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Rice PE, Thumuluri D, Barnstaple R, Fanning J, Laurita-Spanglet J, Soriano CT, Hugenschmidt CE. Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework. J Alzheimers Dis 2024:JAD230741. [PMID: 39031353 DOI: 10.3233/jad-230741] [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: 07/22/2024]
Abstract
Background Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging. Objective To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations. Methods Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life). Results High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified. Conclusions Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.
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Affiliation(s)
- Paige E Rice
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Deepthi Thumuluri
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Christina T Soriano
- Department of Theatre and Dance, Wake Forest University, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Sharma N, Chahal A, Balasubramanian K, Sanjeevi RR, Rai RH, Bansal N, Muthukrishnan R, Sharma A. Effects of resistance training on muscular strength, endurance, body composition and functional performance among sarcopenic patients: a systematic review. J Diabetes Metab Disord 2023; 22:1053-1071. [PMID: 37975091 PMCID: PMC10638274 DOI: 10.1007/s40200-023-01283-5] [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: 06/02/2023] [Accepted: 08/15/2023] [Indexed: 11/19/2023]
Abstract
Background Sarcopenia, a gradual loss of muscle mass and strength associated with ageing, contributes to a decline in physical abilities, increase in disability and frailty and loss of functional independence. This functional deterioration which comes with ageing, can be slowed in pace with exercise. Objective The objective of the current review was to thoroughly search for literature assessing impact of RT on physical performance, body composition, muscle strength and endurance in sarcopenic elderly patients. Methods PubMed, Scopus, Web of Science, and PEDro databases were brought in use for a thorough search for articles published from 2010 to 2023. Two researchers independently retrieved data from studies that complied with the inclusion and exclusion criteria, while they also evaluated quality of the evidence. Results In total, 14 studies with 742 patients with mean age of 72.4 ± 9.22 years were included in the analysis for this review. Results indicate, RT improves body composition (p = 0.001), functional performance (p 0.001), postural stability (p = 0.005) and muscle strength (p 0.001) in elderly sarcopenic patients. Conclusion A promising intervention for the management of sarcopenia is RT. To yield RT's positive effects, a well-designed prescription is the need of the hour, just like it is with other treatment strategies.
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Affiliation(s)
- Nidhi Sharma
- Department of Physiotherapy, Uttaranchal College of Health Sciences, Uttaranchal University, Prem Nagar, Dehradun, 248007 Uttarakhand India
| | - Aksh Chahal
- Department of Physiotherapy, School of Medical and Allied Health Sciences, Galgotias University, Greater Noida, 203201 Uttar Pradesh India
| | - Karthick Balasubramanian
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, Jazan, 45142 Saudi Arabia
| | - Ramya Ramasamy Sanjeevi
- Physical Therapy Department, College of Applied Medical Sciences, Jazan University, Jazan, 45142 Saudi Arabia
| | - Richa Hirendra Rai
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Nitesh Bansal
- OP Jindal Global University, Sonipat, 131001 Haryana India
| | - Ramprasad Muthukrishnan
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - Abhishek Sharma
- Department of Physiotherapy, Arogyam Institute of Paramedical and Allied Sciences (Affiliated to H.N.B. Uttarakhand Medical Education University), Roorkee, 247661 Uttarakhand India
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Gao B, Li L, Shen P, Zhou Z, Xu P, Sun W, Zhang C, Song Q. Effects of proprioceptive neuromuscular facilitation stretching in relieving pain and balancing knee loading during stepping over obstacles among older adults with knee osteoarthritis: A randomized controlled trial. PLoS One 2023; 18:e0280941. [PMID: 36780435 PMCID: PMC9924997 DOI: 10.1371/journal.pone.0280941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 11/04/2022] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of an 8-week proprioceptive neuromuscular facilitation (PNF) stretching in relieving pain and balancing knee loading during stepping over obstacles among older people with knee osteoarthritis, and further explore the improvements in gait patterns. DESIGN Thirty-two older adults (66~72 years) with KOA were recruited and randomly assigned into PNF or control groups. They received PNF stretching or health lecture series for 8 weeks. Final data analyses were conducted among 13 participants in the PNF and 14 in the control groups. At weeks 0 and 9, they were asked to step over an obstacle of 20% of their leg length. The pain scores and knee abduction moment (KAM) (primary outcomes) were analyzed by multivariate ANOVA, and the gait variables (secondary outcomes) were analyzed by two-way (group by pre-/post) ANOVAs with repeated measures. RESULTS Significant interactions were detected in the pain score, first and second peaks of KAM, and crossing velocity during stepping over obstacles, and significant between-group differences of these outcomes were detected at week 9. CONCLUSION An 8-week PNF stretching could relieve pain and balance loading between knee compartments, as well as increase crossing velocity during stepping over obstacles. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2100042278.
