1
|
Joundi RA, Hu B, Rangarajan S, Leong DP, Islam S, Smith EE, Mirrakhimov E, Seron P, Alhabib KF, Assembekov B, Chifamba J, Yusuf R, Khatib R, Felix C, Yusufali A, Mohammadifard N, Rosengren A, Oguz A, Iqbal R, Yeates K, Avezum A, Kruger I, Anjana R, Pvm L, Gupta R, Zatońska K, Barbarash O, Pelliza E, Rammohan K, Li M, Li X, Ismail R, Lopez-Jaramillo P, Evans M, O'Donnell M, Yusuf S. Activity limitations, use of assistive devices, and mortality and clinical events in 25 high-income, middle-income, and low-income countries: an analysis of the PURE study. Lancet 2024; 404:554-569. [PMID: 39068950 DOI: 10.1016/s0140-6736(24)01050-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/04/2024] [Accepted: 05/16/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The focus of most epidemiological studies has been mortality or clinical events, with less information on activity limitations related to basic daily functions and their consequences. Standardised data from multiple countries at different economic levels in different regions of the world on activity limitations and their associations with clinical outcomes are sparse. We aimed to quantify the prevalence of activity limitations and use of assistive devices and the association of limitations with adverse outcomes in 25 countries grouped by different economic levels. METHODS In this analysis, we obtained data from individuals in 25 high-income, middle-income, and low-income countries from the Prospective Urban Rural Epidemiological (PURE) study (175 660 participants). In the PURE study, individuals aged 35-70 years who intended to continue living in their current home for a further 4 years were invited to complete a questionnaire on activity limitations. Participant follow-up was planned once every 3 years either by telephone or in person. The activity limitation screen consisted of questions on self-reported difficulty with walking, grasping, bending, seeing close, seeing far, speaking, hearing, and use of assistive devices (gait, vision, and hearing aids). We estimated crude prevalence of self-reported activity limitations and use of assistive devices, and prevalence standardised by age and sex. We used logistic regression to additionally adjust prevalence for education and socioeconomic factors and to estimate the probability of activity limitations and assistive devices by age, sex, and country income. We used Cox frailty models to evaluate the association between each activity limitation with mortality and clinical events (cardiovascular disease, heart failure, pneumonia, falls, and cancer). The PURE study is registered with ClinicalTrials.gov, NCT03225586. FINDINGS Between Jan 12, 2001, and May 6, 2019, 175 584 individuals completed at least one question on the activity limitation questionnaire (mean age 50·6 years [SD 9·8]; 103 625 [59%] women). Of the individuals who completed all questions, mean follow-up was 10·7 years (SD 4·4). The most common self-reported activity limitations were difficulty with bending (23 921 [13·6%] of 175 515 participants), seeing close (22 532 [13·4%] of 167 801 participants), and walking (22 805 [13·0%] of 175 554 participants); prevalence of limitations was higher with older age and among women. The prevalence of all limitations standardised by age and sex, with the exception of hearing, was highest in low-income countries and middle-income countries, and this remained consistent after adjustment for socioeconomic factors. The use of gait, visual, and hearing aids was lowest in low-income countries and middle-income countries, particularly among women. The prevalence of seeing close limitation was four times higher (6257 [16·5%] of 37 926 participants vs 717 [4·0%] of 18 039 participants) and the prevalence of seeing far limitation was five times higher (4003 [10·6%] of 37 923 participants vs 391 [2·2%] of 18 038 participants) in low-income countries than in high-income countries, but the prevalence of glasses use in low-income countries was half that in high-income countries. Walking limitation was most strongly associated with mortality (adjusted hazard ratio 1·32 [95% CI 1·25-1·39]) and most consistently associated with other clinical events, with other notable associations observed between seeing far limitation and mortality, grasping limitation and cardiovascular disease, bending limitation and falls, and between speaking limitation and stroke. INTERPRETATION The global prevalence of activity limitations is substantially higher in women than men and in low-income countries and middle-income countries compared with high-income countries, coupled with a much lower use of gait, visual, and hearing aids. Strategies are needed to prevent and mitigate activity limitations globally, with particular emphasis on low-income countries and women. FUNDING Funding sources are listed at the end of the Article.
Collapse
Affiliation(s)
- Raed A Joundi
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada.
| | - Bo Hu
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
| | - Darryl P Leong
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
| | | | | | | | | | | | | | | | - Rita Yusuf
- Independent University, Dhaka, Bangladesh
| | - Rasha Khatib
- Advocate Aurora Research Institute, Milwaukee, WI, USA
| | | | | | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aytekin Oguz
- Istanbul Medeniyet University, Istanbul, Türkiye
| | | | | | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz and UNISA, São Paulo University, São Paulo, Brazil
| | | | | | - Lakshmi Pvm
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Rajasthan, India
| | | | | | | | | | - Mengya Li
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaocong Li
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rosnah Ismail
- Universiti Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Marc Evans
- Philippine General Hospital, Manila, Philippines
| | | | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
| |
Collapse
|
2
|
Veley A, Degen M, Rimmer L, Collins L, Dorocicz I, Smith J, Barclay R, Scodras S, Alsbury-Nealy K, Salbach NM. Do measures of physical capacity and walking self-efficacy relate to frailty in older adults with difficulty walking outdoors? A secondary data analysis. Disabil Rehabil 2024; 46:3905-3912. [PMID: 37787058 DOI: 10.1080/09638288.2023.2258336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Measures of physical capacity and self-efficacy may help rehabilitation professionals better understand and detect frailty in older adults. We aimed to characterize frailty, walking self-efficacy, physical capacity, and their inter-relationships in older adults with difficulty walking outdoors. MATERIALS AND METHODS A secondary analysis of baseline data from 187 older adults (age ≥ 65 years) with mobility limitations was performed. Frailty was evaluated using the cardiovascular health study frailty index. Physical capacity was measured using the 10-meter walk test (10mWT), 6-min walk test (6MWT), 30-second sit-to-stand test (30STST), mini balance evaluation systems test (mini-BESTest), and hand dynamometry. Self-efficacy was assessed using the ambulatory self-confidence questionnaire (ASCQ). We evaluated associations between scores on physical capacity and walking self-efficacy measures and frailty level using an ANOVA or the Kruskal Wallis H-test. RESULTS The percentage of participants not frail, pre-frail, and frail was 33.7%, 57.2%, and 9.1%, respectively. Median score on the 10mWT-comfortable pace, 10mWT-fast pace, 6MWT, 30STST, mini-BESTest, grip strength, and ASCQ was 1.06 m/s, 1.42 m/s, 354.0 m, 9.0 repetitions, 22 points, 23.0 kg, and 8.1 points, respectively. Scores on physical capacity and walking self-efficacy measures were associated with frailty level (p < 0.01). CONCLUSIONS Findings provide insight into the utility of rehabilitation measures to indicate frailty among older adults with mobility limitations.
Collapse
Affiliation(s)
- Andrew Veley
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Maja Degen
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Rimmer
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Collins
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Izabela Dorocicz
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Smith
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Stephanie Scodras
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kyla Alsbury-Nealy
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| |
Collapse
|
3
|
Ryan E, MacLaughlin H, Hay R, Cawte A, Naumann L, Woodruff G, Cottrell M, Window P. Improving multidisciplinary management of patients living with obesity: The evaluation of seated bioimpedance measures and relationship to functional performance following targeted intervention. Clin Obes 2024; 14:e12655. [PMID: 38487943 DOI: 10.1111/cob.12655] [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: 12/14/2023] [Revised: 02/15/2024] [Accepted: 02/29/2024] [Indexed: 07/13/2024]
Abstract
Management of obesity requires a multidisciplinary approach including physical activity interventions, which have significant impacts on overall health outcomes. Greater levels of lean muscle mass are significantly associated with improved health and reduced risk of comorbidities and should be preserved where possible when undertaking rapid weight loss. This article reports on the physical and functional outcomes achieved during a 12-week intensive multidisciplinary intervention targeting obesity and evaluates correlations between body composition and functional outcomes. We additionally aimed to investigate the test-retest reliability and levels of agreement in body composition measurements using bioimpedance spectroscopy between seated and standing positions. Of the 35 participants included in analysis, significant differences were observed between baseline and post-intervention measures. These included weight loss of 12.6 kg, waist circumference reduction of 10.5 cm, fat mass reduction by 2.9%, muscle mass increase by 1.6%, 54.5 m improvement in the 6-minute walk test and 3.8 rep improvement in the 30-second sit-to-stand test. No significant correlations were observed between physical and functional outcome measures. Excellent test re-test reliability was observed in bioimpedance spectroscopy seated measurements (ICC >.9). Significant differences were observed between seated and standing bioimpedance spectroscopy measurements, however they are regarded as small differences in a clinical setting.
