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Boyd MC, Burdette JH, Miller ME, Lyday RG, Hugenschmidt CE, Jack Rejeski W, Simpson SL, Baker LD, Tomlinson CE, Kritchevsky SB, Laurienti PJ. Association of physical function with connectivity in the sensorimotor and dorsal attention networks: why examining specific components of physical function matters. GeroScience 2024; 46:4987-5002. [PMID: 38967698 PMCID: PMC11336134 DOI: 10.1007/s11357-024-01251-8] [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: 03/25/2024] [Accepted: 06/07/2024] [Indexed: 07/06/2024] Open
Abstract
Declining physical function with aging is associated with structural and functional brain network organization. Gaining a greater understanding of network associations may be useful for targeting interventions that are designed to slow or prevent such decline. Our previous work demonstrated that the Short Physical Performance Battery (eSPPB) score and body mass index (BMI) exhibited a statistical interaction in their associations with connectivity in the sensorimotor cortex (SMN) and the dorsal attention network (DAN). The current study examined if components of the eSPPB have unique associations with these brain networks. Functional magnetic resonance imaging was performed on 192 participants in the BNET study, a longitudinal and observational trial of community-dwelling adults aged 70 or older. Functional brain networks were generated for resting state and during a motor imagery task. Regression analyses were performed between eSPPB component scores (gait speed, complex gait speed, static balance, and lower extremity strength) and BMI with SMN and DAN connectivity. Gait speed, complex gait speed, and lower extremity strength significantly interacted with BMI in their association with SMN at rest. Gait speed and complex gait speed were interacted with BMI in the DAN at rest while complex gait speed, static balance, and lower extremity strength interacted with BMI in the DAN during motor imagery. Results demonstrate that different components of physical function, such as balance or gait speed and BMI, are associated with unique aspects of brain network organization. Gaining a greater mechanistic understanding of the associations between low physical function, body mass, and brain physiology may lead to the development of treatments that not only target specific physical function limitations but also specific brain networks.
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Affiliation(s)
- Madeline C Boyd
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Jonathan H Burdette
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Michael E Miller
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Robert G Lyday
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Christina E Hugenschmidt
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section On Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Sean L Simpson
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Laura D Baker
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section On Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Chal E Tomlinson
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Janssen R&D of Johnson & Johnson, Raritan, NJ, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section On Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paul J Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
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Sharma AR, Chatterjee S, Lee YH, Lee SS. Targeting Crosstalk of Signaling Pathways among Muscles-Bone-Adipose Tissue: A Promising Therapeutic Approach for Sarcopenia. Aging Dis 2024; 15:1619-1645. [PMID: 37815907 PMCID: PMC11272187 DOI: 10.14336/ad.2023.00903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/03/2023] [Indexed: 10/12/2023] Open
Abstract
The aging process is associated with the development of a wide range of degenerative disorders in mammals. These diseases are characterized by a progressive decline in function at multiple levels, including the molecular, cellular, tissue, and organismal. Furthermore, it is responsible for various healthcare costs in developing and developed countries. Sarcopenia is the deterioration in the quality and functionality of muscles, which is extremely concerning as it manages many functions in the human body. This article reviews the molecular crosstalk involved in sarcopenia and the specific roles of many mediator molecules in establishing cross-talk between muscles, bone, and fatty tissues, eventually leading to sarcopenia. Besides, the involvement of various etiological factors, such as neurology, endocrinology, lifestyle, etc., makes it exceedingly difficult for clinicians to develop a coherent hypothesis that may lead to the well-organized management system required to battle this debilitating disease. The several hallmarks contributing to the progression of the disease is a vital question that needs to be addressed to ensure an efficient treatment for sarcopenia patients. Also, the intricate molecular mechanism involved in developing this disease requires more studies. The direct relationship of cellular senescence with aging is one of the pivotal issues contributing to disease pathophysiology. Some patented treatment strategies have been discussed, including drugs undergoing clinical trials and emerging options like miRNA and protein-enclosed extracellular vesicles. A clear understanding of the secretome, including the signaling pathways involved between muscles, bone, and fatty tissues, is extremely beneficial for developing novel therapeutics for curing sarcopenia.
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Affiliation(s)
| | | | | | - Sang-Soo Lee
- Institute for Skeletal Aging & Orthopedic Surgery, Hallym University-Chuncheon Sacred Heart Hospital, Chuncheon-si, 24252, Gangwon-do, Republic of Korea
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Yang M, Leung LY, Lim ZY, Ang RW, Ip HM, Lee XQ, Lim KY, Teoh LC, Yeung MT. Reference Values for Habitual and Fast Gait Speed in Singapore Adults Aged 21 to 80. J Clin Med 2024; 13:3507. [PMID: 38930036 PMCID: PMC11205154 DOI: 10.3390/jcm13123507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Objectives: Gait speed indicates the individual's functional status and predicts overall health. This study aims to determine (1) the intra- and inter-rater and test-retest reliability of the dynamic 4 m gait speed test protocol; (2) establish the normative reference values of habitual and fast gait speeds in community-dwelling healthy Singaporean adults aged 21 to 80; and (3) explore the association of age, gender, height, weight, and body mass index (BMI) on gait speed. Methods: This prospective cross-sectional study recruited healthy ambulatory community-dwelling Singaporeans aged 21 to 80 who could ambulate independently without aid. Participants were excluded if they required walking aids; were pregnant; or had physical, medical, or cognitive conditions that may affect gait. Each participant completed at least two habitual and fast gait speed test trials via a 4 m walkway with a dynamic start. The data were analysed by descriptive statistics, the Mann-Whitney test, the Spearman coefficient, and the interclass correlation coefficient (ICC). Results: In total, 178 males and 201 females were included in the data analysis. The median age was 45.0 years [interquartile range (IQR) 26.2-59.0], and the median height was 1.64 metres (m) (IQR 1.58-1.70). The median habitual gait speed was 1.08 metre/second (m/s) (IQR 0.97-1.22), and the fast gait speed was 1.55 m/s (IQR 1.40-1.70). The ICC for reliability ranged from 0.84 to 0.99, indicating that the 4 m gait speed test had good-to-excellent reliability. Conclusions: Gait speeds were not influenced by gender but declined with age advancement. Age and height and age and BMI were weakly correlated to habitual and fast gait speed, respectively. We established the norm values for the 4 m gait speeds in Singapore and proved it to be a reliable gait speed assessment ready for immediate community applications.
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Affiliation(s)
- Mingxing Yang
- Allied Health, Singhealth Polyclinic, Singapore 150167, Singapore;
| | - Leik Yu Leung
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Zhi Yan Lim
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Richmond W. Ang
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Ho Man Ip
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Xin Qian Lee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Kellee Y. Lim
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Li Ching Teoh
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
| | - Meredith T. Yeung
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 138683, Singapore
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Kar R, Wasnik AP. Determinants of public institutional births in India: An analysis using the National Family Health Survey (NFHS-5) factsheet data. J Family Med Prim Care 2024; 13:1408-1420. [PMID: 38827686 PMCID: PMC11141982 DOI: 10.4103/jfmpc.jfmpc_982_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 06/04/2024] Open
Abstract
Background Institutional births ensure deliveries happen under the supervision of skilled healthcare personnel in an enabling environment. For countries like India, with high neonatal and maternal mortalities, achieving 100% coverage of institutional births is a top policy priority. In this respect, public health institutions have a key role, given that they remain the preferred choice by most of the population, owing to the existing barriers to healthcare access. While research in this domain has focused on private health institutions, there are limited studies, especially in the Indian context, that look at the enablers of institutional births in public health facilities. In this study, we look to identify the significant predictors of institutional birth in public health facilities in India. Method We rely on the National Family Health Survey (NFHS-5) factsheet data for analysis. Our dependent variable (DV) in this study is the % of institutional births in public health facilities. We first use Welch's t-test to determine if there is any significant difference between urban and rural areas in terms of the DV. We then use multiple linear regression and partial F-test to identify the best-fit model that predicts the variation in the DV. We generate two models in this study and use Akaike's Information Criterion (AIC) and adjusted R2 values to identify the best-fit model. Results We find no significant difference between urban and rural areas (P = 0.02, α =0.05) regarding the mean % of institutional births in public health facilities. The best-fit model is an interaction model with a moderate effect size (Adjusted2 = 0.35) and an AIC of 179.93, lower than the competitive model (AIC = 183.56). We find household health insurance (β = -0.29) and homebirth conducted under the supervision of skilled healthcare personnel (β = -0.56) to be significant predictors of institutional births in public facilities in India. Additionally, we observe low body mass index (BMI) and obesity to have a synergistic impact on the DV. Our findings show that the interaction between low BMI and obesity has a strong negative influence (β = -0.61) on institutional births in public health facilities in India. Conclusion Providing households with health insurance coverage may not improve the utilisation of public health facilities for deliveries in India, where other barriers to public healthcare access exist. Therefore, it is important to look at interventions that minimise the existing barriers to access. While the ultimate objective from a policy perspective should be achieving 100% coverage of institutional births in the long run, a short-term strategy makes sense in the Indian context, especially to manage the complications arising during births outside an institutional setting.
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Affiliation(s)
- Rohan Kar
- Doctoral Researcher, Marketing Area, Indian Institute of Management Ahmedabad. Gujarat, India
| | - Anurag Piyamrao Wasnik
- Doctoral Researcher, Innovation and Strategy, Beedie School of Business, Simon Fraser University (SFU), Vancouver, Canada
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He M, Lian T, Liu Z, Li J, Qi J, Li J, Guo P, Zhang Y, Luo D, Guan H, Zhang W, Zheng Z, Yue H, Zhang W, Wang R, Zhang F, Zhang W. An investigation into the potential association between nutrition and Alzheimer's disease. Front Nutr 2024; 11:1306226. [PMID: 38515521 PMCID: PMC10955128 DOI: 10.3389/fnut.2024.1306226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Background Malnutrition is the most common nutritional issue in Alzheimer's disease (AD) patients, but there is still a lack of a comprehensive evaluation of the nutritional status in AD patients. This study aimed to determine the potential association of various nutritional indices with AD at different stages. Methods Subjects, including individuals with normal cognition (NC) and patients diagnosed with AD, were consecutively enrolled in this cross-sectional study. Demographics, body composition, dietary patterns, nutritional assessment scales and nutrition-related laboratory variables were collected. Binary logistics regression analyses and receiver operating characteristic (ROC) curves were used to indicate the association between nutrition-related variables and AD at different stages. Results Totals of 266 subjects, including 73 subjects with NC, 72 subjects with mild cognitive impairment due to AD (AD-MCI) and 121 subjects with dementia due to AD (AD-D) were included. There was no significant difference in dietary patterns, including Mediterranean diet and Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet between the three groups. Lower BMI value, smaller hip and calf circumferences, lower Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI) scores, and lower levels of total protein, albumin, globulin, and apolipoprotein A1 were associated with AD (all p < 0.05). Total protein and albumin levels had the greatest ability to distinguish AD from non-AD (AUC 0.80, 95% CI 0.74-0.84, p < 0.001), increased by combining calf circumference, MNA score and albumin level (AUC 0.83, 95% CI 0.77-0.88, p < 0.001). Albumin level had the greatest ability to distinguish NC from AD-MCI (AUC 0.75, 95% CI 0.67-0.82, p < 0.001), and MNA score greatest ability to distinguish AD-MCI from AD-D (AUC 0.72, 95% CI 0.65-0.78, p < 0.001). Conclusion Nutritional status of AD patients is significantly compromised compared with normal controls, and tends to be worsened with AD progresses. Early identification and intervention of individuals with nutritional risk or malnutrition may be significantly beneficial for reducing the risk, development, and progression of AD.
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Affiliation(s)
- Mingyue He
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tenghong Lian
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhan Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinghui Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Qi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Guo
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanan Zhang
- Department of Blood Transfusion, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dongmei Luo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huiying Guan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Weijia Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zijing Zheng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hao Yue
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenjing Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ruidan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fan Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Parkinson’s Disease Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory on Parkinson Disease, Beijing, China
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Hung CY, Liu KH, Tsai CY, Lai CC, Hsu JT, Hsu CC, Hung YS, Chou WC. Impact of preoperative frailty on the surgical and survival outcomes in older patients with solid cancer after elective abdominal surgery. J Formos Med Assoc 2024; 123:257-266. [PMID: 37482474 DOI: 10.1016/j.jfma.2023.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/14/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Frailty is common in older patients with cancer; however, its clinical impact on the survival outcomes has seldom been examined in these patients. This study aimed to investigate the association of frailty with the survival outcomes and surgical complications in older patients with cancer after elective abdominal surgery in Taiwan. METHODS We prospectively enrolled 345 consecutive patients aged ≥65 years with newly diagnosed cancer who underwent elective abdominal surgery between 2016 and 2018. They were allocated into the fit, pre-frail, and frail groups according to comprehensive geriatric assessment (CGA) findings. RESULTS The fit, pre-frail, and frail groups comprised 62 (18.0%), 181 (52.5%), and 102 (29.5%) patients, respectively. After a median follow-up of 48 (interquartile range, 40-53) months, the mortality rates were 12.9%, 31.5%, and 43.1%, respectively. The adjusted hazard ratio was 1.57 (95% confidence interval [CI], 0.73-3.39; p = 0.25) and 2.87 (95% CI, 1.10-5.35; p = 0.028) when the pre-frail and frail groups were compared with the fit group, respectively. The frail group had a significantly increased risk for a prolonged hospital stay (adjusted odds ratio, 2.22; 95% CI, 1.05-4.69; p = 0.022) compared with the fit group. CONCLUSION Pretreatment frailty was significantly associated with worse survival outcomes and more surgical complications, with prolonged hospital stay, in the older patients with cancer after elective abdominal surgery. Preoperative frailty assessment can assist physicians in identifying patients at a high risk for surgical complications and predicting the survival outcomes of older patients with cancer.
