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Mishra RK, Bara RO, Zulbaran-Rojas A, Park C, Fernando ME, Ross J, Lepow B, Najafi B. The Application of Digital Frailty Screening to Triage Nonhealing and Complex Wounds. J Diabetes Sci Technol 2024; 18:389-396. [PMID: 35856398 PMCID: PMC10973858 DOI: 10.1177/19322968221111194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE We investigated the association between the complexity of diabetic foot ulcers (DFUs) and frailty. RESEARCH DESIGN AND METHODS Individuals (n = 38) with Grade 2 Wagner DFU were classified into 3 groups based on the Society for Vascular Surgery risk-stratification for major limb amputation as Stage 1 at very low risk (n = 19), Stage 2 at low risk (n = 9), and Stage 3 to 4 at moderate-to-high risk (n = 10) of major limb amputation. Frailty status was objectively assessed using a validated digital frailty meter (FM). The FM works by quantifying weakness, slowness, rigidity, and exhaustion over a 20-second repetitive elbow flexion-extension exercise using a wrist-worn sensor. FM generates a frailty index (FI) ranging from 0 to 1; higher values indicate progressively greater severity of frailty. Skin perfusion pressure (SPP), albumin, and tissue oxygenation level (SatO2) were also measured. One-way analysis of variance (ANOVA) was used to identify group effect for wound complexity. Pearson's correlation coefficient was used to assess the associations with frailty and clinical endpoints. RESULTS Frailty index was higher in Stage 3 and 4 as compared to Stage 1 (d = 1.4, P < .01) and Stage 2 (d = 1.2, P < .01). Among assessed frailty phenotypes, exhaustion was correlated with SPP (r = -0.63, P < .01) and albumin (r = -0.5, P < .01). CONCLUSION Digital biomarkers of frailty may predict complexity of DFU and thus triage individuals who can be treated more simply in their primary clinic versus higher risk patients who require prompt referral to multidisciplinary, more complex care.
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Affiliation(s)
- Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Rasha O. Bara
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Alejandro Zulbaran-Rojas
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Catherine Park
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC, USA
| | - Malindu E. Fernando
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Ulcer and Wound Healing Consortium (UHEAL), Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jeffrey Ross
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Brian Lepow
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- School of Health Professions, Baylor College of Medicine, Houston, TX, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
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Pradeep Kumar D, Zanotto T, Cozart JS, Bruce AS, Befort C, Siengsukon C, Shook R, Lynch S, Mahmoud R, Simon S, Hibbing PR, Drees B, Huebner J, Bradish T, Robichaud J, Sosnoff JJ, Bruce JM. Association between frailty and sleep quality in people living with multiple sclerosis and obesity: An observational cross-sectional study. Mult Scler Relat Disord 2024; 81:105154. [PMID: 38043367 DOI: 10.1016/j.msard.2023.105154] [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: 08/15/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND A majority of the people with multiple sclerosis (pwMS) experience sleep disturbances. Frailty is also common in pwMS. The geriatric literature strongly suggests that frailty is associated with worse sleep outcomes in community-dwelling older adults, but this association has yet to be explored among pwMS. This study focused on examining the association between frailty and sleep quality in pwMS. METHODS Seventy-six people with both MS and obesity (mean age: 47.6 ± 10.9 years, 81.6 % female, mean body mass index (BMI): 37.10 ± 5.5 kg/m2, mean Patient Determined Disease Steps (PDDS): 0.82 ± 1.20) were included in this cross-sectional secondary analysis. A comprehensive frailty index (FI) based on 41 health deficits from various health domains was calculated based on standardized procedures. Sleep quality was determined by the Pittsburgh Sleep Quality Index questionnaire (PSQI). RESULTS Overall, 67.1 % of the participants were identified as non-frail (FI ≤ 0.25), and 32.9 % were identified as frail (FI > 0.25). A significant correlation was observed between FI scores and global PSQI scores (ρ = 0.43, p < 0.05). Cross-tabulation analyses revealed that frail participants had worse subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and higher use of sleep medications compared to non-frail participants (p < 0.05). CONCLUSIONS The current study identified a significant association between frailty and sleep quality in people with both MS and obesity with minimal disability. These findings underscore the importance of untangling the relationship between frailty and sleep quality in pwMS. These results could lead to a more targeted approach for rehabilitation interventions aiming to improve frailty in MS.
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Affiliation(s)
- Danya Pradeep Kumar
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Tobia Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Centre for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
| | - Julia S Cozart
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Amanda S Bruce
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA; Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christie Befort
- Department of Population Health, University Kansas Medical Center, Kansas City, KS, USA
| | - Catherine Siengsukon
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Robin Shook
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA; Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA; School of Medicine, University of Missouri-Kansas City, Kansas City, MO USA
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rola Mahmoud
- Department of Neurology, University of Missouri, Kansas City, Saint Luke's Hospital, Kansas City, MO, USA
| | - Steve Simon
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Paul R Hibbing
- Department of Kinesiology & Nutrition, University of Illinois Chicago, Chicago, IL, USA
| | - Betty Drees
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA; Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA; Graduate School of the Stowers Institute for Medical Research, USA
| | - Joanie Huebner
- UMKC Department of Community and Family Medicine, University Health Lakewood Medical Center, Kansas City, MO, USA
| | - Taylor Bradish
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Jade Robichaud
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Jacob J Sosnoff
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Centre for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jared M Bruce
- Department of Biomedical and Health Informatics, University of Missouri - Kansas City School of Medicine, University of Missouri - Kansas City, Kansas City, MO, USA; Departments of Neurology and Psychiatry, University Health, Kansas City, MO, USA.
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Lorenz EC, Hickson LJ, Khairallah P, Najafi B, Kennedy CC. Cellular Senescence and Frailty in Transplantation. CURRENT TRANSPLANTATION REPORTS 2023; 10:51-59. [PMID: 37576589 PMCID: PMC10414789 DOI: 10.1007/s40472-023-00393-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 03/28/2023]
Abstract
Purpose of review To summarizes the literature on cellular senescence and frailty in solid-organ transplantation and highlight the emerging role of senotherapeutics as a treatment for cellular senescence. Recent findings Solid-organ transplant patients are aging. Many factors contribute to aging acceleration in this population, including cellular senescence. Senescent cells accumulate in tissues and secrete proinflammatory and profibrotic proteins which result in tissue damage. Cellular senescence contributes to age-related diseases and frailty. Our understanding of the role cellular senescence plays in transplant-specific complications such as allograft immunogenicity and infections is expanding. Promising treatments, including senolytics, senomorphics, cell-based regenerative therapies, and behavioral interventions, may reduce cellular senescence abundance and frailty in patients with solid-organ transplants. Summary Cellular senescence and frailty contribute to adverse outcomes in solid-organ transplantation. Continued pursuit of understanding the role cellular senescence plays in transplantation may lead to improved senotherapeutic approaches and better graft and patient outcomes.
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Affiliation(s)
| | - LaTonya J. Hickson
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, Florida
| | | | - Bijan Najafi
- Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, Texas
| | - Cassie C. Kennedy
- Division of Pulmonary, Critical Care, and Sleep Medicine, Mayo Clinic, Rochester, Minnesota
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Pradeep Kumar D, Najafi B, Laksari K, Toosizadeh N. Sensor-Based Assessment of Variability in Daily Physical Activity and Frailty. Gerontology 2023; 69:1147-1154. [PMID: 37231977 DOI: 10.1159/000530900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 04/26/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Frailty is a common geriatric syndrome associated with decline in physiological reserve. While several digital biomarkers of daily physical activity (DPA) have been used in frailty assessment, the association between DPA variability and frailty is still not clear. The goal of this study was to determine the association between frailty and DPA variability. METHODS This is an observational cross-sectional study conducted between September 2012 and November 2013. Older adults (≥65 years), without any severe mobility disorder, and the ability to walk 10 m (with or without an assistive device) were eligible for the study. DPA including sitting, standing, walking, lying, and postural transition were recorded for 48 h continuously. DPA variability was analyzed from two perspectives: (i) DPA duration variability in terms of coefficient of variation (CoV) of sitting, standing, walking, and lying down durations; and (ii) DPA performance variability in terms of CoV of sit-to-stand (SiSt) and stand-to-sit (StSi) durations and stride time (i.e., slope of power spectral density - PSD). RESULTS Data was analyzed from 126 participants (44 non-frail, 60 pre-frail, and 22 frail). For DPA duration variability, CoV of lying and walking duration was significantly larger among non-frail compared to pre-frail and frail groups (p < 0.03, d = 0.89 ± 0.40). For DPA performance variability, StSi CoV and PSD slope were significantly smaller for non-frail compared to pre-frail and frail groups (p < 0.05, d = 0.78 ± 0.19). CONCLUSION Lower DPA duration variability in pre-frail and frail groups may be attributed to the set daily routines frail older adults tend to follow, compared to variable physical activity routines of non-frail older adults. Higher DPA performance variability in the frail group may be attributed to reduced physiological capabilities toward walking for longer durations and the reduced muscle strength in the lower extremities, leading to incosistency in performing postural transitions.
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Affiliation(s)
- Danya Pradeep Kumar
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA,
| | - Bijan Najafi
- Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Kaveh Laksari
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
- Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
- Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, Arizona, USA
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McKenzie BA, Chen FL. Assessment and Management of Declining Physical Function in Aging Dogs. Top Companion Anim Med 2022; 51:100732. [DOI: 10.1016/j.tcam.2022.100732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/13/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
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Gruzdeva OV, Dyleva YA, Belik EV, Sinitsky MY, Kozyrin KA, Barbarash OL. Characteristics of adipocytokine expression by local fat depots of the heart: Relationship with the main risk factors for cardio-vascular diseases. Front Endocrinol (Lausanne) 2022; 13:991902. [PMID: 36157437 PMCID: PMC9493308 DOI: 10.3389/fendo.2022.991902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
In our study we investigated the relationships between adipocytokines in adipose tissue (AT) and cardiovascular disease (CVD) risk factors; (2) Methods: fat tissue biopsies were obtained from 134 patients with stable CAD undergoing coronary artery bypass grafting and 120 patients undergoing aortic or mitral valve replacement. Adipocytes were isolated from subcutaneous (SAT), epicardial (EAT), and perivascular AT (PVAT) samples, and cultured for 24 h, after which gene expression of adipocytokines in the culture medium was determined; (3) Results: men showed reduced ADIPOQ expression in EAT and PVAT, LEP expression in PVAT, and LEPR expression in SAT and PVAT compared to women. Men also exhibited higher SAT and lower PVAT IL6 than women. Meanwhile, dyslipidemia associated with decreased ADIPOQ expression in EAT and PVAT, LEPR in EAT, and IL6 in PVAT. Arterial hypertension (AH) associated with low EAT and PVAT ADIPOQ, and high EAT LEP, SAT, as well as PVAT LEPR, and IL6 in SAT and EAT. ADIPOQ expression decreased with increased AH duration over 20 years against an increased LEP background in ATs. Smoking increased ADIPOQ expression in all ATs and increased LEP in SAT and EAT, however, decreased LEPR in PVAT. Patients 51-59 years old exhibited the highest EAT and PVAT LEP, IL-6, and LEPR expression compared to other age groups; (4) Conclusions: decreased EAT ADIPOQ expression against an increased pro-inflammatory IL6 background may increase atherogenesis and contribute to CAD progression in combination with risk factors including male sex, dyslipidemia, and AH.
