1
|
Younossi ZM, Kremer AE, Swain MG, Jones D, Bowlus C, Trauner M, Henry L, Gerber L. Assessment of fatigue and its impact in chronic liver disease. J Hepatol 2024:S0168-8278(24)00276-9. [PMID: 38670320 DOI: 10.1016/j.jhep.2024.04.008] [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: 01/23/2024] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Patient-reported outcomes (PROs), such as health-related quality of life (HRQL), are important outcome measures for patients with chronic liver diseases (CLDs). Presence of cirrhosis and advanced liver disease have been associated with worsened HRQL and fatigue. On the other hand, some patients with earlier stages of CLD also experience fatigue, causing PRO impairment. Treatment for some CLDs may improve HRQL and, sometimes, levels of fatigue. We aimed to provide an in-depth expert review of concepts related to fatigue and HRQL in patients with primary biliary cholangitis, hepatitis C virus and MASLD (metabolic dysfunction-associated steatotic liver disease). A panel of experts in fatigue and CLD reviewed and discussed the literature and collaborated to provide this expert review of fatigue in CLD. Herein, we review and report on the complexity of fatigue, highlighting that it is comprised of peripheral (neuromuscular failure, often in conjunction with submaximal cardiorespiratory function) and central (central nervous system dysfunction) causes. Fatigue and HRQL are measured using validated self-report instruments. Additionally, fatigue can be measured through objective tests (e.g. grip strength). Fatigue has deleterious effects on HRQL and one's ability to be physically active and socially engaged but does not always correlate with CLD severity. Treatments for hepatitis C virus and MASLD can improve levels of fatigue and HRQL, but current treatments for primary biliary cholangitis do not seem to affect levels of fatigue. We conclude that obtaining PRO data, including on HRQL and fatigue, is essential for determining the comprehensive burden of CLD and its potential treatments.
Collapse
Affiliation(s)
- Zobair M Younossi
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; The Global Liver Council, Washington DC, USA.
| | - Andreas E Kremer
- Department of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Mark G Swain
- Professor of Medicine, Cal Wenzel Family Foundation Chair in Hepatology, University of Calgary Liver Unit, Calgary, Canada
| | - David Jones
- Professor of Liver Immunology, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Bowlus
- Lena Valente Professor and Chief, Division of Gastroenterology and Hepatology, University of California Davis, United States
| | - Michael Trauner
- Div. of Gastroenterology & Hepatology, Dept. of Internal Medicine III, MedUni Wien, Medical University of Vienna, Austria
| | - Linda Henry
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; The Global Liver Council, Washington DC, USA; Center for Outcomes Research in Liver Diseases, Washington DC, USA
| | - Lynn Gerber
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; The Global Liver Council, Washington DC, USA
| |
Collapse
|
2
|
Braun M, Schroé H, Van Dyck D, Crombez G, De Paepe AL. The relationship of affective and bodily states with goals and plans to increase physical activity: An 8-day study in students. Appl Psychol Health Well Being 2024; 16:273-295. [PMID: 37667612 DOI: 10.1111/aphw.12485] [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: 01/23/2023] [Accepted: 08/12/2023] [Indexed: 09/06/2023]
Abstract
Planning is an important tool to translate intentions into physical activity (PA) behavior. Affective and bodily states are known to influence how much PA individuals perform, but their impact on to formulation of PA plans is not yet known. The aim of the current study is to explore the effect of within- and between-subject variations in affective and bodily states on the content of PA goals and plans. Over eight consecutive days, 362 students created action and coping plans to achieve their daily PA goals. They also reported their affective and bodily states. Generalized linear mixed effect models were used to analyze the associations between these states and the content of the goals and plans. The results showed that both between- and within-subject variations in affective and bodily states were associated with goals formulated in terms of minutes, the intensity and context of planned activities, and anticipated barriers, though more effects were found for within-subject differences. Affective and bodily states impact daily PA goals and plans, highlighting the dynamic nature of planning. Our findings can be a first step toward personalized suggestions for goals, action plans, and coping strategies that are based on individual affective and bodily states.
Collapse
Affiliation(s)
- Maya Braun
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Helene Schroé
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Annick L De Paepe
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
3
|
Haischer MH, Opielinski LE, Mirkes LM, Uhrich TD, Bollaert RE, Danduran M, Bement MH, Piacentine LB, Papanek PE, Hunter SK. Heart rate variability is reduced in COVID-19 survivors and associated with physical activity and fatigue. Physiol Rep 2024; 12:e15912. [PMID: 38243329 PMCID: PMC10799199 DOI: 10.14814/phy2.15912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/21/2024] Open
Abstract
Reduced heart rate variability (HRV) and fatigue are common after COVID-19 infection and both are potentially influenced by physical activity (PA). We compared resting HRV, PA from accelerometers and questionnaires, and self-reported fatigue in 41 COVID-19 survivors (~8 months postinfection, 38 ± 17 years) with 41 matched controls. Differences in HRV were observed on acceleration capacity (p = 0.041), deceleration capacity (p = 0.032), high-frequency peak frequency (p = 0.019), absolute low-frequency power (p = 0.042), relative very low-frequency power (p = 0.012), SD2 (from Poincare plot; p = 0.047), and DFA2 (slope of long-term detrended fluctuation analysis; p = 0.004). Fatigue was greater in COVID-19 survivors (p < 0.001) with no differences in PA. Moderate-vigorous physical activity (MVPA) (Standardized Beta = -0.427, p = 0.003) and steps per day (Standardized Beta = -0.402, p = 0.007) were associated with DFA2 in COVID-19 survivors after controlling for age, sex, and body fat percentage. Fatigue was correlated to less MVPA (Spearman's rho = 0.342, p = 0.031) and fewer steps per day (rho = 0.329, p = 0.038) in COVID-19 survivors, and was indirectly linked to HRV through these PA mediators (Estimate = -0.20; p = 0.040). We present a model showing the complex relations between HRV, PA, and fatigue that provides the foundation for strategies to improve outcomes and rehabilitation after COVID-19 infection.
Collapse
Affiliation(s)
- Michael H. Haischer
- Exercise Science ProgramMarquette UniversityMilwaukeeWisconsinUSA
- Athletic and Human Performance Research CenterMarquette UniversityMilwaukeeWisconsinUSA
| | | | - Lindsey M. Mirkes
- Department of Physical TherapyMarquette UniversityMilwaukeeWisconsinUSA
- College of NursingMarquette UniversityMilwaukeeWisconsinUSA
| | - Toni D. Uhrich
- Exercise Science ProgramMarquette UniversityMilwaukeeWisconsinUSA
- Athletic and Human Performance Research CenterMarquette UniversityMilwaukeeWisconsinUSA
- Human Performance Assessment CoreMarquette UniversityMilwaukeeWisconsinUSA
| | | | - Michael Danduran
- Exercise Science ProgramMarquette UniversityMilwaukeeWisconsinUSA
- Children’s WisconsinMilwaukeeWisconsinUSA
| | | | - Linda B. Piacentine
- Athletic and Human Performance Research CenterMarquette UniversityMilwaukeeWisconsinUSA
- College of NursingMarquette UniversityMilwaukeeWisconsinUSA
| | - Paula E. Papanek
- Exercise Science ProgramMarquette UniversityMilwaukeeWisconsinUSA
| | - Sandra K. Hunter
- Exercise Science ProgramMarquette UniversityMilwaukeeWisconsinUSA
- Athletic and Human Performance Research CenterMarquette UniversityMilwaukeeWisconsinUSA
| |
Collapse
|
4
|
Moyle DB, Kudiersky MN, Totton MN, Sassani DM, Nichols DS, Jenkins DT, Redgrave DJ, Baig DS, Nair DKPS, Majid PA, Ali DAN. Remote ischaemic conditioning for fatigue after stroke (RICFAST): A pilot randomised controlled trial. J Stroke Cerebrovasc Dis 2023; 32:107420. [PMID: 37832270 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Post stroke fatigue (PSF) affects 50 % of stroke survivors, and can be disabling. Remote ischaemic conditioning (RIC), can preserve mitochondrial function, improve tissue perfusion and may mitigate PSF. This pilot randomised controlled trial evaluates the safety and feasibility of using RIC for PSF and evaluated measures of cellular bioenergetics. METHODS 24 people with debilitating PSF (7 item Fatigue Severity Score, FSS-7 > 4) were randomised (1:1) in this single-centre phase 2 study to RIC (blood pressure cuff inflation around the upper arm 200 mmHg for 5 min followed by 5 min of deflation), or sham (inflation pressure 20 mmHg), repeated 4 cycles, 3 times per week for 6 weeks. Primary outcomes were safety, acceptability, and compliance. Secondary outcomes included FSS-7, 6 min walking test (6MWT), peak oxygen consumption (V̇O2peak), ventilatory anaerobic threshold (VAT), and muscle adenosine triphosphate (ATP) content measured using 31-phosphorous magnetic resonance spectroscopy of tibialis anterior. RESULTS RIC was safe (no serious adverse events, adverse events mild) and adherence excellent (91 % sessions completed). Exploratory analysis revealed lower FSS-7 scores in the RIC group compared to sham at 6 weeks (between group difference FSS-7 -0.7, 95 %CI -2.0 to 0.6), 3 months (-1.0, 95 %CI -2.2 to 0.2) and 6 months (-0.9, 95 %CI -2.0 to 0.2). There were trends towards increased VAT, increased muscle ATP content and improved 6MWT in the RIC group. DISCUSSION RIC is safe and acceptable for people with PSF and may result in clinically meaningful improvements in fatigue and muscle bioenergetics that require further investigation in larger studies.
Collapse
Affiliation(s)
| | | | | | - Dr Matilde Sassani
- Translational Brain Science, Institute of Metabolism and Systems Research, UK
| | | | - Dr Tom Jenkins
- Sheffield Institute for Translational Neurology, UK; Royal Perth Hospital, Western Australia, UK
| | | | | | | | | | - Dr Ali N Ali
- Sheffield Teaching Hospitals NIHR Biomedical Research Centre, University of Sheffield, UK.
| |
Collapse
|
5
|
Zalewska A, Gałczyk M, Mierzejewska A. Fatigue and physical activity levels in poles living in Poland and the United Kingdom in the further year of the COVID-19 pandemic: a pilot study. BMC Public Health 2023; 23:2260. [PMID: 37974181 PMCID: PMC10655265 DOI: 10.1186/s12889-023-17191-5] [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: 04/11/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES The aim of this study was to conduct a preliminary assessment of the prevalence of fatigue and level of physical activity, as well as the relationship between fatigue and physical activity among Poles living in Poland and the United Kingdom (UK) in the further year in the COVID-19 pandemic. METHODS A web-based online survey was conducted among Poles living permanently in Poland and the UK in January 2023. Responses were obtained from 200 respondents aged 18-69 years. The level of fatigue was assessed by the Modified Fatigue Impact Scale (MFIS). The level of physical activity was measured by the International Physical Activity Questionnaire (IPAQ). RESULTS The median for the total fatigue score was equal to 17 points out of a possible 105. 13.5% of the subjects had a low level of physical activity, the average MET for high-intensity activity was 1294.55 METs, for moderate activity 714.44 METs, and for walking 631 METs. As age and number of COVID-19 cases increased, scores on the MFIS questionnaire scale also increased. With an increase in the number of COVID-19 cases, high-intensity MET scores decreased. CONCLUSIONS The level of fatigue, in contrast to the level of physical activity, was low in the study population. There were few statistically significant differences in fatigue between people living in Poland and the UK. Further experimental studies on the physiological mechanism of differences in fatigue and physical activity are needed.
Collapse
Affiliation(s)
- Anna Zalewska
- Faculty of Health Sciences, University of Lomza, 14 Akademicka St, Lomza, 18-400, Poland.
| | - Monika Gałczyk
- Faculty of Health Sciences, University of Lomza, 14 Akademicka St, Lomza, 18-400, Poland
| | - Aneta Mierzejewska
- Department of Psychology, Apsley Business School London, 2 Apsley House, 176 Upper Richmond Road, SW15 2SH, London, UK
| |
Collapse
|
6
|
Liu JYW, Yin YH, Kor PPK, Kwan RYC, Lee PH, Chien WT, Siu PM, Hill KD. Effects of an individualised exercise programme plus Behavioural Change Enhancement (BCE) strategies for managing fatigue in frail older adults: a cluster randomised controlled trial. BMC Geriatr 2023; 23:370. [PMID: 37328797 PMCID: PMC10273765 DOI: 10.1186/s12877-023-04080-0] [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: 11/24/2022] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND To the best of our knowledge, although ageing-induced fatigue could cause adverse outcomes such as frailty, there is currently no intervention for it. This study evaluated the effects of an individualised exercise programme with/without BCE strategies on reducing fatigue in older adults. METHODS A three-armed cluster-randomised controlled trial (RCT) was conducted with 184 participants (mean age: 79.1 ± 6.4; mean frailty score: 2.8 + 0.8) from 21 community centres (ClinicalTrials.gov: NCT03394495). They were randomised into either: the COMB group (n = 64), receiving 16 weeks of exercise training plus the BCE programme; the EXER group (n = 65), receiving exercise training and health talks; or the control group (n = 55), receiving only health talks. Fatigue was assessed using the Multi-dimensional Fatigue Inventory (range: 20 to 100, with higher scores indicating higher fatigue levels) at baseline, and immediately, 6 months, and 12 months post-intervention. RESULTS The GEE analyses showed significant interaction (time x group) between the COMB and control groups immediately (p < 0.001), 6 months (p < 0.001), and 12 months (p < 0.001) post-intervention. Comparing the COMB and EXER groups, there was a significant interaction immediately (p = 0.013) and at 12 months post-intervention (p = 0.007). However, no significant difference was seen between the EXER group and control group at any time point. CONCLUSIONS The COMB intervention showed better immediate and sustainable effects (i.e., 12 months after the intervention) on reducing fatigue in frail older adults than exercise training or health education alone. TRIAL REGISTRATION ClinicalTrials.gov (NCT03394495), registered on 09/01/2018.
