1
|
Kim J, Chang H. Can tailored home-delivered meal services alleviate self-rated frailty of the low-income older adults in Korea? Nutr Res Pract 2023; 17:1007-1018. [PMID: 37780217 PMCID: PMC10522816 DOI: 10.4162/nrp.2023.17.5.1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/05/2023] [Accepted: 05/01/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to examine whether the tailored home-delivered meal (HDM) services included nutrition counseling impacts alleviating self-rated frailty among low-income older adults in Korea. SUBJECTS/METHODS Pre- and post-test were implemented on May 27 and on November 25 in 2019 during 3 weeks, respectively, before and after the 6 months intervention program. Participants completed a questionnaire measuring frailty, malnutrition, food security, depression, and underlying diseases. Initially, 136 older adults were selected as participants for this study, they were recipients of a free meal program from 2 senior welfare centers in Seoul, the final sample size of those who completed the intervention program was 117 (female 70.9%, male 29.1%). Statistical analyses were conducted with IBM SPSS package program, paired t-test and χ2 test to validate the test. RESULTS There were statistically significant differences in the score of the Tilburg Frailty Indicator (TFI) before and after receiving the tailored HDM services (pre-test 9.46, post-test 2.8, P < 0.01). The differences in the score of TFI by 3 risk groups at the pre-test decreased as a result of receiving these services. CONCLUSIONS The tailored HDM services alleviated the self-rated frailty of low-income older adults with limited mobility in a community setting. Based on the positive outcomes this study could be applied to developing social services for aging in place.
Collapse
Affiliation(s)
- Junghyun Kim
- Policy Research Department, Seoul Welfare Foundation, Seoul 04147, Korea
| | - Hyeja Chang
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| |
Collapse
|
2
|
Hennah C, Doumas M. Dual-task walking on real-world surfaces: Adaptive changes in walking speed, step width and step height in young and older adults. Exp Gerontol 2023; 177:112200. [PMID: 37160198 DOI: 10.1016/j.exger.2023.112200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Age-related changes in dual-task walking are well established, but research in this topic is based on evidence from laboratory rather than real-world studies. We investigated how dual-task walking on real-world surfaces affects young and older adults' gait characteristics and cognitive resource allocation. METHOD Sixteen young (aged 19-35, 12 female) and fifteen older adults (aged 70-85, 7 female) with no major neurological or musculoskeletal disorders walked at a self-selected speed on forty-metre outdoor paths that had asphalt or grass surface. They walked with or without a cognitive task (counting backwards). Cognitive task difficulty was individually adjusted at 80 % accuracy. Participants performed the three tasks in Single Task (ST Asphalt, ST Grass, ST Cognitive) and Dual Task context (DT Asphalt-Cognitive, DT Grass-Cognitive). RESULTS The two groups showed similar dual task effects in cognition and walking speed, both of which were slower when dual-task walking. Older adults' steps were wider overall but only young adults widened their step width when dual-task walking on grass compared to asphalt. Similarly, young adults' step height increased from single to dual-task walking when on grass, where older adults' did not. DISCUSSION The lack of adaptation of step width and height when dual-task walking may leave older adults vulnerable to tripping or falling in common real-world conditions, such as while walking on grass, gravel, or uneven city sidewalks. Considering this, the built environment should be made more accessible to facilitate older adults' safe walking.
Collapse
Affiliation(s)
| | - Michail Doumas
- School of Psychology, Queen's University Belfast, Belfast, UK
| |
Collapse
|
3
|
Portegijs E, Saajanaho M, Leppä H, Koivunen K, Eronen J, Rantanen T. Impact of mobility restrictions on active aging; cross-sectional associations and longitudinal changes parallel to COVID-19 restrictions. Arch Gerontol Geriatr 2021; 98:104522. [PMID: 34638047 DOI: 10.1016/j.archger.2021.104522] [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: 06/29/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we studied active aging scores two years prior to and amid COVID-19, when governments restricted mobility of residents to slow the COVID-19 outbreak. METHODS AGNES cohort data were collected in 2017-2018 and spring 2020. Individuals were queried about their will, ability, and opportunity, and extent of doing 17 activities, and subsequently, item, composite and sub-scores of active aging were computed. Neighborhood mobility was assessed as frequency of moving in or beyond own neighborhood (limited, regular, daily=reference). Associations were studied using Generalized Linear Models (cross-sectionally, n = 1007) and General Estimating Equations (prospectively, n = 774). RESULTS Participants with limited baseline neighborhood mobility had lower active aging scores than those with daily mobility, but the decline over time was similar. Some item scores on opportunity to act and extent of doing, e.g. for making one's day more interesting and advancing matters of faith or worldview, were better retained amid COVID-19 by those with limited mobility, attenuating group differences. CONCLUSIONS Active aging scores were somewhat compromised in individuals with limited neighborhood mobility, but opportunities for and engagement in several activities seemed to be better retained amid COVID-19 than for those with daily mobility. Thus, active aging may be possible despite mobility restriction.