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Giri S, Dahal S, Bal S, Godby KN, Richman J, Olszewski AJ, Williams GR, Brown C, Buford TW, Costa LJ, Bhatia S. Pre-treatment neutrophil to lymphocyte ratio as a biomarker of frailty and predictor of survival among older adults with multiple myeloma. J Geriatr Oncol 2021; 13:486-492. [PMID: 34924305 DOI: 10.1016/j.jgo.2021.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/16/2021] [Accepted: 12/06/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Neutrophil to Lymphocyte Ratio (NLR) combines a marker of inflammation and reduced cell turnover to reflect age related alterations in the immune system. Whether NLR can serve as a biomarker of frailty and predict survival among older adults with Multiple Myeloma (MM) is unknown. MATERIALS AND METHODS We used an electronic health record-derived database to identify older adults (age ≥ 60y) with incident MM diagnosed between 1/2011 and 2/2020, with known pre-treatment absolute neutrophil and lymphocyte count up to 90 days before the start of therapy. The calculated NLR values were stratified into quartiles (Q1-Q4). We constructed a previously validated, simplified frailty index combining age, comorbidity and ECOG performance status. We measured the association between NLR quartiles and this frailty index using a logistic regression, adjusted for age, sex and race/ethnicity. We used Kaplan Meier methods and multivariable Cox regression to assess the impact of NLR on overall survival adjusting for potential confounders. RESULTS We identified 1729 older adults with newly diagnosed MM, at a median age of 73y (IQR: 67-78y). The median NLR was 2.13 (IQR: 1.44 to 3.31). Of the 1135 evaluable patients, 55% met criteria for frailty. Multivariable analysis revealed a 2.1-fold higher odds of frailty (95%CI = 1.42-3.10, p < 0.001) for patients in the NLR Q4 group vs. NLR Q1 group. In a multivariable analysis, adjusting for age, sex, race/ethnicity, M-protein type, stage, high risk cytogenetics, baseline creatinine, LDH and type of first line therapy, patients in NLR Q4 group had a 1.51 times increased hazards of death (95%CI = 1.15-1.98, p 0.002) when compared to those in NLR Q1 group. CONCLUSION NLR, a readily available laboratory biomarker, is associated with frailty measured using a simplified frailty index as well as inferior overall survival among older adults with MM. Future studies should explore its value as a screening tool to identify frail older adults with MM.
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Affiliation(s)
- Smith Giri
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, AL, United States; Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Sumit Dahal
- Department of Hospital Medicine, St. Joseph Hospital, Bangor, ME, United States
| | - Susan Bal
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kelly N Godby
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Joshua Richman
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Adam J Olszewski
- Division of Hematology-Oncology, Lifespan Cancer Institute, Providence, RI, United States
| | - Grant R Williams
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, AL, United States; Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Cynthia Brown
- Division of Gerontology, Geriatrics & Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Thomas W Buford
- Division of Gerontology, Geriatrics & Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Luciano J Costa
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Smita Bhatia
- Institute for Cancer Outcomes & Survivorship, University of Alabama at Birmingham, Birmingham, AL, United States
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Jergović M, Coplen CP, Uhrlaub JL, Nikolich-Žugich J. Immune response to COVID-19 in older adults. J Heart Lung Transplant 2021; 40:1082-1089. [PMID: 34140221 PMCID: PMC8111884 DOI: 10.1016/j.healun.2021.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the third highly pathogenic coronavirus to emerge in the human population in last two decades. SARS-CoV-2 spread from Wuhan, China, across the globe, causing an unprecedented public healthcare crisis. The virus showed remarkable age dependent pathology, with symptoms resembling common cold in most adults and children while causing more severe respiratory distress and significant mortality in older and frail humans. Even before the SARS-CoV-2 outbreak infectious diseases represented one of the major causes of death of older adults. Loss of immune function and reduced protection from infectious agents with age - immunosenescence - is a result of complex mechanisms affecting production and maintenance of immune cells as well as the initiation, maintenance and termination of properly directed immune responses. Here we briefly discuss the current knowledge on how this process affects age-dependent outcomes of SARS-CoV-2 infection.
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Affiliation(s)
- Mladen Jergović
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, Arizona; University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, Arizona.
| | - Christopher P Coplen
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, Arizona; University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, Arizona
| | - Jennifer L Uhrlaub
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, Arizona; University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, Arizona
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, Arizona; University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, Arizona
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Baek KW, Jung YK, Park JS, Kim JS, Hah YS, Kim SJ, Yoo JI. Two Types of Mouse Models for Sarcopenia Research: Senescence Acceleration and Genetic Modification Models. J Bone Metab 2021; 28:179-191. [PMID: 34520651 PMCID: PMC8441530 DOI: 10.11005/jbm.2021.28.3.179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022] Open
Abstract
Sarcopenia leads to loss of skeletal muscle mass, quality, and strength due to aging; it was recently given a disease code (International Classification of Diseases, Tenth Revision, Clinical Modification, M62.84). As a result, in recent years, sarcopenia-related research has increased. In addition, various studies seeking to prevent and treat sarcopenia by identifying the various mechanisms related to the reduction of skeletal muscle properties have been conducted. Previous studies have identified muscle synthesis and breakdown; investigating them has generated evidence for preventing and treating sarcopenia. Mouse models are still the most useful ones for determining mechanisms underlying sarcopenia through correlations and interventions involving specific genes and their phenotypes. Mouse models used to study sarcopenia often induce muscle atrophy by hindlimb unloading, denervation, or immobilization. Though it is less frequently used, the senescence-accelerated mouse can also be useful for sarcopenia research. Herein, we discuss cases where senescence-accelerated and genetically engineered mouse models were used in sarcopenia research and different perspectives to use them.
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Affiliation(s)
- Kyung-Wan Baek
- Department of Physical Education, Gyeongsang National University, Jinju, Korea.,Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea
| | - Youn-Kwan Jung
- Biomedical Research Institute, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea
| | - Jin Sung Park
- Department of Orthopaedic Surgery and Institute of Health Sciences, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Ji-Seok Kim
- Department of Physical Education, Gyeongsang National University, Jinju, Korea
| | - Young-Sool Hah
- Biomedical Research Institute, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea
| | - So-Jeong Kim
- Department of Convergence Medical Science, Gyeongsang National University, Jinju, Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Gyeongsang National University, Jinju, Korea
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Jung D, Kim J, Kim M, Won CW, Mun KR. Frailty Assessment Using Temporal Gait Characteristics and a Long Short-Term Memory Network. IEEE J Biomed Health Inform 2021; 25:3649-3658. [PMID: 33755570 DOI: 10.1109/jbhi.2021.3067931] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Faced with the rapidly aging world population, frailty has emerged as a major health burden among the elderly. This study aimed to investigate the feasibility of using temporal gait characteristics and a long short-term memory network for assessing frailty. Seventy-four community-dwelling elderly individuals participated in this study. The participants were categorized into three groups by their FRAIL scale: robust, pre-frail, and frail groups. The participants completed a 7-meter walking at the self-selected pace with a gyroscope on each foot. Analyzing the gyroscopic data produced seven temporal gait parameters per each gait cycle. Enumerating six consecutive values of each gait parameter produced the gait sequence features which were used as frailty predictors along with the demographic features. Five-fold cross-validation was applied to 70% of the data, and the remaining 30% were used as test data. An F1-score of 0.931 was achieved in classifying the robust, pre-frail, and frail groups by the random forest model trained with age, sex, and the outputs of the long short-term memory network-based classifier that used the initial and terminal double-limb support, step, and stride times as inputs. The proposed approach of assessing frailty using the arrhythmic gait pattern of the elderly and machine learning technique is novel and promising. Pioneering a way that self-monitor frailty at home without any help from experts, the study can contribute toearly diagnosis of frailty and make timely medical intervention possible.
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Minici D, Cola G, Giordano A, Antoci S, Girardi E, Bari MD, Avvenuti M. Towards automated assessment of frailty status using a wrist-worn device. IEEE J Biomed Health Inform 2021; 26:1013-1022. [PMID: 34329175 DOI: 10.1109/jbhi.2021.3100979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Wearable sensors potentially enable monitoring the users physical activity in daily life. Therefore, they are particularly appealing for the evaluation of older subjects in their environment, to capture early signs of frailty and mobility-related problems. This study explores the use of body-worn accelerometers for automated assessment of frailty during walking activity. Experiments involved 34 volunteers aged 70+, who were initially screened by geriatricians for the presence of frailty according to Frieds criteria. After screening, the volunteers were asked to walk 60 m at preferred speed, while wearing two accelerometers, one positioned on the lower back and the other on the wrist. Sensor-derived signals were analyzed independently to compare the ability of the two signals (wrist vs. lower back) in frailty status assessment. A gait detection technique was applied to identify segments made of four gait cycles. These segments were then used as input to compute 25 features in time and time-frequency domains, the latter by means of the Wavelet Transform. Finally, five machine learning models were trained and evaluated to classify subjects as robust or non-robust (i.e., pre-frail or frail). Gaussian naive Bayes applied to the features derived from the wrist sensor signal identified non-robust subjects with 91% sensitivity and 82% specificity, compared to 87% sensitivity and 64% specificity achieved with the lower back sensor. Results demonstrate that a wrist-worn accelerometer provides valuable information for the recognition of frailty in older adults, and could represent an effective tool to enable automated and unobtrusive assessment of frailty.
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Between-day repeatability of sensor-based in-home gait assessment among older adults: assessing the effect of frailty. Aging Clin Exp Res 2021; 33:1529-1537. [PMID: 32930988 DOI: 10.1007/s40520-020-01686-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 08/14/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND While sensor-based daily physical activity (DPA) gait assessment has been demonstrated to be an effective measure of physical frailty and fall-risk, the repeatability of DPA gait parameters between different days of measurement is not clear. AIMS To evaluate test-retest reliability (repeatability) of DPA gait performance parameters, representing the quality of walking, and quantitative gait measures (e.g. number of steps) between two separate days of assessment among older adults. METHODS DPA was acquired for 48-h from older adults (age ≥ 65 years) using a tri-axial accelerometer. Continuous walking bouts (≥ 60 s) were identified from acceleration data and used to extract gait performance parameters, including time- and frequency-domain gait parameters, representing walking speed, variability, and irregularity. To assess repeatability, intraclass correlation coefficient (ICC) was calculated using two-way mixed effects F-test models for day-1 vs. day-2 as the independent random effect. Repeatability tests were performed for all participants and also within frailty groups (non-frail and pre-frail/frail identified using Fried phenotype). RESULTS Data was analyzed from 63 older adults (29 non-frail and 34 pre-frail/frail). Most of the time- and frequency-domain gait performance parameters showed good to excellent repeatability (ICC ≥ 0.70), while quantitative parameters, including number of steps and walking duration showed poor repeatability (ICC < 0.30). Among majority of the gait performance parameters, we observed higher repeatability among the pre-frail/frail group (ICC > 0.78) compared to non-frail individuals (0.39 < ICC < 0.55). CONCLUSION Gait performance parameters, showed higher repeatability compared to quantitative measures. Higher repeatability among pre-frail/frail individuals may be attributed to a reduced functional capacity for performing more intense and variable physical tasks. TRIAL REGISTRATION The clinical trial was retrospectively registered on June 18th, 2013 with ClinicalTrials.gov, identifier NCT01880229.
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Xie WQ, He M, Yu DJ, Wu YX, Wang XH, Lv S, Xiao WF, Li YS. Mouse models of sarcopenia: classification and evaluation. J Cachexia Sarcopenia Muscle 2021; 12:538-554. [PMID: 33951340 PMCID: PMC8200444 DOI: 10.1002/jcsm.12709] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 02/06/2023] Open
Abstract
Sarcopenia is a progressive and widespread skeletal muscle disease that is related to an increased possibility of adverse consequences such as falls, fractures, physical disabilities and death, and its risk increases with age. With the deepening of the understanding of sarcopenia, the disease has become a major clinical disease of the elderly and a key challenge of healthy ageing. However, the exact molecular mechanism of this disease is still unclear, and the selection of treatment strategies and the evaluation of its effect are not the same. Most importantly, the early symptoms of this disease are not obvious and are easy to ignore. In addition, the clinical manifestations of each patient are not exactly the same, which makes it difficult to effectively study the progression of sarcopenia. Therefore, it is necessary to develop and use animal models to understand the pathophysiology of sarcopenia and develop therapeutic strategies. This paper reviews the mouse models that can be used in the study of sarcopenia, including ageing models, genetically engineered models, hindlimb suspension models, chemical induction models, denervation models, and immobilization models; analyses their advantages and disadvantages and application scope; and finally summarizes the evaluation of sarcopenia in mouse models.