Collapse
Affiliation(s)
- Justina Y W Liu
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Yue-Heng Yin
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Patrick P K Kor
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Rick Y C Kwan
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Paul H Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Wai Tong Chien
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China
| | - Parco M Siu
- Division of Kinesiology, School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Keith D Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, 3800, Australia
| |
Collapse
|
7
|
Cammisuli DM, Franzoni F, Fusi J, Scarfò G, Castelnuovo G. Engagement in a structured physical activity program and its effects upon health-related quality of life in elderly women: An observational study. Front Psychol 2023; 14:1135433. [PMID: 37034950 PMCID: PMC10075252 DOI: 10.3389/fpsyg.2023.1135433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/24/2023] [Indexed: 04/11/2023] Open
Abstract
Aging is a complex process associated with an impairment in functional capacity and low health-related quality of life (HRQoL) due to a high frequency of chronic diseases in the elderly population. Regular physical activity (PA) may limit some physiological effects of sedentary lifestyle and increase life expectancy. An observational was conducted to measure the HRQoL among older adults living in the community, by comparing a convenience sample of elderly females practicing a structured program of PA from 2 to 3 times per week in 60-min sessions (i.e., active females, AFs) to a sample of participants adopting lifestyle behaviors expending little energy (i.e., sedentary females, SFs). A validated questionnaire (the RAND 36-item) was used as outcome measure. All participants were assessed in terms of cognitive status (Montreal Cognitive Assessment, MoCA) to exclude mild cognitive impairment, divided attention/executive functioning (Trail Making Test, Stroop Test) and psychopathological dimensions of anxiety (Geriatric Anxiety Inventory, GAI), and depression (Geriatric Depression Scale, GDS). Non-parametric analysis revealed that AFs and SFs differed significantly in the RAND Energy/Fatigue (E/F), Emotional Wellbeing (EW), and Social Functioning (SoF), that was however influenced by education level. Moreover, E/F and EW were negatively associated to anxiety and depression, while SoF was influenced by divided attention. PA results in a healthful behavior for combating feelings of fatigue and low energy as well as emotional distress that can affect health status perception in older women.
Collapse
Affiliation(s)
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jonathan Fusi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgia Scarfò
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano, Milan, Italy
| |
Collapse
|
8
|
Belloni S, Arrigoni C, Baroni I, Conte G, Dellafiore F, Ghizzardi G, Magon A, Villa G, Caruso R. Non-pharmacologic interventions for improving cancer-related fatigue (CRF): A systematic review of systematic reviews and pooled meta-analysis. Semin Oncol 2023:S0093-7754(23)00035-0. [PMID: 36973125 DOI: 10.1053/j.seminoncol.2023.03.004] [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: 10/19/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Literature encloses numerous systematic reviews (SRs) on nonpharmacologic interventions for improving cancer-related fatigue (CRF). The effect of these interventions remains controversial, and the available SRs have not been synthesized yet. We conducted a systematic synthesis of SRs and meta-analysis to determine the effect of nonpharmacologic interventions on CRF in adults. MATERIAL AND METHODS We systematically searched 4 databases. The effect sizes (standard mean difference) were quantitatively pooled using a random-effects model. Chi-squared (Q) and I-square statistics (I²) tested the heterogeneity. RESULTS We selected 28 SRs, including 35 eligible meta-analyses. The pooled effect size (standard mean difference, 95% CI) was -0.67 (-1.16, -0.18). The subgroup analysis by types of interventions showed a significant effect in all the investigated approaches (complementary integrative medicine, physical exercise, self-management/e-health interventions). CONCLUSIONS There is evidence that nonpharmacologic interventions are associated with CRF reduction. Future research should focus on testing these interventions on specific population clusters and trajectories. PROSPERO REGISTRATION CRD42020194258.
Collapse
Affiliation(s)
- Silvia Belloni
- IRCCS Humanitas Research Hospital, Educational and Research Unit, Rozzano, Italy.
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Greta Ghizzardi
- Health Professions Directorate, Bachelor in Nursing Course, ASST Lodi, Lodi, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| |
Collapse
|
9
|
Güneş M, Demirer B. A Comparison of Caffeine Intake and Physical Activity According to Fatigue Severity in University Students. Eval Health Prof 2023; 46:92-99. [PMID: 36412049 DOI: 10.1177/01632787221141504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study aims to compare caffeine intake and physical activity levels in university students with severe and ineffective fatigue and examine the relationship between them. A total of 647 (F:527; M:120) university students were included in this cross-sectional study. Individuals' socio-demographic information, severity of fatigue (Fatigue Severity Scale (FSS)), amount of caffeine intake and physical activity level (International Physical Activity Questionnaire-Short Form (IPAQ-SF)) were evaluated. It was determined that 56.5% of the university students (age: 21.21 ± 2.57) participating in the study had severe fatigue. Caffeine intake and physical activity level of students with severe fatigue were statistically significantly lower than those with ineffective fatigue (p < 0.05). In addition, there was a weak negative correlation between fatigue and caffeine intake (r = -0.157; p < 0.001) and physical activity level (r = -0.096; p < 0.017). There was a significant positive correlation between caffeine intake and physical activity (r = 0.143; p < 0.001). This study showed that a significant portion of university students have severe fatigue. In addition, individuals with severe fatigue have decreased caffeine intake and lower physical activity levels. To reduce fatigue, caffeine intake in safe doses should be encouraged in accordance with the individual's metabolic and physiological parameters. In addition, physical activity counseling should be given to encourage physical activity.
Collapse
Affiliation(s)
- Musa Güneş
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 175170Karabuk University, Karabuk, Turkey
| | - Büşra Demirer
- Faculty of Health Sciences, Department of Nutrition and Dietetics, 175170Karabuk University, Karabuk, Turkey
| |
Collapse
|
10
|
Baattaiah BA, Zedan HS, Almasaudi AS, Alashmali S, Aldhahi MI. Physical activity patterns among women during the postpartum period: an insight into the potential impact of perceived fatigue. BMC Pregnancy Childbirth 2022; 22:678. [PMID: 36057543 PMCID: PMC9440528 DOI: 10.1186/s12884-022-05015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background Regular participation in physical activity (PA) improves physical well-being and reduces the risk of contracting noncommunicable diseases. However, fatigue could negatively impact the PA participation of women in their postpartum period. This study delineated the levels of perceived fatigue and characterized the association between fatigue and the PA patterns of postpartum women. Methods A cross-sectional study was conducted using an online questionnaire distributed to postpartum women living in Saudi Arabia. Their perceived postpartum fatigue (PPF) was assessed using the fatigue severity scale; their PA, using the short form of the International Physical Activity Questionnaires; and their postpartum depression, using the Edinburgh Postnatal Depression Scale. Descriptive statistics were expressed as the mean ± standard deviation for normally distributed variables and as the median (interquartile range) for non-normally distributed variables. Between-group differences were tested using the Mann–Whitney U test for independent samples. To determine the relationship between the study variables, Spearman’s rho correlation coefficient was calculated. Multiple linear regression analysis was performed to explain the role of fatigue severity as an independent predictor of the variance of the PA level. Results A total of 499 postpartum women were divided into the PPF group (43%), who self-reported fatigue, and the non-PPF group (57%), who self-reported no fatigue. There was a significant difference in the median of vigorous PA, and moderate PA which were significantly higher in the non-PPF group than in the PPF group. The women with PPF reported less engagement in walking and a longer sitting duration than the women without PPF. High fatigue severity was associated with lower moderate PA (β = -10.90; p = .005; R2 = .21) and vigorous PA (β = -04; p < .001; R2 = .13). These associations remained significant in the regression model after adjustment for the mother’s depression score; age; number of children; body mass index (kg/m2); employment status; intake of vitamins B1 (thiamin), C, and D and of Omega-3; and walking metabolic equivalent. Conclusion PPF may reduce the PA of postpartum women. Strategies targeting PPF may buffer its harmful impacts, and thus, improve postpartum women’s health.
Collapse
Affiliation(s)
- Baian A Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Haya S Zedan
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Arwa S Almasaudi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shoug Alashmali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| |
Collapse
|
11
|
Aldhahi MI, Alshehri MM, Alqahtani F, Alqahtani AS. A pilot study of the moderating effect of gender on the physical activity and fatigue severity among recovered COVID-19 patients. PLoS One 2022; 17:e0269954. [PMID: 35830386 PMCID: PMC9278785 DOI: 10.1371/journal.pone.0269954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/31/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Clinical data point toward gender-based differences in COVID-19 severity. However, there is insufficient research examining whether gender predicts physical activity (PA) and fatigue severity in patients recovering from COVID-19. Therefore, this study aimed to characterize the PA and fatigue severity in a cohort of patients recovering from COVID-19 infection and measure the extent to which gender-based differences moderate the relationship of PA with fatigue. METHOD A cross-sectional survey was conducted in Riyadh, Saudi Arabia. The sample comprised patients recovering from COVID-19 over at least 3 months. Recovered patients were stratified into two groups based on gender. The survey included items pertaining to sociodemographic, a fatigue severity scale and a self-reported international PA questionnaire. RESULTS Eighty-seven patients (44 women and 43 men) met the inclusion criteria. Compared with men, women reported sedentary behavior (70%) and high fatigue severity (64%). A significantly higher number of women had a low PA score compared with men (p = .002). The findings indicated that gender significantly moderates the effect of total PA in metabolic equivalents (METs; min/wk) on fatigue severity [F = 4.8, p = .03, ΔR2 = 0.24]. CONCLUSIONS The current study suggests that women might be at risk of higher fatigue severity, in addition to engaging less in PA. Physical activity may plays a significant role in modulate the fatigue severity. Consequently, interventions aimed at promoting physical activity in women stand high chances of addressing the disparity in the distribution of prevalence of fatigue between men and women.
Collapse
Affiliation(s)
- Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohammed M. Alshehri
- Physical Therapy Department, Jazan University, Jazan, Saudi Arabia
- Medical Research Center, Jazan University, Jazan, Saudi Arabia
| | - Faleh Alqahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdulfattah Saeed Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
12
|
Zhong R, Liao J, Xu Y. Fatigue Assessment of Sedentary Office Workers using Smart Phones: A Preliminary Study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022; 29:723-734. [PMID: 35574672 DOI: 10.1080/10803548.2022.2077000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Smartphone-based gait assessment provides a novel method to evaluate fatigue. OBJECTIVE This study aimed to examine self-reported fatigue and gait parameters recorded using a smartphone before and after an 8-hour work day in bank workers, and identify the relationship between self-reported fatigue and gait parameters. METHODS 100 bank workers (20-45 years) were tested before and after an 8-hour work day using a reaction time test, self-reported fatigue scale, and gait test. Spearman correlation coefficient analysis and partial least squares regression were used to identify the relationship between self-reported fatigue and gait parameters. RESULTS Reaction time and self-reported fatigue increased significantly after work. Gait parameters (step frequency, minimum acceleration, acceleration root mean square, step regularity, and step counts) decreased; step time and step time variability increased significantly (p < 0.05). We found a significant correlation between Δwork engagement (delta: Δ) and Δstep frequency (r = -0.20, p < 0.05), Δwork engagement and Δstep time (r = 0.21, p < 0.05), and Δwork tasks and Δstep symmetry (r = -0.20, p < 0.05). DISCUSSION This study suggests that step frequency, step time and step symmetry measured using a smartphone have the potential to be used as predictors of work fatigue.
