Balance and mobility relationships in older adults: A representative population-based cross-sectional study in Madeira, Portugal

The characteristics of the body mass frequency index in dysmobility syndrome: A pilot study

BACKGROUND

With the advancement of global aging, there has been an increase in patients with dysmobility syndrome (DS), often accompanied by osteoporosis, sarcopenia, and sarcopenic obesity. The objective of this study was to evaluate the application value of the body mass frequency index (BMFI) in older patients with DS by comprehensively analyzing the differences in BMFI between community-dwelling older subjects using medical and engineering methods.

METHODS

A cross-sectional study was conducted to recruit community-dwelling older subjects aged 60-90 years. Various assessments and measurements were performed, including basic information collection, gait analysis, bone mineral density (BMD) and body composition measurement, fall and fracture risk et al. Gait analysis and body mass index (BMI) are in the established model to calculate BMFI. Analysis of BMFI was performed in community-dwelling older subjects, and the specificity and threshold of BMFI in predicting dysmobility syndrome (DS) were further analyzed.

RESULTS

Significant differences in BMFI were observed between older adults with DS and those without DS. BMFI in older people was associated with bone quality, fracture risk, body fat percentage, appendicular skeletal muscle mass index (ASMI), grip strength, and speed. The odds ratio (OR) and 95 % confidence interval (CI) for BMFI in the non-DS and DS groups were 0.823 (0.743-0.901), respectively. Receiver operating characteristic (ROC) analysis demonstrated that BMFI had predictive value in distinguishing non-DS from DS (AUC = 0.669) (P < 0.05). The optimal threshold for predicting non-DS and DS was found to be 16.04 (sensitivities = 0.483, specificities = 0.774).

CONCLUSION

The measurement of BMFI has demonstrated disparities in musculoskeletal status among older adults with and without DS. Notably, BMFI exhibits a unique predictive capacity for DS among the elderly population.

Association of Moderate-to-Vigorous Physical Activity, Sedentary Time, Fat Percentage, and Physical Fitness with Gait Parameters in Women with Fibromyalgia: The Al-Ándalus Project

Gait impairments have been found in women with fibromyalgia, reducing the physical activity possibilities in this population and leading to a negative correlation with fibromyalgia impact. The aim of this study was to analyze the individual and independent associations of moderate-to-vigorous physical activity (MVPA), sedentary time, fat percentage, and physical fitness with gait parameters in women with fibromyalgia. A total of 84 women with fibromyalgia were included. MVPA and sedentary time were assessed with accelerometry, fat percentage with bioimpedance analysis, and physical fitness with field-based fitness tests. Gait was assessed during a "6 min walk test" and categorized in velocity, cadence, step length, step cycle duration, unipedal stance phase, and bipedal stance phase. Individual relationships were analyzed by partial correlations and independent relationships by linear regressions, adjusting by age and height. MVPA, sedentary time, fat percentage, and physical fitness were correlated with most gait parameters (rpartial between |0.842| and |0.219|; p ≤ 0.05). Physical fitness was independently associated with all gait parameters (β between |0.346| and |0.761|; p ≤ 0.002). In addition, MVPA was independently associated with velocity and step length (β = 0.241 and 0.292; both p = 0.004), and fat percentage was associated with bipedal stance phase (β = 0.242; p = 0.049). Good levels of MVPA, physical fitness, and adequate weight balance are associated with improved gait parameters in women with fibromyalgia.

A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults

OBJECTIVE

To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes.

DATA SOURCES

PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021.

STUDY SECTION

Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted.

DATA EXTRACTION

The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted.

DATA SYNTHESIS

Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors.

CONCLUSIONS

Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults

This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.

Exploring Mediation Effects of Gait Speed, Body Balance, and Falls in the Relationship between Physical Activity and Health-Related Quality of Life in Vulnerable Older Adults

The present study aimed to examine whether gait speed (GS), body balance (BB), and falls mediated the relationship between physical activity (PA) and health-related quality of life (HRQoL) in community-dwelling older adults. This is a cross-sectional study that included 305 men and 314 women (69.5 ± 5.6 years), residing in the Autonomous Region of Madeira, Portugal. HRQoL and PA were assessed using the SF-36 and Baecke Questionnaires, respectively. While BB was obtained by the Fullerton Advance Balance (FAB) scale, GS by the 50-foot (15 m) walk test, and the frequency of falls was obtained by self-report. According to the analyses, when GS and BB were placed concomitantly as mediators, the direct effect revealed by the model revealed a non-significant relationship between PA and falls. Thus, in the context of falls, GS and BB partially mediated the association between PA and HRQoL in approximately 29.7%, 56%, and 49.2%, respectively. The total HRQoL model explained a variance of 36.4%. The results can help to understand the role that GS, BB, and falls play in the relationship between PA and HRQoL of the vulnerable older adult population.

Psychophysiological Indicators of Postural Control. Contribution of the Russian Scientific School. Part I

This article aimed to systematically review the published results of studies of psychophysiological mechanisms of posture maintenance and identify the key factors that influence the effectiveness of postural control. The recommendations of "Preferred Reporting Elements for Systematic Reviews and Meta-Analyzes" (PRISMA) were followed for the review. The results were classified, taking into account the target psychophysiological mechanisms and factors affecting postural control. The article presents the theoretical and empirical results of the Russian scientific school of research on the role of support afferentation in the sensorimotor mechanisms of cognitive and postural functions. Due to the limited number of randomized studies found, it was impossible to make meta-analytic comparisons, so the literature analysis was carried out only qualitatively. Meanwhile, our systematic review provides promising information about possible relationships between stabilometric and psychological indicators of postural control, which have theoretical significance and application in the correction and training of posture control. However, more thorough research is needed to overcome the methodological shortcomings that we have encountered in our qualitative analysis.

