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Schneider WJ, Flanagan DP, Niileksela CR, Engler JR. The effect of measurement error on the positive predictive value of PSW methods for SLD identification: How buffer zones dispel the illusion of inaccuracy. J Sch Psychol 2024; 103:101280. [PMID: 38432731 DOI: 10.1016/j.jsp.2023.101280] [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: 01/05/2022] [Revised: 07/18/2023] [Accepted: 12/29/2023] [Indexed: 03/05/2024]
Abstract
Patterns of Strengths and Weaknesses (PSW) methods are widely used for identifying specific learning disabilities (SLDs). Several researchers, however, have reported that the diagnostic accuracy of PSW methods is unacceptably low when strict thresholds were used to identify students with SLDs. We believe these findings give a misleading impression of the magnitude of the diagnostic errors that are likely to arise in PSW assessments. In a simulation study of 10 million cases using a simplified PSW method for demonstration, most of what have been called diagnostic errors were cases in which observed scores and true scores fell on opposite sides of a strict threshold but were still within a buffer zone the size of a typical measurement error. Because small score differences do not result in meaningfully different case conceptualizations, the use of buffer zones reveals that previous estimates of the diagnostic accuracy of PSW methods are misleadingly low. We also demonstrate that diagnostic decisions become increasingly reliable when observed scores are comfortably distant from diagnostic thresholds. For practitioners, we present a flowchart and practical guidelines to improve the accuracy and stability of SLD identification decisions.
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Liao X, Cheng D, Li J, Zhu L, Zhang S, Jing X, Shi L. Effects of oral oligopeptide preparation and exercise intervention in older people with sarcopenia: a randomized controlled trial. BMC Geriatr 2024; 24:260. [PMID: 38500043 PMCID: PMC10946144 DOI: 10.1186/s12877-024-04860-2] [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: 11/22/2023] [Accepted: 03/01/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Nutrition and exercise are important interventions for sarcopenia. There were few studies on oral oligopeptide nutrition preparations combined with exercise to intervene in the older people with sarcopenia. The aim of this study was to verify the effectiveness of oligopeptide nutrition preparation combined with exercise intervention on the older people with sarcopenia in community. METHODS A total of 219 subjects aged 65 years or older with sarcopenia were randomly divided into 4 groups. The nutrition group (n = 58) was given individualized nutrition education and oral oligopeptide nutrition preparation. The exercise group (n = 50) received exercise intervention. The combined group (n = 52) received both oral nutrition preparation and exercise interventions. The control group (n = 59) only received individualized nutrition education. The nutrition preparation can provide energy 185kcal and protein 24.2g per day. The exercise intervention including warm-up exercise, resistance exercise and aerobic exercise, the training time was 60min for 5 times every week. The intervention lasted for 16 weeks. Hand grip strength, gait speed, body composition and hematology parameters were measured before and after intervention. RESULTS A total of 159 subjects completed the study. Compared with baseline, the left grip strength and 6-m walking speed of the subjects in nutrition group increased significantly after the intervention, and the grip strength of both hands in exercise group and combined group increased significantly. The body weight of the subjects in nutrition group, exercise group and combined group increased significantly after intervention, but no increase in soft lean mass (SLM) and skeletal muscle mass (SMM) was observed in any of the four groups. The fat-free mass (FFM) of the legs of the control group, exercise group and nutrition group decreased after intervention, and only the FFM of the legs of the combined group maintained the level before the intervention. CONCLUSION Both oral peptide nutrition and exercise interventions can improve the muscle strength or function of the older people with sarcopenia. However, there were no increases in muscle mass observed. TRIAL REGISTRATION ChiCTR, ChiCTR2100052135. Registered 20 October 2021, https://www.chictr.org.cn/showproj.html?proj=135743.
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Affiliation(s)
- Xinyi Liao
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Daomei Cheng
- School of Public Health, Chengdu Medical College, Sichuan Province, Chengdu, China
| | - Jingjing Li
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China
| | - Lin Zhu
- Zhengxing Community Health Service Center of Tianfu New District, Sichuan Province, Chengdu, China
| | - Suqiong Zhang
- Shibantan Community Health Service Center of Xindu District, Sichuan Province, Chengdu, China
| | - Xiaofan Jing
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China.
| | - Lei Shi
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China.
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Hainline G, Hainline RD, Handlery R, Fritz S. A Scoping Review of the Predictive Qualities of Walking Speed in Older Adults. J Geriatr Phys Ther 2023:00139143-990000000-00040. [PMID: 37820357 PMCID: PMC11006824 DOI: 10.1519/jpt.0000000000000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND AND PURPOSE Walking speed (WS) is an easily assessable and interpretable functional outcome measure with great utility for the physical therapist providing care to older adults. Since WS was proposed as the sixth vital sign, research into its interpretation and use has flourished. The purpose of this scoping review is to identify the current prognostic value of WS for the older adult. METHODS A scoping review was conducted using PubMed, CINAHL, and SPORTDiscus to find relevant articles highlighting the predictive capabilities of WS for older adults. Titles and abstracts were reviewed to identify relevant articles. Articles were excluded based on the following criteria: sample included both younger and older adults without separate analyses, sample was focused on a particular disease, if the study was published before 2017, or if the study did not report relevant cut points for interpretation of WS. The search returned 1064 results. Following removal of articles not meeting inclusion criteria and critical appraisal, relevant cut points were extracted from 47 original research publications. RESULTS AND DISCUSSION A preliminary review of the included articles showed that WS is a valuable prognostic tool across many health domains, including mental health, mortality, disability, pain, bone and joint health, falls, cognition, physical activity, metabolic health, risk for cardiovascular disease, socialization, and metabolic health. The fastest WS of 1.32 meters per second (m/s) served as a cutoff for decreased risk for incident development of type 2 diabetes, while the slowest WS of less than 0.2 m/s was associated with increased duration of hospitalization. Multiple studies reported on the prognostic value of WS slower than 1.0 m/s. CONCLUSION Although the reported range of predictive WS values was broad, multiple studies found WS of approximately 1.0 m/s to be a useful marker for delineating risk or decline across a variety of health domains. Clinicians may find it useful to use a WS slower than 1.0 m/s as a "yellow flag" to guide evaluation and intervention for their older adult clients.
