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Benjamim CJR, Lopes da Silva LS, da Silva Gonçalves L, Tasinafo Júnior MF, Spellanzon B, Rebelo MA, Tanus-Santos JE, Bueno Júnior CR. The effects of dietary nitrate ingestion on physical performance tests in 50-65 years old postmenopausal women: A pilot randomized, double-blind, placebo-controlled, and crossover study. Clin Nutr 2024; 43:1642-1646. [PMID: 38805867 DOI: 10.1016/j.clnu.2024.05.031] [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: 03/14/2024] [Revised: 05/06/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND & AIMS The post-menopausal period represents a noteworthy stage in a woman's life characterized by hormonal shifts that can influence diverse biological processes encompassing energy metabolism and physical performance. NO3- effects on physical performance in 50-65 years old postmenopausal women after short-term supplementation remain unknown. METHODS This is a randomized, double-blind, placebo-controlled, crossover study. After two sessions in non-consecutive days of familiarization tests, fifteen post-menopausal women aged between 50 and 65 were enrolled in this study. The trial consisted of two eight-day arms: a) NO3- -70 mL of beetroot juice (BRJ) with ˜400 mg of NO3-, and b) placebo (PLA) -70 mL of BRJ NO3- depleted. Both interventions were obtained from the same manufacturer's product, presenting the same organoleptic properties. After this period, five physical performance tests (handgrip strength, arm curl, sit-to-stand, agility and dynamic balance and 6-min walk test (6MWT)) were applied. RESULTS Fourteen participants completed all experimental protocols, including a minimum seven-day washout period between protocols. NO2- plasma concentrations were consistently elevated in the NO3- condition at 0.41 (0.40) μM compared to the PLA at 0.18 (0.18) μM (p < 0.001). The 6MWT showed higher values in BRJ with NO3- condition (19.6 m [95%CI: 1.33 to 37.88]; p = 0.038), while the other physical performance tests did not show significant difference between conditions (p > 0.05). CONCLUSIONS Our findings suggest benefits in the physical performance of activities with longer durations, indicating that the adaptation caused by ingestion of NO3- may be related to the cardiorespiratory capacity.
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Affiliation(s)
- Cicero Jonas R Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, (FMRP/USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão, Preto, Brazil.
| | - Leonardo Santos Lopes da Silva
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, (FMRP/USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão, Preto, Brazil
| | - Leonardo da Silva Gonçalves
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, (FMRP/USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão, Preto, Brazil
| | | | - Bruno Spellanzon
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, United Kingdom
| | - Macario Arosti Rebelo
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
| | - José E Tanus-Santos
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, (FMRP/USP), Ribeirão Preto, SP, Brazil
| | - Carlos Roberto Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, (FMRP/USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão, Preto, Brazil
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Väisänen D, Ekblom B, Wallin P, Andersson G, Ekblom-Bak E. Reference values for estimated VO 2max by two submaximal cycle tests: the Åstrand-test and the Ekblom-Bak test. Eur J Appl Physiol 2024; 124:1747-1756. [PMID: 38252302 PMCID: PMC11129997 DOI: 10.1007/s00421-023-05398-8] [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: 10/25/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024]
Abstract
AIMS Submaximal tests estimating VO2max have inherent biases; hence, using VO2max estimations from the same test is essential for reducing this bias. This study aimed to establish sex- and age-specific reference values for estimated VO2max using the Åstrand-test (Å-test) and the Ekblom-Bak test (EB-test). We also assessed the effects of age, exercise level, and BMI on VO2max estimations. METHODS We included men and women (20-69 years) from the Swedish working population participating in Health Profile Assessments between 2010 and 2020. Excluding those on heart rate-affecting medicines and smokers, n = 263,374 for the Å-test and n = 95,043 for the EB-test were included. VO2max reference values were based on percentiles 10, 25, 40, 60, 75, and 90 for both sexes across 5-year age groups. RESULTS Estimated absolute and relative VO2max were for men 3.11 L/min and 36.9 mL/min/kg using the Å-test, and 3.58 L/min and 42.4 mL/min/kg using the EB-test. For women, estimated absolute and relative VO2max were 2.48 L/min and 36.6 mL/min/kg using the Å-test, and 2.41 L/min and 35.5 mL/min/kg using the EB-test. Higher age (negative), higher exercise level (positive), and higher BMI (negative) were associated with estimated VO2max using both tests. However, explained variance by exercise on estimated VO2max was low, 10% for the Å-test and 8% for the EB-test, and moderate for BMI, 23% and 29%. CONCLUSION We present reference values for estimated VO2max from two submaximal cycle tests. Age, exercise, and BMI influenced estimated VO2max. These references can be valuable in clinical evaluations using the same submaximal tests.
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Affiliation(s)
- Daniel Väisänen
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
| | - Björn Ekblom
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Peter Wallin
- Department of Research, HPI Health Profile Institute, Danderyd, Stockholm, Sweden
| | - Gunnar Andersson
- Department of Research, HPI Health Profile Institute, Danderyd, Stockholm, Sweden
| | - Elin Ekblom-Bak
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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Benjamim CJR, da Silva LSL, Sousa YBA, Rodrigues GDS, Pontes YMDM, Rebelo MA, Gonçalves LDS, Tavares SS, Guimarães CS, da Silva Sobrinho AC, Tanus-Santos JE, Gualano B, Bueno Júnior CR. Acute and short-term beetroot juice nitrate-rich ingestion enhances cardiovascular responses following aerobic exercise in postmenopausal women with arterial hypertension: A triple-blinded randomized controlled trial. Free Radic Biol Med 2024; 211:12-23. [PMID: 38092272 DOI: 10.1016/j.freeradbiomed.2023.11.039] [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: 08/31/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The increase in blood pressure (BP) levels in the postmenopausal period can be partly explained by the decrease in nitric oxide synthases (NOS). OBJECTIVE To investigate the acute and one-week effects of beetroot juice nitrate-rich (BRJ-NO3-rich) ingestion on cardiovascular and autonomic performance in response to submaximal aerobic exercise in postmenopausal women with systemic arterial hypertension (SAH) who are physically inactive. METHODS Fourteen postmenopausal women with SAH [mean (SD) age: 59(4) y; BMI (kg/m2): 29.2(3.1)] completed submaximal aerobic exercise bouts after an acute and a one-week intervention with BRJ in a placebo-controlled, randomized, triple-blind, crossover design. Participants ingested either BRJ (800 mg of NO3-) or placebo acutely and drank either BRJ (400 mg of NO3-) or placebo every day for the next six days. After two and ½ hours, they performed a session of aerobic submaximal aerobic exercise, and their systolic BP (SBP) and diastolic BP (DBP), flow-mediated dilation (FMD), heart rate (HR) recovery, and HR variability were measured. RESULTS In the post-exercise recovery period, SBP dropped significantly in the BRJ-NO3-rich group (-9.28 mmHg [95%CI: -1.68 to -16.88] ES: -0.65, p = 0.019) compared to placebo after acute ingestion. The FMD values increased after acute BRJ-NO3-rich on post-exercise (3.18 % [0.36 to 5.99] ES: 0.87, p = 0.031). After the one-week intervention, FMD values were higher in the BRJ-NO3-rich group before (4.5 % [1.62 to 7.37] ES: 1.21, p = 0.005) and post-exercise measurements (4.2 % [1.52 to 6.87] ES: 1.22, p = 0.004) vs. placebo. HRV indices with remarkable parasympathetic modulation to heart recovered faster on the BRJ-NO3-rich group than placebo group. No between-group differences were identified in values of HR post-exercise recovery in the 30s, 60s, 120s, 180s, and 300s. CONCLUSIONS Acute and short-term BRJ-NO3-rich ingestion may enhance cardiovascular and autonomic behavior in response to aerobic exercise in postmenopausal women diagnosed with SAH. CLINICAL TRIAL REGISTRY NUMBER https://clinicaltrials.gov/ct2/show/NCT05384340.
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Affiliation(s)
- Cicero Jonas R Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil.
| | - Leonardo Santos L da Silva
- School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil
| | - Yaritza B Alves Sousa
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, USP, Ribeirao Preto, Sao Paulo, Brazil
| | - Guilherme da Silva Rodrigues
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil
| | | | - Macario Arosti Rebelo
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
| | | | - Simone Sakagute Tavares
- School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil
| | - Carolina S Guimarães
- Ribeirao Preto Nursing School, University of São Paulo (EERP/USP), Ribeirão Preto, SP, Brazil
| | - Andressa C da Silva Sobrinho
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil
| | - Jose E Tanus-Santos
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, SP, Brazil
| | - Bruno Gualano
- Center of Lifestyle Medicine, Applied Physiology & Nutrition Research Group, University of São Paulo, Medical School (FMUSP), São Paulo, SP, Brazil
| | - Carlos R Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil; Ribeirao Preto Nursing School, University of São Paulo (EERP/USP), Ribeirão Preto, SP, Brazil
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Ibrahim A, Mat Ludin AF, Shahar S, Hamzah NH, Chin AV, Singh DKA. Association between maximal oxygen consumption and physical performance tests among older adults with cognitive frailty. Exp Gerontol 2023; 184:112326. [PMID: 37967590 DOI: 10.1016/j.exger.2023.112326] [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: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Cardiorespiratory fitness has an inverse relationship with cognitive impairment and frailty in older adults. Direct assessment of maximal oxygen consumption (VO2 max) is the gold standard to assess cardiorespiratory fitness. However, it is costly and requires a laboratory setting. Therefore, VO2 max estimation among older adults with cognitive frailty (CF) will allow the assessment of aerobic capacity, which is commonly overlooked due to the complexity of the test. AIM This study aims to determine the use of one of three physical performance tests (2-minute step, 2-minute walk, and 1-minute sit to stand) to effectively estimate cardiorespiratory fitness among older adults with CF. METHODS In this cross-sectional study, community-dwelling individuals aged 60 years old and above in Klang Valley were screened for CF. The participants performed three physical performance tests (2-minute walk, 2-minute step, and 1-minute sit to stand) followed by treadmill-based maximal exercise testing on another day. RESULTS A total of 32 older adults with cognitive frailty (mean age; SD: 67.1;4.7 years) participated in this study. Nearly half of them had hypertension (43.5 %), hypercholesterolemia (43.5 %), and multimorbidity (47.8 %). Among the endurance tests performed, only the 2-minute walk test independently predicted VO2 max by sex-specific with men (R2 = 0.58, p = 0.03) and women (R2 = 0.34, p = 0.01). The 2-minute walk test had good agreement with VO2 max (ICC = 0.77, 95 % CI: -3.1-2.4). CONCLUSION The 2-minute walk test is a valid tool for estimating cardiorespiratory fitness among older adults with CF. However, it should be further tested across a larger population.
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Affiliation(s)
- Azianah Ibrahim
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Noor Hazfalinda Hamzah
- Center for Diagnostic, Therapeutic & Investigative Studies (CODTIS), Forensic Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Ai-Vyrn Chin
- Geriatric Division, Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia.