Collapse
Affiliation(s)
- Erja Portegijs
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland.
| | - Milla Saajanaho
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Heidi Leppä
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Johanna Eronen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| |
Collapse
|
4
|
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
|
5
|
Liu F, Wanigatunga AA, Kuo PL, Zipunnikov V, Simonsick EM, Ferrucci L, Schrack JA. Association between walking energetics and fragmented physical activity in mid-to-late life. J Gerontol A Biol Sci Med Sci 2021; 76:e281-e289. [PMID: 33963748 DOI: 10.1093/gerona/glab127] [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: 12/18/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Physical activity becomes increasingly fragmented with age, which may be an early marker of functional decline. Energetic cost of walking and energy capacity are also linked with functional decline, but their associations with activity fragmentation, and the potential modifying roles of total daily physical activity and age, remains unclear. METHODS 493 participants (50-93 years) from the Baltimore Longitudinal Study of Aging underwent measures of: energetic cost of usual-paced overground walking (ml/kg/m), energy demand during slow walking (ml/kg/min) on a treadmill (0.67 m/s, 0% grade),m/s, 0% grade), and average peak walking energy expenditure (ml/kg/min) during a fast-paced 400-m walk. A ratio of slow walking to peak walking energy expenditure ("cost-to-capacity ratio") was calculated. Activity fragmentation was quantified as an active-to-sedentary transition probability (ASTP) using Actiheart accelerometer data. Linear regression models with ASTP as the dependent variable were used to test whether poorer energy cost and capacity were associated with higher ASTP and whether the associations differed by daily physical activity or age. RESULTS After adjusting for demographics, body composition, comorbidities and daily physical activity, every 10% higher cost-to-capacity ratio was associated with 0.4% greater ASTP (p=0.005). This association was primarily driven by the least active participants (pinteraction=0.023). Peak walking energy expenditure was only associated with ASTP among participants aged ≥70 years. CONCLUSIONS Higher cost-to-capacity ratio and lower energy capacity may manifest as more fragmented physical activity, especially among those less active or aged ≥70 years. Future studies should examine whether an increasing cost-to-capacity ratio or declining energy capacity predicts subsequent activity fragmentation.
Collapse
Affiliation(s)
- Fangyu Liu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amal A Wanigatunga
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Pei-Lun Kuo
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Vadim Zipunnikov
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
6
|
Foucher KC, Huang CH, Aydemir B. Walking energetics and abductor strength are associated with physical activity in older women with hip osteoarthritis. Gait Posture 2021; 85:151-156. [PMID: 33578307 PMCID: PMC8085128 DOI: 10.1016/j.gaitpost.2021.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteoarthritis (OA) can hinder physical activity in older adults for reasons that are not fully understood. Functional barriers may exist such as reduced muscle strength around the affected joint, potentially affecting physical activity. Aging-associated declines in energy capacity may also be exacerbated by OA. These factors may work together to influence physical activity in people with OA. RESEARCH QUESTION Our objective was to evaluate the combined role of walking energetics and hip abductor strength on physical activity in older women with hip OA. METHODS We evaluated 30 women with moderately symptomatic hip OA (61 ± 10 yrs; 30.7 ± 4.9 kg/m2) in this cross-sectional observational study. We measured physical activity using the UCLA activity score and quantified activity frequency and intensity using accelerometers worn for seven days (7 ± 2 days). We used a portable oxygen exchange system to measure energy used during walking at preferred speeds (relative to total energy capacity assessed using a six-minute walk test) and a dynamometer to measure hip abductor strength. We used Pearson correlations and regression analysis to test our hypotheses. RESULTS Greater energy used during walking was associated with lower self-reported physical activity (R=-0.626, p < 0.001), more sedentary time (R = 0.567, p = 0.002), and less light activity time (R=-0.644, p < 0.001). Lower hip abductor strength was associated with lower self-reported physical activity (R = 0.406, p = 0.039). While there was no association between hip abductor strength and energy used during walking, together these variables predicted 55.5 % of the variance in self-reported physical activity. SIGNIFICANCE Results suggest intervention targets to promote physical activity in this population.