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Affiliation(s)
- Wen-Qing Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Miao He
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Deng-Jie Yu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yu-Xiang Wu
- School of Kinesiology, Jianghan University, Wuhan, Hubei, China
| | - Xiu-Hua Wang
- Xiang Ya Nursing School, The Central South University, Changsha, Hunan, China
| | - Shan Lv
- Department of Geriatric Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wen-Feng Xiao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yu-Sheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Jergović M, Thompson HL, Bradshaw CM, Sonar SA, Ashgar A, Mohty N, Joseph B, Fain MJ, Cleveland K, Schnellman RG, Nikolich-Žugich J. IL-6 can singlehandedly drive many features of frailty in mice. GeroScience 2021; 43:539-549. [PMID: 33629207 PMCID: PMC8110675 DOI: 10.1007/s11357-021-00343-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 11/30/2022] Open
Abstract
Frailty is a geriatric syndrome characterized by age-related declines in function and reserve resulting in increased vulnerability to stressors. The most consistent laboratory finding in frail subjects is elevation of serum IL-6, but it is unclear whether IL-6 is a causal driver of frailty. Here, we characterize a new mouse model of inducible IL-6 expression (IL-6TET-ON/+ mice) following administration of doxycycline (Dox) in food. In this model, IL-6 induction was Dox dose-dependent. The Dox dose that increased IL-6 levels to those observed in frail old mice directly led to an increase in frailty index, decrease in grip strength, and disrupted muscle mitochondrial homeostasis. Littermate mice lacking the knock-in construct failed to exhibit frailty after Dox feeding. Both naturally old mice and young Dox-induced IL-6TET-ON/+ mice exhibited increased IL-6 levels in sera and spleen homogenates but not in other tissues. Moreover, Dox-induced IL-6TET-ON/+ mice exhibited selective elevation in IL-6 but not in other cytokines. Finally, bone marrow chimera and splenectomy experiments demonstrated that non-hematopoietic cells are the key source of IL-6 in our model. We conclude that elevated IL-6 serum levels directly drive age-related frailty, possibly via mitochondrial mechanisms.
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Affiliation(s)
- Mladen Jergović
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, AZ USA ,University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ 85724 USA
| | - Heather L. Thompson
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, AZ USA ,University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ 85724 USA ,Present Address: Ventana-Roche Medical Systems, Oro Valley, AZ USA
| | - Christine M. Bradshaw
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, AZ USA ,University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ 85724 USA
| | - Sandip Ashok Sonar
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, AZ USA ,University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ 85724 USA
| | - Arveen Ashgar
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, AZ USA ,University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ 85724 USA
| | - Niels Mohty
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, AZ USA ,University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ 85724 USA
| | - Bellal Joseph
- Division of Trauma Surgery, Department of Surgery, University of Arizona College of Medicine-Tucson, Tucson, AZ USA
| | - Mindy J. Fain
- University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ 85724 USA ,Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, AZ USA
| | - Kristan Cleveland
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ USA
| | - Rick G. Schnellman
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ USA ,Southern Arizona Veterans Affairs Health Care System, Tucson, AZ USA ,Southwest Environmental Health Science Center, University of Arizona, Tucson, AZ USA
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA. .,University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, P.O.Box. 249221, 1501 N. Campbell Ave., Tucson, AZ, 85724, USA.
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Zahiri M, Wang C, Gardea M, Nguyen H, Shahbazi M, Sharafkhaneh A, Ruiz IT, Nguyen CK, Bryant MS, Najafi B. Remote Physical Frailty Monitoring-The Application of Deep Learning-Based Image Processing in Tele-Health. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2020; 8:219391-219399. [PMID: 33777594 PMCID: PMC7996628 DOI: 10.1109/access.2020.3042451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Remote screening physical frailty (PF) may assist in triaging patients with chronic obstructive pulmonary disease (COPD) who are in clinical priorities to visit a clinical center for preventive care. Conventional PF assessment tools have however limited feasibility for remote patient monitoring applications. To improve the safety of PF assessment, we previously developed and validated a quick and safe PF screening tool called Frailty Meter (FM). FM works by quantifying weakness, slowness, rigidity, and exhaustion during a 20-second repetitive elbow flexion/extension task using a wrist-worn sensor and generates a frailty index (FI) ranging from zero to one; higher values indicate progressively greater severity of frailty. However, the use of wrist-sensor limits its applications in telemedicine and remote patient monitoring. In this study, we developed a sensor-less FM based on deep learning-based image processing, which can be easily integrated into mobile health and enables remote assessment of physical frailty. The sensor-less FM extracts kinematic features of the forearm motion from the video of 20-second elbow flexion and extension recorded by a tablet camera, and then calculates frailty phenotypes and FI. To test the validity of sensor-less FM, 11 COPD patients admitted to a Telehealth pulmonary rehabilitation clinic and 10 healthy young volunteers (controls) were recruited. All participants completed the test indicating high feasibility. Strong correlations (0.72 < r < 0.99) were observed between the sensor-based FM and sensor-less FM to extract all frailty phenotypes and FI. After adjusting with age and body mass index(BMI), sensor-less FM enables distinguishing COPD group from controls (p<0.050) with the largest effect sizes observed for weakness (Cohen's effect size d=2.24), frailty index (d=1.70), and slowness (d=1.70). These pilot findings suggest feasibility and proof of concept validity of this sensor-less FM toward remote assessment of PF in COPD patients.
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Affiliation(s)
- Mohsen Zahiri
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Changhong Wang
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Manuel Gardea
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hung Nguyen
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mohammad Shahbazi
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Amir Sharafkhaneh
- Telehealth Cardio-Pulmonary Rehabilitation Program, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ilse Torres Ruiz
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Christina K Nguyen
- Telehealth Cardio-Pulmonary Rehabilitation Program, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - Monthaporn S Bryant
- Telehealth Cardio-Pulmonary Rehabilitation Program, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - Bijan Najafi
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
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16
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Najafi B, Veranyan N, Zulbaran-Rojas A, Park C, Nguyen H, Nakahara QK, Elizondo-Adamchik H, Chung J, Mills JL, Montero-Baker M, Armstrong DG, Rowe V. Association Between Wearable Device-Based Measures of Physical Frailty and Major Adverse Events Following Lower Extremity Revascularization. JAMA Netw Open 2020; 3:e2020161. [PMID: 33211104 PMCID: PMC7677765 DOI: 10.1001/jamanetworkopen.2020.20161] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Physical frailty is a key risk factor associated with higher rates of major adverse events (MAEs) after surgery. Assessing physical frailty is often challenging among patients with chronic limb-threatening ischemia (CLTI) who are often unable to perform gait-based assessments because of the presence of plantar wounds. OBJECTIVE To test a frailty meter (FM) that does not rely on gait to determine the risk of occurrence of MAEs after revascularization for patients with CLTI. DESIGN, SETTING, AND PARTICIPANTS This cohort study included 184 consecutively recruited patients with CLTI at 2 tertiary care centers. After 32 individuals were excluded, 152 participants were included in the study. Data collection was conducted between May 2018 and June 2019. EXPOSURES Physical frailty measurement within 1 week before limb revascularization and incidence of MAEs for as long as 1 month after surgery. MAIN OUTCOMES AND MEASURES The FM works by quantifying weakness, slowness, rigidity, and exhaustion during a 20-second repetitive elbow flexion-extension exercise using a wrist-worn sensor. The FM generates a frailty index (FI) ranging from 0 to 1; higher values indicate progressively greater severity of physical frailty. RESULTS Of 152 eligible participants (mean [SD] age, 67.0 [11.8] years; 59 [38.8%] women), 119 (78.2%) were unable to perform the gait test, while all could perform the FM test. Overall, 53 (34.9%), 58 (38.1%), and 41 (27.0%) were classified as robust (FI <0.20), prefrail (FI ≥0.20 to <0.35), or frail (FI ≥0.35), respectively. Within 30 days after surgery, 24 (15.7%) developed MAEs, either major adverse cardiovascular events (MACE; 8 [5.2%]) or major adverse limb events (MALE; 16 [10.5%]). Baseline demographic characteristics were not significantly different between frailty groups. In contrast, the FI was approximately 30% higher in the group that developed MAEs (mean [SD] score, 0.36 [0.14]) than those who were MAE free (mean [SD] score, 0.26 [0.13]; P = .001), with observed MAE rates of 4 patients (7.5%), 7 patients (12.1%), and 13 patients (31.7%) in the robust, prefrail and frail groups, respectively (P = .004). The FI distinguished individuals who developed MACE and MALE from those who were MAE free (MACE: mean [SD] FI score, 0.38 [0.16]; P = .03; MALE: mean [SD] FI score, 0.35 [0.13]; P = .004) after adjusting by body mass index. CONCLUSIONS AND RELEVANCE In this cohort study, measuring physical frailty using a wrist-worn sensor during a short upper extremity test was a practical method for stratifying the risk of MAEs following revascularization for CLTI when the administration of gait-based tests is often challenging.
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Affiliation(s)
- Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Narek Veranyan
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Alejandro Zulbaran-Rojas
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Catherine Park
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Hung Nguyen
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | | | - Hector Elizondo-Adamchik
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Jayer Chung
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Joseph L. Mills
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Miguel Montero-Baker
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | | | - Vincent Rowe
- Keck School of Medicine, University of Southern California, Los Angeles
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17
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Age-Related Deterioration of Mitochondrial Function in the Intestine. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:4898217. [PMID: 32922652 PMCID: PMC7453234 DOI: 10.1155/2020/4898217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/22/2020] [Indexed: 12/29/2022]
Abstract
Aging is an important and inevitable biological process in human life, associated with the onset of chronic disease and death. The mechanisms behind aging remain unclear. However, changes in mitochondrial function and structure, including reduced activity of the mitochondrial respiratory chain and increased production of reactive oxygen species—thus oxidative damage—are believed to play a major role. Mitochondria are the main source of cellular energy, producing adenosine triphosphate (ATP) via oxidative phosphorylation. Accumulation of damaged cellular components reduces a body's capacity to preserve tissue homeostasis and affects biological aging and all age-related chronic conditions. This includes the onset and progression of classic degenerative diseases such as cardiovascular disease, kidney failure, neurodegenerative diseases, and cancer. Clinical manifestations of intestinal disorders, such as mucosal barrier dysfunction, intestinal dysmotility, and chronic obstipation, are highly prevalent in the elderly population and have been shown to be associated with an age-dependent decline of mitochondrial function. This review summarizes our current understanding of the role of mitochondrial dysfunction in intestinal aging.
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18
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Newell-Stamper BL, Huibregtse BM, Boardman JD, Domingue BW. A mutation associated with stress resistance in mice is associated with human grip strength and mortality. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 65:245-256. [PMID: 32727277 DOI: 10.1080/19485565.2020.1744425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Hand grip strength (GS) is a valid and reliable predictor of future morbidity and mortality and is considered a useful indicator of aging. In this paper, we use results from the genetic analysis in animal studies to evaluate associations for GS, frailty, and subsequent mortality among humans. Specifically, we use data from the Health and Retirement Survey (HRS) to investigate the association between three polymorphisms in a candidate frailty gene (Tiam1) and GS. Results suggest that the A allele in rs724561 significantly reduces GS among older adults in the US (b = -0.340; p < .006) and is significantly associated with self-reported weakness (b = 0.221; p = .036). This same polymorphism was weakly associated (one-tailed) with an increased risk of mortality (b = 1.091; p < .093) and adjustments for GS rendered this association statistically non-significant (b = 1.048; p < .361). Overall, our results provide tentative evidence that the Tiam1 gene may be associated with frailty development, but we encourage further studies.
