Testing a Model of Successful Aging on Masters Athletes and Non-Sporting Adults

Subjective cognitive concerns, APOE ε4, PTSD symptoms, and risk for dementia among older veterans

BACKGROUND

Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are associated with self-reported problems with cognition as well as risk for Alzheimer's disease and related dementias (ADRD). Overlapping symptom profiles observed in cognitive disorders, psychiatric disorders, and environmental exposures (e.g., head injury) can complicate the detection of early signs of ADRD. The interplay between PTSD, head injury, subjective (self-reported) cognitive concerns and genetic risk for ADRD is also not well understood, particularly in diverse ancestry groups.

METHODS

Using data from the U.S. Department of Veterans Affairs (VA) Million Veteran Program (MVP), we examined the relationship between dementia risk factors (APOE ε4, PTSD, TBI) and subjective cognitive concerns (SCC) measured in individuals of European (n = 140,921), African (n = 15,788), and Hispanic (n = 8,064) ancestry (EA, AA, and HA, respectively). We then used data from the VA electronic medical record to perform a retrospective survival analysis evaluating PTSD, TBI, APOE ε4, and SCC and their associations with risk of conversion to ADRD in Veterans aged 65 and older.

RESULTS

PTSD symptoms (B = 0.50-0.52, p < 1E-250) and probable TBI (B = 0.05-0.19, p = 1.51E-07 - 0.002) were positively associated with SCC across all three ancestry groups. APOE ε4 was associated with greater SCC in EA Veterans aged 65 and older (B = 0.037, p = 1.88E-12). Results of Cox models indicated that PTSD symptoms (hazard ratio [HR] = 1.13-1.21), APOE ε4 (HR = 1.73-2.05) and SCC (HR = 1.18-1.37) were positively associated with risk for ADRD across all three ancestry groups. In the EA group, probable TBI also contributed to increased risk of ADRD (HR = 1.18).

CONCLUSIONS

The findings underscore the value of SCC as an indicator of ADRD risk in Veterans 65 and older when considered in conjunction with other influential genetic, clinical, and demographic risk factors.

Effects of a similar amount of regular non-structured or competitive physical activity across late adulthood: a cross-sectional study

Introduction

Master athletes are examples of successful aging. It is not clear whether it is the competitive-oriented training or just the amount of total regular exercise that reduces the age-related decline in physiological functions. We aimed to compare health-related parameters in competitive (C) and physically active older adults (A) that performed the same weekly physical activity (PA) amount.

Methods

Seventeen C and 17 A were matched for age (8 and 9 male participants under and over 70 years old respectively, for both groups) and weekly PA amount (GPAQ). Body composition, leg and arm maximal strength, balance and reaction time were measured; moreover, leg and arm exercise efficiency, estimated VO2max, and VO2/HR relationships were evaluated. Perception of life and sleep quality was also assessed through specific questionnaires (SF-36 and PSQI). The effect of group (C vs. A), age (U70 vs. O70) and their interaction was examined through a Two-Way ANOVA test.

Results

C dedicated more time to vigorous PA compared to A (p = 0.03), while less to moderate daily work (p < 0.01) and active commuting (p = 0.06). C exhibited better body composition (all p < 0.05), higher leg maximal strength (p < 0.05) and a trend for elevated arm strength (p = 0.06). Reaction time, leg and arm cycling efficiency were similar in the two groups (all p > 0.05), while balance reduced in A O70. Estimated VO2max was higher for C in leg cycling (p = 0.05) and remained constant across ages (all p > 0.05). VO2/HR relationship, life and sleep quality did not differ for groups and ages.

Conclusions

Regular physical exercise of about 6,000 METs/week seems to have a beneficial effect on health-related parameters, both in non-structured and competitive PA, when compared to sedentary behaviour. However, the older adults engaged in competitive training exhibit further advantages: better body composition, higher arm and leg muscle strength, and higher leg VO2max. This study highlights the importance of encouraging active lifestyles for maintaining long-term health, high levels of life quality perception and reducing age-related decline. However, vigorous training suitability needs to be verified by a team of PA specialists.