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Lavie I, Schnaider Beeri M, Schwartz Y, Soleimani L, Heymann A, Azuri J, Ravona-Springer R. Decrease in Gait Speed Over Time Is Associated With Increase in Number of Depression Symptoms in Older Adults With Type 2 Diabetes. J Gerontol A Biol Sci Med Sci 2023; 78:1504-1512. [PMID: 36626301 PMCID: PMC10395563 DOI: 10.1093/gerona/glad008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND We examined the cross-sectional and longitudinal relationships of motor functions with depression in older adults with type 2 diabetes (T2D). METHODS Participants (n = 984) were from the longitudinal Israel Diabetes and Cognitive Decline (IDCD) study. They were initially cognitively normal and underwent evaluations of motor functions (grip strength and gait speed) and of depression (using the 15-item version of the Geriatric Depression Scale [GDS]) approximately every 18 months. We applied Hierarchical Linear Mixed Models (HLMM) to investigate the associations between motor functions and depression adjusting for sociodemographic, cardiovascular factors, overall cognitive score, and subjective report of exhaustion. RESULTS Participants' baseline characteristics were 72 (±5) years of age (59.6% males), 13 (±4) years of education, Mini-Mental Status Exam (MMSE) score of 28.01 (±1.78), and a GDS score of (2 ± 2.00), consistent with normal cognitive status and lack of major affective symptomatology. Slower gait speed at baseline was associated with higher GDS scores (p = .001) and with their increase over time (p = .049). A decrease in walking speed from baseline was associated with an increase in GDS scores (p = .015). Lower grip strength at baseline was associated with higher GDS scores (p = .002), but not with trajectories in GDS scores over time. A faster decrease in grip strength from baseline was associated with a faster increase in GDS scores (p = .022). CONCLUSIONS Both gait speed and grip strength are cross-sectionally associated with depression. However, only gait speed and its decrease over time can potentially be used to predict incident depression symptoms, thus facilitating the introduction of depression prevention strategies.
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Affiliation(s)
- Inbar Lavie
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- The Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel
| | - Yonathan Schwartz
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Laili Soleimani
- The Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anthony Heymann
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
- Maccabi Healthcare Services, Israel
| | - Joseph Azuri
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
- Maccabi Healthcare Services, Israel
| | - Ramit Ravona-Springer
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Psychiatric Division, Sheba Medical Center, Tel-Hashomer, Israel
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von der Recke F, Warmerdam E, Hansen C, Romijnders R, Maetzler W. Reduced Range of Gait Speed: A Parkinson's Disease-Specific Symptom? JOURNAL OF PARKINSON'S DISEASE 2023; 13:197-202. [PMID: 36872788 PMCID: PMC10041422 DOI: 10.3233/jpd-223535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Reduced range of gait speed (RGS) may lead to decreased environmental adaptability in persons with Parkinson's disease (PwPD). Therefore, lab-measured gait speed, step time, and step length during slow, preferred, and fast walking were assessed in 24 PwPD, 19 stroke patients, and 19 older adults and compared with 31 young adults. Only PwPD, but not the other groups, showed significantly reduced RGS compared to young adults, driven by step time in the low and step length in the high gait speed range. These results suggest that reduced RGS may occur as a PD-specific symptom, and different gait components seem to contribute.
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Affiliation(s)
| | - Elke Warmerdam
- Division of Surgery, Saarland University, Homburg, Germany
| | - Clint Hansen
- Department of Neurology, Kiel University, Kiel, Germany
| | - Robbin Romijnders
- Department of Neurology, Kiel University, Kiel, Germany
- Digital Signal Processing and System Theory, Institute of Electrical and Information Engineering, Kiel University, Kiel, Germany
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Marín-Jiménez N, Cruz-León C, Perez-Bey A, Conde-Caveda J, Grao-Cruces A, Aparicio VA, Castro-Piñero J, Cuenca-García M. Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review. J Clin Med 2022; 11:jcm11020328. [PMID: 35054020 PMCID: PMC8779466 DOI: 10.3390/jcm11020328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.
