16-0,84); exigência física para o trabalho (OR=0,40; IC95%=0,17-0,97); hospitalização (OR=0,14; IC95%=0,03-0,57); dificuldades no sono (OR=0,12; IC95%=0,04-0,43); autopercepção de saúde ruim (OR=0,22; IC95%=0,09-0,54); queixas de sintomas osteomusculares nos últimos 7 dias (OR=0,29, IC95%=0,10-0,87); e sintomas que comprometem o trabalho (OR=0,25; IC95%=0,08-0,82). Conclusão: fatores sociodemográficos, ocupacionais e condição de saúde comprometeram a ótima capacidade para o trabalho em idosos.

Cross-sectional and longitudinal analyses of the association between lung function and exercise capacity in healthy Norwegian men

BACKGROUND

It is widely accepted that exercise capacity in healthy individuals is limited by the cardiac function, while the respiratory system is considered oversized. Although there is physiological, age-related decline in both lung function and physical capacity, the association between decline in lung function and decline in exercise capacity is little studied. Therefore, we examined the longitudinal association between lung function indices and exercise capacity, assessed by the total amount of work performed on a standardized incremental test, in a cohort of middle-aged men.

METHODS

A total of 745 men between 40 and 59 years were examined using spirometry and standardized bicycle exercise ECG test within "The Oslo Ischemia Study," at two time points: once during 1972-1975, and again, approximately 16 years later, during 1989-1990. The subjects exercise capacity was assessed as physical fitness i.e. the total bicycle work (in Joules) at all workloads divided by bodyweight (in kg).

RESULTS

Higher FEV₁, FVC and PEF values related to higher physical fitness at both baseline and follow-up (all p values < 0.05). Higher explanatory values were found at follow-up than baseline for FEV₁ (r² = 0.16 vs. r² = 0.03), FVC (r² = 0.14 vs. r² = 0.03) and PEF (r² = 0.13 vs. r² = 0.02). No significant correlations were found between decline in physical fitness and declines in FEV₁, FVC or PEF.

CONCLUSIONS

A weak association between lung function indices and exercise capacity, assessed through physical fitness, was found in middle-aged, healthy men. This association was strengthened with increasing age, suggesting a larger role for lung function in limiting exercise capacity among elderly subjects. However, decline in physical fitness over time was not related to decline in lung function.

Factors associated with work ability in the elderly: systematic review

OBJECTIVE

To synthesize the evidence on factors associated with the maintenance of work ability during the aging process.

METHODS

SciELO, LILACS and PubMed databases were consulted, in order to find out studies in Portuguese, English and Spanish published from 2000 to 2013. Descriptors which encompassed terms related to work ability, aging and elderly were used. Quantitative observational studies were included to investigate the work ability and the effect of aging. Studies aiming at analyzing the clinical course of illnesses related to aging and/or papers and publications in the form of editorials, interviews, projects, clinical notes and preliminary or conceptual data were excluded.

RESULTS

A total of 924 articles were obtained, but 27 were included in the analyses. Later on, 2 intervention and 8 repeated studies were excluded. Variables that showed negative correlations with work ability were the following: age, smoking, service time and physical demands in occupational activities. Satisfaction with life, sufficient income, physical activity, volunteerism and mental workload were considered positive associations that protect the elderly from functional loss.

CONCLUSION

This study was reported as a protective mechanism against depression, disability and fragility, maintaining the well-being, good cognitive function and autonomy in daily activities. Increased investments in the health care of this population are needed regarding musculoskeletal and cardiorespiratory capacity. Physical activity must be encouraged by policies to foster health promotion.

Lumbar intervertebral discs T2 relaxometry and T1ρ relaxometry correlation with age in asymptomatic young adults

BACKGROUND

To investigate the detection of intervertebral disc (IVD) composition aging-related changes using T2 and T1ρ relaxometry in vivo in asymptomatic young adults.

METHODS

We recruited ninety asymptomatic and young adults (42 men and 48 women) between 20 and 40 years old. T2 and T1ρ lumbar spine mappings were acquired using 1.5 T magnetic resonance imaging (MRI) scanner. Two independent observers manually segmented 450 lumbar discs in all slices. They also performed sub region segmentation of annulus fibrosus (AF) and nucleus pulposus (NP) at the central MRI sagittal slices.