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Affiliation(s)
- Chia-Yen Hung
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Keng-Hao Liu
- Department of General Surgery, and Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Yi Tsai
- Department of General Surgery, and Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Chou Lai
- Department of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jun-Te Hsu
- Department of General Surgery, and Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Chung Hsu
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Shin Hung
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chi Chou
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Wu C, Suzuki K. The Effects of Flavonoids on Skeletal Muscle Mass, Muscle Function, and Physical Performance in Individuals with Sarcopenia: A Systematic Review of Randomized Controlled Trials. Nutrients 2023; 15:3897. [PMID: 37764681 PMCID: PMC10537400 DOI: 10.3390/nu15183897] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/03/2023] [Accepted: 09/03/2023] [Indexed: 09/29/2023] Open
Abstract
Sarcopenia has become a significant obstacle to healthy aging in older adults. Flavonoids may contribute to treating sarcopenia, and attenuate the age-related loss of skeletal muscle mass, muscle strength, and physical function, however, their benefits in sarcopenic individuals remain unclear. This systematic review aimed to evaluate the effect of flavonoids on muscle mass, muscle strength, and physical performance in adults with sarcopenia based on randomized controlled trials (RCTs). This review was conducted in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the risk of bias was assessed using the Cochrane risk of bias tool. The article search was conducted using PubMed, Scopus, Embase, Cochrane, Web of Science databases, and Google Scholar for the period until June 2023. RCTs that assessed the effects of flavonoids/flavonoids combined with other supplementation/flavonoid-rich supplementations on skeletal muscle mass, muscle strength, and physical performance in adults diagnosed with sarcopenia before intervention were included. From the 309 articles found, a total of 6 RCTs met the inclusion criteria. RCTs evaluated the main outcomes of tea catechins, epicatechin, and isoflavones intervention. Skeletal muscle mass significantly increased in three studies, muscle strength significantly elevated in two studies, and physical performance significantly improved in two studies. The majority of studies (five in six) found at least one of the main outcomes is elevated by flavonoids intervention. Flavonoids may have a great potential to treat sarcopenia.
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Affiliation(s)
- Cong Wu
- Graduate School of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan;
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
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Bruce DG, Davis WA, Davis TME. Group-Based Trajectory Modelling of Changes in Mobility over Six Years in Type 2 Diabetes: The Fremantle Diabetes Study Phase II. J Clin Med 2023; 12:4528. [PMID: 37445563 DOI: 10.3390/jcm12134528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
To investigate temporal changes in mobility in community-based people with type 2 diabetes, Fremantle Diabetes Study Phase II (FDS2) data were analysed. The baseline assessment included the Timed Up and Go (TUG) test, which was repeated biennially for up to six years. Group-based trajectory modelling (GBTM) identified TUG trajectory groups in participants with ≥2 tests. Independent associates of group membership were assessed using multinomial regression. Of 1551 potential FDS2 participants, 1116 (72.0%; age 64.9 ± 11.0 years, 45.6% female) were included in the modelling. The best-fitting GBTM model identified two groups with linear, minimally changing trajectories (76.2% and 19.4% of participants; baseline TUG times 8 ± 2 and 12 ± 3 s, respectively), and a third (4.5%; baseline TUG 17 ± 5 s) with a TUG that increased over time then fell at Year 6, reflecting participant attrition. Both slower groups were older, more likely to be female, obese, and had greater diabetes-associated complications and comorbidities. Almost one-quarter of the FDS2 cohort had clinically relevant mobility impairment that persisted or worsened over six years, was multifactorial in origin, and was associated with excess late withdrawals and deaths. The TUG may have important clinical utility in assessing mobility and its consequences in adults with type 2 diabetes.
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Affiliation(s)
- David G Bruce
- Medical School, The University of Western Australia, Fremantle Hospital, Alma Street, Fremantle, WA 6160, Australia
| | - Wendy A Davis
- Medical School, The University of Western Australia, Fremantle Hospital, Alma Street, Fremantle, WA 6160, Australia
| | - Timothy M E Davis
- Medical School, The University of Western Australia, Fremantle Hospital, Alma Street, Fremantle, WA 6160, Australia
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Tan TC, Guo YY, Ho DJ, Sanwari NAB, Quek PH, Tan RS, Yap FS, Yang M, Yeung MT. Reference Values, Determinants and Regression Equation for the Timed-Up and Go Test (TUG) in Healthy Asian Population Aged 21 to 85 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095712. [PMID: 37174230 PMCID: PMC10178718 DOI: 10.3390/ijerph20095712] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/10/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
The "Timed-Up-and-Go" test (TUG) is a standard assessment tool for functional mobility as it assesses several functional components, including balance, gait, and lower-extremity strength. It has good reliability and validity and is cost-effective and safe, making it an ideal screening tool for falls in various populations, such as older adults or various conditions. However, TUG interpretation relies on comparisons against local normative reference values (NRV), which few studies established for the Asian or younger population. Hence, this study aims to: (1) establish the normative reference values NRV for the population aged 21 to 85 years; (2) determine demographic and anthropometric variables that influence the TUG results; and (3) establish the regression equation of the TUG. A prospective, convenience sampling cross-sectional study recruited subjects aged 21-85 from the community to complete two TUG trials in various parts of Singapore. Variables collected include gender, age, height (meters, m), weight (kilograms, kg), and hand grip strength (HGS) (kg). The intraclass correlation coefficient (ICC) and 95% confidence interval (95% CI) determined test-retest, intra- and inter-rater reliabilities. TUG and variables were analyzed with descriptive statistics and multiple linear regression. p < 0.05 was accepted as statistical significance. Further, 838 subjects (542 females, 296 males) completed the data collection. The mean TUG time was 9.16 s (95% CI 9.01-9.3). Slower TUG was observed with advanced age and female gender. Multiple linear regression analysis demonstrated that age, height, and weight were the best variables to predict TUG scores. The regression formula presented as: TUG (second) = 9.11 + 0.063 (Age, years)-3.19 (Height, meters) + 0.026 (Weight, Kilograms) (R2 = 0.374, p < 0.001). This study provided the TUG NRV and regression formula for healthy Asian adults aged 21 to 85. The information may provide a quick reference for the physical function to interpret assessment findings and guide decision-making in various health and healthcare settings.
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Affiliation(s)
- Teck Chye Tan
- Physiotherapy, SingHealth Polyclinics, Singapore 150167, Singapore
| | - Yan Y Guo
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Dilys J Ho
- Singapore Institute of Technology, Singapore 138683, Singapore
| | | | - Patricia H Quek
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Rachel S Tan
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Felicia S Yap
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Mingxing Yang
- Physiotherapy, SingHealth Polyclinics, Singapore 150167, Singapore
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Yamauchi Y, Kinoshita T, Fukumitsu S, Aida K, Maruyama K, Saito I, Yamamoto N. Pharmacokinetics and effect of maslinic acid with physical exercise on grip strength and trunk muscle mass in healthy Japanese individuals. J Clin Biochem Nutr 2023; 72:270-277. [DOI: 10.3164/jcbn.23-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/12/2023] [Indexed: 03/28/2023] Open
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Tian S, Ding M, Sun H. The effects of resistance exercise on body composition and physical function in prostate cancer patients undergoing androgen deprivation therapy: an update systematic review and meta-analysis. Aging Male 2022; 25:281-292. [PMID: 36382930 DOI: 10.1080/13685538.2022.2146670] [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] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The aim of the meta-analysis was to explore effects of resistance exercise (RE) on body composition and physical function in patients with prostate cancer (PCa). DATA SOURCES We searched the electronic databases of Pubmed, Embase, Cochrane, and web of science. Published studies have been collected from these databases. Search terms include resistance training, strength training, RE, androgen suppression therapy, androgen deprivation therapy and PCa, with a deadline of 31 March 2022. MAIN RESULTS These studies showed significant improvements of body composition(Lean body mass MD: 1.12 95% CI [0.48, 1.76], p < 0.01; Body fat rate MD: -1.12 95% CI [-1.99,-0.24], p < 0.05; Appendicular skeletal mass MD: 0.74 95% CI [0.45, 1.03], p < 0.01) and physical function (leg press MD: 77.95 95% CI [38.90, 117.00], p < 0.01; stair climb MD:-0.30 95% CI [-0.49, -0.12], p < 0.01). In addition, the improvement of Body fat mass (MD: -0.21 95% CI [-0.79, 0.37], p > 0.05), 400 m walk (MD: -21.74 95% CI [-45.53, 2.05], p > 0.05) and times up and go (MD: -0.50 95% CI [-1.03, 0.03], p > 0.05) were not obvious. Subgroup analyses showed that RE for ≥ 6 months (compared with RE intervention for < 6 months) and starting exercise immediately after androgen deprivation therapy (ADT) (compared with delayed exercise after ADT) resulted in more significant improvements in body composition. Furthermore, the results showed that the exercise intensity of 8-12 RM significantly improved body composition. CONCLUSIONS RE seems to be a promising approach in order to improve body composition and physical function in PCa patients to offset their treatment-related side effects. RE should be used as a means of rehabilitation and care for PCa. Starting exercise immediately after ADT and extending exercise time while choosing the right intensity can better improve the patients' body composition and function. REGISTRATION NUMBER INPLASY202280019.
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Affiliation(s)
- Siyu Tian
- College of Physical Education, Shandong Normal University, Jinan, China
| | - Meng Ding
- College of Physical Education, Shandong Normal University, Jinan, China
| | - Hongfu Sun
- Institute of Great Health Products Research, Shandong Academy of Chinese Medicine, Jinan, China
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12
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Prediction of abdominal CT body composition parameters by thoracic measurements as a new approach to detect sarcopenia in a COVID-19 cohort. Sci Rep 2022; 12:6443. [PMID: 35440794 PMCID: PMC9017415 DOI: 10.1038/s41598-022-10266-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 03/30/2022] [Indexed: 12/11/2022] Open
Abstract
As most COVID-19 patients only receive thoracic CT scans, but body composition, which is relevant to detect sarcopenia, is determined in abdominal scans, this study aimed to investigate the relationship between thoracic and abdominal CT body composition parameters in a cohort of COVID-19 patients. This retrospective study included n = 46 SARS-CoV-2-positive patients who received CT scans of the thorax and abdomen due to severe disease progression. The subcutaneous fat area (SF), the skeletal muscle area (SMA), and the muscle radiodensity attenuation (MRA) were measured at the level of the twelfth thoracic (T12) and the third lumbar (L3) vertebra. Necessity of invasive mechanical ventilation (IMV), length of stay, or time to death (TTD) were noted. For statistics correlation, multivariable linear, logistic, and Cox regression analyses were employed. Correlation was excellent for the SF (r = 0.96) between T12 and L3, and good for the respective SMA (r = 0.80) and MRA (r = 0.82) values. With adjustment (adj.) for sex, age, and body-mass-index the variability of SF (adj. r2 = 0.93; adj. mean difference = 1.24 [95% confidence interval (95% CI) 1.02–1.45]), of the SMA (adj. r2 = 0.76; 2.59 [95% CI 1.92–3.26]), and of the MRA (adj. r2 = 0.67; 0.67 [95% CI 0.45–0.88]) at L3 was well explained by the respective values at T12. There was no relevant influence of the SF, MRA, or SMA on the clinical outcome. If only thoracic CT scans are available, CT body composition values at T12 can be used to predict abdominal fat and muscle parameters, by which sarcopenia and obesity can be assessed.
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13
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Chiu CJ, Li ML, Chou CY. Trends and biopsychosocial correlates of physical disabilities among older men and women in Taiwan: examination based on ADL, IADL, mobility, and frailty. BMC Geriatr 2022; 22:148. [PMID: 35193512 PMCID: PMC8864881 DOI: 10.1186/s12877-022-02838-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study examines correlates of disabilities related to ADL, IADL, mobility, and frailty in men and women with a nationally representative sample of older adults living in the community. Methods A total of 10,898 noninstitutionalized Taiwanese nationals aged 65 years and older enrolled in the 2001 (N = 2,064), 2005 (N = 2,727), 2009 (N = 2,904), and 2013 (N = 3,203) National Health Interview Survey (NHIS) were analyzed. Results The prevalence of mobility disabilities and frailty in older adults in Taiwan decreased during the past decade (\documentclass[12pt]{minimal}
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\begin{document}$${\chi }_{Frailty}^{2}= -6.2$$\end{document}χFrailty2=-6.2). Exercise, social engagement, and tea and coffee intake were found to be associated with lower levels of all types of disabilities in both men and women. In addition, a diet based on carbohydrates, falls, depressive symptomatology, lung and metabolic diseases were risks for most of the disabilities under consideration. Gender-specific independent correlates included: being married (OR = 0.63, 95%CI: 0.40–0.98), eggs/beans/fish/meat consumption (OR = 0.35, 95% CI = 0.16–0.80); depressive symptoms, obesity and cataracts, which were associated with higher IADL (OR = 3.61, 1.63, and 1.18, respectively) and frailty limitations (OR = 10.89, 1.27, and 1.20, respectively) in women. Cognitive impairment was found to be an important correlate for ADL limitations in men (OR = 3.64, 95%CI: 2.38–5.57). Conclusions Exercise, social participation and diet (more tea and coffee intake and lower carbohydrates) were correlates for lower levels of disability. Some gender-specific correlates were also identified, including associations of disability with depressive symptoms, obesity, and cataracts that were more distinct in women, and lower levels of disability which were especially significant in men who were married, eat more eggs, beans, fish, and meat, and those free from cognitive impairment.
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Affiliation(s)
- Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Ling Li
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chieh-Ying Chou
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 70403, Taiwan.