Facilitators and constraints to adult sports participation: A systematic review

Despite the well-documented health, social and economic benefits of sports participation, adults' participation in organised sport declines as age increases. To date, no review has summarised the multi-level factors that influence adults' decisions to participate in sport. Therefore, this systematic literature review aimed to: 1) determine the facilitators, constraints and negotiated constraints to adults' (25-64 years) sport participation, and 2) summarise these factors according to the multiple levels of the social-ecological model. A total of 91 articles were identified following an extensive literature search conducted according to the PRISMA guidelines. Studies were published over four decades (1983-2023), predominantly located in North America (n = 45; 49.5%), ranged from 5 to 10,646 participants, examined mainly middle-aged adults (Mrange = 35-44 years; n = 52; 48.6%), included more males (61.6%) than females (38.1%), and were conducted in primarily single sport contexts (n = 63; 69.2%). Overall, more unique facilitators (55 items) were identified than constraints (35 items) and negotiated constraints (13 items). The desire for improved health and enjoyment were the most frequently reported facilitators, and the main constraints were injury or illness and family commitments. Constraint negotiation strategies largely included individual (e.g., implementing financial strategies) and interpersonal factors (e.g., encouraging others to participate). This review highlighted the expansive multi-level factors that influence adults' sports participation, reiterated the complexity of developing appropriate sport offerings, and identified a lack of studies examining non-sport participants. Strategies to support adult sport participation should focus on enjoyment, consider co-designed sport modifications to alleviate perceived constraints and integrate behaviour change theory to foster positive sport participation habits.

Risks and Benefits of Judo Training for Middle-Aged and Older People: A Systematic Review

This systematic overview aimed to review studies investigating the benefits and risks of judo training in older people, and to explore practical methodological applications (Registration ID: CRD42021274825). Searches of EBSCOhost, ISI-WoS, and Scopus databases, with no time restriction up to December 2022, resulted in 23 records meeting the inclusion criteria. A quality assessment was performed through the following tools: ROBINS-I for 10 experimental studies, NIH for 7 observational studies, and AGREE-II for 6 methodological studies. A serious risk of bias emerged for 70% of the experimental studies, whereas 100% of the observational and 67% of the methodological studies presented a “fair” quality. When involving 1392 participants (63 ± 12 years; females: 47%), the studies investigated novice (n = 13), amateur/intermediate (n = 4), expert (n = 4), and unknown (n = 3) level judoka by means of device-based, self-reported, and visual evaluation measures. Mean training encompassed 2 ± 1 sessions. week−1 of 61 ± 17 min for 7 ± 6 months. In relation to judo training exposure and outcomes, three main themes emerged: (i) health (56% of studies; e.g., bones, anthropometry, quality of life); (ii) functional fitness (43%; e.g., balance, strength, walking speed); and iii) psychosocial aspects (43%; e.g., fear of falling, cognition, self-efficacy). Although the included studies presented relevant methodological weaknesses, the data support the positive effects of judo training with advancing age. Future research is needed to help coaches plan judo programs for older people.

Investigating External and Internal Loads in Male Older Adult Basketball Players during Official Games