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Corral-Pérez J, Martinez-Tellez B, Velázquez-Díaz D, Ponce-Gonzalez JG, Carbonell-Baeza A, Jiménez-Pavón D. Thermal resting pattern and acute skin temperature response to exercise in older adults: Role of cardiorespiratory fitness. J Therm Biol 2023; 117:103678. [PMID: 37659343 DOI: 10.1016/j.jtherbio.2023.103678] [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: 04/24/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Infrared thermography is a growing area of interest in sports science due to the potential of skin temperature (Tsk) measurements to provide valuable information from rest to exercise. However, limited research exists on Tsk in older adults and the impact of factors such as sex and cardiorespiratory fitness (CRF) on Tsk. This study aims to investigate Tsk at rest and after acute exercise in older adults and assess whether sex or CRF influences Tsk. METHODS Ninety-two participants (41 women, 68.48 ± 3.01 years) were examined with a thermographic camera in a conditioned room (23.02 ± 3.01 °C) at rest and after a graded protocol. The Tsk of 25 regions of interest (ROIs) were extracted and analysed. RESULTS Men had higher overall Tsk at rest in 76% of ROIs, showing significant differences (p < 0.010) in six specific ROIs, independent of CRF. Both sexes had similar Tsk responses after graded exercise, with increases in distal parts (1.06 ± 0.50 °C), decreases in proximal parts (-0.62 ± 0.42 °C), and stable central Tsk (0.23 ± 0.59 °C). Increases in lower limb Tsk were significantly associated with CRF in men and women (β = 0.438, p = 0.001, and β = 0.535, p < 0.001, respectively), explaining 17% and 27% of the variance, respectively. CONCLUSIONS This study demonstrates a sex-specific effect on resting Tsk in older adults, suggesting that sex-specific Tsk patterns should be considered when analysing Tsk in this population. Additionally, the association between increases in lower limb Tsk and CRF suggests that Tsk could be a promising predictor of CRF in older adults.
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Affiliation(s)
- Juan Corral-Pérez
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Borja Martinez-Tellez
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Crta. Alfacar S/n, Granada, 18071, Spain; Department of Medicine, Leiden University Medical Center, Division of Endocrinology and Einthoven Laboratory for Experimental Vascular Medicina, Leiden, 2333, ZA, Netherlands
| | - Daniel Velázquez-Díaz
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain; Brain Aging & Cognitive Health Lab, Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Jesus Gustavo Ponce-Gonzalez
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Ana Carbonell-Baeza
- MOVE-IT Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain.
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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Letnes JM, Nes BM, Wisløff U. Age-related decline in peak oxygen uptake: Cross-sectional vs. longitudinal findings. A review. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 16:200171. [PMID: 36874046 PMCID: PMC9975246 DOI: 10.1016/j.ijcrp.2023.200171] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Cardiorespiratory fitness is established as an important prognostic factor for cardiovascular and general health. In clinical settings cardiorespiratory fitness is often measured by cardiopulmonary exercise testing determining the gold-standard peak oxygen uptake (VO2peak). Due to the considerable impact of age and sex on VO2peak, results from cardiopulmonary exercise testing are typically assessed in the context of age- and sex-specific reference values, and multiple studies have been conducted establishing reference materials by age and sex using cross-sectional designs. However, crossectional and longitudinal studies have shown somewhat conflicting results regarding age-related declines of VO2peak, with larger declines reported in longitudinal studies. In this brief review, we compare findings from crossectional and longitudinal studies on age-related trajectories in VO2peak to highlight differences in these estimates which should be acknowledged when clinicians interpret VO2peak measurements repeated over time.
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Affiliation(s)
- Jon Magne Letnes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Bjarne M Nes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
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Damme KSF, Gupta T, Ristanovic I, Kimhy D, Bryan AD, Mittal VA. Exercise Intervention in Individuals at Clinical High Risk for Psychosis: Benefits to Fitness, Symptoms, Hippocampal Volumes, and Functional Connectivity. Schizophr Bull 2022; 48:1394-1405. [PMID: 35810336 PMCID: PMC9673264 DOI: 10.1093/schbul/sbac084] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Individuals at clinical high risk for psychosis (CHR-p) are less fit than nonclinical peers and show hippocampal abnormalities that relate to clinical symptoms. Exercise generates hippocampal neurogenesis that may ameliorate these hippocampal abnormalities and related cognitive/clinical symptoms. This study examines the impact of exercise on deficits in fitness, cognitive deficits, attenuated psychotic symptoms, hippocampal volumes, and hippocampal connectivity in individuals at CHR-p. STUDY DESIGN In a randomized controlled trial, 32 individuals at CHR-p participated in either an exercise (n = 17) or waitlist (no exercise) (n = 15) condition. All participants were sedentary at use and absent of current antipsychotic medication, psychosis diagnoses, or a substance use disorder. The participants completed a series of fitness, cognitive tasks, clinical assessments, and an MRI session preintervention and postintervention. The exercise intervention included a high-intensity interval exercise (80% of VO2max) with 1-minute high-intensity intervals (95% of VO2max) every 10 minutes) protocol twice a week over 3 months. STUDY RESULTS The exercise intervention was well tolerated (83.78% retention; 81.25% completion). The exercising CHR-p group showed that improved fitness (pre/post-d = 0.53), increased in cognitive performance (pre/post-d = 0.49), decrease in positive symptoms (pre/post-d = 1.12) compared with the waitlist group. Exercising individuals showed stable hippocampal volumes; waitlist CHR-p individuals showed 3.57% decreased hippocampal subfield volume. Exercising individuals showed that increased exercise-related hippocampal connectivity compared to the waitlist individuals. CONCLUSIONS The exercise intervention had excellent adherence, and there were clear signs of mechanism engagement. Taken together, evidence suggests that high-intensity exercise can be a beneficial therapeutic tool in the psychosis risk period.
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Affiliation(s)
- Katherine S F Damme
- To whom correspondence should be addressed; Department of Psychology, Northwestern University, 2029 Sheridan Rd.Evanston, IL 60208, USA; tel: 402-890-3606, e-mail:
| | - Tina Gupta
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Ivanka Ristanovic
- Department of Psychology, Northwestern University, Evanston, IL, USA,Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
| | - David Kimhy
- Department of Psychology, Northwestern University, Evanston, IL, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,MIRECC, The James J. Peters VA Medical Center, Bronx, NY, USA
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA,Institute for Neuroscience, University of Colorado, Boulder, CO, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA,Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA,Institute for Cognitive Science, University of Colorado, Boulder, CO, USA,Department of Psychiatry, Northwestern University, Chicago, IL, USA,Medical Social Sciences, Northwestern University, Chicago, IL, USA,Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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Prevention of Loss of Muscle Mass and Function in Older Adults during COVID-19 Lockdown: Potential Role of Dietary Essential Amino Acids. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138090. [PMID: 35805748 PMCID: PMC9265941 DOI: 10.3390/ijerph19138090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
As the COVID-19 pandemic became a global emergency, social distancing, quarantine, and limitations in outdoor activities have resulted in an environment of enforced physical inactivity (EPI). A prolonged period of EPI in older individuals accelerates the deterioration of skeletal muscle health, including loss of muscle mass and function, commonly referred to as sarcopenia. Sarcopenia is associated with an increased likelihood of the progression of diabetes, obesity, and/or depression. Well-known approaches to mitigate the symptoms of sarcopenia include participation in resistance exercise training and/or intake of balanced essential amino acids (EAAs) and high-quality (i.e., containing high EEAs) protein. As the pandemic situation discourages physical exercise, nutritional approaches, especially dietary EAA intake, could be a good alternative for counteracting against EPI-promoted loss of muscle mass and function. Therefore, in the present review, we cover (1) the impact of EPI-induced muscle loss and function on health, (2) the therapeutic potential of dietary EAAs for muscle health (e.g., muscle mass and function) in the EPI condition in comparison with protein sources, and finally (3) practical guidelines of dietary EAA intake for optimal anabolic response in EPI.
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Petek BJ, Tso JV, Churchill TW, Guseh JS, Loomer G, DiCarli M, Lewis GD, Weiner RB, Kim JH, Wasfy MM, Baggish AL. Normative cardiopulmonary exercise data for endurance athletes: the Cardiopulmonary Health and Endurance Exercise Registry (CHEER). Eur J Prev Cardiol 2021; 29:536-544. [PMID: 34487164 DOI: 10.1093/eurjpc/zwab150] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/05/2021] [Accepted: 08/24/2021] [Indexed: 11/14/2022]
Abstract
AIMS Accurate interpretation of cardiopulmonary exercise testing (CPET) relies on age, gender, and exercise modality-specific reference values. To date, clinically applicable CPET reference values derived from a source population of endurance athletes (EAs) have been lacking. The purpose of this study was to generate CPET reference values for use in the clinical assessment of EA. METHODS AND RESULTS Prospective data accrued during the clinical care of healthy EA were used to derive CPET reference values and to develop novel equations for V˙O2peak. The performance of these equations was compared to the contemporary standard of care equations and assessed in a discrete EA validation cohort. A total of 272 EA (age = 42 ± 15 years, female = 31%, V˙O2peak = 3.6 ± 0.83 L/min) met inclusion criteria and comprised the derivation cohort. V˙O2peak prediction equations derived from general population cohorts described a modest amount of V˙O2peak variability [R2 = 0.58-0.70, root mean square error (RMSE) = 0.46-0.54 L/min] but were mis-calibrated (calibration-in-the-large = 0.45-1.18 L/min) among EA leading to significant V˙O2peak underestimation. Newly derived, externally validated V˙O2peak prediction equations for EA that included age, sex, and height for both treadmill (R2 = 0.74, RMSE = 0.42 L/min) and cycle ergometer CPET (Cycle: R2 = 0.69, RMSE = 0.42 L/min) demonstrated improved accuracy. CONCLUSION Commonly used V˙O2peak prediction equations derived from general population cohorts perform poorly among competitive EA. Newly derived CPET reference values including novel V˙O2peak prediction equations may improve the clinical utility of CPET in this rapidly growing patient population.
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Affiliation(s)
- Bradley J Petek
- Division of Cardiology, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - Jason V Tso
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road, NE, Suite 502, Atlanta, GA 30322, USA
| | - Timothy W Churchill
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - J Sawalla Guseh
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - Garrett Loomer
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - Milena DiCarli
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - Gregory D Lewis
- Division of Cardiology, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - Rory B Weiner
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - Jonathan H Kim
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road, NE, Suite 502, Atlanta, GA 30322, USA
| | - Meagan M Wasfy
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, USA
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10
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Sobejana M, van den Hoek J, Metsios GS, Kitas GD, Jorstad HT, van der Leeden M, Pijnappels M, Lems WF, Nurmohamed MT, van der Esch M. Cardiorespiratory fitness and physical activity in people who have rheumatoid arthritis at an increased risk of cardiovascular disease: a cross-sectional study. Rheumatol Int 2021; 41:2177-2183. [PMID: 34331578 DOI: 10.1007/s00296-021-04903-6] [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: 12/17/2020] [Accepted: 05/22/2021] [Indexed: 10/20/2022]
Abstract
Lower cardiorespiratory fitness (CRF) and physical activity (PA) associate with higher cardiovascular disease (CVD) risk, but the relationship between CRF and PA in people who have rheumatoid arthritis (RA) at an increased CVD risk (CVD-RA) is not known. The objectives of this study were to determine the levels of CRF and PA in people who have CVD-RA and to investigate the association of CRF with PA in people who have CVD-RA. A total of 24 consecutive patients (19 women) with CVD-RA (> 4% for 10-year risk of fatal CVD development as calculated using the Systematic Coronary Risk Evaluation)-were included in the study. CRF was assessed with a graded maximal exercise test determining maximal oxygen uptake (VO2max). PA was assessed with an accelerometer to determine the amount of step count, sedentary, light and moderate-to-vigorous physical activity (MVPA) minutes per day. Mean age of patients was 65.3 ± 8.3 years. CRF mean values were 16.3 ± 1.2 ml·kg-1 min-1, mean step count per day was 6033 ± 2256, and the mean MVPA time was 16.7 min per day. Significant positive associations were found for CRF with step count (B = 0.001, P = 0.01) and MVPA time (B = 0.15, P = 0.02); a negative association was found for CRF with sedentary time (B = - 0.02, P = 0.03). CRF is low and is associated with step count, sedentary time and MVPA time in people who have RA at an increased CVD risk.