Cognitive ability and motor performances in the elderly

Background/Aim. Aging entails a wide range of cognitive processes that are not independent of one another. It leads to changes in physical-motor characteristics and sometimes to disability. The aim of this study was to examine the association between multiple cognitive performances in elderly subjects and their physical-motor abilities. Method. The study included 98 elderly participants (60+) (16 males and 82 females). Cognitive abilities were assessed by the Montreal Cognitive Assessment (MoCA)/Serbian version, and physical measures were assessed by the Senior Fitness Test with its five subtests, supplemented by the Walking Speed Test. Results. Several MoCA items demonstrated relatively low variability, i.e., they proved to be too easy for most of the participants. The participants exhibited the lowest performance on the memory relating to other domains, followed by executive functions, visuospatial skills, attention, concentration, and working memory domains, with the highest performance on temporal and spatial orientation relating to other domains. Executive functions and language correlated most significantly with physical strength. Agility and dynamic balance, lower- and upper-body strength, and aerobic endurance correlated moderately and positively. Conclusion. This study underlines the positive correlation between physical fitness and cognitive level in the elderly and emphasizes the importance of physical fitness for cognitive functions, especially those of executive type in elderly subjects. Clinicians should consider the association between cognitive function and physical-motor performances when dealing with functioning improvement in the elderly. The importance of designing the most efficient exercise pro-grams to achieve maximal somatic and cognitive effects is emphasized.

Is functional fitness performance a useful predictor of risk of falls among community-dwelling older adults?

Background

Falls among older adults are a serious public health problem. Many studies indicate that positive functional fitness performance decreases the risk of falls. A limited amount of previous study has investigated the association between broad functional fitness and the fall risk. This study examines the associations between functional fitness and the risk of falling among community-dwelling older adults.

Methods

Three waves of cross-sectional data were collected from 2017 to 2019 in Taipei City, Taiwan. Six hundred sixty-five participants aged ≥65 years were randomly recruited from 12 districts of Taipei. Eight functional fitness tests (i.e., back scratch, chair-sit and-reach, 8-ft up-and-go, 30-s sit-to-stand, 30-s arm curl, 30-s single-leg stance, 2-min step, and hand grip strength tests) were performed to record the physical performance of older subjects. A Chinese version of the fall-risk questionnaire (FRQ) was used to calculate the fall risk scores. Linear regression and logistic regression were utilized to estimate the relationships of each functional fitness and fall risk.

Result

The results showed that 37.45% of older adults had a high risk of falling. It was found for each functional fitness that performance was linearly associated with the risk of falling. Moreover, older adults with low-performance levels in all functional fitness except back-scratching were more likely to have a higher risk of falling.

Conclusions

Our study indicated that functional fitness performance appears to provide valid predictive guidance for reducing the risk of falling among the older population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00608-1.

Diagnostic dependence of muscle strength measurements and the risk of falls in the elderly

Low muscle strength appears to increase balance disorders and the tendency to fall. Diagnostic terms indicate that sarcopenia and risks of falling are related. The aim of this study is to verify which diagnostic tools used for the assessment of muscle strength in sarcopenia can be used for fall risk assessment in older women. The study included 56 females [71.77 ± 7.43(SD)]. The results of handgrip strength (HGS) and knee extensors torque [knee extension strength (KES)] were compared to the results of stabilographic parameters from Biodex Balance System platform in static and dynamic environment. The one-way ANOVA and Pearson correlation were performed. There were significant differences between groups with low and normal HGS in the chair test, and between groups with low and normal KES in the fall risk index, FRI12-6 and chair test (P < 0.05). Static parameters did not differentiate groups, due to a muscle strength of the upper and lower limbs. There was a statistically significant difference in FRI12-6 values between participants with low and normal KES in age groups (P = 0.047). No differences were found in FRI12-6 values between participants with low and normal HGS in age groups (P = 0.949). Statistical analysis showed differences in FRI12-6 between fallers with low KES and non-fallers with normal KES, non-fallers with low KES and non-fallers with normal KES. Results of the study show that there is diagnostic dependence in muscle strength of lower limbs and risk of falls in older women. KES and chair test can be used in fall risk assessment for older women.

Selected Tools for Assessing the Risk of Falls in Older Women

Methods

Fifty-five females were examined (May 2018-June 2019). Stabilographic examinations were performed with eyes open (EO) and closed (EC). An analysis of variance (ANOVA) and Spearman rank correlation were performed to determine the relationships and differences between the above tests.

Results

The results of the TUG correlate with the overall stability index (OSI) EO (r = 0.314), medial-lateral stability index (MLSI) EO (r = 0.297), and fall risk index (FRI6-2; r = 0.435) in stabilographic examinations and the FRT (r = −0.399). The results of the modified Unterberger test correlate with MLSI EO (r = 0.276), OSI EC (r = 0.310), and MLSI EC (r = 0.378). There are statistically significant differences between faller and nonfaller groups in TUG (p = 0.0068), FRT (p = 0.001), and MLSI EO (p = 0.0118).

Conclusions

The modified Unterberger test and TUG can be considered effective in functional FR assessment in older women. Using at least two different functional tests may improve the assessment of FR.