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Wang H, Liang Y, Wu H, Shi H, Hou R. Effect of multicomponent exercise intervention in community dwelling frail elderly: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 126:105543. [PMID: 38908349 DOI: 10.1016/j.archger.2024.105543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/03/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To assess the impact of multicomponent exercises on physical functions of frail elderly in communities, evaluating their effect on muscle strength, balance, and endurance, and their influence on quality of life. METHOD PubMed, Embase, Cochrane, and Web of Science were searched to collect relevant randomized controlled trials. The search cutoff date was January 24, 2024. Included studies met pre-specified inclusion and exclusion criteria. Data analysis was performed using Revman 5.4 and Stata 15.0 software. RESULT This analysis included 19 studies. After 12 weeks, the multicomponent exercises significantly enhanced participants' performance in various physical function assessments. Specifically, in the Timed Up and Go Test, the exercise group showed a significant reduction in time [SMD = -0.86 (95 % CI: -1.40 to -0.33)]. In the Short Physical Performance Battery, interventions shorter than 6 weeks significantly increased scores [SMD = 1.01 (95 % CI: 0.64 to 1.37)], and those longer than 6 weeks showed improvements [SMD = 0.53 (95 % CI: 0.26 to 0.80)]. Muscle strength also improved, with handgrip strength and knee extensor strength enhancements [SMD = 0.93 (95 % CI: 0.27 to 1.59); SMD = 0.72 (95 % CI: 0.24 to 1.20)]. However, there was no statistically significant difference in walking speed between the groups [SMD = 0.04 (95 % CI: -0.33 to 0.40)]. CONCLUSION Although multicomponent exercises significantly improve muscle strength, balance, and endurance in frail elderly individuals, there is no conclusive evidence of their effect on enhancing quality of life or long-term health outcomes. Further research is needed to explore the specific impacts of different types and intensities of exercises on this population.
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Affiliation(s)
- Haifang Wang
- Faculty of Nursing, Linfen Vocational and Technical College, Linfen 041000, China
| | - Yan Liang
- Department of Ophthalmology, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116000, China
| | - Huijuan Wu
- Department of Nursing, The First Affiliated Hospital of Linfen Vocational and Technical College, Linfen 041000, China
| | - Hongyu Shi
- Department of Neurology, The First Affiliated Hospital of Linfen Vocational and Technical College, Linfen 041000, China
| | - Ran Hou
- Department of Otolaryngology, The Second Hospital of Shanxi Medical University, Taiyuan, 030000, China.
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Quintero-Cruz MV, Mantilla-Morrón M, Urina-Jassir M, Pinillos-Patiño Y, Quijano-Del Gordo CI, Buelvas W, De Ávila-Quintana L, Cotes K, Urina-Triana M. Factors associated with frailty among older individuals with chronic diseases: A multicenter study. SAGE Open Med 2024; 12:20503121241255000. [PMID: 38799003 PMCID: PMC11119381 DOI: 10.1177/20503121241255000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Frailty is a syndrome that predisposes older individuals to adverse health outcomes, such as disability, dependence, falls, hospitalization, post-operative complications, and poor health in general. This study aimed to identify factors associated with frailty in older people with chronic diseases in Colombia. Methods A cross-sectional study was conducted with a nonprobabilistic sample of 230 older people (aged ⩾ 60 years) from four Colombian cities. Frailty was based on Fried's phenotype (frail defined as having ⩾3 criteria). Comorbidities were classified based on Charlson's Comorbidity Index and key questionnaires for activities of daily living (ADLs) were evaluated. Results Most were female (57.8%) with a mean ± SD age of 71.9 ± 8 years. Among them, 27.4% were frail and 58.7% were prefrail. Female gender, age ⩾ 75 years, low educational and socioeconomic level, dependence on ADLs, and cognitive impairment were associated with higher odds of prefrailty/frailty. Conclusions Prefrailty and frailty are common among older people with chronic diseases in Colombia. This syndrome is associated with social and health-related conditions, which should be addressed when providing care for these patients.
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Affiliation(s)
| | - Mirary Mantilla-Morrón
- Faculty of Health Sciences, Physiotherapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Manuel Urina-Jassir
- Department of Medicine, Boston Medical Center and Boston University Chobanian, Avedisian School of Medicine, Boston, MA, USA
| | - Yisel Pinillos-Patiño
- Faculty of Health Sciences, Physiotherapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | | | | | - Luzdaris De Ávila-Quintana
- Centro de Rehabilitación Pulmonar Integral, Cartagena, Cordoba, Colombia
- Universidad de San Buenaventura, Cartagena, Colombia
| | | | - Miguel Urina-Triana
- Faculty of Health Sciences, Universidad Simón Bolívar, Barranquilla, Atlántico, Colombia
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Gutiérrez-Reguero H, Buendía-Romero Á, Franco-López F, Martínez-Cava A, Hernández-Belmonte A, Courel-Ibáñez J, Ara I, Alcazar J, Pallarés JG. Effects of multicomponent training and HMB supplementation on disability, cognitive and physical function in institutionalized older adults aged over 70 years: a cluster-randomized controlled trial. J Nutr Health Aging 2024; 28:100208. [PMID: 38489992 DOI: 10.1016/j.jnha.2024.100208] [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: 02/10/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES To investigate the synergist effects of exercise and β-hydroxy β-methylbutyrate (HMB) supplementation on disability, cognitive and physical function, and muscle power in institutionalized older people. DESIGN Cluster-randomized controlled trial. PARTICIPANTS Seventy-two institutionalized older adults (age = 83 ± 10 years old; 63% women) were randomized in four groups: exercise plus placebo (EX), HMB supplementation, EX plus HMB supplementation (EX + HMB), and control (CT). INTERVENTION The exercising participants completed a 12-week tailored multicomponent exercise intervention (Vivifrail; 5 days/week of an individualized resistance, cardiovascular, balance and flexibility program), whereas the HMB groups received a drink containing 3 g/day of HMB. MEASUREMENTS Participants were assessed Pre and Post intervention for disability and cognitive function (validated questionnaires), physical function (short physical performance battery, SPPB), handgrip strength and sit-to-stand relative muscle power. Linear mixed-effect models were used to compare changes among groups. RESULTS Compared to baseline, both EX and EX + HMB improved cognitive function (+2.9 and +1.9 points; p < 0.001), SPPB score (+2.9 points and +2.4 points; p < 0.001) and relative muscle power (+0.64 and +0.48 W·kg-1; p < 0.001), while CT and HMB remained unchanged (p > 0.05). Significant between-group differences were noted between CT, EX and EX + HMB for cognitive function (p < 0.01), between CT and EX + HMB for physical function (p = 0.043), and between CT, EX and EX + HMB for relative muscle power (p < 0.001). CONCLUSION The Vivifrail exercise program was effective in improving cognitive and physical function, and muscle power in nursing home residents, while HMB supplementation did not provide additional benefits when combined with exercise. These results emphasize the importance of physical exercise interventions in very old people as an essential basis for improving their overall health and quality of life.
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Affiliation(s)
- Héctor Gutiérrez-Reguero
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Ángel Buendía-Romero
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Francisco Franco-López
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | - Alejandro Martínez-Cava
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | | | - Javier Courel-Ibáñez
- Department of Physical Education and Sport, University of Granada, Granada, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.
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Baltasar-Fernandez I, Soto-Paniagua H, Alcazar J, Uceta Espinosa MI, Alegre LM, Gracía-García FJ, Ara I, Alfaro Acha A, Losa-Reyna J. Long-Term Effects of a 6-Week Power-Based Resistance Training and Fast Walking Interval Training Program on Physical Function, Muscle Power, Disability, and Frailty in Pre-Frail and Frail Older Adults. Gerontology 2024; 70:701-714. [PMID: 38574485 DOI: 10.1159/000536363] [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: 07/19/2022] [Accepted: 01/15/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Concurrent training has been shown to be a beneficial approach to improve overall health status in older adults. However, little is known about the adaptations of this type of training in the long term (i.e., after cessation of exercise), even less in older people affected by frailty syndrome. Therefore, this study aimed (i) to assess the effects of a 6-week concurrent training program composed of power-oriented resistance training and fast walking interval training on physical function, muscle power, disability in activities of daily living and frailty in pre-frail and frail older people, and (ii) to assess the effects of a 6-month detraining period on these outcomes. METHODS A total of 59 pre-frail and frail older adults (>75 years old; Frailty Phenotype >1) were allocated into intervention (INT; n = 32; 81.8 years; 21 women) or control (CON; n = 27; 82.5 years; 19 women) groups. Primary outcomes of this study were Short Physical Performance Battery (SPPB), relative sit-to-stand (STS) power, Barthel index, Lawton scale and Frailty Phenotype. Assessments were performed at baseline (PRE), after the concurrent training programme (POST) and after 6 months of follow-up (DET) in both groups. Mixed model repeated measures ANOVA with Bonferroni's post hoc tests was used. RESULTS Immediately after the intervention (∆ = POST-PRE), INT improved SPPB (∆ = 3.0 points; p < 0.001), relative STS power (∆ = 0.87 W·kg-1; p < 0.001) and reduced their frailty levels (∆ = -1.42 criteria; p < 0.001), while no changes were observed in CON. After 6 months of detraining (∆ = DET-PRE), INT showed higher SPPB (∆ = 2.2 points; p < 0.001), higher relative STS power (∆ = 0.73 W·kg-1; p < 0.001) and lower frailty (∆ = -1.24 criteria; p < 0.001) values than those reported at baseline, which were significantly different than those reported by CON. Both, Barthel index and Lawton scale values were not modified during the study in either group. CONCLUSIONS The 6-week concurrent training program improved physical function, muscle power and reduced frailty in pre-frail and frail older people and these improvements were maintained above baseline levels after 6 months of detraining. However, due to the individual variability found, future studies of long-term responders versus non-responders in frail populations are required.
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Affiliation(s)
- Ivan Baltasar-Fernandez
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
- Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
| | - Hector Soto-Paniagua
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
- Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
| | | | - Luis M Alegre
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
| | - Francisco José Gracía-García
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
- Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
| | - Ana Alfaro Acha
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
- Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain
| | - José Losa-Reyna
- CIBER of Frailty and Healthy Ageing (CIBERFES), Madrid, Spain
- Valoración del Rendimiento Deportivo, Actividad Física y Salud y Lesiones Deportivas (REDAFLED). Universidad de Valladolid, Soria, Spain
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Pajski ML, Byrd C, Nandigama N, Seguin E, Seguin A, Fennell A, Graber TG. Endurance exercise preserves physical function in adult and older male C57BL/6 mice: high intensity interval training (HIIT) versus voluntary wheel running (VWR). FRONTIERS IN AGING 2024; 5:1356954. [PMID: 38523671 PMCID: PMC10958787 DOI: 10.3389/fragi.2024.1356954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 02/23/2024] [Indexed: 03/26/2024]
Abstract
Exercise has been shown to improve physical function, mitigate aspects of chronic disease and to potentially alter the trajectory of age-related onset of frailty and sarcopenia. Reliable and valid preclinical models are necessary to elucidate the underlying mechanisms at the intersection of age, exercise, and functional decline. The purpose of this study was to compare, head to head, the effects of two common pre-clinical models of endurance exercise: high intensity interval training (HIIT) and voluntary wheel running (VWR). The hypothesis was that a prescribed and regimented exercise program, HIIT, would prove to be a superior training method to unregulated voluntary exercise, VWR. To investigate this hypothesis, we evaluated adult (n = 24, designated 10 m, aged 6 months at the beginning of the study, 10 months at its completion) and older adult (n = 18, designated 26 m, aging from 22 months to 26 months over the course of the study) C57BL/6 male mice. These mice were randomly assigned (with selection criteria) to a 13-week program of voluntary wheel running (VWR), high intensity interval training (HIIT), or sedentary control (SED). The functional aptitude of each mouse was determined pre- and post-training using our composite CFAB (comprehensive functional assessment battery) scoring system consisting of voluntary wheel running (volitional exercise and activity rate), treadmill (endurance), rotarod (overall motor function), grip meter (forelimb strength), and inverted cling (whole body strength/endurance). To measure sarcopenia, we tracked body mass, body composition (with EchoMRI), plantar flexor torque (in 10 m), and measured muscle wet mass post-training. Overall, adult CFAB scores decreased while body mass and percent body fat increased as they matured; however, exercise significantly mitigated the changes (p < 0.05) compared to SED. Older adults demonstrated preservation of function (CFAB) and reduced body fat (p < 0.05) compared to SED. To conclude, both types of exercise maintained physical function equally in older mice.