Collapse
Affiliation(s)
- Runting Zhong
- School of Business, Jiangnan University, Wuxi, China
| | - Jingxian Liao
- School of Business, Jiangnan University, Wuxi, China
| | - Yunlong Xu
- School of Business, Jiangnan University, Wuxi, China
| |
Collapse
|
13
|
Loh KP, Sanapala C, Janelsins M, Klepin HD, Schnall R, Culakova E, Sohn MB, Vertino P, Susiarjo M, Jensen-Battaglia M, Becker MW, Liesveld J, Mendler JH, Huselton E, Lin PJ, Mustian K. Protocol for a pilot randomized controlled trial of a mobile health exercise intervention for older patients with myeloid neoplasms (GO-EXCAP 2). J Geriatr Oncol 2022; 13:545-553. [PMID: 34949540 PMCID: PMC9058183 DOI: 10.1016/j.jgo.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION We have shown the Exercise for Cancer Patients (EXCAP©®) exercise program improved physical function and symptoms and reduced inflammatory markers in patients with cancer. However, adherence to exercise was lower in older adults compared to their younger counterparts. We then leveraged a mobile app to deliver EXCAP©® and adapted the intervention [Geriatric-Oncology (GO)-EXCAP] for older patients with myeloid neoplasms. In this pilot randomized trial, the primary goal is to determine effect sizes. We propose to assess the preliminary efficacy of GO-EXCAP compared to a behavioral placebo control on physical function, patient-reported outcomes (fatigue, mood, and quality of life), and inflammatory markers in 100 patients aged ≥60 years with myeloid neoplasms receiving outpatient chemotherapy. METHODS GO-EXCAP consists of the EXCAP©® exercise prescription (daily home-based progressive aerobic walking and resistance exercises with rated perceived exercise of 5-8), EXCAP©® kit (i.e., activity tracker, resistance bands, print manual, bag), a mobile app, and an in-person or virtual session with the exercise physiologist to deliver exercise prescription. The intervention will last for three cycles of chemotherapy (approximately 12 weeks). The primary outcome measure will be physical function (Short Physical Performance Battery). Secondary outcome measures include fatigue (Brief Fatigue Inventory), mood (Center for Epidemiologic Studies Depression Scale), and quality of life (Functional Assessment of Cancer Therapy-Leukemia). Exploratory outcome measures include inflammatory markers. DISCUSSION Older adults with myeloid neoplasms receiving outpatient chemotherapy serve as an ideal model for studying an individually tailored mobile health exercise intervention in vulnerable older patients receiving cancer treatments to prevent physical function decline and improve symptoms.
Collapse
Affiliation(s)
- Kah Poh Loh
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Michelle Janelsins
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Heidi D Klepin
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston-Salem, NC, USA.
| | | | - Eva Culakova
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Michael B Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA.
| | - Paula Vertino
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, USA.
| | - Martha Susiarjo
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Michael W Becker
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jane Liesveld
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jason H Mendler
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Eric Huselton
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Po-Ju Lin
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Karen Mustian
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| |
Collapse
|
14
|
Buarque GLA, Borim FSA, Neri AL, Yassuda MS, de Melo RC. Relationships between self-reported dyspnea, health conditions and frailty among Brazilian community-dwelling older adults: a cross-sectional study. SAO PAULO MED J 2022; 140:356-365. [PMID: 35508002 PMCID: PMC9671253 DOI: 10.1590/1516-3180.2021.0237.r2.27072021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/27/2021] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Dyspnea is a symptom present in several chronic diseases commonly seen among older adults. Since individuals with dyspnea tend to stay at rest, with consequently reduced levels of physical activity, they are likely to be at greater risk of developing frailty, especially at older ages. DESIGN AND SETTING Cross-sectional study at community level, Brazil. OBJECTIVE To analyze the relationships between self-reported dyspnea, health conditions and frailty status in a sample of community-dwelling older adults. METHOD Secondary data from the follow-up of the Frailty in Brazilian Elderly (FIBRA) study, involving 415 community-dwelling older adults (mean age: 80.3 ± 4.68 years), were used. The variables analyzed were sociodemographic characteristics, reported dyspnea, clinical data and frailty phenotype. Associations between dyspnea and other variables (age, sex, education and body mass index) were verified through the crude (c) and adjusted (a) odds ratios. RESULTS The prevalence of dyspnea in the entire sample was 21.0%. Dyspnea was more present in individuals with pulmonary diseases, heart disease, cancer and depression. Older adults with multimorbidities (adjusted odds ratio, ORa = 2.91; 95% confidence interval, CI = 1.41-5.99) and polypharmacy (ORa = 2.02; 95% CI = 1.15-3.54) were more likely to have dyspnea. Those who reported dyspnea were 2.54 times more likely to be frail (ORa = 2.54; 95% CI = 1.08-5.97), and fatigue was their most prevalent phenotype component. CONCLUSION Dyspnea was associated with different diseases, multimorbidities, polypharmacy and frailty. Recognizing the factors associated with dyspnea may contribute to its early identification and prevention of its negative outcomes among older adults.
Collapse
Affiliation(s)
- Giselle Layse Andrade Buarque
- PT, MSc. Physiotherapist and Doctoral Student, Postgraduate Program on Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Flávia Silva Arbex Borim
- PT, PhD. Physiotherapist, Assistant Professor, Department of Collective Health, School of Health Sciences, Universidade de Brasília (UnB), Brasília (DF), Brazil; and Advisor, Postgraduate Program on Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Anita Liberalesso Neri
- PhD. Psychologist and Collaborating Professor, Department of Medical Psychology and Psychiatry and Advisor, Postgraduate Program on Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Mônica Sanches Yassuda
- PhD. Psychologist, Full Professor, School of Arts, Sciences and Humanities, and Advisor, Postgraduate Program on Gerontology, School of Arts, Sciences and Humanities, Universidade de São Paulo (USP), São Paulo (SP), Brazil; and Advisor, Postgraduate Program on Gerontology, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Ruth Caldeira de Melo
- PT, PhD. Physiotherapist and Assistant Professor, School of Arts, Sciences and Humanities, and Advisor, Postgraduate Program on Gerontology, School of Arts, Sciences and Humanities, Universidade de São Paulo (USP), São Paulo (SP), Brazil.
| |
Collapse
|
15
|
A single-arm pilot study of a mobile health exercise intervention (GO-EXCAP) in older patients with myeloid neoplasms. Blood Adv 2022; 6:3850-3860. [PMID: 35320340 PMCID: PMC9278283 DOI: 10.1182/bloodadvances.2022007056] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Our mobile health exercise intervention adapted for older patients with myeloid neoplasms is feasible, usable, and safe. Geriatric assessment domain impairments are highly prevalent; there is a need for supportive care interventions to mitigate toxicities.
Many older patients with myeloid neoplasms experience treatment-related toxicities. We previously demonstrated that a home-based, progressive aerobic walking and resistance exercise program (EXCAP) improved physical and psychological outcomes in patients with cancer. However, older patients have more difficulty adhering to exercise than younger patients. Reasons may include low motivation, difficulty with transportation, and limited access to exercise professionals. To improve exercise adherence, we integrated a mobile app with EXCAP (GO-EXCAP) and assessed its feasibility and usability in a single-arm pilot study among older patients with myeloid neoplasms undergoing outpatient chemotherapy. GO-EXCAP intervention lasts for 2 cycles of treatment, and the primary feasibility metric was data reporting on the app. Usability was evaluated via the system usability scale (SUS). Patients were interviewed at mid and postintervention to elicit their feedback, and deductive thematic analysis was applied to the transcripts. Twenty-five patients (mean age, 72 years) were recruited. Recruitment and retention rates were 64% and 88%, respectively. Eighty-two percent (18/22) of patients entered some exercise data on the app at least half of the study days, excluding hospitalization (a priori, we considered 70% as feasible). Averaged daily steps were 2848 and 3184 at baseline and after intervention, respectively. Patients also performed resistance exercises 26.2 minutes per day, 2.9 days per week at low intensity (rate of perceived exertion 3.8/10). Usability was above average (SUS, 70.3). In qualitative analyses, 3 themes were identified, including positive experience with the intervention, social interactions, and flexibility. The GO-EXCAP intervention is feasible and usable for older patients with myeloid neoplasms undergoing outpatient chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT04035499.
Collapse
|
16
|
Sheffler JL, Schmiege SJ, Sussman J, Bekelman DB. A longitudinal analysis of the relationships between depression, fatigue, and pain in patients with heart failure. Aging Ment Health 2021; 25:2272-2278. [PMID: 33287562 PMCID: PMC8796211 DOI: 10.1080/13607863.2020.1855626] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Depression, pain, and fatigue are common and bothersome symptoms in heart failure, a serious illness in older adults. Understanding longitudinal pathways among depression, pain, and fatigue in heart failure could inform treatment and improve quality of life. METHODS We completed secondary, longitudinal data analyses of a sample of older adults with heart failure (baseline N = 317). Bootstrapped mediation was used to examine two longitudinal models of pain and depression, with fatigue at 6-months as the mediator. The outcome variables were 12-month pain and depression. RESULTS Depressive symptoms were associated with new onset of pain symptoms; however, this association was mediated by fatigue. Pain was not associated with new depression or fatigue symptoms in this sample. DISCUSSION In patients with heart-failure, worsening pain symptoms appear to be directly related to levels of depression and fatigue. These findings demonstrate that depression and fatigue may be key to reducing pain symptoms in this population.
Collapse
Affiliation(s)
- Julia L Sheffler
- Center for Translational Behavioral Science, Florida State University, Tallahassee, FL, USA
| | - Sarah J Schmiege
- Anschutz Medical Campus, University of Colorado, Denver, CO, USA
| | | | | |
Collapse
|
17
|
Effect of Lower Limb Muscle Fatigue on Fall Risk for Transfemoral Amputee: A Pilot Study. Occup Ther Int 2021; 2021:4357473. [PMID: 34707468 PMCID: PMC8519703 DOI: 10.1155/2021/4357473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Muscle fatigue is a decline in muscle maximum force during contraction and can influence the fall risk among people. This study is aimed at identifying the effect of fatigue on prospective fall risk in transfemoral amputees (TFA). Fourteen subjects were involved in this study with TFA (34.7 ± 8.1 yrs, n = 7) and normal subjects (31.1 ± 7.4 yrs, n = 7). Fatigue of lower limb muscles was induced with the fatigue protocol. Subjects were tested prefatigue and postfatigue using the standardized fall risk assessment. All results were calculated and compared between pre- and postfatigue to identify fatigue's effect on both groups of subjects. The results showed that the fall risk increased significantly during pre- and postfatigue for TFA (p = 0.018), while there were no significant differences in normal subjects (p = 0.149). Meanwhile, the fall risk between TFA and normal subjects for prefatigue (p = 0.082) and postfatigue (p = 0.084) also showed no significant differences. The percentage (%) of increased fall risk for TFA was 19.2% compared to normal subjects only 16.7%. However, 61.4% increased of % fall risk in TFA after fatigue by using the baseline of the normal subject as the normalized % of fall risk. The increasing fall risks for TFA after fatigue are three times higher than the potential fall risk in normal subjects. The result indicates that they need to perform more precautions while prolonging lower limb activities. These results showed the implications of fatigue that can increase the fall risk due to muscle fatigue from repetitive and prolonged activities. Therefore, rehabilitation programs can be done very safely and precisely so that therapists can pursue fitness without aggravating existing injuries.
Collapse
|
18
|
Hevel DJ, Dunton GF, Maher JP. Acute Bidirectional Relations Between Affect, Physical Feeling States, and Activity-Related Behaviors Among Older Adults: An Ecological Momentary Assessment Study. Ann Behav Med 2021; 55:41-54. [PMID: 32441738 DOI: 10.1093/abm/kaaa027] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The majority of older adults are physically inactive; therefore, strategies are needed to effectively promote sustained engagement in physical activity. PURPOSE This study was designed to investigate acute bidirectional relationships between affective and physical feeling states and activity-related behaviors among older adults in the context of everyday life using Ecological Momentary Assessment (EMA). METHODS Older adults (n = 103, Mage = 72, Range: 60-98) participated in a 10-day study where they completed up to 6 smartphone-based EMA prompts/day. At each EMA prompt, participants reported their current positive and negative affect and physical feeling states. Participants wore an activPAL accelerometer to measure time spent standing and time spent stepping before and after the prompt. Separate multilevel random coefficient linear and logistic regression models examined these bidirectional relationships. RESULTS On occasions when older adults engaged in more standing and more stepping than was typical for them in the 15 and 30 min prior to the EMA prompt, they tended to report greater feelings of energy at the prompt. On occasions when older adults reported greater feelings of energy than was typical for them, they engaged in more standing and more stepping in the 15 and 30 min following the EMA prompt. Positive and negative affect was unrelated to activity-related behaviors. CONCLUSIONS Feelings of energy appear to be strongly linked to activity-related behaviors in older adults; however, this was not the case for positive or negative affect. These findings may have implications for optimal delivery of just-in-time intervention context based on affective states or current behaviors.