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Affiliation(s)
- Breanne L Newell-Stamper
- Department of Integrative Physiology, University of Colorado at Boulder , Boulder, Colorado, USA
- Institute for Behavioral Genetics, University of Colorado at Boulder , Boulder, Colorado, USA
| | - Brooke M Huibregtse
- Institute for Behavioral Genetics, University of Colorado at Boulder , Boulder, Colorado, USA
| | - Jason D Boardman
- Department of Integrative Physiology, University of Colorado at Boulder , Boulder, Colorado, USA
- Institute for Behavioral Genetics, University of Colorado at Boulder , Boulder, Colorado, USA
- Department of Sociology, University of Colorado at Boulder , Boulder, Colorado, USA
| | - Benjamin W Domingue
- Graduate School of Education, Stanford University , Stanford, California, USA
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Keller K, Kane A, Heinze-Milne S, Grandy SA, Howlett SE. Chronic Treatment With the ACE Inhibitor Enalapril Attenuates the Development of Frailty and Differentially Modifies Pro- and Anti-inflammatory Cytokines in Aging Male and Female C57BL/6 Mice. J Gerontol A Biol Sci Med Sci 2020; 74:1149-1157. [PMID: 30256910 DOI: 10.1093/gerona/gly219] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Indexed: 11/13/2022] Open
Abstract
Studies on interventions that can delay or treat frailty in humans are limited. There is evidence of beneficial effects of angiotensin converting enzyme (ACE) inhibitors on aspects related to frailty, such as physical function, even in those without cardiovascular disease. This study aimed to longitudinally investigate the effect of an ACE inhibitor on frailty in aging male and female mice. Frailty was assessed with a clinical frailty index (FI) which quantifies health-related deficits in middle-aged (9-13 months) and older (16-25 months) mice. Chronic treatment with enalapril (30 mg/kg/day in feed) attenuated frailty in middle-aged and older female mice, and older male mice, without a long-term effect on blood pressure. Enalapril treatment resulted in a reduction in the proinflammatory cytokines interleukin (IL)-1α, monocyte chemoattractant protein-1 and macrophage inflammatory protein-1a in older female mice, and an increase in the anti-inflammatory cytokine IL-10 in older male mice compared with control animals. These sex-specific effects on inflammation may contribute to the protective effects of enalapril against frailty. This is the first study to examine the longitudinal effect of an intervention on the FI in mice, and provides preclinical evidence that enalapril may delay the onset of frailty, even when started later in life.
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Affiliation(s)
- Kaitlyn Keller
- Department of Pharmacology, Dalhousie University, Halifax, Canada
| | - Alice Kane
- Department of Pharmacology, Dalhousie University, Halifax, Canada
| | - Stefan Heinze-Milne
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - Scott A Grandy
- Department of Pharmacology, Dalhousie University, Halifax, Canada.,School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - Susan E Howlett
- Department of Pharmacology, Dalhousie University, Halifax, Canada.,Department of Medicine (Geriatric Medicine), Dalhousie University, Halifax, Canada
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Pradeep Kumar D, Toosizadeh N, Mohler J, Ehsani H, Mannier C, Laksari K. Sensor-based characterization of daily walking: a new paradigm in pre-frailty/frailty assessment. BMC Geriatr 2020; 20:164. [PMID: 32375700 PMCID: PMC7203790 DOI: 10.1186/s12877-020-01572-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 04/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Frailty is a highly recognized geriatric syndrome resulting in decline in reserve across multiple physiological systems. Impaired physical function is one of the major indicators of frailty. The goal of this study was to evaluate an algorithm that discriminates between frailty groups (non-frail and pre-frail/frail) based on gait performance parameters derived from unsupervised daily physical activity (DPA). METHODS DPA was acquired for 48 h from older adults (≥65 years) using a tri-axial accelerometer motion-sensor. Continuous bouts of walking for 20s, 30s, 40s, 50s and 60s without pauses were identified from acceleration data. These were then used to extract qualitative measures (gait variability, gait asymmetry, and gait irregularity) and quantitative measures (total continuous walking duration and maximum number of continuous steps) to characterize gait performance. Association between frailty and gait performance parameters was assessed using multinomial logistic models with frailty as the dependent variable, and gait performance parameters along with demographic parameters as independent variables. RESULTS One hundred twenty-six older adults (44 non-frail, 60 pre-frail, and 22 frail, based on the Fried index) were recruited. Step- and stride-times, frequency domain gait variability, and continuous walking quantitative measures were significantly different between non-frail and pre-frail/frail groups (p < 0.05). Among the five different durations (20s, 30s, 40s, 50s and 60s), gait performance parameters extracted from 60s continuous walks provided the best frailty assessment results. Using the 60s gait performance parameters in the logistic model, pre-frail/frail group (vs. non-frail) was identified with 76.8% sensitivity and 80% specificity. DISCUSSION Everyday walking characteristics were found to be associated with frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the early stages of frailty. In-home gait assessment offers an opportunity to screen for and monitor frailty. TRIAL REGISTRATION The clinical trial was retrospectively registered on June 18th, 2013 with ClinicalTrials.gov, identifier NCT01880229.
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Affiliation(s)
- Danya Pradeep Kumar
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA.
- Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Jane Mohler
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
- Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Hossein Ehsani
- Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Cassidy Mannier
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Kaveh Laksari
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
- Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, AZ, USA
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21
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Lee MM, Jebb SA, Oke J, Piernas C. Reference values for skeletal muscle mass and fat mass measured by bioelectrical impedance in 390 565 UK adults. J Cachexia Sarcopenia Muscle 2020; 11:487-496. [PMID: 31943835 PMCID: PMC7113534 DOI: 10.1002/jcsm.12523] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/25/2019] [Accepted: 11/14/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Loss of skeletal muscle mass (SMM) increases the risk of frailty and, together with excess fat mass (FM), is a risk factor for cardio-metabolic disease. However, use of body composition measurements in nutritional surveillance and routine clinical practice is limited by the lack of reference data. Our aim was to produce age-specific and sex-specific reference values for SMM and FM in the White ethnic adult population in the UK. Secondary objectives were to examine the tracking over time using a subsample of the population with repeated measures of body composition and to assess the validity of these reference values in different ethnic subgroups. METHODS We used data from segmental bioelectrical impedance analysis (BIA) in 390 565 participants, aged 40-69 years, in the UK Biobank, and data from dual-energy X-ray absorptiometry from n = 905 participants to validate the BIA measurements. SMM was calculated as the sum of the predicted muscle mass from the limbs. The LMS method was used to produce percentile curves for the SMM index (SMMI = SMM/height2 ) and the FM index (FMI = FM/height2 ). We investigated the validity of the White ethnic reference values by plotting z-scores (99.7% confidence interval) from Black and Asian groups to check if their confidence interval included zero. Longitudinal trajectories were predicted based on the baseline z-scores and the correlation between repeated measurements at follow-up. RESULTS The percentile curves show that SMMI declines in men from the age of 40, whereas in women, SMMI is more stable and decreases only slightly among women in the higher percentiles. FMI increases with age in both men and women. Women have higher FMI and lower SMMI than men in all age groups. The validity of the White-based reference values for non-White ethnic groups is poor. Longitudinal trajectories in body composition in the subsample of participants with a follow-up assessment show regression towards the mean in both men and women, with some evidence of declining SMMI only among men. The predicted 90% limits for the expected 5 year trajectories of SMMI and FMI can be used to identify people with unusual trajectories and in clinical practice to identify and track individuals at risk of excessive loss of SMM. CONCLUSIONS These body composition reference values developed from BIA in a middle/older-aged healthy White ethnic population in the UK could be used as a simple assessment tool for nutritional surveillance and to identify individuals with low SMMI or high FMI who may be at increased risk of disease and/or frailty.
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Affiliation(s)
- Mei-Man Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jason Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Błaszczyszyn M, Szczęsna A, Piechota K. sEMG Activation of the Flexor Muscles in the Foot during Balance Tasks by Young and Older Women: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224307. [PMID: 31698684 PMCID: PMC6888320 DOI: 10.3390/ijerph16224307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/30/2019] [Accepted: 11/04/2019] [Indexed: 12/19/2022]
Abstract
Objective: In this publication, we suggest that young adults and seniors use various defense mechanisms to counteract loss of balance. One of the hypotheses is the change in the coordination of antagonistic muscle groups, especially within the ankles. In this study, we tried to determine if there is a relationship between the condition from resilient, to pre-frail, to frail and the ability to maintain balance during free standing and balance tasks. The aim of the study was to define the importance of muscle activity in the ankle joint, dorsal flexor of the foot for the following: tibialis anterior (TA), plantar flexor of the foot gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and peroneus longus (PER), during balance tasks with eyes open (EO) and closed (EC). We hypothesized that there are differences in the activity and co-activation of the tested muscles in young and older women, which may indicate an increased risk of falls and walking disorders. Materials and methods: A group of 20 women qualified for the study. The group was divided into two subgroups, young (G1) and elderly women (G2). The aim of the study was to define the importance of muscle activity in the ankle joint, dorsal flexor of the foot for the following: tibialis anterior (TA), plantar flexor of the foot gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and peroneus longus (PER), during balance tasks with eyes open (EO) and closed (EC). Results: In this study, we observed significant differences between groups in the maximum and mean values of electromyography activity (EMG) activation of the examined muscles on different types of surfaces and with open and closed eyes. Older women generated higher values of EMG activation in all muscles except the gastrocnemius medialis muscle. The results were significant for co-activation at rest for muscles as follows: tibialis anterior and gastrocnemius medialis with eyes closed (p = 0.01) and peroneus and gastrocnemius lateralis at rest with eyes open (p = 0.03), eyes closed (p = 0.04), and on a foam (p = 0.02). The sEMG amplitude of the tested muscles means that agonist muscle activity changed relative to antagonistic muscle activity. Conclusions: Activation of sEMG and coordination of ankle muscles during balance tasks change with age. It can be hypothesized that assessment of balance during free standing and equivalent tasks can predict the state of frailty, after taking into account other physiological variables that are believed to affect balance control.
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Affiliation(s)
- Monika Błaszczyszyn
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Prószkowska 76, 45-758 Opole, Poland;
- Correspondence:
| | - Agnieszka Szczęsna
- Institute of Informatics, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland;
| | - Katarzyna Piechota
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Prószkowska 76, 45-758 Opole, Poland;
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Furtado GE, Letieri R, Hogervorst E, Teixeira AB, Ferreira JP. Physical Frailty and cognitive performance in older populations, part I: systematic review with meta-analysis. CIENCIA & SAUDE COLETIVA 2019; 24:203-218. [PMID: 30698254 DOI: 10.1590/1413-81232018241.03692017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 06/04/2017] [Indexed: 01/10/2023] Open
Abstract
The purpose of present study was to analyze the magnitude of the effect-size in the assessment of the cognitive status of populations over 60 years of age. The search strategy included PubMed, B-on, Ebsco, Ebsco Health, Scielo, Eric, Lilacs and Sportdiscus data bases. Only observational, cohort and cross-sectional studies were included in the meta-analysis. The central descriptors were elderly-frail, older adults, cognition and geriatric assessment and other additional terms. After applying the additional search criteria, 12 manuscripts were selected from an initial universe of 1,078 identified. When comparing the mean cognitive profile scores of the participants of the pre-frail (n =11,265) and frail (n = 2,460) groups, significant statistical differences were found (p<0,001), with lower mean scores emerging in frail-group. The results showed that cognitive decline is strongly associated with frailty, being a probable main clinical outcome. In this sense, any strategy aimed at mitigating or reversing the incidence of frailty with ageing should take into account that physical and cognitive frailty seem to have similar temporal trajectories.
