Accelerated Decline of Aerobic Fitness With Healthy Aging

Females Display Lower Risk of Myocardial Infarction From Higher Estimated Cardiorespiratory Fitness Than Males: The Tromsø Study 1994-2014

Objective

To examine the dose-response association between estimated cardiorespiratory fitness (eCRF) and risk of myocardial infarction (MI).

Patients and Methods

Adults who attended Tromsø Study surveys 4-6 (Janurary 1,1994-December 20, 2008) with no previous cardiovascular disease were followed up through December 31, 2014 for incident MI. Associations were examined using restricted cubic splines Fine and Gray regressions, adjusted for education, smoking, alcohol, diet, sex, adiposity, physical activity, study survey, and age (timescale) in the total cohort and subsamples with hyperlipidemia (n=2956), hypertension (n=8290), obesity (n=5784), metabolic syndrome (n=1410), smokers (n=3823), and poor diet (n=3463) and in those who were physically inactive (n=6255).

Results

Of 14,285 participants (mean age ± SD, 53.7±11.4 years), 979 (6.9%) experienced MI during follow-up (median, 7.2 years; 25th-75th, 5.3-14.6 years). Females with median eCRF (32 mL/kg/min) had 43% lower MI risk (subdistributed hazard ratio [SHR], 0.57; 95% CI, 0.48-0.68) than those at the 10th percentile (25 mL/kg/min) as reference. The lowest MI risk was observed at 47 mL/kg/min (SHR, 0.02; 95% CI, 0.01-0.11). Males had 26% lower MI risk at median eCRF (40 mL/kg/min; SHR, 0.74; 95% CI, 0.63-0.86) than those at the 10th percentile (32 mL/kg/min), and the lowest risk was 69% (SHR, 0.31; 95% CI, 0.14-0.71) at 60 mL/kg/min. The associations were similar in subsamples with cardiovascular disease risk factors.

Conclusion

Higher eCRF associated with lower MI risk in females and males, but associations were more pronounced among females than those in males. This suggest eCRF as a vital estimate to implement in medical care to identify individuals at high risk of future MI, especially for females.

Differences between Treadmill and Cycle Ergometer Cardiopulmonary Exercise Testing Results in Triathletes and Their Association with Body Composition and Body Mass Index

Cardiopulmonary exercise testing (CPET) is the method of choice to assess aerobic fitness. Previous research was ambiguous as to whether treadmill (TE) and cycle ergometry (CE) results are transferrable or different between testing modalities in triathletes. The aim of this paper was to investigate the differences in HR and VO2 at maximum exertion between TE and CE, at anaerobic threshold (AT) and respiratory compensation point (RCP) and evaluate their association with body fat (BF), fat-free mass (FFM) and body mass index (BMI). In total, 143 adult (n = 18 female), Caucasian triathletes had both Tr and CE CPET performed. The male group was divided into <40 years (n = 80) and >40 years (n = 45). Females were aged between 18 and 46 years. Body composition was measured with bioelectrical impedance before tests. Differences were evaluated using paired t-tests, and associations were evaluated in males using multiple linear regression (MLR). Significant differences were found in VO2 and HR at maximum exertion, at AT and at RCP between CE and TE testing, in both males and females. VO2AT was 38.8 (±4.6) mL/kg/min in TE vs. 32.8 (±5.4) in CE in males and 36.0 (±3.6) vs. 32.1 (±3.8) in females (p < 0.001). HRAT was 149 (±10) bpm in TE vs. 136 (±11) in CE in males and 156 (±7) vs. 146 (±11) in females (p < 0.001). VO2max was 52 (±6) mL/kg/min vs. 49 (±7) in CE in males and 45.3 (±4.9) in Tr vs. 43.9 (±5.2) in females (p < 0.001). HRmax was 183 (±10) bpm in TE vs. 177 (±10) in CE in males and 183 (±9) vs. 179 (±10) in females (p < 0.001). MLR showed that BMI, BF and FFM are significantly associated with differences in HR and VO2 at maximum, AT and RCP in males aged >40. Both tests should be used independently to achieve optimal fitness assessments and further training planning.

Does sedentary time increase in older adults in the days following participation in intense exercise?

BACKGROUND

Older adults have the highest sedentary time across all age groups, and only a small portion is meeting the minimum recommendations for weekly physical activity. Little research to date has looked at how changes in one of these behaviours influences the other.

AIM

To assess changes in 24-h movement behaviours (sedentary time, light intensity physical activity (LPA), moderate-vigorous PA (MVPA) and sleep) over three consecutive days, following acute bouts of exercise of varying intensity in older adults.