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14
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Measurement System for Unsupervised Standardized Assessments of Timed Up and Go Test and 5 Times Chair Rise Test in Community Settings—A Usability Study. SENSORS 2022; 22:s22030731. [PMID: 35161478 PMCID: PMC8840449 DOI: 10.3390/s22030731] [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: 12/20/2021] [Revised: 01/09/2022] [Accepted: 01/14/2022] [Indexed: 02/01/2023]
Abstract
Comprehensive measurements are needed in older populations to detect physical changes, initiate prompt interventions, and prevent functional decline. While established instruments such as the Timed Up and Go (TUG) and 5 Times Chair Rise Test (5CRT) require trained clinicians to assess corresponding functional parameters, the unsupervised screening system (USS), developed in a two-stage participatory design process, has since been introduced to community-dwelling older adults. In a previous article, we investigated the USS’s measurement of the TUG and 5CRT in comparison to conventional stop-watch methods and found a high sensitivity with significant correlations and coefficients ranging from 0.73 to 0.89. This article reports insights into the design process and evaluates the usability of the USS interface. Our analysis showed high acceptance with qualitative and quantitative methods. From participant discussions, suggestions for improvement and functions for further development could be derived and discussed. The evaluated prototype offers a high potential for early detection of functional limitations in elderly people and should be tested with other target groups in other locations.
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15
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Pelicioni PHS, Pereira MP, Lahr J, dos Santos PCR, Gobbi LTB. Assessment of Force Production in Parkinson's Disease Subtypes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910044. [PMID: 34639343 PMCID: PMC8507744 DOI: 10.3390/ijerph181910044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022]
Abstract
Muscle weakness is a secondary motor symptom of Parkinson's disease (PD), especially in the subtype characterized by postural instability and gait difficulty (PIGD). Since the PIGD subtype also presents worse bradykinesia, we hypothesized that it also shows a decreased rate of force development, which is linked to an increased risk of falling in PD. Therefore, we investigated the effects of PD and PD subtypes on a force production profile and correlated the force production outcomes with clinical symptoms for each PD subtype. We assessed three groups of participants: 14 healthy older adults (OA), 10 people with PD composing the PIGD group, and 14 people with PD composing the tremor-dominant group. Three knee extension maximum voluntary isometric contractions were performed in a leg extension machine equipped with a load cell to assess the force production. The outcome measures were: peak force and rate of force development (RFD) at 50 ms (RFD50), 100 ms (RFD100), and 200 ms (RFD200). We observed lower peak force, RFD50, RFD100, and RFD200 in people with PD, regardless of subtypes, compared with the OA group (p < 0.05 for all comparisons). Together, our results indicated that PD affects the capacity to produce maximal and rapid force. Therefore, future interventions should consider rehabilitation programs for people with PD based on muscle power and fast-force production, and consequently reduce the likelihood of people with PD falling from balance-related events, such as from an unsuccessful attempt to avoid a tripping hazard or a poor and slower stepping response.
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Affiliation(s)
- Paulo Henrique Silva Pelicioni
- School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin 9016, New Zealand
- Posture and Locomotion Studies Laboratory, Universidade Estadual Paulista (UNESP), Rio Claro 13506-900, Brazil; (M.P.P.); (J.L.); (P.C.R.d.S.); (L.T.B.G.)
- Correspondence:
| | - Marcelo Pinto Pereira
- Posture and Locomotion Studies Laboratory, Universidade Estadual Paulista (UNESP), Rio Claro 13506-900, Brazil; (M.P.P.); (J.L.); (P.C.R.d.S.); (L.T.B.G.)
| | - Juliana Lahr
- Posture and Locomotion Studies Laboratory, Universidade Estadual Paulista (UNESP), Rio Claro 13506-900, Brazil; (M.P.P.); (J.L.); (P.C.R.d.S.); (L.T.B.G.)
| | - Paulo Cezar Rocha dos Santos
- Posture and Locomotion Studies Laboratory, Universidade Estadual Paulista (UNESP), Rio Claro 13506-900, Brazil; (M.P.P.); (J.L.); (P.C.R.d.S.); (L.T.B.G.)
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Lilian Teresa Bucken Gobbi
- Posture and Locomotion Studies Laboratory, Universidade Estadual Paulista (UNESP), Rio Claro 13506-900, Brazil; (M.P.P.); (J.L.); (P.C.R.d.S.); (L.T.B.G.)
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16
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Chua KY, Lin X, Wang Y, Chong YS, Lim WS, Koh WP. Visceral fat area is the measure of obesity best associated with mobility disability in community dwelling oldest-old Chinese adults. BMC Geriatr 2021; 21:282. [PMID: 33910516 PMCID: PMC8082923 DOI: 10.1186/s12877-021-02226-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 01/23/2023] Open
Abstract
Background Although obesity can be clinically defined by body mass index (BMI), waist circumference, percent body fat, or visceral fat area, it is unclear which specific measure is best associated with mobility disability in oldest-old adults. Methods Among 589 Chinese participants aged 85 years and older in a population-based cohort in Singapore, we measured waist circumference, computed BMI, estimated appendicular skeletal muscle mass, percent body fat, and visceral fat area using bioelectrical impedance analysis, and evaluated mobility disability using the Loco-Check questionnaire. We computed areas under the receiver operating characteristic curves (AUCROC) to compare how well these measures discriminated between those with and without mobility disability. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between obesity defined by these measures and mobility disability. Results Compared to BMI, which had an AUCROC (95% CI) of 0.68 (0.64–0.72) for the discrimination of mobility disability, only visceral fat area had a significantly higher discriminative performance [AUCROC (95% CI) of 0.71 (0.67–0.75) (Padjusted = 0.002)]. The optimal cut-offs of visceral fat area for the discrimination of mobility disability were ≥ 104 cm2 in men and ≥ 137 cm2 in women. In fully adjusted models, only obesity defined by visceral fat area was significantly associated with mobility disability [OR (95% CI) of 2.04 (1.10–3.77)]; obesity defined by the other measures were not associated with mobility disability after adjusting for visceral fat. Conclusion In oldest-old adults, visceral fat area was the best discriminator for obesity associated with mobility disability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02226-6.
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Affiliation(s)
- Kevin Yiqiang Chua
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Xinyi Lin
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.,Singapore Clinical Research Institute, Singapore, Singapore
| | - Yeli Wang
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Wee-Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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17
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Mangione KK, Posner MA, Craik RL, Wolff EF, Fortinsky RH, Beamer BA, Binder EF, Orwig DL, Magaziner J, Resnick B. Using Treatment Fidelity Measures to Understand Walking Recovery: A Secondary Analysis From the Community Ambulation Project. Phys Ther 2021; 101:6210027. [PMID: 33823028 PMCID: PMC8520021 DOI: 10.1093/ptj/pzab109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/30/2020] [Accepted: 02/24/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Physical therapist intervention studies can be deemed ineffective when, in fact, they may not have been delivered as intended. Measurement of treatment fidelity (TF) can address this issue. The purpose of this study was to describe TF of a home-based intervention, identify factors associated with TF, and examine whether components of TF were associated with the outcome of change in 6-minute walk distance (∆6MWD). METHODS This is a secondary analysis of community-dwelling hip fracture participants who completed standard therapy and were randomly assigned to the active intervention (Push). Push was 16 weeks of lower extremity strengthening, function, and endurance training. TF was defined as delivery (attendance rate, exercise duration) and receipt (progression in training load, heart rate reserve [HRR] during endurance training, and exercise position [exercise on floor]). The outcome was ∆6MWD. Independent variables included baseline (demographic and clinical) measures. Descriptive statistics were calculated; linear and logistic regressions were performed. RESULTS Eighty-nine participants were included in this analysis; 59 (66%) had attendance of 75% or greater. Participants walked for 20 minutes or more for 78% of sessions. The average training load increased by 22%; the mean HRR was 35%; and 61 (69%) participants exercised on the floor for at least 75% of sessions. Regression analyses showed that a higher body mass index and greater baseline 6MWD were related to components of TF; 4 out of 5 components of TF were significantly related to ∆6MWD. The strongest TF relationship showed that those who exercised on the floor improved by 62 m (95% CI = 31-93 m) more than those who did not get on the floor. CONCLUSIONS Measures of TF should extend beyond attendance rate. This analysis demonstrates how measures of TF, including program attendance, progression in training load, endurance duration, and exercising on the floor were significantly related to improvement in 6MWD in participants post hip fracture. IMPACT This careful analysis of treatment fidelity assured that the intervention was delivered and received as intended. Analysis of data from a large trial with participants after hip fracture showed that regular attendance, frequent endurance training for 20 minutes, increases in lower extremity training loads, and exercising on the floor were associated with improvements in the outcome of 6-minute-walk distance. The strongest association with improvement was exercising on the floor.
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Affiliation(s)
- Kathleen K Mangione
- Department of Physical Therapy, Arcadia University, 450 S Easton Rd, Glenside, Pennsylvania, USA,Address all correspondence to Dr Mangione at:
| | - Michael A Posner
- Department of Mathematics and Statistics, Villanova University, Villanova, Pennsylvania, USA
| | - Rebecca L Craik
- College of Health Science, Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
| | - Edward F Wolff
- Department of Computer Science and Mathematics, Arcadia University, Glenside, Pennsylvania, USA
| | - Richard H Fortinsky
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Brock A Beamer
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA,Geriatric Research, Education, and Clinical Center at the Veterans Affairs Maryland Health Care System, Baltimore, Maryland, USA
| | - Ellen F Binder
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Denise L Orwig
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jay Magaziner
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Barbara Resnick
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
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18
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Kim SH, Ju SK. Comparison of muscle activity during sit-to-stand movement at different chair heights between obese and normal-weight subjects. J Exerc Rehabil 2021; 17:39-44. [PMID: 33728287 PMCID: PMC7939984 DOI: 10.12965/jer.2040800.400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/11/2020] [Indexed: 12/25/2022] Open
Abstract
The purpose of present study was to compare the tibialis anterior (TA), rectus femoris (RF), and erector spinae (ES) muscle activities at variety chair height during sit-to-stand (STS) on normal weight and obese subjects. Also, we compared the muscle activity difference between the normal weight and obese subjects. The study included 26 subjects (normal weight 13 and obese 13). Each subject performed STS at three chair heights (40 cm, 50 cm, 60 cm) and TA, RF, and ES muscle activities measured. According to the results of the measurement, muscle activation of TA showed significantly higher than RF and ES muscle activation during STS at all chair heights on obese subjects. The muscle activation of TA showed significantly higher than RF muscle activation during STS at all chair heights on normal weight subjects. The muscle activation of RF and ES showed significantly higher in normal weight subjects than obese subjects at 40 cm and 50 cm of chair heights. However, the TA muscle activation showed no significant difference between normal weight subjects and obese subjects. This study’s results suggested that obese subjects should practice the use of RF and ES muscles in a low-height chair during STS.
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Affiliation(s)
- Soo-Han Kim
- Department of Physical Therapy, College of Biomedical Science, Kaya University, Gimhae, Korea
| | - Sung-Kwang Ju
- Department of Physical Therapy, College of Biomedical Science, Kaya University, Gimhae, Korea
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19
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Lawrence MM, Van Pelt DW, Confides AL, Hettinger ZR, Hunt ER, Reid JJ, Laurin JL, Peelor FF, Butterfield TA, Miller BF, Dupont-Versteegden EE. Muscle from aged rats is resistant to mechanotherapy during atrophy and reloading. GeroScience 2021; 43:65-83. [PMID: 32588343 PMCID: PMC8050124 DOI: 10.1007/s11357-020-00215-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/09/2020] [Indexed: 12/22/2022] Open
Abstract
Massage is a viable mechanotherapy to improve protein turnover during disuse atrophy and improve muscle regrowth during recovery from disuse atrophy in adult muscle. Therefore, we investigated whether massage can cause beneficial adaptations in skeletal muscle from aged rats during normal weight-bearing (WB) conditions, hindlimb suspension (HS), or reloading (RE) following HS. Aged (30 months) male Fischer 344/Brown Norway rats were divided into two experiments: (1) WB for 7 days (WB, n = 8), WB with massage (WBM, n = 8), HS for 7 days (HS7, n = 8), or HS with massage (HSM, n = 8), and (2) WB for 14 days (WB14, n = 8), HS for 14 days (HS14, n = 8), reloading (RE, n = 10), or reloading with massage (REM, n = 10) for 7 days following HS. Deuterium oxide (D2O) labeling was used to assess dynamic protein and ribosome turnover in each group and anabolic signaling pathways were assessed. Massage did have an anabolic benefit during RE or WB. In contrast, massage during HS enhanced myofibrillar protein turnover in both the massaged limb and contralateral non-massaged limb compared with HS, but this did not prevent muscle loss. Overall, the data demonstrate that massage is not an effective mechanotherapy for prevention of atrophy during muscle disuse or recovery of muscle mass during reloading in aged rats.
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Affiliation(s)
- Marcus M Lawrence
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Douglas W Van Pelt
- Department of Physical Therapy, University of Kentucky, Lexington, KY, 40536, USA
- Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA
| | - Amy L Confides
- Department of Physical Therapy, University of Kentucky, Lexington, KY, 40536, USA
- Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA
| | - Zachary R Hettinger
- Department of Physical Therapy, University of Kentucky, Lexington, KY, 40536, USA
- Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA
| | - Emily R Hunt
- Department of Physical Therapy, University of Kentucky, Lexington, KY, 40536, USA
- Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA
| | - Justin J Reid
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Jaime L Laurin
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Frederick F Peelor
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Timothy A Butterfield
- Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, 40536, USA
| | - Benjamin F Miller
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Esther E Dupont-Versteegden
- Department of Physical Therapy, University of Kentucky, Lexington, KY, 40536, USA.
- Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA.
- College of Health Sciences, University of Kentucky, 900 S. Limestone CTW210E, Lexington, KY, 40536-0200, USA.