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Affiliation(s)
- Bo Gao
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Li Li
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia, United States of America
| | - Peixin Shen
- School of Sport Science, Beijing Sport University, Beijing, China
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Zhipeng Zhou
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Peiming Xu
- Enterprise Technology Centre, Taishan Sports Industry Group, Leling, China
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Cui Zhang
- Laboratory of Biomechanics, Shandong Institute of Sport Science, Jinan, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
- * E-mail:
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Nygård AJ, Taraldsen K, Granbo R, Selbæk G, Helbostad JL. Impacts of COVID-19 restrictions on level of physical activity and health in home-dwelling older adults in Norway. Eur Rev Aging Phys Act 2022; 19:30. [PMID: 36494614 PMCID: PMC9733310 DOI: 10.1186/s11556-022-00309-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The spread of the coronavirus in spring 2020 led to a lockdown of physical activity (PA) offers. The aim of this study was to investigate how PA, as well as general and mental health, in community-dwelling older adults were affected by the COVID-19 restrictions in Norway. METHODS Invitation to participate in the study was sent via Facebook and the Norwegian Pensioners' Association. Inclusion criteria were being ≥ 65 years old and living at home. Participants completed a questionnaire either digitally or on paper in June-August 2020. The questionnaire included questions on PA, general health, and mental health both before (13th of March) and during lockdown. RESULTS We included 565 participants (mean age 74 ± 5.3 years, 60.4% female); almost 60% had a university degree, 84% reported performing PA more than once per week, and 20% reported a fall in the previous 12 months. The Wilcoxon signed-rank test indicated that the corona lockdown significantly reduced activity level (Z = -4.918, p < 0.001), general health (Z = -6,910, p < 0.001) and mental health (Z = -12.114, p < 0.001). Those who were less active during lockdown had higher odds of experiencing worse health than those who maintained their activity level, odds ratio: 9.36 (95% CI = 4.71-18.58, p < 0.001) for general health and 2.41 (95% CI = 1.52-3.83, p < 0.001) for mental health. Those who attended organized exercise offers before lockdown had higher odds of being less active during lockdown compared to those who did not exercise in an organized setting, odds ratio: 3.21 (95% CI = 2.17-5.76, p < 0.001). CONCLUSIONS In a relatively highly educated and active group of older participants, COVID-19 restrictions still negatively affected level of activity as well as general and mental health. These short-term decreases in activity level and health suggest that preventive actions and increased focus on measures to support older adults in maintaining an active lifestyle are needed.
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Affiliation(s)
- Arnhild J. Nygård
- grid.5947.f0000 0001 1516 2393Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kristin Taraldsen
- grid.412414.60000 0000 9151 4445Department of Physiotherapy, Oslo Metropolitan University (OsloMet), Oslo, Norway
| | - Randi Granbo
- grid.5947.f0000 0001 1516 2393Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Geir Selbæk
- grid.55325.340000 0004 0389 8485Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway ,grid.417292.b0000 0004 0627 3659Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jorunn L. Helbostad
- grid.5947.f0000 0001 1516 2393Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Railey AF, Muller C, Noonan C, Schmitter-Edgecombe M, Sinclair K, Kim C, Look M, Kaholokula JK. Cost Effectiveness of a Cultural Physical Activity Intervention to Reduce Blood Pressure Among Native Hawaiians with Hypertension. PHARMACOECONOMICS - OPEN 2022; 6:85-94. [PMID: 34389923 PMCID: PMC8807791 DOI: 10.1007/s41669-021-00291-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The aim of this study was to calculate the costs and assess whether a culturally grounded physical activity intervention offered through community-based organizations is cost effective in reducing blood pressure among Native Hawaiian adults with hypertension. METHODS Six community-based organizations in Hawai'i completed a randomized controlled trial between 2015 and 2019. Overall, 263 Native Hawaiian adults with uncontrolled hypertension (≥ 140 mmHg systolic, ≥ 90 mmHg diastolic) were randomized to either a 12-month intervention group of hula (traditional Hawaiian dance) lessons and self-regulation classes, or to an education-only waitlist control group. The primary outcome was change in systolic blood pressure collected at baseline and 3, 6, and 12 months for the intervention compared with the control group. Incremental cost-effectiveness ratios (ICERs) were calculated for primary and secondary outcomes. Non-parametric bootstrapping and sensitivity analyses evaluated uncertainty in parameters and outcomes. RESULTS The mean intervention cost was US$361/person, and the 6-month ICER was US$103/mmHg reduction in systolic blood pressure and US$95/mmHg in diastolic blood pressure. At 12 months, the intervention group maintained reductions in blood pressure, which exceeded reductions for usual care based on blood pressure outcomes. The change in blood pressure at 12 months resulted in ICERs of US$100/mmHg reduction in systolic blood pressure and US$93/mmHg in diastolic blood pressure. Sensitivity analyses suggested that at the estimated intervention cost, the probability that the program would lower systolic blood pressure by 5 mmHg was 67 and 2.5% at 6 and 12 months, respectively. CONCLUSION The 6-month Ola Hou program may be cost effective for low-resource community-based organizations. Maintenance of blood pressure reductions at 6 and 12 months in the intervention group contributed to potential cost effectiveness. Future studies should further evaluate the cost effectiveness of indigenous physical activity programs in similar settings and by modeling lifetime costs and quality-adjusted life-years. TRIAL REGISTRATION NUMBER NCT02620709.