Collapse
Affiliation(s)
- Elizabeth Ryan
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Tertiary Obesity Multidisciplinary Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Helen MacLaughlin
- Tertiary Obesity Multidisciplinary Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Nutrition Research Collaborative, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Robin Hay
- Tertiary Obesity Multidisciplinary Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Nutrition Research Collaborative, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Andrea Cawte
- Tertiary Obesity Multidisciplinary Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Nutrition Research Collaborative, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Leonie Naumann
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Gemma Woodruff
- Tertiary Obesity Multidisciplinary Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Michelle Cottrell
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Peter Window
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, Metro North Health and University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
4
|
Tarca B, Jesudason S, Bennett PN, Wycherley TP, Ferrar KE. Modifiable Physical Factors That Influence Physical Function for People Receiving Peritoneal Dialysis. Kidney Int Rep 2024; 9:1298-1309. [PMID: 38707811 PMCID: PMC11068959 DOI: 10.1016/j.ekir.2024.01.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/13/2023] [Accepted: 01/29/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction People receiving peritoneal dialysis experience physical function decline, impairing their ability to complete everyday activities, leading to poorer quality of life. Physical factors, including cardiorespiratory fitness, muscle strength, physical activity, and sedentary behavior are associated with physical function. However, little is known about this relationship, or temporal changes of these factors in this cohort. This study aimed to explore modifiable physical factors that are associated with physical function, identify which factor has the strongest influence, and explore temporal changes. Methods Adults receiving peritoneal dialysis underwent objective and self-reported physical function, cardiorespiratory fitness, muscle strength, physical activity and sedentary behavior assessments 3 times over a 12-month observation period (at baseline, 6 months, and 12 months). Results Eighty-two participants underwent assessments. All modifiable physical factors were predominantly moderate to strongly associated with physical function at baseline. Cardiorespiratory fitness had the strongest and most consistent influence with every meter conferring a 0.08-unit (P < 0.01) and 0.01-unit (P < 0.05) increase in self-report and objective physical function score, respectively. Temporal changes were observed for modifiable physical factors with significant mean changes in cardiorespiratory fitness (-9.8%), quadricep strength (-5%), moderate-to-vigorous (-25.9%) and total (-16.2%) physical activity, and sedentary behavior (+7.1%). Conclusion The results of this study indicate that cardiorespiratory fitness could be routinely monitored to detect risk of physical function decline and targeted through intervention to enhance physical function for people receiving peritoneal dialysis. Nevertheless, all factors should be considered when designing interventions to mitigate temporal changes and induce the numerous health benefits offered by being physically active.
Collapse
Affiliation(s)
- Brett Tarca
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service Clinical Research Group, Royal Adelaide Hospital, Adelaide, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, Australia
| | - Paul N. Bennett
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
- Medical and Clinical Affairs, Satellite Healthcare, San Jose, California, USA
| | - Thomas P. Wycherley
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Katia E. Ferrar
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| |
Collapse
|
5
|
Tanriverdi A, Ozcan Kahraman B, Sezgin NH, Erez Y, Acar S, Birlik AM, Ozpelit E, Savci S. Functional capacity, physical activity, and arterial stiffness in patients with systemic sclerosis. Clin Rheumatol 2024; 43:1657-1664. [PMID: 38573481 DOI: 10.1007/s10067-024-06953-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Systemic sclerosis (SSc) is a complex immune-mediated connective tissue disease, involving skin manifestations, vascular features, and organ-based complications that may affect functional capacity and physical activity. Functional capacity and physical activity are associated with arterial stiffness; however, this relationship has not been evaluated in patients with SSc. Therefore, the objective of this study was to investigate the association of functional capacity and physical activity with arterial stiffness in patients with SSc. METHODS Sixty-five patients with SSc were enrolled in this cross-sectional study. Arterial stiffness was evaluated with carotid-femoral pulse wave velocity (cf-PWV). Functional capacity and physical activity were assessed with a six-min walk test (6MWT) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. RESULTS All participants were women, and the mean age was 54.91 ± 11.18 years. 6MWT distance and IPAQ-SF were inversely associated with cf-PWV in crude analysis (p < 0.05). The relationship between 6MWT distance and cf-PWV was maintained in the fully adjusted model (β = - 0.007, 95% CI, - 0.013 to 0.000). Similarly, the association between IPAQ-SF and cf-PWV remained significant in the fully adjusted model (β = - 0.001, 95% CI, - 0.002 to - 0.001). CONCLUSION The present study indicates that functional capacity and self-reported physical activity are independently associated with arterial stiffness in patients with SSc. Exercise interventions targeted to increase functional capacity and physical activity may help to regulate arterial stiffness in patients with SSc. Key Points • Arterial stiffness is an independent predictor of cardiovascular risk. • SSc patients exhibit decreased exercise capacity and functional capacity. • The association of functional capacity and physical activity with arterial stiffness in patients with SSc is unknown. • Functional capacity and self-reported physical activity are independently associated with arterial stiffness in patients with SSc.
Collapse
Affiliation(s)
- Aylin Tanriverdi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey.
- Present address: Çankırı Karatekin University Uluyazı Campus, Çankırı, Turkey.
| | - Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | | | - Yesim Erez
- Cigli Training and Research Hospital, Izmir, Turkey
| | - Serap Acar
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ahmet Merih Birlik
- Department of Internal Disease, Rheumatology Department, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| |
Collapse
|
6
|
Cummings SR, Lui LY, Glynn NW, Mau T, Cawthon PM, Kritchevsky SB, Coen PM, Goodpaster B, Marcinek DJ, Hepple RT, Patel S, Newman AB. Energetics and clinical factors for the time required to walk 400 m: The Study of Muscle, Mobility and Aging (SOMMA). J Am Geriatr Soc 2024; 72:1035-1047. [PMID: 38243364 DOI: 10.1111/jgs.18763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/31/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Walking slows with aging often leading to mobility disability. Mitochondrial energetics has been found to be associated with gait speed over short distances. Additionally, walking is a complex activity but few clinical factors that may be associated with walk time have been studied. METHODS We examined 879 participants ≥70 years and measured the time to walk 400 m. We tested the hypothesis that decreased mitochondrial energetics by respirometry in muscle biopsies and magnetic resonance spectroscopy in the thigh and is associated with longer time to walk 400 m. We also used cardiopulmonary exercise testing to assess the energetic costs of walking: maximum oxygen consumption (VO2peak) and energy cost-capacity (the ratio of VO2, at a slow speed to VO2peak). In addition, we tested the hypothesis that selected clinical factors would also be associated with 400-m walk time. RESULTS Lower Max OXPHOS was associated with longer walk time, and the association was explained by the energetic costs of walking, leg power, and weight. Additionally, a multivariate model revealed that longer walk time was also significantly associated with lower VO2peak, greater cost-capacity ratio, weaker leg power, heavier weight, hip and knee stiffness, peripheral neuropathy, greater perceived exertion while walking slowly, greater physical fatigability, less moderate-to-vigorous exercise, less sedentary time, and anemia. Significant associations between age, sex, muscle mass, and peripheral artery disease with 400-m walk time were explained by other clinical and physiologic factors. CONCLUSIONS Lower mitochondrial energetics is associated with needing more time to walk 400 m. This supports the value of developing interventions to improve mitochondrial energetics. Additionally, doing more moderate-to-vigorous exercise, increasing leg power, reducing weight, treating hip and knee stiffness, and screening for and treating anemia may reduce the time required to walk 400 m and reduce the risk of mobility disability.
Collapse
Affiliation(s)
- Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Li-Yung Lui
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Nancy W Glynn
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Theresa Mau
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Peggy M Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Paul M Coen
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Bret Goodpaster
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - David J Marcinek
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Russell T Hepple
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Sheena Patel
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
7
|
Schene MR, Wyers CE, Driessen JHM, Vranken L, Meijer K, van den Bergh JP, Willems HC. The "Can Do, Do Do" Framework Applied to Assess the Association between Physical Capacity, Physical Activity and Prospective Falls, Subsequent Fractures, and Mortality in Patients Visiting the Fracture Liaison Service. J Pers Med 2024; 14:337. [PMID: 38672964 PMCID: PMC11050804 DOI: 10.3390/jpm14040337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 04/28/2024] Open
Abstract
The "can do, do do" framework combines measures of poor and normal physical capacity (PC, measured by a 6 min walking test, can do/can't do) and physical activity (PA, measured by accelerometer, do do/don't do) into four domains and is able to categorize patient subgroups with distinct clinical characteristics, including fall and fracture risk factors. This study aims to explore the association between domain categorization and prospective fall, fracture, and mortality outcomes. This 6-year prospective study included patients visiting a Fracture Liaison Service with a recent fracture. Outcomes were first fall (at 3 years of follow-up, measured by fall diaries), first subsequent fracture, and mortality (at 6 years). Cumulative incidences of all three outcomes were calculated. The association between domain categorization and time to the three outcomes was assessed by uni- and multivariate Cox proportional hazard analysis with the "can do, do do" group as reference. The physical performance of 400 patients with a recent fracture was assessed (mean age: 64 years; 70.8% female), of whom 61.5%, 20.3%, and 4.9% sustained a first fall, sustained a subsequent fracture, or had died. Domain categorization using the "can do, do do" framework was not associated with time to first fall, subsequent fracture, or mortality in the multivariate Cox regression analysis for all groups. "Can't do, don't do" group: hazard ratio [HR] for first fall: 0.75 (95% confidence interval [CI]: 0.45-1.23), first fracture HR: 0.58 (95% CI: 0.24-1.41), and mortality HR: 1.19 (95% CI: 0.54-6.95). Categorizing patients into a two-dimensional framework seems inadequate to study complex, multifactorial outcomes. A personalized approach based on known fall and fracture risk factors might be preferable.