Collapse
Affiliation(s)
- Derek J Hevel
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jaclyn P Maher
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| |
Collapse
|
19
|
Qiao Y(S, Gmelin T, Renner SW, Boudreau RM, Martin S, Wojczynski MK, Christensen K, Andersen SL, Cosentino S, Santanasto AJ, Glynn NW. Evaluation of the Bidirectional Relations of Perceived Physical Fatigability and Physical Activity on Slower Gait Speed. J Gerontol A Biol Sci Med Sci 2021; 76:e237-e244. [PMID: 33170216 PMCID: PMC8436994 DOI: 10.1093/gerona/glaa281] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Lower physical activity levels and greater fatigability contribute independently to slower gait speed in older adults. To fully understand the bidirectional relations between physical activity and fatigability, and to inform potential intervention strategies, we examined whether physical activity or fatigability explains more of the other factor's association on slower gait speed. METHODS Two generations (probands and offspring) of older adults (N = 2079, mean age 73.0 ± 10.0 years, 54.2% women, 99.7% White) enrolled in the Long Life Family Study were assessed at Visit 2 (2014-2017). Self-reported physical activity was measured with the Framingham Physical Activity Index and perceived physical fatigability using the Pittsburgh Fatigability Scale. Statistical mediation analyses were conducted separately by generation with linear mixed-effect models accounting for family relatedness and adjusted for demographics, health conditions, and field center. RESULTS Greater perceived physical fatigability explained the association of lower physical activity on slower gait speed via a 22.5% attenuation of the direct association (95% confidence interval [CI]: 15.0%-35.2%) for the probands and 39.5% (95% CI: 22.8%-62.6%) for the offspring. Whereas lower physical activity explained the association of greater perceived fatigability on slower gait speed via a 22.5% attenuation of the direct association (95% CI: 13.4%-32.8%) for the probands and 6.7% (95% CI: 3.8%-15.4%) for the offspring. CONCLUSIONS Our findings suggest that the impact of greater perceived physical fatigability on the association between lower physical activity and slower gait speed differs between younger-old and middle-to-oldest-old adults, indicating perceived physical fatigability as a potential mediator in the disablement pathway.
Collapse
Affiliation(s)
| | - Theresa Gmelin
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sharon W Renner
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Robert M Boudreau
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarah Martin
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary K Wojczynski
- Department of Genetics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kaare Christensen
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Stacy L Andersen
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, New York
| | - Adam J Santanasto
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Nancy W Glynn
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
20
|
Foucher KC, Aydemir B, Huang CH. Walking energetics and fatigue are associated with physical activity in people with knee osteoarthritis. Clin Biomech (Bristol, Avon) 2021; 88:105427. [PMID: 34303950 PMCID: PMC9841508 DOI: 10.1016/j.clinbiomech.2021.105427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aberrant biomechanics may influence osteoarthritis-associated physical activity limitations. Our purpose was to evaluate the association of walking energetics, fatigue, and fatigability on physical activity in people with knee osteoarthritis. We hypothesized that using increased energy for walking, experiencing more fatigue, or being more fatigable are associated with less activity, and that fatigue and fatigability mediate the relationships between walking energetics and physical activity. METHODS We tested our hypothesis in 30 people with knee osteoarthritis (age 58 ± 9 years, 10 Male/20 Female). Physical activity was assessed using the University of California Los Angeles score. We used a six-minute walk test to predict VO2max. Next we used a portable oxygen exchange system to measure relative energy used (100 * VO2rate/VO2max) and VO2cost during walking at preferred speeds. We used the Knee injury and Osteoarthritis Outcome Score subscale to quantify pain, and the Patient Reported Outcome Measurement Instrument System Fatigue survey and a treadmill-based fatigability test to assess fatigue and fatigability. Spearman correlations, regression, and mediation analysis were used to test our hypotheses. FINDINGS Greater energy used during walking, fatigue, and fatigability were all associated with lower physical activity (rho = -0.585 to -0.379, P = 0.001 to 0.043). These associations persisted when incorporating pain into the models. Fatigue and fatigability mediated the associations between walking energetics and physical activity. INTERPRETATION Walking energetics could be a useful target to promote physical activity in people with osteoarthritis. Further, the effect of walking energetics on physical activity may work through its impact on fatigability.
Collapse
Affiliation(s)
- Kharma C Foucher
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA.
| | - Burcu Aydemir
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| | - Chun-Hao Huang
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| |
Collapse
|
21
|
Sprague BN, Zhu X, Ehrenkranz RC, Tian Q, Gmelin TA, Glynn NW, Rosso AL, Rosano C. Declining energy predicts incident mobility disability and mortality risk in healthy older adults. J Am Geriatr Soc 2021; 69:3134-3141. [PMID: 34297847 DOI: 10.1111/jgs.17372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The purpose was to examine whether longitudinal changes in self-reported energy predict incident mobility disability and mortality. We further explored whether changes in energy-related behaviors (physical activity, appetite, or sleep quality) would explain these associations. METHODS N = 2021 participants from the Health, Aging and Body Composition Study free from mobility disability and with at least three energy assessments from years 2 to 10. MEASUREMENTS The outcomes were time to first self-reported inability to walk a quarter of a mile (mobility disability) and death. Self-reported energy level (SEL) was a single-item indicator over the prior month, ranging from 0 to 10; person-specific slopes measured whether individuals increased or decreased in SEL across the total follow-up time (mean 7.09 years, +1.72, range 2-8 years). Potential energy-related mediators were baseline and change in self-reported physical activity, appetite, and sleep quality. Covariates were baseline levels and change in demographics, health characteristics and behaviors, tiredness, cognition, mood, and gait speed. RESULTS A total of 947 developed disability and 567 died over the study follow-up. A one-point change in SEL over the follow-up (or an average 0.125 points/year) was inversely associated with a 35% risk of incident mobility disability (hazard ratio = 0.65, 95% confidence interval [CI] = 0.55, 0.76, p < 0.001) and 35% risk of death (hazard ratio = 0.67, 95% CI = 0.42, 0.87, p = 0.003), independent of covariates. Potential energy-related mediators did not attenuate this association. CONCLUSIONS In this longitudinal analysis of community-dwelling older adults, energy decline was common and a significant independent predictor of disability risk and mortality.
Collapse
Affiliation(s)
- Briana N Sprague
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rebecca C Ehrenkranz
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Qu Tian
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Theresa A Gmelin
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
22
|
Janssen L, Blijlevens NMA, Drissen MMCM, Bakker EA, Nuijten MAH, Janssen JJWM, Timmers S, Hopman MTE. Fatigue in chronic myeloid leukemia patients on tyrosine kinase inhibitor therapy: predictors and the relationship with physical activity. Haematologica 2021; 106:1876-1882. [PMID: 32616528 PMCID: PMC8252933 DOI: 10.3324/haematol.2020.247767] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Indexed: 12/22/2022] Open
Abstract
Fatigue is a common side effect of tyrosine kinase inhibitor (TKI) therapy in patients with chronic myeloid leukemia (CML). However, the prevalence of TKI-induced fatigue remains uncertain and little is known about predictors of fatigue and its relationship with physical activity. In this study, 220 CML patients receiving TKI therapy and 110 genderand age-matched controls completed an online questionnaire to assess fatigue severity and fatigue predictors (Part 1). In addition, physical activity levels were objectively assessed for 7 consecutive days in 138 severely fatigued and non-fatigued CML patients using an activity monitor (Part 2). We demonstrated that the prevalence of severe fatigue was 55.5% in CML patients and 10.9% in controls (P<0.001). We identified five predictors of fatigue in our CML population: age (odds ratio [OR] 0.96, 95% confidence interval [95% CI]: 0.93-0.99), female gender (OR 1.76, 95% CI: 0.92-3.34), Charlson Comorbidity Index (OR 1.91, 95% CI: 1.16-3.13), the use of comedication known to cause fatigue (OR 3.43, 95% CI: 1.58-7.44), and physical inactivity (OR of moderately active, vigorously active and very vigorously active compared to inactive 0.43 (95% CI: 0.12-1.52), 0.22 (95% CI: 0.06-0.74), and 0.08 (95% CI: 0.02-0.26), respectively). Objective monitoring of activity patterns confirmed that fatigued CML patients performed less physical activity of both light (P=0.017) and moderate to vigorous intensity (P=0.009). In fact, compared to the non-fatigued patients, fatigued CML patients performed 1 hour less of physical activity per day and took 2,000 fewer steps per day. Our findings facilitate the identification of patients at risk of severe fatigue and highlight the importance of setting reduction of fatigue as a treatment goal in CML care. This study was registered at The Netherlands Trial Registry, NTR7308 (Part 1) and NTR7309 (Part 2).
Collapse
Affiliation(s)
- Lando Janssen
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Meggie M C M Drissen
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esmée A Bakker
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Malou A H Nuijten
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen J W M Janssen
- Dept of Hematology, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands
| | - Silvie Timmers
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Maria T E Hopman
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
23
|
Loh KP, Sanapala C, Di Giovanni G, Klepin HD, Janelsins M, Schnall R, Culakova E, Vertino P, Susiarjo M, Mendler JH, Liesveld JL, Lin PJ, Dunne RF, Kleckner I, Mustian K, Mohile SG. Developing and adapting a mobile health exercise intervention for older patients with myeloid neoplasms: A qualitative study. J Geriatr Oncol 2021; 12:909-914. [PMID: 33676900 PMCID: PMC8260435 DOI: 10.1016/j.jgo.2021.02.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Older patients with myeloid neoplasms (MN) receiving outpatient chemotherapy are at risk of experiencing treatment-related toxicities such as functional decline. A mobile health (mHealth) exercise intervention may ameliorate these toxicities. This qualitative study aimed to inform the design of a mHealth exercise intervention for this population. METHODS This was a qualitative study of thirteen patients aged ≥60 years receiving hypomethylating agents for MN. EXCAP©® is a home-based walking and progressive resistance exercise program. We combined EXCAP©® with a mobile app; the combination (GO-EXCAP Mobile App) has not been previously tested. A brief verbal description about the intervention was provided to the participants but they did not perform it. Participants were interviewed and inductive thematic analysis was used to analyze the data. RESULTS Mean age was 71.6 (SD 8.5). Three themes were identified: 1) Perceptions of the intervention feasibility, 2) Ways to leverage the app to deliver the exercise intervention, and 3) Personalized exercise goals. Walking and resistance exercises were perceived to be feasible. Patients were comfortable initiating the intervention in cycle 2 of chemotherapy, with exercise increments occurring from week 2-4 of the cycle. Ways to leverage the app to deliver EXCAP©® include 1) Video feature for exercise demonstration and interactions, and 2) Exercise data and symptom surveys to be communicated to the exercise physiologist and primary oncology team. Preservation of existing function and activity was an important goal to participants. CONCLUSIONS Our findings provide insights about the preferences of older adults with MN for a mHealth exercise intervention.
Collapse
Affiliation(s)
- Kah Poh Loh
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | | | | | - Heidi D Klepin
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston-Salem, NC, USA.
| | - Michelle Janelsins
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Eva Culakova
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Paula Vertino
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, USA.
| | - Martha Susiarjo
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jason H Mendler
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jane L Liesveld
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Po-Ju Lin
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Richard F Dunne
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Ian Kleckner
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Karen Mustian
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Supriya G Mohile
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| |
Collapse
|
24
|
Zhu B, Chen P, Kim MJ, Chen X, Quinn L, Fritschi C. Fluctuations in Self-Reported Symptoms Predict Objective Physical Activity in Adults With Type 2 Diabetes. Sci Diabetes Self Manag Care 2021; 47:255-263. [PMID: 34036870 DOI: 10.1177/26350106211015889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to examine the association between self-reported symptoms including fatigue and sleep disturbance with moderate-intensity physical activity among adults with type 2 diabetes. METHODS This report was a secondary analysis of a cross-sectional study. Data from 53 participants with at least 6 days of repeated measures were used. Daytime physical activity and energy expenditure were assessed using a wrist-worn accelerometer at the free-living setting. Fatigue upon awakening was measured using a 0 to 10 scale. Sleep (eg, restorative sleep, sleep duration, and sleep efficiency) was measured using the Consensus Sleep Diary for Morning. Data were analyzed using linear mixed models by including within- and between-person effects. RESULTS Participants were predominantly females (54.7%) with a mean age of 60.3 years. Controlling for the covariates, at the individual level (within-person), fluctuations in restorative sleep and fatigue upon awakening predicted moderate-intensity PA. Similarly, at the individual level, fluctuations in restorative sleep and fatigue upon awakening predicted average hourly energy expenditure. However, at the group level (between-person), no significant associations were found between fatigue and restorative sleep with moderate-intensity physical activity. CONCLUSIONS The study findings suggest that within-person fluctuations in fatigue and restorative sleep upon awakening predict daytime moderate-intensity physical activity. At the individual level, reducing fluctuations in fatigue and restorative sleep might encourage participation in physical activity. More research is warranted to uncover the underlying causes of fluctuations in fatigue and restorative sleep. Meanwhile, diabetes care and education specialists should pay attention to the within-person fluctuations of fatigue and sleep.