Collapse
Affiliation(s)
- Kharma C. Foucher
- Corresponding Author: Kharma C. Foucher, MD, PhD, Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA,
| | | | | |
Collapse
|
7
|
Liu F, Wanigatunga AA, Zampino M, Knuth ND, Simonsick EM, Schrack JA, Ferrucci L. Association of Mitochondrial Function, Substrate Utilization, and Anaerobic Metabolism With Age-Related Perceived Fatigability. J Gerontol A Biol Sci Med Sci 2021; 76:426-433. [PMID: 32803242 DOI: 10.1093/gerona/glaa201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Indexed: 11/13/2022] Open
Abstract
Previous work has shown that poorer mitochondrial function is associated with age-related perceived fatigability. However, whether glucose oxidation and anaerobic metabolism are intermediate factors underlying this association remains unclear. We examined the total cross-sectional association between mitochondrial function and perceived fatigability in 554 adults aged 22-99 years. Mitochondrial function was assessed by skeletal muscle oxidative capacity (kPCr) using 31P magnetic resonance spectroscopy. Perceived fatigability was measured by rating of perceived exertion after a 5-minute (0.67 m/s) treadmill walk. The intermediate role of glucose oxidation (measured by the rate of change of respiratory exchange ratio [RER change rate] during the 5-minute treadmill walk) and anaerobic metabolism (measured by ventilatory threshold [VeT] during a maximal treadmill test) was evaluated by examining their cross-sectional associations with kPCr and perceived exertion. For each 0.01/s lower kPCr, perceived fatigability was 0.47 points higher (p = .002). A 0.01/s lower kPCr was also associated with 8.3 L/min lower VeT (p < .001). Lower VeT was associated with higher fatigability at lower levels of kPCr but not at higher kPCr levels (β for interaction = 0.017, p = .002). kPCr and RER change rate were not significantly associated (p = .341), but a 0.01/min higher RER change rate was associated with 0.12-point higher fatigability (p = .001). Poorer mitochondrial function potentially contributes to higher perceived fatigability through higher glucose oxidation and higher anaerobic metabolism. Future studies to further explore the longitudinal mechanisms between these metabolic changes and fatigability are warranted.
Collapse
Affiliation(s)
- Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | - 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
| | - Marta Zampino
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | | | - Eleanor M Simonsick
- National Institute on Aging, National Institutes of Health, 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
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| |
Collapse
|
8
|
Coelho-Junior HJ, Marzetti E, Picca A, Cesari M, Uchida MC, Calvani R. Protein Intake and Frailty: A Matter of Quantity, Quality, and Timing. Nutrients 2020; 12:E2915. [PMID: 32977714 PMCID: PMC7598653 DOI: 10.3390/nu12102915] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
Frailty is a geriatric syndrome that refers to a state of reduced resiliency to stressful events that occurs in response to physiological and/or psychosocial detriments. Frailty is a predictor of poor prognosis, given that frail older adults are at higher risk of many adverse health-related events. Hence, the identification of potential strategies to prevent the development and progression of frailty is of extreme importance for avoiding its negative outcomes. An adequate protein consumption is advocated as a possible intervention for the management of frailty in older adults due to its effects on muscle mass and physical function. However, empirical evidence is still needed to support this proposition. On the other hand, substantial evidence from observational studies has provided important information on the association between frailty and dietary protein-related parameters. Here, we provide a narrative review of the current literature regarding the association between protein intake (amount (how much?), quality (what type?), and distribution across meals (when?)) and frailty-related parameters. The ultimate aim of this work is to offer practical, evidence-based indications to healthcare professionals responsible for the care of frail older adults.