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Affiliation(s)
- M Sobejana
- Reade, Center for Rehabilitation and Rheumatology, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - J van den Hoek
- Reade, Center for Rehabilitation and Rheumatology, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands
| | - G S Metsios
- Faculty of Education, Health and Wellbeing, UK Department of Rheumatology, University of Wolverhampton, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.,School of Physical Education and Sport Science, University of Thessaly, Volos, Greece.,Clinical Research Unit, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK
| | - G D Kitas
- Clinical Research Unit, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, UK
| | - H T Jorstad
- Department of Cardiology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - M van der Leeden
- Reade, Center for Rehabilitation and Rheumatology, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M Pijnappels
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - W F Lems
- Reade, Center for Rehabilitation and Rheumatology, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands.,Department of Rheumatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M T Nurmohamed
- Reade, Center for Rehabilitation and Rheumatology, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands.,Department of Rheumatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M van der Esch
- Reade, Center for Rehabilitation and Rheumatology, Amsterdam Rehabilitation Research Center
- Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands. .,Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
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11
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Cardiopulmonary Exercise Testing Following Open Repair for a Proximal Thoracic Aortic Aneurysm or Dissection. J Cardiopulm Rehabil Prev 2021; 40:108-115. [PMID: 31478921 DOI: 10.1097/hcr.0000000000000446] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE There are limited data on cardiopulmonary exercise testing (CPX) and cardiorespiratory fitness (CRF), following open repair for a proximal thoracic aortic aneurysm or dissection. The aim was to evaluate serious adverse events, abnormal CPX event rate, CRF (peak oxygen uptake, (Equation is included in full-text article.)O2peak), and blood pressure. METHODS Patients were retrospectively identified from cardiac rehabilitation participation or prospectively enrolled in a research study and grouped by phenotype: (1) bicuspid aortic valve/thoracic aortic aneurysm, (2) tricuspid aortic valve/thoracic aortic aneurysm, and (3) acute type A aortic dissection. RESULTS Patients (n = 128) completed a CPX a median of 2.9 mo (interquartile range: 1.8, 3.5) following repair. No serious adverse events were reported, although 3 abnormal exercise tests (2% event rate) were observed. Eighty-one percent of CPX studies were considered peak effort (defined as respiratory exchange ratio of ≥1.05). Median measured (Equation is included in full-text article.)O2peak was <36% predicted normative values (19.2 mL·kgmin vs 29.3 mLkgmin, P < .0001); the most marked impairment in (Equation is included in full-text article.)O2peak was observed in the acute type A aortic dissection group (<40% normative values), which was significantly different from other groups (P < .05). Peak exercise systolic and diastolic blood pressures were 160 mm Hg (144, 172) and 70 mm Hg (62, 80), with no differences noted between groups. CONCLUSIONS We observed no serious adverse events with an abnormal CPX event rate of only 2% 3 mo following repair for a proximal thoracic aortic aneurysm or dissection. (Equation is included in full-text article.)O2peak was reduced among all patient groups, especially the acute type A aortic dissection group, which may be clinically significant, given the well-established prognostic importance of reduced cardiorespiratory fitness.
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12
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Damme KSF, Sloan RP, Bartels MN, Ozsan A, Ospina LH, Kimhy D, Mittal VA. Psychosis risk individuals show poor fitness and discrepancies with objective and subjective measures. Sci Rep 2021; 11:9851. [PMID: 33972634 PMCID: PMC8110757 DOI: 10.1038/s41598-021-89301-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/20/2021] [Indexed: 11/25/2022] Open
Abstract
Exercise is a promising intervention for individuals at clinical high-risk for psychosis (CHR). However, these youth may not be reliable reporters on fitness. There have been no investigations that utilized objective fitness assessment in this population. The present study objectively characterizes the level of fitness in CHR youth, compares the accuracy of self-report measures to objective fitness indices, and explores clinical factors that may influence the accuracy of self-reported measures of fitness. Forty CHR individuals completed an exercise survey and objective indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed objective indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness. CHR youth showed greater BMI and lowered VO2max compared to healthy volunteers. In the CHR group, self-report items (perceived fitness) did not reflect objective indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with objective fitness measurements. Exploratory analyses suggested that symptoms (grandiosity and avolition) related to errors in self-perception. Results indicate that CHR individuals are less fit than controls as indexed by objective measures of fitness and that it is important to consider unique population clinical characteristics when employing self-report data.
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Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA.
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA.
| | - Richard P Sloan
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Matthew N Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Rehabilitation Medicine, Montefiore Medical Center, New York, NY, USA
| | - Alara Ozsan
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | - Luz H Ospina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- MIRECC, The James J. Peters VA Medical Center, Bronx, NY, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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13
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Takao N, Iwasaka J, Kurose S, Miyauchi T, Tamanoi A, Tsuyuguchi R, Fujii A, Tsutsumi H, Kimura Y. Evaluation of oxygen uptake adjusted by skeletal muscle mass in cardiovascular disease patients with type 2 diabetes. J Phys Ther Sci 2021; 33:94-99. [PMID: 33642681 PMCID: PMC7897529 DOI: 10.1589/jpts.33.94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023] Open
Abstract
[Purpose] We aimed to evaluate oxygen uptake adjusted by total skeletal muscle mass in
patients with cardiovascular disease with or without type 2 diabetes mellitus.
[Participants and Methods] The participants included 54 males ≥50 years of age without
heart failure who underwent cardiopulmonary exercise testing during cardiac
rehabilitation. We divided the participants into two groups: patients with type 2 diabetes
mellitus (DM group) and patients without type 2 diabetes mellitus (NDM group). [Results]
We found no significant differences in age, weight, fat mass, or skeletal muscle mass
between the groups. There were also no differences in cardiac function, body composition,
and heart rate response. The DM group showed significantly lower peak oxygen uptake values
adjusted by skeletal muscle mass, despite the absence of significant differences in
skeletal muscle mass. A significant positive correlation was found between peak oxygen
uptake and age, weight, and skeletal muscle mass. Stepwise regression analysis revealed
that age, skeletal muscle mass, and medical history of diabetes were independent
predictors of absolute peak oxygen uptake. [Conclusion] Peak oxygen uptake adjusted by
skeletal muscle mass in patients with cardiovascular disease and type 2 diabetes mellitus
is lower than that in those without type 2 diabetes mellitus.
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Affiliation(s)
- Nana Takao
- Department of Health Science, Graduate School of Medicine, Kansai Medical University: 2-5-1 Shinmachi, Hirakata 573-1010, Japan.,Health Science Center, Kansai Medical University Hospital, Japan
| | - Junji Iwasaka
- Department of Medicine II, Kansai Medical University, Japan
| | - Satoshi Kurose
- Department of Health Science, Kansai Medical University, Japan
| | - Takumi Miyauchi
- Department of Health Science, Graduate School of Medicine, Kansai Medical University: 2-5-1 Shinmachi, Hirakata 573-1010, Japan.,Health Science Center, Kansai Medical University Hospital, Japan
| | - Astuko Tamanoi
- Health Science Center, Kansai Medical University Hospital, Japan
| | - Ryota Tsuyuguchi
- Department of Health Science, Graduate School of Medicine, Kansai Medical University: 2-5-1 Shinmachi, Hirakata 573-1010, Japan
| | - Aya Fujii
- Department of Health Science, Graduate School of Medicine, Kansai Medical University: 2-5-1 Shinmachi, Hirakata 573-1010, Japan.,Health Science Center, Kansai Medical University Hospital, Japan
| | - Hiromi Tsutsumi
- Department of Health Science, Kansai Medical University, Japan
| | - Yutaka Kimura
- Health Science Center, Kansai Medical University Hospital, Japan.,Department of Health Science, Kansai Medical University, Japan
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14
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Varma VR, Ghosal R, Hillel I, Volfson D, Weiss J, Urbanek J, Hausdorff JM, Zipunnikov V, Watts A. Continuous gait monitoring discriminates community-dwelling mild Alzheimer's disease from cognitively normal controls. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12131. [PMID: 33598530 PMCID: PMC7864220 DOI: 10.1002/trc2.12131] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/25/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Few studies have explored whether gait measured continuously within a community setting can identify individuals with Alzheimer's disease (AD). This study tests the feasibility of this method to identify individuals at the earliest stage of AD. METHODS Mild AD (n = 38) and cognitively normal control (CNC; n = 48) participants from the University of Kansas Alzheimer's Disease Center Registry wore a GT3x+ accelerometer continuously for 7 days to assess gait. Penalized logistic regression with repeated five-fold cross-validation followed by adjusted logistic regression was used to identify gait metrics with the highest predictive performance in discriminating mild AD from CNC. RESULTS Variability in step velocity and cadence had the highest predictive utility in identifying individuals with mild AD. Metrics were also associated with cognitive domains impacted in early AD. DISCUSSION Continuous gait monitoring may be a scalable method to identify individuals at-risk for developing dementia within large, population-based studies.
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Affiliation(s)
- Vijay R. Varma
- Clinical and Translational Neuroscience SectionLaboratory of Behavioral NeuroscienceNational Institute on Aging (NIA)National Institutes of Health (NIH)BaltimoreMarylandUSA
| | - Rahul Ghosal
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Inbar Hillel
- Center for the Study of Movement, Cognition and MobilityTel Aviv Sourasky Medical Center, Neurological InstituteTel AvivIsrael
| | - Dmitri Volfson
- Neuroscience AnalyticsComputational Biology, TakedaCambridgeMassachusettsUSA
| | - Jordan Weiss
- Department of DemographyUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Jacek Urbanek
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition and MobilityTel Aviv Sourasky Medical Center, Neurological InstituteTel AvivIsrael
- Sagol School of NeuroscienceTel Aviv UniversityTel AvivIsrael
- Rush Alzheimer's Disease Center and Department of Orthopaedic SurgeryRush University Medical CenterChicagoUSA
- Department of Physical Therapy, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Vadim Zipunnikov
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Amber Watts
- Department of PsychologyUniversity of KansasLawrenceKansasUSA
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15
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Morris JK, Zhang G, Dougherty RJ, Mahnken JD, John CS, Lose SR, Cook DB, Burns JM, Vidoni ED, Okonkwo O. Collective effects of age, sex, genotype, and cognitive status on fitness outcomes. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12058. [PMID: 32695870 PMCID: PMC7364859 DOI: 10.1002/dad2.12058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Individuals with Alzheimer's disease (AD) broadly exhibit lower cardiorespiratory fitness (CRF) compared to cognitively healthy older adults. Other factors, such as increasing age and female sex, are also known to track with lower CRF levels. However, it is unclear how these factors together with AD diagnosis and genetic risk (apolipoprotein e4 ; APOE4) collectively affect CRF. METHODS Our primary objective was to characterize the collective relationship of age, sex, APOE4 carrier status , and cognitive status (nondemented or AD) with two commonly reported CRF outcomes, VO2 max and oxygen uptake efficiency slope (OUES). To interrogate the unique and combined effect of age, sex, APOE4, and cognitive status on CRF, we pooled multiple datasets and tested several statistical models allowing all possible interactions. RESULTS AD diagnosis was consistently associated with lower maximal CRF, which declined with increasing age. APOE4 was also associated with lower maximal CRF (VO2max), but only in male subjects. Submaximal CRF (OUES) was lower in APOE4 carriers of both sexes, although this difference converged in male subjects with advancing age. DISCUSSION This multi-cohort analysis (n = 304) suggests that APOE4 carrier status and sex are important considerations for studies that evaluate maximal and submaximal CRF.