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Affiliation(s)
- Megan L. Pajski
- Department of Physical Therapy, East Carolina University, Greenville, NC, United States
| | - Chris Byrd
- Department of Physical Therapy, East Carolina University, Greenville, NC, United States
| | - Nainika Nandigama
- Department of Public Health, East Carolina University, Greenville, NC, United States
| | - Emily Seguin
- Department of Kinesiology, East Carolina University, Greenville, NC, United States
| | - Anna Seguin
- Department of Kinesiology, East Carolina University, Greenville, NC, United States
| | - Alyssa Fennell
- Department of Kinesiology, East Carolina University, Greenville, NC, United States
| | - Ted G. Graber
- Department of Physical Therapy, East Carolina University, Greenville, NC, United States
- Department of Kinesiology, East Carolina University, Greenville, NC, United States
- Department of Physiology, East Carolina University, Greenville, NC, United States
- East Carolina Obesity and Diabetes Institute, East Carolina University, Greenville, NC, United States
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Kiah Hui Siew S, Yu J, Teo TL, Chua KC, Mahendran R, Rawtaer I. Technology and physical activity for preventing cognitive and physical decline in older adults: Protocol of a pilot RCT. PLoS One 2024; 19:e0293340. [PMID: 38394113 PMCID: PMC10889650 DOI: 10.1371/journal.pone.0293340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/07/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Cognitive frailty, defined as having both physical frailty and cognitive impairment that does not satisfy the criteria for Major Neurocognitive Disorder, represents an elevated risk for morbidity. Hence, it is crucial to mitigate such risks. Physical activity interventions have been found effective in protecting against physical frailty and cognitive deterioration. This pilot RCT examines if smartwatches and mobile phone applications can help to increase physical activity, thereby improving physical and cognitive outcomes. METHODS Older individuals (n = 60) aged 60 to 85 years old will have their physical activity tracked using a smartwatch. The subjects will be randomized into two arms: one group will receive daily notification prompts if they did not reach the recommended levels of PA; the control group will not receive prompts. Outcome variables of physical activity level, neurocognitive scores, and physical frailty scores will be measured at baseline, T1 (3 months), and T2 (6 months). Sleep quality, levels of motivation, anxiety, and depression will be controlled for in our analyses. We hypothesize that the intervention group will have higher levels of physical activity resulting in improved cognitive and physical outcomes at follow-up. This study was approved by the National University of Singapore's Institutional Review Board on 17 August 2020 (NUS-IRB Ref. No.: H-20-038). DISCUSSION Wearable sensors technology could prove useful by facilitating self-management in physical activity interventions. The findings of this study can justify the use of technology in physical activity as a preventive measure against cognitive frailty in older adults. This intervention also complements the rapidly rising use of technology, such as smartphones and wearable health devices, in our lives today. REGISTRATION DETAILS This study has been retrospectively registered on clinicaltrials.gov on 5th January 2021 (NCT Identifier: NCT04692974), after the first participant was recruited.
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Affiliation(s)
- Savannah Kiah Hui Siew
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Tat Lee Teo
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Kuang Chua Chua
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Rathi Mahendran
- Yeo Boon Khim Mind Science Centre, National University of Singapore, Singapore, Singapore
| | - Iris Rawtaer
- Department of Psychiatry, Sengkang General Hospital, Singapore, Singapore
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Baltasar-Fernandez I, Alcazar J, Martín-Braojos S, Ara I, Alegre LM, García-García FJ, Alfaro-Acha A, Losa-Reyna J. Power-oriented resistance training combined with high-intensity interval training in pre-frail and frail older people: comparison between traditional and cluster training set configurations on the force-velocity relationship, physical function and frailty. Eur J Appl Physiol 2024; 124:623-632. [PMID: 37688638 PMCID: PMC10858062 DOI: 10.1007/s00421-023-05298-x] [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: 11/19/2022] [Accepted: 08/11/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVES To analyse the force-velocity relationship changes in response to two different training programmes differing in the set configuration (cluster vs. traditional), and their impact on physical function and frailty in pre-frail and frail older adults. METHODS 43 pre-frail and frail (Frailty Phenotype ≥ 1 criteria) older adults (81.4 ± 5.1 years) participated in this study. Participants were assigned to cluster (CT; n = 10; 10-s intra-set rest), traditional (TT; n = 13; no intra-set rest) or control (CON; n = 20) groups. Force-velocity relationship (F0, V0 and Pmax), physical function (Short Physical Performance Battery, SPPB) and frailty (Frailty Phenotype, FP) were assessed at baseline and after the training programme. RESULTS Both CT and TT groups showed similar improvements in Pmax after training (CT = + 36.7 ± 34.2 W; TT = + 33.8 ± 44.6 W; both p < 0.01). V0 was improved by both CT (+ 0.08 ± 0.06 m s-1; p < 0.01), and TT (+ 0.07 ± 0.15 m s-1, p > 0.05). F0 remained unchanged in CT (+ 68.6 ± 224.2 N, p > 0.05) but increased in TT (+ 125.4 ± 226.8 N, p < 0.05). Finally, SPPB improved in both training conditions (CT = + 2.3 ± 1.3 points; TT = + 3.0 ± 1.2 points; both p < 0.05) and in the CON group (+ 0.9 ± 1.4 points, p < 0.05). CT and TT reduced their FP (CT = - 1.1 criteria; TT = - 1.6 criteria; both p < 0.01), while no changes were observed in the CON group (- 0.2 criteria, p = 0.38). CONCLUSIONS Both training methods were equally effective for improving Pmax, physical function and reducing frailty in pre-frail and frail older people. TT may be effective for improving both force and velocity parameters, while CT may be effective for improving velocity parameters alone, although further research is required to confirm these findings.
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Affiliation(s)
- Ivan Baltasar-Fernandez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, Talavera de la Reina, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Susana Martín-Braojos
- Department of Geriatrics, Complejo Hospitalario de Toledo, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Luis M Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Francisco José García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Department of Geriatrics, Complejo Hospitalario de Toledo, Hospital Virgen del Valle, Toledo, Spain
| | - Ana Alfaro-Acha
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Department of Geriatrics, Complejo Hospitalario de Toledo, Hospital Virgen del Valle, Toledo, Spain
| | - José Losa-Reyna
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
- Grupo de Investigación Valoración del Rendimiento Deportivo, Actividad Física y Salud y Lesiones Deportivas (REDAFLED), Universidad de Valladolid, Calle Universidad S/N, 42004, Soria, Spain.
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López-López S, Abuín-Porras V, Berlanga LA, Martos-Duarte M, Perea-Unceta L, Romero-Morales C, Pareja-Galeano H. Functional mobility and physical fitness are improved through a multicomponent training program in institutionalized older adults. GeroScience 2024; 46:1201-1209. [PMID: 37493861 PMCID: PMC10828358 DOI: 10.1007/s11357-023-00877-4] [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] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/14/2023] [Indexed: 07/27/2023] Open
Abstract
Physical exercise has demonstrated its effectiveness in the management of the deleterious process of aging. However, it is less studied in institutionalized elderly people. This investigation aims to clarify the benefits of a multicomponent training program in institutionalized older adults. A randomized controlled trial was conducted with institutionalized older adults (≥ 70 years old). Intervention group (IG; N = 18) were submitted to a multicomponent training program based on muscle power training and interval endurance exercise, 2 times/week for 12 weeks. Control group (CG; N = 16) continued their usual mobility exercises. Independence was estimated with the Barthel index, and physical fitness and functional mobility were evaluated by the Short Physical Performance Battery (SPPB), the Timed Up and Go (TUG) test, the 6-min Walking Test (6'WT), the 10-Meter Walking Test (10MWT), hand grip strength dynamometry, and lower limb muscle strength and power. The IG improved, compared with the CG, in TUG scores in -7.43 s (95% IC: 3.28, 11.59; p < 0.001); in 10MWT scores in -5.19 s (95% IC: 1.41, 8.97; p = 0.004) and -4.43 s (95% IC: 1.14, 7.73; p = 0.002), 6'WT scores in + 54.54 m (95% IC: 30.24, 78.84; p < 0.001); and SPPB in + 2.74 points (95% IC: 2.10, 3.37; p < 0.001). Maximum muscle power and maximum strength did not show statistically significant differences. The multicomponent training program based on muscle power and interval endurance exercise was shown to be safe, well tolerated and effective for the improvement of functional mobility and physical fitness, but not for independence in institutionalized older adults.
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Affiliation(s)
| | | | - Luis A Berlanga
- Department of Physical Activity and Sport, Centro de Estudios Universitarios Cardenal Spínola CEU, Seville, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Luis Perea-Unceta
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Helios Pareja-Galeano
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain
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Fang J, Ren J, Wang J, Qiu X, Zhang S, Yuan S, Wu L, Xie L, Yu L. Utility of Goal Attainment Scaling (GAS) in evaluating a multicomponent exercise programme for community-dwelling pre-frail older adults. Fam Med Community Health 2024; 12:e002410. [PMID: 38267219 PMCID: PMC10824033 DOI: 10.1136/fmch-2023-002410] [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: 08/01/2023] [Revised: 11/14/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the effectiveness of Goal Attainment Scaling (GAS) in assessing an intervention for pre-frail senior citizens. Additionally, the study aimed to explain how the GAS goals were established based on the International Classification of Functioning, Disability and Health (ICF) categories, including body function, activity and participation and environmental factors. METHODS In this study, 220 pre-frail older adults were randomly selected to participate in a controlled trial. The intervention group engaged in multicomponent exercise three times a week, once at a community health service location and twice at home. The control group received advice on physical activity but did not have supervised exercise. Participants in both groups selected individualised GAS goals from 23 goals developed based on ICF by focus group discussion. The study used generalised estimating equations to analyse the differences between the groups. RESULTS The study included 144 participants, 72 in the exercise group and 72 in the control group. The top three individualised goals for all participants were vestibular functions (53.5%), pain management (43.1%) and lifting and carrying objects (31.9%). Both groups saw a significant increase in GAS scores at week 8 and week 24 of the intervention (p<0.05), but the exercise group showed a more significant improvement (p<0.05). The participants living alone were associated with lower postintervention improvements in the GAS scores. In contrast, the participants who were using a smartphone were likely to get higher postintervention improvements in the GAS scores. CONCLUSIONS GAS can be a valuable tool for setting and evaluating individualised and meaningful goals in body functions, activity and participation and environmental factors. The multicomponent exercise interventions can help pre-frail older adults achieve their expected goals as measured by the GAS.
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Affiliation(s)
- Juan Fang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
- School of Medicine, Huzhou University, Huzhou, Zhejiang, China
| | - Jianping Ren
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jinjing Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xiantao Qiu
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Shiyan Zhang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Shuang Yuan
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Liangfeng Wu
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Lin Xie
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Le Yu
- Ziyang Street Community Health Service Center, Hangzhou, Zhejiang, China
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Seko T, Akasaka H, Koyama M, Himuro N, Saitoh S, Ogawa S, Miura S, Mori M, Ohnishi H. The Contributions of Knee Extension Strength and Hand Grip Strength to Factors Relevant to Physical Frailty: The Tanno-Sobetsu Study. Geriatrics (Basel) 2024; 9:9. [PMID: 38247984 PMCID: PMC10801561 DOI: 10.3390/geriatrics9010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Sarcopenia is the core factor of frailty. This study specifically focused on lower limb muscle strength and examined muscle indices that indicate the risk of frailty or pre-frailty in older adults. The study included 327 community-dwelling individuals aged ≥65 years (43.7% male) who participated in the cohort. Frailty was defined based on five symptoms: weight loss, low activity level, exhaustion, weakness and slowness. Participants were classified into frail (three or more applicable), pre-frail (one to two applicable) and non-frail groups. Muscle strength (knee extension strength, toe grip strength and hand grip strength) were assessed, and appendicular muscle mass was assessed via a bioelectrical impedance analysis. The adjusted odds ratio (OR) of muscle indices for with frailty (frail group vs. pre-frail group) or pre-frailty (pre-frail group vs. non-frail group) were calculated. The prevalence of frail and pre-frail was 7% and 40%, respectively. Adjusted for age, sex, albumin and medical history, knee extension strength was significantly associated with frailty (odds ratio 0.95, 95% CI 0.92-0.98), while hand grip strength was associated with pre-frailty (odds ratio 0.92, 95% CI 0.88-0.97) but not with other muscle indices. This study is significant for identifying knee extension strength as a factor relevant to frailty in older adults considered pre-frailty, emphasizing the importance of this specific muscle measure in predicting and managing frailty.
