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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Zaide M, Rayner D, Khattab N, Bhatt V, Goodin C, Song JW(B, Smal J, Budd N. Physical mobility determinants among older adults: a scoping review of self-reported and performance-based measures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2153303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Vidhi Bhatt
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | | | - Justin Smal
- Manitoulin Physio Centre, M'Chigeeng, Canada
| | - Natalie Budd
- The Arthtitis and Sports Medicine Centre, Ancaster, Canada
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2
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Runzer-Colmenares FM, Gutierrez GAE, Yance-Cacñahuaray G, Chambergo-Michilot D, Falvy-Bockos I, Vidal-Neira LF. Association Between Hip-Waist Ratio and Physical Performance in Older Adults. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/11566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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3
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Yu WY, Hwang HF, Lin MR. Variations in situational risk factors for fractures of the distal forearm, hip, and vertebrae in older women. BMC Geriatr 2021; 21:214. [PMID: 33789569 PMCID: PMC8011116 DOI: 10.1186/s12877-021-02157-2] [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: 10/27/2020] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Situational factors during a fall among three common types of fractures of the distal forearm, hip, and vertebrae among older women in Taiwan were investigated. Methods In 2016 ~ 2017, study participants were identified from those aged ≥65 years who visited emergency departments due to a fall in two university-affiliated hospitals in Taipei. In addition to individual characteristics, situational factors during the fall (location, activity, change of center of mass, fall mode, fall direction, initiating a protective response, and being hit) were collected. A sample of 203 distal-forearm fractures, 189 vertebral fractures, and 375 hip fractures was recruited, while 717 women with a soft-tissue injury were used as a control group. The identification of situational risk factors for each type of fracture was validated by using those who sustained one of the other two types of fracture as a control group. Results After adjusting for age and other individual characteristics, compared to soft-tissue injuries, distal-forearm fractures were significantly more likely to occur with slips (odds ratio [OR] = 11.0; 95% confidence interval [CI] = 4.76 ~ 25.4), trips (OR = 3.40; 95% CI = 1.42 ~ 8.17), step-downs (OR = 4.95; 95% CI = 2.15 ~ 11.4), and from sideways falls (OR = 1.73; 95% CI = 1.12 ~ 2.67) and significantly less likely to occur indoors (OR = 0.62; 95% CI = 0.42 ~ 0.90) or from backwards falls (OR = 0.62; 95% CI = 0.41 ~ 0.95). Hip fractures were significantly more likely to occur with step-downs (OR = 1.76; 95% CI = 1.13 ~ 2.75) and from backwards (OR = 3.16; 95% CI = 2.15 ~ 4.64) or sideways falls (OR = 5.56; 95% CI = 3.67 ~ 8.41) and significantly less likely when hitting an object (OR = 0.26; 95% CI = 0.13 ~ 0.52) or initiating a protective response (OR = 0.58; 95% CI = 0.36 ~ 0.93). Vertebral fractures were significantly more likely to occur with slips (OR = 2.42; 95% CI = 1.30 ~ 4.50), step-downs (OR = 2.53; 95% CI = 1.43 ~ 4.48), and backwards falls (OR = 2.15; 95% CI = 1.39 ~ 3.32). Similar results were found in the validation analyses. Conclusions Large variations in situational risk factors for the three types of fracture in older women existed. A combination of individual and situational risk factors may display a more-comprehensive risk profile for the three types of fracture, and an intervention that adds training programs on safe landing strategies and effective compensatory reactions may be valuable in preventing serious injuries due to a fall. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02157-2.
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Affiliation(s)
- Wen-Yu Yu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan, R.O.C.,Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan, R.O.C
| | - Hei-Fen Hwang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, R.O.C
| | - Mau-Roung Lin
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan, R.O.C..
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4
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Does a Multicomponent Exercise Program Improve Physical Fitness in Older Adults? Findings From a 5-Year Longitudinal Study. J Aging Phys Act 2021; 29:814-821. [PMID: 33761457 DOI: 10.1123/japa.2020-0070] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/22/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022]
Abstract
The objective was to assess the physical fitness of older adults participating in a 5-year multicomponent exercise program. The sample consisted of 138 older adults aged 60-93 years (70.4 ± 7.8 years) evaluated with the Senior Fitness Test (muscle strength, flexibility, balance, and cardiorespiratory fitness). The multicomponent program was carried out between the months of March and November of each year. Data were analyzed using generalized estimating equations (factor year: Year 1, Year 2, Year 3, Year 4, and Year 5; factor time: pretest and posttest) with Bonferroni's post hoc test. Participation in the multicomponent exercise program for 5 years (baseline pretest Year 1 and follow-up Year 5) improved lower and upper limb strength, lower limb flexibility, and balance and cardiorespiratory fitness, while upper limb flexibility was maintained. Year-by-year analysis revealed variable patterns for each fitness parameter. The results of this study show the potential benefits of implementing a long-term community-based exercise program.