Collapse
Affiliation(s)
- Merle R. Schene
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, P.O. Box 1926, 5900 BX Venlo, The Netherlands
- Internal Medicine and Geriatrics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Caroline E. Wyers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, P.O. Box 1926, 5900 BX Venlo, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Johanna H. M. Driessen
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
- Department of Clinical Pharmacy, CARIM School for Cardiovascular Research Institute Maastricht, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Lisanne Vranken
- Department of Internal Medicine, VieCuri Medical Center, P.O. Box 1926, 5900 BX Venlo, The Netherlands
| | - Kenneth Meijer
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Nutrition and Movement Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Joop P. van den Bergh
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Center, P.O. Box 1926, 5900 BX Venlo, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Hanna C. Willems
- Internal Medicine and Geriatrics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Bone Center, Amsterdam Movement Sciences, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| |
Collapse
|
8
|
Craighead DH, Freeberg KA, Heinbockel TC, Rossman MJ, Jackman RA, McCarty NP, Jankowski LR, Nemkov T, Reisz JA, D’Alessandro A, Chonchol M, Bailey EF, Seals DR. Time-Efficient, High-Resistance Inspiratory Muscle Strength Training Increases Exercise Tolerance in Midlife and Older Adults. Med Sci Sports Exerc 2024; 56:266-276. [PMID: 37707508 PMCID: PMC10840713 DOI: 10.1249/mss.0000000000003291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE This study aimed to determine if time-efficient, high-resistance inspiratory muscle strength training (IMST), comprising 30 inhalation-resisted breaths per day, improves cardiorespiratory fitness, exercise tolerance, physical function, and/or regional body composition in healthy midlife and older adults. METHODS We performed a double-blind, randomized, sham-controlled clinical trial (NCT03266510) testing 6 wk of IMST (30 breaths per day, 6 d·wk -1 , 55%-75% maximal inspiratory pressure) versus low-resistance sham training (15% maximal inspiratory pressure) in healthy men and women 50-79 yr old. Subjects performed a graded treadmill exercise test to exhaustion, physical performance battery (e.g., handgrip strength, leg press), and body composition testing (dual x-ray absorptiometry) at baseline and after 6 wk of training. RESULTS Thirty-five participants (17 women, 18 men) completed high-resistance IMST ( n = 17) or sham training ( n = 18). Cardiorespiratory fitness (V̇O 2peak ) was unchanged, but exercise tolerance, measured as treadmill exercise time during a graded exercise treadmill test, increased with IMST (baseline, 539 ± 42 s; end intervention, 606 ± 42 s; P = 0.01) but not sham training (baseline, 562 ± 39 s; end intervention, 553 ± 38 s; P = 0.69). IMST increased peak RER (baseline, 1.09 ± 0.02; end intervention, 1.13 ± 0.02; P = 0.012), peak ventilatory efficiency (baseline, 25.2 ± 0.8; end intervention, 24.6 ± 0.8; P = 0.036), and improved submaximal exercise economy (baseline, 23.5 ± 1.1 mL·kg -1 ⋅min -1 ; end intervention, 22.1 ± 1.1 mL·kg -1 ⋅min -1 ; P < 0.001); none of these factors were altered by sham training (all P > 0.05). Changes in plasma acylcarnitines (targeted metabolomics analysis) were consistently positively correlated with changes in exercise tolerance after IMST but not sham training. IMST was associated with regional increases in thorax lean mass (+4.4%, P = 0.06) and reductions in trunk fat mass (-4.8%, P = 0.04); however, peripheral muscle strength, muscle power, dexterity, and mobility were unchanged. CONCLUSIONS These data suggest that high-resistance IMST is an effective, time-efficient lifestyle intervention for improving exercise tolerance in healthy midlife and older adults.
Collapse
Affiliation(s)
- Daniel H. Craighead
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Kaitlin A. Freeberg
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Thomas C. Heinbockel
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Matthew J. Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Rachel A. Jackman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Narissa P. McCarty
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Lindsey R. Jankowski
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Travis Nemkov
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Julie A. Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - E. Fiona Bailey
- Department of Physiology, University of Arizona College of Medicine, Tucson, AZ
| | - Douglas R. Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| |
Collapse
|
9
|
Nevelikova M, Dosbaba F, Pepera G, Felsoci M, Batalikova K, Su JJ, Batalik L. Validity and reliability of automated treadmill six-minute walk test in patients entering exercise-based cardiac rehabilitation. Ann Med 2024; 55:2304664. [PMID: 38233732 PMCID: PMC10798278 DOI: 10.1080/07853890.2024.2304664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction: The six-minute walk test (6MWT) is a well-established tool for assessing submaximal functional capacity for cardiac patients, but space limitations challenge its implementation. Treadmill-based (TR) 6MWT is a promising alternative, but it requires patients to complete a familiarization test to adapt treadmill speed regulation. With the advancement of sensors, it is possible to automatically control speed for individual patients and thus overcome the space limitation or the speed control difficulty on the treadmill for each patient.Methods: This study investigated the validity and interchangeability of automated speed TR6MWT and standard hallway (HL) 6MWT. Eighteen patients were assessed at baseline of the 12-week cardiac rehabilitation program. Fourteen of them were assessed after rehabilitation. All patients performed three TR6MWTs and three HL6MWTs at baseline and one of each test after the program.Results: Patients well tolerated the TR6MWT. There was a strong correlation between both test methods (r = 0.79). However, patients performed significantly better in HL6MWT (514.8m ± 59.7m) than in TR6MWT (447.2 ± 79.1m) with 95% CI, 40.4-94.6m, p < 0.05. Both tests showed high test-retest reliability (intraclass correlation coefficient of 0.86). The TR6MWT showed a valuable comparison of the effect of the cardiac rehabilitation program (20% increase, effect size 1.1) even though it is not interchangeable with the HL6MWT.Conclusion: The automated speed TR6MWT appears to be an acceptable tool with adequate validity, reliability, and responsiveness for assessing functional capacity in patients utilizing cardiac rehabilitation programs.
Collapse
Affiliation(s)
- Marketa Nevelikova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Marian Felsoci
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
| | - Katerina Batalikova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| |
Collapse
|
10
|
Kubo H, Asai T, Fukumoto Y, Oshima K, Koyama S, Monjo H, Tajitsu H, Oka T. Value of the 3-min walk test and its association with motor functions in older adults. Physiother Theory Pract 2024; 40:144-152. [PMID: 35957533 DOI: 10.1080/09593985.2022.2110849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The 3-min walk test (3MWT) has been used in the clinical setting. OBJECTIVE To present the 3MWT value and investigate its association with motor and respiratory functions of healthy older adults. METHODS Two hundred six older adults and 27 younger adults were enrolled. The 3MWT was assessed by the walking distance within 3 min. Knee extension muscle strength (KEMS), 5-repetition sit-to-stand (5 R-STS), Timed Up and Go (TUG), forced vital capacity (FVC), forced expiratory volume 1.0 (FEV1.0), maximal expiratory pressure (MEP), and maximal inspiratory pressure (MIP) were measured. The 3MWT distance was examined by age group (18-39, 60-69, 70-79, and 80-89 years). A multivariate regression analysis investigated the association between 3MWT and motor function test. RESULTS The 3MWT values in each age group were 273-385, 233-414, 93-351, and 171-345 m for men and 215-375, 220-349, 198-325, and 174-332 m for women respectively. The 3MWT values were correlated with age, body mass index (BMI), KEMS, 5 R-STS, TUG, FVC, FEV1.0, MEP, and MIP. On the multivariate regression analysis, 3MWT was significantly associated with BMI (standard beta = -0.18; 95% confidence interval [CI], -3.20 to 0.83), KEMS (standard beta = 0.37; 95% CI, 0.06-0.13), 5 R-STS (standard beta = -0.13; 95% CI, -5.70 to -0.13), and TUG (standard beta = -0.36; 95% CI, -17.15 to -7.73) in older adults (adjusted R2 = 0.47). CONCLUSIONS The 3MWT distance decreased with age and was associated with motor and respiratory functions. No range trends were observed among groups. Our findings suggest that 3MWT reflects functional capacity.
Collapse
Affiliation(s)
- Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami City, Japan
- Researcher, Kansai Medical University, Hirakata City, Japan
| | - Tsuyoshi Asai
- Faculty of Rehabilitation, Kansai Medical University, Hirakata City, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe City, Japan
| | - Yoshihiro Fukumoto
- Faculty of Rehabilitation, Kansai Medical University, Hirakata City, Japan
| | | | - Shota Koyama
- Department of Rehabilitation, Saiseikai Hyogoken Hospital, Kobe-City, Japan
| | | | - Hirotsugu Tajitsu
- Department of Rehabilitation, Wakayama National Hospital, Hidakagun, Japan
| | - Tomohiro Oka
- Department of Rehabilitation Science, Faculty of Allied Health Sciences, Osaka Health Science University, Osaka-City, Japan
| |
Collapse
|
11
|
Cummings SR, Lui LY, Glynn NW, Mau T, Cawthon PM, Kritchevsky SB, Coen PM, Goodpaster B, Marcinek DJ, Hepple RT, Patel S, Newman AB. Energetics and Clinical Factors for the Time Required to Walk 400 Meters The Study of Muscle, Mobility and Aging (SOMMA). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.10.23298299. [PMID: 37986884 PMCID: PMC10659495 DOI: 10.1101/2023.11.10.23298299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Walking slows with aging often leading to mobility disability. Mitochondrial energetics has been found to influence gait speed over short distances. Additionally, walking is a complex activity but few clinical factors that may influence walk time have been studied. Methods We examined 879 participants ≥70 years and measured the time to walk 400m. We tested the hypothesis that decreased mitochondrial energetics by respirometry in muscle biopsies and magnetic resonance spectroscopy in the thigh, is associated with longer time to walk 400m. We also used cardiopulmonary exercise testing to assess the energetic costs of walking: maximum oxygen consumption (VO 2 peak) and energy cost-capacity (the ratio of VO2, at a slow speed to VO 2 peak). In addition, we tested the hypothesis that selected clinical factors would also be associated with 400m walk time. Results Lower Max OXPHOS was associated with longer walk time and the association was explained by the energetics costs of walking, leg power and weight. Additionally, a multivariate model revealed that longer walk time was also significantly associated with lower VO 2 peak, greater cost-capacity ratio, weaker leg power, heavier weight, hip and knee stiffness, peripheral neuropathy, greater perceived exertion while walking slowly, greater physical fatigability, less moderate-to-vigorous exercise, less sedentary time and anemia. Significant associations between age, sex, muscle mass, and peripheral artery disease with 400m walk time were explained by other clinical and physiologic factors. Conclusions Lower mitochondrial energetics is associated with needing more time to walk 400m. This supports the value of developing interventions to improve mitochondrial energetics. Additionally, doing more moderate-to-vigorous exercise, increasing leg power, reducing weight, treating hip and knee stiffness, and screening for and treating anemia may reduce the time required to walk 400m and reduce the risk of mobility disability.