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Affiliation(s)
- Toshiaki Seko
- Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, Chitose 066-0055, Japan; (S.O.); (M.M.)
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan;
| | - Masayuki Koyama
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
| | - Nobuaki Himuro
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
| | - Shigeyuki Saitoh
- Division of Medical and Behavioral Subjects, Sapporo Medical University School of Health Science, Sapporo 060-8556, Japan;
| | - Shunichi Ogawa
- Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, Chitose 066-0055, Japan; (S.O.); (M.M.)
| | - Sayo Miura
- Department of Rehabilitation, Japan Health Care College, Sapporo 062-0053, Japan;
| | - Mitsuru Mori
- Department of Rehabilitation, Hokkaido Chitose College of Rehabilitation, Chitose 066-0055, Japan; (S.O.); (M.M.)
| | - Hirofumi Ohnishi
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (M.K.); (N.H.); (H.O.)
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Casals C, Ávila-Cabeza-de-Vaca L, González-Mariscal A, Marín-Galindo A, Costilla M, Ponce-Gonzalez JG, Vázquez-Sánchez MÁ, Corral-Pérez J. Effects of an educational intervention on frailty status, physical function, physical activity, sleep patterns, and nutritional status of older adults with frailty or pre-frailty: the FRAGSALUD study. Front Public Health 2023; 11:1267666. [PMID: 38098822 PMCID: PMC10720710 DOI: 10.3389/fpubh.2023.1267666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/09/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction The prevalence of frailty is increasing worldwide, emphasizing the importance of prioritizing healthy ageing. To address this, cost-effective and minimally supervised interventions are being sought. This study aimed to assess the impact of an educational program on frailty status, physical function, physical activity, sleep patterns, and nutritional status in community-dwelling older adults with at least 1 Fried's frailty criteria. Methods A 6-month multicentre randomized controlled trial was conducted from March 2022 to February 2023 in 14 health centres located in Cadiz and Malaga, Spain. The educational intervention consisted of 4 group sessions and 6 follow-up phone calls spread over 6 months. The program focused on educating participants about frailty and its impact on health, providing guidelines for physical activity, healthy dietary habits, cognitive training, psychological well-being and social activities. A total of 163 participants, divided into control (n = 80) and educational groups (n = 83) were assessed before and after the intervention. Results The results showed a significant group-time interaction in the physical function evaluated with a large effect on Short Physical Performance Battery score (η2p = 0.179, -0.1 [-1.2-1.0] points for control group vs. 1.0 [0.0-3.0] points for educational group, p < 0.001), and an effect on the 4-meter gait test ((η2p = 0.122, 0.5 [0.1-0.0] s for control group vs. -0.4 [-0.5- -0.3] s for educational group, p < 0.001), and the 5-repetition sit-to-stand test (η2p = 0.136, 1.0 [0.0-1.2] s for control group vs. -4.3 [-7.0- -2.3] for educational group, p < 0.001). Additionally, the use of accelerometers to assess physical activity, inactivity, and sleep patterns revealed a significant small effect in the number of awakenings at night ((η2p = 0.040, 1.1 [-0.5-3.4] awakenings for control group vs. 0.0 [-2.2-0.0] awakenings for educational group, p = 0.009). The findings also highlighted a significant medium effect regarding malnutrition risk, which was assessed using the Mini-Nutritional Assessment score (η2p = 0.088, -0.7 [-2.3-1.5] points for control group vs. 1.5 [-0.5-3.0] points for educational group, p < 0.001). Discussion Thus, the 6-month educational program effectively improved physical function, sleep patterns, and nutritional status compared to usual healthcare attendance in community-dwelling older adults with frailty or pre-frailty. These findings underscore the potential of minimally supervised interventions in promoting a healthy lifestyle in this vulnerable population.
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Affiliation(s)
- Cristina Casals
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Laura Ávila-Cabeza-de-Vaca
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Andrea González-Mariscal
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Alberto Marín-Galindo
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Manuel Costilla
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Jesus G. Ponce-Gonzalez
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - María Ángeles Vázquez-Sánchez
- Department of Nursing, PASOS Research Group, Faculty of Health Sciences, UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, Málaga, Spain
| | - Juan Corral-Pérez
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
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12
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Kolle AT, Lewis KB, Lalonde M, Backman C. Reversing frailty in older adults: a scoping review. BMC Geriatr 2023; 23:751. [PMID: 37978444 PMCID: PMC10655301 DOI: 10.1186/s12877-023-04309-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 09/12/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Individuals 65 years or older are presumably more susceptible to becoming frail, which increases their risk of multiple adverse health outcomes. Reversing frailty has received recent attention; however, little is understood about what it means and how to achieve it. Thus, the purpose of this scoping review is to synthesize the evidence regarding the impact of frail-related interventions on older adults living with frailty, identify what interventions resulted in frailty reversal and clarify the concept of reverse frailty. METHODS We followed Arksey and O'Malley's five-stage scoping review approach and conducted searches in CINAHL, EMBASE, PubMed, and Web of Science. We hand-searched the reference list of included studies and conducted a grey literature search. Two independent reviewers completed the title, abstract screenings, and full-text review using the eligibility criteria, and independently extracted approximately 10% of the studies. We critically appraised studies using Joanna Briggs critical appraisal checklist/tool, and we used a descriptive and narrative method to synthesize and analyze data. RESULTS Of 7499 articles, thirty met the criteria and three studies were identified in the references of included studies. Seventeen studies (56.7%) framed frailty as a reversible condition, with 11 studies (36.7%) selecting it as their primary outcome. Reversing frailty varied from either frail to pre-frail, frail to non-frail, and severe to mild frailty. We identified different types of single and multi-component interventions each targeting various domains of frailty. The physical domain was most frequently targeted (n = 32, 97%). Interventions also varied in their frequencies of delivery, intensities, and durations, and targeted participants from different settings, most commonly from community dwellings (n = 23; 69.7%). CONCLUSION Some studies indicated that it is possible to reverse frailty. However, this depended on how the researchers assessed or measured frailty. The current understanding of reverse frailty is a shift from a frail or severely frail state to at least a pre-frail or mildly frail state. To gain further insight into reversing frailty, we recommend a concept analysis. Furthermore, we recommend more primary studies considering the participant's lived experiences to guide intervention delivery.
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Affiliation(s)
- Aurélie Tonjock Kolle
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Krystina B Lewis
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Michelle Lalonde
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institute du Savoir Montfort, Montfort Hospital, Ottawa, ON, Canada
| | - Chantal Backman
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- Bruyère Research Institute, Ottawa, ON, Canada.
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13
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Zhao X, Yu J, Liu N. Developing a predictive equation of muscular age to evaluate muscle health in Chinese community-dwelling older women. Health Care Women Int 2023; 44:1587-1600. [PMID: 36995745 DOI: 10.1080/07399332.2023.2194245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023]
Abstract
Muscle health plays an important role in most common age-related diseases and injuries. To date, a standardized quantitative method to assess muscle health has not yet been developed. Principal component analysis was employed to develop a predictive equation of muscular age based on muscle health variables including skeletal muscle mass of lower limb, grip strength and maximal gait speed. Then validity of muscular age was tested by comparing chronological age to muscular age of the elderly. A predictive equation of muscular age was developed. Muscular age = 0.690 × chronological age - 1.245 × skeletal muscle mass of lower limb + 0.453 × grip strength - 1.291 × maximal walking speed + 40.547. Cross-sectional validity test showed that the predictive equation of muscular age is a valid method to assess muscle health. It is applicable not only to the normal elderly but to the elderly with pre-sarcopenia or sarcopenia.
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Affiliation(s)
- Xiaoguang Zhao
- Department of Research Academy of Grand Health, Ningbo University, Zhejiang, China
- Faculty of Sport Science, Ningbo University, Zhejiang, China
| | - Jiabin Yu
- Department of Research Academy of Grand Health, Ningbo University, Zhejiang, China
- Faculty of Sport Science, Ningbo University, Zhejiang, China
| | - Nan Liu
- Faculty of Sport Science, Ningbo University, Zhejiang, China
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14
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Kasa AS, Drury P, Traynor V, Lee SC, Chang HCR. The effectiveness of nurse-led interventions to manage frailty in community-dwelling older people: a systematic review. Syst Rev 2023; 12:182. [PMID: 37777786 PMCID: PMC10543273 DOI: 10.1186/s13643-023-02335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 08/25/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND The global increase in the number of frail older people and the accompanying increase in chronic conditions underline the need to develop effective health promotion and preventive interventions for these population groups. Wide ranging of physical, psychological, and social health factors influence frailty in older people and leads to increased vulnerability to many adverse outcomes. To reverse or reduce the progression of frailty, nurses play a pivotal role in delivering health promotion and preventive interventions. The purpose of the review is to determine the effectiveness of nurse-led interventions in reducing frailty in community-dwelling older people. METHODS The following electronic databases: PubMed, MEDLINE, Web of Science, SCOPUS, CINAHL, PsychInfo, and WHO Global Index Medicus were searched until June 2022. Nurse-led, "nurse led", education, training, intervention, program, teaching, frail*, fragile*, "frailty syndrome", debility, infirmity, elder*, aged*, old*, geriatric, "community based settings", "community-based", "community setting", community were the search terms. Before data extraction, eligible articles were assessed for their methodological quality. The JBI critical appraisal checklist for reporting experimental studies was utilised to appraise the methodological quality of the studies. Data were systematically examined using a narrative review to determine the effectiveness of the intervention. RESULTS Of the 156 studies identified, from the search, six studies with samples ranging from 40 to 1387 older people were eligible for inclusion in the review. Two quasi-experimental studies and one Randomised Controlled Trial (RCT) showed a moderate risk of bias. The Nurse-led frailty interventions used a multi-component intervention approach across the studies. The interventions reversed frailty progression, improve physical functioning, nutritional status, and quality of life, enhance perceptions of social support, improve mental health, and reduce depression. CONCLUSIONS Few studies have explored the effectiveness of a nurse-led intervention to decrease frailty in older people. Evaluating physical functioning, nutritional status, mental health, and quality of life in community-dwelling frail older people can contribute to developing appropriate interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO ID of CRD42022348064.
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Affiliation(s)
- Ayele Semachew Kasa
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Peta Drury
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Shu-Chun Lee
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
- School of Nursing and Midwifery, Western Sydney University, Parramatta South Campus, Parramatta, NSW, Australia
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15
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Fernández-García ÁI, Gómez-Cabello A, Gómez-Bruton A, Moradell A, Navarrete-Villanueva D, Pérez-Gómez J, González-Gross M, Ara I, Casajús JA, Vicente-Rodríguez G. Effects of multicomponent training and detraining on the fitness of older adults with or at risk of frailty: results of a 10-month quasi-experimental study. Eur J Sport Sci 2023; 23:1696-1709. [PMID: 35876120 DOI: 10.1080/17461391.2022.2104657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aims of this study were (1) to analyse the effects of a 6-month multicomponent training (MCT) on the physical fitness of older adults with or at risk of frailty; (2) to study the consequences of a 4-month detraining period; (3) to analyse the influence of frailty status on the training and detraining adaptations. A total of 102 robust, frail and prefrail older adults (80.1 ± 6.1 y) were divided into an intervention (TRAIN) and control group (CON). The TRAIN performed a 6-month MCT, while the CON continued with their usual lifestyle. Fitness assessment was mainly based on the Senior Fitness Test. Four evaluations were carried out; at baseline, and at 3, 6 and 10 months from baseline. Linear mixed models were performed to analyse group by time interactions and to compare differences in changes within groups between different time points. After 6-month MCT, TRAIN showed greater improvements for all fitness variables (group effects p < 0.05, except for flexibility) when compared to the CON. During the 4-month detraining period, TRAIN significantly decreased their balance, upper-limb flexibility and upper and lower-limb strength (all p < 0.05). CON only decreased upper-limb flexibility. When accounting for frailty status in the TRAIN, the frail-prefrail showed lower adaptations to the training and were more affected by detraining than the robust. The presented MCT is a good strategy to improve fitness in this population, but its positive effects are limited in time. It is, therefore, critical to avoid detraining periods.Trial registration: ClinicalTrials.gov identifier: NCT03831841.HighlightsOur 6-month MCT-program improves the physical fitness of robust, frail and prefrail older adultsA detraining period of four months partially deteriorates the physical fitness of robust, frail and prefrail older adults, so it is recommended to promote ongoing exercise programs or smaller break periodsIt seems that those older adults with a more advanced frailty status may not benefit from exercise to the same degree and will be more affected by detraining. Therefore, trainers may need to individualize training protocols to obtain the greatest exercise benefits.