Collapse
Affiliation(s)
- Hélio J. Coelho-Junior
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, 083-851 Campinas-SP, Brazil;
- Mãe Mariana Nursing Home, Rehabilitation Unit, 08562-460 Poá-SP, Brazil
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (R.C.)
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (R.C.)
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20133 Milan, Italy;
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marco C. Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, 083-851 Campinas-SP, Brazil;
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (R.C.)
| |
Collapse
|
9
|
Palmberg L, Portegijs E, Rantanen T, Aartolahti E, Viljanen A, Hirvensalo M, Rantakokko M. Neighborhood Mobility and Unmet Physical Activity Need in Old Age: A 2-Year Follow-Up. J Aging Phys Act 2020; 28:442-447. [PMID: 31743089 DOI: 10.1123/japa.2019-0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 09/02/2019] [Accepted: 09/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Many older people report a willingness to increase outdoor physical activity (PA), but no opportunities for it, a situation termed as unmet PA need. The authors studied whether lower neighborhood mobility and PA precede the development of unmet PA need. METHODS Community-dwelling 75- to 90-year-old people (n = 700) were interviewed annually for 2 years. Unmet PA need, neighborhood mobility, and PA were self-reported. In addition, accelerometer-based step counts were assessed among a subgroup (n = 156). RESULTS Logistic regression analyses revealed that lower baseline neighborhood mobility (odds ratio 3.02, 95% confidence interval [1.86, 4.90] vs. daily) and PA (odds ratio 4.37, 95% confidence interval [2.62, 7.29] vs. high) were associated with the development of unmet PA need over 2 years. The participants with higher step counts had a lower risk for unmet PA need (odds ratio 0.68, 95% confidence interval, [0.54, 0.87]). CONCLUSION Maintaining higher PA levels and finding solutions for daily outdoor mobility, especially for those with declines in health, may protect from the development of unmet PA need.
Collapse
|
10
|
O'Connell ML, Coppinger T, McCarthy AL. The role of nutrition and physical activity in frailty: A review. Clin Nutr ESPEN 2019; 35:1-11. [PMID: 31987100 DOI: 10.1016/j.clnesp.2019.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/14/2019] [Indexed: 12/12/2022]
Abstract
Frailty is a clinical syndrome with a worldwide prevalence of 5-27% among those aged over 65 years. Frailty is characterised by loss of muscle strength and impaired physical function, and is associated with increased falls, hospitalisation and death. Nutritional deficiencies and low physical activity are common in this age group due to ill health, disability and reductions in enthusiasm, food intake and therefore, energy availability. Both low physical activity and inadequate dietary intake have a significant role to play in the onset and progression of frailty, primarily through bone and muscle health implications. Frailty is, however, preventable and reversible, and several interventions have been carried out to offset and reverse the condition. This article reports the recent evidence on the role of nutrition and physical activity in the pathogenesis of frailty and provides a critical review of previously implemented interventions focussed on physical activity and nutrition to prevent and reduce frailty among older adults.
Collapse
Affiliation(s)
- Maeve Lorraine O'Connell
- Department of Biological Sciences, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland.
| | - Tara Coppinger
- Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland
| | - Aoife Louise McCarthy
- Department of Biological Sciences, Cork Institute of Technology, Rossa Avenue, Bishopstown, Cork, Ireland
| |
Collapse
|
11
|
Energy Cost of Slow and Normal Gait Speeds in Low and Normally Functioning Adults. Am J Phys Med Rehabil 2019; 98:976-981. [DOI: 10.1097/phm.0000000000001228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
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
|
13
|
Martinez-Amezcua P, Matsushita K, Simonsick EM, Ferrucci L, Schrack JA. Fatigability and functional performance among older adults with low-normal ankle-brachial index: Cross-sectional findings from the Baltimore Longitudinal Study of Aging. Atherosclerosis 2018; 272:200-206. [PMID: 29627740 PMCID: PMC5994755 DOI: 10.1016/j.atherosclerosis.2018.03.037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/24/2018] [Accepted: 03/21/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Peripheral artery disease (PAD) is associated with poor mobility and fatigue, but the relationship between preclinical ankle-brachial index (ABI) and early markers of fatigue and functional decline has not been defined. METHODS 570 adults, 50 and older, from the Baltimore Longitudinal Study of Aging (N = 570), with normal values of ABI (1-1.39), were classified into ABI tertiles. Perceived fatigability was assessed after a 5-min, treadmill walk (1.5 mph) using the Borg rating of perceived exertion (RPE, range 6-20). Functional evaluation included the Health, Aging and Body Composition Physical Performance Battery (HABC PPB), time to complete a 400-m corridor walk (LDCW), and VO2 peak (ml/kg/min). High RPE and poor walking endurance (PWE) were defined as RPE≥10 and taking >5 min for the LDCW, respectively. Differences between tertiles in fatigability and functional measures were tested adjusting for demographics, behavioral characteristics, self-reported fatigue, and medical history. RESULTS Mean LDCW time and RPE were greater for participants in the lowest tertile compared to those in the highest; mean VO2 peak and HABC PPB scores were lower, suggesting hierarchical associations between fatigability, functional performance, and ABI (p < 0.05 for all). Odds of PWE were greater for those in the lowest ABI tertile compared to the highest; odds of reporting high RPE were greater for those in the middle tertile. CONCLUSIONS Lower ABI is associated with poorer physical function and increased fatigability, suggesting that early changes in ABI may infer greater risk of functional decline, even among those who may not progress to PAD.