Collapse
|
12
|
Coulshed A, Coulshed D, Pathan F. Systematic Review of the Use of the 6-Minute Walk Test in Measuring and Improving Prognosis in Patients With Ischemic Heart Disease. CJC Open 2023; 5:816-825. [PMID: 38020329 PMCID: PMC10679465 DOI: 10.1016/j.cjco.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/10/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The 6-minute walk test (6MWT) has been used for over 30 years to assess exercise capacity in patients with respiratory disease, and more recently, in those with heart failure. However, despite being a simple and reproducible test of real-world exercise capacity, its use in patients with ischemic heart disease (IHD) is less well accepted. We sought to review systematically the evidence surrounding the 6MWT in IHD. Methods We searched the Medline, PubMed, Embase, and Scopus databases for the following key terms: "six minute walk test/6 minute walk test/6MWT" and "angina/coronary artery disease/coronary disease/IHD/ischemic heart disease." We followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to select publications for full-text review and analyzed the collated data. Results A total of 1228 unique papers were found, of which 71 were chosen for full-text review and 37 for detailed analysis. Most (23) concerned the effect on 6MWT distance (6MWTd) of cardiac rehabilitation, with measurements commenced after an intervention (acute myocardial infarction, n = 4; open heart surgery (OHS), n = 5; percutaneous coronary intervention (PCI), n = 3; or other, n = 11). The effect on 6MWTd of OHS was investigated in 6 studies and of PCI in one study. The 6MWT is a useful measurement of physical capacity; data are limited on its ability to assess benefit following PCI. Conclusions The 6MWT has been studied inconsistently in IHD. The majority of data are on patients before and after CR. Data are limited concerning the effect on 6MWTd of OHS or PCI. The available data support the 6MWT as a measure of change in performance status following coronary intervention. More work is required to confirm this hypothesis.
Collapse
Affiliation(s)
- Andrew Coulshed
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - David Coulshed
- Department of Cardiology, Nepean Hospital, University of Sydney, Penrith, New South Wales, Australia
| | - Faraz Pathan
- Department of Cardiology, Nepean Hospital, University of Sydney, Penrith, New South Wales, Australia
| |
Collapse
|
13
|
Browne J, Elbogen EB, Mueser KT, Rudolph JL, Wu WC, Philip NS, Mills WL, Sloane R, Hall KS. Physical Function Assessment of Older Veterans With Serious Mental Illness. Am J Geriatr Psychiatry 2023; 31:657-666. [PMID: 36941144 PMCID: PMC10474249 DOI: 10.1016/j.jagp.2023.02.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To characterize the physical function of older veterans with serious mental illness (SMI) across endurance, strength, and mobility domains. DESIGN Retrospective analysis of clinical performance data. SETTING Gerofit program, a national outpatient supervised exercise program for older veterans, delivered in Veterans Health Administration sites. PARTICIPANTS Older veterans aged 60 and older (n = 166 with SMI, n = 1,441 without SMI) enrolled across eight national Gerofit sites between 2010 and 2019. MEASUREMENTS Performance measures of physical function covering endurance (6-minute walk test), strength (chair stands, arm curls), and mobility (10-m walk, 8-foot-up-and-go), were administered at Gerofit enrollment. Baseline data from these measures were analyzed to characterize the functional profiles of older veterans with SMI. One sample t tests were examined to compare functional performance of older veterans with SMI to age- and sex-based reference scores. Propensity score matching (1:3) and linear mixed effects models were used to evaluate differences in function between veterans with and without SMI. RESULTS Older veterans with SMI performed worse on all measures of function (chair stands, arm curls, 10-m walk, 6-minute walk test, 8-foot-up-and-go) compared to age- and sex-based reference scores with statistically significant differences present in the male sample. Functional performance of those with SMI was also worse compared to propensity-score matched older veterans without SMI with statistically significant differences on chair stands, 6-minute walk test, and 10-m walk. CONCLUSION Older veterans with SMI have compromised strength, mobility, and endurance. Physical function should be a core component of screening and treatment for this population.
Collapse
Affiliation(s)
- Julia Browne
- Research Service, VA Providence Healthcare System, Providence, RI; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI; Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC.
| | - Eric B Elbogen
- Durham VA Health Care System, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation and Departments of Occupational Therapy, Psychology, and Psychiatry, Boston University, Boston, MA
| | - James L Rudolph
- Center of Innovation in Long Term Services and Supports, VA Providence Healthcare System, Providence, RI
| | - Wen-Chih Wu
- Medical Service, VA Providence Healthcare System, Providence, RI
| | - Noah S Philip
- VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI
| | - Whitney L Mills
- Center of Innovation in Long Term Services and Supports, VA Providence Healthcare System, Providence, RI; Department of Health Services, Policy & Practice, Brown University, Providence, RI
| | - Richard Sloane
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
| | - Katherine S Hall
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC; Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
| |
Collapse
|
14
|
Lin JC, Chen IH, Cheng FY. Review articles (Meta-Analyses) effects of walking on cognitive function in individuals with mild cognitive impairment: a systematic review and meta-analysis. BMC Geriatr 2023; 23:500. [PMID: 37605156 PMCID: PMC10441758 DOI: 10.1186/s12877-023-04235-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Previous studies have shown that regular exercise can improve cognition and physical performance in older adults. Walking is a low-technology and low-cost exercise that has been proven to improve cognition and mobility in healthy elderly individuals. However, no systematic review or meta-analysis has explored whether walking can improve cognitive function in older adults with MCI. This study aimed to explore the effects of walking interventions on cognitive functions in individuals with MCI. METHODS In accordance with the PRISMA guidelines, MEDLINE, PubMed, SPORTDiscus, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan were searched from inception to July 2023. Independent reviewers selected randomized clinical trials (RCT) that compared the effects of walking with no intervention or other exercises in individuals with MCI. The primary outcomes were cognitive functions, and the secondary outcome was walking endurance. Three reviewers independently conducted data extraction. The risk of bias was assessed using the Revised Cochrane Risk of Bias assessment tool. RESULTS Fourteen RCTs were included in this review. The quality of evidence in these studies was rated as good to excellent. The results of the meta-analysis showed that the individuals with MCI had no significant improvement in cognitive function but had significant improvement in the 6-min walk test (Mean Difference=23.70, p=0.008) after walking interventions compared to no intervention or other exercises. CONCLUSION Walking intervention has no significant improvement on cognitive functions in older adults with MCI. However, walking induces beneficial effects on aerobic capacity. TRIAL REGISTRATION This systematic review has the registration number CRD42021283753 on PROSPERO.
Collapse
Affiliation(s)
- Jia-Chi Lin
- MacKay Medical College, Institute of Long-Term Care, No.46, Sec. 3, Zhongzheng Rd, Sanzhi Dist, New Taipei City, 252, Taiwan
| | - I-Hsuan Chen
- Department of Physical Therapy, Fooyin University, Kaohsiung City, Taiwan
| | - Fang-Yu Cheng
- MacKay Medical College, Institute of Long-Term Care, No.46, Sec. 3, Zhongzheng Rd, Sanzhi Dist, New Taipei City, 252, Taiwan.
| |
Collapse
|
15
|
Lopez P, Rech A, Petropoulou M, Newton RU, Taaffe DR, Galvão DA, Turella DJP, Freitas SR, Radaelli R. Does High-Velocity Resistance Exercise Elicit Greater Physical Function Benefits Than Traditional Resistance Exercise in Older Adults? A Systematic Review and Network Meta-Analysis of 79 Trials. J Gerontol A Biol Sci Med Sci 2023; 78:1471-1482. [PMID: 36378500 PMCID: PMC10395570 DOI: 10.1093/gerona/glac230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND A systematic review and network meta-analysis was undertaken to examine the effectiveness of different modes of resistance exercise velocity in fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests in older adults. METHODS CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus, and Web of Science databases were searched up to February 2022. Eligible randomized trials examined the effects of supervised high-velocity or traditional resistance exercise in older adults (ie, ≥60 years). The primary outcome for this review was physical function measured by fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests, while maximal muscle power and muscle strength were secondary. A random-effects network meta-analysis was undertaken to examine the effects of different resistance exercise interventions. RESULTS Eighty articles describing 79 trials (n = 3 575) were included. High-velocity resistance exercise was the most effective for improving fast walking speed (standardized mean difference [SMD] -0.44, 95% confidence interval [CI]: 0.00 to 0.87), timed-up and go (SMD -0.76, 95% CI: -1.05 to -0.47), and 5-times sit-to-stand (SMD -0.74, 95% CI: -1.20 to -0.27), while traditional resistance exercise was the most effective for 30-second sit-to-stand (SMD 1.01, 95% CI: 0.68 to 1.34) and 6-minute walking (SMD 0.68, 95% CI: 0.34 to 1.03). CONCLUSION Our study provides evidence that resistance exercise velocity effects are specific in older adults, as evidenced by physical function test dependence. We suggest that prescriptions based on the velocity of contraction should be individualized to address the specific functional needs of participants.