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Affiliation(s)
- Ángel Iván Fernández-García
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Centro Universitario de la Defensa, Zaragoza, Spain
- Instituto Agroalimentario de Aragón-IA2 (CITA-Universidad de Zaragoza), Zaragoza, Spain
| | - Alejandro Gómez-Bruton
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
| | - Ana Moradell
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Jorge Pérez-Gómez
- HEME (Health, Economy, Motricity and Education) Research Group, University of Extremadura, Cáceres, Spain
| | - Marcela González-Gross
- ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Ignacio Ara
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
| | - José A Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences, FCSD, Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
- Red española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET), Toledo, Spain
- Instituto Agroalimentario de Aragón-IA2 (CITA-Universidad de Zaragoza), Zaragoza, Spain
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Cammisuli DM, Franzoni F, Fusi J, Scarfò G, Castelnuovo G. Engagement in a structured physical activity program and its effects upon health-related quality of life in elderly women: An observational study. Front Psychol 2023; 14:1135433. [PMID: 37034950 PMCID: PMC10075252 DOI: 10.3389/fpsyg.2023.1135433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/24/2023] [Indexed: 04/11/2023] Open
Abstract
Aging is a complex process associated with an impairment in functional capacity and low health-related quality of life (HRQoL) due to a high frequency of chronic diseases in the elderly population. Regular physical activity (PA) may limit some physiological effects of sedentary lifestyle and increase life expectancy. An observational was conducted to measure the HRQoL among older adults living in the community, by comparing a convenience sample of elderly females practicing a structured program of PA from 2 to 3 times per week in 60-min sessions (i.e., active females, AFs) to a sample of participants adopting lifestyle behaviors expending little energy (i.e., sedentary females, SFs). A validated questionnaire (the RAND 36-item) was used as outcome measure. All participants were assessed in terms of cognitive status (Montreal Cognitive Assessment, MoCA) to exclude mild cognitive impairment, divided attention/executive functioning (Trail Making Test, Stroop Test) and psychopathological dimensions of anxiety (Geriatric Anxiety Inventory, GAI), and depression (Geriatric Depression Scale, GDS). Non-parametric analysis revealed that AFs and SFs differed significantly in the RAND Energy/Fatigue (E/F), Emotional Wellbeing (EW), and Social Functioning (SoF), that was however influenced by education level. Moreover, E/F and EW were negatively associated to anxiety and depression, while SoF was influenced by divided attention. PA results in a healthful behavior for combating feelings of fatigue and low energy as well as emotional distress that can affect health status perception in older women.
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Affiliation(s)
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jonathan Fusi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgia Scarfò
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, Milan, Italy
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Avelino AP, Silva ADS, Pinto SS, Bezerra EDS. Velocity walking test: Selective influences on physical functional performance for better tracking of older women. Arch Gerontol Geriatr 2023; 109:104962. [PMID: 36804697 DOI: 10.1016/j.archger.2023.104962] [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: 01/04/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To examine the selective influences of changes in walking test capability on physical functional performance (COD speed, COD deficit, linear sprint speed, chair stand test, handgrip strength, and unloaded vertical jump) in community dwelling older women. METHODS The performances of eighty women ((age, 64.7 ± 3.38 y; body mass, 66.3 ± 11.15 kg; height, 153.5 ± 5.71 cm, BMI, 28.08 ± 4.00 kg/m2) were assessed in the 6-m walk test, timed up and go test, chair stand test, handgrip strength, and unloaded vertical jump. The change of direction velocity (CODv) deficit (m.s-1) was calculated as TUG velocity - 6-m walk velocity. Estimation statistics were adopted, which focus on the effect size of the higher/lower, as opposed to significance testing. The bootstrap with 5000 replicates was used to obtain bias-corrected and accelerated 95% compatibility intervals (CI) of the point estimate of each effect RESULTS: There were large effects between faster older women compared to slower older women in COD velocity (TUG), chair stand test, and CODv deficit. On the other hand, we observed no influence of 6-m walk test performance on vertical jumps or the handgrip strength test. CONCLUSION Strength and conditioning coaches and professionals involved with older women should consider the COD deficit (i.e., linear velocity minus change of direction velocity), as a complementary measure to provide an initial idea of the adequate pathway for exercise prescription and to track responses in older women.
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Affiliation(s)
- Aluísio Pinto Avelino
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
| | - Andreza Dos S Silva
- Laboratório de Estudos do Desempenho Humano, Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas. Manaus, Amazonas, Brazil
| | - Suzy Silva Pinto
- Secretária de Estado de Educação (SEDUC), Manaus, Amazonas, Brazil
| | - Ewertton de Souza Bezerra
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil; Laboratório de Estudos do Desempenho Humano, Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas. Manaus, Amazonas, Brazil.
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Carcelén-Fraile MDC, Lorenzo-Nocino MF, Afanador-Restrepo DF, Rodríguez-López C, Aibar-Almazán A, Hita-Contreras F, Achalandabaso-Ochoa A, Castellote-Caballero Y. Effects of different intervention combined with resistance training on musculoskeletal health in older male adults with sarcopenia: A systematic review. Front Public Health 2023; 10:1037464. [PMID: 36684863 PMCID: PMC9853907 DOI: 10.3389/fpubh.2022.1037464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
Objectives Nowadays, there is a significant increase in the elderly population in many countries around the world, and sarcopenia is one of the most common consequences of this with resistance training being one of the best treatments. Hence, this systematic review was conducted to determine what are the effects of different combinations of resistance training-based interventions on the musculoskeletal health of older male adults with sarcopenia. Methods This systematic review was performed following the PRISMA 2020 guidelines. The search was performed between February and August 2022 in three electronic databases: Pubmed (MEDLINE), Web of Science (WOS) and Scopus employing different keywords combined with Boolean operators. Only 13 articles were included out of the initial 1,019. Results The articles studied the effects of resistance training combined with other interventions, 6 articles combined it with protein and vitamin supplementation, 4 with protein supplements only, while 3 combined it with aerobic training, finding beneficial results mainly on strength, functionality, and body composition. Conclusion Resistance Training combined with Aerobic Training or nutritional supplements has better effects than Resistance Training alone in older male adults with sarcopenia. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42022354184.
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Affiliation(s)
| | | | - Diego Fernando Afanador-Restrepo
- ZIPATEFI Research Group, Faculty of Health Sciences and Sports, University Foundation of the Área Andina, Pereira, Colombia
- GIP Pedagogy Research Group, Faculty of Distance and Virtual Education, Antonio José Camacho University Institution, Santiago de Cali, Colombia
| | - Carlos Rodríguez-López
- Clinical Director at Sinapse Neurology, CEO Mbody Research and Formation Group, University Schools Gimbernat, Attached to the University of Cantabria, A Coruña, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
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Blondal BS, Geirsdottir OG, Beck AM, Halldorsson TI, Jonsson PV, Sveinsdottir K, Ramel A. HOMEFOOD randomized trial-beneficial effects of 6-month nutrition therapy on body weight and physical function in older adults at risk for malnutrition after hospital discharge. Eur J Clin Nutr 2023; 77:45-54. [PMID: 36028775 PMCID: PMC9876791 DOI: 10.1038/s41430-022-01195-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 07/21/2022] [Accepted: 08/03/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND/OBJECTIVES Malnutrition is common among older adults. Dietary intervention studies in older adults aiming to improve anthropometrics measures and physical function have been inconsistent. We aimed to investigate the effects of nutrition therapy in combination with home delivered meals and oral nutritional supplements (ONS) in community-dwelling older adults discharged from hospital. METHODS A total of 106 participants (>65 years) were randomized into the intervention group (n = 53) and into the control group (n = 53). The intervention group received individual nutrition therapy (five in person visits and three phone calls) and freely delivered energy- and protein- rich foods, while the control group received standard care. Dietary intake, anthropometrics, and short physical performance battery (SPPB) were assessed at baseline and at endpoint. RESULTS Energy intake at baseline was similar in both groups (~1500 kcal at the hospital) but there was a significant increase in energy intake and body weight in the intervention group (+919 kcal/day and 1.7 kg, P < 0.001 in both cases) during the study period, compared to a significant decrease in both measures among controls (-815 kcal/day and -3.5 kg, P < 0.001 in both cases). SPPB score increased significantly in the intervention group while no changes were observed among controls. CONCLUSIONS Most Icelandic older adults experience substantial weight loss after hospital discharge when receiving current standard care. However, a 6-month multi-component nutrition therapy, provided by a clinical nutritionist in combination with freely delivered supplemental energy- and protein-dense foods has beneficial effects on body weight, physical function, and nutritional status. STUDY REGISTRATION This study was registered at ClinicalTrials.gov ( NCT03995303 ).
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Affiliation(s)
- B S Blondal
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland.
| | - O G Geirsdottir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
| | - A M Beck
- University College Copenhagen, Institute of Nursing and Nutrition, Sigurdsgade 26, 2200, Copenhagen, Denmark
- The Dietetic and Nutritional Research Unit, EFFECT, Herlev and Gentofte University Hospital, Borgmester Ib Juuls Vej 50, 2730, Herlev, Denmark
| | - T I Halldorsson
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
| | - P V Jonsson
- The Icelandic Gerontological Research Institute, Tungata 26, 101, Reykjavik, Iceland
- Faculty of Medicine, School of Health, University of Iceland, Reykjavík, Iceland
- Department of Geriatrics, The National University Hospital of Iceland, Reykjavík, Iceland
| | | | - A Ramel
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
- Matís ohf, Vinlandsleið 12, 113, Reykjavik, Iceland
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Fernández-García ÁI, Moradell A, Navarrete-Villanueva D, Subías-Perié J, Pérez-Gómez J, Ara I, González-Gross M, Casajús JA, Vicente-Rodríguez G, Gómez-Cabello A. Effects of Multicomponent Training Followed by a Detraining Period on Frailty Level and Functional Capacity of Older Adults with or at Risk of Frailty: Results of 10-Month Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912417. [PMID: 36231712 PMCID: PMC9566070 DOI: 10.3390/ijerph191912417] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 05/13/2023]
Abstract
This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (-0.7 ± 1.3), and FTS-5 (-5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (-1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.
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Affiliation(s)
- Ángel Iván Fernández-García
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia, 5, 22001 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
| | - Ana Moradell
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia, 5, 22001 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
| | - David Navarrete-Villanueva
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Subías-Perié
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Pérez-Gómez
- HEME (Health, Economy, Motricity and Education) Research Group, University of Extremadura, 10003 Cáceres, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marcela González-Gross
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - José Antonio Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia, 5, 22001 Huesca, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Instituto Agroalimentario de Aragón—IA2—(CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
| | - Alba Gómez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain
- Red Española de Investigación en Ejercicio Físico y Salud en Poblaciones Especiales (EXERNET)
- Instituto Agroalimentario de Aragón—IA2—(CITA-Universidad de Zaragoza), 50009 Zaragoza, Spain
- Centro Universitario de la Defensa, 50090 Zaragoza, Spain
- Correspondence: ; Tel.: +34-976-739-794
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Sheng CY, Son YH, Jang J, Park SJ. In vitro skeletal muscle models for type 2 diabetes. BIOPHYSICS REVIEWS 2022; 3:031306. [PMID: 36124295 PMCID: PMC9478902 DOI: 10.1063/5.0096420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Type 2 diabetes mellitus, a metabolic disorder characterized by abnormally elevated blood sugar, poses a growing social, economic, and medical burden worldwide. The skeletal muscle is the largest metabolic organ responsible for glucose homeostasis in the body, and its inability to properly uptake sugar often precedes type 2 diabetes. Although exercise is known to have preventative and therapeutic effects on type 2 diabetes, the underlying mechanism of these beneficial effects is largely unknown. Animal studies have been conducted to better understand the pathophysiology of type 2 diabetes and the positive effects of exercise on type 2 diabetes. However, the complexity of in vivo systems and the inability of animal models to fully capture human type 2 diabetes genetics and pathophysiology are two major limitations in these animal studies. Fortunately, in vitro models capable of recapitulating human genetics and physiology provide promising avenues to overcome these obstacles. This review summarizes current in vitro type 2 diabetes models with focuses on the skeletal muscle, interorgan crosstalk, and exercise. We discuss diabetes, its pathophysiology, common in vitro type 2 diabetes skeletal muscle models, interorgan crosstalk type 2 diabetes models, exercise benefits on type 2 diabetes, and in vitro type 2 diabetes models with exercise.