Collapse
Affiliation(s)
- Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
14
|
Foucher KC, Cinnamon CC, Ryan CA, Chmell SJ, Dapiton K. Hip abductor strength and fatigue are associated with activity levels more than 1 year after total hip replacement. J Orthop Res 2018; 36:1519-1525. [PMID: 29077218 PMCID: PMC5924444 DOI: 10.1002/jor.23783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/21/2017] [Indexed: 02/04/2023]
Abstract
Despite improvements in pain and function, people who undergo total hip arthroplasty (THR) may not always return to desired levels of physical activity (PA). The factors associated with low activity levels are not fully understood. Abductor weakness and fatigue have both been proposed as factors that limit activity in older adults or people with hip osteoarthritis, but have not been investigated after THR. We hypothesized that abductor weakness and fatigue are associated with lower activity levels in people who have undergone a THR and that fatigue mediates the association between abductor strength and activity. We evaluated 16 subjects (24 ± 10 months post-THR; age 56.8 ± 8.4 yrs; BMI 31 ± 7 kg/m2 ). Fatigue was assessed using the PROMIS fatigue short-form 7a. Peak isometric hip abductor torque was assessed using a dynamometer with subjects in a sidelying position. We assessed activity level using the UCLA activity score. We used Pearson correlations to explore the associations among the variables. Next we used a three-step linear regression procedure to test whether or not fatigue acted as a mediator between abductor torque and UCLA activity scores. Higher abductor torque was associated with less fatigue (R2 = 0.275; p = 0.037) and with higher UCLA scores (R2 = 0.488, p = 0.003). Higher fatigue was associated with lower UCLA scores (R2 = 0. 307, p = 0.017), however there was no evidence of mediation. This suggests that addressing both abductor strength and fatigue may increase physical activity. Statement of Clinical Significance: Fatigue and abductor weakness should be evaluated in sedentary THR patients presenting for long-term follow-up. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1519-1525, 2018.
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
| | - Christopher C. Cinnamon
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| | - Colleen A. Ryan
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| | - Samuel J. Chmell
- Department of Orthopedics, University of Illinois at Chicago, 835 South Wood Street, Room E270, Chicago, IL 60612, USA
| | - Kris Dapiton
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| |
Collapse
|
15
|
Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030333. [PMID: 28327543 PMCID: PMC5369168 DOI: 10.3390/ijerph14030333] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 11/17/2022]
Abstract
The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75–90-year-old adults living independently in Central Finland were interviewed (n = 839) and reassessed for self-reported physical activity one or two years later (n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score ≤9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was calculated from geographic information and categorized into tertiles. Accelerometer-based step counts were registered for one week (n = 174). Better walkability was associated with higher numbers of perceived environmental facilitators (p < 0.001) and higher physical activity (self-reported p = 0.021, step count p = 0.010). Especially among those with physical limitations, reporting more environmental facilitators was associated with higher odds for reporting at least moderate physical activity (p < 0.001), but not step counts. Perceived environmental facilitators only predicted self-reported physical activity at follow-up. To conclude, high walkability of the living environment provides opportunities for physical activity in old age, but among those with physical limitations especially, awareness of environmental facilitators may be needed to promote physical activity.