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Affiliation(s)
- Ashley F Railey
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
- Department of Sociology, Indiana University, 1022 E. Third St, Bloomington, IN, 47405-7103, USA.
| | - Clemma Muller
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Carolyn Noonan
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | | | - Ka'imi Sinclair
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Corin Kim
- Kilohana, University of Hawai'i at Hilo, Hilo, HI, USA
| | - Mele Look
- Department of Native Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Mānoa, HI, USA
| | - J Keawe'aimoku Kaholokula
- Department of Native Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Mānoa, HI, USA
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Status Quo or Drop-Off: Do Older Adults Maintain Benefits From Choose to Move-A Scaled-Up Physical Activity Program-12 Months After Withdrawing the Intervention? J Phys Act Health 2021; 18:1236-1244. [PMID: 34407507 DOI: 10.1123/jpah.2020-0850] [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: 12/15/2020] [Revised: 04/27/2021] [Accepted: 06/07/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Choose to Move is one of few scaled-up health-promoting interventions for older adults. The authors evaluated whether Choose to Move participants maintained their intervention-related gains in physical activity (PA), mobility, and social connectedness 12 months after the intervention ended. METHODS The authors assessed PA, mobility, loneliness, social isolation, and muscle strength via questionnaire and objective measures in 235 older adults at 0 months (baseline), 6 months (end of intervention), and 18 months (12-months postintervention). The authors fitted linear mixed models to examine the change in each outcome from 6 to 18 months (primary objective) and 0 to 18 months (secondary objective) and reported by age group (60-74 and ≥75 y). RESULTS In younger participants, PA decreased between 6 and 18 months, but remained significantly higher than at baseline. Intervention-related benefits in loneliness, social isolation, mobility, and muscle strength were maintained between 6 and 18 months in the younger participants. Older participants maintained their intervention benefits in loneliness, mobility, and muscle strength. When compared with baseline values, PA levels in older participants were unchanged, whereas social isolation increased. CONCLUSIONS Older adults maintained some, but not all, health benefits of Choose to Move 12 months after the intervention ended. Long-term commitments are needed to deliver effective health-promoting interventions for older adults if benefits are to be maintained.
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7
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Sprague BN, Phillips CB, Ross LA. Cognitive Training Attenuates Decline in Physical Function Across 10 Years. J Gerontol B Psychol Sci Soc Sci 2021; 76:1114-1124. [PMID: 32484891 DOI: 10.1093/geronb/gbaa072] [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: 09/19/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Poor physical function is associated with negative health and cognitive outcomes. Although nine studies demonstrated that cognitive training reduces age-related declines in physical function, only one study has examined the effects beyond immediate posttest changes. The first aim of this study was to assess the impact of three cognitive training programs on physical function measures across 10 years and the second aim was to examine whether baseline cognitive self-efficacy or depressive symptoms moderated training effects. METHOD Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial, older adults in a no-contact control condition (n = 698) were compared to those receiving processing speed (n = 702), memory (n = 703), or reasoning (n = 694) training. Intention-to-treat (ITT) and dosage analyses were conducted for grip strength and Turn 360. Participants were followed up to 10 years posttest. RESULTS There were no significant ITT effects of processing speed, memory, or reasoning training assignment to any physical function outcome (p > .05). Dosage models indicated that there were small age-related attenuation effects in Turn 360 decline with more processing speed training (b = -.011, p < .001), memory training (b = -.011, p < .001), and reasoning training (b = -.012, p < .001). There was no significant transfer to grip strength. These training gains were greater for those with more baseline depressive symptoms who received more processing speed training (b = -.001, p < .001). DISCUSSION This is the first study to demonstrate the effects of cognitive training to complex physical function across 10 years.