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Affiliation(s)
- Christina Y. Sheng
- Biohybrid Systems Group, Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University School of Medicine, Atlanta, Georgia 30322, USA
| | - Young Hoon Son
- Biohybrid Systems Group, Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University School of Medicine, Atlanta, Georgia 30322, USA
| | | | - Sung-Jin Park
- Biohybrid Systems Group, Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University School of Medicine, Atlanta, Georgia 30322, USA
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22
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A Meta-Analysis to Detect Efficacy of Physical Activity Interventions to Enhance Effects Related to the Fragility among Older Adults. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3424972. [PMID: 35991130 PMCID: PMC9391150 DOI: 10.1155/2022/3424972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
Background The role of physical activity is well-known to intercept the condition of fragility and decrease its outcomes. This study aimed to determine the efficacious physical activity intervention measure which enhances the outcomes associated to fragility in the older adults. Material and Methods. We searched MEDLINE, Cochrane Central Register of Controlled, and EMBASE for the published studies in the duration June 2000 to February 2020 which were further shortlisted as per the inclusion and exclusion criteria of the study. The elder population considered from the selected studies was considered in an age of 65 years or more who were pre-fragile or fragile. Here, we included the clinical as well as randomized control trials. Results After extracting the data, we measured the risk ratio for aerobic intervention for physical intervention group as 0.55 [95% confidence interval (C.I) as 0.29, 1.03], mobility/rehabilitation interventions were nonsignificant for both groups with reported risk ratio as 1.13 (95% C.I as 0.96, 1.33), muscular strength randomized control trails as a significant integrated outcome estimate over the mobility measure, where the risk ratio was obtained as 1.17 (95% C.I 1.00, 1.35), for the randomized control trials of the mixed interventions showed a significant integrated outcome over the measures of mobility with obtained risk difference 0.03 (95% C.I -0.03, 0.09) and significant effects for daily life activities for intervention group with odds ratio 0.98 (95% C.I was 0.68, 1.41). Conclusion From the conducted systematic review and meta-analysis, we determined a low to medium authentication that different physical activities interventions are considered to be advantageous for the pre-fragile as well as the fragile elderly people. The studies are required to be more comprehensive and clear about defining the fragility so as to assure the determination and performing of such interventions into a clinical execution.
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Effect of combined locomotor training and aerobic exercise on increasing handgrip strength in elderly with locomotive syndrome: A randomised controlled trial. Ann Med Surg (Lond) 2022; 78:103800. [PMID: 35734655 PMCID: PMC9207023 DOI: 10.1016/j.amsu.2022.103800] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 01/08/2023] Open
Abstract
Background Elderly with the locomotive syndrome is at high risk for fall and fractures. Thus multimodal therapy is needed to minimize the risk. Objective Analyzing the effect of combined locomotor training and aerobic exercise on muscle strength in elderly with locomotive syndrome stage 1. Methods This study used a pre-test and post-test design with 20 participants (treatment group = 10 participants and control group = 10 participants). The treatment group was given combined locomotor training and aerobic exercise, while the control group was only given aerobic exercise for eight weeks. Locomotor training was provided three times/week with progressive increase of set and repetition at each activity. Meanwhile, aerobic exercise was given seven times/week for 30 min per session. Participants were examined for muscle strength (handgrip strength) before and after the intervention. The analysis included paired t-test and an independent t-test with a p-value <0.05. Results The participants' mean age was 73.85 ± 4.75 years, with treatment group = 75.4 ± 4.88 years and control group = 72.3 ± 4.30 years (t = 1.508; 95% CI = −1.220 – 7420; p = 0.149). The HGS values in the treatment group were 13.89 ± 5.27 (pre-test) and 19.06 ± 4.54 (post-test; t = 11.765; 95% CI = −6.164 to −4.176; p < 0.001). Meanwhile, the HGS values in the control group at pre-test and post-test were 11.27 ± 2.17 and 13.03 ± 2.54, respectively (t = 2.057; 95% CI = −1.600 – 0.076; p = 0.070). The ΔHGS values of treatment and control group were 5.17 ± 1.39 and 1.76 ± 2.07, respectively (t = 4.329; 95% CI = 1.755–5.065; p < 0.001). Conclusion Combined locomotor training and aerobic exercise have increased muscle strength, as proven by increased handgrip strength. Combined locomotor training and aerobic exercise minimize fall risk and fracture in the elderly. Combined locomotor training and aerobic exercise are effective for the management of locomotive syndrome stage 1. Combined locomotor training and aerobic exercise reduce the GLFS-25 score.
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Qiao X, Ji L, Jin Y, Si H, Bian Y, Wang W, Liu Q, Yu J, Wang C. A theory-driven exercise intervention among community-dwelling (pre)frail older adults: Protocol for a stepped-wedge cluster-randomized trial. J Adv Nurs 2022; 78:2634-2645. [PMID: 35621366 DOI: 10.1111/jan.15303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 11/26/2022]
Abstract
AIM This study is aimed to evaluate the effectiveness of a theory-driven exercise intervention for Chinese community-dwelling (pre)frail older adults, and to clarify the underlying mechanisms of the exercise intervention in this population. DESIGN A stepped-wedge cluster-randomized trial. METHODS A stepped-wedge cluster-randomized trial will be conducted among (pre)frail older adults at six communities in a county of central China. A 12-week multicomponent exercise intervention based on the integration of the Health Belief Model (HBM) and the Theory of Planned Behaviour (TPB) will be implemented to all participants during the study period. The primary outcomes are frailty, muscle mass, muscle strength and physical performance. Secondary outcomes include beliefs in exercise, exercise behaviours and other physical, mental and social functioning. Assessments will be conducted at baseline and at week 12, 24 and 36. A multilevel regression model will be used to evaluate the effectiveness of exercise interventions. A multilevel mediation model will be used to clarify the underlying mechanisms of this exercise intervention. DISCUSSION This study is expected to provide an effective and practical mode for exercise interventions among Chinese community-dwelling (pre)frail older adults, and contribute to the existing evidence in this field. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100041981.
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Affiliation(s)
- Xiaoxia Qiao
- School of Nursing, Peking University, Beijing, China
| | - Lili Ji
- School of Nursing, Peking University, Beijing, China
| | - Yaru Jin
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Yanhui Bian
- School of Nursing, Peking University, Beijing, China
| | - Wenyu Wang
- School of Nursing, Peking University, Beijing, China
| | - Qinqin Liu
- School of Nursing, Peking University, Beijing, China
| | - Jiaqi Yu
- School of Nursing, Peking University, Beijing, China
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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Mulasso A, Roppolo M, Rainoldi A, Rabaglietti E. Effects of a Multicomponent Exercise Program on Prevalence and Severity of the Frailty Syndrome in a Sample of Italian Community-Dwelling Older Adults. Healthcare (Basel) 2022; 10:healthcare10050911. [PMID: 35628048 PMCID: PMC9141371 DOI: 10.3390/healthcare10050911] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Frailty is a well-known condition that leads to a lack of resilience, with a reduced homeostatic capacity and a consequent higher risk of suffering adverse health outcomes. This study investigated the effectiveness of an exercise program to improve and reverse physical frailty amongst Italian older adults. Methods: One hundred and twenty-three community dwelling older adults (mean age 74 years, SD = 6; 64% women) were involved in an experimental (EG; n = 62) and a control (CG; n = 61) group. Frailty was assessed at baseline and after the intervention using an adapted version of the frailty phenotype. The EG took part in a 16-week exercise program, consisting of endurance, strength, balance and flexibility exercises, while the CG maintained the same routine. Results: After the exercise program, the EG was more robust than the CG (F = 43.51, p < 0.001). Within the EG, 46% of pre-frail and 50% of frail people reached the robust and pre-frail levels, respectively. Effects of training were higher in frail and pre-frail people (reduction of frailty of 0.67 and 0.76 points, respectively) compared to robust ones (who frailty levels increased by 0.23 points; F = 11.32, p < 0.001). Conclusions: A multicomponent exercise program may be effective at improving and reverting frailty, specifically for frail and pre-frail people.
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Affiliation(s)
- Anna Mulasso
- Neuromuscular Function Research Group, Department of Medical Sciences, School of Exercise and Sport Sciences, University of Torino, 10143 Torino, Italy;
- Correspondence:
| | - Mattia Roppolo
- Department of Psychology, University of Torino, 10124 Torino, Italy; (M.R.); (E.R.)
| | - Alberto Rainoldi
- Neuromuscular Function Research Group, Department of Medical Sciences, School of Exercise and Sport Sciences, University of Torino, 10143 Torino, Italy;
| | - Emanuela Rabaglietti
- Department of Psychology, University of Torino, 10124 Torino, Italy; (M.R.); (E.R.)
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Quantitative Ultrasound Changes in Echotexture and Functional Parameters after a Multicomponent Training Program in Pre-Frailty Individuals: A Pilot Randomized Clinical Trial. Healthcare (Basel) 2021; 9:healthcare9101279. [PMID: 34682959 PMCID: PMC8535283 DOI: 10.3390/healthcare9101279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/13/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: Currently, ultrasound imaging (USI) is considered a feasible tool in the evaluation of structural and textural muscle differences due to aging. The main aim of this study was to evaluate sonographic changes in muscular structure and function after a 12-week multicomponent training program in pre-frailty individuals. Design: A prospective, randomized, clinical trial was carried out. Participants: Thirty-two pre-frailty subjects were recruited and randomly divided into a multicomponent training program group (n = 16; Multicomponent group) and a conventional care group (n = 14; Control group) with a 12-week follow up. Main outcome measures: Rectus femoris thickness, cross-sectional area (CSA), echointensity, echovariation and vastus lateralis pennation angle tests were carried out to assess the structure and echotexture, and the force-velocity (F-V) profile for muscle power and muscle strength was employed to assess the functional parameters. Results: Statistically significant differences (p < 0.05) were shown for the left rectus femoris echointensity and in the functional parameter of muscle power after a 12-week program for the multicomponent training group compared to the conventional care group. Conclusions: Pre-frailty elderly subjects showed a decrease in rectus femoris echointensity (RF-EI) and an increase in the functional parameter of muscle power after a 12-week multicomponent training program compared to the control group.