Collapse
Affiliation(s)
- Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Pei Chen
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Min Jung Kim
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Xiangfang Chen
- Department of Endocrinology, Shanghai Changzheng Hospital, Shanghai, China (Dr Chen)
| | - Laurie Quinn
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Cynthia Fritschi
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| |
Collapse
|
25
|
Shimo S, Sakamoto Y, Amari T, Chino M, Sakamoto R, Nagai M. Differences between the Sexes in the Relationship between Chronic Pain, Fatigue, and QuickDASH among Community-Dwelling Elderly People in Japan. Healthcare (Basel) 2021; 9:healthcare9060630. [PMID: 34070450 PMCID: PMC8230304 DOI: 10.3390/healthcare9060630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 01/10/2023] Open
Abstract
Chronic pain and fatigue have negative effects on the health, ADL, work, and hobbies of the elderly. As the proportion of people 65 years of age and older in the population increases, chronic pain and disability research regarding this group is receiving more consideration. However, little empirical evidence of the association between chronic pain, fatigue, and physical disability between the sexes is available. This study investigated the association between chronic pain, fatigue, and instrumental activities of daily living among community-dwelling elderly people by sex in Japan. Concerning the presence of chronic pain, 61% of males and 78% of females reported chronic pain, indicating that many elderly people living in the community suffer from chronic pain and fatigue on a daily basis. The number of sites of chronic pain was higher in females than in males (p = 0.016), with more chronic pain in the knees (p < 0.001) and upper arms (p = 0.014). Regarding chronic pain, males showed a higher correlation with QuickDASH-DS (rs = 0.433, p = 0.017) and QuickDASH-SM (rs = 0.643, p = 0.018) than females. Furthermore, fatigue also showed a higher correlation with QuickDASH-W (rs = 0.531, p = 0.003) in males than in females. These results indicate that the association between chronic pain, fatigue, and QuickDASH differed between the sexes among community-dwelling elderly people in Japan. A better understanding of the risk factors for elderly chronic pain and fatigue among sexes will facilitate the development of elderly healthcare welfare and policies.
Collapse
Affiliation(s)
- Satoshi Shimo
- Department of Occupational Therapy, Health Science University, Fujikawaguchiko, Yamanashi 401-0380, Japan
- Correspondence: ; Tel.: +81-555-83-5266
| | - Yuta Sakamoto
- Department of Physical Therapy, Health Science University, Fujikawaguchiko, Yamanashi 401-0380, Japan; (Y.S.); (T.A.)
| | - Takashi Amari
- Department of Physical Therapy, Health Science University, Fujikawaguchiko, Yamanashi 401-0380, Japan; (Y.S.); (T.A.)
| | - Masaaki Chino
- Yamanashi Research Institute Foundation, Kofu, Yamanashi 400-0031, Japan;
| | - Rie Sakamoto
- Fuefuki City Council of Social Welfare, Fuefuki, Yamanashi 406-0822, Japan;
| | - Masanori Nagai
- Department of Welfare Psychology, Health Science University, Fujikawaguchiko, Yamanashi 401-0380, Japan;
| |
Collapse
|
26
|
Knoop V, Cloots B, Costenoble A, Debain A, Vella Azzopardi R, Vermeiren S, Jansen B, Scafoglieri A, Bautmans I. Fatigue and the prediction of negative health outcomes: A systematic review with meta-analysis. Ageing Res Rev 2021; 67:101261. [PMID: 33548508 DOI: 10.1016/j.arr.2021.101261] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/23/2020] [Accepted: 01/24/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Fatigue is a common complaint among older adults. Evidence grows that fatigue is linked to several negative health outcomes. A general overview of fatigue and its relationship with negative health outcomes still lacks in the existing literature. This brings complications for healthcare professionals and researchers to identify fatigue-related health risks. Therefore, this study gives an overview of the prospective predictive value of the main negative health outcomes for fatigue in community-dwelling older adults. METHODS PubMed, Web of Knowledge and PsycINFO were systematically screened for prospective studies regarding the relationship between fatigue and negative health outcomes resulting in 4595 articles (last search 5th March 2020). Meta-analyses were conducted in RevMan using Odds ratios (ORs), Hazard ratios (HRs) and relative risk ratios (RR) that were extracted from the included studies. Subgroup-analyses were performed based on (1) gender (male/female), (2) length of follow-up and (3) fatigue level (low, medium and high). RESULTS In total, thirty articles were included for this systematic review and meta-analysis encompassing 152 711 participants (age range 40-98 years), providing information on the relationship between fatigue and health outcomes. The results showed that fatigue is related to an increased risk for the occurrence of all studied health outcomes (range OR 1.299-3.094; HR/RR 1.038-1.471); for example, mortality OR 2.14 [1.74-2.63]; HR/RR 1.44 [1.28-1.62]), the development of disabilities in basic activities of daily living (OR 3.22 [2.05-5.38]), or the occurrence of physical decline (OR 1.42 [1.29-1.57]). CONCLUSION Overall fatigue increases the risk for developing negative health outcomes. The analyses presented in this study show that fatigue related physical decline occurs earlier than hospitalization, diseases and mortality, suggesting the importance of early interventions.
Collapse
Affiliation(s)
- V Knoop
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - B Cloots
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - A Costenoble
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - A Debain
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - R Vella Azzopardi
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - S Vermeiren
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - B Jansen
- Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium; Imec, Leuven, Belgium
| | - A Scafoglieri
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Supporting Clinical Science Department and Research Department of Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - I Bautmans
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium.
| |
Collapse
|
27
|
Malak MZ, Abu Adas M, Al-Amer R, Yousef NN, Ali RM. Evaluation of Fatigue among Older Population in Jordan. Exp Aging Res 2021; 47:464-477. [PMID: 33792513 DOI: 10.1080/0361073x.2021.1908764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Fatigue among older adults has not received empirical attention in the Arabic region. Thus, this study aimed to assess the levels of fatigue and its related psychosocial factors and examine the predictors of fatigue in older Jordanians aged 60 years and more.Methods: This study used a cross-sectional design and our sample was 250 older adults receiving health services at comprehensive healthcare centers in Amman Governorate, the capital of Jordan. The study used the following scales: Fatigue scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, Multidimensional Social Support Scale, and sociodemographic and lifestyle behaviors datasheet.Results: The results showed that approximately 57% of the participants experienced severe fatigue. Nearly 90% of the older adults reported having moderate to high levels of stress, around 97% experienced moderate and high levels of social support, and almost 68% had normal self-esteem. The significant predictors of the total fatigue scores were, consuming soft drinks, practicing exercise, perceived levels of stress, and social support levels.Conclusions: Awareness of the magnitude and the factors predicting fatigue among elderlies in Jordan should inform the practice and encourage clinicians to implement individualized care plans that include fatigue reduction strategies, to elderlies visiting healthcare centers.
Collapse
Affiliation(s)
- Malakeh Z Malak
- Asso'ciate Professor, Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Mohammed Abu Adas
- Community Health Nursing, College of Nursing-Khamis Mushait, King Khalid University, Ahba, Kingdom of Saudi Arabia
| | - Rasmieh Al-Amer
- Psychiatric Health Nursing, Faculty of Nursing, Isra University, Amman, Jordan; Adjunct Fellow, Western Sydney University, School of Nursing and Midwifery, Sydney, NSW, Australia
| | - Nancy N Yousef
- Marj Al-Hamam Health Center, Registered Nurse, Adult Health Nursing, Ministry of Health, Amman, Jordan
| | - Raed M Ali
- Clinical Instructor, Adult Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| |
Collapse
|
28
|
Vetrovsky T, Omcirk D, Malecek J, Stastny P, Steffl M, Tufano JJ. Morning fatigue and structured exercise interact to affect non-exercise physical activity of fit and healthy older adults. BMC Geriatr 2021; 21:179. [PMID: 33711945 PMCID: PMC7953813 DOI: 10.1186/s12877-021-02131-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/04/2021] [Indexed: 01/28/2023] Open
Abstract
Background Exercise training is crucial for maintaining physical and mental health in aging populations. However, as people participate in structured exercise training, they tend to behaviorally compensate by decreasing their non-exercise physical activity, thus potentially blunting the benefits of the training program. Furthermore, physical activity of older adults is substantially influenced by physical feelings such as fatigue. Nevertheless, how older people react to day-to-day fluctuations of fatigue and whether fatigue plays a role in non-exercise physical activity compensation is not known. Thus, the purpose of this study was twofold: (1) To explore whether the volume and intensity of habitual physical activity in older adults were affected by morning fatigue. (2) To investigate the effect of attending power and resistance exercise sessions on the levels of non-exercise physical activity later that day and the following day. Methods Twenty-eight older adults wore an accelerometer during a 4-week low-volume, low-intensity resistance and power training program with three exercise sessions per week and for 3 weeks preceding and 1 week following the program. During the same period, the participants were prompted every morning, using text messages, to rate their momentary fatigue on a scale from 0 to 10. Results Greater morning fatigue was associated with lower volume (p = 0.002) and intensity (p = 0.017) of daily physical activity. Specifically, one point greater on the fatigue scale was associated with 3.2 min (SE 1.0) less moderate-to-vigorous physical activity. Furthermore, attending an exercise session was associated with less moderate-to-vigorous physical activity later that day by 3.7 min (SE 1.9, p = 0.049) compared to days without an exercise session. During the next day, the volume of physical activity was greater, but only in participants with a body mass index up to 23 (p = 0.008). Conclusions Following low-volume exercise sessions, fit and healthy older adults decreased their non-exercise physical activity later that day, but this compensation did not carry over into the next day. As momentary morning fatigue negatively affects daily physical activity, we suggest that the state level of fatigue should be monitored during intensive exercise programs, especially in less fit older adults with increased fatigability.
Collapse
Affiliation(s)
- Tomas Vetrovsky
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Jose Martiho 269/31, 162 52, Prague, Czech Republic.
| | - Dan Omcirk
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Jose Martiho 269/31, 162 52, Prague, Czech Republic
| | - Jan Malecek
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Jose Martiho 269/31, 162 52, Prague, Czech Republic
| | - Petr Stastny
- Department of Sport Games, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michal Steffl
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Jose Martiho 269/31, 162 52, Prague, Czech Republic
| | - James J Tufano
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Jose Martiho 269/31, 162 52, Prague, Czech Republic
| |
Collapse
|
29
|
Kim YJ, Joshi V, Wu Q. Subjective factors of depressive symptoms, ambulation, pain, and fatigue are associated with physical activity participation in cardiac arrest survivors with fatigue. Resusc Plus 2021; 5:100057. [PMID: 34223329 PMCID: PMC8244480 DOI: 10.1016/j.resplu.2020.100057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 02/08/2023] Open
Abstract
AIM This study aimed to examine the associations between participation in physical activities and objective and subjective factors modifiable by rehabilitation in cardiac arrest survivors with fatigue. METHODS Participants in a clinical feasibility study (N = 19) completed several subjective (patient-reported) and objective outcome measures on one occasion only. The associations between an individual's level of participation in physical activities (Participation Objective Participation Subjective) and their levels of cognition (Computer Assessment of Mild Cognitive Impairment), body movement (Keitel Functional Test), depressive symptoms (Center for Epidemiologic Studies Depression Scale), ambulation and pain (Health Utilities Index Mark 3), and fatigue impact (Modified Fatigue Impact Scale) were explored. Pearson's correlation coefficientr was calculated for all associations, except for body movement (Spearman's correlation coefficient rs ). RESULTS As hypothesized, we found weak-to-moderate, positive associations between participation in physical activities and objective factors of cognition (r = 0.370) and body movement (rs = 0.414) and a subjective factor of ambulation ability (r = 0.501). We found moderate, negative associations between participation in physical activities and subjective factors of depressive symptoms (r=-0.590), pain (r=-0.495), physical fatigue impact (r=-0.629), cognitive fatigue impact (r=-0.591), and psychosocial fatigue impact (r=-0.557). CONCLUSION The moderate, negative and positive associations between participation in physical activities and subjective factors suggest that subjective complaints of depressive symptoms, ambulation ability, pain, and fatigue impact may be important factors when seeking to improve participation in physical activities. In particular, addressing physical and cognitive endurance as well as perceptions of fatigue may hold the key to increasing physical activity in cardiac arrest survivors with fatigue.
Collapse
Affiliation(s)
- Young Joo Kim
- 600 Moye Blvd, MS668, HSB3305, Department of Occupational Therapy, College of Allied Health Sciences, East Carolina University, Greenville, NC, 27834, USA
| | - Vicky Joshi
- Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), University of Southern Denmark, and Odense University Hospital, Denmark
| | - Qiang Wu
- 600 Moye Blvd, 2209 East Carolina Heart Institute, Department of Biostatistics, College of Allied Health Sciences, East Carolina University, Greenville, NC, 27834, USA
| |
Collapse
|
30
|
Liu M, Sun Q, Cui L, Liu J, Liu L, Wu X, Wang Z, Zhou X, Xie J, Cheng AS. Fear of Movement and Physical Self-Efficacy Partially Mediate the Association Between Fatigue and Physical Activity Among Kidney Transplant Recipients. Clin Nurs Res 2021; 30:950-959. [PMID: 33511857 DOI: 10.1177/1054773821990263] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fatigue is one of the most distressing symptoms in renal transplant patients, causing functional impairment and worsening their quality of life. However, the mechanism by which fatigue affects physical activity is unclear. A cross-sectional study using a convenient sampling approach was utilized to investigate 665 kidney transplant recipients recruited from the transplantation centers of six general hospitals from July and September 2019. Structural equation modeling was used to examine the interaction among fatigue, fear of movement, physical self-efficacy, and physical activity. Our study found fatigue was directly negatively associated with physical activity and had an indirect impact on physical activity through the mediating effects of physical self-efficacy and fear of movement. These variables accounted for 44.4% of the variation in physical activity. Our findings alert healthcare providers for the importance of fatigue management for physical activity and focused attention on fear of movement and physical self-efficacy in renal transplant recipients.
