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Virto N, Río X, Méndez-Zorrilla A, García-Zapirain B. Non invasive techniques for direct muscle quality assessment after exercise intervention in older adults: a systematic review. BMC Geriatr 2024; 24:642. [PMID: 39085773 PMCID: PMC11293103 DOI: 10.1186/s12877-024-05243-3] [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: 11/28/2023] [Accepted: 07/24/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The aging process induces neural and morphological changes in the human musculoskeletal system, leading to a decline in muscle mass, strength and quality. These alterations, coupled with shifts in muscle metabolism, underscore the essential role of physical exercise in maintaining and improving muscle quality in older adults. Muscle quality's morphological domain encompasses direct assessments of muscle microscopic and macroscopic aspects of muscle architecture and composition. Various tools exist to estimate muscle quality, each with specific technical requirements. However, due to the heterogeneity in both the studied population and study methodologies, there is a gap in the establishment of reference standards to determine which are the non-invasive and direct tools to assess muscle quality after exercise interventions. Therefore, the purpose of this review is to obtain an overview of the non-invasive tools used to measure muscle quality directly after exercise interventions in healthy older adults, as well as to assess the effects of exercise on muscle quality. MAIN TEXT To address the imperative of understanding and optimizing muscle quality in aging individuals, this review provides an overview of non-invasive tools employed to measure muscle quality directly after exercise interventions in healthy older adults, along with an assessment of the effects of exercise on muscle quality. RESULTS Thirty four studies were included. Several methods of direct muscle quality assessment were identified. Notably, 2 studies harnessed CT, 20 utilized US, 9 employed MRI, 2 opted for TMG, 2 adopted myotonometry, and 1 incorporated BIA, with several studies employing multiple tests. Exploring interventions, 26 studies focus on resistance exercise, 4 on aerobic training, and 5 on concurrent training. CONCLUSIONS There is significant diversity in the methods of direct assessment of muscle quality, mainly using ultrasound and magnetic resonance imaging; and a consistent positive trend in exercise interventions, indicating their efficacy in improving or preserving muscle quality. However, the lack of standardized assessment criteria poses a challenge given the diversity within the studied population and variations in methodologies.. These data emphasize the need to standardize assessment criteria and underscore the potential benefits of exercise interventions aimed at optimizing muscle quality.
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Affiliation(s)
- Naiara Virto
- eVida Research Lab, Faculty of Engineering, University of Deusto, Bilbo, Spain.
| | - Xabier Río
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, Bilbo, Spain
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Pérez Coello L, Bouza Bellas L, Veras Castro R. [Prevalence of frailty in a population aged 70 and older who pay a visit to health center and its detection in primary care]. Rev Esp Geriatr Gerontol 2024; 59:101454. [PMID: 38218135 DOI: 10.1016/j.regg.2023.101454] [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: 10/23/2022] [Revised: 11/03/2023] [Accepted: 11/28/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION The detection of frailty in the elderly is key to preventing disability. The main objective of this study is to find out the proportion of frail people in subjects aged 70 and over who attend a health center in A Coruña (Spain). METHODS Cross-sectional study, carried out from August 2020 to April 2021. Consecutive selection of patients ≥70 years, with Barthel ≥90, who accessed the health center. DEPENDENT VARIABLES Short Physical Performance Battery (SPPB), Get Up and Go (TUG) and Gait Speed (MV); independent: gender, age, number of falls in the last year, number of drugs used chronically, and Charlson index. RESULTS The sample was 114 people. The proportion of frail people is 16.7% (95% CI 10.94-24.57) with the SPPB, 28.6% in those aged 80 and over; and 36.8% using VM. The risk of frailty increases by at least 4.1% for each year of age after 70. Being a woman multiplies the risk by at least 1.5. The concordance between frailty according to the SPPB and MV is 46.8% (95% CI 30.85-62.77). CONCLUSIONS The prevalence of frailty in independent people for basic ADL who attend a health center is at least 10.94%. Both the SPPB and the MV are feasible and useful methods in primary care.