RESULTS

There was no difference between men and women for T2 (P=0.37) or T1ρ relaxometry (P=0.97). There was a negative correlation between age (20-40 years) and IVD T2 relaxation time of the whole disc (r=-0.30, P<0.0001), NP (r=-0.20 to -0.51, P<0.05) and posterior AF (r=-0.21 to -0.31, P<0.05) at all lumbar disc levels. There was no statistical correlation between aging and IVD T1ρ relaxation both for NP and AF.

CONCLUSIONS

T2 relaxometry detected gradual IVD dehydration in the first two decades of adulthood. We observed no significant variation of T1ρ or volumetry with aging in our study group. Our results suggest that T2 mapping may be more appropriate to detect early IVD aging changes.

Age, human performance, and physical employment standards

The proportion of older workers has increased substantially in recent years, with over 25% of the Canadian labour force aged ≥55 years. Along with chronological age comes age-related declines in functional capacity associated with impairments to the cardiorespiratory and muscular systems. As a result, older workers are reported to exhibit reductions in work output and in the ability to perform and/or sustain the required effort when performing work tasks. However, research has presented some conflicting views on the consequences of aging in the workforce, as physically demanding occupations can be associated with improved or maintained physical function. Furthermore, the current methods for evaluating physical function in older workers often lack specificity and relevance to the actual work tasks, leading to an underestimation of physical capacity in the older worker. Nevertheless, industry often lacks the appropriate information and/or tools to accommodate the aging workforce, particularly in the context of physical employment standards. Ultimately, if appropriate workplace strategies and work performance standards are adopted to optimize the strengths and protect against the vulnerability of the aging workers, they can perform as effectively as their younger counterparts. Our aim in this review is to evaluate the impact of different individual (including physiological decline, chronic disease, lifestyle, and physical activity) and occupational (including shift work, sleep deprivation, and cold/heat exposure) factors on the physical decline of older workers, and therefore the risk of work-related injuries or illness.

Differences in physical aging measured by walking speed: evidence from the English Longitudinal Study of Ageing

BACKGROUND

Physical functioning and mobility of older populations are of increasing interest when populations are aging. Lower body functioning such as walking is a fundamental part of many actions in daily life. Limitations in mobility threaten independent living as well as quality of life in old age. In this study we examine differences in physical aging and convert those differences into the everyday measure of single years of age.

METHODS

We use the English Longitudinal Study of Ageing, which was collected biennially between 2002 and 2012. Data on physical performance, health as well as information on economics and demographics of participants were collected. Lower body performance was assessed with two timed walks at normal pace each of 8 ft (2.4 m) of survey participants aged at least 60 years. We employed growth curve models to study differences in physical aging and followed the characteristic-based age approach to illustrate those differences in single years of age.

RESULTS

First, we examined walking speed of about 11,700 English individuals, and identified differences in aging trajectories by sex and other characteristics (e.g. education, occupation, regional wealth). Interestingly, higher educated and non-manual workers outperformed their counterparts for both men and women. Moreover, we transformed the differences between subpopulations into single years of age to demonstrate the magnitude of those gaps, which appear particularly high at early older ages.

CONCLUSIONS

This paper expands research on aging and physical performance. In conclusion, higher education provides an advantage in walking of up to 15 years for men and 10 years for women. Thus, enhancements in higher education have the potential to ensure better mobility and independent living in old age for a longer period.

Sleep-dependent motor memory consolidation in older adults depends on task demands

It is often suggested that sleep-dependent consolidation of motor learning is impaired in older adults. The current study challenges this view and suggests that the degree of motor consolidation seen with sleep in older age groups depends on the kinematic demands of the task. We show that, when tested with a classic sequence learning task, requiring individuated finger movements, older adults did not show sleep-dependent consolidation. By contrast, when tested with an adapted sequence learning task, in which movements were performed with the whole hand, sleep-dependent motor improvement was observed in older adults. We suggest that age-related decline in fine motor dexterity may in part be responsible for the previously described deficit in sleep-dependent motor consolidation with aging.