Collapse
Affiliation(s)
- Min Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qian Sun
- Xiangya Nursing School, Central South University, Changsha, China
| | - Lina Cui
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jia Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lifang Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoxia Wu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhimin Wang
- Nursing Department of the Second Affiliated Hospital, Nanhua University, Hengyang, China
| | - Xin Zhou
- Transplantation Center of Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Jianfei Xie
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China
| |
Collapse
|
31
|
Ward AL, Jospe M, Morrison S, Reynolds AN, Kuroko S, Fangupo LJ, Smith C, Galland BC, Taylor RW. Bidirectional associations between sleep quality or quantity, and dietary intakes or eating behaviors in children 6-12 years old: a systematic review with evidence mapping. Nutr Rev 2021; 79:1079-1099. [PMID: 33440009 DOI: 10.1093/nutrit/nuaa125] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
CONTEXT Although dietary advice has long been a cornerstone of a healthy lifestyle, how sleep quality and quantity may interact with dietary intake or eating behaviors remains unclear. OBJECTIVE To consider a bidirectional relationship between sleep and diet in children aged 6-12 years via a systematic review following PRISMA guidelines. DATA SOURCES Relevant trials and observational studies were identified by searching the PubMed, Medline, Embase, and CENTRAL databases up to June 1, 2019, without language or date restrictions and supplemented with hand searching. Recognized procedures and reporting standards were applied. DATA EXTRACTION Data on participant characteristics, study parameters, diet measures, sleep measures, and findings of study quality assessment criteria were collected. DATA ANALYSIS Forty-five articles involving 308 332 participants on a diverse range of topics were included. Meta-analyses were planned but were impossible to perform due to high study heterogeneity. Most studies (82%) were cross-sectional, which prevented examining directionality of the observed associations. Risk of bias was assessed for trial, cohort studies, and cross-sectional studies, using the Cochrane Risk of Bias Tool or Newcastle Ottawa Scale. RESULTS Of 16 studies in which the effect of sleep on dietary intake was investigated, 81% (n = 13) reported a significant association. All studies (n = 8) of sugar-sweetened or caffeinated beverages reported a negative association with sleep, and in 6 of 7 studies in which eating behaviors were investigated, associations with sleep were reported. The use of objective measures of sleep and diet were scarce, with most trials and studies relying on subjective measures of sleep (68%) or diet (93%). CONCLUSION Because most studies investigating the relationship between sleep and diet in this age group are cross-sectional, temporality could not be determined. Additional randomized controlled trials and long-term cohort studies in middle childhood, particularly those using objective rather than questionnaire measures of sleep, are required to better understand interactions between diet and sleep. SYSTEMATIC REVIEW REGISTRATION Prospectively registered with PROSPERO International Prospective Register of Systematic Reviews (CRD42018091647).
Collapse
Affiliation(s)
- Aimee L Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand and Department of Geography, Kent State University, Kent, Ohio, USA
| | - Michelle Jospe
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Sarahmarie Kuroko
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Louise J Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Claire Smith
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
32
|
Kim H, Son H. A Moderated-Mediation Model of the Relationship between Dietary Satisfaction and Fatigue in Older Adults with Diabetes: The Role of Meal Planning and Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8823. [PMID: 33261015 PMCID: PMC7729502 DOI: 10.3390/ijerph17238823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 01/12/2023]
Abstract
Little research has examined the pathways between psychological factors and fatigue in older adults with diabetes. This study explored the pathways between diet-related quality of life and depressive symptoms in predicting fatigue using a moderated-mediation model. A convenience sample of adults ≥65 years (n = 127) with diabetes completed a cross-sectional survey including measures of fatigue severity, diet-related quality of life, and depressive symptoms, and a moderated-mediation analysis assessed the relationships between them. Diet satisfaction was negatively related to fatigue, which was mediated by depressive symptoms. In the moderated-mediation model, diet satisfaction had a conditional effect on fatigue through the mediating effect of depressive symptoms, moderated by meal planning difficulty. At higher levels of perceived meal planning difficulty, lower diet satisfaction was indirectly associated with higher fatigue through depressive symptoms, but this pathway was non-significant at lower levels. Findings suggest that supportive care for diet therapy might improve psychological outcomes in older adults with diabetes, especially for those having difficulties with daily dietary practice. Meal planning difficulties in the dietary management of diabetes accompanied by low diet satisfaction may lead to negative psychological outcomes. Monitoring satisfaction and burdens associated with dietary practices could improve fatigue in this population.
Collapse
Affiliation(s)
- Hyerang Kim
- Department of Nursing Science, Howon University, 64 Howondae 3gil, Impi, Gunsan 54058, Jeollabuk-do, Korea;
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
| |
Collapse
|
33
|
Zaslavsky O, Su Y, Rillamas-Sun E, Roopsawang I, LaCroix AZ. Accelerometer-Measured Physical Activity Levels and Fatigue in Older Women. J Aging Phys Act 2020; 28:692-698. [PMID: 32303001 DOI: 10.1123/japa.2019-0308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/08/2019] [Accepted: 12/30/2019] [Indexed: 11/18/2022]
Abstract
The authors examined whether the associations between physical activity (PA) levels and fatigue vary by body mass index and physical performance, and whether substituting sedentary time (ST) with low light PA, high light PA, and moderate to vigorous PA (MVPA) was associated with better mean fatigue scores. In total, 6,111 participants (aged 65 years and older) were from the Women's Health Initiative Objective Physical Activity and Cardiovascular Health Study. PA levels were from a hip-worn GT3X accelerometer. Overall fatigue, energy, and weariness subdomains were from the RAND-36 Vitality subscale. Isotemporal substitution models examined the time-substitution effects. Interactions were observed between MVPA and short physical performance battery performance measure (p < .05). Substituting ST with 34.3 min of MVPA was associated on average with a 1.63-point improvement in fatigue score. Substituting ST with 50.2 min of low light PA and 34.3 min of MVPA was associated on average with an energy score improvement of 1.18 and 2.06 points respectively. Substituting ST with 34.3 min of MVPA was associated on average with a 1.08-point improvement in weariness score (p < .05 for all).
Collapse
|
34
|
Kwan RY, Lee D, Lee PH, Tse M, Cheung DS, Thiamwong L, Choi KS. Effects of an mHealth Brisk Walking Intervention on Increasing Physical Activity in Older People With Cognitive Frailty: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16596. [PMID: 32735218 PMCID: PMC7428907 DOI: 10.2196/16596] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 05/12/2020] [Accepted: 06/14/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cognitive frailty is the coexistence of physical frailty and cognitive impairment and is an at-risk state for many adverse health outcomes. Moderate-to-vigorous physical activity (MVPA) is protective against the progression of cognitive frailty. Physical inactivity is common in older people, and brisk walking is a feasible form of physical activity that can enhance their MVPA. Mobile health (mHealth) employing persuasive technology has been successful in increasing the levels of physical activity in older people. However, its feasibility and effects on older people with cognitive frailty are unclear. OBJECTIVE We aimed to identify the issues related to the feasibility of an mHealth intervention and the trial (ie, recruitment, retention, participation, and compliance) and to examine the effects of the intervention on cognitive function, physical frailty, walking time, and MVPA. METHODS An open-label, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for the participants were age ≥60 years, having cognitive frailty, and having physical inactivity. In the intervention group, participants received both conventional behavior change intervention and mHealth (ie, smartphone-assisted program using Samsung Health and WhatsApp) interventions. In the control group, participants received conventional behavior change intervention only. The outcomes included cognitive function, frailty, walking time, and MVPA. Permuted block randomization in 1:1 ratio was used. The feasibility issue was described in terms of participant recruitment, retention, participation, and compliance. Wilcoxon signed-rank test was used to test the within-group effects in both groups separately. RESULTS We recruited 99 participants; 33 eligible participants were randomized into either the intervention group (n=16) or the control (n=17) group. The median age was 71.0 years (IQR 9.0) and the majority of them were females (28/33, 85%). The recruitment rate was 33% (33/99), the participant retention rate was 91% (30/33), and the attendance rate of all the face-to-face sessions was 100% (33/33). The majority of the smartphone messages were read by the participants within 30 minutes (91/216, 42.1%). ActiGraph (58/66 days, 88%) and smartphone (54/56 days, 97%) wearing compliances were good. After the interventions, cognitive function improvement was significant in both the intervention (P=.003) and the control (P=.009) groups. The increase in frailty reduction (P=.005), walking time (P=.03), step count (P=.02), brisk walking time (P=.009), peak cadence (P=.003), and MVPA time (P=.02) were significant only in the intervention group. CONCLUSIONS Our mHealth intervention is feasible for implementation in older people with cognitive impairment and is effective at enhancing compliance with the brisk walking training program delivered by the conventional behavior change interventions. We provide preliminary evidence that this mHealth intervention can increase MVPA time to an extent sufficient to yield clinical benefits (ie, reduction in cognitive frailty). A full-powered and assessor-blinded RCT should be employed in the future to warrant these effects. TRIAL REGISTRATION HKU Clinical Trials Registry HKUCTR-2283; http://www.hkuctr.com/Study/Show/31df4708944944bd99e730d839db4756.
Collapse
Affiliation(s)
- Rick Yc Kwan
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong (China)
| | - Deborah Lee
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong (China)
| | - Paul H Lee
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (China)
| | - Mimi Tse
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong (China)
| | - Daphne Sk Cheung
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong (China)
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Kup-Sze Choi
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (China)
| |
Collapse
|
35
|
Acaröz Candan S. Body Mass Index, Physical Activity Habits and Physical Function Contribute to Fatigue in the Rest Home Residents. Exp Aging Res 2020; 46:323-335. [PMID: 32452295 DOI: 10.1080/0361073x.2020.1769392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUNDS Fatigue is a common complaint in older adults living in rest homes. The aim of this study was to investigate the factors associated with fatigue among older adults living in a rest home. METHODS This cross-sectional study was carried out with a total of 92 older adults. Fatigue was evaluated by the Fatigue Severity Scale (FSS). The sociodemographic characteristics, quadriceps and handgrip strength, functional capacity and physical function were assessed using a structured questionnaire, digital dynamometers, 6-minute walking test and Short Physical Performance Battery, respectively. RESULTS The prevalence of fatigue was 67.4%. FSS showed significant correlations with age, female gender, body mass index, physical activity habits, quadriceps strength, handgrip strength, functional exercise capacity, and physical function. However, in the regression analysis, only body mass index, physical activity habits and physical function were responsible for 51% of the variance in fatigue among rest home residents. Physical activity habits and physical function were the best predictors of fatigue explaining 47.5% of variance. CONCLUSION This study demonstrated that body mass index, physical activity habits and physical function contributed to fatigue in rest home residents. These factors can be used to identify individuals at high risk of fatigue and to attenuate fatigue levels.
Collapse
Affiliation(s)
- Sevim Acaröz Candan
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Ordu University , Ordu, Turkey
| |
Collapse
|
36
|
Braaten RS, Askim T, Gunnes M, Indredavik B. Fatigue and activity after stroke. Secondary results from the Life After Stroke study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 25:e1851. [PMID: 32431023 DOI: 10.1002/pri.1851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/11/2020] [Accepted: 04/29/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The aim of this study was to describe how the prevalence of fatigue changed from the subacute phase to the chronic phase after stroke, and to investigate how activity was associated with fatigue among participants included in the randomized controlled multicentre-study Life After STroke (LAST). METHODS The present study represents secondary analysis based on data from the LAST study. One-hundred-and-forty-five patients with mild and moderate stroke (mean (SD) age: 71.5 (10.5) years, 57.2% males) recruited from St. Olav's University Hospital were included. Fatigue was assessed by the Fatigue Severity Scale (FSS-7) at inclusion, 3 months after stroke, and at follow-up 18 months later. activPAL was used to measure activity at follow-up. RESULTS A total of 46 (31.7%) participants reported fatigue at inclusion and 43 (29.7%) at follow-up (p = .736). In the univariable regression analysis, sedentary behaviour, walking and sedentary bouts were significantly associated with fatigue (p ≤ .015), whereas only time spent walking was significantly associated with fatigue in the multivariable regression analysis (p = .017). CONCLUSIONS The present study showed that fatigue is a common symptom after stroke and that the prevalence of fatigue remained unchanged from the subacute to the chronic phase. The study also showed that increased time spent walking was strongly related to lower fatigue, while no such associations were found between the other activity categories and fatigue.
