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Wunderle V, Kuzu TD, Tscherpel C, Fink GR, Grefkes C, Weiss PH. Age- and sex-related changes in motor functions: a comprehensive assessment and component analysis. Front Aging Neurosci 2024; 16:1368052. [PMID: 38813530 PMCID: PMC11133706 DOI: 10.3389/fnagi.2024.1368052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/23/2024] [Indexed: 05/31/2024] Open
Abstract
Age-related motor impairments often cause caregiver dependency or even hospitalization. However, comprehensive investigations of the different motor abilities and the changes thereof across the adult lifespan remain sparse. We, therefore, extensively assessed essential basic and complex motor functions in 444 healthy adults covering a wide age range (range 21 to 88 years). Basic motor functions, here defined as simple isolated single or repetitive movements in one direction, were assessed by means of maximum grip strength (GS) and maximum finger-tapping frequency (FTF). Complex motor functions, comprising composite sequential movements involving both proximal and distal joints/muscle groups, were evaluated with the Action Research Arm Test (ARAT), the Jebsen-Taylor Hand Function Test (JTT), and the Purdue Pegboard Test. Men achieved higher scores than women concerning GS and FTF, whereas women stacked more pins per time than men during the Purdue Pegboard Test. There was no significant sex effect regarding JTT. We observed a significant but task-specific reduction of basic and complex motor performance scores across the adult lifespan. Linear regression analyses significantly predicted the participants' ages based on motor performance scores (R2 = 0.502). Of note, the ratio between the left- and right-hand performance remained stable across ages for all tests. Principal Component Analysis (PCA) revealed three motor components across all tests that represented dexterity, force, and speed. These components were consistently present in young (21-40 years), middle-aged (41-60 years), and older (61-88 years) adults, as well as in women and men. Based on the three motor components, K-means clustering analysis differentiated high- and low-performing participants across the adult life span. The rich motor data set of 444 healthy participants revealed age- and sex-dependent changes in essential basic and complex motor functions. Notably, the comprehensive assessment allowed for generating robust motor components across the adult lifespan. Our data may serve as a reference for future studies of healthy subjects and patients with motor deficits. Moreover, these findings emphasize the importance of comprehensively assessing different motor functions, including dexterity, force, and speed, to characterize human motor abilities and their age-related decline.
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Affiliation(s)
- Veronika Wunderle
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Taylan D. Kuzu
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Caroline Tscherpel
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Department of Neurology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Gereon R. Fink
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Christian Grefkes
- Department of Neurology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Peter H. Weiss
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
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Johansson A, Torgé CJ, Fristedt S, Bravell ME. Relationships and gender differences within and between assessments used in Swedish home rehabilitation - a cross-sectional study. BMC Health Serv Res 2022; 22:807. [PMID: 35729529 PMCID: PMC9215038 DOI: 10.1186/s12913-022-08177-x] [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: 03/01/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Home rehabilitation programmes are increasingly implemented in many countries to promote independent living. Home rehabilitation should include a comprehensive assessment of functioning, but the scientific knowledge about the assessment instruments used in this context is limited. The aim of this study was to explore relationships between standardised tests and a self-reported questionnaire used in a home rehabilitation programme. We specifically studied whether there were gender differences within and between assessments. Method De-identified data from 302 community-dwelling citizens that participated in a municipal home rehabilitation project in Sweden was analysed. A Mann Whitney test and an independent t-test were used to analyse differences within the following assessment instruments: the Sunnaas Activity of Daily Living Index, the General Motor Function assessment scale and the European Quality of Life Five Dimension Five Level Scale. Spearman’s bivariate correlation test was used to analyse relationships between the instruments, and a Fischer’s Z test was performed to compare the strengths of the correlation coefficients. Result Gender differences were found both within and between the assessment instruments. Women were more independent in instrumental activities of daily living than men. The ability to reach down and touch one’s toes while performing personal activities of daily living was stronger for men. There was a difference between men’s self-reported performance of usual activities that included instrumental activities of daily living and the standardised assessment in performing instrumental activities of daily living. The result also showed an overall difference between the self-reported assessment and the standardised test of motor function for the total group. Conclusion The results indicate that a comprehensive assessment with the combination of standardised tests, questionnaires and patient-specific instruments should be considered in a home rehabilitation context in order to capture different dimensions of functioning. Assessment instruments that facilitate a person-centred home rehabilitation supporting personally meaningful activities for both men and women should be applied in daily practice. Further research about gender-biased instruments is needed to facilitate agreement on which specific instruments to use at both individual and organisation levels to promote gender-neutral practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08177-x.