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Takauji S, Hifumi T, Saijo Y, Yokobori S, Kanda J, Kondo Y, Hayashida K, Shimazaki J, Moriya T, Yagi M, Yamaguchi J, Okada Y, Okano Y, Kaneko H, Kobayashi T, Fujita M, Shimizu K, Yokota H, Yaguchi A. Association between frailty and mortality among patients with accidental hypothermia: a nationwide observational study in Japan. BMC Geriatr 2021; 21:507. [PMID: 34563118 PMCID: PMC8466946 DOI: 10.1186/s12877-021-02459-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/10/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Frailty has been associated with a risk of adverse outcomes, and mortality in patients with various conditions. However, there have been few studies on whether or not frailty is associated with mortality in patients with accidental hypothermia (AH). In this study, we aim to determine this association in patients with AH using Japan's nationwide registry data. METHODS The data from the Hypothermia STUDY 2018&19, which included patients of ≥18 years of age with a body temperature of ≤35 °C, were obtained from a multicenter registry for AH conducted at 120 institutions throughout Japan, collected from December 2018 to February 2019 and December 2019 to February 2020. The clinical frailty scale (CFS) score was used to determine the presence and degree of frailty. The primary outcome was the comparison of mortality between the frail and non-frail patient groups. RESULTS In total, 1363 patients were included in the study, of which 920 were eligible for the analysis. The 920 patients were divided into the frail patient group (N = 221) and non-frail patient group (N = 699). After 30-days of hospitalization, 32.6% of frail patients and 20.6% of non-frail patients had died (p < 0.001). Frail patients had a significantly higher risk of 90-day mortality (Hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.25-2.17; p < 0.001). Based on the Cox proportional hazards analysis using multiple imputation, after adjustment for age, potassium level, lactate level, pH value, sex, CPK level, heart rate, platelet count, location of hypothermia incidence, and rate of tracheal intubation, the HR was 1.69 (95% CI, 1.25-2.29; p < 0.001). CONCLUSIONS This study showed that frailty was associated with mortality in patients with AH. Preventive interventions for frailty may help to avoid death caused by AH.
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Affiliation(s)
- Shuhei Takauji
- Department of Emergency Medicine, Asahikawa Medical University Hospital, 2-1, Midorigaoka higashi, Asahikawa, 078-8510, Japan. .,Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.
| | - Toru Hifumi
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Shoji Yokobori
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Kanda
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency Medicine, Teikyo University Hospital, Tokyo, Japan
| | - Yutaka Kondo
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Kei Hayashida
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, Manhasset, NY, USA
| | - Junya Shimazaki
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School, Osaka, Japan
| | - Takashi Moriya
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masaharu Yagi
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency, Disaster and Critical Care Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Junko Yamaguchi
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Acute Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yohei Okada
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Primary care and Emergency medicine, Graduate school of medicine, Kyoto University, Kyoto, Japan
| | - Yuichi Okano
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency Medicine, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Hitoshi Kaneko
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Tatsuho Kobayashi
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, Aizuwakamatsu, Japan
| | - Motoki Fujita
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Japan
| | - Keiki Shimizu
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Hiroyuki Yokota
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Arino Yaguchi
- Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee, Tokyo, Japan.,Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Hayes LD, Elliott BT, Yasar Z, Bampouras TM, Sculthorpe NF, Sanal-Hayes NEM, Hurst C. High Intensity Interval Training (HIIT) as a Potential Countermeasure for Phenotypic Characteristics of Sarcopenia: A Scoping Review. Front Physiol 2021; 12:715044. [PMID: 34504439 PMCID: PMC8423251 DOI: 10.3389/fphys.2021.715044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/20/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Sarcopenia is defined as a progressive and generalized loss of skeletal muscle quantity and function associated predominantly with aging. Physical activity appears the most promising intervention to attenuate sarcopenia, yet physical activity guidelines are rarely met. In recent years high intensity interval training (HIIT) has garnered interested in athletic populations, clinical populations, and general population alike. There is emerging evidence of the efficacy of HIIT in the young old (i.e. seventh decade of life), yet data concerning the oldest old (i.e., ninth decade of life onwards), and those diagnosed with sarcopenic are sparse. Objectives: In this scoping review of the literature, we aggregated information regarding HIIT as a potential intervention to attenuate phenotypic characteristics of sarcopenia. Eligibility Criteria: Original investigations concerning the impact of HIIT on muscle function, muscle quantity or quality, and physical performance in older individuals (mean age ≥60 years of age) were considered. Sources of Evidence: Five electronic databases (Medline, EMBASE, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials [CENTRAL]) were searched. Methods: A scoping review was conducted using the Arksey and O'Malley methodological framework (2005). Review selection and characterization were performed by two independent reviewers using pretested forms. Results: Authors reviewed 1,063 titles and abstracts for inclusion with 74 selected for full text review. Thirty-two studies were analyzed. Twenty-seven studies had a mean participant age in the 60s, two in the 70s, and three in the 80s. There were 20 studies which examined the effect of HIIT on muscle function, 22 which examined muscle quantity, and 12 which examined physical performance. HIIT was generally effective in Improving muscle function and physical performance compared to non-exercised controls, moderate intensity continuous training, or pre-HIIT (study design-dependent), with more ambiguity concerning muscle quantity. Conclusions: Most studies presented herein utilized outcome measures defined by the European Working Group on Sarcopenia in Older People (EWGSOP). However, there are too few studies investigating any form of HIIT in the oldest old (i.e., ≥80 years of age), or those already sarcopenic. Therefore, more intervention studies are needed in this population.
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Affiliation(s)
- Lawrence D Hayes
- School of Health and Life Sciences, University of the West of Scotland, Hamilton, United Kingdom
| | - Bradley T Elliott
- Translational Physiology Research Group, School of Life Sciences, University of Westminster, London, United Kingdom
| | - Zerbu Yasar
- Active Ageing Research Group, Institute of Health, University of Cumbria, Lancaster, United Kingdom
| | - Theodoros M Bampouras
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom.,The Centre for Ageing Research, Lancaster University, Lancaster, United Kingdom
| | - Nicholas F Sculthorpe
- School of Health and Life Sciences, University of the West of Scotland, Hamilton, United Kingdom
| | | | - Christopher Hurst
- AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,National Institute for Health Research Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals National Health Service Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom
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29
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Yuan Y, Lapane KL, Tjia J, Baek J, Liu SH, Ulbricht CM. Physical frailty and cognitive impairment in older nursing home residents: a latent class analysis. BMC Geriatr 2021; 21:487. [PMID: 34493211 PMCID: PMC8425049 DOI: 10.1186/s12877-021-02433-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/25/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Little is known about the heterogeneous clinical profile of physical frailty and its association with cognitive impairment in older U.S. nursing home (NH) residents. METHODS Minimum Data Set 3.0 at admission was used to identify older adults newly-admitted to nursing homes with life expectancy ≥6 months and length of stay ≥100 days (n = 871,801). Latent class analysis was used to identify physical frailty subgroups, using FRAIL-NH items as indicators. The association between the identified physical frailty subgroups and cognitive impairment (measured by Brief Interview for Mental Status/Cognitive Performance Scale: none/mild; moderate; severe), adjusting for demographic and clinical characteristics, was estimated by multinomial logistic regression and presented in adjusted odds ratios (aOR) and 95% confidence intervals (CIs). RESULTS In older nursing home residents at admission, three physical frailty subgroups were identified: "mild physical frailty" (prevalence: 7.6%), "moderate physical frailty" (44.5%) and "severe physical frailty" (47.9%). Those in "moderate physical frailty" or "severe physical frailty" had high probabilities of needing assistance in transferring between locations and inability to walk in a room. Residents in "severe physical frailty" also had greater probability of bowel incontinence. Compared to those with none/mild cognitive impairment, older residents with moderate or severe impairment had slightly higher odds of belonging to "moderate physical frailty" [aOR (95%CI)moderate cognitive impairment: 1.01 (0.99-1.03); aOR (95%CI)severe cognitive impairment: 1.03 (1.01-1.05)] and much higher odds to the "severe physical frailty" subgroup [aOR (95%CI)moderate cognitive impairment: 2.41 (2.35-2.47); aOR (95%CI)severe cognitive impairment: 5.74 (5.58-5.90)]. CONCLUSIONS Findings indicate the heterogeneous presentations of physical frailty in older nursing home residents and additional evidence on the interrelationship between physical frailty and cognitive impairment.
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Affiliation(s)
- Yiyang Yuan
- Clinical and Population Health Research PhD Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Kate L Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Jennifer Tjia
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Jonggyu Baek
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Shao-Hsien Liu
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Christine M Ulbricht
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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30
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Alcazar J, Alegre LM, Van Roie E, Magalhães JP, Nielsen BR, González‐Gross M, Júdice PB, Casajús JA, Delecluse C, Sardinha LB, Suetta C, Ara I. Relative sit-to-stand power: aging trajectories, functionally relevant cut-off points, and normative data in a large European cohort. J Cachexia Sarcopenia Muscle 2021; 12:921-932. [PMID: 34216098 PMCID: PMC8350203 DOI: 10.1002/jcsm.12737] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/13/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A validated, standardized, and feasible test to assess muscle power in older adults has recently been reported: the sit-to-stand (STS) muscle power test. This investigation aimed to assess the relationship between relative STS power and age and to provide normative data, cut-off points, and minimal clinically important differences (MCID) for STS power measures in older women and men. METHODS A total of 9320 older adults (6161 women and 3159 men) aged 60-103 years and 586 young and middle-aged adults (318 women and 268 men) aged 20-60 years were included in this cross-sectional study. Relative (normalized to body mass), allometric (normalized to height squared), and specific (normalized to legs muscle mass) muscle power values were assessed by the 30 s STS power test. Body composition was evaluated by dual energy X-ray absorptiometry and bioelectrical impedance analysis, and legs skeletal muscle index (SMI; normalized to height squared) was calculated. Habitual and maximal gait speed, timed up-and-go test, and 6 min walking distance were collected as physical performance measures, and participants were classified into two groups: well-functioning and mobility-limited older adults. RESULTS Relative STS power was found to decrease between 30-50 years (-0.05 W·kg-1 ·year-1 ; P > 0.05), 50-80 years (-0.10 to -0.13 W·kg-1 ·year-1 ; P < 0.001), and above 80 years (-0.07 to -0.08 W·kg-1 ·year-1 ; P < 0.001). A total of 1129 older women (18%) and 510 older men (16%) presented mobility limitations. Mobility-limited older adults were older and exhibited lower relative, allometric, and specific power; higher body mass index (BMI) and legs SMI (both only in women); and lower legs SMI (only in men) than their well-functioning counterparts (all P < 0.05). Normative data and cut-off points for relative, allometric, and specific STS power and for BMI and legs SMI were reported. Low relative STS power occurred below 2.1 W·kg-1 in women (area under the curve, AUC, [95% confidence interval, CI] = 0.85 [0.84-0.87]) and below 2.6 W·kg-1 in men (AUC [95% CI] = 0.89 [0.87-0.91]). The age-adjusted odds ratios [95% CI] for mobility limitations in older women and men with low relative STS power were 10.6 [9.0-12.6] and 14.1 [10.9-18.2], respectively. MCID values for relative STS power were 0.33 W·kg-1 in women and 0.42 W·kg-1 in men. CONCLUSIONS Relative STS power decreased significantly after the age of 50 years and was negatively and strongly associated with mobility limitations. Our study provides normative data, functionally relevant cut-off points, and MCID values for STS power for their use in daily clinical practice.