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Affiliation(s)
- Nuria Marín-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Carolina Cruz-León
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alejandro Perez-Bey
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
- Correspondence: ; Tel.: +34-65-7588624
| | - Julio Conde-Caveda
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alberto Grao-Cruces
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, 18071 Granada, Spain;
- Sport and Health University Research Centre, University of Granada, 18007 Granada, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Magdalena Cuenca-García
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
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Influences of dopaminergic system dysfunction on late-life depression. Mol Psychiatry 2022; 27:180-191. [PMID: 34404915 PMCID: PMC8850529 DOI: 10.1038/s41380-021-01265-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/28/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022]
Abstract
Deficits in cognition, reward processing, and motor function are clinical features relevant to both aging and depression. Individuals with late-life depression often show impairment across these domains, all of which are moderated by the functioning of dopaminergic circuits. As dopaminergic function declines with normal aging and increased inflammatory burden, the role of dopamine may be particularly salient for late-life depression. We review the literature examining the role of dopamine in the pathogenesis of depression, as well as how dopamine function changes with aging and is influenced by inflammation. Applying a Research Domain Criteria (RDoC) Initiative perspective, we then review work examining how dopaminergic signaling affects these domains, specifically focusing on Cognitive, Positive Valence, and Sensorimotor Systems. We propose a unified model incorporating the effects of aging and low-grade inflammation on dopaminergic functioning, with a resulting negative effect on cognition, reward processing, and motor function. Interplay between these systems may influence development of a depressive phenotype, with an initial deficit in one domain reinforcing decline in others. This model extends RDoC concepts into late-life depression while also providing opportunities for novel and personalized interventions.
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Rosmaninho I, Ribeirinho-Soares P, Nunes JPL. Walking Speed and Mortality: An Updated Systematic Review. South Med J 2021; 114:697-702. [PMID: 34729613 DOI: 10.14423/smj.0000000000001318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of our systematic review was to update the current evidence on the association between slow walking speed (WS) and mortality, expanding the current knowledge available in the literature. METHODS A systematic review of the published data on the association of WS and mortality was carried out by searching on PubMed and ISI Web of Knowledge databases. RESULTS From a title and abstract analysis, 61 articles were included that met the prespecified criteria. After a full-text analysis, 6 articles were excluded and the remaining articles accounted for 120,838 patients and > 25,148 deaths were registered. The duration of follow-ups ranged between 2 and 21 years. In general, studies have shown a consistent association between WS and mortality from all causes. CONCLUSIONS WS showed continuous and consistent evidence to be a good predictor of mortality. As such, our study supports the use of this tool in clinical practice as a way to improve health care.
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Affiliation(s)
- Irene Rosmaninho
- From the Faculdade de Medicina da Universidade do Porto, and the Centro Hospitalar Universitário São João, Porto, Portugal
| | - Pedro Ribeirinho-Soares
- From the Faculdade de Medicina da Universidade do Porto, and the Centro Hospitalar Universitário São João, Porto, Portugal
| | - José Pedro L Nunes
- From the Faculdade de Medicina da Universidade do Porto, and the Centro Hospitalar Universitário São João, Porto, Portugal
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Cho K, Suzuki M, Iso N, Okabe T, Goto H, Hirata K, Shimizu J. Impact of different bilateral knee extension strengths on lower extremity performance. Medicine (Baltimore) 2021; 100:e27297. [PMID: 34559141 PMCID: PMC8462631 DOI: 10.1097/md.0000000000027297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/03/2021] [Indexed: 01/05/2023] Open
Abstract
Despite the impact of leg muscle strength on lower extremity motor performance-including walking and sit-to-stand transfer-it remains difficult to predict the relationship between bilateral leg muscle strength and lower extremity performance. Therefore, this study was designed to predict lower extremity function through the differential modeling of logarithmic and linear regression, based on knee extension strength.The study included 121 individuals living in the same community. The bilateral strengths of the knee extensors were measured using a handheld dynamometer, and the Timed Up & Go test (TUG) performance time and 5-m minimum walking times were assessed to predict lower extremity motor functions. Bilateral normalized knee extension muscle strengths and lower extremity motor function scores, including walking or TUG performance times, were assessed on the logarithmic and linear models. The Akaike information criterion (AIC) was used to evaluate the coefficient compatibility between the logarithmic regression model and the linear regression model.The AIC value for the linear model was lower than that for the logarithmic model regarding the walking time. For walking time estimation in the linear model, the coefficient value of knee extension strength was larger on the strong than on the weak side; however, the AIC value for the logarithmic model was lower than that for the linear model regarding TUG performance time. In the logarithmic model's TUG performance time estimation, the coefficient value of knee extension strength was larger on the weak than on the strong side.In conclusion, our study demonstrated different models reflecting the relationship between both legs' strengths and lower extremity performance, including the walking and TUG performance times.
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Slowing: A Vascular Geriatric Syndrome? J Am Med Dir Assoc 2021; 23:47-53.e2. [PMID: 34454919 DOI: 10.1016/j.jamda.2021.07.031] [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: 05/07/2021] [Revised: 07/01/2021] [Accepted: 07/25/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to investigate the interrelation between slowing in walking, thinking and mood, and their relationship with cerebral small vessel disease (CSVD) in a geriatric population. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS 566 geriatric outpatients from the Amsterdam Aging Cohort (49% female; age 79 ±6 years), who visited the Amsterdam UMC geriatric outpatient memory clinic. METHODS Patients underwent a comprehensive geriatric assessment, brain imaging, and a neuropsychological assessment as part of medical care. Three slowing aspects were investigated: gait speed, processing speed, and apathy symptoms (higher scores indicating more advanced slowing). We visually rated CSVD [white matter hyperintensities (WMHs), strategic lacunes, and microbleeds] on brain imaging. RESULTS Regression analyses showed that slowing in walking (gait speed) was associated with slowing in thinking [processing speed; β = 0.35, 95% confidence interval (CI) 0.22, 0.48] and slowing in mood (apathy symptoms; β = 0.21, 95% CI 0.13, 0.30), independent of important confounders. Large confluent areas of WMH (Fazekas 3) were associated with all slowing aspects: gait speed (β = 0.49, 95% CI 0.28, 0.71), processing speed (β = 0.36, 95% CI 0.19, 0.52) and apathy symptoms (β = 0.30, 95% CI 0.09, 0.51). In addition, in patients with more slowing aspects below predefined cutoffs, severe WMH was more common. Presence of ≥3 microbleeds was associated with apathy symptoms (β = 0.39, 95% CI 0.12, 0.66), whereas lacunes were not associated with slowing. CONCLUSIONS AND IMPLICATIONS This study provides evidence that slowing in walking, thinking, and mood are closely related and associated with CSVD. This phenotype or geriatric syndrome could be helpful to identify and characterize patients with CSVD.