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20
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Resistance Training in Hypoxia as a New Therapeutic Modality for Sarcopenia-A Narrative Review. Life (Basel) 2021; 11:life11020106. [PMID: 33573198 PMCID: PMC7912455 DOI: 10.3390/life11020106] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/15/2022] Open
Abstract
Hypoxic training is believed to be generally useful for improving exercise performance in various athletes. Nowadays, exercise intervention in hypoxia is recognized as a new therapeutic modality for health promotion and disease prevention or treatment based on the lower mortality and prevalence of people living in high-altitude environments than those living in low-altitude environments. Recently, resistance training in hypoxia (RTH), a new therapeutic modality combining hypoxia and resistance exercise, has been attempted to improve muscle hypertrophy and muscle function. RTH is known to induce greater muscle size, lean mass, increased muscle strength and endurance, bodily function, and angiogenesis of skeletal muscles than traditional resistance exercise. Therefore, we examined previous studies to understand the clinical and physiological aspects of sarcopenia and RTH for muscular function and hypertrophy. However, few investigations have examined the combined effects of hypoxic stress and resistance exercise, and as such, it is difficult to make recommendations for implementing universal RTH programs for sarcopenia based on current understanding. It should also be acknowledged that a number of mechanisms proposed to facilitate the augmented response to RTH remain poorly understood, particularly the role of metabolic, hormonal, and intracellular signaling pathways. Further RTH intervention studies considering various exercise parameters (e.g., load, recovery time between sets, hypoxic dose, and intervention period) are strongly recommended to reinforce knowledge about the adaptational processes and the effects of this type of resistance training for sarcopenia in older people.
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21
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Morgan PT, Smeuninx B, Breen L. Exploring the Impact of Obesity on Skeletal Muscle Function in Older Age. Front Nutr 2020; 7:569904. [PMID: 33335909 PMCID: PMC7736105 DOI: 10.3389/fnut.2020.569904] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/06/2020] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia is of important clinical relevance for loss of independence in older adults. The prevalence of obesity in combination with sarcopenia ("sarcopenic-obesity") is increasing at a rapid rate. However, whilst the development of sarcopenia is understood to be multi-factorial and harmful to health, the role of obesity from a protective and damaging perspective on skeletal muscle in aging, is poorly understood. Specifically, the presence of obesity in older age may be accompanied by a greater volume of skeletal muscle mass in weight-bearing muscles compared with lean older individuals, despite impaired physical function and resistance to anabolic stimuli. Collectively, these findings support a potential paradox in which obesity may protect skeletal muscle mass in older age. One explanation for these paradoxical findings may be that the anabolic response to weight-bearing activity could be greater in obese vs. lean older individuals due to a larger mechanical stimulus, compensating for the heightened muscle anabolic resistance. However, it is likely that there is a complex interplay between muscle, adipose, and external influences in the aging process that are ultimately harmful to health in the long-term. This narrative briefly explores some of the potential mechanisms regulating changes in skeletal muscle mass and function in aging combined with obesity and the interplay with sarcopenia, with a particular focus on muscle morphology and the regulation of muscle proteostasis. In addition, whilst highly complex, we attempt to provide an updated summary for the role of obesity from a protective and damaging perspective on muscle mass and function in older age. We conclude with a brief discussion on treatment of sarcopenia and obesity and a summary of future directions for this research field.
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Affiliation(s)
- Paul T. Morgan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Cellular & Molecular Metabolism Laboratory, Monash Institute of Pharmacological Sciences, Monash University, Parkville, VIC, Australia
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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22
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Meng H, Gorniak SL. Effects of adiposity on postural control and cognition in older adults. Gait Posture 2020; 82:147-152. [PMID: 32927221 DOI: 10.1016/j.gaitpost.2020.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Understanding the impacts of increased adiposity on postural control and cognitive deficits in adults is critical for health practitioners in recommending or prescribing effective weight loss regimens. Despite prior work in this area, the knowledge of increased adiposity impacts on postural control and cognitive deficits in older adults (OAs) is still limited. RESEARCH QUESTION The purposes of the current study were: (a) to assess the relationship between postural measures and adiposity measures by using regression model analyses and, (b) to examine the impacts of increased adiposity and age on cognitive performance. METHODS A total of thirty (30) individuals aged 60+ years participated in the study. Participants were classified into three groups based upon their BMI scores at the onset of the study. The normal weight (NW) (BMI: 18.5-24.9 kg/m2), the overweight (OW) (BMI: 25-29.9 kg/m2), and the obese (OB) groups (BMI: 30-40 kg/m2) each had five females and five males. Participants were required to perform two test sessions: (1) anthropometry assessment and body composition scanning; and (2) evaluation of plantar tactile function, postural control, and cognitive function. RESULTS Overall, our findings indicate that increased adiposity in OAs is associated with declines in both cognitive function and postural control. SIGNIFICANCE Our data also indicate that measures such as BMI and abdominal fat mass amounts/ratios offer the best insight to the impact of adiposity on cognitive function and postural control measures. However, further work is still needed to clarify the mechanistic links between adiposity and cognitive-postural deficits.
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Affiliation(s)
- Hao Meng
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States
| | - Stacey L Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, United States.
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23
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Waite SJ, Maitland S, Thomas A, Yarnall AJ. Sarcopenia and frailty in individuals with dementia: A systematic review. Arch Gerontol Geriatr 2020; 92:104268. [PMID: 33011431 DOI: 10.1016/j.archger.2020.104268] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Population aging has resulted in an increase in age-related conditions. Sarcopenia, the progressive loss of muscle mass and strength, and frailty, vulnerability to poor resolution of homeostasis after a stressor, are common causes of functional decline in older individuals. There is a paucity of work on how they interrelate with dementia. The objective of this review was to examine the literature on sarcopenia and frailty in dementia. METHODS AND RESULTS Studies of sarcopenia and frailty in dementia were searched for in EMBASE, PubMed and Web of Science, and via hand-searching. Citations were screened for independently by two reviewers, with disagreements resolved by a third reviewer. To be eligible for inclusion, the articles needed to fulfil: (1) English language; (2) human studies; and (3) full-text available. Dementia of any aetiology was included. 303 non-duplicate recorders were identified, of which 270 irrelevant papers were excluded. Of the remaining 33, 27 examined frailty and 13 sarcopenia, with six of these measuring both. An increased prevalence of frailty and sarcopenia was noted in dementia patients. However, nine papers did not specify dementia aetiologies. Of those that did (n = 21), 20 examined Alzheimer's disease, with three also including Lewy body dementia, three vascular dementia, and one Parkinson's disease dementia. CONCLUSION Most papers examined frailty, rather than sarcopenia, in dementia. The studies were heterogeneous, using different protocols and non-validated definitions. However, dementia patients may have an increased prevalence of frailty and sarcopenia. This review highlights key gaps in accurate diagnosis of frailty/sarcopenia and in non-Alzheimer's dementia.
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Affiliation(s)
- Samantha J Waite
- NIHR Newcastle Biomedical Research Centre, Newcastle University Translational Clinical Research Institute, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
| | - Stuart Maitland
- NIHR Newcastle Biomedical Research Centre, Newcastle University Translational Clinical Research Institute, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Alan Thomas
- NIHR Newcastle Biomedical Research Centre, Newcastle University Translational Clinical Research Institute, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK; Gateshead Health NHS Foundation Trust, Newcastle, UK
| | - Alison J Yarnall
- NIHR Newcastle Biomedical Research Centre, Newcastle University Translational Clinical Research Institute, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
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Crossland H, Piasecki J, McCormick D, Phillips BE, Wilkinson DJ, Smith K, McPhee JS, Piasecki M, Atherton PJ. Targeted genotype analyses of GWAS-derived lean body mass and handgrip strength-associated single-nucleotide polymorphisms in elite master athletes. Am J Physiol Regul Integr Comp Physiol 2020; 319:R184-R194. [PMID: 32579386 PMCID: PMC7473897 DOI: 10.1152/ajpregu.00110.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/18/2020] [Accepted: 06/18/2020] [Indexed: 01/24/2023]
Abstract
Recent large genome-wide association studies (GWAS) have independently identified a set of genetic loci associated with lean body mass (LBM) and handgrip strength (HGS). Evaluation of these candidate single-nucleotide polymorphisms (SNPs) may be useful to investigate genetic traits of populations at higher or lower risk of muscle dysfunction. As such, we investigated associations between six SNPs linked to LBM or HGS in a population of elite master athletes (MA) and age-matched controls as a representative population of older individuals with variable maintenance of muscle mass and function. Genomic DNA was isolated from buffy coat samples of 96 individuals [consisting of 48 MA (71 ± 6 yr, age-graded performance 83 ± 9%) and 48 older controls (75 ± 6 yr)]. SNP validation and sample genotyping were conducted using the tetra-primer amplification refractory mutation system (ARMS). For the three SNPs analyzed that were previously associated with LBM (FTO, IRS1, and ADAMTSL3), multinomial logistic regression revealed a significant association of the ADAMTSL3 genotype with %LBM (P < 0.01). For the three HGS-linked SNPs, neither GBF1 nor GLIS1 showed any association with HGS, but for TGFA, multinomial logistic regression revealed a significant association of genotype with HGS (P < 0.05). For ADAMTSL3, there was an enrichment of the effect allele in the MA (P < 0.05, Fisher's exact test). Collectively, of the six SNPs analyzed, ADAMTSL3 and TGFA showed significant associations with LBM and HGS, respectively. The functional relevance of the ADAMTSL3 SNP in body composition and of TGFA in strength may highlight a genetic component of the elite MA phenotype.
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Affiliation(s)
- Hannah Crossland
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Nottingham, United Kingdom
| | - Jessica Piasecki
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Daniel McCormick
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Nottingham, United Kingdom
| | - Bethan E Phillips
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Nottingham, United Kingdom
| | - Daniel J Wilkinson
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Nottingham, United Kingdom
| | - Kenneth Smith
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Nottingham, United Kingdom
| | - Jamie S McPhee
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Mathew Piasecki
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Nottingham, United Kingdom
| | - Philip J Atherton
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Nottingham, United Kingdom
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Fudickar S, Hellmers S, Lau S, Diekmann R, Bauer JM, Hein A. Measurement System for Unsupervised Standardized Assessment of Timed "Up & Go" and Five Times Sit to Stand Test in the Community-A Validity Study. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2824. [PMID: 32429306 PMCID: PMC7287989 DOI: 10.3390/s20102824] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 01/07/2023]
Abstract
Comprehensive and repetitive assessments are needed to detect physical changes in an older population to prevent functional decline at the earliest possible stage and to initiate preventive interventions. Established instruments like the Timed "Up & Go" (TUG) Test and the Sit-to-Stand Test (SST) require a trained person (e.g., physiotherapist) to assess physical performance. More often, these tests are only applied to a selected group of persons already functionally impaired and not to those who are at potential risk of functional decline. The article introduces the Unsupervised Screening System (USS) for unsupervised self-assessments by older adults and evaluates its validity for the TUG and SST. The USS included ambient and wearable movement sensors to measure the user's test performance. Sensor datasets of the USS's light barriers and Inertial Measurement Units (IMU) were analyzed for 91 users aged 73 to 89 years compared to conventional stopwatch measurement. A significant correlation coefficient of 0.89 for the TUG test and of 0.73 for the SST were confirmed among USS's light barriers. Correspondingly, for the inertial data-based measures, a high and significant correlation of 0.78 for the TUG test and of 0.87 for SST were also found. The USS was a validated and reliable tool to assess TUG and SST.
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Affiliation(s)
- Sebastian Fudickar
- Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany; (S.H.); (R.D.); (A.H.)
| | - Sandra Hellmers
- Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany; (S.H.); (R.D.); (A.H.)
| | - Sandra Lau
- Center for Geriatric Medicine, Agaplesion Bethanien Krankenhaus Heidelberg, University Heidelberg, 69117 Heidelberg, Germany; (S.L.); (J.M.B.)
| | - Rebecca Diekmann
- Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany; (S.H.); (R.D.); (A.H.)
| | - Jürgen M. Bauer
- Center for Geriatric Medicine, Agaplesion Bethanien Krankenhaus Heidelberg, University Heidelberg, 69117 Heidelberg, Germany; (S.L.); (J.M.B.)
| | - Andreas Hein
- Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany; (S.H.); (R.D.); (A.H.)
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26
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Fanning J, Rejeski WJ, Chen SH, Guralnik J, Pahor M, Miller ME. Relationships Between Profiles of Physical Activity and Major Mobility Disability in the LIFE Study. J Am Geriatr Soc 2020; 68:1476-1483. [PMID: 32196636 DOI: 10.1111/jgs.16386] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/21/2020] [Accepted: 02/01/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the relationship between time spent in light physical activity (LPA) and in moderate to vigorous physical activity (MVPA) and the pattern of accumulation on the risk for major mobility disability (MMD) in a large multicenter study of physical activity (PA) and aging, the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN Data were collected from individuals randomized to a PA intervention as part of the LIFE study, an eight-center single-blind randomized clinical trial conducted between February 2010 and December 2013. SETTING Lifestyle Interventions and Independence for Elders Study PARTICIPANTS: Older adult participants (78.4 years; N = 507) at risk for MMD. INTERVENTION All older adults included in these analyses were randomized to a structured PA intervention that included two center-based plus three to four home-based exercise sessions per week with a primary goal of walking for 150 minutes weekly. Participants attended the intervention for 2.5 years on average. MEASUREMENTS MMD was defined as the inability to complete a 400-m walk within 15 minutes and without assistance. Physical function was assessed via the Short Physical Performance Battery (SPPB). Actigraph accelerometers were used to quantify amount and variability in LPA and MVPA. RESULTS In an adjusted Cox proportional hazards regression, we identified a significant interaction (P = .017) between SPPB score and LPA amount and variability such that more LPA was associated with a reduced risk for MMD among those with higher initial function, as was lower variability (eg, via distributing LPA across the day). The SPPB × MVPA interaction was significant (P = .04), such that more MVPA was associated with lower MMD risk among those with lower function. Finally, greater MVPA variability was associated with lower risk for MMD. CONCLUSION A prescription of PA for older adults should account for key factors such as physical function and emphasize both amount and pattern of accumulation of PA from across the intensity continuum. J Am Geriatr Soc 68:1476-1483, 2020.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina
| | - W Jack Rejeski
- Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina
| | - Shyh-Huei Chen
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jack Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Michael E Miller
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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27
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Shin EJ, Jo S, Choi S, Cho CW, Lim WC, Hong HD, Lim TG, Jang YJ, Jang M, Byun S, Rhee Y. Red Ginseng Improves Exercise Endurance by Promoting Mitochondrial Biogenesis and Myoblast Differentiation. Molecules 2020; 25:E865. [PMID: 32079067 PMCID: PMC7070955 DOI: 10.3390/molecules25040865] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/08/2020] [Accepted: 02/15/2020] [Indexed: 12/25/2022] Open
Abstract
Red ginseng has been reported to elicit various therapeutic effects relevant to cancer, diabetes, neurodegenerative diseases, and inflammatory diseases. However, the effect of red ginseng on exercise endurance and skeletal muscle function remains unclear. Herein, we sought to investigate whether red ginseng could affect exercise endurance and examined its molecular mechanism. Mice were fed with red ginseng extract (RG) and undertook swimming exercises to determine the time to exhaustion. Animals fed with RG had significantly longer swimming endurance. RG treatment was also observed to enhance ATP production levels in myoblasts. RG increased mRNA expressions of mitochondrial biogenesis regulators, NRF-1, TFAM, and PGC-1α, which was accompanied by an elevation in mitochondrial DNA, suggesting an enhancement in mitochondrial energy-generating capacity. Importantly, RG treatment induced phosphorylation of p38 and AMPK and upregulated PGC1α expression in both myoblasts and in vivo muscle tissue. In addition, RG treatment also stimulated C2C12 myogenic differentiation. Our findings show that red ginseng improves exercise endurance, suggesting that it may have applications in supporting skeletal muscle function and exercise performance.
