Incidence and Predictors of Physical Inactivity Among Malaysian Community-Dwelling Older Persons

Association between maximal oxygen consumption and physical performance tests among older adults with cognitive frailty

INTRODUCTION

Cardiorespiratory fitness has an inverse relationship with cognitive impairment and frailty in older adults. Direct assessment of maximal oxygen consumption (VO2 max) is the gold standard to assess cardiorespiratory fitness. However, it is costly and requires a laboratory setting. Therefore, VO2 max estimation among older adults with cognitive frailty (CF) will allow the assessment of aerobic capacity, which is commonly overlooked due to the complexity of the test.

AIM

This study aims to determine the use of one of three physical performance tests (2-minute step, 2-minute walk, and 1-minute sit to stand) to effectively estimate cardiorespiratory fitness among older adults with CF.

METHODS

In this cross-sectional study, community-dwelling individuals aged 60 years old and above in Klang Valley were screened for CF. The participants performed three physical performance tests (2-minute walk, 2-minute step, and 1-minute sit to stand) followed by treadmill-based maximal exercise testing on another day.

RESULTS

A total of 32 older adults with cognitive frailty (mean age; SD: 67.1;4.7 years) participated in this study. Nearly half of them had hypertension (43.5 %), hypercholesterolemia (43.5 %), and multimorbidity (47.8 %). Among the endurance tests performed, only the 2-minute walk test independently predicted VO2 max by sex-specific with men (R2 = 0.58, p = 0.03) and women (R2 = 0.34, p = 0.01). The 2-minute walk test had good agreement with VO2 max (ICC = 0.77, 95 % CI: -3.1-2.4).

CONCLUSION

The 2-minute walk test is a valid tool for estimating cardiorespiratory fitness among older adults with CF. However, it should be further tested across a larger population.

Mediating role of cognitive status on performance in the two-minute step test and its normative data among Malaysian community-dwelling older persons

INTRODUCTION

The two-minute step test (2MST) has been used to estimate cardiorespiratory fitness and optimum scores are needed for performing activities of daily living with ease among older persons. However, there is limited information on the mediating role of cognitive impairment on 2MST performance and the 2MST normative data. Hence, we aim to identify the mediating role of cognitive status on performance in the 2MST among community-dwelling older adults and to establish the normative values of the 2MST.

METHODS

Participants aged 60 years and above were recruited through multistage random sampling from four states in Malaysia. The participants performed the 2MST using standard protocols. Mean comparison was done using an independent sample t-test or one-way analysis of variance. The 2MST normative values were then outlined descriptively.

RESULTS

Older age groups (60-69 years: 65.4 ± 21.9 times; 70-79 years: 61.7 ± 22.9 times; ≥80 years: 51.6 ± 24.5 times) had significantly lower levels of 2MST performance (p < 0.001). Women (56.6 ± 20.9 times) and participants with mild cognitive impairment (MCI) (58.7 ± 21.7 times) also had significantly lower levels of 2MST performance (p < 0.001) compared with men (69.1 ± 20.7 times) and participants with normal cognition (63.7 ± 21.6 times). Cognitive status had a significant mediation effect for age and sex on 2MST performance (p < 0.001). Therefore, the 2MST normative values were stratified according to cognitive status, sex, and age groups.

CONCLUSION

Validation of these findings in a larger number of older populations with MCI may provide directions for cardiorespiratory fitness training to be emphasised among older persons with MCI. Geriatr Gerontol Int 2022; ••: ••-••.