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Affiliation(s)
- Briana N Sprague
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | | | - Lesley A Ross
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park.,Department of Psychology, Clemson University, South Carolina
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Walker RL, Greenwood-Hickman MA, Bellettiere J, LaCroix AZ, Wing D, Higgins M, Richmire K, Larson EB, Crane PK, Rosenberg DE. Associations between physical function and device-based measures of physical activity and sedentary behavior patterns in older adults: moving beyond moderate-to-vigorous intensity physical activity. BMC Geriatr 2021; 21:216. [PMID: 33789584 PMCID: PMC8011072 DOI: 10.1186/s12877-021-02163-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Research supports that moderate-to-vigorous intensity physical activity (MVPA) is key to prolonged health and function. Among older adults, substantial changes to MVPA may be infeasible, thus a growing literature suggests a shift in focus to whole-day activity patterns. Methods With data from 795 older adults aged 65–100 in the Adult Changes in Thought Activity Monitoring study, we used linear regression to estimate associations between ActiGraph and activPAL measured activity patterns – including light intensity physical activity, steps, standing, and sedentary behaviors – and physical function as measured by a short Performance-based Physical Function (sPPF) score (range 0–12), a composite score based on three standardized physical performance tasks: gait speed, timed chair stands, and grip strength. We examined whether relationships persisted when controlling for MVPA or differed across age, gender, or quartiles of MVPA. Results In models unadjusted for MVPA, a 1-standard deviation (SD) increment of daily sitting (1.9 h more), mean sitting bout duration (8 min longer average), or time spent in sedentary activity (1.6 h more) was associated with ~ 0.3–0.4 points lower mean sPPF score (all p < 0.05). A 1-SD increment in daily steps (~ 3500 more steps) was associated with ~ 0.5 points higher mean sPPF score (95% CI: 0.22 to 0.73). MVPA adjustment attenuated all relationships. The association between physical function and steps was strongest among adults aged 75+; associations of worse function with greater sedentary behavior were more pronounced in participants with the lowest levels of MVPA. Conclusions We found associations between function and activity metrics other than MVPA in key subgroups, findings that support research on broader activity patterns and may offer ideas regarding practical intervention opportunities for improving function in older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02163-4.
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Affiliation(s)
- Rod L Walker
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.
| | | | - John Bellettiere
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Andrea Z LaCroix
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - David Wing
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Michael Higgins
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - KatieRose Richmire
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Paul K Crane
- University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
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Azhar G, Wei JY, Schutzler SE, Coker K, Gibson RV, Kirby MF, Ferrando AA, Wolfe RR. Daily Consumption of a Specially Formulated Essential Amino Acid-Based Dietary Supplement Improves Physical Performance in Older Adults With Low Physical Functioning. J Gerontol A Biol Sci Med Sci 2021; 76:1184-1191. [PMID: 33475727 DOI: 10.1093/gerona/glab019] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Indexed: 02/07/2023] Open
Abstract
We have investigated the hypothesis that nutritional supplementation of the diet in low-physical-functioning older individuals with a specially formulated composition based on essential amino acids (EAAs) would improve physical function as compared to supplementation with the same amount of whey protein. A third group of comparable volunteers were given nutrition education but no supplementation of the diet. After 6 weeks of whey protein supplementation (n = 32), there was no effect on the distance walked in 6 minutes, but the distance walked improved significantly from the pre-value after 12 weeks of whey supplementation. EAA consumption (n = 28) significantly improved walking distance at both 6 and 12 weeks. The distance walked at 12 weeks (419.0 ± 25.0 m) was 35.4 m greater than the pre-value of 384.0 ± 23.0 m (p < .001). The increase in distance walked by the EAA group was also significantly greater than that in the whey group at both 6 and 12 weeks (p < .01). In contrast, a decrease in distance walked was observed in the control group (n = 32) (not statistically significant, NS). EAA supplementation also improved grip strength and leg strength, and decreased body weight and fat mass. Plasma low-density lipoprotein concentration was significantly reduced in the EAA group, as well as the concentration of macrophage migration inhibitory factor. There were no adverse responses in any groups, and compliance was greater than 95% in all individuals consuming supplements. We conclude that dietary supplementation with an EAA-based composition may be a beneficial therapy in older individuals with low physical functional capacity. Clinical Trials Registration Number: This study was registered with ClinicalTrials.gov: NCT03424265-"Nutritional interventions in heart failure."
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Affiliation(s)
- Gohar Azhar
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Jeanne Y Wei
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Scott E Schutzler
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Karen Coker
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Regina V Gibson
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Mitchell F Kirby
- Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Arny A Ferrando
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Robert R Wolfe
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, USA
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10
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Brown JD, Wang CY, Groessl EJ, Pahor M, Manini TM. Three-Year, Postintervention, Follow-up Comparison of Health Care Resource Utilization and Costs in the Lifestyle Interventions and Independence for Elders (LIFE) Study. J Gerontol A Biol Sci Med Sci 2021; 76:272-276. [PMID: 32270182 DOI: 10.1093/gerona/glaa088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Lifestyle Interventions and Independence for Elders (LIFE) Study physical activity (PA) intervention was found to be cost-effective compared to health education (HE). However, long-term effects postintervention are unknown. METHOD This was a secondary analysis of LIFE Study data linked to Medicare claims data (2014-2016). Participants were linked via Social Security Numbers to Medicare claims data. Utilization and cost variables were analyzed using generalized linear models with negative binomial and Tweedie distributions. Unadjusted means and 95% confidence intervals were compared by year and overall stratified. Each model compared PA versus HE and adjusted for other baseline characteristics and stratified by study site. Additional models were stratified by baseline physical functioning assessment scores. RESULTS Of the 1,635 LIFE Study participants, 804 (53.5%) were linked to Medicare claims with an average of 33 months of follow-up time during the 3-year data linkage period. Mean outpatient (6.6 vs 6.8), inpatient (0.40 vs 0.40), and other utilization metrics were similar between PA and HE groups. Costs were also similar for each group and each type of service, for example, outpatient: $2,070 versus $2,093 and inpatient: $4,704 versus $4,792. Regression results indicated no statistically significant differences between PA and HE groups. CONCLUSIONS While the LIFE Study demonstrated that PA reduced mobility disability in older adults and was cost-effective, it did not appear to affect long-term health care utilization costs posttrial. These findings suggest that it remains challenging to affect long-term health care costs using PA interventions effects.