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Affiliation(s)
- Anette Johansson
- Health Care Administration, Jönköping Municipality, Jönköping University, School of Health and Welfare, SE 551 11, Jönköping, Sweden.
| | | | - Sofi Fristedt
- Jönköping University, School of Health and Welfare, Jönköping, Sweden
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Fristedt S, Kammerlind AS, Fransson EI, Ernsth Bravell M. Physical functioning associated with life-space mobility in later life among men and women. BMC Geriatr 2022; 22:364. [PMID: 35473475 PMCID: PMC9040227 DOI: 10.1186/s12877-022-03065-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background Life-space mobility is defined as the ability to access different areas extending from the room where the person sleeps to places outside one’s hometown. Life-space mobility is vital to support performance of daily life activities and autonomous participation in social life. However, there is a dearth of research that investigates a wider range of physical functions and functioning in relation to life-space mobility rather than just single aspects. Thus, the purpose of the present study was to identify and describe several measures of physical functioning associated with life-space mobility among older men and women. Methods Data used in this study was derived from the OCTO 2 study, a population-based study of health, functioning and mobility among older persons (n = 312) in Sweden. Associations between Life-Space Assessment (LSA) total score and age, sex, Short Physical Performance Battery (SPPB), dizziness, lung function i.e. Peak Expiratory Flow (PEF), grip strength, self-rated vision and hearing were analysed through bivariate and multivariate regression models. Results The bivariate models showed that life-space mobility was significantly associated with sex, but also age, SPPB, PEF and grip strength in the total group as well as among men and women. In addition, hearing was significantly associated with life-space mobility among women. Those factors that were statistically significant in the bivariate models were further analysed in multivariable models for the total group, and for men and women separately. In these models, sex, grip strength and SPPB remained significantly associated with life-space mobility in the total group, as well as SPPB among both men and women. Conclusion Sex, physical function in terms of physical performance measured by SPPB (balance, gait speed and chair stand), and grip strength are associated with life-space mobility. Consequently, these factors need to be considered in assessments and interventions aiming to maintain mobility in old age.
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Affiliation(s)
- Sofi Fristedt
- School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden. .,Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden.
| | - Ann-Sofi Kammerlind
- Futurum, SE-551 85, Linköping, Region Jönköping County, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83, Linköping, Sweden
| | - Eleonor I Fransson
- School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden
| | - Marie Ernsth Bravell
- School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden
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Marín-Jiménez N, Cruz-León C, Perez-Bey A, Conde-Caveda J, Grao-Cruces A, Aparicio VA, Castro-Piñero J, Cuenca-García M. Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review. J Clin Med 2022; 11:jcm11020328. [PMID: 35054020 PMCID: PMC8779466 DOI: 10.3390/jcm11020328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.
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Affiliation(s)
- Nuria Marín-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Carolina Cruz-León
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alejandro Perez-Bey
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
- Correspondence: ; Tel.: +34-65-7588624
| | - Julio Conde-Caveda
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alberto Grao-Cruces
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, 18071 Granada, Spain;
- Sport and Health University Research Centre, University of Granada, 18007 Granada, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Magdalena Cuenca-García
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
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Finkel D, Ernsth Bravell M, Pedersen NL. Role of motor function and lung function in pathways to ageing and decline. Aging Clin Exp Res 2020; 32:2479-2487. [PMID: 32056153 PMCID: PMC7680325 DOI: 10.1007/s40520-020-01494-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/22/2020] [Indexed: 11/26/2022]
Abstract
Background Extensive research has investigated the association between age changes in various domains, including lung function and motor function. However, a few analyses have tested models that incorporate bidirectional longitudinal influences between lung and motor function to test the temporal chain of events in the disability process. Dual change score models (DCSM) assist with identification of leading indicators of change by leveraging longitudinal data to examine the extent to which changes in one variable influence subsequent changes in a second variable, and vice versa. Aims The purpose of the current-analysis study was to apply DCSM to data from the Swedish Adoption/Twin Study of ageing to examine the nature of the longitudinal relationship between motor functioning and lung function. Methods Three motor functioning factors were created from 20 performance measures, including measures of balance, flexibility, and fine motor skills. Peak expiratory flow measured lung function. Participants were 829 adults aged 50–88 at the first of 9 waves of testing covering a 27-year follow-up period; 80% participated in at least three waves. Results Model comparisons indicated that decline in lung function preceded and contributed to subsequent decline in motor function. Discussion Combined with previous results, these results suggest that declining lung function results in increasing difficulties in motor function, which contribute to subsequent declines in multiple domains. Conclusion Understanding the cascade of events that can lead to dependence can help in the development of interventions targeted early in the disablement process. Electronic supplementary material The online version of this article (10.1007/s40520-020-01494-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Deborah Finkel
- Department of Psychology, Indiana University Southeast, New Albany, IN, USA.
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | | | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Finkel D, Ernsth Bravell M. Cohort by Education Interactions in Longitudinal Changes in Functional Abilities. J Aging Health 2018; 32:208-215. [PMID: 30466342 DOI: 10.1177/0898264318814108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Investigations of cohort differences in relationships between education and health tend to focus on mortality or self-reported health. We report one of the first analyses of cohort differences in relationships between education and objective measures of functional abilities across the lifespan. Method: Up to 26 years of follow-up data were available from 859 adults from the Swedish Adoption/Twin Study of Aging. The sample was divided into two cohorts by birth year: 1900-1924 and 1925-1948. Latent growth curve models (LGCM) were compared across cohort and educational levels. Results: LGCM indicated divergence between adults with lower and higher educational attainment in longitudinal trajectories of change with age in the Balance and Flexibility factors for the later born cohort only. Discussion: Results support the cumulative advantage theory and suggest that education-health disparities are increasing in recent cohorts, even in counties with national health care systems and strong support of education.
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Affiliation(s)
- Deborah Finkel
- Indiana University Southeast, New Albany, USA.,Jönköping University, Sweden
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