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Affiliation(s)
- Lucía Pérez Coello
- Medicina Familiar y Comunitaria, Centro de Salud de San Xosé, A Coruña, España.
| | - Lucía Bouza Bellas
- Medicina Familiar y Comunitaria, Centro de Salud de Vilalba, Lugo, España
| | - Ramón Veras Castro
- Medicina Familiar y Comunitaria, Centro de Salud de San Xosé, A Coruña, España
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López-García L, Lorenzo-Villalba N, Molina-Puente JI, Kishta A, Sanchez-Sauce B, Aguilar-Rodriguez F, Bernanbeu-Wittel M, Muñoz-Rivas N, Soler-Rangel L, Fernández-Carmena L, Andrès E, Deodati F, Trapiello-Valbuena F, Casasnovas-Rodríguez P, López-Reboiro ML, Méndez-Bailon M. Clinical Characteristics and Prognostic Impact of Short Physical Performance Battery in Hospitalized Patients with Acute Heart Failure-Results of the PROFUND-IC Registry. J Clin Med 2023; 12:5974. [PMID: 37762915 PMCID: PMC10531733 DOI: 10.3390/jcm12185974] [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: 07/27/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Most patients diagnosed with heart failure (HF) are older adults with multiple comorbidities. Multipathological patients constitute a population with common characteristics: greater clinical complexity and vulnerability, frailty, mortality, functional deterioration, polypharmacy, and poorer health-related quality of life with more dependency. OBJECTIVES To evaluate the clinical characteristics of hospitalized patients with acute heart failure and to determine the prognosis of patients with acute heart failure according to the Short Physical Performance Battery (SPPB) scale. METHODS Observational, prospective, and multicenter cohort study conducted from September 2020 to May 2022 in patients with acute heart failure as the main diagnosis and NT-ProBNP > 300 pg. The cohort included patients admitted to internal medicine departments in 18 hospitals in Spain. Epidemiological variables, comorbidities, cardiovascular risk factors, cardiovascular history, analytical parameters, and treatment during admission and discharge of the patients were collected. Level of frailty was assessed by the SPPB scale, and dependence, through the Barthel index. A descriptive analysis of all the variables was carried out, expressed as frequencies and percentages. A bivariate analysis of the SPPB was performed based on the score obtained (SPPB ≤ 5 and SPPB > 5). For the overall analysis of mortality, HF mortality, and readmission of patients at 30 days, 6 months, and 1 year, Kaplan-Meier survival curves were used, in which the survival experience among patients with an SPPB > 5 and SPPB ≤ 5 was compared. RESULTS A total of 482 patients were divided into two groups according to the SPPB with a cut-off point of an SPPB < 5. In the sample, 349 patients (77.7%) had an SPPB ≤ 5 and 100 patients (22.30%) had an SPPB > 5. Females (61%) predominated in the group with an SPPB ≤ 5 and males (61%) in those with an SPPB > 5. The mean age was higher in patients with an SPPB ≤ 5 (85.63 years). Anemia was more frequent in patients with an SPPB ≤ 5 (39.5%) than in patients with an SPPB ≥ 5 (29%). This was also seen with osteoarthritis (32.7%, p = 0.000), diabetes (49.6%, p = 0.001), and dyslipidemia (69.6%, p = 0.011). Patients with an SPPB score > 5 had a Barthel index < 60 in only 4% (n = 4) of cases; the remainder of the patients (96%, n = 96) had a Barthel index > 60. Patients with an SPPB > 5 showed a higher probability of survival at 30 days (p = 0.029), 6 months (p = 0.031), and 1 year (p = 0.007) with (OR = 7.07; 95%CI (1.60-29.80); OR: 3.9; 95%CI (1.30-11.60); OR: 6.01; 95%CI (1.90-18.30)), respectively. No statistically significant differences were obtained in the probability of readmission at 30 days, 6 months, and 1 year (p > 0.05). CONCLUSIONS Patients admitted with acute heart failure showed a high frequency of frailty as assessed by the SPPB. Patients with an SPPB ≤ 5 had greater comorbidities and greater functional limitations than patients with an SPPB > 5. Patients with heart failure and a Barthel index > 60 frequently presented an SPPB < 5. In daily clinical practice, priority should be given to performing the SPPB in patients with a Barthel index > 60 to assess frailty. Patients with an SPPB ≤ 5 had a higher risk of mortality at 30 days, 6 months, and 1 year than patients with an SPPB ≤ 5. The SPPB is a valid tool for identifying frailty in acute heart failure patients and predicting 30-day, 6-month, and 1-year mortality.