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Affiliation(s)
- Joshua D Brown
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville.,Center for Drug Evaluation & Safety, University of Florida, Gainesville
| | - Ching-Yu Wang
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville
| | - Erik J Groessl
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla.,VA San Diego Healthcare System, California
| | - Marco Pahor
- Department of Aging & Geriatric Research, University of Florida College of Medicine, Gainesville.,Institute on Aging, University of Florida, Gainesville
| | - Todd M Manini
- Department of Aging & Geriatric Research, University of Florida College of Medicine, Gainesville.,Institute on Aging, University of Florida, Gainesville
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Azhar G, Raza S, Pangle A, Coleman K, Dawson A, Schrader A, Wolfe RR, Wei JY. Potential Beneficial Effects of Dietary Protein Supplementation and Exercise on Functional Capacity in a Pilot Study of Individuals with Heart Failure with Preserved Ejection Fraction. Gerontol Geriatr Med 2021; 6:2333721420982808. [PMID: 33426179 PMCID: PMC7758656 DOI: 10.1177/2333721420982808] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 01/02/2023] Open
Abstract
Approximately half of heart failure patients in the US have heart failure with preserved ejection fraction (HFpEF). HFpEF impairs physical performance and thus reduces quality of life. Increasing dietary protein intake can increase lean body mass and physical performance in healthy elderly individuals, but the effect of a high-quality protein supplement, with or without a structured exercise program, has not been investigated in HFpEF patients. Twenty-three obese elderly HFpEF patients with grade 1 or 2 diastolic dysfunction were randomized into three groups: control, protein supplementation alone, and protein plus exercise. Protein supplementation involved providing sufficient whey protein so that total intake was 1.2 g protein/kg/day. The exercise intervention was 2 days of hydrotherapy and 1 day of gym sessions per week under supervision of a fitness expert. Physical parameters and functional tests were performed at baseline and at 12 weeks. Protein supplementation alone failed to improve physical performance. However, when combined with light exercise, there was significant improvement in some (6-minute walk, 10 m walking speed, quadriceps strength), but not all, physical function measurements. The results of this pilot study suggest that further exploration of potential interactive effects between protein supplementation and light exercise in individuals with HFpEF is warranted.
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Affiliation(s)
- Gohar Azhar
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
| | - Sakeena Raza
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
| | - Amanda Pangle
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
| | - Kellie Coleman
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
| | - Amanda Dawson
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
| | - Amy Schrader
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
| | - Robert R Wolfe
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
| | - Jeanne Y Wei
- Donald W. Reynolds Institute on Aging, UAMS, Little Rock, AR, USA
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Baranauskas MN, Altherr CA, Gruber AH, Coggan AR, Raglin JS, Gupta SK, Carter SJ. Beetroot supplementation in women enjoying exercise together (BEE SWEET): Rationale, design and methods. Contemp Clin Trials Commun 2021; 21:100693. [PMID: 33392416 PMCID: PMC7773568 DOI: 10.1016/j.conctc.2020.100693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/11/2020] [Accepted: 12/16/2020] [Indexed: 01/22/2023] Open
Abstract
Background Postmenopausal women exhibit higher rates of disability and cardiovascular disease (CVD) with aging compared to men. Whereas habitual exercise training is a known strategy to enhance physiologic function in men and premenopausal women, exercise-related adaptations are often modest in postmenopausal women. We propose dietary nitrate (beetroot juice) administered prior to exercise training may be a feasible approach to improve mobility and cardio-metabolic health outcomes in postmenopausal women. Methods Our randomized, placebo-controlled study aims to determine preliminary effects sizes for changes in functional mobility and endothelium-dependent vasodilation across three study arms: exercise only (EX), exercise + placebo (EX + PL), and exercise + beetroot (EX + BR). Thirty-six postmenopausal women are recruited in small cohorts wherein group exercise is implemented to facilitate social support and adherence to an 8-week training progression. Participants are randomized to one of three study arms (n = 12 per group) following baseline assessments. Post-intervention assessments are used to determine pre-post changes in outcome measures including distance covered during a 6 min walk test, walking economy, muscle speed and power, and endothelial-dependent vasodilation as determined by flow-mediated dilation. Measures of feasibility include recruitment, retention, adherence to exercise prescription, perceived exercise session difficulty, and adverse event rates. Discussion Evidence-based, translational strategies are needed to optimize exercise training-related adaptations in postmenopausal women. Findings will inform larger randomized clinical trials to determine if pre-exercise consumption of beetroot juice is an efficacious strategy to promote mobility and attenuate CVD disease risk.