Collapse
Affiliation(s)
- Ragnhild Sunde Braaten
- Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Clinical Services, Department of Physiotherapy, St. Olav's University Hospital, Trondheim, Norway
| | - Torunn Askim
- Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Mari Gunnes
- Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bent Indredavik
- Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
37
|
Ho LYW, Ng SSM. Non-pharmacological interventions for fatigue in older adults: a systematic review and meta-analysis. Age Ageing 2020; 49:341-351. [PMID: 32101281 DOI: 10.1093/ageing/afaa019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/14/2019] [Accepted: 01/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-pharmacological interventions are widely used to treat fatigue in clients with specific diseases but the findings may not be applicable to older adults experiencing fatigue, which also relates to the physiological changes of ageing. Non-pharmacological interventions for fatigue alleviation in older adults have not been reviewed and meta-analysed. OBJECTIVE To evaluate the immediate and long-term effects of non-pharmacological interventions on fatigue in community-dwelling older adults. METHODS Randomised controlled trials published from 2008 to May 2018 were searched in CINAHL, Cochrane Library, Embase, Medline, PsycINFO, PubMed and Web of Science databases. The reference lists of the publications, forward citation and clinical trial registries were also reviewed. Relevant data were extracted and meta-analysis was conducted using Cochrane Review Manager 5.3. RESULTS Eight studies, with a total of 1093 participants, were identified. Non-pharmacological interventions included mindfulness meditation, a behavioural lifestyle programme, muscle relaxation, pet insect-assisted therapy, yoga, Tai Chi and cognitive behavioural therapy. Non-pharmacological interventions elicited significant immediate positive effects on fatigue (SMD: -0.40, 95% CI -0.62 to -0.18), although there was no lasting effect. Both physical and cognitive/mental interventions effectively alleviated fatigue. CONCLUSION Non-pharmacological interventions appear to be effective in alleviating fatigue at immediate post-intervention in community-dwelling older adults. More studies with robust designs and adequate sample sizes are needed in the future.
Collapse
Affiliation(s)
- Lily Y W Ho
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| |
Collapse
|
38
|
Kim H, Son H. Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4502. [PMID: 31731588 PMCID: PMC6887975 DOI: 10.3390/ijerph16224502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 01/10/2023]
Abstract
Older adults with diabetes appear more susceptible to fatigue compared to younger adults with diabetes or healthy older adults, since aging and diabetes independently and synergistically influence fatigue. Few studies have investigated fatigue in older adults with diabetes using a multidimensional approach. This study explored the influences of physical, psychological, interpersonal, and contextual factors on diabetes fatigue using a dynamic biopsychosocial model. Face-to-face surveys were administered to community-dwelling older adults with diabetes and included variables across four domains (i.e., physical, psychological, interpersonal, and contextual factors). Univariate analyses and multiple linear regression were used. The mean fatigue score was 3.94 (standard deviation (SD) = 1.81) out of 7, and the prevalence of fatigue was 48.8%. Significant differences in fatigue severity by psychological, interpersonal, and contextual factors were found. Comorbidity and psychological factors were significant predictors of fatigue in the model, explaining 31.9% of the variance. As nearly half the sample experienced moderate or severe fatigue, which was significantly influenced by both comorbidity and psychological factors, including depression, sleep quality, and diet-related psychological characteristics, assessing patients' psychological status may be important. Awareness of fatigue could be incorporated into dietary interventions for older adults with diabetes.
Collapse
Affiliation(s)
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea;
| |
Collapse
|
39
|
Park S, Thøgersen-Ntoumani C, Veldhuijzen van Zanten JJCS, Ntoumanis N. The Role of Physical Activity and Sedentary Behavior in Predicting Daily Pain and Fatigue in Older Adults: a Diary Study. Ann Behav Med 2019. [PMID: 28646335 DOI: 10.1007/s12160-017-9921-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Little attention has been paid to within-person daily associations among light physical activity (PA), moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) with subsequent bodily pain and fatigue. Daily reports of pain and fatigue are less likely to be affected by recall bias and to conflate days of high and low pain/ fatigue into one overall score. Purpose The purpose of this study was to examine daily within-person associations between pain, fatigue, and physical health and ascertain whether such associations are moderated by individual differences in these variables. Methods Participants were 63 community-living older adults (female n = 43, mean age = 70.98 years). Questionnaires measured typical levels of PA, SB, bodily pain, fatigue, and physical health. Subsequently, on a daily basis over a 1-week period, participants' levels of light PA, MVPA, and SB were measured using accelerometers. Participants completed a questionnaire rating their pain and fatigue at the end of each day. Results Multilevel modeling revealed positive within-person associations between daily light PA, dailyMVPA, and pain, as well as negative within-person associations between daily SB and pain. For individuals with higher typical levels of fatigue, there was a negative association between daily light PA, MVPA, and fatigue. For individuals with better levels of physical health, there was also a negative association between daily MVPA and fatigue. For those with higher typical levels of fatigue and better levels of physical health, there was a positive association between daily SB and fatigue. No such interaction effects were found between high levels of typical pain and PA or SB. Conclusions Our findings indicate that efforts to promote daily PA in older adults might be more effective for those who report high typical levels of fatigue and physical health, compared to those who report high levels of daily physical pain.
Collapse
Affiliation(s)
- Saengryeol Park
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | | | - Nikos Ntoumanis
- School of Psychology & Speech Pathology, Curtin University, Perth, WA, Australia
| |
Collapse
|
40
|
Wanigatunga AA, Simonsick EM, Zipunnikov V, Spira AP, Studenski S, Ferrucci L, Schrack JA. Perceived Fatigability and Objective Physical Activity in Mid- to Late-Life. J Gerontol A Biol Sci Med Sci 2019; 73:630-635. [PMID: 29028920 DOI: 10.1093/gerona/glx181] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 09/15/2017] [Indexed: 11/14/2022] Open
Abstract
Background Fatigability, defined as fatigue in relation to a standardized task, predicts functional decline in older adults independent of reported tiredness or energy level. Although the sensation of fatigue, tiredness, and energy level adversely affect physical activity (PA), the association between fatigability and objectively measured PA is unknown. Methods Participants in the Baltimore Longitudinal Study of Aging (n = 557, 50% women, aged 50-97 years) were instructed to wear an Actiheart accelerometer for 7 consecutive days in the free-living environment. Perceived fatigability was assessed using the Borg rating of perceived exertion (RPE) after 5 minutes of treadmill walking at 1.5 mph (0.67 m/s) and categorized as low (6-7 RPE), intermediate (8-9 RPE), and high (10+ RPE) fatigability. Time-of-day PA differences between fatigability groups were assessed using mixed-effects modeling. Results Total daily PA was 1.3% lower for every unit increment in perceived fatigability after adjusting for demographic, behavioral, and medical factors (p = .01). In time-of-day analyses, the high fatigability group was less active compared to the low fatigability group throughout the day (8:00 am to 8:00 pm) and the intermediate fatigability group in the morning (8:00 am to 12:00 pm). Patterns of PA within the high fatigability group differed from both the intermediate and low groups in the morning but mirrored the intermediate group in the afternoon and evening. Discussion These results suggest that RPE is a bio-marker of fatigability associated with progressively lower PA with aging. Whether the effects of fatigability occurring at the end of the day reflect waning energy levels or a voluntary choice that could be modified remains to be evaluated.
Collapse
Affiliation(s)
- Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Adam P Spira
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Stephanie Studenski
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
41
|
Araújo RS, Nascimento ÉRD, Barros RDS, Ritter SRF, Abreu AMS, Garcia PA. Can clinical and physical-functional factors predict falls in cognitively impaired older adults? REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.190211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to investigate the frequency of falls and clinical and physical-functional factors associated with falls, and the accuracy of such factors to identify the risk of falling in cognitively impaired older adults. Method: a cross-sectional study with cognitively impaired older adults was carried out using the Mini-Mental State Examination. The dependent variable was a history of falls in the previous six months. The independent variables were self-reported mental confusion, hearing and visual impairment, physical fatigue, muscle weakness, dizziness, body imbalance, insecurity when walking, diagnosed depression, hospitalizations, continuous use medications (form from study used), muscle mass (calf circumference) and handgrip strength (dynamometry), functional capacity (Pfeffer) and mobility (SAM-Br). Descriptive statistics were applied. The groups were compared using the Mann Whitney U test, the risk factors were identified by univariate and multivariate logistic regression, and the area under the ROC curve (AUC) was calculated for the associated factors. Results: 216 cognitively impaired older adults were included in the analysis, 41.7% of whom were fallers. Multivariate regression analyzes indicated that complaints of visual impairment (OR=2.8; p=0.015) and body imbalance (OR=2.7; p=0.004), and greater medication use (OR=1.1; p=0.038) were associated with a history of falls. The AUC found poor accuracy for quantity of medications as a screening tool for fallers (AUC=0.6 [0.5; 0.7]; p=0.028). Conclusion: cognitively impaired older adults had a high frequency of falls. Complaints of visual impairment, body imbalance and polypharmacy were predictors of falls. The early assessment of these factors can contribute to the identification of cognitively-impaired older adults at risk of falling in clinical practice and research.
Collapse
|
42
|
Palmberg L, Viljanen A, Rantanen T, Kaprio J, Rantakokko M. The Relationship Between Sleep Characteristics and Unmet Physical Activity Need in Older Women. J Aging Health 2018; 32:199-207. [PMID: 30466337 DOI: 10.1177/0898264318814021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: We examined among older women the association of sleep quality, daytime tiredness, and sleep duration with unmet physical activity need, that is, wishing to be more physically active but perceiving no opportunity for it. Method: Cross-sectional logistic regression analyses among women aged 74 to 86 years (Finnish Twin Study on Aging, third wave, n = 302). Results: Thirty-one participants reported unmet physical activity need. Short sleepers had fivefold and long sleepers threefold odds for unmet physical activity need compared with normative sleepers, while for daytime tiredness the odds were double. Presence of daytime tiredness and unmet physical activity coincided with higher prevalence of chronic diseases, depressive symptoms and walking difficulties, which partly explains the observed associations. Poor sleep quality was not associated with unmet physical activity need. Discussion: Older women with nonoptimal sleep characteristics who perceive unmet physical activity need may benefit from solutions that improve their perceived opportunities for physical activity.
Collapse
Affiliation(s)
- Lotta Palmberg
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Anne Viljanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, Helsinki, Finland.,Department of Public Health, University of Helsinki, Finland
| | - Merja Rantakokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| |
Collapse
|
43
|
Waller K, Vähä-Ypyä H, Lindgren N, Kaprio J, Sievänen H, Kujala UM. Self-reported Fitness and Objectively Measured Physical Activity Profile Among Older Adults: A Twin Study. J Gerontol A Biol Sci Med Sci 2018; 74:1965-1972. [DOI: 10.1093/gerona/gly263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Maintaining good fitness and good level of physical activity are important factors for maintaining physical independence later in life. The aim was to investigate the relationship between self-reported fitness and objectively measured physical activity and sedentary behavior in the elderly.
Methods
Same-sex twin pairs born 1940–1944 in Finland were invited to the study. Altogether 787 individuals (mean age 72.9 years), of whom 404 were female, used a hip-worn triaxial accelerometer for at least 4 days and answered a question on perceived fitness. First, individual differences were studied between four fitness categories. Second, pairwise differences were examined among twin pairs discordant for fitness.
Results
Self-reported fitness explained moderately the variation in objectively measured physical activity parameters: R2 for daily steps 26%, for daily mean metabolic equivalent 31%, for daily moderate-to-vigorous activity time 31%, and lower for sedentary behavior time 14% (all p < .001). Better self-reported fitness was associated with more steps taken on average (8,558 daily steps [very good fitness] vs 2,797 steps [poor fitness], p < .001) and with a higher amount of moderate-to-vigorous activity (61 min vs 12 min p < .001, respectively) in the adjusted multivariable model. Among 156 twin pairs discordant for self-reported fitness, co-twins with better fitness took more steps, did more moderate-to-vigorous activity, and had less sedentary behavior (all, p < .05) compared to their less fit co-twins; however, difference was smaller among monozygotic than dizygotic pairs.
Conclusion
One simple question on self-reported fitness is associated with daily activity profile among community-dwelling older people. However, genetic factors modulate this association to some extent.
Collapse
Affiliation(s)
- Katja Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Noora Lindgren
- Turku PET Centre, Turku University Hospital and University of Turku, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| |
Collapse
|
44
|
LaRoche DP, Melanson EL, Baumgartner MP, Bozzuto BM, Libby VM, Marshall BN. Physiological determinants of walking effort in older adults: should they be targets for physical activity intervention? GeroScience 2018; 40:305-315. [PMID: 29961239 DOI: 10.1007/s11357-018-0032-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/24/2018] [Indexed: 12/25/2022] Open
Abstract
Older adults do not get enough physical activity increasing risk for chronic disease and loss of physical function. The purpose of this study was to determine whether neuromuscular, metabolic, and cardiorespiratory indicators of walking effort explain daily activity in community-dwelling older adults. Sixteen women and fourteen men, 78 ± 8 years, performed a steady-state walk on a treadmill at 1.25 m s-1 while muscle activation, heart rate, lactate, respiratory exchange ratio, oxygen consumption (VO2), ventilation, and rating of perceived exertion (RPE) were recorded as markers of Walking Effort. Daily walking time, sitting/lying time, energy expenditure, and up-down transitions were recorded by accelerometers as markers of Daily Activity. Structural equation modeling was used to explore the relationship between the latent variables Walking Effort and Daily Activity controlling for age and BMI. Participants spent 9.4 ± 1.9 h of the waking day sedentary and 1.9 ± 0.6 h walking. In the structural equation model, the latent variable Walking Effort explained 64% of the variance in the Daily Activity latent variable (β = 0.80, p = 0.004). Walking Effort was identified by heart rate (β = 0.64), ventilation (β = 0.88), vastus lateralis activation (β = 0.49), and lactate (β = 0.58), all p < 0.05, but not RPE or VO2. Daily Activity was identified by stepping time (β = 0.75) and up-down transitions (β = 0.52), all p < 0.05. Walking effort mediated the effects of age and BMI on older adults' daily activity making physiological determinants of walking effort potential points of intervention.