Collapse
Affiliation(s)
- Pedro Lopez
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Anderson Rech
- Curso de Educação Física, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
| | - Maria Petropoulou
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Douglas J P Turella
- Curso de Educação Física, Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
| | - Sandro R Freitas
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada Dafundo, Portugal
| | - Régis Radaelli
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada Dafundo, Portugal
- CIPER, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada, Dafundo, Portugal
| |
Collapse
|
16
|
LaMonte MJ. Cardiorespiratory Fitness in the Prevention and Management of Cardiovascular Disease. Rev Cardiovasc Med 2022; 23:382. [PMID: 39076181 PMCID: PMC11269081 DOI: 10.31083/j.rcm2311382] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 07/31/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death among adults in the U.S. and elsewhere. Variation in the presence, severity, and control of major modifiable risk factors accounts for much of the variation in CVD rates worldwide. Cardiorespiratory fitness (CRF) reflects the integration of ventilation, circulation, and metabolism for the delivery and utilization of oxygen in support of dynamic aerobic physical activity. The gold standard measure of CRF is maximal oxygen uptake. Because the primary factor underlying differences in this measure between individuals is maximal cardiac output, it can serve as a clinical indicator of cardiac function. Higher CRF is associated with favorable levels of major CVD risk factors, lower prevalence and severity of subclinical atherosclerosis, and lower risks of developing both primary and secondary clinical CVD events. The beneficial associations between CRF and CVD are seen in women and men, older and younger adults, in those with multiple coexisting risk factors or prior diagnosis of CVD. Exercise training and regular physical activity of at least moderate intensities and volumes improves CRF in adults, and improvements in CRF are associated with lower risks of subsequent CVD and mortality. Routine assessment of CRF in primary care settings could enhance individual-level CVD risk assessment and thereby guide implementation of appropriate measures to prevent future clinical events.
Collapse
Affiliation(s)
- Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo – SUNY, Buffalo, NY 14214, USA
| |
Collapse
|
17
|
McKenzie BA, Chen FL. Assessment and Management of Declining Physical Function in Aging Dogs. Top Companion Anim Med 2022; 51:100732. [DOI: 10.1016/j.tcam.2022.100732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/13/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
|
18
|
Fukuoka Y, Katzman WB, Gladin A, Lane NE, Yoo JO. Factors associated with the 6-minute walk test performance in older adults with hyperkyphosis. Geriatr Nurs 2022; 47:95-99. [PMID: 35901578 PMCID: PMC9675409 DOI: 10.1016/j.gerinurse.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/20/2022]
Abstract
Age-related hyperkyphosis is associated with adverse health outcomes, such as falls, fractures, and mortality. However, few studies investigated the relationship between the severity of hyperkyphosis and physical endurance in older adults. This study examined whether a degree of hyperkyphosis curvature was independently associated with the 6-minute walk test (6MWT) distance. We analyzed the baseline data of 112 older adults aged 60-92 enrolled in the Specialized Center of Research (SCOR) Kyphosis trial. The majority of the sample had at least a college degree and were white. On average, participants walked 503.9 (SD 82.3) meters in 6 minutes. Multivariate regression results showed that the degree of hyperkyphosis curvature was not independently associated with the 6MWT distance, but taller height, lighter weight, and less prescription medication were significant predictors of better performance on the 6MWT distance. Validation of the study findings in a large, diverse older adult population is warranted.
Collapse
Affiliation(s)
- Yoshimi Fukuoka
- Department of Physiological Nursing, University of California, San Francisco, CA, USA.
| | - Wendy B Katzman
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, CA, USA
| | - Amy Gladin
- Department of Pain Medicine, Kaiser Permanente Northern California, San Francisco Medical Center, San Francisco, CA, USA
| | - Nancy E Lane
- Department of Medicine, Division of Rheumatology and Immunology, School of Medicine, University of California, Davis, CA, USA
| | - Jung Oh Yoo
- Department of Communication, University of California, Davis, CA, USA
| |
Collapse
|
19
|
Yu P, Liang P, Pang S, Yuan W, Zhao Y, Huang Q. The Function, Role and Process of DDX58 in Heart Failure and Human Cancers. Front Oncol 2022; 12:911309. [PMID: 35814394 PMCID: PMC9257035 DOI: 10.3389/fonc.2022.911309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Heart failure (HF) is the most common outcome of cardiovascular disease, and an increasing number of patients with heart failure die from noncardiac causes, such as cancer. Epidemiological data suggest that ischemic cardiomyopathy–induced HF (ischemic HF) may be associated with an increased incidence of cancer. This study aimed to investigate the possible mechanisms of the association between ischemic HF and cancer, as well as potential therapeutic targets. Methods Weighted gene co-expression network analysis was performed to analyze the correlations between phenotypes and gene modules using immune cells as phenotypes. Differential analysis was then performed to screen differentially expressed genes (DEGs) in ischemic HF and normal control samples. The macrophage-related Brown module was identified as the key module, and immune-related DEGs were obtained by taking the intersection of the Brown module, DEGs, and immune-related genes using a Venn diagram. DDX58 was identified as the key gene using a protein–protein interaction network and expression analyses and validated using immunohistochemistry. Kaplan–Meier survival analysis was performed to analyze the correlation between DDX58 expression and tumor prognosis. Spearman correlation analysis was performed to assess the correlation between DDX58 expression and immune cell infiltration. Results DDX58 was identified as a key immune-related gene associated with ischemic HF and was highly expressed in most cancer types. The survival analysis revealed a significant negative correlation between high DDX58 expression and prognosis in multiple tumor types. Moreover, DDX58 expression was significantly associated with immune cell infiltration and immune checkpoint gene expression in many cancer types. Conclusion DDX58 is a key immune-related gene in ischemic HF and may play a crucial role in the relationship between ischemic HF and cancer. Pan-cancer analysis suggests that DDX58 is a promising clinical prognostic marker for most cancers and may be a therapeutic target for cancer patients and ischemic HF patients at an increased risk of cancer.
Collapse
Affiliation(s)
- Ping Yu
- Department of Cardiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Peng Liang
- Department of Cardiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shifeng Pang
- Department of Cardiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenjian Yuan
- Department of Cardiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuxiang Zhao
- United New Drug Research and Development Center, Biotrans Technology Co., LTD., Ningbo, China
- Institute of Bioengineering, Biotrans Technology Co., LTD., Ningbo, China
- *Correspondence: Yuxiang Zhao, ; Qiaojuan Huang,
| | - Qiaojuan Huang
- Department of Cardiology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Yuxiang Zhao, ; Qiaojuan Huang,
| |
Collapse
|
20
|
Núñez-Cortés R, Malhue-Vidal C, Gath F, Valdivia-Lobos G, Torres-Castro R, Cruz-Montecinos C, Martinez-Arnau FM, Pérez-Alenda S, López-Bueno R, Calatayud J. The Impact of Charlson Comorbidity Index on the Functional Capacity of COVID-19 Survivors: A Prospective Cohort Study with One-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127473. [PMID: 35742722 PMCID: PMC9223623 DOI: 10.3390/ijerph19127473] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023]
Abstract
Objective: To determine the association between the Charlson comorbidity index (CCI) score after discharge with 6-min walk test (6MWT) 1 year after discharge in a cohort of COVID-19 survivors. Methods: In this prospective study, data were collected from a consecutive sample of patients hospitalized for COVID-19. The CCI score was calculated from the comorbidity data. The main outcome was the distance walked in the 6MWT at 1 year after discharge. Associations between CCI and meters covered in the 6MWT were assessed through crude and adjusted linear regressions. The model was adjusted for possible confounding factors (sex, days of hospitalization, and basal physical capacity through sit-to-stand test one month after discharge). Results: A total of 41 patients were included (mean age 58.8 ± 12.7 years, 20/21 men/women). A significant association was observed between CCI and 6MWT (meters): (i) crude model: β = −18.7, 95% CI = −34.7 to −2.6, p < 0.05; (ii) model adjusted for propensity score including sex, days of hospitalization, and sit-to-stand: β = −23.0, 95% CI = −39.1 to −6.8, p < 0.05. Conclusions: A higher CCI score after discharge indicates worse performance on the 6MWT at 1-year follow-up in COVID-19 survivors. The CCI score could also be used as a screening tool to make important clinical decisions.
Collapse
Affiliation(s)
- Rodrigo Núñez-Cortés
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (R.N.-C.); (C.C.-M.); (F.M.M.-A.); (S.P.-A.)
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380286, Chile;
- Service of Physical Therapy, Hospital Clínico La Florida, Santiago 8240000, Chile; (C.M.-V.); (F.G.); (G.V.-L.)
| | - Constanza Malhue-Vidal
- Service of Physical Therapy, Hospital Clínico La Florida, Santiago 8240000, Chile; (C.M.-V.); (F.G.); (G.V.-L.)
| | - Florencia Gath
- Service of Physical Therapy, Hospital Clínico La Florida, Santiago 8240000, Chile; (C.M.-V.); (F.G.); (G.V.-L.)
| | - Gonzalo Valdivia-Lobos
- Service of Physical Therapy, Hospital Clínico La Florida, Santiago 8240000, Chile; (C.M.-V.); (F.G.); (G.V.-L.)