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Affiliation(s)
- Eun Ju Shin
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
| | - Seongin Jo
- Division of Bioengineering, Incheon National University, Incheon 22012, Korea; (S.J.); (S.C.)
| | - Sungbin Choi
- Division of Bioengineering, Incheon National University, Incheon 22012, Korea; (S.J.); (S.C.)
| | - Chang-Won Cho
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
| | - Won-Chul Lim
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
| | - Hee-Do Hong
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
| | - Tae-Gyu Lim
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
- Department of Food Science & Biotechnology, Sejong University, Seoul 05006, Korea
| | - Young Jin Jang
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
| | - Mi Jang
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
| | - Sanguine Byun
- Division of Bioengineering, Incheon National University, Incheon 22012, Korea; (S.J.); (S.C.)
| | - Youngkyung Rhee
- Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Korea; (E.J.S.); (C.-W.C.); (W.-C.L.); (H.-D.H.); (T.-G.L.); (Y.J.J.); (M.J.)
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Assessment of the Health Status of the Oldest Olds Living on the Greek Island of Ikaria: A Population Based-Study in a Blue Zone. Curr Gerontol Geriatr Res 2019; 2019:8194310. [PMID: 31885554 PMCID: PMC6914977 DOI: 10.1155/2019/8194310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 10/11/2019] [Indexed: 12/02/2022] Open
Abstract
Objective To describe the demographic characteristics, socio-economic status, functional status (autonomy, strength), and health status (cognitive and thymic functions, cardiovascular risk factors, and nutritional status) of the oldest olds living on the Greek island of Ikaria. We also try to explain the longevity observed in this population. Methods A cross-sectional observational study of people aged 90 and over living in both municipalities of north-western Ikaria (Evdilos and Raches) was conducted over one year, from October 21, 2012 to October 21, 2013. The participants were interviewed (medical history), had a brief clinical examination, and underwent standardized geriatric assessments including the Geriatric Depression Scale (GDS-15), the Mini-Mental-State Examination (MMSE), the Activities of Daily Living (ADL), the Instrumental ADL (IADL), and an assessment of grip strength. Results Seventy-one persons (37 females, 34 males), aged 94.1 years on average, were interviewed at their homes. Seven percent were current smokers (females 5.4%, males 8.8%). Hypertension was diagnosed in 70.4% of participants, diabetes in 19.7%, hypercholesterolemia in 12.7%, and obesity in 17.2%; 66.0% of the population had one chronic disease or more. The mean score for the GDS-15 scale was 3.7/15.0, 23.7/30.0 for the MMSE, 4.0/6.0 for the ADL, and 4.2/8.0 in females and 3.6/5.0 in males for the IADL. Grip strength was 17.0 kg in females and 26.5 kg in males. Conclusions This study provides an overview of the socio-demographic and medical characteristics of the oldest olds living in a longevity Blue Zone.
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Tessier AJ, Wing SS, Rahme E, Morais JA, Chevalier S. Physical function-derived cut-points for the diagnosis of sarcopenia and dynapenia from the Canadian longitudinal study on aging. J Cachexia Sarcopenia Muscle 2019; 10:985-999. [PMID: 31307126 PMCID: PMC6818452 DOI: 10.1002/jcsm.12462] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/18/2019] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Aging is associated with sarcopenia (low muscle mass) and dynapenia (low muscle strength) leading to disability and mortality. Widely used previous cut-points for sarcopenia were established from dated, small, or pooled cohorts. We aimed to identify cut-points of low strength as a determinant of impaired physical performance and cut-points of low appendicular lean mass (ALM) as a predictor of low strength in a single, large, and contemporary cohort of community-dwelling older adults and compare these criteria with others. METHODS Cross-sectional analyses were conducted on baseline data from 4725 and 4363 community-dwelling men and women (65-86 years, 96.8% Caucasian) of the Canadian longitudinal study on aging comprehensive cohort. Physical performance was evaluated from gait speed, timed up-and-go, chair rise, and balance tests; a weighted-sum score was computed using factor analysis. Strength was measured by handgrip dynamometry; ALM, by dual-energy X-ray absorptiometry and ALM index (ALMI; kg/m2 ), was calculated. Classification and regression tree analyses determined optimal sex-specific cut-points of ALMI predicting low strength and of strength predicting impaired physical performance (score < 1.5 SD below the sex-specific mean). RESULTS Modest associations were found between ALMI and strength and between strength and physical performance score in both sexes. ALMI was not an independent predictor of physical performance score. Cut-points of <33.1 and <20.4 kg were found to define dynapenia in men and in women, respectively, corresponding to 21.5% and 24.0% prevalence rates. Sarcopenia cut-points were <7.76 kg/m2 in men and <5.72 kg/m2 in women; prevalence rates of 21.7% and 13.7%. Overall, 8.3% of men and 5.5% of women had sarco-dynapenia. Sarcopenic were older and had lower fat mass and body mass index (BMI) than non-sarcopenic participants. While the agreement between current criteria and the updated European Working Group for Sarcopenia in Older Persons recommendations was fair, we found only slight agreement with the Foundation for the National Institute of Health sarcopenia project. Older persons identified with sarcopenia as per the Foundation for the National Institute of Health criteria (using ALM/BMI as the index) have higher BMI and fat mass compared with non-sarcopenic and have normal ALMI as per our criteria. CONCLUSIONS The proposed function-derived cut-points established from this single, large, and contemporary Canadian cohort should be used for the identification of sarcopenia and dynapenia in Caucasian older adults. We advise on using criteria based on ALMI in the diagnosis of sarcopenia. The modest agreement between sarcopenia and dynapenia denotes potential distinct health implications justifying to study both components separately.
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Affiliation(s)
- Anne-Julie Tessier
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Canada.,Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Simon S Wing
- Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada
| | - Elham Rahme
- Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada
| | - José A Morais
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Canada.,Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Canada.,Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada
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30
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Shuler K, Sucic JF, Talley SA, Goldberg A. Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism, Lower Extremity Strength, and Physical Performance in Older Adults. Phys Ther 2019; 99:998-1009. [PMID: 31087072 DOI: 10.1093/ptj/pzz073] [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: 02/21/2018] [Revised: 10/24/2018] [Accepted: 02/03/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Evidence for associations between the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene and physical performance is conflicting. Furthermore, investigations of relationships between lower extremity strength and physical performance have usually not considered the role of the ACE genotype, and it is unclear whether there are variations in relationships between lower extremity strength and physical performance among ACE genotypes in older adults. OBJECTIVE The objectives of this study were to investigate associations between the ACE I/D polymorphism and physical performance and to determine whether relationships between lower extremity strength and physical performance vary among ACE genotypes in older adults. DESIGN This was a cross-sectional observational study. METHODS Community-dwelling adults (N = 88) who were at least 60 years old completed physical performance and lower extremity strength tests. After DNA was extracted from saliva, ACE I/D polymorphism genotyping was done. The Spearman rank order correlation coefficient was used to examine associations between lower extremity strength and physical performance within ACE genotype subgroups. Analysis of covariance and linear regression were used to examine ACE genotype and ACE genotype × lower extremity strength interaction effects in relation to physical performance. RESULTS Genotype-specific correlation coefficients exhibited substantial variation among ACE genotype subgroups; however, differences did not attain statistical significance. Statistically significant genotype × lower extremity strength interaction effects in relation to physical performance were detected. LIMITATIONS The cross-sectional design precludes inferring causal relationships between strength and performance. The small sample size contributed to limited power to detect additional interaction effects and to detect statistically significant differences between correlation coefficients among ACE genotype subgroups. CONCLUSIONS The ACE I/D polymorphism is, interactively with lower extremity strength, associated with physical performance. Genotype-specific correlation coefficients and ACE genotype × lower extremity strength interaction effects on physical performance are consistent with variations in relationships between lower extremity strength and performance among ACE genotype subgroups.
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Affiliation(s)
- Kurt Shuler
- Department of Biology, College of Arts and Sciences, University of Michigan-Flint, Flint, Michigan
| | - Joseph F Sucic
- Department of Biology, College of Arts and Sciences, University of Michigan-Flint
| | - Susan Ann Talley
- Physical Therapy Department, College of Health Sciences, University of Michigan-Flint
| | - Allon Goldberg
- Physical Therapy Department, College of Health Sciences, University of Michigan-Flint, 303 East Kearsley Rd, Flint, MI 48502 (USA)
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Grishina EE, Zmijewski P, Semenova EA, Cięszczyk P, Humińska-Lisowska K, Michałowska-Sawczyn M, Maculewicz E, Crewther B, Orysiak J, Kostryukova ES, Kulemin NA, Borisov OV, Khabibova SA, Larin AK, Pavlenko AV, Lyubaeva EV, Popov DV, Lysenko EA, Vepkhvadze TF, Lednev EM, Bondareva EA, Erskine RM, Generozov EV, Ahmetov II. Three DNA Polymorphisms Previously Identified as Markers for Handgrip Strength Are Associated With Strength in Weightlifters and Muscle Fiber Hypertrophy. J Strength Cond Res 2019; 33:2602-2607. [PMID: 31361736 DOI: 10.1519/jsc.0000000000003304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Grishina, EE, Zmijewski, P, Semenova, EA, Cięszczyk, P, Humińska-Lisowska, K, Michałowska-Sawczyn, M, Maculewicz, E, Crewther, B, Orysiak, J, Kostryukova, ES, Kulemin, NA, Borisov, OV, Khabibova, SA, Larin, AK, Pavlenko, AV, Lyubaeva, EV, Popov, DV, Lysenko, EA, Vepkhvadze, TF, Lednev, EM, Bondareva, EA, Erskine, RM, Generozov, EV, and Ahmetov, II. Three DNA polymorphisms previously identified as markers for handgrip strength are associated with strength in weightlifters and muscle fiber hypertrophy. J Strength Cond Res 33(10): 2602-2607, 2019-Muscle strength is a highly heritable trait. So far, 196 single nucleotide polymorphisms (SNPs) associated with handgrip strength have been identified in 3 genome-wide association studies. The aim of our study was to validate the association of 35 SNPs with strength of elite Russian weightlifters and replicate the study in Polish weightlifters. Genotyping was performed using micro-array analysis or real-time polymerase chain reaction. We found that the rs12055409 G-allele near the MLN gene (p = 0.004), the rs4626333 G-allele near the ZNF608 gene (p = 0.0338), and the rs2273555 A-allele in the GBF1 gene (p = 0.0099) were associated with greater competition results (total lifts in snatch and clean and jerk adjusted for sex and weight) in 53 elite Russian weightlifters. In the replication study of 76 sub-elite Polish weightlifters, rs4626333 GG homozygotes demonstrated greater competition results (p = 0.0155) and relative muscle mass (p = 0.046), adjusted for sex, weight, and age, compared with carriers of the A-allele. In the following studies, we tested the hypotheses that these SNPs would be associated with skeletal muscle hypertrophy and handgrip strength. We found that the number of strength-associated alleles was positively associated with fast-twitch muscle fiber cross-sectional area in the independent cohort of 20 male power athletes (p = 0.021) and with handgrip strength in 87 physically active individuals (p = 0.015). In conclusion, by replicating previous findings in 4 independent studies, we demonstrate that the rs12055409 G-, rs4626333 G-, and rs2273555 A-alleles are associated with higher levels of strength, muscle mass, and muscle fiber size.