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Affiliation(s)
- Guilherme Eustáquio Furtado
- Centro de Investigação em Desporto e Atividade Física, Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra. Av. Conímbriga/Estádio Universitário de Coimbra Pavilhão III, Santa Clara. 3040248 Coimbra Portugal.
| | - Rubens Letieri
- Núcleo de pesquisa multidisciplinar em EducaçãoFísica, Universidade Federal de Tocantins. Tocantinópolis TO Brasil
| | - Eef Hogervorst
- Grupo de Pesquisa Cognição Aplicada, Escola de Ciências do Esporte e do Ecercício, Universidade de Loughborough. Loughborough Reino Unido
| | - Ana Botelho Teixeira
- Centro de Investigação em Desporto e Atividade Física, Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra. Av. Conímbriga/Estádio Universitário de Coimbra Pavilhão III, Santa Clara. 3040248 Coimbra Portugal.
| | - José Pedro Ferreira
- Centro de Investigação em Desporto e Atividade Física, Faculdade de Ciências do Desporto e Educação Física, Universidade de Coimbra. Av. Conímbriga/Estádio Universitário de Coimbra Pavilhão III, Santa Clara. 3040248 Coimbra Portugal.
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24
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Fielder E, Weigand M, Agneessens J, Griffin B, Parker C, Miwa S, von Zglinicki T. Sublethal whole-body irradiation causes progressive premature frailty in mice. Mech Ageing Dev 2019; 180:63-69. [PMID: 30954485 PMCID: PMC6546927 DOI: 10.1016/j.mad.2019.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/07/2019] [Accepted: 03/26/2019] [Indexed: 12/24/2022]
Abstract
There is an unmet need to develop and validate therapies that can treat or at least prevent premature therapy-induced frailty, multi-morbidity and mortality in long-term tumour survivors. In an approach to develop a first mouse model for therapy-induced long-term frailty, we irradiated male C57Bl/6 mice at 5-6 months of age sub-lethally with 3 × 3 Gy (whole body) and assessed subsequent frailty for up to 6 months using a Rockwood-type frailty index (FI). Frailty scorers were trained to obtain excellent inter- and intra-observer reproducibility. Irradiated mice developed progressive frailty approximately twice as fast as controls. This was premature frailty; it was phenotypically identical to that in non-irradiated mice at higher age. As expected, frailty was associated with decreased cognition and predicted mortality. In irradiated mice, frailty and neuromuscular performance, measured by Rotarod and Hanging Wire tests, were not associated with each other, probably because of long-term decreased body weights after irradiation. We conclude that progressive frailty following sub-lethal irradiation comprises a sensitive and easy to use test bed for interventions to stop premature ageing in long-term tumour survivors.
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Affiliation(s)
- Edward Fielder
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biology, Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK
| | - Melanie Weigand
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biology, Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK
| | - Julien Agneessens
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biology, Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK
| | - Brigid Griffin
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biology, Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK
| | - Craig Parker
- NIHR Newcastle Biomedical Research Centre, Institute of Neurosciences, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Satomi Miwa
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biology, Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK
| | - Thomas von Zglinicki
- Newcastle University Institute for Ageing and Institute for Cell and Molecular Biology, Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK.
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26
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Huang DD, Fan SD, Chen XY, Yan XL, Zhang XZ, Ma BW, Yu DY, Xiao WY, Zhuang CL, Yu Z. Nrf2 deficiency exacerbates frailty and sarcopenia by impairing skeletal muscle mitochondrial biogenesis and dynamics in an age-dependent manner. Exp Gerontol 2019; 119:61-73. [PMID: 30690066 DOI: 10.1016/j.exger.2019.01.022] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/12/2019] [Accepted: 01/22/2019] [Indexed: 01/18/2023]
Abstract
AIM Mitochondrial dysfunction during aging is a key factor that contributes to sarcopenia. Nuclear factor erythroid 2-related factor 2 (Nrf2) has been increasingly recognized to regulate mitochondrial function. The present study aimed to investigate the role of Nrf2 in the development of frailty and sarcopenia during aging, and to demonstrate whether Nrf2 contributes to the maintenance of muscle mass and function by regulation of mitochondrial biogenesis and dynamics during the aging process. METHODS Young (5-6 months), middle-aged (11-13 months), old (20-24 months) Nrf2-/- (knockout, KO) mice and age-matched wild-type (WT) C57/BL6 mice were used in this study. Physical function of the mice in the 6 groups was assessed by grip strength test, four paw inverted hanging test, rotarod analysis, open field analysis, and treadmill endurance test. Muscle mass was measured by cross-sectional area (CSA) of tibialis anterior muscles and gastrocnemius muscle weight. The frailty status of the 25 old WT mice and 23 old KO mice were assessed based on the mouse frailty phenotype assessment. Expression levels of genes involved in mitochondrial biogenesis (nuclear respiratory factor 1 (Nrf1), peroxisome proliferative activated receptor, gamma, coactivator 1 alpha (PGC-1α), mitochondrial transcription factor A (TFAM)) and mitochondrial dynamics (optic atrophy protein 1 (Opa1), mitofusin 1 (Mfn1), mitofusin 2 (Mfn2), and dynamin-related protein 1 (Drp1)) were measured in the skeletal muscle. SDH staining was performed and mitochondrial DNA (mtDNA) copy number was measured. Transmission electron microscopy was used to measure the mitochondria number and morphology. RESULTS Physical function and muscle mass decreased during aging. The mRNA expression levels of Nrf2 decreased with increasing frailty phenotype scores in the old WT mice. There were minimal differences in the physical function and muscle mass between the WT and KO mice in the young groups, whereas Nrf2 deficiency caused a declined physical function and muscle mass in the middle-aged and old mice, and exacerbated frailty in the old mice. The decreases of the physical function and muscle mass were accompanied by the reduced expression levels of genes involved in mitochondrial biogenesis and dynamics, as well as a reduction of mitochondrial number, mitochondrial content, mtDNA copy number, and an impaired mitochondria morphology in the skeletal muscle. CONCLUSION Nrf2 deficiency exacerbated frailty and sarcopenia during aging, at least partially by impairing skeletal muscle mitochondrial biogenesis and dynamics in an age-dependent manner.
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Affiliation(s)
- Dong-Dong Huang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Sheng-Dong Fan
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xi-Yi Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xia-Lin Yan
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xian-Zhong Zhang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Bing-Wei Ma
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ding-Ye Yu
- Department of General Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wen-Yu Xiao
- Shanghai Tenth People's Hospital Chongming Branch Affiliated to Tongji University, Shanghai, China
| | - Cheng-Le Zhuang
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Zhen Yu
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Tenth People's Hospital Chongming Branch Affiliated to Tongji University, Shanghai, China.
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27
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Zhou H, Razjouyan J, Halder D, Naik AD, Kunik ME, Najafi B. Instrumented Trail-Making Task: Application of Wearable Sensor to Determine Physical Frailty Phenotypes. Gerontology 2018; 65:186-197. [PMID: 30359976 DOI: 10.1159/000493263] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 08/27/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The physical frailty assessment tools that are currently available are often time consuming to use with limited feasibility. OBJECTIVE To address these limitations, an instrumented trail-making task (iTMT) platform was developed using wearable technology to automate quantification of frailty phenotypes without the need of a frailty walking test. METHODS Sixty-one older adults (age = 72.8 ± 9.9 years, body mass index [BMI] = 27.4 ± 4.9 kg/m2) were recruited. According to the Fried Frailty Criteria, 39% of participants were determined as robust and 61% as non-robust (pre-frail or frail). In addition, 17 young subjects (age = 29.0 ± 7.2 years, BMI = 26.2 ± 4.6 kg/m2) were recruited to determine the healthy benchmark. The iTMT included reaching 5 indexed circles (including numbers 1-to-3 and letters A&B placed in random orders), which virtually appeared on a computer-screen, by rotating one's ankle-joint while standing. By using an ankle-worn inertial sensor, 3D ankle-rotation was estimated and mapped into navigation of a computer-cursor in real-time (100 Hz), allowing subjects to navigate the computer-cursor to perform the iTMT. The ankle-sensor was also used for quantifying ankle-rotation velocity (representing slowness), its decline during the test (representing exhaustion), and ankle-velocity variability (representing movement inefficiency), as well as the power (representing weakness) generated during the test. Comparative assessments included Fried frailty phenotypes and gait assessment. RESULTS All subjects were able to complete the iTMT, with an average completion time of 125 ± 85 s. The iTMT-derived parameters were able to identify the presence and absence of slowness, exhaustion, weakness, and inactivity phenotypes (Cohen's d effect size = 0.90-1.40). The iTMT Velocity was significantly different between groups (d = 0.62-1.47). Significant correlation was observed between the iTMT Velocity and gait speed (r = 0.684 p < 0.001). The iTMT-derived parameters and age together enabled significant distinguishing of non-robust cases with area under curve of 0.834, sensitivity of 83%, and specificity of 67%. CONCLUSION This study demonstrated a non-gait-based wearable platform to objectively quantify frailty phenotypes and determine physical frailty, using a quick and practical test. This platform may address the hurdles of conventional physical frailty phenotypes methods by replacing the conventional frailty walking test with an automated and objective process that reduces the time of assessment and is more practical for those with mobility limitations.
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Affiliation(s)
- He Zhou
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Javad Razjouyan
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.,VA HSR&D, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | - Debopriyo Halder
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.,College of Natural Sciences and Mathematics, University of Houston, Houston, Texas, USA
| | - Anand D Naik
- VA HSR&D, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.,Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, Texas, USA
| | - Mark E Kunik
- VA HSR&D, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.,Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, Texas, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas,
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Giboin LS, Gruber M, Kramer A. Additional Intra- or Inter-session Balance Tasks Do Not Interfere With the Learning of a Novel Balance Task. Front Physiol 2018; 9:1319. [PMID: 30283361 PMCID: PMC6157309 DOI: 10.3389/fphys.2018.01319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/31/2018] [Indexed: 11/23/2022] Open
Abstract
Background: It has been shown that balance training induces task-specific performance improvements with very limited transfer to untrained tasks. Thus, regarding fall prevention, one strategy is to practice as many tasks as possible to be prepared for a multitude of situations with increased fall risk. However, it is not clear whether the learning of several different balance tasks interfere with each other. A positive influence could be possible via the contextual interference (CI) effect, a negative influence could be induced by the disruption of motor memory during consolidation or retrieval. Methods: In two 3-week training experiments, we tested: (1) whether adding an additional balance task in the same training session would influence the learning of a balance task [first task: one-leg stance on a tilt-board (TB), six sessions, 15 × 20 s per session; additional task: one-leg stance on a slack line (SL), same amount of additional training]; (2) whether performing a different balance task (SL) in between training sessions of the first task (TB) would influence the learning of the first task. Twenty-six healthy subjects participated in the first experiment, 40 in the second experiment. In both experiments the participants were divided into three groups, TB only, TB and SL, and control. Before and after the training period, performance during the TB task (3 × 20 s) was recorded with a Vicon motion capturing system to assess the time in equilibrium. Results: Analyses of variance revealed that neither the additional intra-session balance task in experiment 1 nor the inter-session task in experiment 2 had a significant effect on balance performance improvement in the first task (no significant group × time interaction effect for the training groups, p = 0.83 and p = 0.82, respectively, only main effects of time). Conclusion: We could not find that additional intra- or intersession balance tasks interfere with the learning of a balance task, neither impairing it nor having a significant positive effect. This can also be interpreted as further evidence for the specificity of balance training effects, as different balance tasks do not seem to elicit interacting adaptations.