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Affiliation(s)
- Jill K. Morris
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKansasUSA
- University of Kansas Alzheimer's Disease Research CenterFairwayKansasUSA
| | - Guanlin Zhang
- Department of Biostatistics and Data ScienceUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Ryan J Dougherty
- Department of KinesiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterMadisonWisconsinUSA
| | - Jonathan D. Mahnken
- Department of Biostatistics and Data ScienceUniversity of Kansas Medical CenterKansas CityKansasUSA
- University of Kansas Alzheimer's Disease Research CenterFairwayKansasUSA
| | - Casey S. John
- University of Kansas Alzheimer's Disease Research CenterFairwayKansasUSA
| | - Sarah R. Lose
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterMadisonWisconsinUSA
| | - Dane B. Cook
- Department of KinesiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Jeffrey M. Burns
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKansasUSA
- University of Kansas Alzheimer's Disease Research CenterFairwayKansasUSA
| | - Eric D. Vidoni
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKansasUSA
- University of Kansas Alzheimer's Disease Research CenterFairwayKansasUSA
| | - Ozioma Okonkwo
- Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterMadisonWisconsinUSA
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16
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Intzandt B, Sabra D, Foster C, Desjardins-Crépeau L, Hoge RD, Steele CJ, Bherer L, Gauthier CJ. Higher cardiovascular fitness level is associated with lower cerebrovascular reactivity and perfusion in healthy older adults. J Cereb Blood Flow Metab 2020; 40:1468-1481. [PMID: 31342831 PMCID: PMC7308519 DOI: 10.1177/0271678x19862873] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aging is accompanied by vascular and structural changes in the brain, which include decreased grey matter volume (GMV), cerebral blood flow (CBF), and cerebrovascular reactivity (CVR). Enhanced fitness in aging has been related to preservation of GMV and CBF, and in some cases CVR, although there are contradictory relationships reported between CVR and fitness. To gain a better understanding of the complex interplay between fitness and GMV, CBF and CVR, the present study assessed these factors concurrently. Data from 50 participants, aged 55 to 72, were used to derive GMV, CBF, CVR and VO2peak. Results revealed that lower CVR was associated with higher VO2peak throughout large areas of the cerebral cortex. Within these regions lower fitness was associated with higher CBF and a faster hemodynamic response to hypercapnia. Overall, our results indicate that the relationships between age, fitness, cerebral health and cerebral hemodynamics are complex, likely involving changes in chemosensitivity and autoregulation in addition to changes in arterial stiffness. Future studies should collect other physiological outcomes in parallel with quantitative imaging, such as measures of chemosensitivity and autoregulation, to further understand the intricate effects of fitness on the aging brain, and how this may bias quantitative measures of cerebral health.
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Affiliation(s)
- Brittany Intzandt
- INDI Department, Concordia University, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - Dalia Sabra
- Départment de Médecine, Université de Montréal, Canada
| | - Catherine Foster
- PERFORM Centre, Concordia University, Montreal, Canada.,Physics Department, Concordia University, Montreal, Canada
| | - Laurence Desjardins-Crépeau
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.,Centre de Recherche de l'Institut de Cardiologie de Montréal, Montréal, Canada
| | - Richard D Hoge
- Department of Neurology and Neurosurgery, McGill University, Canada
| | - Christopher J Steele
- Department of Psychology, Concordia University, Montreal, Canada.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Louis Bherer
- PERFORM Centre, Concordia University, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.,Départment de Médecine, Université de Montréal, Canada.,Centre de Recherche de l'Institut de Cardiologie de Montréal, Montréal, Canada
| | - Claudine J Gauthier
- PERFORM Centre, Concordia University, Montreal, Canada.,Physics Department, Concordia University, Montreal, Canada.,Centre de Recherche de l'Institut de Cardiologie de Montréal, Montréal, Canada
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17
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Park SY, Kwak YS, Pekas EJ. Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial. J Appl Physiol (1985) 2019; 127:940-949. [PMID: 31369328 DOI: 10.1152/japplphysiol.00209.2019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with attenuated vascular function, cardiorespiratory capacity, physical function, and muscular strength. It is essential to combat these negative effects on health by incorporating lifestyle interventions to slow disease progression, such as exercise. We sought to examine the effects of aquatic walking exercise on cardiovascular function, cardiorespiratory capacity [maximal volume of oxygen consumption (V̇o2max)], exercise tolerance [6-min walking distance (6MWD)], physical function, muscular strength, and body composition in patients with PAD. Patients with PAD (n = 72) were recruited and randomly assigned to a 12-wk aquatic walking training group (AQ, n = 35) or a control group (CON, n = 37). The AQ group performed walking and leg exercises in waist-to-chest-deep water. Leg arterial stiffness [femoral-to-ankle pulse wave velocity (legPWV)], heart rate (HR), blood pressure (BP), ankle-to-brachial index (ABI), V̇o2max, 6MWD, physical function, muscular strength, body composition, resting metabolic rate (RMR), and flexibility were measured before and after 12 wk. There were significant group × time interactions (P < 0.05) after 12 wk for legPWV and HR, which significantly decreased (P < 0.05) in AQ, and V̇o2max, 6MWD, physical function, and muscular strength, which significantly increased (P < 0.05) in AQ, compared with no changes in CON. There were no significant differences (P > 0.05) for BP, ABI, RMR, or flexibility after 12 wk. Interestingly, there was relatively high adherence (84%) to the aquatic walking exercise program in this population. These results suggest that aquatic walking exercise is an effective therapy to reduce arterial stiffness and resting HR and improve cardiorespiratory capacity, exercise tolerance, physical function, and muscular strength in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that aquatic walking exercise can decrease arterial stiffness and improve exercise tolerance, cardiorespiratory capacity, and muscular strength in patients with peripheral artery disease (PAD). Aquatic walking exercise training demonstrates relatively high exercise adherence in this population. Aquatic walking exercise training may be a useful therapeutic intervention for improving physical function in patients with PAD.
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Affiliation(s)
- Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska.,Department of Physical Education, Dong-Eui University, Busan, South Korea
| | - Yi-Sub Kwak
- Department of Physical Education, Dong-Eui University, Busan, South Korea
| | - Elizabeth J Pekas
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
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18
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Takken T, Mylius C, Paap D, Broeders W, Hulzebos H, Van Brussel M, Bongers B. Reference values for cardiopulmonary exercise testing in healthy subjects – an updated systematic review. Expert Rev Cardiovasc Ther 2019; 17:413-426. [DOI: 10.1080/14779072.2019.1627874] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- T. Takken
- Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C.F. Mylius
- Research Group Healthy Ageing, Hanze University of Applied Sciences, Allied Health Care and Nursing, Groningen, The Netherlands
| | - D. Paap
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W. Broeders
- Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H.J. Hulzebos
- Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M. Van Brussel
- Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - B.C. Bongers
- Department of Nutrition and Movement Sciences, Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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19
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Kotte EMW, de Groot JF, Winkler AMF, Veenhof C, Takken T. Fitkids Treadmill Test: Clinical Utility and Factors Associated With Its Use Among Physical Therapists. Phys Ther 2019; 99:428-439. [PMID: 30690630 DOI: 10.1093/ptj/pzy142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 09/04/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although the Fitkids Treadmill Test (FTT) has been validated and normative values are available for healthy 6- to 18-year-old children and adolescents, these facts do not automatically imply uptake of the test in routine practice of physical therapists. OBJECTIVE The objectives of this study were to evaluate the utility of the FTT in different diagnostic groups and to explore potential factors affecting the use of the FTT in clinical practice. DESIGN Mixed methods with both quantitative and qualitative data were used in this study. METHODS Outcome parameters from the FTT were retrieved from the Fitkids database. For evaluation of the utility of the FTT, 2 indicators, exercise duration and maximal effort, were used. An online survey was sent to physical therapists in Fitkids practices to identify factors affecting the use of the FTT in clinical practice. RESULTS The proportion of children and adolescents in each of the diagnostic groups who reached the minimal duration of a maximal exercise test ranged from 94% to 100%. The proportion of participants who reached a peak heart rate ≥180 beats/min ranged from 46% for participants with cognitive, psychological, or sensory disorders to 92% for participants with metabolic diseases. The most important facilitator for use of the FTT was the fact that most physical therapists were convinced of the additional value of the FTT. The main barriers were therapists' attitudes (resistance to change/lack of experience) and, on the environmental level, the absence of a treadmill ergometer in physical therapist practice. LIMITATIONS Structured interviews would have provided more information on potential factors affecting the use of the FTT in clinical practice. CONCLUSIONS This study has shown the clinical utility of the FTT in different diagnostic groups in pediatric physical therapist practice. Responding to the factors identified in this study should enable improved uptake of the FTT in clinical practice.
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Affiliation(s)
- Elles M W Kotte
- Fitkids Foundation, Box 75751, 1070 AT Amsterdam, the Netherlands
| | - Janke F de Groot
- University of Applied Science, Utrecht, the Netherlands; Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands; and Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Cindy Veenhof
- University of Applied Science; and University Medical Center Utrecht
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht
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Borges-Machado F, Ribeiro Ó, Sampaio A, Marques-Aleixo I, Meireles J, Carvalho J. Feasibility and Impact of a Multicomponent Exercise Intervention in Patients With Alzheimer's Disease: A Pilot Study. Am J Alzheimers Dis Other Demen 2019; 34:95-103. [PMID: 30525876 PMCID: PMC10852450 DOI: 10.1177/1533317518813555] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This quasi-experimental, nonrandomized study examined the feasibility and impact of a multicomponent (MT) intervention on 7 community-dwelling individuals diagnosed with probable Alzheimer's disease (AD) at mild to moderate stage. During 6 months, patients with AD and their caregivers were submitted to a biweekly exercise program, including muscle strengthening, aerobics, balance, and postural exercises. The following tests were used: Senior Fitness Test and Incremental Treadmill Test, Disability Assessment for Dementia Scale, Alzheimer Disease Assessment Scale-Cognitive, and Quality of Life-Alzheimer's. Attendance and retention mean rates were high (86% and 78%, respectively). No adverse events occurred. Results revealed a significant beneficial effect on cardiorespiratory fitness ( P = .028), upper ( P = .018) and lower ( P = .026) body muscle strength, agility ( P = .018), and ability to perform daily activities ( P = .018). Data suggest that a biweekly MT intervention is feasible to conduct in patients with AD. Findings also suggest a potential positive effect on mitigating cognitive decline and in positively influencing quality of life.