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Affiliation(s)
- Julian Alcazar
- GENUD Toledo Research GroupUniversidad de Castilla‐La ManchaToledoSpain
- CIBER of Frailty and Healthy Aging (CIBERFES)MadridSpain
- Geriatric Research Unit, Geriatric DepartmentBispebjerg‐Frederiksberg University HospitalCopenhagenDenmark
| | - Luis M. Alegre
- GENUD Toledo Research GroupUniversidad de Castilla‐La ManchaToledoSpain
- CIBER of Frailty and Healthy Aging (CIBERFES)MadridSpain
| | - Evelien Van Roie
- Department of Movement Sciences, Physical Activity, Sports and Health Research GroupKU LeuvenLeuvenBelgium
| | - João P. Magalhães
- Exercise and Health Laboratory, CIPER, Facultade de Motricidade HumanaUniversidade de LisboaLisbonPortugal
| | - Barbara R. Nielsen
- Department of Internal Medicine, Geriatric DivisionAmager and Hvidovre Hospital, GlostrupCopenhagenDenmark
| | - Marcela González‐Gross
- ImFine Research Group, Departamento de Salud y Rendimiento Humano, Facultad de Ciencias de la Actividad Física y del DeporteUniversidad Politécnica de MadridMadridSpain
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN)MadridSpain
| | - Pedro B. Júdice
- Exercise and Health Laboratory, CIPER, Facultade de Motricidade HumanaUniversidade de LisboaLisbonPortugal
| | - Jose A. Casajús
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN)MadridSpain
- Growth, Exercise, Nutrition, and Development Research GroupUniversity of ZaragozaZaragozaSpain
| | - Christophe Delecluse
- Department of Movement Sciences, Physical Activity, Sports and Health Research GroupKU LeuvenLeuvenBelgium
| | - Luis B. Sardinha
- Exercise and Health Laboratory, CIPER, Facultade de Motricidade HumanaUniversidade de LisboaLisbonPortugal
| | - Charlotte Suetta
- Geriatric Research Unit, Geriatric DepartmentBispebjerg‐Frederiksberg University HospitalCopenhagenDenmark
- Department of Clinical Physiology, Nuclear Medicine & PET, Righospitalet‐GlostrupCopenhagen University HospitalCopenhagenDenmark
- Geriatric Research Unit, Department of Internal MedicineHerlev‐Gentofte University HospitalHerlevDenmark
| | - Ignacio Ara
- GENUD Toledo Research GroupUniversidad de Castilla‐La ManchaToledoSpain
- CIBER of Frailty and Healthy Aging (CIBERFES)MadridSpain
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Effectiveness of physical activity interventions in older adults with frailty or prefrailty: a systematic review and meta-analysis. CMAJ 2021. [PMCID: PMC8315283 DOI: 10.9778/cmajo.20200222] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Methods: Results: Interpretation: PROSPERO registration:
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Bambrick P, Phelan N, Grant E, Byrne T, Harrison M, Mulcahy R, Cooke J. Diet and Exercise for FRAILty (DEFRAIL): protocol for a study to examine the effect of a novel community-based group exercise and nutritional intervention, designed to reverse frailty in older adults. BMJ Open 2021; 11:e042408. [PMID: 34130954 PMCID: PMC8207997 DOI: 10.1136/bmjopen-2020-042408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Frailty refers to a multifaceted age-related loss of physiological reserve. Aside from the immediate challenges it presents, it is also associated with various adverse health outcomes. Given our ageing population, the healthcare and societal costs resulting from frailty present a significant and growing public health challenge. Rapidly accumulating evidence suggests that resistance exercise combined with protein supplementation can reverse frailty in older adults. However, translation of these findings into practice has proven difficult, due to either a lack of clarity regarding the interventions used or the use of interventions not suitable for widespread implementation. There remains an absence of evidence-based programmes suitable for delivery to frail older adults in the community. METHODS AND ANALYSIS This paper outlines the protocol for a study to examine the effect of a novel programme of exercise and protein supplementation. This intervention has been developed by an expert consensus group, specifically for delivery to frail older adults in a group setting in the community. The study will take the form of a within-subjects non-randomised trial. Participants will be assessed at baseline, then following an 8-week period of regular activity, then following the 8-week intervention. Frailty (according to the Fried Frailty criteria) will be the primary outcome measure, along with a range of secondary outcome measures (including physical performance measures, body mass composition, psychosocial assessments and frailty-related biomarkers). If shown to be feasible to implement and effective at reversing frailty, the Diet and Exercise for FRAILty (DEFRAIL) intervention may facilitate more widespread participation in resistance exercise for frail older adults. ETHICS AND DISSEMINATION This study received ethical approval from the Research Ethics committees of both the Health Service Executive South-Eastern Area and Waterford Institute of Technology. Its findings will be disseminated through journal publications, conference presentations and other forms of public engagement. TRIAL REGISTRATION NUMBER ISRCTN46458028; Pre-results.
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Affiliation(s)
- Pádraig Bambrick
- Department of Geriatric Medicine, University Hospital Waterford, Waterford, Ireland
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Niamh Phelan
- Department of Geriatric Medicine, University Hospital Waterford, Waterford, Ireland
| | - Emma Grant
- Department of Geriatric Medicine, University Hospital Waterford, Waterford, Ireland
| | - Thomas Byrne
- Department of Sport & Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Michael Harrison
- Department of Sport & Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Ríona Mulcahy
- Department of Geriatric Medicine, University Hospital Waterford, Waterford, Ireland
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Cooke
- Department of Geriatric Medicine, University Hospital Waterford, Waterford, Ireland
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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33
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Alcazar J, Aagaard P, Haddock B, Kamper RS, Hansen SK, Prescott E, Ara I, Alegre LM, Frandsen U, Suetta C. Assessment of functional sit-to-stand muscle power: Cross-sectional trajectories across the lifespan. Exp Gerontol 2021; 152:111448. [PMID: 34118352 DOI: 10.1016/j.exger.2021.111448] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 05/11/2021] [Accepted: 06/07/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The 30-s sit-to-stand (STS) muscle power test is a valid test to assess muscle power in older people; however, whether it may be used to assess trajectories of lower-limb muscle power through the adult lifespan is not known. This study evaluated the pattern and time course of variations in relative, allometric and specific STS muscle power throughout the lifespan. METHODS Subjects participating in the Copenhagen Sarcopenia Study (729 women and 576 men; aged 20 to 93 years) were included. Lower-limb muscle power was assessed with the 30-s version of the STS muscle power test. Allometric, relative and specific STS power were calculated as absolute STS power normalized to height squared, body mass and leg lean mass as assessed by DXA, respectively. RESULTS Relative STS muscle power tended to increase in women (0.08 ± 0.05 W·kg-1·yr-1; p = 0.082) and increased in men (0.14 ± 0.07 W·kg-1·yr-1; p = 0.046) between 20 and 30 years, followed by a slow decline (-0.05 ± 0.05 W·kg-1·yr-1 and -0.06 ± 0.08 W·kg-1·yr-1, respectively; both p > 0.05) between 30 and 50 years. Then, relative STS power declined at an accelerated rate up to oldest age in men (-0.09 ± 0.02 W·kg-1·yr-1) and in women until the age of 75 (-0.09 ± 0.01 W·kg-1·yr-1) (both p < 0.001). A lower rate of decline was observed in women aged 75 and older (-0.04 ± 0.02 W·kg-1·yr-1; p = 0.039). Similar age-related patterns were noted for allometric and specific STS power. CONCLUSIONS The STS muscle power test appears to provide a feasible and inexpensive tool to monitor cross-sectional trajectories of muscle power throughout the lifespan.
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Affiliation(s)
- Julian Alcazar
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Geriatric Research Unit, Geriatric Department, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Per Aagaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Bryan Haddock
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet-Glostrup University Hospital, Copenhagen, Denmark
| | - Rikke S Kamper
- Geriatric Research Unit, Geriatric Department, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Sofie K Hansen
- Geriatric Research Unit, Geriatric Department, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Eva Prescott
- Department of Cardiology, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark; Copenhagen City Heart Study, Frederiksberg University Hospital, Copenhagen, Denmark
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Luis M Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Ulrik Frandsen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Charlotte Suetta
- Geriatric Research Unit, Geriatric Department, Bispebjerg University Hospital, Copenhagen, Denmark; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet-Glostrup University Hospital, Copenhagen, Denmark; Geriatric Research Unit, Department of Internal Medicine, Herlev-Gentofte University Hospital, Copenhagen, Denmark.
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Núñez Vergara C, Smith Plaza R, Pérez Ramírez N. [Effectiveness of high intensity interval training in the cardiorespiratory capacity of people older than 65 years old: A systematic review]. Rev Esp Geriatr Gerontol 2021; 56:297-307. [PMID: 34083059 DOI: 10.1016/j.regg.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 12/09/2022]
Abstract
The objective of this review was to analyze the effect of HIIT on cardiorespiratory fitness, health-related quality of life (HRQL) and safety of its execution in people over 65 years of age. A systematic search was carried out, following the PRISMA recommendations, in 11 electronic databases, evaluating the resolution of the HIIT, affecting cardiorespiratory capacity as the main result and secondarily HRQL and safety of its execution, assessing the risk of bias using Rob 2.0 and ROBINS-I. Thirteen studies met the inclusion criteria, consisting of people >65 years, HIIT intervention >4 weeks, and studies assessing cardiorespiratory fitness. It can be concluded that HIIT improves cardiorespiratory capacity in people over 65 years of age, with respect to HRQL and the safety of its execution, the results are not conclusive. It becomes essential to unify criteria in intervention protocols, requiring further research in this regard.
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Affiliation(s)
| | - Raúl Smith Plaza
- Subdirección de Investigación, Sociedad Pro-Ayuda al Niño Lisiado, Teletón, Chile; Unidad de Ejercicio y Deporte Adaptado, Teletón, Chile; Hospital Clínico Mutual de Seguridad C.Ch.C, Santiago, Chile; Alemana Sport, Clínica Alemana de Santiago, Chile
| | - Natalia Pérez Ramírez
- Subdirección de Investigación, Sociedad Pro-Ayuda al Niño Lisiado, Teletón, Chile; Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
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35
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Zhang J, Liu Z, Liu Y, Ye L. Exercise interventions for older people at risk for frailty: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25940. [PMID: 34011071 PMCID: PMC8137036 DOI: 10.1097/md.0000000000025940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Frailty is a state of age-related reduced physiological reserve characterized by an increased risk of adverse clinical outcomes. Studies have shown that exercise can improve frailty in older people. However, it remains to be seen which exercises will most improve the fitness of older people with frailty or those at the risk for frailty.Objective: This protocol aims to determine whether physical exercise can improve frailty in older people, and if which methods are most effective. METHODS We searched the following databases for relevant articles published between January 1, 2012 and January 1, 2021: PubMed, EMBASE, the Cochrane Library, Wanfang, the China National Knowledge Infrastructure, Clinical Trials Database, and the Science Network. Two independent reviewers will carry out data extraction, discuss and resolve differences, and obtain consensus from the third author. We will select randomized control trials (RCTs) according to the preformulated inclusion criteria. The main outcomes in this study are scores from Fried Frailty Phenotype Criteria; the Frailty Trait Scale-short form; the SHARE Frailty Instrument; the FRAIL scale; the Gérontopôle Frailty Screening Tool; the Clinical Frailty Scale, the Rockwood and Mitnitsky Frailty Index; the Study of Osteoporotic Fractures Index; the Edmonton Frailty Scale; the Fatigue, Resistance, Ambulation, Illness and Loss of Weight Index; the Multidimensional Prognostic Index; the Tilburg Frailty Indicator; PRISMA-7; the Groningen Frailty Indicator; the Sherbrooke Postal Questionnaire; and the Kihon Checklist. Secondary outcomes are muscle strength, gait velocity, stair-climbing power, and level of spontaneous physical activity. If the heterogeneity test shows slight or no statistical heterogeneity, a fixed effects model will be used for data synthesis; otherwise, a random effects model will be used. We will develop a unified data extraction table that includes a number of parameters. The Cochrane Cooperative Bias Risk Tool will be used to evaluate the methodological quality of the selected RCTs. RevMan Manager 5.3 and STATA 14.0 will be used for data analysis if enough RCTs (more than 10) are identified and selected. RESULT The final results will provide information on the effectiveness of intervention programs for frail older adul and further demonstrate which exercise programs are more effective and which methods can significantly improve frailty. CONCLUSION This protocol will contribute to the development of more effective interventions for elderly individuals with frailty. ETHICS AND DISSEMINATION This study applies existing literature references; therefore, ethical approval is not required. INPLASY REGISTRATION NUMBER INPLASY202130107.
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Affiliation(s)
- Jianna Zhang
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhixi Liu
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Liu
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Ye
- West China School of Nursing
- Department of Emergency Medicine, Disaster Medical Center, West China Hospital, Sichuan University, Chengdu, China
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Feasibility of reducing frailty components in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial (AD-HOMEX). Exp Gerontol 2021; 150:111390. [PMID: 33962026 DOI: 10.1016/j.exger.2021.111390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/24/2021] [Accepted: 04/29/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVES There is a need for interventions to reduce frailty in older people with Alzheimer's dementia (AD). The purpose of this study was to investigate the effect of a home-based multimodal exercise program for older adults with AD (AD-HOMEX) on frailty. DESIGN A parallel single-blind randomized controlled trial comparing a home-based exercise program and usual care. SETTING AND PARTICIPANTS A home-based program in Brazil. Forty individuals aged 65years or older with mild to moderate AD. METHODS The intervention group (IG) participated in a 16-week protocol involving three 60-minute sessions per week of progressive individualized physical exercises supervised by a physical therapist. The participants in the control group (CG) maintained their usual care. Frailty was assessed using the FRAIL questionnaire, the Edmonton Frail Scale (EFS) and a subjective assessment by the evaluator (SAE) at baseline and follow-up. Per-protocol analysis was performed. RESULTS Thirty-five participants completed the program (IG = 16; CG = 19). Frailty improved in the IG based on the EFS (P = .004) and FRAIL (P ≤ .001). An interaction between group and time (P = .008) and a significant difference between times (P = .047) were found for the SAE responsiveness domain. An improvement in the classification of frailty (EFS and FRAIL) was found between times in the IG (P = .003) and between groups at follow-up (P = .027). A significant difference in the SAE classification was found between groups at follow-up (P = .034), with a worsening between times in the CG (P = .032). Interestingly, a more favorable frailty transition pattern was found in the IG based on both the EFS and FRAIL. CONCLUSIONS AND IMPLICATIONS AD-HOMEX seems to reduce frailty and improve frailty transition patterns. Our findings provide a further theoretical basis for designing home-based physical interventions as routine practice for older frail adults with AD.