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Affiliation(s)
- Elina E Grishina
- Laboratory of Molecular Genetics, Kazan State Medical University, Kazan, Russia
| | - Piotr Zmijewski
- Faculty of Medicine, University of Information Technology and Management in Rzeszow, Poland.,Research and Development Center Legia Lab, Legia Warszawa, Poland
| | - Ekaterina A Semenova
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia.,Department of Biochemistry, Kazan Federal University, Kazan, Russia
| | - Paweł Cięszczyk
- Department of Theory and Practice of Sport, Academy of Physical Education in Katowice, Katowice, Poland
| | - Kinga Humińska-Lisowska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | | | - Ewelina Maculewicz
- Independent Laboratory of Genetics and Molecular Biology, Kaczkowski Military Institute of Hygiene Epidemiology, Warsaw, Poland
| | - Blair Crewther
- Institute of Sport-National Research Institute, Warsaw, Poland
| | - Joanna Orysiak
- Institute of Sport-National Research Institute, Warsaw, Poland
| | - Elena S Kostryukova
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia
| | - Nickolay A Kulemin
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia
| | - Oleg V Borisov
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia.,Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Bonn, Germany
| | - Sofya A Khabibova
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia
| | - Andrey K Larin
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia
| | - Alexander V Pavlenko
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia
| | - Ekaterina V Lyubaeva
- Laboratory of Exercise Physiology, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Daniil V Popov
- Laboratory of Exercise Physiology, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Evgeny A Lysenko
- Laboratory of Exercise Physiology, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Tatiana F Vepkhvadze
- Laboratory of Exercise Physiology, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Egor M Lednev
- Laboratory of Exercise Physiology, Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Elvira A Bondareva
- Research Institute and Museum of Anthropology, Lomonosov Moscow State University, Moscow, Russia
| | - Robert M Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.,Institute of Sport, Exercise and Health, University College London, London, United Kingdom
| | - Edward V Generozov
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia
| | - Ildus I Ahmetov
- Laboratory of Molecular Genetics, Kazan State Medical University, Kazan, Russia.,Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, Russia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.,Sports Genetics Laboratory, St. Petersburg Research Institute of Physical Culture, St. Petersburg, Russia
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The relationship between body mass index and disability-free survival in elderly Japanese: the Ohsaki Cohort 2006 Study. Int J Obes (Lond) 2019; 43:2254-2263. [PMID: 30940914 DOI: 10.1038/s41366-019-0359-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND The relationship between body mass index (BMI) and disability-free survival (DFS) remains unclear. METHODS We conducted a 10-year prospective cohort study of 12,666 Japanese individuals aged ≥ 65 y. Information on BMI and lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. Subjects were divided into seven groups according to BMI (<19, 19-21, 21-23, 23-25, 25-27, 27-29 and ≥29). Fiftieth percentile differences (PDs) and 95% confidence intervals (CIs) in the DFS period (differences of period until the first 50% of the composite outcome (disability or death) occurred in each of the BMI groups) were calculated using the Laplace regression model. RESULTS There was a U-shaped relationship between BMI and the risk of incident composite outcome, with a BMI nadir of 25-27. Based on BMI 25-27 as a reference, the 50th PDs (95% CIs) (in months) in age at disability or death (median DFS) were -20.8 (-26.4, -15.2) (P < 0.001) months for BMI <19, -13.5 (-18.2, -8.7) (P < 0.001) months for BMI 19-21, -9.8 (-14.2, -5.4) (P < 0.001) months for BMI 21-23, -2.9 (-7.5, 1.7) (P = 0.21) months for BMI 23-25, -2.7 (-8.4, 2.9) (P = 0.34) months for BMI 27-29, and -11.5 (-19.6, -3.5) (P = 0.005) months for BMI ≥ 29. These relationships did not differ by sex. CONCLUSION Older individuals with a BMI of <23 or ≥29 have a significantly shorter DFS period than those with a BMI of 25-27. It is suggested that the optimal BMI range for maximization of disability-free life expectancy in the elderly population is 23-29.
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Alba DL, Wu L, Cawthon PM, Mulligan K, Lang T, Patel S, King NJ, Carter JT, Rogers SJ, Posselt AM, Stewart L, Shoback DM, Schafer AL. Changes in Lean Mass, Absolute and Relative Muscle Strength, and Physical Performance After Gastric Bypass Surgery. J Clin Endocrinol Metab 2019; 104:711-720. [PMID: 30657952 PMCID: PMC6339456 DOI: 10.1210/jc.2018-00952] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/23/2018] [Indexed: 11/19/2022]
Abstract
CONTEXT Bariatric surgery results in reduced muscle mass as weight is lost, but postoperative changes in muscle strength and performance are incompletely understood. OBJECTIVE To examine changes in body composition, strength, physical activity, and physical performance following Roux-en-Y gastric bypass (RYGB). DESIGN, PARTICIPANTS, OUTCOMES In a prospective cohort of 47 adults (37 women, 10 men) aged 45 ± 12 years (mean ± SD) with body mass index (BMI) 44 ± 8 kg/m2, we measured body composition by dual-energy X-ray absorptiometry, handgrip strength, physical activity, and physical performance (chair stand time, gait speed, 400-m walk time) before and 6 and 12 months after RYGB. Relative strength was calculated as absolute handgrip strength/BMI and as absolute strength/appendicular lean mass (ALM). RESULTS Participants experienced substantial 12-month decreases in weight (-37 ± 10 kg or 30% ± 7%), fat mass (-48% ± 12%), and total lean mass (-13% ± 6%). Mean absolute strength declined by 9% ± 17% (P < 0.01). In contrast, relative strength increased by 32% ± 25% (strength/BMI) and 9% ± 20% (strength/ALM) (P < 0.01 for both). There were clinically significant postoperative improvements in all physical performance measures, including mean improvement in gait speed of >0.1 m/s (P < 0.01) and decrease in 400-m walk time of nearly a full minute. CONCLUSIONS In the setting of dramatic weight loss, lean mass and absolute grip strength declined after RYGB. However, relative muscle strength and physical function improved meaningfully and are thus noteworthy positive outcomes of gastric bypass.
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Affiliation(s)
- Diana L Alba
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco, California
- Diabetes Center, University of California, San Francisco, San Francisco, California
- Correspondence and Reprint Requests: Diana L. Alba, MD, University of California, San Francisco, Medical Sciences S1230, 513 Parnassus Avenue, San Francisco, California 94143. E-mail:
| | - Lucy Wu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Peggy M Cawthon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
- California Pacific Medical Center, Research Institute, San Francisco, California
| | - Kathleen Mulligan
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Thomas Lang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Sheena Patel
- California Pacific Medical Center, Research Institute, San Francisco, California
| | - Nicole J King
- Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Jonathan T Carter
- Department of Surgery, University of California, San Francisco, California
| | - Stanley J Rogers
- Department of Surgery, University of California, San Francisco, California
| | - Andrew M Posselt
- Department of Surgery, University of California, San Francisco, California
| | - Lygia Stewart
- Department of Surgery, University of California, San Francisco, California
- Surgical Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Dolores M Shoback
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco, California
- Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Anne L Schafer
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
- Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, California
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Härkänen T, Sainio P, Stenholm S, Lundqvist A, Valkeinen H, Aromaa A, Koskinen S. Projecting long-term trends in mobility limitations: impact of excess weight, smoking and physical inactivity. J Epidemiol Community Health 2019; 73:443-450. [PMID: 30777889 DOI: 10.1136/jech-2017-210413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 12/20/2018] [Accepted: 01/10/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Policy makers need disability projections for planning adequate services and measures for health promotion. The aim of this study is to provide projections on severe mobility limitations up to year 2044 and illustrate how the projected prevalence and the number of persons with severe mobility limitations are affected by potential changes in the modifiable risk factors, namely excess weight, physical inactivity and smoking. METHODS We analysed the nationally representative, repeated measures Health 2000 and 2011 Surveys (BRIF8901) with 8615 and 6740 participants, respectively, aged 18 years and older. Severe mobility limitations were defined as major difficulties or unable to walk about half a kilometre. We applied a multistate model on repeated measures to account for both individual risk factors and their changes over time. RESULTS The number of people with severe mobility limitations was projected to double by the year 2044 in Finland, due to the rapid ageing of the population. Eliminating half of the excess weight would reduce their number by one-fifth, while reductions in the prevalence of smoking and physical inactivity would have a minor impact. Even if excess weight, smoking and physical inactivity were completely eliminated, the number of persons with severe mobility limitations is projected to increase. CONCLUSIONS Designing and implementing strategies to promote healthy weight are important to slow down the rapid increase in mobility limitations due to population ageing. Providing adequate health and social services for the increasing population with disabilities will nevertheless be an increasing national challenge.
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Affiliation(s)
- Tommi Härkänen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Päivi Sainio
- National Institute for Health and Welfare, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland
| | | | - Heli Valkeinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
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Korkmaz M, Eyigor S. Association between sarcopenia and rheumatological diseases. World J Rheumatol 2019; 9:1-8. [DOI: 10.5499/wjr.v9.i1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/12/2018] [Accepted: 01/05/2019] [Indexed: 02/06/2023] Open
Abstract
Sarcopenia (“sarx” for muscle, “penia” for loss) is an important problem in the elderly. Although muscle loss is a part of natural aging, excessive loss that limits physical activity is considered pathological. Sarcopenia is associated with age, malnutrition, physical inactivity, inflammatory stress and hormonal changes. Although relationships between sarcopenia and various chronic inflammatory diseases have been shown, the role of rheumatologic disease in sarcopenia development is currently unknown. Our aim in this mini-review was to increase the awareness of clinicians to sarcopenia, and to evaluate studies in which the relationship between sarcopenia and rheumatologic diseases was investigated. We also aimed to determine whether the available literature was sufficient to confirm a strong relationship between these conditions. Although our findings showed that diseases such as rheumatoid arthritis, osteoarthritis and systemic sclerosis may have a role in sarcopenia development and progress, the methodologies and results of the majority of studies were insufficient in determining direct causal relationships. We believe future studies would benefit from focusing on the factors and causes of sarcopenia, with a goal of determining the factors associated with rheumatologic disease that are most effective in sarcopenia development.
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Affiliation(s)
- Murat Korkmaz
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Afyon Saglik Bilimleri University, Afyonkarahisar 03000, Turkey
| | - Sibel Eyigor
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Ege University, Izmir 35100, Turkey
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Ponti F, Santoro A, Mercatelli D, Gasperini C, Conte M, Martucci M, Sangiorgi L, Franceschi C, Bazzocchi A. Aging and Imaging Assessment of Body Composition: From Fat to Facts. Front Endocrinol (Lausanne) 2019; 10:861. [PMID: 31993018 PMCID: PMC6970947 DOI: 10.3389/fendo.2019.00861] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/25/2019] [Indexed: 01/10/2023] Open
Abstract
The aging process is characterized by the chronic inflammatory status called "inflammaging", which shares major molecular and cellular features with the metabolism-induced inflammation called "metaflammation." Metaflammation is mainly driven by overnutrition and nutrient excess, but other contributing factors are metabolic modifications related to the specific body composition (BC) changes occurring with age. The aging process is indeed characterized by an increase in body total fat mass and a concomitant decrease in lean mass and bone density, that are independent from general and physiological fluctuations in weight and body mass index (BMI). Body adiposity is also re-distributed with age, resulting in a general increase in trunk fat (mainly abdominal fat) and a reduction in appendicular fat (mainly subcutaneous fat). Moreover, the accumulation of fat infiltration in organs such as liver and muscles also increases in elderly, while subcutaneous fat mass tends to decrease. These specific variations in BC are considered risk factors for the major age-related diseases, such as cardiovascular diseases, type 2 diabetes, sarcopenia and osteoporosis, and can predispose to disabilities. Thus, the maintenance of a balance rate of fat, muscle and bone is crucial to preserve metabolic homeostasis and a health status, positively contributing to a successful aging. For this reason, a detailed assessment of BC in elderly is critical and could be an additional preventive personalized strategy for age-related diseases. Despite BMI and other clinical measures, such as waist circumference measurement, waist-hip ratio, underwater weighing and bioelectrical impedance, are widely used as a surrogate measure for body adiposity, they barely reflect the distribution of body fat. Because of the great advantages offered by imaging tools in research and clinics, the attention of clinicians is now moving to powerful imaging techniques such as computed tomography, magnetic resonance imaging, dual-energy X-ray absorptiometry and ultrasound to obtain a more accurate estimation of BC. The aim of this review is to present the state of the art of the imaging techniques that are currently available to measure BC and that can be applied to the study of BC changes in the elderly, outlining advantages and disadvantages of each technique.
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Affiliation(s)
- Federico Ponti
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- *Correspondence: Aurelia Santoro
| | - Daniele Mercatelli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Conte
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Morena Martucci
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Luca Sangiorgi
- Department of Medical Genetics and Rare Orthopedic Disease & CLIBI Laboratory, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Department of Applied Mathematics, Institute of Information Technology, Mathematics and Mechanics (ITMM), Lobachevsky State University of Nizhny Novgorod-National Research University (UNN), Nizhny Novgorod, Russia
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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The joint associations of weight status and physical activity with mobility disability: The NIH-AARP Diet and Health Study. Int J Obes (Lond) 2018; 43:1830-1838. [PMID: 30575803 DOI: 10.1038/s41366-018-0294-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/26/2018] [Accepted: 11/02/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES The purpose of this study was to determine the joint associations of weight status and physical activity with mobility disability in older men and women. SUBJECTS/METHODS We analyzed prospective data from 135,220 participants in the NIH-AARP Diet and Health Study between 1995-1996 and 2004-2005. METHODS Height and weight, as well as light- and moderate-to-vigorous-intensity physical activity typical of the past 10 years (h/week) were self-reported at baseline, and body mass index (BMI: kg/m2) was categorized into normal weight (BMI 18 to <25 kg/m2); overweight (BMI 25 to <30 kg/m2); and obese (BMI ≥ 30 kg/m2). Mobility was assessed by self-report at follow-up and mobility disability was defined as reporting "unable to walk" or an "easy usual walking pace (<2 mph)". Multivariable logistic regression determined the independent and joint associations of weight status and total physical activity with the odds of mobility disability. RESULTS Twenty-one percent of men and 37% of women reported a mobility disability at follow-up. We observed a curvilinear dose-response association between increasing categories of weight status and mobility disability within each tertile of physical activity, with the highest odds experienced by men and women with overweight (OR = 2.45; 95%CI: 2.25, 2.67 for men and OR = 2.99; 95%CI: 2.78, 3.22 for women) and obesity (OR = 3.93; 95%CI: 3.58, 4.32 for men and OR = 5.08; 95% CI: 4.65, 5.54 for women) in combination with low physical activity. Moreover, among those reporting 7 or fewer hours/week of total physical activity, being of normal body weight did not eliminate the excess odds of mobility disability. CONCLUSIONS These findings highlight the combined importance of obesity prevention and physical activity promotion to mobility in older age. Given aging demographics and the global economic burden associated with aging- and disuse-related disability, there is tremendous public health benefit to understanding how various modifiable determinants of mobility disability can interact in older age.