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Affiliation(s)
- Lidia López-García
- Facultad de Enfermería, Universidad Complutense, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - Noel Lorenzo-Villalba
- Service de Médecine Interne, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Juan Igor Molina-Puente
- Servicio de Medicina Interna, Complejo Hospitalario de Ávila, 05004 Avila, Spain; (J.I.M.-P.); (A.K.)
| | - Aladin Kishta
- Servicio de Medicina Interna, Complejo Hospitalario de Ávila, 05004 Avila, Spain; (J.I.M.-P.); (A.K.)
| | - Beatriz Sanchez-Sauce
- Servicio de Medicina Interna, Hospital Universitario Fundación de Alcorcón, 28922 Madrid, Spain
| | | | | | - Nuria Muñoz-Rivas
- Servicio de Medicina Interna, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Llanos Soler-Rangel
- Servicio de Medicina Interna, Hospital Infanta Sofia, 28702 San Sebastián de los Reyes, Spain
| | | | - Emmanuel Andrès
- Service de Médecine Interne, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Francesco Deodati
- Servicio de Medicina Interna, Hospital Infanta Cristina, 28981 Parla, Spain
| | | | | | | | - Manuel Méndez-Bailon
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Segura Cardona A, Cardona Arango D, Segura Cardona A, Robledo Marín C, Muñoz Rodríguez D. Friendly Residential Environments That Generate Autonomy in Older Persons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:409. [PMID: 36612730 PMCID: PMC9819148 DOI: 10.3390/ijerph20010409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study aimed to explore the housing and residential environment conditions associated with functional autonomy in older persons. METHODS A quantitative cross-sectional study was conducted, including 175 individuals over the age of 60. Participants were non-institutionalized urban residents of Medellín, Colombia, selected by random two-stage sampling (neighborhoods and blocks). Analysis was done according to functional autonomy of action (dependent variable); and demographic conditions, housing, and the physical and social environment suggested by the World Health Organization (WHO) in the strategy of age-friendly cities (independent variables). Univariate, bivariate, and multivariate analyses were performed with these variables, where the odds ratio (OR), association hypothesis test, and confidence intervals were estimated, using logistic regression models. RESULTS 89.7% of older persons had moderate physical performance. The performance of intergenerational activities (OR = 5.28) and community actions (OR = 11.28) were part of social environments. The adaptations in public transport (OR = 90.33), sanitary services (OR = 4.1), and lighting in parks (OR = 19.9) of the physical environment were the associations found with functional autonomy. CONCLUSIONS Exploring how the physical and social environments surrounding housing are associated with the functional performance of older persons can generate useful information to support public health and city infrastructure strategies that improve their physical performance and maintain autonomy.
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Markotegi M, Irazusta J, Sanz B, Rodriguez-Larrad A. Effect of the COVID-19 pandemic on the physical and psychoaffective health of older adults in a physical exercise program. Exp Gerontol 2021; 155:111580. [PMID: 34601075 PMCID: PMC8492068 DOI: 10.1016/j.exger.2021.111580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
COVID-19 lockdowns restricted physical activity levels for individuals in many countries. In particular, older adults experienced limited access to their usual activities, including physical exercise programs. How such restrictions and interruptions in physical exercise programs might impact the physical and mental health of older adults has not yet been studied. We sought to analyse changes in the physical and mental health of older adults enrolled in a group-based multicomponent physical exercise (MPE) program that was interrupted due to the COVID-19 pandemic. We followed 17 participants of this program from October 2018 to October 2020, including the interruption of the program during the pandemic. The MPE program included strength, balance, and stretching exercises. We compared anthropometric and cardiovascular parameters, physical fitness, frailty, quality of life, and psychoaffective status of participants before and during the COVID-19 pandemic. Most parameters followed the same pattern, improving after 8 months of the first MPE season (Oct. 2018-Jun. 2019), worsening after 4 months of summer rest, improving from October 2019 to January 2020 in the second MPE season (Oct. 2019-Jan. 2020), and severely worsening after 7 months of program interruption. We show that an MPE program has clear benefits to the physical and psychoaffective health of older adults, and interruption of these programs could adversely impact participants. These results highlight the need to maintain physical exercise programs or facilitate engagement in physical activity and reduce sedentary behaviour in older adults, particularly in situations such as the COVID-19 pandemic.
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Affiliation(s)
- Mikel Markotegi
- Fundación Siel Bleu, Spain; Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain.
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
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