Reliability and validity of the work role functioning questionnaire (Spanish version)

PURPOSE

Recently, the cross-cultural adaptation of the Work Role Functioning Questionnaire to Spanish was carried out, achieving satisfactory psychometric properties. Now we examined the reliability and validity of the adapted [Work role functioning questionnaire-Spanish version (WRFQ-SpV)] in a general working population with and without (physical and mental) health issues to evaluate its measurement properties.

METHODS

A cross-sectional study was conducted among active workers. For reliability, we calculated Cronbach alphas to assess 'internal consistency', and the standard error of measurement (SEM) to evaluate 'measurement error'. We assessed the 'structural validity' through confirmatory factor analyses and 'construct validity' by means of hypotheses testing. The consensus-based standard for the selection of health status measurement instruments (COSMIN) taxonomy were used in the design of the study.

RESULTS

A total of 455 workers completed the questionnaire. It showed excellent internal consistency (α = 0.98). The SEM for the overall scale was 7.10. The original five factor structure reflected fair dimensionality of the construct (Chi square, 1,445.8; 314 degrees of freedom; root mean square error of approximation = 0.08; comparative fit index >0.95 and weighed root mean residual >0.90). For construct validity, all hypotheses were confirmed differentiating groups with different jobs, health conditions and ages. Moderate to strong correlations were found between WRFQ-SpV and a related construct (work ability).

CONCLUSIONS

Our study provides evidence of the reliability and validity of the WRFQ-SpV to measure health-related work functioning in day-to-day practice and research in occupational health care and the rehabilitation of disabled workers. It should be useful to monitor improvements in work functioning after implementing rehabilitation and/or accommodation programs. Longitudinal studies are needed to assess the responsiveness of the questionnaire.

Towards a comprehensive Functional Capacity Evaluation for hand function

The aim of this study was to develop a more efficient (i.e. shortened) protocol for hand function capacity evaluation and to test the agreement of the protocol compared to the original protocol. 643 Healthy subjects performed tests for hand function. Agreement between two shortened protocols was compared with an existing protocol. The original protocol was performed once and the proposed shortened protocol differed in the number of trials which were reduced by statistical elimination. Agreement was determined with Intraclass Correlation Coefficients (ICC) and Limits of Agreement (LoA). Excellent ICCs (≥0.91) were observed in all proposed protocols except for the one trial purdue pegboard test protocol. For all tests of hand function, shorter protocols are valid to determine hand function. For Tip Pinch Strength testing, Palmar Pinch Strength testing and the Purdue Pegboard test, a two-trial protocol is recommended, because the LoA were considerable, which could affect decision-making with regards to hand capacity. For the Hand Grip strength test, the Key Pinch Strength test and the Complete Minnesota Dexterity Test, a one-trial protocol is recommended, because the LoA were acceptable. It was concluded that for healthy subjects, this shorter protocol is a reliable measure. Further testing of the short form hand FCE protocols should be completed on patients with disabling conditions prior to widespread use of these protocols among clinical samples.

Age-related weakness of proximal muscle studied with motor cortical mapping: a TMS study

Aging-related weakness is due in part to degeneration within the central nervous system. However, it is unknown how changes to the representation of corticospinal output in the primary motor cortex (M1) relate to such weakness. Transcranial magnetic stimulation (TMS) is a noninvasive method of cortical stimulation that can map representation of corticospinal output devoted to a muscle. Using TMS, we examined age-related alterations in maps devoted to biceps brachii muscle to determine whether they predicted its age-induced weakness. Forty-seven right-handed subjects participated: 20 young (22.6±0.90 years) and 27 old (74.96±1.35 years). We measured strength as force of elbow flexion and electromyographic activation of biceps brachii during maximum voluntary contraction. Mapping variables included: 1) center of gravity or weighted mean location of corticospinal output, 2) size of map, 3) volume or excitation of corticospinal output, and 4) response density or corticospinal excitation per unit area. Center of gravity was more anterior in old than in young (p<0.001), though there was no significant difference in strength between the age groups. Map size, volume, and response density showed no significant difference between groups. Regardless of age, center of gravity significantly predicted strength (β = −0.34, p = 0.005), while volume adjacent to the core of map predicted voluntary activation of biceps (β = 0.32, p = 0.008). Overall, the anterior shift of the map in older adults may reflect an adaptive change that allowed for the maintenance of strength. Laterally located center of gravity and higher excitation in the region adjacent to the core in weaker individuals could reflect compensatory recruitment of synergistic muscles. Thus, our study substantiates the role of M1 in adapting to aging-related weakness and subtending strength and muscle activation across age groups. Mapping from M1 may offer foundation for an examination of mechanisms that preserve strength in elderly.