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Affiliation(s)
- Flávia Borges-Machado
- CIAFEL—Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
- Faculty of Sport, University of Porto, Porto, Portugal
| | - Óscar Ribeiro
- CINTESIS—Center for Health Technology and Services Research, Porto, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Arnaldina Sampaio
- CIAFEL—Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
- Faculty of Sport, University of Porto, Porto, Portugal
| | - Inês Marques-Aleixo
- CIAFEL—Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
- Lusófona University of Porto, Porto, Portugal
| | - Joana Meireles
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joana Carvalho
- CIAFEL—Research Centre in Physical Activity, Health and Leisure, Porto, Portugal
- Faculty of Sport, University of Porto, Porto, Portugal
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21
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Dougherty RJ, Lindheimer JB, Stegner AJ, Van Riper S, Okonkwo OC, Cook DB. An Objective Method to Accurately Measure Cardiorespiratory Fitness in Older Adults Who Cannot Satisfy Widely Used Oxygen Consumption Criteria. J Alzheimers Dis 2019; 61:601-611. [PMID: 29226867 DOI: 10.3233/jad-170576] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cardiorespiratory fitness (CRF) is routinely investigated in older adults; however, the most appropriate CRF measure to use for this population has received inadequate attention. This study aimed to 1) evaluate the reliability and validity of the oxygen uptake efficiency slope (OUES) as a sub-maximal measurement of CRF; 2) examine demographic, risk-factor, and exercise testing differences in older adults who satisfied standardized criteria for a peak oxygen consumption (V̇O2peak) test compared to those who did not; and 3) determine the difference between directly measured V̇O2peak values and OUES-predicted V̇O2peak values. One hundred ten enrollees from the Wisconsin Registry for Alzheimer's Prevention participated in this study. Participants performed a graded maximal exercise test and wore an accelerometer for 7 days. For each participant, the OUES was calculated at 75%, 90%, and 100% of exercise duration. V̇O2peak was recorded at peak effort, and one week of physical activity behavior was measured. OUES values calculated at separate relative exercise durations displayed excellent reliability (ICC = 0.995; p < 0.001), and were strongly correlated with V̇O2peak (rrange = 0.801-0.909; p < 0.001). As hypothesized, participants who did not satisfy V̇O2peak criteria were significantly older than those who satisfied criteria (p = 0.049) and attained a directly measured V̇O2peak that was 2.31 mL·kg·min-1 less than the value that was predicted by OUES V̇O2peak (p = 0.003). Older adults are less likely to satisfy V̇O2peak criteria, which results in an underestimation of their CRF. Without adhering to standardized criteria, V̇O2peak measurement error may lead to misinterpretation of CRF and age-related associations. Here, we conclude that OUES is a reliable, valid measurement of CRF which does not require achievement of standardized criteria.
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Affiliation(s)
- Ryan J Dougherty
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,Department of Kinesiology, University of Wisconsin School of Education, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jacob B Lindheimer
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,Department of Kinesiology, University of Wisconsin School of Education, Madison, WI, USA.,Department of Veterans Affairs, New Jersey Healthcare System, War Related Illness and Injury Study Center, East Orange, NJ, USA
| | - Aaron J Stegner
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,Department of Kinesiology, University of Wisconsin School of Education, Madison, WI, USA
| | - Stephanie Van Riper
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,Department of Kinesiology, University of Wisconsin School of Education, Madison, WI, USA
| | - Ozioma C Okonkwo
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Dane B Cook
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,Department of Kinesiology, University of Wisconsin School of Education, Madison, WI, USA
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Wong A, Kwak YS, Scott SD, Pekas EJ, Son WM, Kim JS, Park SY. The effects of swimming training on arterial function, muscular strength, and cardiorespiratory capacity in postmenopausal women with stage 2 hypertension. Menopause 2018; 26:653-658. [DOI: 10.1097/gme.0000000000001288] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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23
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Impact of Aging on Endurance and Neuromuscular Physical Performance: The Role of Vascular Senescence. Sports Med 2018; 47:583-598. [PMID: 27459861 DOI: 10.1007/s40279-016-0596-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The portion of society aged ≥60 years is the fastest growing population in the Western hemisphere. Aging is associated with numerous changes to systemic physiology that affect physical function and performance. We present a narrative review of the literature aimed at discussing the age-related changes in various metrics of physical performance (exercise economy, anaerobic threshold, peak oxygen uptake, muscle strength, and power). It also explores aging exercise physiology as it relates to global physical performance. Finally, this review examines the vascular contributions to aging exercise physiology. Numerous studies have shown that older adults exhibit substantial reductions in physical performance. The process of decline in endurance capacity is particularly insidious over the age of 60 years and varies considerably as a function of sex, task specificity, and individual training status. Starting at the age of 50 years, aging also implicates an impressive deterioration of neuromuscular function, affecting muscle strength and power. Muscle atrophy, together with minor deficits in the structure and function of the nervous system and/or impairments in intrinsic muscle quality, plays an important role in the development of neuromotor senescence. Large artery stiffness increases as a function of age, thus triggering subsequent changes in pulsatile hemodynamics and systemic endothelial dysfunction. For this reason, we propose that vascular senescence has a negative impact on cerebral, cardiac, and neuromuscular structure and function, detrimentally affecting physical performance.
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24
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The Reliability and Validity of a Modified Squat Test to Predict Cardiopulmonary Fitness in Healthy Older Men. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4863454. [PMID: 29487868 PMCID: PMC5816896 DOI: 10.1155/2018/4863454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/16/2017] [Indexed: 12/20/2022]
Abstract
Background Shortcomings are noted in currently available cardiopulmonary field tests for the older adult and thus relevant research is still ongoing. Purpose The purpose of this study was to investigate the reliability and validity of a modified squat test and to establish a regression model for predicting aerobic fitness in the older adult. Methods Twenty-five healthy men aged 60 to 75 years completed this study. Each subject performed two modified squat tests with a prototype testing equipment and a maximal exercise test to determine maximal oxygen consumption. Recovery heart rates (HR) (0~30, 60~90, and 120~150 seconds) were measured following the modified squat tests. The fitness indexes included the sum of recovery HR, recovery HR index, age-adjusted recovery HR index, and immediate HR. Results The results revealed that the age-adjusted recovery HR index fitness had the highest intraclass correlation coefficients (ICC) of 0.9 and Pearson's correlation coefficients of 0.71, which suggested the modified squat test can reasonably assess cardiopulmonary fitness for the older adult. The regression equation for estimating aerobic power was [Formula: see text] = 16.781 + 16.732 × (age-adjusted recovery HR index) + 0.02467 × (physical activity level). Conclusion The modified squat test is a valid and reliable field test and thus can be an option to assess the cardiopulmonary fitness level of healthy older men in clinics or communities.
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25
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Combined exercise reduces arterial stiffness, blood pressure, and blood markers for cardiovascular risk in postmenopausal women with hypertension. Menopause 2018; 24:262-268. [PMID: 27779565 DOI: 10.1097/gme.0000000000000765] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Postmenopausal women exhibit elevated brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, which is associated with an increased risk of cardiovascular events and mortality. The purpose of this study is to examine the impact of combined resistance and aerobic exercise training on baPWV, blood pressure (BP), and cardiovascular fitness in postmenopausal women with stage 1 hypertension. METHODS Twenty postmenopausal women (age, 75 ± 2 y; systolic BP, 152 ± 2 mm Hg, diastolic BP, 95 ± 3 mm Hg) were randomly assigned to a "no-exercise" (CON, n = 10) or combined exercise (EX, n = 10) group. The EX group performed resistance and aerobic exercise for 12 weeks, 3 times per week. Exercise intensity was increased gradually, from 40% to 70% of heart rate reserve, every 4 weeks. BaPWV, BP, blood nitrite/nitrate, endothelin-1 (ET-1), cardiovascular fitness, and body composition were measured before and after the 12-week intervention. RESULTS BP, baPWV (-1.2 ± 0.4 m/s), ET-1 (-2.7 ± 0.3 μmol/mL), nitrite/nitrate (+4.5 ± 0.5 μM), functional capacity, and body composition were significantly improved (P < 0.05) in the EX group after 12 weeks of training, but no changes were observed in the CON group. CONCLUSIONS These findings indicate that 12 weeks of combined exercise training improves arterial stiffness, BP, ET-1, blood nitrite/nitrate, functional capacity, and body composition in postmenopausal women with stage 1 hypertension. Thus, this study provides evidence that combined exercise training is a useful therapeutic method to improve cardiovascular health which can reduce cardiovascular disease risk in postmenopausal women with hypertension.
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26
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Marker RJ, Cox-Martin E, Jankowski CM, Purcell WT, Peters JC. Evaluation of the effects of a clinically implemented exercise program on physical fitness, fatigue, and depression in cancer survivors. Support Care Cancer 2017; 26:1861-1869. [PMID: 29270829 DOI: 10.1007/s00520-017-4019-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 12/10/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Despite national recommendations, exercise programs are still not clinically implemented as standard of care for cancer survivors. This investigation examined the effects of a clinically implemented and personalized exercise program on physical fitness, fatigue, and depression in a diverse population of cancer survivors. The association of various participant characteristics on program performance was also examined. METHODS Data were collected from 170 cancer survivors who had participated in a clinical exercise program. Any cancer type was included and survivors were either undergoing medical treatment or had completed treatment (< 6 months prior to program initiation). Baseline and post program measures of estimated VO2peak, grip strength, fatigue, and depression were compared in survivors who completed the program follow-up. Multiple regressions were performed to investigate the association of age, gender, body mass index (BMI), and medical treatment status on baseline and change scores in outcome measures, as well as program adherence. RESULTS All measures improved in participants who completed the program (p < 0.01). Age, gender, and BMI were associated with baseline measures of estimated VO2peak and grip strength (p < 0.01), and age was inversely associated with baseline fatigue (p = 0.02). Only BMI was inversely associated with change in estimated VO2peak (p < 0.01). No participant characteristics or baseline measures were predictive of program adherence (p > 0.05). CONCLUSION This investigation provides evidence that a personalized, clinical exercise program can be effective at improving physical fitness, fatigue, and depression in a diverse population of cancer survivors.
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Affiliation(s)
- Ryan J Marker
- Department of Physical Therapy, School of Health Sciences and Human Performance, Ithaca College, Ithaca, NY, USA.
| | - Emily Cox-Martin
- Division of Medical Oncology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - W Thomas Purcell
- Division of Medical Oncology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John C Peters
- Anschutz Health and Wellness Center, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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27
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Billinger SA, Vidoni ED, Morris JK, Thyfault JP, Burns JM. Exercise Test Performance Reveals Evidence of the Cardiorespiratory Fitness Hypothesis. J Aging Phys Act 2017; 25:240-246. [PMID: 27705069 PMCID: PMC5374040 DOI: 10.1123/japa.2015-0321] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Positive physiologic and cognitive responses to aerobic exercise have resulted in a proposed cardiorespiratory (CR) fitness hypothesis in which fitness gains drive changes leading to cognitive benefit. The purpose of this study was to directly assess the CR fitness hypothesis. Using data from an aerobic exercise trial, we examined individuals who completed cardiopulmonary and cognitive testing at baseline and 26 weeks. Change in cognitive test performance was not related to CR fitness change (r2 = .06, p = .06). However, in the subset of individuals who gave excellent effort during exercise testing, change in cognitive test performance was related to CR fitness change (r2 = .33, p < .01). This was largely due to change in the cognitive domain of attention (r2 = .36, p < .01). The magnitude of change was not explained by duration of exercise. Our findings support further investigation of the CR fitness hypothesis and mechanisms by which physiologic adaptation may drive cognitive change.
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28
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Varma VR, Watts A. Daily Physical Activity Patterns During the Early Stage of Alzheimer's Disease. J Alzheimers Dis 2017; 55:659-667. [PMID: 27716669 PMCID: PMC5859579 DOI: 10.3233/jad-160582] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a neurodegenerative disease that results in severe disability. Very few studies have explored changes in daily physical activity patterns during early stages of AD when components of physical function and mobility may be preserved. OBJECTIVE Our study explored differences in daily physical activity profiles, independent of the effects of non-cognitive factors including physical function and age, among individuals with mild AD compared to controls. METHODS Patients with mild AD and controls (n = 92) recruited from the University of Kansas Alzheimer's Disease Center Registry, wore the Actigraph GT3X+ for seven days, and provided objective physical function (VO2 max) and mobility data. Using multivariate linear regression, we explored whether individuals with mild AD had different daily average and diurnal physical activity patterns compared to controls independent of non-cognitive factors that may affect physical activity, including physical function and mobility. RESULTS We found that mild AD was associated with less moderate-intensity physical activity (p < 0.05), lower peak activity (p < 0.01), and lower physical activity complexity (p < 0.05) particularly during the morning. Mild AD was not associated with greater sedentary activity or less lower-intensity physical activity across the day after adjusting for non-cognitive covariates. CONCLUSIONS These findings suggest that factors independent of physical capacity and mobility may drive declines in moderate-intensity physical activity, and not lower-intensity or sedentary activity, during the early stage of AD. This underscores the importance of a better mechanistic understanding of how cognitive decline and AD pathology impact physical activity. Findings emphasize the potential value of designing and testing time-of-day specific physical activity interventions targeting individuals in the early stages of AD, prior to significant declines in mobility and physical function.