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Vive S, Elam C, Bunketorp-Käll L. Comfortable and Maximum Gait Speed in Individuals with Chronic Stroke and Community-Dwelling Controls. J Stroke Cerebrovasc Dis 2021; 30:106023. [PMID: 34375858 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/02/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The relationship between maximum and comfortable gait speed in individuals with mild to moderate disability in the chronic phase of stroke is unknown. OBJECTIVE This study examines the relationship between comfortable and maximum gait speed in individuals with chronic stroke and whether the relationship differ from that seen in a community-dwelling elderly population. Further, we investigate the influence of age, gender, time post-stroke and degree of disability on gait speed. MATERIALS AND METHODS Gait speed was measured using the 10-meter walk test (10MWT) and the 30-meter walk test (30MWT) in 104 older individuals with chronic stroke and 154 community-dwelling controls, respectively. RESULTS We found that the maximum gait speed in individuals with stroke could be estimated by multiplying the comfortable speed by 1.41. This relationship differed significantly from that of the control group, for which the corresponding factor was 1.20. In the stroke group, age, gender and time post-stroke did not affect the relationship, whereas the degree of disability was negatively correlated with maximum speed - but not when included in the multiple analysis. In the community-dwelling population, higher age and female gender had a negative relationship with maximum gait speed. When correcting for those parameters, the coefficient was 1.07. CONCLUSIONS The maximum gait speed in the chronic phase of stroke can be estimated by multiplying the individual's comfortable gait speed by 1.41. This estimation is not impacted by age, gender, degree of disability and time since stroke. A similar but weaker relationship can be seen in the community-dwelling controls.
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Affiliation(s)
- Sara Vive
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Neurocampus, Sophiahemmet Hospital, Box 5605, 114 86, Stockholm, Sweden.
| | - Cecilia Elam
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Lina Bunketorp-Käll
- Section for Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Centre for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden.
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Lugtenburg A, Zuidersma M, Wardenaar KJ, Aprahamian I, Rhebergen D, Schoevers RA, Oude Voshaar RC. Subtypes of Late-Life Depression: A Data-Driven Approach on Cognitive Domains and Physical Frailty. J Gerontol A Biol Sci Med Sci 2021; 76:141-150. [PMID: 32442243 DOI: 10.1093/gerona/glaa110] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND With increasing age, symptoms of depression may increasingly overlap with age-related physical frailty and cognitive decline. We aim to identify late-life-related subtypes of depression based on measures of depressive symptom dimensions, cognitive performance, and physical frailty. METHODS A clinical cohort study of 375 depressed older patients with a DSM-IV depressive disorder (acronym NESDO). A latent profile analysis was applied on the three subscales of the Inventory of Depressive Symptomatology, as well as performance in five cognitive domains and two proxies for physical frailty. For each class, we investigated remission, dropout, and mortality at 2-year follow-up as well as change over time of depressive symptom severity, cognitive performance, and physical frailty. RESULTS A latent profile analysis model with five classes best described the data, yielding two subgroups suffering from pure depression ("mild" and "severe" depression, 55% of all patients) and three subgroups characterized by a specific profile of cognitive and physical frailty features, labeled as "amnestic depression," "frail-depressed, physically dominated," and "frail-depressed, cognitively dominated." The prospective analyses showed that patients in the subgroup of "mild depression" and "amnestic depression" had the highest remission rates, whereas patients in both frail-depressed subgroups had the highest mortality rates. CONCLUSIONS Late-life depression can be subtyped by specific combinations of age-related clinical features, which seems to have prospective relevance. Subtyping according to the cognitive profile and physical frailty may be relevant for studies examining underlying disease processes as well as to stratify treatment studies on the effectiveness of antidepressants, psychotherapy, and augmentation with geriatric rehabilitation.