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5
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Mikkola TM, Salonen MK, Kajantie E, Kautiainen H, Eriksson JG. Associations of Fat and Lean Body Mass with Circulating Amino Acids in Older Men and Women. J Gerontol A Biol Sci Med Sci 2021; 75:885-891. [PMID: 31095700 DOI: 10.1093/gerona/glz126] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Indexed: 12/16/2022] Open
Abstract
Circulating amino acids are potential markers of body composition. Previous studies are mainly limited to middle age and focus on either fat or lean mass, thereby ignoring overall body composition. We investigated the associations of fat and lean body mass with circulating amino acids in older men and women. We studied 594 women and 476 men from the Helsinki Birth Cohort Study (age 62-74 years). Bioelectrical impedance analysis was used to indicate two main body compartments by fat (fat mass/height2) and lean mass indices (lean mass/height2), dichotomized based on sex-specific medians. Eight serum amino acids were quantified using nuclear magnetic resonance spectroscopy. General linear models were adjusted for age, smoking, and fasting glucose. Higher lean mass index (LMI) was associated with higher concentrations of branched-chain amino acids in both sexes (p ≤ .001). In men, LMI was also positively associated with tyrosine (p = .006) and inversely with glycine (p < .001). Higher fat mass index was associated with higher concentrations of all branched-chain amino acids, aromatic amino acids (phenylalanine and tyrosine), and alanine in both sexes (p ≤ .008). Associations between body composition and amino acids are largely similar in older men and women. The associations are largely similar to those previously observed in younger adults.
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Affiliation(s)
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland.,Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Eero Kajantie
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway.,Children's Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Primary Health Care Unit, Kuopio University Hospital, Finland
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland.,Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Finland.,Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore
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6
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Ko SU, Jerome GJ, Simonsick EM, Ferrucci L. Obstacle-Crossing Task-Related Usual Gait Patterns of Older Adults Differentiating Falls and Gait Ability. J Aging Phys Act 2020; 28:675-679. [PMID: 32084628 DOI: 10.1123/japa.2019-0227] [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: 06/20/2019] [Revised: 12/17/2019] [Accepted: 12/26/2019] [Indexed: 11/18/2022]
Abstract
Obstacle crossing, such as stepping over a curb, exerts additional demands on balance control, and therefore the study of usual-pace gait patterns associated with obstacle-crossing performance may provide additional insight into understanding falls and deterioration of gait in older adults. Participants included 432 adults aged 60-96 years (218 women). Participants who failed the obstacle-crossing task (n = 181) walked slower with smaller knee range of motion than participants who successfully completed the obstacle-crossing task (all ps < .001). Participants who failed the obstacle crossing reported a greater likelihood of falling in the previous year, more balance problems, lower walking ability, and needed longer time to complete 5 chair stands than those who passed the task (all ps < .05). Obstacle-crossing task may identify gait patterns in older adults who appear functionally intact, but who are nonetheless at risk of fall and balance problems.
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7
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Wennman H, Jerome GJ, Simonsick EM, Sainio P, Valkeinen H, Borodulin K, Stenholm S. Adiposity Markers as Predictors of 11-Year Decline in Maximal Walking Speed in Late Midlife. J Appl Gerontol 2020; 40:1110-1115. [PMID: 32167399 PMCID: PMC8299779 DOI: 10.1177/0733464820911542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Obesity is linked to poorer physical functioning in older adults, but impact of excess adiposity on loss of functional capacity in late midlife is unclear. This study examined associations between adiposity markers and 11-year change in maximal walking speed, a sensitive indicator of physical functioning, among adults aged 55 to 69 years. Method: Maximal walking speed over 6.1 m was assessed in 2000 and 2011 among Finnish men (n = 409) and women (n = 498) from the prospective Health 2000 Survey. Body mass index (BMI) and waist circumference were assessed in 2000. Generalized estimating equation models estimated changes in maximal walking speed by BMI and waist circumference, stratified by sex. Results: BMI greater than 30 kg/m2 was associated with accelerated decline in maximal walking speed particularly in women. Associations with waist circumference were nonsignificant. Conclusion: Late midlife obesity may speed up the decline in functional capacity as measured by maximal walking speed, especially in women.