METHODS

Participants (n = 28, 69.7 ± 6.5 years) completed a maximal exercise test and the following exercise protocols in random order: moderate continuous exercise (MOD), high-intensity interval exercise (HI) and sprint interval exercise (SPRT). A thigh-worn device (ActivPAL™) was used to measure movement behaviours at baseline and the 3 days following each exercise session.

RESULTS

Repeated measures analysis of variance indicated that compared to baseline, participants decreased MVPA in the 3 days following all exercise sessions and decreased LPA following HI and SPRT (p < 0.05). Over half of the sample had clinically meaningful increases in sedentary time (30 min/day) in the days following exercise participation.

DISCUSSION

Older adults who compensate for exercise participation by reducing physical activity and increasing sedentary time in subsequent days may require behavioural counseling to ensure that incidental and recreational physical activities are not reduced.

CONCLUSION

It appears that older adults compensate for acute exercise by decreasing MVPA and LPA, and increasing sedentary time in the days following exercise. Future research is needed to determine whether compensation persists with regular engagement.

Anatomical location, sex, and age influence murine arterial circumferential cyclic strain before and during dobutamine infusion

Background

One of the primary biomechanical factors influencing arterial health is their deformation across the cardiac cycle, or cyclic strain, which is often associated with arterial stiffness. Deleterious changes in the cardiovascular system, e.g., increased arterial stiffness, can remain undetected until the system is challenged, such as under a cardiac stressor like dobutamine.

Purpose

To quantify cyclic strain in mice at different locations along the arterial tree prior to and during dobutamine infusion, while evaluating the effects of sex and age.

Study Type

Control/cohort study.

Animal Model

Twenty C57BL/6 mice; male, female; ∼12 and 24 weeks of age; n = 5 per group.

Field Strength/Sequence

7T; CINE MRI with 12 frames, velocity compensation, and prospective cardiac gating.

Assessment

Prior to and during the infusion of dobutamine, Green–Lagrange circumferential cyclic strain was calculated from perimeter measurements derived from CINE data acquired at the carotid artery, suprarenal and infrarenal abdominal aorta, and iliac artery.

Statistical Tests

Analysis of variance (ANOVA) followed by post‐hoc tests was used to evaluate the influence of dobutamine, anatomical location, sex, and age.

Results

Heart rates did not differ between groups prior to or during dobutamine infusion (P = 0.87 and P = 0.08, respectively). Dobutamine increased cyclic strain in each group. Within a group, increases in strain were similar across arteries. At the suprarenal aorta, strain was reduced in older mice at baseline (young 27.6 > mature 19.3%, P = 0.01) and during dobutamine infusion (young 53.0 > mature 36.2%, P = 0.005). In the infrarenal aorta, the response (dobutamine – baseline) was reduced in older mice (young 21.9 > mature 13.5%, P = 0.04).

Data Conclusion

Dobutamine infusion increases circumferential cyclic strain throughout the arterial tree of mice. This effect is quantifiable using CINE MRI. The results demonstrate that strain prior to and during dobutamine is influenced by anatomical location, sex, and age.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2019;49:69–80.

Relationship Between Aerobic Capacity With Oxidative Stress and Inflammation Biomarkers in the Blood of Older Mexican Urban-Dwelling Population

The maximal oxygen uptake (VO2max) constitutes an indicator of an organism’s capacity to integrate oxygen into the metabolism to obtaining energy. The aim of this study was to determine the relationship between VO2max and oxidative stress (OxS) and chronic inflammation in the elderly individuals. A cross-sectional and exploratory study was conducted in a sample of 52 older persons. We measured plasma lipid peroxides (LPO), red blood cell glutathione peroxidase, red blood cell superoxide dismutase, and total antioxidant status. The interleukin 10 and tumor necrosis factor-α (TNF-α) were measured in serum by ELISA. The VO2max was determined by the Rockport aerobic test, and the energy expenditure (caloric expenditure and metabolic equivalence unit (MET) per day) was measured by a 3-day activity record. We observed a positive correlation between VO2 max with IL-10, MET/day•day-1 and kcal•day-1 (r = 0.31, P < .05, r = 0.44, P < .01, and r = 0.29, P < .05, respectively), and a negative correlation with the body mass index, TNF-α, and LPO (r = −0.27, P < .05, r = −0.29, P < .05, and r = −0.40, P < .01 respectively). Our findings suggest that there is an inverse relationship between the aerobic capacity and the OxS and chronic inflammation biomarkers in the blood in older Mexican adults.