This study aimed at assessing the external [Player Load (PL), acceleration (ACC), changes of direction (COD), JUMP, and their relative values (PL/min; ACC/min; COD/min and JUMP/min)] and internal [percentage of the peak heart rate (%HRpeak) and the training load calculated with the session rating of perceived exertion (sRPE) method (sRPE-load)] loads of masters (senior citizen) basketball players during official games. Thirteen male basketball masters players (age: 66.6 ± 2.1 years; body mass: 89.9 ± 8.7 kg; stature: 183.7 ± 4.6 cm) were monitored during an official Lietuvos Krepsinio Veteranu Lyga (LKVL) 65-year game. Beside descriptive analysis, a chi-square goodness of fit test was adopted to assess the differences in the distribution within JUMP, ACC and COD classes of intensities (i.e., low, medium and high). The results revealed PL = 269.9 ± 83.3 AU and PL/min = 6.54 ± 1.29 AU/min. Moreover, significant differences (p < 0.001) in the distribution of the intensity classes were found for JUMP, ACC, and COD, with the lowest intensities as the most frequent. Finally, HRpeak = 81.7 ± 8.1% and sRPE-load = 148.9 ± 69.7 AU were found, with sRPE = ~3 AU. In conclusion, a low external load during an official basketball game was found compared to other basketball populations. Moreover, a high objective internal load did not correspond to a low perceived demand, which might increase the training adherence and motivation during long-term studies.

The Interlink among Age, Functional Fitness, and Perception of Health and Quality of Life: A Mediation Analysis

In aging societies, physical activity may benefit functional fitness influencing the health of older people. The aim of this study was to explore the interrelation between age and perception of health and quality of life, and the mediating effects of functional fitness in older individuals. One hundred and sixty-six late middle-aged (55–64 years, young-old (65–74 years), and old (75–84 years) adults, divided into senior athletes (n = 44), physically active (n = 59), and sedentary individuals (n = 63) were evaluated for functional fitness (flexibility, strength, interlimb coordination, endurance) and physical (Physical Component Summary-PCS) and mental (Mental Component Summary-MCS) health and quality of life perception. Multiple mediation analyses were applied to assess the relationship between age and PCS and MCS indices and the role of functional fitness-related mediators. For MCS only, the mediation analysis showed a positive total and direct effect of age and a negative total indirect effect through mediators. No effects emerged for PCS. Despite a decline in their functional fitness, older individuals were able to maintain a mental health perception, also demonstrating how beneficial effects of physically active lifestyle on functional fitness can positively impact the cognitive-emotional dimension of mental health with advancing age.

Psychosocial Aspects of Participation in Competitive Sports Among Older Athletes: A Scoping Review

BACKGROUND AND OBJECTIVES

In the last decade, sport has been considered a tool in active aging to maintain physical fitness, improve mental wellbeing and form social relationships among older people. However, a thorough psychosocial understanding of the phenomenon of older athletes competing in sports events is lacking. Most research has focused on competitive sports participation in the young population. This study analyzes the general state of knowledge of competitive sports participation among athletes aged 50 years and older from a psychosocial perspective.

RESEARCH DESIGN AND METHODS

We followed the five-step process outlined by Arksey and O'Malley (2005) and expanded by Levac and colleagues (2010). After the search in four electronic databases, 69 peer-reviewed articles met the inclusion criteria.

RESULTS

The findings indicate that psychosocial research into older people's participation in competitive sports has grown moderately in the last decade. While intrapersonal and interpersonal aspects have dominated the academic psychosocial discourse on older athletes' competitive sports participation, aspects related to the environment/community and policy have largely been overlooked.

DISCUSSION AND IMPLICATIONS

We identified several critical gaps in the literature, classified into conceptual (e.g., lesser attention to personality, emotional and cognitive aspects), methodological (e.g., longitudinal studies almost absent), and diverse aspects (e.g., focus on a wide indiscriminate age range; few comparisons between types of sports; underrepresentation of some nation or world regions as well as few cross-national comparative studies). These research gaps hint at opportunities that future research on older people's participation in competitive sports should address.

Perceived Time, Frequency, and Intensity of Engagement and Older Masters Athletes' Subjective Experiences

Masters athletes are a unique group of older adults whose experiences may provide valuable insights into the role of sport for successful aging. The purpose of this study was to explore whether masters athletes' social and psychological experiences vary with their time, frequency, and perceived exertion in training and competition. Semi-structured interviews were conducted with 40 men and women older masters athletes, aged 50–79 years (M = 66), who were active at the competitive level across a variety of sports (e.g., volleyball, curling, rowing, dragon boating, running, swimming, and basketball) at the time of the study. Results indicate that all participants experienced social and psychological benefits from engaging in masters sport. Only the high-frequency engagement subgroup (participating five to seven times per week in training and/or competition) reported social downsides, in terms of missing time with family and friends outside of masters sport. However, some participants described the positive family support (e.g., spouse who endorses sport participation) that overrides some of the social costs. These findings have implications for realizing positive experiences with minimal engagement in masters sport, yet an apparent threshold of participation beyond which negative social consequences may be experienced. This is an important consideration for the design and promotion of sport for older adults.