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Affiliation(s)
- Heini Wennman
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Päivi Sainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Heli Valkeinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Borodulin
- Finnish Institute for Health and Welfare, Helsinki, Finland.,Age Institute, Helsinki, Finland
| | - Sari Stenholm
- University of Turku, Finland.,Turku University Hospital, Finland
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Martinez-Amezcua P, Simonsick EM, Wanigatunga AA, Urbanek JK, Shaffer NC, Ferrucci L, Schrack JA. Association Between Adiposity and Perceived Physical Fatigability in Mid- to Late Life. Obesity (Silver Spring) 2019; 27:1177-1183. [PMID: 31127707 PMCID: PMC6591054 DOI: 10.1002/oby.22500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/19/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to compare and contrast the associations between measures of adiposity and fat distribution and perceived fatigability among well-functioning individuals in mid- to late life. METHODS In 1,054 adults (70.4 ± 12.4 years, 52% female), adiposity was measured as BMI, percent fat (dual-energy x-ray absorptiometry), waist and hip circumferences, and waist to height ratio. In a subset of 383 participants, visceral fat was measured. Perceived fatigability was evaluated after a 5-minute treadmill walk (1.5 mph) using the Borg rating of perceived exertion (range, 6-20). Associations between adiposity measures and perceived fatigability were assessed using regression models adjusting for age, sex, race, smoking, and comorbidities. RESULTS All adiposity measures, except subcutaneous fat, were positively associated with perceived fatigability after adjustment (P < 0.05 for all). Standardized coefficients indicated that BMI, hip circumference, and visceral fat had the strongest associations with fatigability. Associations between BMI and fatigability were present only among those above the threshold for overweight and strongest in those aged ≥ 65 years. Moreover, BMI was associated with fatigability only among participants with higher waist circumference. CONCLUSIONS Measures of adiposity, particularly central adiposity, are strongly associated with fatigability, suggesting that weight management may be an effective target for curbing fatigability and maintaining quality of life with aging.
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Affiliation(s)
- Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Eleanor M. Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
| | - Amal A. Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jacek K. Urbanek
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Geriatrics & Gerontology, Johns Hopkins School of Medicine, Baltimore Maryland, USA
| | - Nancy Chiles Shaffer
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland USA
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9
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De Lorenzo A, Gratteri S, Gualtieri P, Cammarano A, Bertucci P, Di Renzo L. Why primary obesity is a disease? J Transl Med 2019; 17:169. [PMID: 31118060 PMCID: PMC6530037 DOI: 10.1186/s12967-019-1919-y] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/10/2019] [Indexed: 12/15/2022] Open
Abstract
Obesity must be considered a real pathology. In the world wide, obesity represent one of the major public health issue associated with increased morbidity and mortality. Overweight or obesity, in fact, significantly increases the risk of contracting diseases, such as: arterial hypertension, dyslipidemia, type 2 diabetes mellitus, coronary heart disease, cerebral vasculopathy, gallbladder lithiasis, arthropathy, ovarian polycytosis, sleep apnea syndrome, and some neoplasms. Despite numerous informative campaigns, unfortunately, the fight against obesity does not seem to work: in the last years, the prevalence continued to increase. The progressive and rapid increase in the incidence of obesity, which has characterized most of the economically advanced countries in the last decade, has been the main stimulus for the research of the mechanisms underlying this pathology and the related disorders. The aims of this review is to provide a revision of the literature in order to define obesity as diseases, secondly to highlight the limits and the inaccuracy of common tools used for the diagnosis of obesity, and as a third thing to strengthen the concept of the complexity of obesity as a disease among political health care providers. Obesity may be viewed as a multifactorial pathology and chronic low-grade inflammatory disease. In fact, people affected by obesity have greater risk of developing comorbility and morbility, respect to healthy. Hence, the absolute therapeutic benefit is directly proportional to the basic risk. So, internationally interest on early diagnosis of obesity is growing to avoid under- and overdiagnosis consequences. Therefore, the consequences are an aggravation of the disease and an increase in obesity related pathology like diabetes, cardiovascular disease, and cancer. The most widely used parameter for diagnosis, body mass index (BMI) is not suitable for assessing the body fat. In fact, several studies demonstrate that BMI alone cannot define obesity, which consists not so much in weight gain as in excess fat mass. The use of suitable tools for the assessment of fat mass percentage combined with clinical and genetic analysis allowed to identify different phenotypes of obesity, which explain the various paradoxes of obesity. It is essential to adopt all possible strategies to be able to combat obesity, ameliorate the suffering of patients, and reduce the social and treatment costs of obesity.