Collapse
|
16
|
Portegijs E, Sipilä S, Viljanen A, Rantakokko M, Rantanen T. Validity of a single question to assess habitual physical activity of community-dwelling older people. Scand J Med Sci Sports 2016; 27:1423-1430. [PMID: 27747944 DOI: 10.1111/sms.12782] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 01/12/2023]
Abstract
The aim is to determine concurrent validity of a single self-report habitual physical activity (PA) question against accelerometer-based PA and mobility variables, and corresponding changes in self-reported PA and mobility. Cross-sectional and longitudinal data of the "Life-space mobility in old age" (LISPE) cohort and its substudy on PA were utilized. At baseline, 848 community-dwelling, 75- to 90-year-old people living independently in central Finland participated in home-based interviews. One and 2 years later, 816 and 761 of them were reassessed by phone, respectively. Tri-axial accelerometer data over 7 days were collected following the baseline assessments in a subsample of 174. Self-reported habitual PA was assessed based on intensity and duration using a single question with seven response options (range: mostly resting to competitive sports). Mobility variables were as follows: life-space mobility, walking difficulty over 500 m, and short physical performance battery. Statistically significant correlations were found between self-reported habitual PA and mobility (Spearman correlation coefficient Rs = 0.40-0.61) and accelerometer-based PA variables [step counts (Rs = 0.49), time in moderate (Rs = 0.49) and low intensity (Rs = 0.40) PA, and time in sedentary behavior (Rs = -0.28)]. A decline in self-reported habitual PA over time was associated with 5-10p decline in life-space mobility (PA improvement with 0-3p increase) and with developing a higher degree of walking difficulty (in 35-44% of participants). In conclusion, based on these results, the self-report question to assess habitual PA is valid and responsive to change and thus useful for epidemiological research in community-dwelling older people, also in follow-up studies.
Collapse
Affiliation(s)
- E Portegijs
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - S Sipilä
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - A Viljanen
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - M Rantakokko
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - T Rantanen
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
17
|
Egerton T, Chastin SFM, Stensvold D, Helbostad JL. Fatigue May Contribute to Reduced Physical Activity Among Older People: An Observational Study. J Gerontol A Biol Sci Med Sci 2015; 71:670-6. [DOI: 10.1093/gerona/glv150] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/29/2015] [Indexed: 01/27/2023] Open
|
18
|
Schrager MA, Hilton J, Gould R, Kelly VE. Effects of blueberry supplementation on measures of functional mobility in older adults. Appl Physiol Nutr Metab 2015; 40:543-9. [PMID: 25909473 DOI: 10.1139/apnm-2014-0247] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Limited functional mobility in older adults has been associated with declines in tests of motor, psychomotor, and executive function. Animal studies have demonstrated reversals in indices of motor and psychomotor function via supplementation with polyphenolic-rich foods such as blueberries. The purpose of this study was to examine whether 6 weeks of daily consumption of 2 cups of frozen blueberries affects functional mobility in older adults. Pre- and post-intervention assessments of grip strength, simple reaction time, adaptive gait, and executive function were completed for older adults (age >60 years) partially randomly assigned to a blueberry (BB) supplementation or a carrot juice drink control (CAR) group. Paired t tests were used to assess within-group effects for outcome variables in each supplementation group, and a mixed-model analysis of covariance (ANCOVA) was used to determine group (CAR vs. BB) differences. Mixed-model analysis indicated that the BB group demonstrated significant improvements relative to the CAR group in performance (i.e., number of step errors) of a challenging dual-task adaptive gait test that were independent of differences in gait speed. Within only the BB group, significant improvements were also seen in 3 other measures (i.e., usual gait speed; number of step errors during single-task adaptive gait; and gait speed during dual-task adaptive gait). These preliminary findings support the hypothesis that blueberry supplementation may provide an effective countermeasure to age-related declines in functional mobility and serve as justification for an expansion to larger trials to more fully assess this nonpharmacologic approach to maintaining optimal mobility and independence.
Collapse
Affiliation(s)
- Matthew A Schrager
- Department of Integrative Health Science, Stetson University, 421 N. Woodland Boulevard, DeLand, FL 32723, USA
| | | | | | | |
Collapse
|