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Affiliation(s)
| | - Markus Gruber
- Sensorimotor Performance Lab, University of Konstanz, Konstanz, Germany
| | - Andreas Kramer
- Sensorimotor Performance Lab, University of Konstanz, Konstanz, Germany
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Wang J, Maxwell CA, Yu F. Biological Processes and Biomarkers Related to Frailty in Older Adults: A State-of-the-Science Literature Review. Biol Res Nurs 2018; 21:80-106. [DOI: 10.1177/1099800418798047] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The objectives of this literature review were to (1) synthesize biological processes linked to frailty and their corresponding biomarkers and (2) identify potential associations among these processes and biomarkers. In September 2016, PubMed, Cumulative Index to Nursing and Allied Health, Cochrane Library, and Embase were searched. Studies examining biological processes related to frailty in older adults (≥60 years) were included. Studies were excluded if they did not employ specific measures of frailty, did not report the association between biomarkers and frailty, or focused on nonelderly samples (average age < 60). Review articles, commentaries, editorials, and non-English articles were also excluded. Fifty-two articles were reviewed, reporting six biological processes related to frailty and multiple associated biomarkers. The processes (biomarkers) include brain changes (neurotrophic factor, gray matter volume), endocrine dysregulation (growth hormones [insulin-like growth factor-1 and binding proteins], hormones related to glucose and insulin, the vitamin D axis, thyroid function, reproductive axis, and hypothalamic–pituitary–adrenal axis), enhanced inflammation (C-reactive protein, interleukin-6), immune dysfunction (neutrophils, monocytes, neopterin, CD8+CD28−T cells, albumin), metabolic imbalance (micronutrients, metabolites, enzyme-activity indices, metabolic end products), and oxidative stress (antioxidants, telomere length, glutathione/oxidized glutathione ratio). Bidirectional interrelationships exist within and between these processes. Biomarkers were associated with frailty in varied strengths, and the causality remains unclear. In conclusion, frailty is related to multisystem physiological changes. Future research should examine the dynamic interactions among these processes to inform causality of frailty. Given the multifactorial nature of frailty, a composite index of multisystem biomarkers would likely be more informative than single biomarkers in early detection of frailty.
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Affiliation(s)
- Jinjiao Wang
- School of Nursing, University of Rochester, Rochester, NY, USA
| | | | - Fang Yu
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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Furtado GE, Caldo A, Rieping T, Filaire E, Hogervorst E, Teixeira AMB, Ferreira JP. Physical frailty and cognitive status over-60 age populations: A systematic review with meta-analysis. Arch Gerontol Geriatr 2018; 78:240-248. [PMID: 30029093 DOI: 10.1016/j.archger.2018.07.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 01/10/2023]
Abstract
The aim of this meta-analysis was to analyse the magnitude of the effect-size of the cognitive status of populations over 60 years of age, when comparing nonfrail versus pre-frail and nonfrail versus frail subgroups. A systematic review of prospective studies published from 2000 to 2017 was completed in Medline, B-on, Ebsco, Ebsco Health, Scielo, ERIC, LILACS and Sport discus databases and observational, cohort and cross-sectional studies were selected. The Mini-Mental State Examination to screening cognitive status and the Fried phenotype for assess physical frailty state was used as clinical outcomes. After applying additional search criteria, 14 manuscripts (26,798 old participants) were selected from an initial universe of 1681 identified. When comparing the scores of cognitive status of the participants who were non-frail (n = 12,729, 47.4%) versus pre-frail (n = 11,559, 43.2%) and non-frail versus frail (n = 2452, 9.4%) subgroups, significant statistical differences were found for both comparisons (M ± SD = 0.60, 95%CI: 0.50-0.62, p < 0.001 and M ± SD = 3.43, 95%CI: 2.26-4.60, p < 0.001, respectively). It is clear that poor cognitive function is strongly closed associated with pre-frailty and frailty subgroups in older populations around the world.
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Affiliation(s)
- Guilherme Eustáquio Furtado
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Adriana Caldo
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Taís Rieping
- Laboratory of Sport and Exercise Psychology of Faculty of Sport Sciences and Physical Education of University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Edith Filaire
- CIAMS, University Paris-Sud, Université, Paris-Saclay, 91405, Orsay Cedex, France; CIAMS, Université d'Orléans, 45067, Orléans, France; Research Team ECRIN, INRA, UMR 1019, Clermont-Ferrand, France; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Ana Maria Botelho Teixeira
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - José Pedro Ferreira
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
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Rahemi H, Nguyen H, Lee H, Najafi B. Toward Smart Footwear to Track Frailty Phenotypes-Using Propulsion Performance to Determine Frailty. SENSORS 2018; 18:s18061763. [PMID: 29857571 PMCID: PMC6021791 DOI: 10.3390/s18061763] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 12/14/2022]
Abstract
Frailty assessment is dependent on the availability of trained personnel and it is currently limited to clinic and supervised setting. The growing aging population has made it necessary to find phenotypes of frailty that can be measured in an unsupervised setting for translational application in continuous, remote, and in-place monitoring during daily living activity, such as walking. We analyzed gait performance of 161 older adults using a shin-worn inertial sensor to investigate the feasibility of developing a foot-worn sensor to assess frailty. Sensor-derived gait parameters were extracted and modeled to distinguish different frailty stages, including non-frail, pre-frail, and frail, as determined by Fried Criteria. An artificial neural network model was implemented to evaluate the accuracy of an algorithm using a proposed set of gait parameters in predicting frailty stages. Changes in discriminating power was compared between sensor data extracted from the left and right shin sensor. The aim was to investigate the feasibility of developing a foot-worn sensor to assess frailty. The results yielded a highly accurate model in predicting frailty stages, irrespective of sensor location. The independent predictors of frailty stages were propulsion duration and acceleration, heel-off and toe-off speed, mid stance and mid swing speed, and speed norm. The proposed model enables discriminating different frailty stages with area under curve ranging between 83.2–95.8%. Furthermore, results from the neural network suggest the potential of developing a single-shin worn sensor that would be ideal for unsupervised application and footwear integration for continuous monitoring during walking.
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Affiliation(s)
- Hadi Rahemi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
- Circulation Concepts Inc., Houston, TX 77030, USA.
| | - Hung Nguyen
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Hyoki Lee
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
- BioSensics LLC, Watertown, MA 02472, USA.
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
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Razjouyan J, Naik AD, Horstman MJ, Kunik ME, Amirmazaheri M, Zhou H, Sharafkhaneh A, Najafi B. Wearable Sensors and the Assessment of Frailty among Vulnerable Older Adults: An Observational Cohort Study. SENSORS (BASEL, SWITZERLAND) 2018; 18:E1336. [PMID: 29701640 PMCID: PMC5982667 DOI: 10.3390/s18051336] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 01/01/2023]
Abstract
Background: The geriatric syndrome of frailty is one of the greatest challenges facing the U.S. aging population. Frailty in older adults is associated with higher adverse outcomes, such as mortality and hospitalization. Identifying precise early indicators of pre-frailty and measures of specific frailty components are of key importance to enable targeted interventions and remediation. We hypothesize that sensor-derived parameters, measured by a pendant accelerometer device in the home setting, are sensitive to identifying pre-frailty. Methods: Using the Fried frailty phenotype criteria, 153 community-dwelling, ambulatory older adults were classified as pre-frail (51%), frail (22%), or non-frail (27%). A pendant sensor was used to monitor the at home physical activity, using a chest acceleration over 48 h. An algorithm was developed to quantify physical activity pattern (PAP), physical activity behavior (PAB), and sleep quality parameters. Statistically significant parameters were selected to discriminate the pre-frail from frail and non-frail adults. Results: The stepping parameters, walking parameters, PAB parameters (sedentary and moderate-to-vigorous activity), and the combined parameters reached and area under the curve of 0.87, 0.85, 0.85, and 0.88, respectively, for identifying pre-frail adults. No sleep parameters discriminated the pre-frail from the rest of the adults. Conclusions: This study demonstrates that a pendant sensor can identify pre-frailty via daily home monitoring. These findings may open new opportunities in order to remotely measure and track frailty via telehealth technologies.
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Affiliation(s)
- Javad Razjouyan
- VA HSR&D, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX 77030, USA; Mona (M.A.).
| | - Aanand D Naik
- VA HSR&D, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), Houston, TX 77030, USA.
| | - Molly J Horstman
- VA HSR&D, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Mark E Kunik
- VA HSR&D, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), Houston, TX 77030, USA.
| | - Mona Amirmazaheri
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX 77030, USA; Mona (M.A.).
| | - He Zhou
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX 77030, USA; Mona (M.A.).
| | - Amir Sharafkhaneh
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX 77030, USA; Mona (M.A.).
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
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MacEntee MI, Donnelly LR. Oral health and the frailty syndrome. Periodontol 2000 2018; 72:135-41. [PMID: 27501496 DOI: 10.1111/prd.12134] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 12/27/2022]
Abstract
The frailty syndrome is an ever-growing area of study among older adults because of its association with an increased risk of falls, hospitalization, institutionalization, dependency and mortality. Frailty is neither a disease nor a disability but is better understood as a medical syndrome of multisystem dysregulation that results in a diminished ability to overcome everyday stressors. The prevalence of frailty in any given population can vary widely, in part because of the way in which it is defined and measured, but in general it is higher among women and in those with advanced age and declining health. Whilst it is largely understood that older adults will differ biologically, psychologically and socially, and that each of these domains can impact oral health, we are only beginning to investigate how the mouth is affected in frailty. Given that both hard and soft structures contribute to oral health and disease status among older adults with varying degrees of impairment and disability, frailty adds yet another dimension to be considered. This paper will discuss how frailty can influence and be influenced by oral disorders, as well as the potential relationship to oral neglect and the resultant consequences among this vulnerable population.
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McClure R, Villani A. Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions. JCSM CLINICAL REPORTS 2017. [DOI: 10.17987/jcsm-cr.v2i2.45] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Sarcopenia and physical frailty are associated with progressive disability and predictive of negative health outcomes. Dietary interventions are considered the cornerstone in the management of sarcopenic symptomology and physical frailty. However few studies have investigated preventative strategies. Moreover, most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns. The Mediterranean Diet (MedDiet) is a dietary pattern that provides evidence for an association between diet quality, healthy ageing and disease prevention. The purpose of this paper was to examine, synthesise and develop a narrative review of the current literature, investigating the potential benefits associated with adherence to a MedDiet and attenuation of physical frailty and sarcopenic symptomology in older adults. We also explored the underlying mechanisms underpinning the potential benefits of the MedDiet on ameliorating physical frailty and sarcopenic symptomology. Synthesis of the reviewed literature is suggestive of a decreased risk of physical frailty and sarcopenic symptomology with greater adherence to a MedDiet. We identified the anti-inflammatory and high antioxidant components of the MedDiet as two potential biological mechanisms involved. Due to a lack of evidence from RCTs to support the proposed physiological mechanisms, we suggest investigating these observations in older adults with type 2 diabetes (T2DM) whom are vulnerable to physical frailty and disability. A number of biological mechanisms describing the pathway to disability in older adults with T2DM have been postulated with many of these mechanisms potentially mitigated with dietary interventions involving the MedDiet. Exploring these mechanisms with the use of well-designed, longer-term dietary intervention studies in older adults with an increased vulnerability to physical frailty and sarcopenia is warranted.