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Abstract
The optimal management of sarcopenia requires appropriate endpoint measures to determine intervention efficacy. While hand grip strength is a predictor of morbidity and mortality, lower extremity strength may be better associated with functional activities in comparison to hand grip strength. The purpose of our study was to examine the comparative association of upper and lower extremity strength with common measures of physical performance in older adults. Thirty community-dwelling men, aged 62.5 ± 9.2 years, completed body composition analysis, quantitative strength testing, and performance-based tests of functional status. Hand grip force values were not significantly associated with knee extensor or flexor torque values (p > 0.05). Hand grip force was only associated with fast gait speed, while knee extensor torque at 60°/s was the only variable significantly associated across all functional outcome measures: customary gait speed, fast gait speed, sit to stand time, and the Physical Performance Test (p < 0.02). Hand grip strength was not a proxy measure of lower extremity strength as assessed in this study. Overall, lower extremity muscle strength values had the strongest associations with participant functional performance. Lower extremity strength testing may provide additional value as an endpoint measure in the assessment and clinical management of sarcopenia.
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Lv YB, Yuan JQ, Mao C, Gao X, Yin ZX, Kraus VB, Luo JS, Chen HS, Zeng Y, Wang WT, Wang JN, Shi XM. Association of Body Mass Index With Disability in Activities of Daily Living Among Chinese Adults 80 Years of Age or Older. JAMA Netw Open 2018; 1:e181915. [PMID: 30646143 PMCID: PMC6324469 DOI: 10.1001/jamanetworkopen.2018.1915] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Body mass index (BMI) shows a U-shaped association with impaired physical functioning among adults; the association is reduced or eliminated with aging. OBJECTIVE To examine whether BMI is associated with subsequent disability in activities of daily living (ADL) in Chinese adults age 80 years or older. DESIGN, SETTING, AND PARTICIPANTS Data were obtained on 16 022 adults age 80 years or older who were able to perform ADL independently at baseline from the Chinese Longitudinal Healthy Longevity Study, a community-based prospective cohort study conducted in 23 provinces of China. The study was initiated in 1998, with follow-up and recruitment of new participants in 2000, 2002, 2005, 2008, 2011, and 2014. MAIN OUTCOMES AND MEASURES Disability in ADL was defined as dependence in eating, toileting, bathing, dressing, indoor activities, and/or continence. RESULTS Among the 16 022 participants, 45.2% were men and 54.8% were women, with a mean (SD) age of 92.2 (7.2) years and a mean (SD) BMI (calculated as weight in kilograms divided by height in meters squared) of 19.3 (3.8). During 70 606 person-years of follow-up, 8113 participants with disability in ADL were identified. Cox proportional hazards regression models with penalized splines showed that BMI was linearly associated with disability in ADL: each 1-kg/m2 increase in BMI corresponded to a 4.5% decrease in the risk of disability in ADL. In comparison with individuals in the fourth quintile for BMI, the adjusted hazard ratio for disability in ADL was 1.38 (95% CI, 1.29-1.48) in the first quintile, 1.37 (95% CI, 1.28-1.47) in the second quintile, 1.11 (95% CI, 1.04-1.19) in the third quintile, and 0.85 (95% CI, 0.79-0.91) in the fifth quintile (P < .001 for trend). When BMI was categorized by Chinese guidelines, the underweight group (BMI <18.5) showed significantly increased risk of disability in ADL (hazard ratio, 1.34; 95% CI, 1.28-1.41) and the overweight or obese group (BMI ≥24.0) showed significantly decreased risk of disability in ADL (hazard ratio, 0.84; 95% CI, 0.78-0.91) compared with the normal weight group (BMI 18.5 to <24.0) (P < .001 for trend). CONCLUSIONS AND RELEVANCE Higher BMI was associated with a lower risk of disability in ADL among Chinese adults age 80 years or older, which suggests that current recommendations for BMI may need to be revisited. More attention should be paid on underweight, rather than overweight or obesity, for the prevention of disability in ADL after age 80 years.
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Affiliation(s)
- Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin-Qiu Yuan
- Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, Philadelphia
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Shuai Chen
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Geriatric Division of School of Medicine, Duke University, Durham, North Carolina
- Center for Study of Healthy Aging and Development Studies, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Wen-Tao Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiao-Nan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Petersen CL, Wechsler EV, Halter RJ, Boateng GG, Proctor PO, Kotz DF, Cook SB, Batsis JA. Detection and Monitoring of Repetitions Using an mHealth-Enabled Resistance Band. ...IEEE...INTERNATIONAL CONFERENCE ON CONNECTED HEALTH: APPLICATIONS, SYSTEMS AND ENGINEERING TECHNOLOGIES. IEEE INTERNATIONAL CONFERENCE ON CONNECTED HEALTH: APPLICATIONS, SYSTEMS AND ENGINEERING TECHNOLOGIES 2018; 2018:22-24. [PMID: 30984918 PMCID: PMC6456081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sarcopenia is defined as an age-related loss of muscle mass and strength which impairs physical function leading to disability and frailty. Resistance exercises are effective treatments for sarcopenia and are critical in mitigating weight-loss induced sarcopenia in older adults attempting to lose weight. Yet, adherence to home-based regimens, which is a cornerstone to lifestyle therapies, is poor and cannot be ascertained by clinicians as no objective methods exist to determine patient compliance outside of a supervised setting. Our group developed a Bluetooth connected resistance band that tests the ability to detect exercise repetitions. We recruited 6 patients aged 65 years and older and recorded 4 specific, physical therapist-led exercises. Three blinded reviewers examined the findings and we also applied a peak Ending algorithm to the data. There were 16.6 repetitions per exercise across reviewers, with an intraclass correlation of 0.912 (95%CI: 0.853-0.953, p<0.001) between reviewers and the algorithm. Using this novel resistance band, we feasibly detected repetition of exercises in older adults.
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Affiliation(s)
- Curtis L Petersen
- The Dartmouth Institute Quantitative Biomedical Science, Dartmouth College,
| | | | | | | | | | - David F Kotz
- Department of Computer Science, Dartmouth College
| | | | - John A Batsis
- The Dartmouth Institute, Dartmouth College, Darmtouth-Hitchcock Medical Center
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Integrating Health Promotion Into Physical Therapy Practice to Improve Brain Health and Prevent Alzheimer Disease. J Neurol Phys Ther 2018. [PMID: 28628597 DOI: 10.1097/npt.0000000000000181] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Alzheimer disease is the most common cause of dementia, and brain pathology appears years before symptoms are evident. Primary prevention through health promotion can incorporate lifestyle improvement across the lifespan. Risk factor assessment and identifying markers of disease might also trigger preventive measures needed for high-risk individuals and groups. SUMMARY OF KEY POINTS Many potential risk factors are modifiable through exercise, and may be responsive to early intervention strategies to reduce the downward slope toward disability. Through the use of common clinical tests to identify cognitive and noncognitive functional markers of disease, detection and intervention can occur at earlier stages, including preclinical stages of disease. Physical activity and exercise interventions to address modifiable risk factors and impairments can play a pivotal role in the prevention and delay of functional decline, ultimately reducing the incidence of dementia. This article discusses prevention, prediction, plasticity, and participation in the context of preserving brain health and preventing Alzheimer disease and related dementias in aging adults. RECOMMENDATIONS FOR CLINICAL PRACTICE Rehabilitation professionals have opportunities to slow disease progression through research, practice, and education initiatives. From a clinical perspective, interventions that target brain health through lifestyle changes and exercise interventions show promise for preventing stroke and associated neurovascular diseases in addition to dementia. Physical therapists are well positioned to integrate primary health promotion into practice for the prevention of dementia and other neurological conditions in older adults.
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Addison O, Ryan AS, Prior SJ, Katzel LI, Kundi R, Lal BK, Gardner AW. Changes in Function After a 6-Month Walking Intervention in Patients With Intermittent Claudication Who Are Obese or Nonobese. J Geriatr Phys Ther 2018; 40:190-196. [PMID: 27341324 DOI: 10.1519/jpt.0000000000000096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Both obesity and peripheral artery disease (PAD) limit function and may work additively to reduce mobility. The purpose of this study was to compare the effects of a 6-month, center-based walking program on mobility function between adults who are weight-stable obese and nonobese with PAD. METHODS This is a secondary data analysis of 2 combined studies taken from previous work. Fifty-three adults with PAD and intermittent claudication participated in 6 months of treadmill training or standard of care. Patients were divided into 4 groups for analyses: exercise nonobese (Ex), exercise obese (ExO), standard-of-care nonobese (SC), and standard-of-care obese (SCO). Mobility was assessed by a standardized treadmill test to measure claudication onset time (COT) and peak walking time (PWT) as well as the distance walked during a 6-minute walk distance (6MWD) test. RESULTS There was a significant (P < .001) interaction (intervention × obesity) effect on 6MWD, wherein both exercise groups improved (Ex = 7%, ExO = 16%; P < .02), the SC group did not change (0.9%; P > .05), and the SCO group tended to decline (-18%; P = .06). Both exercise intervention groups significantly improved COT (Ex = 92%, ExO = 102%; P < .01) and PWT (Ex = 54%, ExO = 103%; P < .001). There was no change (P > .05) in either standard-of-care group. CONCLUSIONS Individuals who are obese and nonobese with PAD made similar improvements after a 6-month, center-based walking program. However, patients who are obese with PAD and do not exercise may be susceptible to greater declines in mobility. Exercise may be particularly important in patients who are obese with PAD to avoid declines in mobility.
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Affiliation(s)
- Odessa Addison
- 1Department of Medicine, Division of Gerontology, University of Maryland, Baltimore. 2Department of Veterans Affairs and Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Centers, Baltimore, Maryland. 3Department of Surgery, Division of Vascular Surgery, University of Maryland, Baltimore. 4Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City
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Demnitz N, Hogan DB, Dawes H, Johansen-Berg H, Ebmeier KP, Poulin MJ, Sexton CE. Cognition and mobility show a global association in middle- and late-adulthood: Analyses from the Canadian Longitudinal Study on Aging. Gait Posture 2018; 64:238-243. [PMID: 29945095 PMCID: PMC6052573 DOI: 10.1016/j.gaitpost.2018.06.116] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/06/2018] [Accepted: 06/17/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Given our aging population, there's great interest in identifying modifiable risk factors for cognitive decline. Studies have highlighted the relationship between aspects of mobility and cognitive processes. However, cognition and mobility are both multifaceted concepts and their interrelationships remain to be well defined. RESEARCH QUESTION Here, we firstly aimed to replicate cross-sectional associations between objective measures of mobility and cognition. Second, we tested whether these associations remained after the consideration of multiple age-related confounders. Finally, to test the hypothesis that the association between mobility and cognition is stronger in older adults, we examined the moderating effect of age in the association between mobility and cognition. METHODS In the Canadian Longitudinal Study on Aging, 28,808 community-dwelling adults (aged 45-87; 51% female) completed mobility (gait, balance and chair stands) and cognitive (memory, executive function and processing speed) assessments. General linear models were used to examine mobility-cognition relationships and the moderating effect of age. RESULTS Cognitive measures were significantly associated with mobility measures (all p < 0.001). Further, age significantly moderated the mobility-cognition relationship, with the strength of the associations generally increasing with age. SIGNIFICANCE All cognitive measures were related to indices of mobility, suggesting a global association. In our moderation analyses, the mobility-cognition relationship often increased with age. However, the small effect sizes observed suggest that mobility is, in isolation, not a strong correlate of cognitive performance in middle and late-adulthood.
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Affiliation(s)
- Naiara Demnitz
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, FMRIB, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Canada
| | - Helen Dawes
- Centre for Movement and Occupational Rehabilitation Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, United Kingdom
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Marc J Poulin
- Department of Physiology and Pharmacology and the Hotchkiss Brain Institute, Cumming School of Medicine and Faculty of Kinesiology, University of Calgary, Canada
| | - Claire E Sexton
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Global Brain Health Institute, Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.
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Fudickar S, Kiselev J, Frenken T, Wegel S, Dimitrowska S, Steinhagen-Thiessen E, Hein A. Validation of the ambient TUG chair with light barriers and force sensors in a clinical trial. Assist Technol 2018; 32:1-8. [PMID: 29482463 DOI: 10.1080/10400435.2018.1446195] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
To initiate appropriate interventions and avoid physical decline, comprehensive measurements are needed to detect functional changes in elderly people at the earliest possible stage. The established Timed Up&Go (TUG) test takes little time and, due to its standardized and easy procedure, can be conducted by elderly people in their own homes without clinical guidance. Therefore, cheap light barriers (LBs) and force sensors (FSs) are well suited ambient sensors that could easily be attached to existing (arm)chairs to measure and report TUG times in order to identify functional decline. We validated the sensitivity of these sensors in a clinical trial with 100 elderlies aged 58-92 years with a mean of 74 (±6.78) years by comparing the sensor-based results with standard TUG measurements using a stopwatch. We further evaluated the accuracy enhancement when calibrating the algorithm via a mixed linear model. With calibration, the LBs achieved a root mean square error (RMSE) of 0.83 s, compared to 1.90 s without, and the FSs achieved 0.90 s compared to 2.12 s without. The suitability of measuring accurate TUG times with each of the ambient sensors and of measuring TUG regularly in the homes of elderly people could be confirmed.
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Affiliation(s)
- Sebastian Fudickar
- Department of Health Services Research, University of Oldenburg, School of Medicine and Health Sciences, Oldenburg, Germany
| | - Jörn Kiselev
- Geriatrics Research Group, Charité Universitätsmedizin Berlin, Germany
| | - Thomas Frenken
- OFFIS - Institute for Information Technology, Oldenburg, Germany
| | - Sandra Wegel
- Geriatrics Research Group, Charité Universitätsmedizin Berlin, Germany
| | | | | | - Andreas Hein
- Department of Health Services Research, University of Oldenburg, School of Medicine and Health Sciences, Oldenburg, Germany.,OFFIS - Institute for Information Technology, Oldenburg, Germany
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Portnoy S, Maayan C, Tsenter J, Ofran Y, Goldman V, Hiller N, Karniel N, Schwartz I. Characteristics of ataxic gait in familial dysautonomia patients. PLoS One 2018; 13:e0196599. [PMID: 29698477 PMCID: PMC5919612 DOI: 10.1371/journal.pone.0196599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 04/16/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction and objectives Progressive ataxic gait is a common symptom in individuals with Familial Dysautonomia (FD). At least 50% of adults with FD require assistance with walking. Our aims were to describe the medical condition of individuals with FD (ii) compare their gait characteristics to healthy individuals, and (iii) assess correlations between gait measures, presence of unstable gait pattern and frequency of falls. Methods Twelve subjects with FD (7 males, age 25.3±10.6 years) and 16 healthy participants (6 males, age 35.9±11.9 years) were recruited. Gait kinematics, gait symmetry, dynamic muscle activity, and foot deep vibration sensation were recorded. Results Ataxic gait degrees were: severe (6 out of 12), moderate (4 out of 12) and low (2 out of 12). The number of falls correlated with base width asymmetry. Crouch gait was noted in 3 out of 12 of the subjects. Conclusions In-depth quantitative gait analysis of individuals with FD revealed ataxic gait. The ataxic pattern might be a result of combined neurological deficiencies and osseous deformities. Increasing the base of support of patients with FD might increase the symmetry of the base width during gait and decrease the number of falls. Additionally, perturbation treatment and dynamic balance exercises may be recommended in order to improve compensatory strategies. Future investigation of this population should include quantification of osseous rotations of the lower limb in order to fully understand its effect on their gait pattern and falls.