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Affiliation(s)
- Astrid Lugtenburg
- Department Old Age Psychiatry, GGZ Drenthe Mental Health Institute, Assen, The Netherlands.,University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Marij Zuidersma
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Klaas J Wardenaar
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Ivan Aprahamian
- Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Internal Medicine Department, Faculty of Medicine of Jundiaí, São Paulo, Brazil
| | - Didi Rhebergen
- Amsterdam University Medical Center, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Robert A Schoevers
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
| | - Richard C Oude Voshaar
- University Center of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, The Netherlands
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13
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Hioka A, Akazawa N, Okawa N, Nagahiro S. Increased total body extracellular-to-intracellular water ratio in community-dwelling elderly women is associated with decreased handgrip strength and gait speed. Nutrition 2021; 86:111175. [PMID: 33631617 DOI: 10.1016/j.nut.2021.111175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/17/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE As the extracellular-to-intracellular water (ECW/ICW) ratio of the thigh is negatively associated with knee extension strength or gait speed in the elderly, an increase in the total body ECW/ICW ratio in the elderly is considered to be related to a decrease in physical function. However, these relationships have not been properly investigated. The aim of this study was to investigate the relationship of handgrip strength and gait speed with the total body ECW/ICW ratio in community-dwelling elderly women. METHODS The present study used a cross-sectional design. We enrolled 71 community-dwelling women, ≥65 y of age, who could independently perform activities of daily living. The total body ECW/ICW ratio was measured using bioelectrical impedance analysis. Relationships between the total body ECW/ICW ratio and grip strength and gait speed were assessed using Pearson's correlation coefficient. Additionally, stepwise multiple regression analysis was used to identify the factors that were independently associated with handgrip strength and gait speed. The independent variables considered were the total body ECW/ICW ratio, age, body mass index, number of medications, presence of pain, and a history of certain conditions. RESULTS The results indicated that an increased total body ECW/ICW ratio in community-dwelling elderly women was associated with a decreased handgrip strength and gait speed. Furthermore, the total body ECW/ICW ratio was significantly, independently associated with handgrip strength even after adjusting for confounding factors. CONCLUSION These findings suggest that the total body ECW/ICW ratio may indicate health conditions in community-dwelling elderly women.
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Affiliation(s)
- Akemi Hioka
- Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima City, Japan
| | - Naoki Akazawa
- Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima City, Japan.
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14
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Stahl ST, Altmann HM, Dew MA, Albert SM, Butters M, Gildengers A, Reynolds CF, Karp JF. The Effects of Gait Speed and Psychomotor Speed on Risk for Depression and Anxiety in Older Adults with Medical Comorbidities. J Am Geriatr Soc 2021; 69:1265-1271. [PMID: 33387385 DOI: 10.1111/jgs.17024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Gait speed and psychomotor speed slow with age and may predict neuropsychiatric disease such as depression and anxiety. We explored the relative predictive values of gait speed, psychomotor slowing, and a composite index of these two measures on time to new episode depression or anxiety in older adults at risk for these common psychiatric conditions. DESIGN Randomized controlled prevention trial with 15-month follow-up. SETTING University-based late-life mental health research clinic. PARTICIPANTS Two hundred thirteen individuals, age 60+ years, with subsyndromal symptoms of depression or anxiety and one of the following risk factors for these common conditions: mild cognitive impairment, knee osteoarthritis, or disabilities requiring home-based care. INTERVENTION Participants in each of the risk factor groups were randomized to a depression-specific preventive intervention or usual care. MEASUREMENTS Gait speed: 4-m walk test from the Short Physical Performance Battery. Psychomotor speed: Coding task of the Repeatable Battery for the Assessment of Neuropsychological Status. We created a composite index of slowing by determining whether participants exceeded established cut-offs for slow performance in both gait speed (≤0.8 m/s) and psychomotor speed (<7 on the coding task). Time to new onset syndromal depression/anxiety was measured using research diagnostic criteria. RESULTS Fifty-four participants developed syndromal depression/anxiety (19.5%) over the course of 15 months. Participants with slowing in both areas were over twice as likely to experience new onset depression/anxiety (hazard ratio (HR) = 2.11; 95% confidence interval (CI) = 1.02-4.40, P = .046) compared to participants with no slowing in either area. Slowed gait (HR = 1.88; 95% CI = 0.992-3.55; P = .052) or slowed psychomotor speed (HR = 0.60; 95% CI = 0.14-2.58; P = .488) alone did not increase risk for depression/anxiety. CONCLUSION Evaluating both gait and psychomotor speed in older adults with medical comorbidities and sub-syndromal depression may predict incident mental illness and inform prevention planning. Future research is needed to validate our observations and explore shared neurobiological mechanisms that explain this elevated risk.
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Affiliation(s)
- Sarah T Stahl
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Helene M Altmann
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary Amanda Dew
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Steven M Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meryl Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ariel Gildengers
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Psychiatry, University of Arizona School of Medicine, Tucson, Arizona, USA
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15
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Musselman KE, Arora T, Chan K, Alavinia M, Bone M, Unger J, Lanovaz J, Oates A. Evaluating Intrinsic Fall Risk Factors After Incomplete Spinal Cord Injury: Distinguishing Fallers From Nonfallers. Arch Rehabil Res Clin Transl 2020; 3:100096. [PMID: 33778471 PMCID: PMC7984974 DOI: 10.1016/j.arrct.2020.100096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To determine whether performance on measures of lower extremity muscle strength, sensory function, postural control, gait speed, and balance self-efficacy could distinguish fallers from nonfallers among ambulatory individuals with spinal cord injury or disease (SCI/D). Design Prospective cohort study. Setting Community. Participants Individuals (N=26; 6 female, aged 58.9±18.2y) with motor incomplete SCI/D (American Spinal Injury Association Impairment Scale rating C [n=5] or D [n=21]) participated. Participants were 7.5±9.1 years post injury. Seventeen participants experienced traumatic causes of spinal cord injury. Main Outcome Measures Participants completed laboratory-based and clinical measures of postural control, gait speed, balance self-efficacy, and lower extremity strength, as well as proprioception and cutaneous pressure sensitivity. Participants were then followed for up to 1 year to track falls using a survey. The survey queried the circumstances and consequences of each fall. If a participant's number of falls equaled or exceeded the median number of falls experience by all participants, they were classified a faller. Results Median follow-up duration was 362 days and median time to first fall was 60.5 days. Fifteen participants were classified as fallers. Most falls occurred during the morning or afternoon (81%), at home (75%), and while walking (47%). The following laboratory-based and clinical measures distinguished fallers from nonfallers (P<.05): measures of lower extremity strength, cutaneous pressure sensitivity, walking speed, and center of pressure velocity in the mediolateral direction. Conclusions There are laboratory-based and clinical measures that can prospectively distinguish fallers from nonfallers among ambulatory individuals with spinal cord injury. These findings may assist clinicians when evaluating their patients' fall risk.