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380286, Chile;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (R.N.-C.); (C.C.-M.); (F.M.M.-A.); (S.P.-A.)
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380286, Chile;
- Section of Research, Innovation and Development in Kinesiology, Kinesiology Unit, San José Hospital, Santiago 8380286, Chile
| | - Francisco M. Martinez-Arnau
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (R.N.-C.); (C.C.-M.); (F.M.M.-A.); (S.P.-A.)
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (R.N.-C.); (C.C.-M.); (F.M.M.-A.); (S.P.-A.)
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark;
- Correspondence:
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark;
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| |
Collapse
|
21
|
Brown RC, Coombes JS, Jungbluth Rodriguez K, Hickman IJ, Keating SE. Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing. Br J Sports Med 2022; 56:bjsports-2021-105118. [PMID: 35715175 DOI: 10.1136/bjsports-2021-105118] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the effectiveness of videoconferencing exercise interventions for people with chronic diseases. DESIGN Systematic review incorporating meta-analysis. DATA SOURCES PubMed, Cinahl, MEDLINE, Web of Science, Embase and Scopus. ELIGIBILITY CRITERIA The current literature was searched following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Trials analysing participants with chronic disease undergoing aerobic and/or resistance exercise training over videoconferencing, with exercise capacity and/or quality of life outcomes were included. Meta-analyses were conducted for between-group comparisons of exercise capacity and quality of life. Risk of bias was analysed using the Downs and Black quality checklist and the certainty of evidence with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RESULTS Thirty-two trials were included in this review, of which 12 were comparator trials. Small-moderate between-group (videoconferencing vs comparator) effects favouring videoconferencing were seen for studies using a non-exercising comparator for exercise capacity (standardised mean difference (SMD)=0.616, 95% CI 0.278 to 0.954; p=<0.001) and quality of life (SMD=0.400, 95% CI 0.099 to 0.701; p=0.009). Small effects favouring videoconferencing were observed for studies using an exercising comparator for quality of life (SMD=0.271, 95% CI 0.028 to 0.515; p=0.029) and exercise capacity (SMD=0.242, 95% CI 0.059 to 0.426; p=0.009). Moderate risk of bias was identified for included studies (16.3±3.6/28), with GRADE certainty ratings of 'low' (quality of life) and 'moderate' (exercise capacity). Session attendance was 70% and was reported in 23 trials. No serious adverse events relating to videoconferencing were found. Nine trials documented the total number of technical issues that occurred in 17% of the sessions. Positive satisfaction outcomes were associated with ease of access and usefulness of technology. CONCLUSION In patients with chronic disease, videoconferencing exercise interventions appear to be feasible and effective for improving exercise capacity and quality of life. More robust methodology is needed in future studies to improve the certainty of the evidence. PROSPERO REGISTRATION NUMBER CRD42020191243.
Collapse
Affiliation(s)
- Riley Cc Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Klaus Jungbluth Rodriguez
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
- Mater Research Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
| |
Collapse
|
22
|
Impact of Exercise Intervention-Based Changes on Physical Function Biomarkers in Older Adults After Hospital Discharge: A Systematic Review with Meta-Analysis of Randomized Clinical Trials. Ageing Res Rev 2022; 80:101673. [PMID: 35718328 DOI: 10.1016/j.arr.2022.101673] [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: 03/27/2022] [Revised: 05/20/2022] [Accepted: 06/13/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND This systematic review with meta-analysis aimed to compare the changes caused by exercise interventions with those provoked by usual care on physical function biomarkers in older adults immediately after hospital discharge. METHODS Two independent authors performed a systematic search (PubMed, Scopus, Web of Science, and SciELO) of studies published from database inception until August 2021. Randomized clinical trials investigating the effects of an exercise intervention compared to usual care were included. The Cochrane Collaboration assessment tool was used to analyze the risk of bias. The comparisons included handgrip strength, the short physical performance battery scale, six-minute walking test, and 10-m gait speed. RESULTS Overall, the exercise intervention led to significantly greater changes compared to usual care in physical function biomarkers [standard mean difference = 0.89, 95% CI = 0.39, 1.42; P = 0.001]. However, considering the very few studies investigating each variable separately, our sub-analysis did not reveal a significant effect of the exercise intervention on handgrip strength, the short physical performance battery, six minutes walking test, and 10-m gait speed. CONCLUSIONS This systematic review with meta-analysis of randomized clinical trials suggests that exercise interventions after hospital discharge induce greater physical function biomarker alterations in older adults after hospitalization than usual care including physical activity guidance. Future trials comparing the effects of these intervention groups on physical function biomarkers in this population are needed to confirm our results.
Collapse
|
23
|
Telles LGDS, Billaut F, Cunha G, Ribeiro ADS, Monteiro ER, Barreto AC, Leitão L, Panza P, Vianna JM, Novaes JDS. Ischemic Preconditioning Improves Handgrip Strength and Functional Capacity in Active Elderly Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116628. [PMID: 35682213 PMCID: PMC9180149 DOI: 10.3390/ijerph19116628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023]
Abstract
Background: Aging decreases some capacities in older adults, sarcopenia being one of the common processes that occur and that interfered with strength capacity. The present study aimed to verify the acute effect of IPC on isometric handgrip strength and functional capacity in active elderly women. Methods: In a single-blind, placebo-controlled design, 16 active elderly women (68.1 ± 7.6 years) were randomly performed on three separate occasions a series of tests: (1) alone (control, CON); (2) after IPC (3 cycles of 5-min compression/5-min reperfusion at 15 mmHg above systolic blood pressure, IPC); and (3) after placebo compressions (SHAM). Testing included a handgrip isometric strength test (HIST) and three functional tests (FT): 30 s sit and stand up from a chair (30STS), get up and go time (TUG), and 6 min walk distance test (6MWT). Results: HIST significantly increased in IPC (29.3 ± 6.9 kgf) compared to CON (27.3 ± 7.1 kgf; 7.1% difference; p = 0.01), but not in SHAM (27.7 ± 7.9; 5.5%; p = 0.16). The 30STS increased in IPC (20.1 ± 4.1 repetitions) compared to SHAM (18.5 ± 3.5 repetitions; 8.7%; p = 0.01) and CON (18.5 ± 3.9 repetitions; 8.6%; p = 0.01). TUG was significantly lower in IPC (5.70 ± 1.35 s) compared to SHAM (6.14 ± 1.37 s; −7.2%; p = 0.01), but not CON (5.91 ± 1.45 s; −3.7%; p = 0.24). The 6MWT significantly increased in IPC (611.5 ± 93.8 m) compared to CON (546.1 ± 80.5 m; 12%; p = 0.02), but not in SHAM (598.7 ± 67.6 m; 2.1%; p = 0.85). Conclusions: These data suggest that IPC can promote acute improvements in handgrip strength and functional capacity in active elderly women.
Collapse
Affiliation(s)
- Luiz Guilherme da Silva Telles
- Physical Education and Sports Department, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (L.G.d.S.T.); (E.R.M.); (J.d.S.N.)
- Estácio de Sá University (UNESA), Rio de Janeiro 20261-063, Brazil;
| | - François Billaut
- Department of Kinesiology, Laval University, Quebec, QC G1V 0A6, Canada;
| | - Gélio Cunha
- Estácio de Sá University (UNESA), Rio de Janeiro 20261-063, Brazil;
| | - Aline de Souza Ribeiro
- Physical Education and Sports Department, Federal University of Juiz de Fora, São Pedro 36036-900, Brazil; (A.d.S.R.); (P.P.); (J.M.V.)
| | - Estêvão Rios Monteiro
- Physical Education and Sports Department, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (L.G.d.S.T.); (E.R.M.); (J.d.S.N.)
- Department of Physical Therapy, University Center of Augusto Motta of UNISUAM, Rio de Janeiro 21041-020, Brazil
| | | | - Luís Leitão
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
- Correspondence:
| | - Patrícia Panza
- Physical Education and Sports Department, Federal University of Juiz de Fora, São Pedro 36036-900, Brazil; (A.d.S.R.); (P.P.); (J.M.V.)
| | - Jeferson Macedo Vianna
- Physical Education and Sports Department, Federal University of Juiz de Fora, São Pedro 36036-900, Brazil; (A.d.S.R.); (P.P.); (J.M.V.)
| | - Jefferson da Silva Novaes
- Physical Education and Sports Department, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (L.G.d.S.T.); (E.R.M.); (J.d.S.N.)
| |
Collapse
|
24
|
Powell TA, Mysliwiec V, Brock MS, Morris MJ. OSA and cardiorespiratory fitness: a review. J Clin Sleep Med 2022; 18:279-288. [PMID: 34437054 PMCID: PMC8807904 DOI: 10.5664/jcsm.9628] [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: 01/03/2023]
Abstract
The effects of untreated obstructive sleep apnea (OSA) on cardiopulmonary function remain unclear. Cardiorespiratory fitness (CRF), commonly reflected by VO2 max measured during cardiopulmonary exercise testing, has gained popularity in evaluating numerous cardiopulmonary conditions and may provide a novel means of identifying OSA patients with the most clinically significant disease. This emerging testing modality provides simultaneous assessment of respiratory and cardiovascular function with results helping uncover evidence of evolving pathology in either organ system. In this review, we highlight the current state of the literature in regard to OSA and CRF with a specific focus on changes in cardiovascular function that have been previously noted. While OSA does not appear to limit respiratory function during exercise, studies seem to suggest an abnormal cardiovascular exercise response in this population including decreased cardiac output, a blunted heart rate response (ie, chronotropic incompetence), and exaggerated blood pressure response. Surprisingly, despite these observed changes in the cardiovascular response to exercise, results involving VO2 max in OSA remain inconclusive. This is reflected by VO2 max studies involving middle-aged OSA patients showing both normal and reduced CRF. As prior studies have not extensively characterized oxygen desaturation burden, we propose that reductions in VO2 max may exist in OSA patients with only the most significant disease (as reflected by nocturnal hypoxia). Further characterizing this relationship remains important as some research suggests that positive airway pressure therapy or aerobic exercise may improve CRF in patients with OSA. In conclusion, while it likely that severe OSA, via an abnormal cardiovascular response to exercise, is associated with decreased CRF, further study is clearly warranted to include determining if OSA with decreased CRF is associated with increased morbidity or mortality. CITATION Powell TA, Mysliwiec V, Brock MS, Morris MJ. OSA and cardiorespiratory fitness: a review. J Clin Sleep Med. 2022;18(1):279-288.