Neurophysiological correlates of aging-related muscle weakness

Muscle weakness associated with aging implicates central neural degeneration. However, role of the primary motor cortex (M1) is poorly understood, despite evidence that gains in strength in younger adults are associated with its adaptations. We investigated whether weakness of biceps brachii in aging analogously relates to processes in M1. We enrolled 20 young (22.6 ± 0.87 yr) and 28 old (74.79 ± 1.37 yr) right-handed participants. Using transcranial magnetic stimulation, representation of biceps in M1 was identified. We examined the effect of age and sex on strength of left elbow flexion, voluntary activation of biceps, corticospinal excitability and output, and short-interval intracortical and interhemispheric inhibition. Interhemispheric inhibition was significantly exaggerated in the old (P = 0.047), while strength tended to be lower (P = 0.075). Overall, women were weaker (P < 0.001). Processes of M1 related to strength or voluntary activation of biceps, but only in older adults. Corticospinal excitability was lower in weaker individuals (r = 0.38), and corticospinal output, intracortical inhibition and interhemispheric inhibition were reduced too in individuals who poorly activated biceps (r = 0.43, 0.54 and 0.38). Lower intracortical inhibition may reflect compensation for reduced corticospinal excitability, allowing weaker older adults to spread activity in M1 to recruit synergists and attempt to sustain motor output. Exaggerated interhemispheric inhibition, however, conflicts with previous evidence, potentially related to greater callosal damage in our older sample, our choice of proximal vs. distal muscle and differing influence of measurement of inhibition in rest vs. active states of muscle. Overall, age-specific relation of M1 to strength and muscle activation emphasizes that its adaptations only emerge when necessitated, as in a weakening neuromuscular system in aging.

Construct validity of functional capacity tests in healthy workers

BACKGROUND

Functional Capacity (FC) is a multidimensional construct within the activity domain of the International Classification of Functioning, Disability and Health framework (ICF). Functional capacity evaluations (FCEs) are assessments of work-related FC. The extent to which these work-related FC tests are associated to bio-, psycho-, or social factors is unknown. The aims of this study were to test relationships between FC tests and other ICF factors in a sample of healthy workers, and to determine the amount of statistical variance in FC tests that can be explained by these factors.

METHODS

A cross sectional study. The sample was comprised of 403 healthy workers who completed material handling FC tests (lifting low, overhead lifting, and carrying) and static work FC tests (overhead working and standing forward bend). The explainable variables were; six muscle strength tests; aerobic capacity test; and questionnaires regarding personal factors (age, gender, body height, body weight, and education), psychological factors (mental health, vitality, and general health perceptions), and social factors (perception of work, physical workloads, sport-, leisure time-, and work-index). A priori construct validity hypotheses were formulated and analyzed by means of correlation coefficients and regression analyses.

RESULTS

Moderate correlations were detected between material handling FC tests and muscle strength, gender, body weight, and body height. As for static work FC tests; overhead working correlated fair with aerobic capacity and handgrip strength, and low with the sport-index and perception of work. For standing forward bend FC test, all hypotheses were rejected. The regression model revealed that 61% to 62% of material handling FC tests were explained by physical factors. Five to 15% of static work FC tests were explained by physical and social factors.

CONCLUSIONS

The current study revealed that, in a sample of healthy workers, material handling FC tests were related to physical factors but not to the psychosocial factors measured in this study. The construct of static work FC tests remained largely unexplained.