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Affiliation(s)
- Kristin E Musselman
- KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Tarun Arora
- School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Katherine Chan
- KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Mohammad Alavinia
- KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Mackenzie Bone
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Janelle Unger
- KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joel Lanovaz
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Alison Oates
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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16
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Impaired Cognition Predicts Falls Among Women With and Without HIV Infection. J Acquir Immune Defic Syndr 2020; 83:301-309. [PMID: 31913989 DOI: 10.1097/qai.0000000000002262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine whether domain-specific neurocognitive (NC) impairments predict falls in HIV+ compared with HIV- women. DESIGN Cross-sectional data analysis from 825 HIV+ and 392 HIV- women in the Women's Interagency HIV Study with NC testing within 2 years before falls surveys. METHODS NC impairment (T score <40) was assessed in 7 domains: executive function, psychomotor speed, attention, learning, memory, fluency, and fine motor function. For domains associated with any fall within 6 months in simple logistic regression (P < 0.05), hierarchical regression models evaluated associations between NC impairment and odds of falling, adjusting for: (1) study site and HIV, (2) demographics, (3) comorbid conditions, (4) substance use/central nervous system active medications, and HIV-specific factors. RESULTS Median age was higher in HIV+ than HIV- women (51 vs. 48 yrs); prevalence of falls was similar (19% HIV+, 16% HIV-). Overall, executive function [OR (odds ratio) = 1.82, 95% CI (confidence interval): 1.21 to 2.74; P = 0.004], psychomotor speed (OR = 1.59, 95% CI: 1.05 to 2.42, P = 0.03), and fine motor (OR 1.70, 95% CI: 1.11 to 2.61, P = 0.02) impairments were associated with greater odds of falls in fully adjusted models. In fully adjusted models, associations of executive function, psychomotor speed, and fine motor were nonsignificant among HIV+ women; conversely, among HIV- women, associations with impaired executive and fine motor functions were strengthened and remained significant. CONCLUSIONS Cognitive impairment was associated with falls among middle-aged HIV- but not HIV+ women. Additional studies should elucidate mechanisms by which domain-specific NC impairment impacts fall risk among older HIV+ and HIV- women and how different factors modify relationships between cognition and falls.
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17
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Marzuca-Nassr GN, SanMartín-Calísto Y, Guerra-Vega P, Artigas-Arias M, Alegría A, Curi R. Skeletal Muscle Aging Atrophy: Assessment and Exercise-Based Treatment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:123-158. [PMID: 32304033 DOI: 10.1007/978-3-030-42667-5_6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In the ordinary course of aging, individuals change their body composition, mainly reducing their skeletal muscle mass and increasing their fat mass. In association, muscle strength and functionality also decrease. The geriatric assessment allows knowing the baseline situation of the patients, determines the impact of diseases, and defines specific treatments. There are various tools to evaluate the health condition of older people. These tools include the assessment scales of necessary Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), physical and functional assessment scales, and instruments that assess the cognitive state of the person. There are several strategies that have been proposed to combat skeletal muscle atrophy due to aging, such as physical exercise, nutritional supplements, or drugs. Some researchers have highlighted the efficacy of the combination of the mentioned strategies. In this chapter, we will focus only on physical exercise as a strategy to reduce skeletal muscle loss during aging.
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Affiliation(s)
- Gabriel Nasri Marzuca-Nassr
- Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile. .,Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.
| | - Yuri SanMartín-Calísto
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Pablo Guerra-Vega
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.,Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Puerto Montt, Chile
| | - Macarena Artigas-Arias
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Andrea Alegría
- Magíster en Terapia Física con menciones, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Rui Curi
- Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil
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18
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Yao S, Zhu YS, Shi GP, Guo JH, Wang ZD, Chu XF, Jiang XY, Jin L, Wang XF. Associations of TNF-α -308 G>A and TNF-β 252 A>G with Physical Function and BNP-Rugao Longevity and Ageing Study. J Nutr Health Aging 2020; 24:358-363. [PMID: 32115620 DOI: 10.1007/s12603-020-1336-1] [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] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To explore the associations of TNF-α -308 G>A (rs1800629) and TNF-β 252 A>G (rs909253) with physical function and plasma B-type natriuretic peptide (BNP). METHODS Data of 1747 community-dwelling elders from the ageing arm of the Rugao Longevity and Ageing Study was used. Physical function was measured by handgrip strength, Timed Up and Go (TUG) test and 5-meter walking test (5MWT). RESULTS AA genotype of the TNF-α -308 G>A was associated with higher mean time of TUG test and 5MWT (multivariable adjusted β=5.75 and 5.70, respectively, p<0.05), compared with GG genotype. For the TNF-β 252 A>G polymorphism, GG genotype was associated with higher mean time of TUG test and 5MWT (multivariable adjusted β=1.55 and 0.83, respectively, p<0.05) and lower handgrip strength (multivariable adjusted β=-0.69, p<0.05), compared with AA genotype. Further, GG was associated with greater odds of low handgrip strength (OR=1.47, 95% CI=1.06-2.04), low speed of TUG test (OR=1.87, 95% CI=1.20-2.01) and elevated BNP (OR=1.30, 95% CI=1.08-1.84). GG also interacted with elevated BNP to be associated with greater odds of low handgrip strength and 5MWT. CONCLUSIONS TNF-β 252 A>G was associated with physical function measurements, plasma BNP level, and odds of elevated BNP in an elderly population. TNF-β 252 A>G also interacted with elevated BNP to be associated with greater odds of physical function measurements.