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Affiliation(s)
- Marissa N. Baranauskas
- Department of Kinesiology, School of Public Health, Bloomington, Indiana University, 47405, USA
| | - Cody A. Altherr
- Department of Kinesiology, School of Public Health, Bloomington, Indiana University, 47405, USA
| | - Allison H. Gruber
- Department of Kinesiology, School of Public Health, Bloomington, Indiana University, 47405, USA
| | - Andrew R. Coggan
- Department of Kinesiology, School of Health and Human Sciences, Indiana University Purdue University Indianapolis, Indianapolis, IN, 46202, USA
| | - John S. Raglin
- Department of Kinesiology, School of Public Health, Bloomington, Indiana University, 47405, USA
| | - Samir K. Gupta
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, 46203, USA
| | - Stephen J. Carter
- Department of Kinesiology, School of Public Health, Bloomington, Indiana University, 47405, USA
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, 46202, USA
- Corresponding author. Department of Kinesiology School of Public Health – Bloomington Indiana University Bloomington, IN, 47405-7109, USA.
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13
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Edmunds K, Reeves P, Scuffham P, Galvão DA, Newton RU, Jones M, Spry N, Taaffe DR, Joseph D, Chambers SK, Tuffaha H. Cost-Effectiveness Analysis of Supervised Exercise Training in Men with Prostate Cancer Previously Treated with Radiation Therapy and Androgen-Deprivation Therapy. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2020; 18:727-737. [PMID: 32107736 DOI: 10.1007/s40258-020-00564-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Exercise for prostate cancer (PCa) survivors has been shown to be effective in addressing metabolic function and associated co-morbidities, as well as sarcopenia and significant functional impairment resulting from long-term androgen deprivation. Evidence on the cost-effectiveness of exercise interventions for PCa, however, is lacking, thus the aim of this study was to determine the cost-effectiveness of a supervised exercise intervention for long-term PCa survivors who previously received radiation therapy and androgen-deprivation therapy. METHODS Cost-effectiveness analysis from an Australian healthcare-payer perspective was conducted using patient-level data from a multicentre randomised controlled trial (RCT) of supervised exercise training (resistance and aerobic) compared to receiving printed exercise material and a recommendation to exercise in long-term PCa survivors (> 5 years post-diagnosis). Analysis was undertaken for the 6-month supervised exercise portion of the intervention, which involved 100 men aged between 62 and 85 years, 50 in each arm. The primary outcome was cost per quality-adjusted life-years (QALYs). RESULTS A 6-month supervised exercise intervention for PCa survivors resulted in an incremental cost-effectiveness ratio of AU$64,235 (2018 AUD) at an incremental cost of AU$546 per person and a QALY gain of 0.0085. At a willingness-to-pay of AU$50,000, the probability that the intervention is cost-effective was 41%. Sensitivity analysis showed that maintenance of benefits via a 6-month home-based intervention, immediately following the supervised intervention, lowered the cost per QALY gained to AU$32,051. DISCUSSION This is the first cost-effectiveness analysis of exercise for PCa survivors. The intervention was effective, but unlikely to be cost-effective at the generally accepted willingness-to-pay of AU$50,000 per QALY. It is likely that evidence to support cost savings from post-intervention outcomes would reveal greater benefits and contribute to a more comprehensive cost-effectiveness analysis. Future RCTs should incorporate longer follow-up durations and collection of data to support modelling to capture future health benefits. Measures of quality of life or utility more sensitive to the impact of physical activity would also improve future economic evaluations.
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Affiliation(s)
- Kim Edmunds
- Centre for Applied Health Economics, Griffith University, Nathan, QLD, Australia.
- Menzies Health Institute Queensland, Gold Coast, QLD, Australia.