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Affiliation(s)
- Sigal Portnoy
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
| | - Channa Maayan
- Familial Dysautonomia Center, Pediatric department, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
| | - Jeanna Tsenter
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
| | - Yonah Ofran
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
| | - Vladimir Goldman
- Department of Orthopedic Surgery, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
| | - Nurit Hiller
- Department of Radiology, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
| | - Naama Karniel
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
| | - Isabella Schwartz
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Hebrew University Hadassah medical school, Jerusalem, Israel
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Goins RT, Schure M, Jensen PN, Suchy-Dicey A, Nelson L, Verney SP, Howard BV, Buchwald D. Lower body functioning and correlates among older American Indians: The Cerebrovascular Disease and Its Consequences in American Indians Study. BMC Geriatr 2018; 18:6. [PMID: 29304750 PMCID: PMC5756432 DOI: 10.1186/s12877-017-0697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 12/19/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND More than six million American Indians live in the United States, and an estimated 1.6 million will be aged ≥65 years old by 2050 tripling in numbers since 2012. Physical functioning and related factors in this population are poorly understood. Our study aimed to assess lower body functioning and identify the prevalence and correlates of "good" functioning in a multi-tribe, community-based sample of older American Indians. METHODS Assessments used the Short Physical Performance Battery (SPPB). "Good" lower body functioning was defined as a total SPPB score of ≥10. Potential correlates included demographic characteristics, study site, anthropometrics, cognitive functioning, depressive symptomatology, grip strength, hypertension, diabetes mellitus, heart disease, prior stroke, smoking, alcohol use, and over-the-counter medication use for arthritis or pain. Data were collected between 2010 and 2013 by the Cerebrovascular Disease and Its Consequences in American Indians Study from community-dwelling adults aged ≥60 years (n = 818). RESULTS The sample's mean age was 73 ± 5.9 years. After adjustment for age and study site, average SPPB scores were 7.0 (95% CI, 6.8, 7.3) in women and 7.8 (95% CI, 7.5, 8.2) in men. Only 25% of the sample were classified with "good" lower body functioning. When treating lower body functioning as a continuous measure and adjusting for age, gender, and study site, the correlates of better functioning that we identified were younger age, male gender, married status, higher levels of education, higher annual household income, Southern Plains study site, lower waist-hip ratio, better cognitive functioning, stronger grip strength, lower levels of depressive symptomatology, alcohol consumption, and the absence of hypertension, diabetes mellitus, and heart disease. In our fully adjusted models, correlates of "good" lower body functioning were younger age, higher annual household income, better cognitive functioning, stronger grip, and the absence of diabetes mellitus and heart disease. CONCLUSIONS These results suggest that "good" lower body functioning is uncommon in this population, whereas its correlates are similar to those found in studies of other older adult populations. Future efforts should include the development or cultural tailoring of interventions to improve lower body functioning in older American Indians.
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Affiliation(s)
- R. Turner Goins
- College of Health and Human Sciences, Western Carolina University, 3971 Little Savannah Road, Cullowhee, NC 28723 USA
| | - Mark Schure
- Community Health, Montana State University, 305 Herrick Hall, Bozeman, MT 59717 USA
| | - Paul N. Jensen
- Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 USA
| | - Astrid Suchy-Dicey
- College of Medicine, Initiative for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
| | - Lonnie Nelson
- College of Nursing, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
| | - Steven P. Verney
- Department of Psychology, University of New Mexico, Logan Hall, MSC03-2220, 1 University of New Mexico, Albuquerque, NM 87131-0001 USA
| | - Barbara V. Howard
- MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, 6525 Belcrest Road, Suite 700, Hyattsville, MD 20782 USA
| | - Dedra Buchwald
- College of Medicine, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA 98101 USA
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Strotmeyer ES, Winger ME, Cauley JA, Boudreau RM, Cusick D, Collins RF, Chalhoub D, Buehring B, Orwoll E, Harris TB, Caserotti P. Normative Values of Muscle Power using Force Plate Jump Tests in Men Aged 77-101 Years: The Osteoporotic Fractures in Men (MrOS) Study. J Nutr Health Aging 2018; 22:1167-1175. [PMID: 30498822 PMCID: PMC8963464 DOI: 10.1007/s12603-018-1081-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine normative values for weight-bearing, countermovement leg extension ("jump") tests in the oldest men and characteristics of those not completing vs. completing tests. DESIGN 2014-16 cross-sectional exam. SETTING Six U.S. sites from the Osteoporotic Fractures in Men (MrOS) Study. PARTICIPANTS Community-dwelling men (N=1,841) aged 84.5±4.2 (range: 77-101) years. INTERVENTIONS N/A. MEASUREMENTS Jump tests on a force plate measured lower-extremity muscle peak power/kg, velocity and force/kg at peak power, with normative values for 5-year age groups and by limitations in moderate-intensity activities of daily living (ADLs) and climbing several flights of stairs. RESULTS Jump completion was 68.9% (N=1,268/1,841) and 98% (1,242/1,268) had ≥1 analyzable trial/participant. Exclusions primarily were due to poor mobility and/or balance: 24.8% (456/1,841) prior to and 6.4% (N=117/1,841) after attempting testing. Peak power was 20.8±5.3 W/kg, with 1.2±0.3 m/s for velocity, and 16.7±1.9 N/kg for force at peak power. Each 5-year age group >80 years had subsequently 10% lower power/kg, with 30% lower power/kg at >90 vs. ≤80 years (all p<0.05). Velocity and force/kg at peak power were 24% and 9% lower respectively, at >90 vs. ≤80 years (all p<0.05). Limitations in both moderate ADLs and climbing several flights of stairs were associated with 16% lower age-adjusted power/kg, equivalent to 5-10 years of aging, with 11% and 6% lower age-adjusted velocity and force/kg respectively, vs. those without limitation (all p<0.05). Men not completing vs. completing jumps had older age, higher BMI, lower physical activity, more comorbidities, worse cognition, more IADLs/ADLs and more falls in the past year (all p<0.05). Post-jump pain occurred in 4.6% (58/1,268), with 2 participants stopping testing due to pain. Only 24/1,242 (2%) had all trials/participant without flight (i.e., inability to lift feet), with 323/1,242 having ≥1 trial/participant without flight (total of 28%). No serious adverse safety events (e.g., injury) occurred. CONCLUSIONS A multicenter cohort of oldest men with a range of function had higher declines in jump power/kg and velocity vs. force/kg across each 5-year age group >80 years. Future research should examine age- and functional-related declines in jump measures related to physical performance decline, falls, fractures, and disability.
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Affiliation(s)
- E S Strotmeyer
- Elsa S. Strotmeyer, PhD, MPH, 130 N. Bellefield Ave., Room 515, Pittsburgh, PA 15213, Office phone: 412-383-1293,
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Jin Y, Tanaka T, Ma Y, Bandinelli S, Ferrucci L, Talegawkar SA. Cardiovascular Health Is Associated With Physical Function Among Older Community Dwelling Men and Women. J Gerontol A Biol Sci Med Sci 2017; 72:1710-1716. [PMID: 28184412 PMCID: PMC5861882 DOI: 10.1093/gerona/glw329] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 01/06/2017] [Indexed: 01/08/2023] Open
Abstract
Background Age related decline in physical function is a significant concern affecting the quality of life of older individuals. Methods We examined the associations between baseline overall cardiovascular health (CVH), its components, and physical function in 906 men and women from the InCHIANTI cohort. Physical function was assessed using the Short Performance Physical Battery and poor physical function was defined as an Short Performance Physical Battery score less than 10. Overall CVH score, ranging from 0 to 12 in the cohort, was operationalized using adherence to ideal levels for health behaviors including smoking status, physical activity, body mass index, and diet quality; and health factors including blood pressure, plasma cholesterol, fasting blood glucose, with higher scores indicating better CVH. Results Mean age at baseline was 74 (SD = 6.7) years and 55% were women. At baseline and over 9 years, as compared to the lowest tertile of overall CVH score, the highest tertile was associated with a 69% (p < .001) and 63% (p < .001), respectively, lower risk of poor physical function. Among the CVH components, adherence to ideal levels of health behaviors was more strongly and consistently associated with lower odds of poor physical function than health factors. Conclusions Better overall CVH was protective against poor physical function in community-dwelling men and women aged 65 years and older. Improving CVH may be instrumental in the prevention of poor physical function in older adults.
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Affiliation(s)
- Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, District of Columbia
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Yan Ma
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, District of Columbia
| | | | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, District of Columbia.,Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, District of Columbia.,Sumner M. Redstone Global Center for Prevention and Wellness at the George Washington University, District of Columbia
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Skinner JS, Abel WM, McCoy K, Wilkins CH. Exploring the "Obesity Paradox" as a Correlate of Cognitive and Physical Function in Community-dwelling Black and White Older Adults. Ethn Dis 2017; 27:387-394. [PMID: 29225439 PMCID: PMC5720948 DOI: 10.18865/ed.27.4.387] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective The obesity paradox has been documented in aged populations, yet it remains unclear if this paradox persists for physical and cognitive outcomes in community-dwelling older adult populations. Our study examines associations between body mass index (BMI) classification, cognitive function, and physical function. We also investigate whether these associations are modified by race or age. Design Cross-sectional study. Setting Senior residential sites and community centers in Saint Louis, Missouri. Participants Study participants included 331 adults, aged >55 years. Age was stratified into young-old (aged 55-74 years) and older (aged ≥75 years). Outcome Measures Physical function was measured using the mini-Physical Performance Test (mini-PPT) and grip strength. Cognitive function was assessed with the Short Blessed Test (SBT) and the Trail Making Tests (TMT-A and TMT-B) performance. Results Older adults who were obese had significantly better cognitive flexibility (TMT-B) performance than normal weight older adults (P=.02), and this association was not influenced by age or race. Adiposity was not associated with psychomotor speed (TMT-A), general cognition (SBT), or measures of physical function (Ps>.05). Conclusion In a diverse sample of community-dwelling older adults, we found partial support for the controversial obesity paradox. Our results suggest excess adiposity may be protective for executive function processes. Future research is needed to examine the underlying physiological processes linking adiposity to executive function in older adults.
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Affiliation(s)
- Jeannine S. Skinner
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC
| | - Willie Mae Abel
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC
| | - Katryna McCoy
- School of Nursing & Health Studies, University of Washington Bothell, Bothell, WA
| | - Consuelo H. Wilkins
- Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN
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Harris SE, Riggio V, Evenden L, Gilchrist T, McCafferty S, Murphy L, Wrobel N, Taylor AM, Corley J, Pattie A, Cox SR, Martin-Ruiz C, Prendergast J, Starr JM, Marioni RE, Deary IJ. Age-related gene expression changes, and transcriptome wide association study of physical and cognitive aging traits, in the Lothian Birth Cohort 1936. Aging (Albany NY) 2017; 9:2489-2503. [PMID: 29207374 PMCID: PMC5764388 DOI: 10.18632/aging.101333] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/26/2017] [Indexed: 12/11/2022]
Abstract
Gene expression is influenced by both genetic variants and the environment. As individuals age, changes in gene expression may be associated with decline in physical and cognitive abilities. We measured transcriptome-wide expression levels in lymphoblastoid cell lines derived from members of the Lothian Birth Cohort 1936 at mean ages 70 and 76 years. Changes in gene expression levels were identified for 1,741 transcripts in 434 individuals. Gene Ontology enrichment analysis indicated an enrichment of biological processes involved in the immune system. Transcriptome-wide association analysis was performed for eleven cognitive, fitness, and biomedical aging-related traits at age 70 years (N=665 to 781) and with mortality. Transcripts for genes (F2RL3, EMILIN1 and CDC42BPA) previously identified as being differentially methylated or expressed in smoking or smoking-related cancers were overexpressed in smokers compared to non-smokers and the expression of transcripts for genes (HERPUD1, GAB2, FAM167A and GLS) previously associated with stress response, autoimmune disease and cancer were associated with telomere length. No associations between expression levels and other traits, or mortality were identified.
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Affiliation(s)
- Sarah E. Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh EH4 2XU, UK
| | - Valentina Riggio
- The Roslin Institute and R(D)SVS, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
| | - Louise Evenden
- Edinburgh Clinical Research Facility, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Tamara Gilchrist
- Edinburgh Clinical Research Facility, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Sarah McCafferty
- Edinburgh Clinical Research Facility, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Lee Murphy
- Edinburgh Clinical Research Facility, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Nicola Wrobel
- Edinburgh Clinical Research Facility, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU, UK
| | - Adele M. Taylor
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Janie Corley
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Alison Pattie
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Simon R. Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Carmen Martin-Ruiz
- Institute for Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
| | - James Prendergast
- The Roslin Institute and R(D)SVS, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
| | - John M. Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh EH8 9JZ, UK
| | - Riccardo E. Marioni
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh EH4 2XU, UK
- Queensland Brain Institute, The University of Queensland, Brisbane 4072, QLD, Australia
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK
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