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Affiliation(s)
- S Yao
- Li Jin, MOE Key Laboratory of Contemporary Anthropology and State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China. E-mail address: . Xiao-Feng Wang, MOE Key Laboratory of Contemporary Anthropology and State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China. E-mail address:
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19
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Aldridge C, Tringali V, Rhodes R, Kershisnik K, Creditt D, Gonzalez‐Mejia J, Lugo‐Vargas J, Eby J. Walking at work: Maximum gait speed is related to work ability in hospital nursing staff. J Occup Health 2020; 62:e12171. [PMID: 33045765 PMCID: PMC7550206 DOI: 10.1002/1348-9585.12171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/29/2020] [Accepted: 09/11/2020] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Like the concept of work ability in occupational health, gait speed is a measure of general fitness and can predict functional decline and morbidity. This is especially important when our care-takers, i.e. nurses, show decline in fitness and become care-receivers. The study aims to describe the demographics of hospital nurses in the context of gait speed and work ability as well as to determine the association between them. METHODS Three-hundred and twelve inpatient nurses and nursing assistants were sampled from a level 1 trauma and teaching hospital from several service lines and acuity levels. Spearman correlation tests were utilized to determine the relationship of gait speed and ratings of item 1 on the Work Ability Index (WAI) as well as Cochran-Armitage test for linear trend of gait speed. RESULTS Maximum gait speed has a significant positive association with work ability with a Rho coefficient of 0.217 (P < .0001). Additionally, the linear trend test of gait speed tertiles was significant (P < .001) for work ability categories of Moderate to Poor (0-7) and Good to Excellent (8-10). CONCLUSIONS Gait speed is correlated with the item 1 self-rating of the WAI in hospital nursing staff. The 10-m walk test is a practical and easy measure that can be utilized in occupational health. More research is required to validate gait speed in other occupational health populations and investigate gait speed changes and its interaction with the work environment longitudinally.
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Affiliation(s)
- Chad Aldridge
- Department of Physical TherapyUniversity of VirginiaCharlottesvilleVAUSA
- Department of Public HealthSchool of MedicineUniversity of VirginiaCharlottesvilleVAUSA
| | - Victor Tringali
- Hoo’s Well Employee HealthUniversity of VirginiaCharlottesvilleVAUSA
| | - Robert Rhodes
- Department of Physical TherapyUniversity of VirginiaCharlottesvilleVAUSA
| | - Kohl Kershisnik
- Department of Physical TherapyUniversity of VirginiaCharlottesvilleVAUSA
| | - Debra Creditt
- School of NursingUniversity of VirginiaCharlottesvilleVAUSA
| | - Jorge Gonzalez‐Mejia
- Department of Public HealthSchool of MedicineUniversity of VirginiaCharlottesvilleVAUSA
| | - Jose Lugo‐Vargas
- Department of Public HealthSchool of MedicineUniversity of VirginiaCharlottesvilleVAUSA
| | - Jean Eby
- Department of Public HealthSchool of MedicineUniversity of VirginiaCharlottesvilleVAUSA
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20
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Patience J, Lai KSP, Russell E, Vasudev A, Montero-Odasso M, Burhan AM. Relationship Between Mood, Thinking, and Walking: A Systematic Review Examining Depressive Symptoms, Executive Function, and Gait. Am J Geriatr Psychiatry 2019; 27:1375-1383. [PMID: 31420232 DOI: 10.1016/j.jagp.2019.07.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/30/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
Prior literature has proposed that the coexistence of late-life depression, executive dysfunction and impaired gait speed may constitute a specific phenotype in older adults with a possible shared brain mechanism. All three conditions are independently associated with negative health outcomes including impaired function, risk of falling, and reduced quality of life. However, the existence, etiology, and implications of having all three conditions as a unitary triad remain unclear. This systematic review examined the literature to assess the consistency of this triad and to explore the possible role of frontal-subcortical circuitry in its etiology. English language literature that assessed mood, executive function, and gait speed using a validated tool in human participants over age 65 were included for this review. Following the PRISMA guidelines, 15 studies including 11,213 participants met criteria for inclusion in this study. The triad's existence was supported by 12 of the 15 studies (80%), including 4 longitudinal studies involving 368 participants. A prevalence of 17% was reported in one population study. The three included intervention studies provided mixed results regarding the benefit of pharmacologic and exercise interventions. Two studies assessed the association between presence of white matter hyperintensities and the triad, with one study finding a significant longitudinal relationship with periventricular white matter hyperintensities. Vascular risk factors were also commonly associated with this triad. Taken together, the relationship between this triad, the vascular depression hypothesis, and frontal-subcortical pathology is suggested. Further longitudinal research is needed to further clarify the etiology and clinical relevance of this concomitant prescence oflate-life depression, executive dysfunction and impaired gait speed.