Collapse
Affiliation(s)
- Dain P LaRoche
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA.
| | - Edward L Melanson
- Division of Endocrinology, Metabolism, and Diabetes/Division of Geriatric Medicine, University of Colorado, Anschutz Medical Campus, Denver, CO, USA.,Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Denver, CO, USA
| | - Morgan P Baumgartner
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA
| | - Breanna M Bozzuto
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA
| | - Victoria M Libby
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA
| | - Brittany N Marshall
- Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA
| |
Collapse
|
45
|
Chen-Edinboro LP, Murray-Kolb LE, Simonsick EM, Ferrucci L, Allen R, Payne ME, Spira AP. Association Between Non-Iron-Deficient Anemia and Insomnia Symptoms in Community-Dwelling Older Adults: The Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 2018; 73:380-385. [PMID: 28329301 PMCID: PMC5861876 DOI: 10.1093/gerona/glw332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/13/2016] [Indexed: 11/14/2022] Open
Abstract
Background Anemia is associated with poorer sleep in children, and clinically, anemia is linked to insomnia. However, the association between anemia and insomnia in older adults is understudied. Methods We examined the cross-sectional association between anemia and insomnia in 1,053 adults (71.4 ± 10.6 years) in the Baltimore Longitudinal Study of Aging. Participants were classified as nonanemic, non-iron-deficient anemic, or iron-deficient anemic based on hemoglobin, ferritin, transferrin saturation, and mean cell volume. Insomnia symptoms were evaluated by the Women's Health Initiative Insomnia Rating Scale (WHIIRS). A total score (range 0-20) was generated, and participants were also classified as having 0, 1, or 2+ symptoms. Results Overall, 10.5% of participants had non-iron-deficient anemia, 0.9% had iron-deficient anemia, and 88.5% had no anemia. Due to its low prevalence, the iron-deficient anemic group was dropped from analyses. In models adjusted for demographics, number of medical conditions, and Center for Epidemiologic Studies Depression Scale score, non-iron-deficient anemic individuals had significantly higher WHIIRS total scores, indicating greater insomnia severity, compared to those without anemia (predicted adjusted mean WHIIRS of 7.24 [95% confidence interval (CI): 6.40-8.08] vs 5.92 [95% CI: 5.65-6.19]). They also had twice the risk of reporting ≥2 insomnia symptoms (vs 0 symptoms; relative risk ratio = 2.20, 95% CI: 1.25-3.89). Conclusions Results suggest that individuals with non-iron-deficient anemia are more likely to experience insomnia symptoms than those who are nonanemic. These results may have implications for insomnia treatment or the identification of underlying frailty in individuals with sleep problems.
Collapse
Affiliation(s)
- Lenis P Chen-Edinboro
- School of Health and Applied Human Sciences, University of North Carolina Wilmington
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Richard Allen
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland
| | - Martha E Payne
- Office of Research Development, Duke University School of Medicine, Durham, North Carolina
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
46
|
Nicklas BJ. No Expiration Date on the Association Between Physical Activity and Mortality. J Am Geriatr Soc 2018; 66:850-852. [PMID: 29319876 DOI: 10.1111/jgs.15243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Barbara J Nicklas
- School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| |
Collapse
|
47
|
Arnold JC, Cantu MA, Kasanga EA, Nejtek VA, Papa EV, Bugnariu N, Salvatore MF. Aging-related limit of exercise efficacy on motor decline. PLoS One 2017; 12:e0188538. [PMID: 29176896 PMCID: PMC5703560 DOI: 10.1371/journal.pone.0188538] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 11/08/2017] [Indexed: 01/05/2023] Open
Abstract
Identifying lifestyle strategies and allied neurobiological mechanisms that reduce aging-related motor impairment is imperative, given the accelerating number of retirees and increased life expectancy. A physically active lifestyle prior to old age can reduce risk of debilitating motor decline. However, if exercise is initiated after motor decline has begun in the lifespan, it is unknown if aging itself may impose a limit on exercise efficacy to decelerate further aging-related motor decline. In Brown-Norway/Fischer 344 F1 hybrid (BNF) rats, locomotor activity begins to decrease in middle age (12-18 months). One mechanism of aging-related motor decline may be decreased expression of GDNF family receptor, GFRα-1, which is decreased in substantia nigra (SN) between 12 and 30 months old. Moderate exercise, beginning at 18 months old, increases nigral GFRα-1 and tyrosine hydroxylase (TH) expression within 2 months. In aged rats, replenishing aging-related loss of GFRα-1 in SN increases TH in SN alone and locomotor activity. A moderate exercise regimen was initiated in sedentary male BNF rats in a longitudinal study to evaluate if exercise could attenuate aging-related motor decline when initiated at two different ages in the latter half of the lifespan (18 or 24 months old). Motor decline was reversed in the 18-, but not 24-month-old, cohort. However, exercise efficacy in the 18-month-old group was reduced as the rats reached 27 months old. GFRα-1 expression was not increased in either cohort. These studies suggest exercise can decelerate motor decline when begun in the latter half of the lifespan, but its efficacy may be limited by age of initiation. Decreased plasticity of GFRα-1 expression following exercise may limit its efficacy to reverse motor decline.
Collapse
Affiliation(s)
- Jennifer C. Arnold
- Department of Pharmacology, Toxicology, and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States of America
- Department of Neurosurgery, New York University School of Medicine, New York, New York, United States of America
| | - Mark A. Cantu
- Institute for Healthy Aging and Center for Neuroscience Discovery, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Ella A. Kasanga
- Institute for Healthy Aging and Center for Neuroscience Discovery, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Vicki A. Nejtek
- Institute for Healthy Aging and Center for Alzheimer’s and Neurodegenerative Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Evan V. Papa
- Department of Physical & Occupational Therapy, Idaho State University–Meridian Health Science Center, Meridian, ID, United States of America
| | - Nicoleta Bugnariu
- School of Health Professions, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Michael F. Salvatore
- Department of Pharmacology, Toxicology, and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States of America
- Institute for Healthy Aging and Center for Neuroscience Discovery, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
- * E-mail:
| |
Collapse
|
48
|
Holtzer R, Yuan J, Verghese J, Mahoney JR, Izzetoglu M, Wang C. Interactions of Subjective and Objective Measures of Fatigue Defined in the Context of Brain Control of Locomotion. J Gerontol A Biol Sci Med Sci 2017; 72:417-423. [PMID: 27567110 DOI: 10.1093/gerona/glw167] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/28/2016] [Indexed: 01/06/2023] Open
Abstract
Background Fatigue adversely impacts quality of life in old age. The relationship between subjective and objective measurements of fatigue, however, is poorly understood. We examined whether subjective fatigue moderated the expression of objective fatigue during locomotion. Associations between objective and subjective measures of fatigue were predicted to manifest only under dual-task conditions that maximized cognitive demands. Methods Participants were 314 nondemented older adults (age = 76.8±6.7 years; % female = 56). Functional near-infrared spectroscopy was used to assess oxygenated hemoglobin (HbO2) levels during walking. A 4×14-foot Zeno electronic walkway was utilized to assess stride velocity (cm/s). Objective fatigue was operationalized as attenuation in HbO2 levels and decline in stride velocity (cm/s) during six continuous straight walks under single- (normal-walk) and dual-task (walk-while-talk) conditions. The Brief Fatigue Inventory assessed subjective fatigue. Results Worse subjective fatigue was associated with attenuated increase in HbO2 levels (estimate = 0.175; p < .05) but not with decline in stride velocity (estimate = 0.394; p > .05) from normal-walk to walk-while-talk conditions. Objective fatigue did not manifest and was not associated with subjective fatigue during the course of normal-walk. Worse subjective fatigue was associated with attenuated HbO2 levels in the fourth (estimate = -0.178; p < .05), fifth (estimate = -0.230; p < .01), and sixth (estimate = -0.231; p < .01) straight walks compared to the first during walk-while-talk. Conclusion Dual-task walking paradigms provide a unique environment to simultaneously assess different facets of fatigue. The prefrontal cortex subserves both subjective and objective measurements of fatigue as defined in the context of attention-demanding locomotion.
Collapse
Affiliation(s)
- Roee Holtzer
- Department of Neurology.,Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - Jennifer Yuan
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York
| | - Joe Verghese
- Department of Neurology.,Department of Medicine, and
| | | | - Meltem Izzetoglu
- School of Biomedical Engineering, Drexel University, Philadelphia, Pennsylvania
| | - Cuiling Wang
- Department of Epidemiology, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
49
|
Abstract
BACKGROUND AND PURPOSE Objective ambulatory activity during daily living has not been characterized for people with Parkinson disease prior to initiation of dopaminergic medication. Our goal was to characterize ambulatory activity based on average daily step count and examine determinants of step count in nonexercising people with de novo Parkinson disease. METHODS We analyzed baseline data from a randomized controlled trial, which excluded people performing regular endurance exercise. Of 128 eligible participants (mean ± SD = 64.3 ± 8.6 years), 113 had complete accelerometer data, which were used to determine daily step count. Multiple linear regression was used to identify factors associated with average daily step count over 10 days. Candidate explanatory variable categories were (1) demographics/anthropometrics, (2) Parkinson disease characteristics, (3) motor symptom severity, (4) nonmotor and behavioral characteristics, (5) comorbidities, and (6) cardiorespiratory fitness. RESULTS Average daily step count was 5362 ± 2890 steps per day. Five factors explained 24% of daily step count variability, with higher step count associated with higher cardiorespiratory fitness (10%), no fear/worry of falling (5%), lower motor severity examination score (4%), more recent time since Parkinson disease diagnosis (3%), and the presence of a cardiovascular condition (2%). DISCUSSION AND CONCLUSIONS Daily step count in nonexercising people recruited for this intervention trial with de novo Parkinson disease approached sedentary lifestyle levels. Further study is warranted for elucidating factors explaining ambulatory activity, particularly cardiorespiratory fitness, and fear/worry of falling. Clinicians should consider the costs and benefits of exercise and activity behavior interventions immediately after diagnosis of Parkinson disease to attenuate the health consequences of low daily step count.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A170).
Collapse
|
50
|
Bivard A, Lillicrap T, Krishnamurthy V, Holliday E, Attia J, Pagram H, Nilsson M, Parsons M, Levi CR. MIDAS (Modafinil in Debilitating Fatigue After Stroke): A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial. Stroke 2017; 48:1293-1298. [PMID: 28404841 PMCID: PMC5404401 DOI: 10.1161/strokeaha.116.016293] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/19/2017] [Accepted: 02/28/2017] [Indexed: 11/16/2022]
Abstract
Background and Purpose— This study aimed to assess the efficacy of modafinil, a wakefulness-promoting agent in alleviating post-stroke fatigue ≥3 months after stroke. We hypothesized that 200 mg of modafinil daily for 6 weeks would result in reduced symptoms of fatigue compared with placebo. Methods— This single-center phase 2 trial used a randomized, double-blind, placebo-controlled, crossover design. The key inclusion criterion was a multidimensional fatigue inventory score of ≥60. Patients were randomized to either modafinil or placebo for 6 weeks of therapy, then after a 1 week washout period swapped treatment arms for a second 6 weeks of therapy. The primary outcome was the multidimensional fatigue inventory; secondary outcomes included the Montreal cognitive assessment, the Depression, Anxiety, and Stress Scale (DASS), and the Stroke-Specific Quality of Life (SSQoL) scale. The multidimensional fatigue inventory is a self-administered questionnaire with a range of 0 to 100. Treatment efficacy was assessed using linear regression by estimating within-person, baseline-adjusted differences in mean outcomes after therapy. This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615000350527). Results— A total of 232 stroke survivors were screened and 36 were randomized. Participants receiving modafinil reported a significant decrease in fatigue (multidimensional fatigue inventory, −7.38; 95% CI, −21.76 to −2.99; P<0.001) and improved quality of life (SSQoL, 11.81; 95% CI, 2.31 to 21.31; P=0.0148) compared with placebo. Montreal cognitive assessment and DASS were not significantly improved with modafinil therapy during the study period (P>0.05). Conclusions— Stroke survivors with nonresolving fatigue reported reduced fatigue and improved quality of life after taking 200 mg daily treatment with modafinil. Clinical Trial Registration— URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368268. Unique identifier: ACTRN12615000350527.
Collapse
Affiliation(s)
- Andrew Bivard
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia.
| | - Thomas Lillicrap
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| | - Venkatesh Krishnamurthy
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| | - Elizabeth Holliday
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| | - John Attia
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| | - Heather Pagram
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| | - Michael Nilsson
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| | - Mark Parsons
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| | - Christopher R Levi
- From the Departments of Neurology, John Hunter Hospital (A.B., T.L., V.K., M.P., C.R.L.), Hunter Medical Research Institute (A.B., T.L., V.K., E.H., J.A., H.P., M.N., M.P., C.R.L.), and Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health (J.A.), University of Newcastle, Australia
| |
Collapse
|