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Affiliation(s)
- Vijay R. Varma
- Clinical and Translational Neuroscience Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
| | - Amber Watts
- Department of Clinical Psychology, University of Kansas, Lawrence, KS, USA
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Billat V, Dhonneur G, Mille-Hamard L, Le Moyec L, Momken I, Launay T, Koralsztein JP, Besse S. Case Studies in Physiology: Maximal oxygen consumption and performance in a centenarian cyclist. J Appl Physiol (1985) 2016; 122:430-434. [PMID: 28035015 DOI: 10.1152/japplphysiol.00569.2016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 12/08/2016] [Accepted: 12/20/2016] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to examine the physiological characteristics of an elite centenarian cyclist who, at 101 yr old, established the 1-h cycling record for individuals ≥100 yr old (24.25 km) and to determine the physiological factors associated with his performance improvement 2 yr later at 103 yr old (26.92 km; +11%). Before each record, he performed an incremental test on a cycling ergometer. For 2 yr, he trained 5,000 km/yr with a polarized training that involved cycling 80% of mileage at "light" rate of perceived exertion (RPE) ≤12 and 20% at "hard" RPE ≥15 at a cadence between 50 and 70 rpm. His body weight and lean body mass did not change, while his maximal oxygen consumption (V̇o2max) increased (31-35 ml·kg-1·min-1; +13%). Peak power output increased from 90 to 125 W (+39%), mainly because of increasing the maximal pedaling frequency (69-90 rpm; +30%). Maximal heart rate did not change (134-137 beats/min) in contrast to the maximal ventilation (57-70 l/min, +23%), increasing with both the respiratory frequency (38-41 cycles/min; +8%) and the tidal volume (1.5-1.7 liters; +13%). Respiratory exchange ratio increased (1.03-1.14) to the same extent as tolerance to V̇co2 In conclusion, it is possible to increase performance and V̇o2max with polarized training focusing on a high pedaling cadence even after turning 100 yr old.NEW & NOTEWORTHY This study shows, for the first time, that maximal oxygen consumption (+13%) and performance (+11%) can still be increased between 101 and 103 yr old with 2 yr of training and that a centenarian is able, at 103 yr old, to cover 26.9 km/h in 1 h.
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Affiliation(s)
- Véronique Billat
- Unit of Integrative Biology of Adaptations to Exercise, EA 7362, Université d'Evry Val d'Essonne, Genopole, Evry, France;
| | - Gilles Dhonneur
- Surgical Intensive Care Unit-Trauma Center, Department of Anaesthesiology and Critical Care Medicine, Université Paris-Est Créteil and Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France
| | - Laurence Mille-Hamard
- Unit of Integrative Biology of Adaptations to Exercise, EA 7362, Université d'Evry Val d'Essonne, Genopole, Evry, France
| | - Laurence Le Moyec
- Unit of Integrative Biology of Adaptations to Exercise, EA 7362, Université d'Evry Val d'Essonne, Genopole, Evry, France
| | - Iman Momken
- Unit of Integrative Biology of Adaptations to Exercise, EA 7362, Université d'Evry Val d'Essonne, Genopole, Evry, France
| | - Thierry Launay
- Unit of Integrative Biology of Adaptations to Exercise, EA 7362, Université d'Evry Val d'Essonne, Genopole, Evry, France.,Université Sorbonne Paris Cité, Paris, France; and
| | | | - Sophie Besse
- Unit of Integrative Biology of Adaptations to Exercise, EA 7362, Université d'Evry Val d'Essonne, Genopole, Evry, France.,Université Sorbonne Paris Cité, Paris, France; and
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Perea RD, Vidoni ED, Morris JK, Graves RS, Burns JM, Honea RA. Cardiorespiratory fitness and white matter integrity in Alzheimer's disease. Brain Imaging Behav 2016; 10:660-8. [PMID: 26239997 PMCID: PMC4740273 DOI: 10.1007/s11682-015-9431-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of this study was to investigate the relationship between cardiorespiratory (CR) fitness and the brain's white matter tract integrity using diffusion tensor imaging (DTI) in the Alzheimer's disease (AD) population. We recruited older adults in the early stages of AD (n = 37; CDR = 0.5 and 1) and collected cross-sectional fitness and diffusion imaging data. We examined the association between CR fitness (peak oxygen consumption [VO2peak]) and fractional anisotropy (FA) in AD-related white matter tracts using two processing methodologies: a tract-of-interest approach and tract-based spatial statistic (TBSS). Subsequent diffusivity metrics (radial diffusivity [RD], mean diffusivity [MD], and axial diffusivity [A × D]) were also correlated with VO2peak. The tract-of-interest approach showed that higher VO2peak was associated with preserved white matter integrity as measured by increased FA in the right inferior fronto-occipital fasciculus (p = 0.035, r = 0.36). We did not find a significant correlation using TBSS, though there was a trend for a positive association between white matter integrity and higher VO2peak measures (p < 0.01 uncorrected). Our findings indicate that higher CR fitness levels in early AD participants may be related to preserved white matter integrity. However to draw stronger conclusions, further study on the relationship between fitness and white matter deterioration in AD is necessary.
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Affiliation(s)
- RD. Perea
- Dept. of Neurology and KU Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS
- Bioengineering Program, The University of Kansas, Lawrence, KS
| | - ED. Vidoni
- Dept. of Neurology and KU Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS
| | - JK. Morris
- Dept. of Neurology and KU Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS
| | - RS. Graves
- Dept. of Neurology and KU Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS
| | - JM. Burns
- Dept. of Neurology and KU Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS
| | - RA. Honea
- Dept. of Neurology and KU Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS
- Bioengineering Program, The University of Kansas, Lawrence, KS
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Watts A, Walters RW, Hoffman L, Templin J. Intra-Individual Variability of Physical Activity in Older Adults With and Without Mild Alzheimer's Disease. PLoS One 2016; 11:e0153898. [PMID: 27097226 PMCID: PMC4838328 DOI: 10.1371/journal.pone.0153898] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/05/2016] [Indexed: 02/02/2023] Open
Abstract
Physical activity shows promise for protection against cognitive decline in older adults with and without Alzheimer's disease (AD). To better understand barriers to adoption of physical activity in this population, a clear understanding of daily and weekly activity patterns is needed. Most accelerometry studies report average physical activity over an entire wear period without considering the potential importance of the variability of physical activity. This study evaluated individual differences in the amount and intra-individual variability of physical activity and determined whether these differences could be predicted by AD status, day of wear, age, gender, education, and cardiorespiratory capacity. Physical activity was measured via accelerometry (Actigraph GT3X+) over one week in 86 older adults with and without AD (n = 33 and n = 53, respectively). Mixed-effects location-scale models were estimated to evaluate and predict individual differences in the amount and intra-individual variability of physical activity. Results indicated that compared to controls, participants with AD averaged 21% less activity, but averaged non-significantly greater intra-individual variability. Women and men averaged similar amounts of physical activity, but women were significantly less variable. The amount of physical activity differed significantly across days of wear. Increased cardiorespiratory capacity was associated with greater average amounts of physical activity. Investigation of individual differences in the amount and intra-individual variability of physical activity provided insight into differences by AD status, days of monitor wear, gender, and cardiovascular capacity. All individuals regardless of AD status were equally consistent in their physical activity, which may have been due to a highly sedentary sample and/or the early disease stage of those participants with AD. These results highlight the value of considering individual differences in both the amount and intra-individual variability of physical activity.
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Affiliation(s)
- Amber Watts
- Department of Clinical Psychology, KU Alzheimer’s Disease Center, University of Kansas, Lawrence, Kansas, United States of America
| | - Ryan W. Walters
- Department of Medicine, Creighton University, Omaha, Nebraska, United States of America
| | - Lesa Hoffman
- Research Design and Analysis Unit, Schiefelbusch Institute for Lifespan Studies, University of Kansas, Lawrence, Kansas, United States of America
| | - Jonathan Templin
- Department of Educational Psychology, University of Kansas, Lawrence, Kansas, United States of America
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KOTTE ELLESMW, DE GROOT JANKEF, BONGERS BARTC, WINKLER ALEXANDERMF, TAKKEN TIM. Validity and Reproducibility of a New Treadmill Protocol. Med Sci Sports Exerc 2015; 47:2241-7. [DOI: 10.1249/mss.0000000000000657] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lange-Maia BS, Strotmeyer ES, Harris TB, Glynn NW, Simonsick EM, Brach JS, Cauley JA, Richey PA, Schwartz AV, Newman AB. Physical Activity and Change in Long Distance Corridor Walk Performance in the Health, Aging, and Body Composition Study. J Am Geriatr Soc 2015; 63:1348-54. [PMID: 26096803 DOI: 10.1111/jgs.13487] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the prospective relationship between self-reported physical activity and aerobic fitness in the Health, Aging, and Body Composition Study (Health ABC) using the Long Distance Corridor Walk (LDCW). DESIGN Cohort study with 7 years of follow-up. SETTING Two U.S. clinical sites. PARTICIPANTS Community-dwelling older adults enrolled in Health ABC (N = 3,075, aged 70-79, 52% female, 42% black) with no self-reported difficulty walking one-quarter of a mile or climbing 10 steps. MEASUREMENTS Participants were classified based on a physical activity questionnaire as being inactive (≤1,000 kcal/wk exercise activity, ≤2,719 kcal/wk total physical activity), lifestyle active (≤1,000 kcal/wk exercise activity, >2,719 kcal/wk total physical activity), or exercisers (≥1,000 kcal/wk exercise activity). The LDCW, an endurance walking test (400 m), was administered at Years 1 (baseline), 2, 4, 6, and 8 to assess aerobic fitness. RESULTS At baseline, LDCW completion times (adjusted for age and sex) were 351.8 seconds (95% confidence interval (CI) = 346.9-356.8 seconds) for the inactive group, 335.9 seconds (95% CI = 332.7-339.1 seconds) for the lifestyle active group, and 307.7 seconds (95% CI = 303.2-312.3 seconds) for the exerciser group (P < .001). From baseline to Year 8, the inactive group slowed 36.1 seconds (95% CI = 28.4-43.8 seconds), the lifestyle active group slowed 38.1 seconds (95% CI = 33.6-42.4 seconds), and the exerciser group slowed 40.8 seconds (95% CI = 35.2-46.5 seconds), and did not differ significantly between groups. In linear mixed-effects models, the rate of change in LDCW time did not differ between the groups, although exercisers consistently had the fastest completion times (P < .001 for all pairwise comparisons). CONCLUSION Decline in LDCW time occurred regardless of baseline activity, although exercisers maintained higher aerobic fitness, which may delay reaching a critically low threshold of aerobic fitness at which independence is impaired.