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Torres KCL, Rezende VBD, Lima-Silva ML, Santos LJDS, Costa CG, Mambrini JVDM, Peixoto SV, Tarazona-Santos E, Martins Filho OA, Lima-Costa MF, Teixeira-Carvalho A. Immune senescence and biomarkers profile of Bambuí aged population-based cohort. Exp Gerontol 2017; 103:47-56. [PMID: 29247791 DOI: 10.1016/j.exger.2017.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/26/2017] [Accepted: 12/09/2017] [Indexed: 01/18/2023]
Abstract
During immunosenescence many proinflammatory markers such as cytokines and chemokines are increased. This process called by Franceschi and colleagues as inflammaging is associated with chronic inflammation and the ethiology and pathophysiolgy of many ageing diseases as Alzheimer's and atherosclerosis. The knowledge of immune profile during ageing may provide some interventions that would improve the immune function in elderly and quality of life for old people. However, the identification of a group of potential biomarkers to monitor the ageing process is very difficult. In addition, most of the evidence evaluating immune biomarkers profile is based on data from older Caucasian adults. To our knowledge, no previous Latin American old population-based cohort has evaluated immunological parameters along the ageing process. The present work evaluated CXCL8, CXCL9, CXCL10, CCL2, CCL5, IL-1, IL-6, IL-12, TNF and IL-10 serum levels in 1494 older adults aged 60 to 95 from a population based ageing cohort in Brazil. Our data suggest that there is an increased positive predicted probability of participants to be a high producer of IL-6, CXCL8 and CXCL9. Moreover, results did not differ between men and women, except for CXCL10 that increased only in men. Results were not different in the adjusted model by many potential confounders, including African genomic ancestry. Together, these findings add novel insights about the immunologic aspects of ageing supported by a large population-based cohort study that provides evidences that corroborate with the inflammaging proposal and subsidize the establishment of biomarkers for monitoring the health status of aged population.
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Affiliation(s)
| | | | | | | | | | | | - Sérgio Viana Peixoto
- Instituto René Rachou, Fundação Oswaldo Cruz, Brazil; Escola de Enfermagem, Universidade Federal de Minas Gerais, Brazil
| | - Eduardo Tarazona-Santos
- Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Low ALT blood levels are associated with lower baseline fitness amongst participants of a cardiac rehabilitation program. J Exerc Sci Fit 2017; 16:1-4. [PMID: 30662484 PMCID: PMC6323158 DOI: 10.1016/j.jesf.2017.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 11/04/2017] [Accepted: 11/10/2017] [Indexed: 11/25/2022] Open
Abstract
Background/Objective Objective assessment tools for patients' frailty are lacking. Such tools would have been highly valuable for assessment of candidates for cardiac rehabilitation programs. Low ALT (Alanine aminotransferase) values were recently shown to be a promising parameter for objective, quantitative frailly assessment. Methods This was a retrospective study of patients participating in a cardiac rehabilitation program. Results Patients with lower ALT activity levels at the initiation of rehabilitation program had lower estimated METs values (6.86 vs. 7.73; p < 0.001), shorter stress test duration (06:41 vs. 07:44 min; p < 0.001), higher resting heart rate (72 ± 13 vs. 70 ± 13 BPM; p = 0.01) and lower heart rate reserve (49 ± 24 vs. 54 ± 24; p < 0.001). Multivariate linear modeling demonstrated that ALT values were Independent determinants of baseline exercise capacity (expressed in METs). Conclusion Lower ALT values, measured prior to the initiation of cardiac rehabilitation programs may indicate frailty of patients and be indicative for poor rehabilitation outcomes. Further, prospective studies should assess the potential correlation between ALT values and rehabilitation efficiency. We aimed to assess the potential correlation between the baseline ALT values and the baseline exercise capacity, as expressed in METs (Metabolic equivalent of tasks). 3806 patients were included in our study.
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Nishijima TF, Deal AM, Williams GR, Guerard EJ, Nyrop KA, Muss HB. Frailty and inflammatory markers in older adults with cancer. Aging (Albany NY) 2017; 9:650-664. [PMID: 28273043 PMCID: PMC5391224 DOI: 10.18632/aging.101162] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 01/15/2017] [Indexed: 01/04/2023]
Abstract
We examined the associations between frailty and inflammatory markers, in particular neutrophil lymphocyte ratio (NLR), in elderly cancer patients. We conducted cross-sectional analyses of data derived from the Carolina Seniors Registry (CSR), a database of geriatric assessments (GA) in older adults (≧65 years) with cancer. We included patients in the CSR who had a GA and complete blood count test before initiation of therapy. The primary outcome was frailty, determined using the 36-item Carolina Frailty Index (CFI). In our sample of 133 patients, the median age was 74, and 54% were robust, 22% were pre-frail, and 24% were frail. There was a significant positive correlation between CFI and NLR (r = 0.22, p = 0.025). In multivariable analysis, patients in the top tertile of NLR had an odds ratio of 3.8 (95% CI = 1.1-12.8) for frail/pre-frail status, adjusting for age, sex, race, education level, marital status, cancer type and stage. In bivariable analyses, higher NLR was associated with lower instrumental activity of daily living (IADL) score (p = 0.040) and prolonged timed up and go (p = 0.016). This study suggests an association between frailty and inflammation in older adults with cancer.
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Affiliation(s)
| | - Allison M Deal
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
| | - Grant R Williams
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA.,University of Alabama at Birmingham, Division of Hematology and Oncology, Birmingham, AL 35294, USA
| | - Emily J Guerard
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA.,University of Wisconsin, Division of Hematology and Oncology, Madison, WI 53792-5669, USA
| | - Kirsten A Nyrop
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
| | - Hyman B Muss
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
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Stout MB, Justice JN, Nicklas BJ, Kirkland JL. Physiological Aging: Links Among Adipose Tissue Dysfunction, Diabetes, and Frailty. Physiology (Bethesda) 2017; 32:9-19. [PMID: 27927801 DOI: 10.1152/physiol.00012.2016] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Advancing age is associated with progressive declines in physiological function that lead to overt chronic disease, frailty, and eventual mortality. Importantly, age-related physiological changes occur in cellularity, insulin-responsiveness, secretory profiles, and inflammatory status of adipose tissue, leading to adipose tissue dysfunction. Although the mechanisms underlying adipose tissue dysfunction are multifactorial, the consequences result in secretion of proinflammatory cytokines and chemokines, immune cell infiltration, an accumulation of senescent cells, and an increase in senescence-associated secretory phenotype (SASP). These processes synergistically promote chronic sterile inflammation, insulin resistance, and lipid redistribution away from subcutaneous adipose tissue. Without intervention, these effects contribute to age-related systemic metabolic dysfunction, physical limitations, and frailty. Thus adipose tissue dysfunction may be a fundamental contributor to the elevated risk of chronic disease, disability, and adverse health outcomes with advancing age.
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Affiliation(s)
- Michael B Stout
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.,Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jamie N Justice
- Department of Internal Medicine-Geriatrics, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina; and
| | - Barbara J Nicklas
- Department of Internal Medicine-Geriatrics, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina; and
| | - James L Kirkland
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota
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39
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Hazuda HP, Espinoza SE. Prevention of Falls and Frailty in Older Adults with Diabetes. CURRENT GERIATRICS REPORTS 2017. [DOI: 10.1007/s13670-017-0209-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Kane AE, Huizer-Pajkos A, Mach J, Mitchell SJ, de Cabo R, Le Couteur DG, Howlett SE, Hilmer SN. A Comparison of Two Mouse Frailty Assessment Tools. J Gerontol A Biol Sci Med Sci 2017; 72:904-909. [PMID: 28549083 DOI: 10.1093/gerona/glx009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Indexed: 01/08/2023] Open
Abstract
The mouse clinical frailty index and the mouse frailty phenotype assessment are two recently developed tools used to assess frailty in mice. The objectives of this study were to investigate whether the same mice are identified as frail with both tools and to examine the association of each of the assessment tools with age and frailty-related outcomes. Frailty was measured using both tools in old (~24 months; n = 36) C57BL/6 male mice. After 2 weeks, blood pressure and heart rate were measured and serum samples were collected for analysis of alanine aminotransferase, creatinine, and albumin levels. The mouse frailty phenotype assessment identified no mice as frail but modification of the assessment tool identified six mice as frail. The mouse clinical frailty index identified 16 mice as frail and the agreement between the two scales was 50.0%. Increasing clinical frailty index scores were correlated with low serum alanine aminotransferase, as well as decreased heart rate, and reduced heart rate variance. We conclude that, consistent with equivalent frailty assessment scales in humans, both tools have value but do not necessarily identify the same mice as frail.
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Affiliation(s)
- Alice E Kane
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research and Sydney Medical School, University of Sydney, New South Wales, Australia.,Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Aniko Huizer-Pajkos
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research and Sydney Medical School, University of Sydney, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - John Mach
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research and Sydney Medical School, University of Sydney, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Sarah J Mitchell
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Rafael de Cabo
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - David G Le Couteur
- Biogerontology Laboratory, Centre for Education and Research on Aging and ANZAC Research Institute, Sydney, New South Wales, Australia
| | - Susan E Howlett
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sarah N Hilmer
- Laboratory of Ageing and Pharmacology, Kolling Institute of Medical Research and Sydney Medical School, University of Sydney, New South Wales, Australia.,Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
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Yorke A, Kane AE, Hancock Friesen CL, Howlett SE, O'Blenes S. Development of a Rat Clinical Frailty Index. J Gerontol A Biol Sci Med Sci 2017; 72:897-903. [PMID: 28158648 PMCID: PMC5458399 DOI: 10.1093/gerona/glw339] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/19/2016] [Indexed: 12/02/2022] Open
Abstract
Rats are a commonly used model for aging studies, and a frailty assessment tool for rats would be of considerable value. There has been a recent focus on the development of preclinical models of frailty in mice. A mouse clinical frailty index (FI) was developed based on clinical frailty assessment tools. This FI measures the accumulation of clinically evident health-related deficits in mice. This paper aimed to develop a rat clinical FI. Male Fischer 344 rats were aged from 6 to 9 months (n = 12), and from 13 to 21 months (n = 41). A FI comprised of 27 health-related deficits was developed from a review of the literature and consultation with a veterinarian. Deficits were scored 0 if absent, 0.5 if mild, or 1 if severe. A FI score was determined for each rat every 3–4 months, and for the older group mortality was assessed up to 21 months. Mean FI scores significantly increased at each time point for the older rats. A high FI score measured at both 17 months of age and terminally was also associated with decreased probability of survival as assessed with Kaplan–Meier curves. The rat clinical FI has significant value for use in aging and interventional studies.
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Affiliation(s)
- Amy Yorke
- Physiology and Biophysics Department
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Palus S, Springer J, Doehner W, von Haehling S, Anker M, Anker S, Springer J. Models of sarcopenia: Short review. Int J Cardiol 2017; 238:19-21. [DOI: 10.1016/j.ijcard.2017.03.152] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 12/18/2022]
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Toosizadeh N, Wendel C, Hsu CH, Zamrini E, Mohler J. Frailty assessment in older adults using upper-extremity function: index development. BMC Geriatr 2017; 17:117. [PMID: 28577355 PMCID: PMC5457588 DOI: 10.1186/s12877-017-0509-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/24/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Numerous multidimensional assessment tools have been developed to measure frailty; however, the clinical feasibility of these tools is limited. We previously developed and validated an upper-extremity function (UEF) assessment method that incorporates wearable motion sensors. The purpose of the current study was to: 1) cross-sectionally validate the UEF method in a larger sample in comparison with the Fried index; 2) develop a UEF frailty index to predict frailty categories including non-frail, pre-frail, and frail based on UEF parameters and demographic information, using the Fried index as the gold standard; and 3) develop a UEF continuous score (points scores for each UEF parameter and a total frailty score) based on UEF parameters and demographic information, using the Fried index as the gold standard. METHODS We performed a cross-sectional validation and index development study within the Banner Medical Center, Tucson, and Banner Sun Health Research Institute, Sun City, Arizona. Community-dwelling and outpatient older adults (≥60 years; n = 352; 132 non-frail, 175 pre-frail, and 45 frail based on Fried criteria) were recruited. For the UEF test, each participant performed a 20-s elbow flexion, within which they repetitively and rapidly flexed and extended their dominant elbow. Using elbow motion outcomes two UEF indexes were developed (categorical and score). The Fried index was measured as the gold standard. RESULTS For the categorical index, speed of elbow flexion, elbow range of motion, elbow moment, number of flexion, speed variability and reduction within 20 s, as well as body mass index (BMI) were included as the pre-frailty/frailty predictor parameters. Results from 10-fold cross-validation showed receiver operator characteristic area under the curve of 0.77 ± 0.07 and 0.80 ± 0.12 for predicting Fried pre-frailty and frailty, respectively. UEF score (0.1 to 1.0) was developed using similar UEF parameters. CONCLUSIONS We present an objective, sensor-based frailty assessment tool based on physical frailty features including slowness, weakness, exhaustion (muscle fatigue), and flexibility of upper-extremity movements. Within the current study, the method was validated cross-sectionally using the Fried index as the gold standard and the UEF categorical index and UEF frailty score were developed for research purposes and potentially for future clinical use.