Tracking of aerobic fitness from adolescence to mid-adulthood

BACKGROUND

Although adults' aerobic fitness is known to be correlated with cardiovascular disease risk, the longitudinal relationship with adolescent aerobic fitness is poorly described.

AIM

To longitudinally investigate the relationship between aerobic fitness during adolescence and adulthood.

SUBJECTS AND METHODS

Participants (207 boys, 149 girls) aged 7-17 years performed annual measures of VO2peak. In adulthood (40 and 50 years), 78 individuals (59 males and 18 females) were reassessed. Serial height measurements were used to estimate age at peak height velocity (APHV). During adolescence, VO2peak was measured via a treadmill test to voluntary exhaustion; adult VO2peak was assessed using submaximal predictive tests. Correlations were tested using Spearman's rho. ANCOVA was used to assess adult VO2peak group differences based off APHV VO2peak groupings (low, average or high).

RESULTS

When sexes were pooled, moderate tracking existed from 2 years prior to APHV to APHV and APHV to 2 years after APHV (0.46, p < 0.001 and 0.35, p < 0.01, respectively). Correlations between APHV and adult values were low when sexes were pooled (p < 0.05). Comparisons of aggregated sexes revealed the low adolescent VO2peak group had lower values in adulthood relative to other groups (p < 0.05).

CONCLUSION

Aerobic fitness has a low tracking between APHV and adulthood.

Influence of exercise intensity on pulmonary oxygen uptake kinetics in young and late middle-aged adults

It is unclear whether pulmonary oxygen uptake (Vo2) kinetics demonstrate linear, first-order behavior during supra gas exchange threshold exercise. Resolution of this issue is pertinent to the elucidation of the factors regulating oxygen uptake (Vo2) kinetics, with oxygen availability and utilization proposed as putative mediators. To reexamine this issue with the advantage of a relatively large sample size, 50 young (24 ± 4 yr) and 15 late middle-aged (54 ± 3 yr) participants completed repeated bouts of moderate and heavy exercise. Pulmonary gas exchange, heart rate (HR), and cardiac output (Q) variables were measured throughout. The phase II τ was slower during heavy exercise in both young (moderate: 22 ± 9; heavy: 29 ± 9 s; P ≤ 0.001) and middle-aged (moderate: 22 ± 9; heavy: 30 ± 8 s; P ≤ 0.001) individuals. The HR τ was slower during heavy exercise in young (moderate: 33 ± 10; heavy: 44 ± 15 s; P ≤ 0.05) and middle-aged (moderate: 30 ± 12; heavy: 50 ± 20 s; P ≤ 0.05) participants, and the Q τ showed a similar trend (young moderate: 21 ± 13; heavy: 28 ± 16 s; middle-aged moderate: 32 ± 13; heavy: 40 ± 15 s; P ≥ 0.05). There were no differences in primary component Vo2 kinetics between age groups, but the middle-aged group had a significantly reduced Vo2 slow component amplitude in both absolute (young: 0.25 ± 0.09; middle-aged: 0.11 ± 0.06 l/min; P ≤ 0.05) and relative terms (young: 15 ± 10; middle-aged: 9 ± 4%; P ≤ 0.05). Thus Vo2 kinetics do not demonstrate dynamic linearity during heavy intensity exercise. Speculatively, the slower phase II τ during heavy exercise might be attributable to reduced oxygen availability. Finally, the primary and slow components of Vo2 kinetics appear to be differentially influenced by middle age.

Interaction between age and aerobic fitness in determining heart rate dynamics

Heart rate variability (HRV) and phase-rectified signal averaging (PRSA) estimates of heart rate dynamics are diminished in older people compared with younger people. However, it is not fully elucidated whether these differences are related to age per se or to the concomitant influence of aerobic fitness. Aerobic fitness (peak oxygen uptake, gas exchange threshold, oxygen uptake kinetics, exercise economy) was assessed in 70 healthy adults (41 male) aged 18-57 years. Participants also underwent a 24 h, ambulatory ECG for the derivation of HRV and PRSA variables. HRV was most sensitive to age and aerobic fitness when measured during the morning period (6 am-12 pm). HRV and PRSA were both diminished with age and were higher in aerobically superior participants. The decline in HRV with age was predominantly attributable to age itself (33%), with aerobic fitness representing an additional modulating factor. The present study also provides tentative evidence that assessment of the influence of aerobic fitness should not rely on [Formula: see text]O(2peak) alone. These findings demonstrate that age per se is an important factor in determining HRV. However, given the clinical importance of diminished HRV and the immutable nature of aging, the potential significance of physical activity/training to enhance cardiac regulatory function should not be underestimated.