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Affiliation(s)
- Brittney S Lange-Maia
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elsa S Strotmeyer
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland
| | - Nancy W Glynn
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Jennifer S Brach
- Department of Physical Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jane A Cauley
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Phyllis A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California
| | - Anne B Newman
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Zlatar ZZ, McGregor KM, Towler S, Nocera JR, Dzierzewski JM, Crosson B. Self-reported physical activity and objective aerobic fitness: differential associations with gray matter density in healthy aging. Front Aging Neurosci 2015; 7:5. [PMID: 25691866 PMCID: PMC4315095 DOI: 10.3389/fnagi.2015.00005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/15/2015] [Indexed: 11/26/2022] Open
Abstract
Aerobic fitness (AF) and self-reported physical activity (srPA) do not represent the same construct. However, many exercise and brain aging studies interchangeably use AF and srPA measures, which may be problematic with regards to how these metrics are associated with brain outcomes, such as morphology. If AF and PA measures captured the same phenomena, regional brain volumes associated with these measures should directly overlap. This study employed the general linear model to examine the differential association between objectively-measured AF (treadmill assessment) and srPA (questionnaire) with gray matter density (GMd) in 29 cognitively unimpaired community-dwelling older adults using voxel based morphometry. The results show significant regional variance in terms of GMd when comparing AF and srPA as predictors. Higher AF was associated with greater GMd in the cerebellum only, while srPA displayed positive associations with GMd in occipito-temporal, left perisylvian, and frontal regions after correcting for age. Importantly, only AF level, and not srPA, modified the relationship between age and GMd, such that higher levels of AF were associated with increased GMd in older age, while decreased GMd was seen in those with lower AF as a function of age. These results support existing literature suggesting that both AF and PA exert beneficial effects on GMd, but only AF served as a buffer against age-related GMd loss. Furthermore, these results highlight the need for use of objective PA measurement and comparability of tools across studies, since results vary dependent upon the measures used and whether these are objective or subjective in nature.
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Affiliation(s)
- Zvinka Z Zlatar
- Department of Psychiatry, Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Keith M McGregor
- Department of Neurology, Emory University Atlanta, GA, USA ; Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center Decatur, GA, USA
| | - Stephen Towler
- Department of Neurology, Emory University Atlanta, GA, USA ; Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center Decatur, GA, USA
| | - Joe R Nocera
- Department of Neurology, Emory University Atlanta, GA, USA ; Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center Decatur, GA, USA
| | - Joseph M Dzierzewski
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System Los Angeles, CA, USA ; David Geffen School of Medicine, University of California, Los Angeles Los Angeles, CA, USA
| | - Bruce Crosson
- Department of Neurology, Emory University Atlanta, GA, USA ; Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center Decatur, GA, USA ; Department of Psychology, Georgia State University Atlanta, GA, USA
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Paap D, Takken T. Reference values for cardiopulmonary exercise testing in healthy adults: a systematic review. Expert Rev Cardiovasc Ther 2014; 12:1439-53. [DOI: 10.1586/14779072.2014.985657] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tian Q, Simonsick EM, Erickson KI, Aizenstein HJ, Glynn NW, Boudreau RM, Newman AB, Kritchevsky SB, Yaffe K, Harris T, Rosano C. Cardiorespiratory fitness and brain diffusion tensor imaging in adults over 80 years of age. Brain Res 2014; 1588:63-72. [PMID: 25204690 DOI: 10.1016/j.brainres.2014.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/22/2014] [Accepted: 09/01/2014] [Indexed: 12/21/2022]
Abstract
A positive association between cardiorespiratory fitness (CRF) and white matter integrity has been consistently reported in older adults. However, it is unknown whether this association exists in adults over 80 with a range of chronic disease conditions and low physical activity participation, which can influence both CRF and brain health. This study examined whether higher CRF was associated with greater microstructural integrity of gray and white matter in areas related to memory and information processing in adults over 80 and examined moderating effects of chronic diseases and physical activity. CRF was measured as time to walk 400 m as quickly as possible with concurrent 3T diffusion tensor imaging in 164 participants (57.1% female, 40.3% black). Fractional anisotropy (FA) was computed for cingulum, uncinate and superior longitudinal fasciculi. Mean diffusivity (MD) was computed for dorsolateral prefrontal cortex, hippocampus, parahippocampus, and entorhinal cortex. Moderating effects were tested using hierarchical regression models. Higher CRF was associated with higher FA in cingulum and lower MD in hippocampus and entorhinal cortex (β, sex-adjusted p: -0.182, 0.019; 0.165, 0.035; and 0.220, 0.006, respectively). Hypertension attenuated the association with MD in entorhinal cortex. Moderating effects of chronic diseases and physical activity in walking and climbing stairs on these associations were not significant. The association of higher CRF with greater microstructural integrity in selected subcortical areas appears robust, even among very old adults with a range of chronic diseases. Intervention studies should investigate whether increasing CRF can preserve memory and information processing by improving microstructure and potential effects of hypertension management.
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Affiliation(s)
- Qu Tian
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD 21225, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Howard J Aizenstein
- Departments of Psychiatry, Bioengineering, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen B Kritchevsky
- Sticht Center on Aging, Section on Gerontology and Geriatric, Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology and Epidemiology, University of California, San Francisco, San Francisco, CA 94121, USA
| | - Tamara Harris
- Intramural Research Program, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD, USA
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Yazdanyar A, Aziz MM, Enright PL, Edmundowicz D, Boudreau R, Sutton-Tyrell K, Kuller L, Newman AB. Association Between 6-Minute Walk Test and All-Cause Mortality, Coronary Heart Disease-Specific Mortality, and Incident Coronary Heart Disease. J Aging Health 2014; 26:583-599. [PMID: 24695552 DOI: 10.1177/0898264314525665] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine the association between 6-min walk test (6 MWT) performance and all-cause mortality, coronary heart disease mortality, and incident coronary heart disease in older adults. METHOD We conducted a time-to-event analysis of 1,665 Cardiovascular Health Study participants without prevalent cardiovascular disease with a 6 MWT. RESULTS During a mean follow-up of 8 years, there were 305 incident coronary heart disease events, and 504 deaths of which 100 were coronary heart disease-related deaths. The 6 MWT performance in the shortest two distance quintiles was associated with increased risk of all-cause mortality (290-338 m: hazard ratio [HR] = 1.7; 95% confidence interval [CI] = [1.2, 2.5]; <290 m: HR = 2.1; 95% CI = [1.4, 3.0]). The adjusted risk of coronary heart disease mortality incident events among those with a 6 MWT < 290 m was not significant. DISCUSSION Performance on the 6 MWT is independently associated with all-cause mortality and is of prognostic utility in community-dwelling older adults.
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Watts AS, Vidoni ED, Loskutova N, Johnson DK, Burns JM. Measuring Physical Activity in Older Adults with and without Early Stage Alzheimer's Disease. Clin Gerontol 2013; 36:356-374. [PMID: 24062599 PMCID: PMC3778925 DOI: 10.1080/07317115.2013.788116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We compared subjective reports of physical activity with objective measures of physical fitness including cardiorespiratory capacity, body composition, and physical performance in 146 older adults with and without early stage Alzheimer's disease (ESAD). Respondents reported primarily unstructured and low-intensity activities, including walking and housework. Individuals with ESAD participated in fewer and lower intensity physical activities than those without ESAD. In those without ESAD, housework was related to lower body mass index, leisure walking was related to faster speed on a timed walking test, and participation in sports was related to higher peak oxygen intake. In individuals with ESAD, reported physical activities did not predict any of the physical fitness, body composition, or physical performance measures. We conclude that measures of physical activity require expansion of unstructured and low intensity activities to improve sensitivity in sedentary populations, especially in older adults with ESAD.
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Affiliation(s)
- Amber S Watts
- Lifespan Institute, Gerontology Center, University of Kansas ; Center for Research Methods and Data Analysis, University of Kansas ; Department of Psychology, University of Kansas
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Alzheimer disease alters the relationship of cardiorespiratory fitness with brain activity during the stroop task. Phys Ther 2013; 93:993-1002. [PMID: 23559521 PMCID: PMC3704231 DOI: 10.2522/ptj.20120465] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite mounting evidence that physical activity has positive benefits for brain and cognitive health, there has been little characterization of the relationship between cardiorespiratory (CR) fitness and cognition-associated brain activity as measured by functional magnetic resonance imaging (fMRI). The lack of evidence is particularly glaring for diseases such as Alzheimer disease (AD) that degrade cognitive and functional performance. OBJECTIVE The aim of this study was to describe the relationship between regional brain activity during cognitive tasks and CR fitness level in people with and without AD. DESIGN A case-control, single-observation study design was used. METHODS Thirty-four individuals (18 without dementia and 16 in the earliest stages of AD) completed maximal exercise testing and performed a Stroop task during fMRI. RESULTS Cardiorespiratory fitness was inversely associated with anterior cingulate activity in the participants without dementia (r=-.48, P=.05) and unassociated with activation in those with AD (P>.7). Weak associations of CR fitness and middle frontal cortex were noted. LIMITATIONS The wide age range and the use of a single task in fMRI rather than multiple tasks challenging different cognitive capacities were limitations of the study. CONCLUSIONS The results offer further support of the relationship between CR fitness and regional brain activity. However, this relationship may be attenuated by disease. Future work in this area may provide clinicians and researchers with interpretable and dependable regional fMRI biomarker signatures responsive to exercise intervention. It also may shed light on mechanisms by which exercise can support cognitive function.
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Aerobic capacity reference data in 3816 healthy men and women 20-90 years. PLoS One 2013; 8:e64319. [PMID: 23691196 PMCID: PMC3654926 DOI: 10.1371/journal.pone.0064319] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/10/2013] [Indexed: 11/19/2022] Open
Abstract
Purpose To provide a large reference material on aerobic fitness and exercise physiology data in a healthy population of Norwegian men and women aged 20–90 years. Methods Maximal and sub maximal levels of VO2, heart rate, oxygen pulse, and rating of perceived exertion (Borg scale: 6–20) were measured in 1929 men and 1881 women during treadmill running. Results The highest VO2max and maximal heart rate among men and women were observed in the youngest age group (20–29 years) and was 54.4±8.4 mL·kg−1·min−1 and 43.0±7.7 mL·kg−1·min−1 (sex differences, p<0.001) and 196±10 beats·min−1 and 194±9 beats·min−1 (sex differences, p<0.05), respectively, with a subsequent reduction of approximately 3.5 mL·kg−1·min−1 and 6 beats·min−1 per decade. The highest oxygen pulses were observed in the 3 youngest age groups (20–29 years, 30–39 years, 40–49 years) among men and women; 22.3 mL·beat−1±3.6 and 14.7 mL·beat−1±2.7 (sex differences, p<0.001), respectively, with no significant difference between these age groups. After the age of 50 we observed an 8% reduction per decade among both sexes. Borg scores appear to give a good estimate of the relative exercise intensity, although observing a slightly different relationship than reported in previous reference material from small populations. Conclusion This is the largest European reference material of objectively measured parameters of aerobic fitness and exercise-physiology in healthy men and women aged 20–90 years, forming the basis for an easily accessible, valid and understandable tool for improved training prescription in healthy men and women.