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Affiliation(s)
- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Santo Gratteri
- Department of Surgery and Medical Science, Magna Græcia University, Germaneto, Catanzaro, Italy
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Andrea Cammarano
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Pierfrancesco Bertucci
- Department of Laboratory Medicine, "Tor Vergata" University Hospital, Viale Oxford 81, 00133, Rome, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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10
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Mikkola TM, von Bonsdorff MB, Salonen MK, Simonen M, Pohjolainen P, Osmond C, Perälä MM, Rantanen T, Kajantie E, Eriksson JG. Body composition as a predictor of physical performance in older age: A ten-year follow-up of the Helsinki Birth Cohort Study. Arch Gerontol Geriatr 2018; 77:163-168. [PMID: 29783137 DOI: 10.1016/j.archger.2018.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND This study assessed how different measures of body composition predict physical performance ten years later among older adults. METHODS The participants were 1076 men and women aged 57 to 70 years. Body mass index (BMI), waist circumference, and body composition (bioelectrical impedance analysis) were measured at baseline and physical performance (Senior Fitness Test) ten years later. Linear regression analyses were adjusted for age, education, smoking, duration of the follow-up and physical activity. RESULTS Greater BMI, waist circumference, fat mass, and percent body fat were associated with poorer physical performance in both sexes (standardized regression coefficient [β] from -0.32 to -0.40, p < 0.001). Lean mass to BMI ratio was positively associated with later physical performance (β = 0.31 in men, β = 0.30 in women, p < 0.001). Fat-free mass index (lean mass/height2) in both sexes and lean mass in women were negatively associated with later physical performance. Lean mass residual after accounting for the effect of height and fat mass was not associated with physical performance. CONCLUSIONS Among older adults, higher measures of adiposity predicted poorer physical performance ten years later whereas lean mass was associated with physical performance in a counterintuitive manner. The results can be used when appraising usefulness of body composition indicators for definition of sarcopenic obesity.
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Affiliation(s)
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland; Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland; Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Mika Simonen
- Centre of Excellence in Research on Intersubjectivity in Interaction, University of Helsinki, Helsinki, Finland
| | | | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Mia-Maria Perälä
- Folkhälsan Research Center, Helsinki, Finland; Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland; Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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11
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Simonsick EM, Aronson B, Schrack JA, Hicks GE, Jerome GJ, Patel KV, Studenski SA, Ferrucci L. Lumbopelvic Pain and Threats to Walking Ability in Well-Functioning Older Adults: Findings from the Baltimore Longitudinal Study of Aging. J Am Geriatr Soc 2018; 66:714-720. [PMID: 29411349 DOI: 10.1111/jgs.15280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the potential contribution of severity of lumbopelvic pain (LPP) in well-functioning older adults to poorer walking efficiency, lack of endurance, slower gait speed, and decline in these mobility parameters over 1 to 5 years. DESIGN Longitudinal analysis of Baltimore Longitudinal Study of Aging data. SETTING National Institute on Aging, Clinical Research Unit, Baltimore, Maryland. PARTICIPANTS Well-functioning men and women aged 60 to 89 (N=878). MEASUREMENTS An interviewer-administered questionnaire was used to ascertain reported presence and severity of back and hip pain in the preceding 12 months and reported walking ability, including ease of walking a mile. Certified examiners assessed usual gait speed, the energetic cost of walking (oxygen consumption, mL per kg/m), and time taken to walk 400 m as quickly as possible. Covariates included sex, age, age-squared, race, height, weight, exercise, and smoking. RESULTS Overall, 31.4% had mild LPP, and 15.7% had moderate to severe LPP. In adjusted analyses, reported walking ability (p<.001), endurance walk performance (p=.007), and energetic cost of walking (p=.049) were worse with increasing LPP severity. Usual gait speed did not vary according to LPP (p=.31). Longitudinally, over an average 2.3 years, persons with new or sustained LPP had worse follow-up level, greater mean decline, and higher likelihood of meaningful decline in reported walking ability than persons free of LPP or whose LPP resolved. Walking performance did not differ according to LPP follow-up status. CONCLUSION LPP was common in well-functioning older adults and was associated with greater energetic cost of walking and poorer perceived and observed walking endurance. The longitudinal effect of LPP is unclear, but worsening perception of walking ability and its contribution to future mobility loss warrants further attention.
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Affiliation(s)
- Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland.,Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Gerald J Jerome
- Department of Kinesiology, Towson University, Towson, Maryland
| | - Kushang V Patel
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
| | | | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland.,Johns Hopkins University School of Medicine, Baltimore, Maryland
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