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Affiliation(s)
- Nima Toosizadeh
- Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, College of Medicine, 1807 E Elm St., PO Box 245072, Tucson, AZ, 85724-5072, USA.
- Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA.
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA.
| | - Christopher Wendel
- Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, College of Medicine, 1807 E Elm St., PO Box 245072, Tucson, AZ, 85724-5072, USA
- Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Edward Zamrini
- Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, College of Medicine, 1807 E Elm St., PO Box 245072, Tucson, AZ, 85724-5072, USA
- Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Jane Mohler
- Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, College of Medicine, 1807 E Elm St., PO Box 245072, Tucson, AZ, 85724-5072, USA
- Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Furtado G, Patrício M, Loureiro M, Teixeira AM, Ferreira JP. Physical Fitness and Frailty Syndrome in Institutionalized Older Women. Percept Mot Skills 2017; 124:754-776. [DOI: 10.1177/0031512517709915] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Guilherme Furtado
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
| | - Miguel Patrício
- Laboratory of Biostatistics and Medical Informatics and IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Marisa Loureiro
- Laboratory of Biostatistics and Medical Informatics and IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Maria Teixeira
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
| | - José Pedro Ferreira
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
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Deepa SS, Bhaskaran S, Espinoza S, Brooks SV, McArdle A, Jackson MJ, Van Remmen H, Richardson A. A new mouse model of frailty: the Cu/Zn superoxide dismutase knockout mouse. GeroScience 2017; 39:187-198. [PMID: 28409332 PMCID: PMC5411367 DOI: 10.1007/s11357-017-9975-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 04/06/2017] [Indexed: 11/29/2022] Open
Abstract
Frailty is a geriatric syndrome that is an important public health problem for the older adults living in the USA. Although several methods have been developed to measure frailty in humans, we have very little understanding of its etiology. Because the molecular basis of frailty is poorly understood, mouse models would be of great value in determining which pathways contribute to the development of frailty. More importantly, mouse models would be critical in testing potential therapies to treat and possibly prevent frailty. In this article, we present data showing that Sod1KO mice, which lack the antioxidant enzyme, Cu/Zn superoxide dismutase, are an excellent model of frailty, and we compare the Sod1KO mice to the only other mouse model of frailty, mice with the deletion of the IL-10 gene. Sod1KO mice exhibit four characteristics that have been used to define human frailty: weight loss, weakness, low physical activity, and exhaustion. In addition, Sod1KO mice show increased inflammation and sarcopenia, which are strongly associated with human frailty. The Sod1KO mice also show alterations in pathways that have been proposed to play a role in the etiology of frailty: oxidative stress, mitochondrial dysfunction, and cell senescence. Using Sod1KO mice, we show that dietary restriction can delay/prevent characteristics of frailty in mice.
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Affiliation(s)
- Sathyaseelan S Deepa
- Department of Geriatric Medicine and the Reynolds Oklahoma Center on Aging, Oklahoma University Health Science Center, Oklahoma City, OK, USA.
| | - Shylesh Bhaskaran
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Sara Espinoza
- Barshop Institute for Longevity & Aging Studies, Medicine, Division of Geriatrics, Gerontology & Palliative Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Geriatrics Research, Education & Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Susan V Brooks
- Department of Molecular and Integrative Physiology, Institute of Gerontology, University of Michigan, Ann Arbor, MI, USA
| | - Anne McArdle
- Department of Musculoskeletal Biology, MRC Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Malcolm J Jackson
- Department of Musculoskeletal Biology, MRC Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Holly Van Remmen
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
- Oklahoma City VA Medical Center, Oklahoma City, OK, USA
| | - Arlan Richardson
- Department of Geriatric Medicine and the Reynolds Oklahoma Center on Aging, Oklahoma University Health Science Center, Oklahoma City, OK, USA
- Oklahoma City VA Medical Center, Oklahoma City, OK, USA
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Parvaneh S, Mohler J, Toosizadeh N, Grewal GS, Najafi B. Postural Transitions during Activities of Daily Living Could Identify Frailty Status: Application of Wearable Technology to Identify Frailty during Unsupervised Condition. Gerontology 2017; 63:479-487. [PMID: 28285311 DOI: 10.1159/000460292] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 02/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Impairment of physical function is a major indicator of frailty. Functional performance tests have been shown to be useful for identification of frailty in older adults. However, these tests are often not translatable into unsupervised and remote monitoring of frailty status at home and/or community settings. OBJECTIVE In this study, we explored daily postural transition quantified using a chest-worn wearable technology to identify frailty in community-dwelling older adults. METHODS Spontaneous daily physical activity was monitored over 24 h in 120 community-dwelling elderly (age: 78 ± 8 years) using an unobtrusive wearable sensor (PAMSys™, BioSensics LLC, Watertown, MA, USA). Participants were classified as non-frail and pre-frail/frail using Fried's criteria. A validated software package was used to identify body postures and postural transition between each independent postural activity such as sit-to-stand, stand-to-sit, stand-to-walk, and walk-to-stand. The transition from walking to sitting was further classified as quick sitting and cautious sitting based on presence/absence of a standing posture pause between sitting and walking. A general linear model univariate test was used for between-group comparison. Pearson's correlation was used to determine the association between sensor-derived parameters and age. Logistic regression model was used to identify independent predictors of frailty. RESULTS According to Fried's criteria, 63% of participants were pre-frail/frail. The total number of postural transitions, stand-to-walk, and walk-to-stand were, respectively, 25.2, 30.2, and 30.6% lower in the pre-frail/frail group when compared to the non-frail group (p < 0.05, Cohen's d = 0.73-0.79). Furthermore, the ratio of cautious sitting was significantly higher by 6.2% in pre-frail/frail compared to non-frail (p = 0.025, Cohen's d = 0.22). Total number of postural transitions and the ratio of cautious sitting also showed significant negative and positive correlations with age, respectively (r = -0.51 and 0.29, p < 0.05). After applying a logistic regression model, among tested parameters, walk-to-stand (odds ratio [OR] = 0.997 p = 0.013), quick sitting (OR = 1.036, p = 0.05), and age (OR = 1.073, p = 0.016) were recognized as independent variables to identify frailty status. CONCLUSIONS This study demonstrated that daily number of specific postural transitions such as walk-to-stand and quick sitting could be used for monitoring frailty status by unsupervised monitoring of daily physical activity. Further study is warranted to explore whether tracking the daily number of specific postural transitions is also sensitive to track change in the status of frailty over time.
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Affiliation(s)
- Saman Parvaneh
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA
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The association between frailty, the metabolic syndrome, and mortality over the lifespan. GeroScience 2017; 39:221-229. [PMID: 28281219 DOI: 10.1007/s11357-017-9967-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/14/2017] [Indexed: 01/17/2023] Open
Abstract
Frailty and the metabolic syndrome are each associated with poor outcomes, but in very old people (90+ years) only frailty was associated with an increased mortality risk. We investigated the relationship between frailty, metabolic syndrome, and mortality risk, in younger (20-65 years) and older (65+ years) people. This is a secondary analysis of the US National Health and Nutrition Examination Survey (NHANES) datasets for 2003-2004 and 2005-2006, linked with mortality data up to 2011. The metabolic syndrome was defined using the International Diabetes Federation criteria. Frailty was operationalized using a 41-item frailty index (FI). Compared to the younger group (n = 6403), older adults (n = 2152) had both a higher FI (0.10 ± 0.00 vs. 0.22 ± 0.00, p < 0.001) and a greater prevalence of the metabolic syndrome (24.1 vs. 45.5%, p < 0.001). The metabolic syndrome and FI were correlated in younger people (r = 0.25, p < 0.001) but not in older people (r = 0.08, p < 0.1). In bivariate analyses, the FI predicted mortality risk in both age groups whereas the metabolic syndrome did so only in the younger group. In Cox models, adjusted for age, sex, race, education, and each other, the FI was associated with increased mortality risk at both ages (younger HR 1.05 (1.04-1.06); older HR 1.04 (1.03-1.04) whereas the metabolic syndrome did not contribute to mortality risk. The FI better predicted mortality than did the metabolic syndrome, regardless of age.
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von Zglinicki T, Varela-Nieto I, Brites D, Karagianni N, Ortolano S, Georgopoulos S, Cardoso AL, Novella S, Lepperdinger G, Trendelenburg AU, van Os R. Frailty in mouse ageing: A conceptual approach. Mech Ageing Dev 2016; 160:34-40. [DOI: 10.1016/j.mad.2016.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/11/2016] [Accepted: 07/15/2016] [Indexed: 01/21/2023]
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49
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With mouse age comes wisdom: A review and suggestions of relevant mouse models for age-related conditions. Mech Ageing Dev 2016; 160:54-68. [DOI: 10.1016/j.mad.2016.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 12/14/2022]
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50
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Katharesan V, Lewis MD, Vink R, Johnson IP. Disparate Changes in Plasma and Brainstem Cytokine Levels in Adult and Ageing Rats Associated with Age-Related Changes in Facial Motor Neuron Number, Snout Muscle Morphology, and Exploratory Behavior. Front Neurol 2016; 7:191. [PMID: 27872607 PMCID: PMC5098431 DOI: 10.3389/fneur.2016.00191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/19/2016] [Indexed: 11/28/2022] Open
Abstract
An overall increase in inflammatory cytokines with age in both the blood and the central nervous system (CNS) has been proposed to explain many aspects of ageing, including decreased motor function and neurodegeneration. This study tests the hypothesis that age-related increases in inflammatory cytokines in the blood and CNS lead to facial motor neuron degeneration. Groups of 3–5 female Sprague-Dawley rats aged 3, 12–18, and 24 months were used. Twelve cytokines interleukin (IL)-1α, IL-β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, tumor necrosis factor-α (TNFα), interferon-γ, and granulocyte macrophage-colony stimulating factor were measured in blood plasma and compared with those in the brainstem after first flushing blood from its vessels. The open-field test was used to measure exploratory behavior, and the morphology of the peripheral target muscle of facial motor neurons quantified. Total numbers of facial motor neurons were determined stereologically in separate groups of 3- and 24-month-old rats. Ageing rats showed a significant 30–42% decrease in blood plasma (peripheral) concentrations of IL-12p70 and TNFα and a significant 43–49% increase in brainstem (central) concentrations of IL-1α, IL-2, IL-4, IL-10, and TNFα. They also showed significant reductions in motor neuron number in the right but not left facial nucleus, reduced exploratory behavior, and increase in peripheral target muscle size. Marginal age-related facial motoneuronal loss occurs in the ageing rat and is characterized by complex changes in the inflammatory signature, rather than a general increase in inflammatory cytokines.
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Affiliation(s)
- Viythia Katharesan
- Anatomy and Pathology, The University of Adelaide , Adelaide, SA , Australia
| | - Martin David Lewis
- Mind and Brain Theme, South Australian Health and Medical Research Institute , Adelaide, SA , Australia
| | - Robert Vink
- Health Sciences Divisional Office, University of South Australia , Adelaide, SA , Australia
| | - Ian Paul Johnson
- Anatomy and Pathology, The University of Adelaide , Adelaide, SA , Australia
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