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Wu ZJ, Wang ZY, Gao HE, Zhou XF, Li FH. Impact of high-intensity interval training on cardiorespiratory fitness, body composition, physical fitness, and metabolic parameters in older adults: A meta-analysis of randomized controlled trials. Exp Gerontol 2021; 150:111345. [PMID: 33836261 DOI: 10.1016/j.exger.2021.111345] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 01/03/2023]
Abstract
High-intensity interval training (HIIT) can effectively increase peak oxygen consumption, body composition, physical fitness, and health-related characteristics of adults; however, its impact in the older population remains highly debated. This review and meta-analysis aimed to evaluate the effects of high-intensity interval training on cardiorespiratory fitness, body composition, physical fitness, and health-related outcomes in older adults. Four electronic databases (PubMed, Scopus, Medline, and Web of Science) were searched (until July 2020) for randomized trials comparing the effect of HIIT on physical fitness, metabolic parameters, and cardiorespiratory fitness in older adults. The Cochrane risk of bias assessment tool was used to evaluate the methodological quality of the included studies; Stata 14.0 software was used for statistical analysis. HIIT significantly improved the maximum rate of oxygen consumption (VO2peak) as compared to a moderate-intensity continuous training (MICT) protocol (HIIT vs. MICT: weighted mean difference = 1.74, 95% confidence interval: 0.80-2.69, p < 0.001). Additional subgroup analyses determined that training periods >12 weeks, training frequencies of 2 sessions/week, session lengths of 40 min, 6 sets and repetitions, training times per repetition of >60 s, and rest times of <90 s were more effective for VO2peak. This systematic review and meta-analysis showed that HIIT induces favorable adaptions in cardiorespiratory fitness, physical fitness, muscle power, cardiac contractile function, mitochondrial citrate synthase activity, and reduced blood triglyceride and glucose levels in older individuals, which may help to maintain aerobic fitness and slow down the process of sarcopenia.
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Affiliation(s)
- Zhi-Jian Wu
- School of Sport Sciences, Nanjing Normal University, Nanjing, China
| | - Zhu-Ying Wang
- School of Sport Sciences, Nanjing Normal University, Nanjing, China
| | - Hao-En Gao
- School of Sport Sciences, Nanjing Normal University, Nanjing, China
| | - Xian-Feng Zhou
- School of Sport Sciences, Nanjing Normal University, Nanjing, China
| | - Fang-Hui Li
- School of Sport Sciences, Nanjing Normal University, Nanjing, China.
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Low relative mechanical power in older adults: An operational definition and algorithm for its application in the clinical setting. Exp Gerontol 2020; 142:111141. [DOI: 10.1016/j.exger.2020.111141] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 12/16/2022]
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Yao S, Zheng P, Ji L, Ma Z, Wang L, Qiao L, Wan Y, Sun N, Luo Y, Yang J, Wang H. The effect of comprehensive assessment and multi-disciplinary management for the geriatric and frail patient: A multi-center, randomized, parallel controlled trial. Medicine (Baltimore) 2020; 99:e22873. [PMID: 33181655 PMCID: PMC7668452 DOI: 10.1097/md.0000000000022873] [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] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND A comprehensive geriatric assessment (CGA) of elderly patients is useful for detecting the patients vulnerabilities. Exercise and early rehabilitation, nutritional intervention, traditional Chinese medicine (TCM), standardized medication guidance, and patient education can, separately, improve and even reverse the physical frailty status. However, the effect of combining a CGA and multi-disciplinary management on frailty in elderly patients remains unclear. The present study assessed the effects of a CGA and multi-disciplinary management on elderly patients with frailty in China. METHODS In this study, 320 in patients with frailty ≥70 years old will be randomly divided into an intervention group and a control group. The intervention group will be given routine management, a CGA and multi-disciplinary management involving rehabilitation exercise, diet adjustment, multi-drug evaluation, acupoint massage in TCM and patient education for 12 months, and the control group will be followed up with routine management for basic diseases. The primary outcomes are the Fried phenotype and short physical performance battery (SPPB). The secondary outcomes are the clinical frailty scale (CFS), non-elective hospital readmission, basic activities of daily living (BADL), 5-level European quality of life 5 dimensions index (EQ-5D), nutrition risk screening-2002 (NRS-2002), medical insurance expenses, fall events, and all-cause mortality. In addition, a cost-effectiveness study will be carried out. DISCUSSION This paper outlines the protocol for a randomized, single-blind, parallel multi-center clinical study. This protocol, if beneficial, will demonstrate the interaction of various intervention strategies, will help improve elderly frailty patients, and will be useful for clinicians, nurses, policymakers, public health authorities, and the general population. TRIAL REGISTRATION Chinese Clinical Trials Register, ChiCTR1900022623. Registered on April 19, 2019, http://www.chictr.org.cn/showproj.aspx?proj=38141.
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Affiliation(s)
- Simin Yao
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
- Peking University Fifth School of Clinical Medicine, Dong Dan, Beijing
| | - Peipei Zheng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
- Peking University Fifth School of Clinical Medicine, Dong Dan, Beijing
| | | | - Zhao Ma
- Department of Rehabilitation
| | | | - Linlin Qiao
- Department of TCM, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Yuhao Wan
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Ning Sun
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Yao Luo
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Jiefu Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Hua Wang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
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Angulo J, El Assar M, Álvarez-Bustos A, Rodríguez-Mañas L. Physical activity and exercise: Strategies to manage frailty. Redox Biol 2020; 35:101513. [PMID: 32234291 PMCID: PMC7284931 DOI: 10.1016/j.redox.2020.101513] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/25/2022] Open
Abstract
Frailty, a consequence of the interaction of the aging process and certain chronic diseases, compromises functional outcomes in the elderly and substantially increases their risk for developing disabilities and other adverse outcomes. Frailty follows from the combination of several impaired physiological mechanisms affecting multiple organs and systems. And, though frailty and sarcopenia are related, they are two different conditions. Thus, strategies to preserve or improve functional status should consider systemic function in addition to muscle conditioning. Physical activity/exercise is considered one of the main strategies to counteract frailty-related physical impairment in the elderly. Exercise reduces age-related oxidative damage and chronic inflammation, increases autophagy, and improves mitochondrial function, myokine profile, insulin-like growth factor-1 (IGF-1) signaling pathway, and insulin sensitivity. Exercise interventions target resistance (strength and power), aerobic, balance, and flexibility work. Each type improves different aspects of physical functioning, though they could be combined according to need and prescribed as a multicomponent intervention. Therefore, exercise intervention programs should be prescribed based on an individual's physical functioning and adapted to the ensuing response.
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Affiliation(s)
- Javier Angulo
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Mariam El Assar
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
| | | | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain.
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Endo Y, Nourmahnad A, Sinha I. Optimizing Skeletal Muscle Anabolic Response to Resistance Training in Aging. Front Physiol 2020; 11:874. [PMID: 32792984 PMCID: PMC7390896 DOI: 10.3389/fphys.2020.00874] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022] Open
Abstract
Loss of muscle mass and strength with aging, also termed sarcopenia, results in a loss of mobility and independence. Exercise, particularly resistance training, has proven to be beneficial in counteracting the aging-associated loss of skeletal muscle mass and function. However, the anabolic response to exercise in old age is not as robust, with blunted improvements in muscle size, strength, and function in comparison to younger individuals. This review provides an overview of several physiological changes which may contribute to age-related loss of muscle mass and decreased anabolism in response to resistance training in the elderly. Additionally, the following supplemental therapies with potential to synergize with resistance training to increase muscle mass are discussed: nutrition, creatine, anti-inflammatory drugs, testosterone, and growth hormone (GH). Although these interventions hold some promise, further research is necessary to optimize the response to exercise in elderly patients.
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Affiliation(s)
- Yori Endo
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Atousa Nourmahnad
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Indranil Sinha
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Harvard Department of Stem Cell and Regenerative Biology, Harvard Stem Cell Institute, Cambridge, MA, United States
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Mierzwicki JT, Fox MA, Griffith KR, Harrison KM, Holstay DK, Singley NM. Comparison of High-Intensity Resistance and Power Training Programs in Pre-Frail and Frail Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1748161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Justin T. Mierzwicki
- Department of Physical Therapy, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Madelyn A. Fox
- Department of Physical Therapy, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Kevin R. Griffith
- Department of Physical Therapy, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Kelsey M. Harrison
- Department of Physical Therapy, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Daryl K. Holstay
- Department of Physical Therapy, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Nikki M. Singley
- Department of Physical Therapy, Lebanon Valley College, Annville, Pennsylvania, USA
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O'Connell ML, Coppinger T, McCarthy AL. The role of nutrition and physical activity in frailty: A review. Clin Nutr ESPEN 2019; 35:1-11. [PMID: 31987100 DOI: 10.1016/j.clnesp.2019.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/14/2019] [Indexed: 12/12/2022]
Abstract
Frailty is a clinical syndrome with a worldwide prevalence of 5-27% among those aged over 65 years. Frailty is characterised by loss of muscle strength and impaired physical function, and is associated with increased falls, hospitalisation and death. Nutritional deficiencies and low physical activity are common in this age group due to ill health, disability and reductions in enthusiasm, food intake and therefore, energy availability. Both low physical activity and inadequate dietary intake have a significant role to play in the onset and progression of frailty, primarily through bone and muscle health implications. Frailty is, however, preventable and reversible, and several interventions have been carried out to offset and reverse the condition. This article reports the recent evidence on the role of nutrition and physical activity in the pathogenesis of frailty and provides a critical review of previously implemented interventions focussed on physical activity and nutrition to prevent and reduce frailty among older adults.
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Affiliation(s)
- Maeve Lorraine O'Connell
- Department of Biological Sciences, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland.
| | - Tara Coppinger
- Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland
| | - Aoife Louise McCarthy
- Department of Biological Sciences, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland
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Seldeen KL, Redae YZ, Thiyagarajan R, Berman RN, Leiker MM, Troen BR. High intensity interval training improves physical performance in aged female mice: A comparison of mouse frailty assessment tools. Mech Ageing Dev 2019; 180:49-62. [PMID: 30951786 PMCID: PMC9841971 DOI: 10.1016/j.mad.2019.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/22/2019] [Accepted: 04/01/2019] [Indexed: 01/19/2023]
Abstract
Frailty syndrome increases the risk for disability and mortality, and is a major health concern amidst the geriatric shift in the population. High intensity interval training (HIIT), which couples bursts of vigorous activity interspersed with active recovery intervals, shows promise for the treatment of frailty. Here we compare and contrast five Fried physical phenotype and one deficit accumulation based mouse frailty assessment tools for identifying the impacts of HIIT on frailty and predicting functional capacity, underlying pathology, and survival in aged female mice. Our data reveal a 10-minute HIIT regimen administered 3-days-a-week for 8-weeks increased treadmill endurance, gait speed and maintained grip strength. One frailty tool identified a benefit of HIIT for frailty, but many were trending suggesting HIIT was beneficial for physical performance in these mice, but the 8-week timeframe may have been insufficient to induce frailty benefits. Finally, most frailty tools distinguished between surviving or non-surviving mice, whereas half correlated with functional capacity measured by nest building ability, and none correlated with underlying pathology. In summary, this study supports the ongoing development of mouse assessment tools as useful instruments for frailty research.
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Affiliation(s)
- Kenneth Ladd Seldeen
- Corresponding author at: 875 Ellicott Street, CTRC Room 8030A, Buffalo, NY 14203, USA. (K.L. Seldeen)
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