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Bouchard DR, Langlois MF, Boisvert-Vigneault K, Farand P, Paulin M, Baillargeon JP. Pilot study: can older inactive adults learn how to reach the required intensity of physical activity guideline? Clin Interv Aging 2013; 8:501-8. [PMID: 23662053 PMCID: PMC3646485 DOI: 10.2147/cia.s42224] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Most individuals do not reach the recommended physical activity level of at least 150 minutes of aerobic exercise (AE) at moderate-to-vigorous intensity per week. For example, only 13% of older Canadian adults reach World Health Organization physical activity guideline (PAG). One of the reasons might be a difficulty identifying the required intensity. Twenty-five inactive older adults received one session about the AE-PAG and how to use a tool or strategy to help them identify AE intensity: heart-rate (HR) monitor (% of maximal HR; N = 9); manual pulse (% of maximal HR; N = 8); or pedometer (walking cadence; N = 8). Participants had 8 weeks to implement their specific tool with the aim of reaching the PAG by walking at home. At pre- and post-intervention, the capacity to identify AE intensity and AE time spent at moderate-to-vigorous intensity were evaluated. Only the two groups using a tool increased total AE time (both P < 0.01), but no group improved the time spent at moderate-to-vigorous intensity. No significant improvement was observed in the ability to correctly identify AE intensity in any of the groups, but a tendency was observed in the pedometer group (P = 0.07). Using walking cadence with a pedometer should be explored as a tool to reach the PAG as it is inexpensive, easy to use, and seemed the best tool to improve both AE time and perception of intensity.
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Validity of the step test for exercise prescription: no extension to a larger age range. J Aging Phys Act 2012; 21:444-54. [PMID: 23238135 DOI: 10.1123/japa.21.4.444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to determine the validity of a submaximal exercise test, the Step Test Exercise Prescription (STEP), in a broad age range and in individuals in the earliest stages of Alzheimer's disease (AD). Individuals (n = 102) underwent treadmill-based maximal exercise testing and a STEP. The STEP failed to predict peak oxygen consumption (VO2peak), and was a biased estimate of VO2peak (p < .0001). Only 43% of subjects' STEP results were within 3.5 ml · kg-1 · min-1 of VO2peak. When categorized into fitness levels these 2 measures demonstrated moderate agreement (kappa = .59). The validity of the STEP was not supported in our participants, including those with AD. The STEP may not be appropriate in the clinic as a basis for exercise recommendations in these groups, although it may continue to have utility in classifying fitness in research or community health screenings.
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Vidoni ED, Billinger SA, Lee C, Hamilton J, Burns JM. The physical performance test predicts aerobic capacity sufficient for independence in early-stage Alzheimer disease. J Geriatr Phys Ther 2012; 35:72-8. [PMID: 22020383 DOI: 10.1519/jpt.0b013e318232bf61] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Early identification of physical impairment related to Alzheimer disease (AD) is increasingly identified as an important aspect of diagnosis and care. Clinically accessible tools for evaluating physical capacity and impairment in AD have been developed but require further characterization for their effective use. PURPOSE To assess the utility of the Physical Performance Test (PPT) for identifying functionally limiting aerobic capacity in older adults with AD and without dementia. METHODS Secondary analysis of a dataset of community dwelling older adults, 70 without dementia and 60 with early-stage AD. Participants were administered the PPT and performed a graded maximal exercise test. The clinical utility of 2 versions of the PPT was described by determining sensitivity and specificity to functionally limiting aerobic capacity. RESULTS The 9-item PPT is predictive of diminished aerobic capacity in older adults with AD. A score of 28 or less indicates likelihood of functionally limiting aerobic capacity that would limit independent function with 67% sensitivity and 67% specificity. The 4-item mini-PPT demonstrates improved capability for identifying impaired functional aerobic capacity with 85% sensitivity and 62% specificity. The PPT was not useful for identifying impaired functional aerobic capacity in older adults without dementia. CONCLUSIONS The PPT, which incorporates basic and instrumental activities of daily living as test items, and the mini-PPT which focuses on basic activities of daily living and simple physical functions, are both clinically useful tool for the evaluation for individuals in the earliest stages of AD and both provide important information about functional performance. The mini-PPT additionally inform the clinician as to whether or not individual with early-stage AD is likely to have insufficient aerobic capacity to perform instrumental daily functions.
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Affiliation(s)
- Eric D Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA.
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Billinger SA, Vidoni ED, Honea RA, Burns JM. Cardiorespiratory response to exercise testing in individuals with Alzheimer's disease. Arch Phys Med Rehabil 2012; 92:2000-5. [PMID: 22133248 DOI: 10.1016/j.apmr.2011.07.194] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 07/20/2011] [Accepted: 07/21/2011] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine exercise testing response in Alzheimer's disease (AD) and possible disease-related change over time. DESIGN Retrospective assessment of a 2-year observational study. SETTING University medical center. PARTICIPANTS Individuals without dementia (n=50) and with AD (n=31). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants underwent a clinical dementia evaluation and performed an incremental exercise test using a treadmill and the modified Bruce protocol at baseline and at a 2-year follow-up. We examined oxygen consumption, minute ventilation, heart rate, and ventilatory equivalents for oxygen and carbon dioxide at submaximal and peak exercise intensities to determine whether the measures were different between groups or over time. RESULTS Participants with AD and those without dementia performed similarly at submaximal effort, and both groups showed similar changes in exercise response over 2 years. However, nondemented individuals had consistently higher values of oxygen consumption (P≤.02) and minute ventilation at peak effort at baseline (P=.003). CONCLUSIONS Individuals with AD demonstrate physiologic responses to submaximal exercise effort that are not significantly different than individuals without dementia. However, differences are apparent at the extreme of effort.
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Affiliation(s)
- Sandra A Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, USA
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Irie M, Nakanishi R, Hamada K, Kido M. Perioperative Short-term Pulmonary Rehabilitation for Patients Undergoing Lung Volume Reduction Surgery. COPD 2011; 8:444-9. [DOI: 10.3109/15412555.2011.626816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vidoni ED, Honea RA, Billinger SA, Swerdlow RH, Burns JM. Cardiorespiratory fitness is associated with atrophy in Alzheimer's and aging over 2 years. Neurobiol Aging 2011; 33:1624-32. [PMID: 21531480 DOI: 10.1016/j.neurobiolaging.2011.03.016] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 02/22/2011] [Accepted: 03/21/2011] [Indexed: 11/17/2022]
Abstract
We sought to describe change in cardiorespiratory (CR) fitness over 2 years in those with early-stage Alzheimer's disease (AD) and nondemented aging and assess the relationship of CR fitness with cognitive decline, brain atrophy, and dementia progression. Individuals with early-stage AD (n = 37) and without dementia (n = 53) attended clinical evaluations, cognitive and exercise tests, and magnetic resonance imaging (MRI) at baseline and 2 years later. CR fitness was lower in those with AD over the study period. Lower baseline CR fitness was associated with progression of dementia severity in AD. Declining CR fitness over 2 years was associated with brain atrophy in AD, especially in the parahippocampus. In nondemented participants, there was a trend for lower baseline fitness to be related to cognitive decline. Both lower baseline CR fitness and declining CR fitness over 2 years were associated with regional brain atrophy. We conclude that CR fitness is chronically reduced in those with AD. Further, in those with AD, CR fitness is associated with progression of dementia severity and brain atrophy in AD, suggesting a link between progression of dementia severity and cardiorespiratory health.
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Affiliation(s)
- Eric D Vidoni
- KU Alzheimer and Memory Program, Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Hakola L, Komulainen P, Hassinen M, Savonen K, Litmanen H, Lakka TA, Rauramaa R. Cardiorespiratory fitness in aging men and women: the DR's EXTRA study. Scand J Med Sci Sports 2010; 21:679-87. [DOI: 10.1111/j.1600-0838.2010.01127.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rydwik E, Gustafsson T, Frändin K, Akner G. Effects of physical training on aerobic capacity in frail elderly people (75+ years). Influence of lung capacity, cardiovascular disease and medical drug treatment: a randomized controlled pilot trial. Aging Clin Exp Res 2010; 22:85-94. [PMID: 20305369 DOI: 10.1007/bf03324820] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Frail elderly people often suffer from a combination of unintentional weight loss and/or low body mass index, as well as a low physical activity level. No studies have investigated the effect of physical training alone or in combination with nutritional intervention on aerobic capacity in frail elderly people. The aim of this pilot study was to determine if a physical training program can affect aerobic capacity in frail elderly people. METHODS Ninety-six community-dwelling frail elderly people (58 women) were included in the study. Subjects were randomized to four different groups: i) physical training program (aerobic, muscle strength, balance), ii) a nutritional intervention program (individually targeted advice and group sessions), iii) a combination of these interventions, and iv) a control group. At baseline, subjects were screened for aerobic capacity, leg muscle strength, spirometry, heart disease and cardiovascular drugs. Aerobic capacity and leg muscle strength were analyzed immediately after the 3-month intervention period (1st follow-up), and after another 6 months (2nd follow-up). RESULTS Subjects mean age was 83 years. The mean compliance rate with the physical training program was 65%. There were no observed effects on aerobic capacity measured as maximal workload, or work time, with or without beta-receptor blockade. Subjects in the training groups without lung disease significantly increased maximal work time when compared with subjects with lung disease. Physical training significantly increased lower extremity muscle strength compared with nutrition alone at the 1st follow-up. No serious adverse events occurred during assessment or physical training. CONCLUSIONS Further studies with larger sample sizes and a more specific aerobic component in the training program are necessary before any further conclusions can be drawn.
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Affiliation(s)
- Elisabeth Rydwik
- Research Unit for the Elderly, North, Jakobsbergs Hospital, Karolinska Institutet, 177 31 Järfälla, Sweden.
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Cardiorespiratory fitness and preserved medial temporal lobe volume in Alzheimer disease. Alzheimer Dis Assoc Disord 2010; 23:188-97. [PMID: 19812458 DOI: 10.1097/wad.0b013e31819cb8a2] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Exercise and cardiorespiratory (CR) fitness may moderate age-related regional brain changes in nondemented (ND) older adults. The relationship of fitness to Alzheimer disease (AD)-related brain change is understudied, particularly in the hippocampus, which is disproportionately affected in early AD. The role of apolipoprotein E4 (apoE4) genotype in modulating this relationship is also unknown. ND (n=56) and early-stage AD patients (n=61) over the age of 65 years had magnetic resonance imaging and CR fitness assessments. Voxel-based morphometry techniques were used to identify AD-related atrophy. We analyzed the relationship of CR fitness with white and gray matter within groups, assessed fitness-related brain volume change in areas most affected by AD-related atrophy, and then analyzed differential fitness-brain relationships between apoE4 carriers. Atrophy was present in the medial temporal, temporal, and parietal cortices in patients with mild AD. There was a significant positive correlation of CR fitness with parietal and medial temporal volume in AD patients. ND patients did not have a significant relationship between brain volume and CR fitness in the global or small volume correction analyses. There was not a significant interaction for fitness x apoE4 genotype in either group. In early-stage AD, CR fitness is associated with regional brain volumes in the medial-temporal and parietal cortices suggesting that maintaining CR fitness may modify AD-related brain atrophy.
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Drew-Nord DC, Hong O, Froelicher ES, Berryman P, Lukes E. Cardiovascular Risk Factors among Career Firefighters. ACTA ACUST UNITED AC 2009. [DOI: 10.1177/216507990905701004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sudden cardiac death is the leading cause of on-duty death among firefighters. Determining firefighters' risk of cardiovascular death or all-cause mortality, cardiovascular risk factor profiles, and energy demands while firefighting may aid in understanding why this occupational group is at risk for on-duty sudden cardiac death. A literature review conducted between 2006 and 2009 did not demonstrate that firefighters are at increased risk of all-cause death compared to the general population. In addition, cardiovascular risk profiles of firefighters are similar to those of the general population. Firefighters may be part of the national obesity epidemic; their hypertension and hypercholesteremia often are not diagnosed or are undertreated. The combination of personal cardiovascular risk factors and extreme physical work demands may contribute to sudden cardiac death in this population.
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