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Affiliation(s)
- James Patience
- Parkwood Institute (JP, ER, MM-O, and AMB), Schulich School of Medicine and Dentistry, Western University (AV, KSPL, and AMB); Lawson Health Research Institute (AV); Geriatric Mood Disorders Lab, Parkwood Institute (AV); Parkwood Institute-Mental Health (AMB); Lawson Health Research Institute Association (AMB); Departments of Medicine (Geriatric Medicine), and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario (MM-O); and Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute (MM-O), London, Canada
| | - Ka Sing Paris Lai
- Parkwood Institute (JP, ER, MM-O, and AMB), Schulich School of Medicine and Dentistry, Western University (AV, KSPL, and AMB); Lawson Health Research Institute (AV); Geriatric Mood Disorders Lab, Parkwood Institute (AV); Parkwood Institute-Mental Health (AMB); Lawson Health Research Institute Association (AMB); Departments of Medicine (Geriatric Medicine), and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario (MM-O); and Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute (MM-O), London, Canada
| | - Elizabeth Russell
- Parkwood Institute (JP, ER, MM-O, and AMB), Schulich School of Medicine and Dentistry, Western University (AV, KSPL, and AMB); Lawson Health Research Institute (AV); Geriatric Mood Disorders Lab, Parkwood Institute (AV); Parkwood Institute-Mental Health (AMB); Lawson Health Research Institute Association (AMB); Departments of Medicine (Geriatric Medicine), and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario (MM-O); and Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute (MM-O), London, Canada
| | - Akshya Vasudev
- Parkwood Institute (JP, ER, MM-O, and AMB), Schulich School of Medicine and Dentistry, Western University (AV, KSPL, and AMB); Lawson Health Research Institute (AV); Geriatric Mood Disorders Lab, Parkwood Institute (AV); Parkwood Institute-Mental Health (AMB); Lawson Health Research Institute Association (AMB); Departments of Medicine (Geriatric Medicine), and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario (MM-O); and Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute (MM-O), London, Canada
| | - Manuel Montero-Odasso
- Parkwood Institute (JP, ER, MM-O, and AMB), Schulich School of Medicine and Dentistry, Western University (AV, KSPL, and AMB); Lawson Health Research Institute (AV); Geriatric Mood Disorders Lab, Parkwood Institute (AV); Parkwood Institute-Mental Health (AMB); Lawson Health Research Institute Association (AMB); Departments of Medicine (Geriatric Medicine), and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario (MM-O); and Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute (MM-O), London, Canada
| | - Amer M Burhan
- Parkwood Institute (JP, ER, MM-O, and AMB), Schulich School of Medicine and Dentistry, Western University (AV, KSPL, and AMB); Lawson Health Research Institute (AV); Geriatric Mood Disorders Lab, Parkwood Institute (AV); Parkwood Institute-Mental Health (AMB); Lawson Health Research Institute Association (AMB); Departments of Medicine (Geriatric Medicine), and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario (MM-O); and Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute (MM-O), London, Canada.
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21
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Depressive Symptoms, Executive Deficit, and Slow Gait: A Geriatric Syndrome? Am J Geriatr Psychiatry 2019; 27:1384-1385. [PMID: 31474460 DOI: 10.1016/j.jagp.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 11/22/2022]
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22
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Shimizu M, Misumi M, Yamada M, Ohishi W, Yamamoto H, Kihara Y. Choice reaction time and grip strength as predictors of cardiovascular mortality in middle‐aged and elderly Japanese: from the Radiation Effects Research Foundation Adult Health study. Intern Med J 2018; 48:1331-1336. [DOI: 10.1111/imj.14002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/11/2018] [Accepted: 06/11/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Masaki Shimizu
- Department of Clinical Studies Radiation Effects Research Foundation Hiroshima Japan
| | - Munechika Misumi
- Department of Statistics (Hiroshima) Radiation Effects Research Foundation Hiroshima Japan
| | - Michiko Yamada
- Department of Clinical Studies Radiation Effects Research Foundation Hiroshima Japan
| | - Waka Ohishi
- Department of Clinical Studies Radiation Effects Research Foundation Hiroshima Japan
| | - Hideya Yamamoto
- Department of Cardiovascular Medicine Hiroshima University Graduate School of Biomedical and Health Sciences Hiroshima Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine Hiroshima University Graduate School of Biomedical and Health Sciences Hiroshima Japan
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Veronese N, Stubbs B, Volpato S, Zuliani G, Maggi S, Cesari M, Lipnicki DM, Smith L, Schofield P, Firth J, Vancampfort D, Koyanagi A, Pilotto A, Cereda E. Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies. J Am Med Dir Assoc 2018; 19:981-988.e7. [DOI: 10.1016/j.jamda.2018.06.007] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/25/2018] [Accepted: 06/04/2018] [Indexed: 12/21/2022]
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Slowing Symptoms as Early Markers of Decline in Older Adults. Am J Geriatr Psychiatry 2017; 25:386-387. [PMID: 28187955 PMCID: PMC5724389 DOI: 10.1016/j.jagp.2017.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/20/2022]
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