The association between flow-mediated dilation and physical function in older men

The probability that an individual is able to live independently decreases sharply below the threshold score of 57 units on the physical functional performance (PFP-10) test.

PURPOSE

To examine the relation between brachial artery flow-mediated dilation (BAFMD) on individual and total scores on the PFP-10. We hypothesized that lower scores on the PFP-10 test would be associated with lower BAFMD.

METHODS

Sixty-four men (age, 84 +/- 11 yr) from the Louisiana Healthy Aging Study were studied. Participants were classified by their performance on the PFP-10 test (Class I, score <26; Class II, score between 26 and 57; and Class III, score > 57). BAFMD was assessed after 5 min of forearm occlusion, using high-resolution ultrasonography.

RESULTS

The average total score on the PFP-10 test and BAFMD were 42.9 +/- 22 U and 2.76 +/- 2.13%, respectively. The BAFMD was associated with total PFP-10 score (r = 0.45, P = 0.0001) and age (r = -0.36, P = 0.003). BAFMD was significantly different (P = 0.001) between the PFP-10 classes (Class I, 1.44% [95% CI, 0.49-2.39]; Class II, 2.67% [95% CI, 1.95-3.38]; and Class III, 4.01% [95% CI, 3.16-4.85]).

CONCLUSIONS

This study reports significant relationships between BAFMD and individual and combined measures of physical function in elderly men. More specifically, when individuals were categorized based on their PFP-10 total score, those in the highest functional class, exhibited the highest BAFMD, compared to those in the middle class, who had greater vasoreactivity than those in the lowest functional class.

A comparison of functional fitness of older Brazilian and American women

The purpose of this cross-sectional study was to generate a functional-fitness profile for older women from the south of Brazil and to compare their functional profile with an age-matched cohort of American women. The Fullerton Functional Fitness Test (body-mass index, 6-min-walk test, chair sit-and-reach, chair stand, arm curl, and 8-ft up-and-go) was administered to 1,033 participants. Z scores indicate that older American women performed better in all functional tests than age-matched Brazilians. This fact could be explained by the delayed establishment of specific health policies for older adults in Brazil. In conclusion, the findings provide guidelines about the normal variation of functional fitness in older women from the southern region of Brazil. In addition, these data can be used to help identify older women with functional losses, thereby assisting in the diagnosis of early disability.

Physical work capacity in older adults: implications for the aging worker

BACKGROUND

In many developed countries, the workforce is rapidly aging. Occupational demands however, have not decreased despite the fact that workers see a decline in physical work capacity with age. The purpose of this review is to examine the physiological adaptations to aging, the impact of aging on performance and the benefits of physical fitness in improving functional work capacity in aging individuals.

METHODS

An extensive search of the scientific literature was performed, acquiring published articles which examined the physiological changes associated with age-related decrements in the physical work capacity of healthy aging adults. The databases accessed included AARP Ageline, AccessScience, Annual Reviews, CISTI, Cochrane Library, Clinical Evidence, Digital Dissertations (Proquest), Embase, HealthSTAR, Medline, PubMed, Scopus, and PASCAL and included relevant information sites obtained on the world wide web.

RESULTS

While a great deal of variation exists, an average decline of 20% in physical work capacity has been reported between the ages of 40 and 60 years, due to decreases in aerobic and musculoskeletal capacity. These declines can contribute to decreased work capacity, and consequential increases in work-related injuries and illness. However, differences in habitual physical activity will greatly influence the variability seen in individual physical work capacity and its components. Well-organized, management-supported, work-site health interventions encouraging physical activity during work hours could potentially decrease the incidence of age-related injury and illness.

CONCLUSIONS

Age-associated functional declines and the accompanying risk of work-related injury can be prevented or at least delayed by the practice of regular physical activity. Older workers could optimally pursue their careers until retirement if they continuously maintain their physical training.

Health capital, life course and ageing

BACKGROUND

The difference in individual ageing remains a not fully understood subject.

OBJECTIVE

To discuss the use of the health capital concept and its application to the life course approach as an alternative to understand factors involved on individual ageing and identify genetic, socioeconomic, psychological and biological influences.

RESULTS

The initial capital (genetics and development in uterus) and other lifelong assets like education, social status, locus of control, cognitive reserve, and humor are important modulators of ageing. The biological assets like basal metabolism, aerobic capacity, and insulin sensitivity also play a major role.

CONCLUSIONS

Health stock at any time will derive from health capital, the depreciative effect of ageing, positive health inputs and negative inputs that increase depreciation. A high health stock increases the chance of successful ageing and a low health stock is compatible with disability and lack of independence.