Lifestyle exercise attenuates immunosenescence; flow cytometry analysis

Background

Interaction of physical activity and overall immune profile is very complex and depends on the intensity, duration and frequency of undertaken physical activity, the exposure to cytomegalovirus (CMV) infection and the age-related changes in the immune system. Daily physical activity, which particularly influences immunity, declines dramatically with age. Therefore, the aim of the study was to explain whether physical activity sustained throughout life can attenuate or reverse immunosenescence.

Methods

Ninety-nine older adults (60–90 years) were recruited for the study. According to the 6-min walk test (6WMT), the Åstrand-Ryhming bike test (VO₂max) and Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, the individuals were classified as physically active (n = 34) and inactive (n = 20) groups. The analysis of T lymphocytes between active vs. inactive participants was performed using eight-parameter flow cytometry.

Results

Analysis of the baseline peripheral naïve and memory T lymphocytes showed a significant relationship of lifestyle exercise with the CD4/CD8 ratio. Above 50% of physically active participants demonstrated the CD4/CD8 ratio ≥ 1 or ≤ 2.5 contrary to the inactive group who showed the ratio < 1. The older adults with the result of 6WMT > 1.3 m/s and VO₂max > 35 mL/kg/min had a significantly higher CD4⁺CD45RA⁺ T lymphocyte percentage and also a higher ratio of CD4⁺CD45RA⁺/CD4⁺CD45RO⁺. Interestingly, in active older adults with IgG CMV⁺ (n = 30) the count of CD4⁺CD45RA⁺ T lymphocytes was higher than in the inactive group with IgG CMV⁺ (n = 20).

Conclusion

Based on the flow cytometry analysis, we concluded that lifestyle exercise could lead to rejuvenation of the immune system by increasing the percentage of naïve T lymphocytes or by reducing the tendency of the inverse CD4/CD8 ratio.

Life Satisfaction, Positive Affect, and Sleep Impairment in Masters Athletes: Modulation by Age, Sex, and Exercise Type

Introduction

The masters athlete has been proposed as a model of successful aging. Research studies investigating psychological outlook in older athletes have primarily addressed negative affects including depression, anxiety, and stress. The impact of lifelong exercise on positive affect and life satisfaction as well as sleep impairment that could impact on these psychological states is largely unknown.

Methods

A series of questionnaires (general life satisfaction, positive affect, and sleep-related impairment) were administered to 240 masters athletes participating in the World Masters Athletics Championships. Total raw scores were converted into T scores for comparison with the general population. Meaningful difference was defined by the PROMIS^® as one-half standard deviation from the centering sample.

Results

Meaningful differences were observed for improved general life satisfaction and reduced sleep impairment for all masters athletes. Positive affect did not reach the meaningful difference threshold. No significant sex differences were found for any of the questionnaires (all p > 0.05). Similarly, no significant differences were found between endurance, sprint, and strength/power sports for general life satisfaction (p = 0.18), positive affect (p = 0.46), and sleep impairment (p = 0.77). In general, life satisfaction increased with age (r = 0.15, p = 0.02), and sleep impairment trended towards reduction with age (r = −0.13, p = 0.05). Positive affect demonstrated no correlation with age (r = 0.09, p = 0.18).

Conclusion

This study demonstrates that the lifestyles of masters athletes contribute to improved general life satisfaction and reduced sleep impairment but not improved positive affect. The beneficial effects were observed irrespective of age, gender, and sporting types.