Collapse
Affiliation(s)
- Tyler A. Powell
- Sleep Medicine Service, Wilford Hall Ambulatory Surgery Center, JBSA Lackland Air Force Base, Texas,Address correspondence to: Tyler A. Powell, MD, Sleep Medicine Service, Wilford Hall Ambulatory Service Center, JBSA Lackland Air Force Base, TX 78234; ,
| | - Vincent Mysliwiec
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Matthew S. Brock
- Sleep Medicine Service, Wilford Hall Ambulatory Surgery Center, JBSA Lackland Air Force Base, Texas
| | - Michael J. Morris
- Graduate Medical Education, Brooke Army Medical Center, JBSA Fort Sam Houston, Texas
| |
Collapse
|
25
|
Rosmaninho I, Ribeirinho-Soares P, Nunes JPL. Walking Speed and Mortality: An Updated Systematic Review. South Med J 2021; 114:697-702. [PMID: 34729613 DOI: 10.14423/smj.0000000000001318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of our systematic review was to update the current evidence on the association between slow walking speed (WS) and mortality, expanding the current knowledge available in the literature. METHODS A systematic review of the published data on the association of WS and mortality was carried out by searching on PubMed and ISI Web of Knowledge databases. RESULTS From a title and abstract analysis, 61 articles were included that met the prespecified criteria. After a full-text analysis, 6 articles were excluded and the remaining articles accounted for 120,838 patients and > 25,148 deaths were registered. The duration of follow-ups ranged between 2 and 21 years. In general, studies have shown a consistent association between WS and mortality from all causes. CONCLUSIONS WS showed continuous and consistent evidence to be a good predictor of mortality. As such, our study supports the use of this tool in clinical practice as a way to improve health care.
Collapse
Affiliation(s)
- Irene Rosmaninho
- From the Faculdade de Medicina da Universidade do Porto, and the Centro Hospitalar Universitário São João, Porto, Portugal
| | - Pedro Ribeirinho-Soares
- From the Faculdade de Medicina da Universidade do Porto, and the Centro Hospitalar Universitário São João, Porto, Portugal
| | - José Pedro L Nunes
- From the Faculdade de Medicina da Universidade do Porto, and the Centro Hospitalar Universitário São João, Porto, Portugal
| |
Collapse
|
26
|
Sokas D, Paliakaitė B, Rapalis A, Marozas V, Bailón R, Petrėnas A. Detection of Walk Tests in Free-Living Activities Using a Wrist-Worn Device. Front Physiol 2021; 12:706545. [PMID: 34456748 PMCID: PMC8397518 DOI: 10.3389/fphys.2021.706545] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Exercise testing to assess the response to physical rehabilitation or lifestyle interventions is administered in clinics thus at best can be repeated only few times a year. This study explores a novel approach to collecting information on functional performance through walk tests, e.g., a 6-min walk test (6MWT), unintentionally performed in free-living activities. Walk tests are detected in step data provided by a wrist-worn device. Only those events of minute-to-minute variation in walking cadence, which is equal or lower than the empirically determined maximal SD (e.g., 5-steps), are considered as walk test candidates. Out of detected walk tests within the non-overlapping sliding time interval (e.g., 1-week), the one with the largest number of steps is chosen as the most representative. This approach is studied on a cohort of 99 subjects, assigned to the groups of patients with cardiovascular disease (CVD) and healthy subjects below and over 40-years-old, who were asked to wear the device while maintaining their usual physical activity regimen. The total wear time was 8,864 subject-days after excluding the intervals of occasionally discontinued monitoring. About 82% (23/28) of patients with CVD and 88% (21/24) of healthy subjects over 40-years-old had at least a single 6MWT over the 1st month of monitoring. About 52% of patients with CVD (12/23) and 91% (19/21) of healthy subjects over 40-years-old exceeded 500 m. Patients with CVD, on average, walked 46 m shorter 6MWT distance (p = 0.04) compared to healthy subjects. Unintentional walk testing is feasible and could be valuable for repeated assessment of functional performance outside the clinical setting.
Collapse
Affiliation(s)
- Daivaras Sokas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Birutė Paliakaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Andrius Rapalis
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| | - Vaidotas Marozas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| | - Raquel Bailón
- Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - Andrius Petrėnas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania.,Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
| |
Collapse
|
27
|
Mirdamadi A, Shirzad M, Abrishamkar R, Behjati M. Flow-Mediated Dilation, a Marker of Endothelial Cell Dysfunction, in Patients with Pulmonary Hypertension. TANAFFOS 2021; 20:332-336. [PMID: 36267930 PMCID: PMC9577205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 04/03/2021] [Indexed: 10/29/2022]
Abstract
Background Flow-mediated dilation (FMD) is considered a marker of endothelial cell dysfunction (ECD) and has been mostly evaluated in coronary artery disease. The role of ECD in the pathogenesis of pulmonary hypertension (PH) is not well-known. This study sought to evaluate the relationship between FMD and PH. Materials and Methods In this cross-sectional study, the FMD of the brachial artery was measured in 40 confirmed PH patients. Meanwhile, echocardiographic findings, the 6-minute walk test (6MWT), and serum pro-brain natriuretic peptide (pro-BNP) level were evaluated. Overall, 20 patients accomplished all evaluations, and their data were analyzed using SPSS software (version 23). Results There was an inverse relationship between pro-BNP and 6MWT (r<0, P<0.05). A significant direct relationship was observed between left ventricular ejection fraction and FMD (P=0.031). Right ventricular (RV) dilation was significantly correlated with pro-BNP (P=0.046). There was a significant direct correlation between RV function and FMD and a significant inverse relationship between pro-BNP and FMD (P=0.05). The independent t-test showed no relationship between FMD and syncope (P=0.75). Conclusion Endothelial cell function, which can be evaluated by FMD, was involved in patients with PH. The FMD and 6MWT were helpful as objective prognostic markers in PH. Furthermore, pro-BNP was a noninvasive indicator in the diagnosis of RV systolic dysfunction.
Collapse
Affiliation(s)
- Ahmad Mirdamadi
- Department of Cardiology, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran
| | - Mohammad Shirzad
- Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran
| | - Raana Abrishamkar
- Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran,,Correspondence to: Abrishamkar R Address: Najafabad Branch, Islamic Azad University, Isfahan, Iran Email address:
| | - Mohaddeseh Behjati
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
28
|
Nakano J, Fukushima T, Tanaka T, Fu JB, Morishita S. Physical function predicts mortality in patients with cancer: a systematic review and meta-analysis of observational studies. Support Care Cancer 2021; 29:5623-5634. [PMID: 33770257 DOI: 10.1007/s00520-021-06171-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/18/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE This systematic review and meta-analysis aimed to determine whether physical function can predict mortality in patients with cancer. METHODS Literature searches were conducted in Web of Science, CINAHL, the Cochrane Library, ProQuest, PEDro, and PubMed for articles published before September 2020. Four review authors retrieved studies using predetermined eligibility criteria and conducted quality assessment and data extraction. RESULTS A total of 1356 titles and abstracts were screened; ultimately, 26 studies were determined to be suitable for meta-analysis. Grip strength was significantly associated with mortality risk in patients with cancer (hazard ratio [HR] = 1.15, P = 0.005). Gait speed was also associated with mortality risk (HR = 1.58, P = 0.0004). In grip strength and gait speed, the subgroup comprised of patients with cancer aged ≥ 80 years had a higher effect size than that of patients aged < 80 years. The short physical performance battery measurement was markedly associated with mortality risk, showing the largest effect size (HR = 2.37, P < 0.00001). The 6-min walking test distance was significantly associated with mortality risk (HR = 1.55, P = 0.001). The timed up and go test was significantly associated with mortality risk with a high effect size (HR = 2.66, P < 0.00001). CONCLUSION This systematic review and meta-analysis demonstrated that physical function predicted mortality in patients with cancer. Furthermore, physical function outcomes in patients aged 80 years and above reflected a higher mortality.