| | - Penny Reeves
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Paul Scuffham
- Centre for Applied Health Economics, Griffith University, Nathan, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast, QLD, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Mark Jones
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nigel Spry
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- GenesisCare, Joondalup, WA, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - David Joseph
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- Faculty of Medicine, University of Western Australia, Nedlands, WA, Australia
- GenesisCare, Wembley, WA, Australia
- 5D Clinics, Claremont, WA, Australia
| | | | - Haitham Tuffaha
- Centre for Applied Health Economics, Griffith University, Nathan, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast, QLD, Australia
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14
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Pahor M, Guralnik JM, Anton SD, Ambrosius WT, Blair SN, Church TS, Espeland MA, Fielding RA, Gill TM, Glynn NW, Groessl EJ, King AC, Kritchevsky SB, Manini TM, McDermott MM, Miller ME, Newman AB, Williamson JD. Impact and Lessons From the Lifestyle Interventions and Independence for Elders (LIFE) Clinical Trials of Physical Activity to Prevent Mobility Disability. J Am Geriatr Soc 2020; 68:872-881. [PMID: 32105353 PMCID: PMC7187344 DOI: 10.1111/jgs.16365] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/25/2019] [Accepted: 11/28/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Walking independently is basic to human functioning. The Lifestyle Interventions and Independence for Elders (LIFE) studies were developed to assess whether initiating physical activity could prevent major mobility disability (MMD) in sedentary older adults. METHODS We review the development and selected findings of the LIFE studies from 2000 through 2019, including the planning phase, the LIFE-Pilot Study, and the LIFE Study. RESULTS The planning phase and the LIFE-Pilot provided key information for the successful implementation of the LIFE Study. The LIFE Study, involving 1635 participants randomized at eight sites throughout the United States, showed that compared with health education, the physical activity program reduced the risk of the primary outcome of MMD (inability to walk 400 m: hazard ratio = 0.82; 95% confidence interval = 0.69-0.98; P = .03), and that the intervention was cost-effective. There were no significant effects on cognitive outcomes, cardiovascular events, or serious fall injuries. In addition, the LIFE studies provided relevant findings on a broad range of other outcomes, including health, frailty, behavioral outcomes, biomarkers, and imaging. To date, the LIFE studies have generated a legacy of 109 peer-reviewed publications, 19 ancillary studies, and 38 independently funded grants and clinical trials, and advanced the development of 59 early career scientists. Data and biological samples of the LIFE Study are now publicly available from a repository sponsored by the National Institute on Aging (https://agingresearchbiobank.nia.nih.gov). CONCLUSIONS The LIFE studies generated a wealth of important scientific findings and accelerated research in geriatrics and gerontology, benefiting the research community, trainees, clinicians, policy makers, and the general public. J Am Geriatr Soc 68:872-881, 2020.
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Affiliation(s)
- Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Jack M Guralnik
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Stephen D Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Walter T Ambrosius
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health University of South Carolina, Columbia, South Carolina
| | | | - Mark A Espeland
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Nancy W Glynn
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erik J Groessl
- VA San Diego Healthcare System and Department of Family and Preventive Medicine, University of California, San Diego, San Diego, California
| | - Abby C King
- Department of Health Research and Policy (Epidemiology) and of Medicine (Stanford Prevention Research Center), Stanford University, School of Medicine, Stanford, California
| | - Stephen B Kritchevsky
- Department of Internal Medicine and the Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Mary M McDermott
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Michael E Miller
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jeff D Williamson
- Department of Internal Medicine and the Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
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15
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Rodriguez-Mañas L, Laosa O, Vellas B, Paolisso G, Topinkova E, Oliva-Moreno J, Bourdel-Marchasson I, Izquierdo M, Hood K, Zeyfang A, Gambassi G, Petrovic M, Hardman TC, Kelson MJ, Bautmans I, Abellan G, Barbieri M, Peña-Longobardo LM, Regueme SC, Calvani R, De Buyser S, Sinclair AJ. Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus. J Cachexia Sarcopenia Muscle 2019; 10:721-733. [PMID: 31016897 PMCID: PMC6711410 DOI: 10.1002/jcsm.12432] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/21/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Type 2 diabetes, a highly prevalent chronic disease, is associated with increasing frailty and functional decline in older people. We aimed to evaluate the effectiveness of a multimodal intervention on functional performance in frail and pre-frail participants aged ≥70 years with type 2 diabetes mellitus. METHODS The MID-Frail study was a cluster-randomized multicenter clinical trial conducted in 74 trial sites across seven European countries. The trial recruited 964 participants who were aged >70 years [mean age in intervention group, 78.4 (SD 5.6) years, 49.2% male and 77.6 (SD 5.29) years, 52.4% male in usual care group], with type diabetes mellitus and determined to be frail or pre-frail using Fried's frailty phenotype. Participants were allocated by trial site to follow either usual care (UCG) or intervention procedures (IG). Intervention group participants received a multimodal intervention composed of (i) an individualized and progressive resistance exercise programme for 16 weeks; (ii) a structured diabetes and nutritional educational programme over seven sessions; and (iii) Investigator-linked training to ensure optimal diabetes care. Short Physical Performance Battery (SPPB) scores were used to assess change in functional performance at 12 months between the groups. An analysis of the cost-effectiveness of the intervention was undertaken using the incremental cost-effectiveness ratio (ICER). Secondary outcomes included mortality, hospitalization, institutionalization, quality of life, burden on caregivers, the frequency and severity of hypoglycaemia episodes, and the cost-effectiveness of the intervention. RESULTS After 12 months, IG participants had mean SPPB scores 0.85 points higher than those in the UCG (95% CI, 0.44 to 1.26, P < 0.0001). Dropouts were higher in frail participants and in the intervention group, but significant differences in SPPB between treatment groups remained consistent after sensitivity analysis. Estimates suggest a mean saving following intervention of 428.02 EUR (2016) per patient per year, with ICER analysis indicating a consistent benefit of the described health care intervention over usual care. No statistically significant differences between groups were detected in any of the other secondary outcomes. CONCLUSIONS We have demonstrated that a 12 month structured multimodal intervention programme across several clinical settings in different European countries leads to a clinically relevant and cost-effective improvement in the functional status of older frail and pre-frail participants with type 2 diabetes mellitus.
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Affiliation(s)
| | - Olga Laosa
- Foundation for Biomedical Research-Hospital Universitario de Getafe, Madrid, Spain
| | - Bruno Vellas
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | | | - Eva Topinkova
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | | | - Mikel Izquierdo
- IdiSNA, Navarra Institute for Health Research, Public University of Navarra, Pamplona, Spain
| | - Kerry Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | | | - Mark J Kelson
- Department of Mathematics, University of Exeter, Exeter, UK
| | - Ivan Bautmans
- Gerontology Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Gabor Abellan
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | | | | | | | | | | | - Alan J Sinclair
- Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Luton, UK
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Winett RA, Ogletree AM. Evidence-Based, High-Intensity Exercise and Physical Activity for Compressing Morbidity in Older Adults: A Narrative Review. Innov Aging 2019; 3:igz020. [PMID: 31380470 PMCID: PMC6658199 DOI: 10.1093/geroni/igz020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Indexed: 12/12/2022] Open
Abstract
Recent research in exercise science has important applications for middle-aged and older adults and points to how the programming of individual and multicomponent interventions including theory-based health behavior change strategies may be improved to compress morbidity by delaying or reducing the disabling process. High-intensity interval training and sprint interval training until recently were seen as only applicable to athletes. But recent lab-based research has adapted these interventions for even older adults and demonstrated their safety with beneficial outcomes on cardiometabolic risk factors comparable to or surpassing the usual lower- to moderate-intensity endurance training, and their potential translatability by showing the efficacy of much lower duration and frequency of training, even by systematic stair climbing. Moreover, people report positive affect while engaged in such training. For a century, resistance training was conceived as weightlifting with heavy weights required. Recent research has shown that using a higher degree of effort with lighter to moderate resistance in simple, time efficient protocols result in gains in strength and muscle mass similar to heavy resistance, as well as improvement of cardiometabolic risk factors, strength, body composition, and cognitive, affective, and functional abilities. More effort-based resistance training with moderate resistance may make resistance training more appealing and accessible to older adults. A key potential translational finding is that with correct technique and a high degree of effort, training with inexpensive, portable elastic bands, useable virtually anywhere, can provide appreciable benefits. More emphasis should be placed on long-term, translational interventions, resources, and programs that integrate interval and resistance trainings. This work may improve public health programs for middle-aged and older adults and reflects an emerging evidence base.
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Affiliation(s)
| | - Aaron M Ogletree
- Health Research and Evaluation, American Institutes for Research, Washington, District of Columbia
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17
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Effects of Two Types of 9-Month Adapted Physical Activity Program on Muscle Mass, Muscle Strength, and Balance in Moderate Sarcopenic Older Women. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5095673. [PMID: 30420965 PMCID: PMC6211206 DOI: 10.1155/2018/5095673] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/12/2018] [Accepted: 10/02/2018] [Indexed: 12/15/2022]
Abstract
The present study aimed to evaluate the effects of two types of 9-month adapted physical activity (APA) program, based on a muscle reinforcement training and a postural training, respectively, on muscle mass, muscle strength, and static balance in moderate sarcopenic older women. The diagnosis of sarcopenia was done in accordance with measurable variables and cut-off points suggested by the European Working Group on Sarcopenia in Older People (EWGSOP). Seventy-two participants were randomly assigned to two groups: the muscle reinforcement training group (RESISTANCE) (n=35; 69.9 ± 2.7 years) and the postural training group (POSTURAL) (n=37; 70.0±2.8 years). Body composition, muscle mass, skeletal muscle mass index (SMI), and handgrip strength (HGS) were evaluated for sarcopenia assessment, whereas Sway Path, Sway Area, Stay Time, and Spatial Distance were evaluated for static balance assessment. Sixty-six participants completed the study (RESISTANCE group: n=33; POSTURAL group: n=33). Significant increases of muscle mass, SMI, and handgrip strength values were found in the RESISTANCE group, after muscle reinforcement program. No significant differences appeared in the POSTURAL group, after postural training. Furthermore, RESISTANCE group showed significant improvements in static balance parameters, whereas no significant differences appeared in the POSTURAL group. On the whole, the results of this study suggest that the APA program based on muscle reinforcement applied on moderate sarcopenic older women was able to significantly improve muscle mass and muscle strength, and it was also more effective than the applied postural protocol in determining positive effects on static balance.
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