Collapse
Affiliation(s)
- Jiro Nakano
- Department of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Takuya Fukushima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Jack B Fu
- Department of Palliative, Rehabilitation & Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shinichiro Morishita
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.
| |
Collapse
|
29
|
Araya-Ramírez F, Moncada-Jiménez J, Grandjean PW, Franklin BA. Improved Walk Test Performance and Blood Pressure Responses in Men and Women Completing Cardiac Rehabilitation: Implications Regarding Exercise Trainability. Am J Lifestyle Med 2021; 16:772-778. [DOI: 10.1177/1559827621995129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/26/2020] [Accepted: 01/27/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose. To evaluate changes in walk test performance and blood pressure (BP) responses following a 12-week exercise-based outpatient cardiac rehabilitation (CR) program. Methods. Six-Minute Walk Test (6MWT) and resting systolic BP (SBP), diastolic BP (DBP), post-6MWT heart rate (HR), and post-6MWT BPs were measured before and after CR in 311 (237 men,74 women) patients. Using age as a covariate, 2 by 2 (Gender × Measurement) ANCOVAs were used to determine differences in 6MWT performance and hemodynamic variables. Results. After adjusting for age, men covered a greater 6MWT distance than women; pre-CR versus post-CR program values are as follows: men, 429.3 ± 94.6 versus 557.6 ± 90.7 m, P ≤ .001; women, 374.9 ± 100.7 versus 483.2 ± 82.9 m, P ≤ .001. Both genders reduced resting DBP following the CR program (men: 67.2 ± 9.8 vs 65.6 ± 8.5 mm Hg, P = .034; women: 69.2 ± 10.7 vs 65.0 ± 8.0 mm Hg, P = .001) and increased HR following the 6MWT after the CR program (men: 97.7 ± 16.8 vs 112.7 ± 21.3 bpm, P ≤ .001; women: 100.7 ± 20.8 vs 110.2 ± 22.0 bpm, P ≤ .001). Similarly, SBP increased immediately following the 6MWT (122.8 ± 18.5 vs 133.6 ± 20.7 mm Hg; P ≤ .001) in men but not in women. Conclusion. The present findings indicate similar relative improvements in 6MWT performance and BP responses in adherent men and women following an exercise-based CR program.
Collapse
Affiliation(s)
- Felipe Araya-Ramírez
- School of Human Movement Science and Quality of Life, National University, Heredia, Costa Rica
| | - José Moncada-Jiménez
- Human Movement Sciences Research Center (CIMOHU), University of Costa Rica, San Jose, Costa Rica
| | - Peter W. Grandjean
- Department of Health, Exercise Science and Recreation Management, University of Mississippi, Oxford, Mississippi
| | - Barry A. Franklin
- Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, Michigan, and Oakland University William Beaumont School of Medicine, Rochester, Michigan
| |
Collapse
|
30
|
Using the 6-min Walk Test to Monitor Peak Oxygen Uptake Response to Cardiac Rehabilitation in Patients With Heart Failure. J Cardiopulm Rehabil Prev 2020; 40:378-382. [PMID: 33031135 PMCID: PMC7592889 DOI: 10.1097/hcr.0000000000000517] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is Available in the Text. Estimated peak oxygen uptake (V˙o2peak) using 6-min Walk Test distance demonstrated poor agreement with measured V˙o2peak from a cardiopulmonary exercise test in patients with heart failure enrolled in cardiac rehabilitation. Purpose: We examined the agreement between peak oxygen uptake (V˙o2peak), estimated using prediction equations from the 6-min Walk Test (6MWT), and V˙o2peak measured using a cardiopulmonary exercise test (CPX) to estimate change in V˙o2peak in patients with heart failure (HF) enrolled in cardiac rehabilitation (CR). Methods: This was secondary analysis of 54 (including 9 women) patients with HF who completed a clinical CR program. Four previously published equations using 6MWT distance were used to estimate V˙o2peak and were compared with a CPX at baseline, follow-up, and change using the standard and modified Bland-Altman method. Analyses were repeated for quartiles of cardiorespiratory fitness (CRF) based on measured V˙o2peak from the CPX. Results: Bland-Altman plots revealed proportional bias between all prediction equations and the measured V˙o2peak. The difference between methods varied by the level of CRF, with overestimation of prediction equations at greater levels of CRF and underestimation at lower levels of CRF. This poor agreement remained when comparisons were made between the estimated and measured V˙o2peak values at quartiles of CRF, indicating prediction equations have limited ability to predict V˙o2peak at any level of CRF. Conclusion: Estimated V˙o2peak using 6MWT distance demonstrated poor agreement with measured V˙o2peak from a CPX. While distance ambulated on the 6MWT remains an important measure of physical performance in patients with HF, prediction equations using 6MWT distance are not appropriate to monitor changes in V˙o2peak following CR in patients with HF.
Collapse
|
31
|
Montgomery G, McPhee J, Pääsuke M, Sipilä S, Maier AB, Hogrel JY, Degens H. Determinants of Performance in the Timed Up-and-Go and Six-Minute Walk Tests in Young and Old Healthy Adults. J Clin Med 2020; 9:E1561. [PMID: 32455757 PMCID: PMC7290512 DOI: 10.3390/jcm9051561] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to assess associations between performance in the timed up-and-go (TUG) and six-minute walk distance (6MWD) with physiological characteristics in young and old healthy adults. Thereto, we determined TUG, 6MWD, normalised jump power, centre of pressure displacement during 1-leg standing, forced expiratory volume in 1 s, percentage of age-predicted maximal heart rate (HR%) and height in 419 healthy young (men: 23.5 ± 2.8 years, women: 23.2 ± 2.9 years) and old (men: 74.6 ± 3.2 years, women: 74.1 ± 3.2 years) adults. Normalised jump power explained 8% and 19% of TUG in young (p = 0.025) and older men (p < 0.001), respectively. When fat mass percentage and age were added to normalised jump power, 30% of TUG was explained in older men (R2adj = 0.30, p < 0.001 to 0.106). Appendicular lean muscle mass percentage (ALM%) and age were the best determinants of TUG for older women (R2adj = 0.16, p < 0.001 to 0.01). HR% explained 17-39% of 6MWD across all groups (R2adj = 0.17 to 39, p < 0.001). In conclusion, in men, jump power was a key determinant for TUG, while in old women only it was the ALM%. As HR% was the most important determinant of 6MWD, motivational bias needs to be considered in the interpretation of this test.
Collapse
Affiliation(s)
- Gallin Montgomery
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Jamie McPhee
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 51014 Tartu, Estonia;
| | - Sarianna Sipilä
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvsäkylä, FI-40014 Jyvsäkylä, Finland;
| | - Andrea B Maier
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands;
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Victoria 3010, Australia
| | - Jean-Yves Hogrel
- Neuromuscular Investigation Center, Institute of Myology, Pitié-Salpêtrière Hospital, 73013 Paris, France;
| | - Hans Degens
- Musculoskeletal Science and Sports Medicine, School of Healthcare Science, Manchester Metropolitan University, Manchester M1 5GD, UK;
- Institute of Sport Science and Innovations, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
- University of Medicine and Pharmacy of Targu Mures, 540142 Targu Mures, Romania
| |
Collapse
|
32
|
S. Stavrinou P, Andreou E, Aphamis G, Pantzaris M, Ioannou M, S. Patrikios I, D. Giannaki C. The Effects of a 6-Month High Dose Omega-3 and Omega-6 Polyunsaturated Fatty Acids and Antioxidant Vitamins Supplementation on Cognitive Function and Functional Capacity in Older Adults with Mild Cognitive Impairment. Nutrients 2020; 12:E325. [PMID: 31991898 PMCID: PMC7071310 DOI: 10.3390/nu12020325] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 12/19/2022] Open
Abstract
The aim of the present study was to examine the effects of a high-dose omega-3 and omega-6 fatty acids supplementation, in combination with antioxidant vitamins, on cognitive function and functional capacity of older adults with mild cognitive impairment (MCI), over a 6-month period in a randomized, double-blind, placebo-controlled trial. Forty-six older adults with MCI (age: 78.8 ± 7.3 years) were randomized 1:1 to receive either a 20 mL dose of a formula containing a mixture of omega-3 (810 mg Eicosapentaenoic acid and 4140 mg Docosahexaenoic acid) and omega-6 fatty acids (1800 mg gamma-Linolenic acid and 3150 mg Linoleic acid) (1:1 w/w), with 0.6 mg vitamin A, vitamin E (22 mg) plus pure γ-tocopherol (760 mg), or 20mL placebo containing olive oil. Participants completed assessments of cognitive function, functional capacity, body composition and various aspects of quality of life at baseline and following three and six months of supplementation. Thirty-six participants completed the study (eighteen from each group). A significant interaction between supplementation and time was found on cognitive function (Addenbrooke's Cognitive Examination -Revised (ACE-R), Mini-Mental State Examination (MMSE) and Stroop Color and Word Test (STROOP) color test; p < 0.001, p = 0.011 and p = 0.037, respectively), functional capacity (6-min walk test and sit-to-stand-60; p = 0.028 and p = 0.032, respectively), fatigue (p < 0.001), physical health (p = 0.007), and daily sleepiness (p = 0.007)-showing a favorable improvement for the participants receiving the supplement. The results indicate that this nutritional modality could be promising for reducing cognitive and functional decline in the elderly with MCI.
Collapse
Affiliation(s)
- Pinelopi S. Stavrinou
- Department of Life and Health Sciences, University of Nicosia, Nicosia 2417, Cyprus; (P.S.S.); (E.A.); (G.A.)
- University of Nicosia Research Foundation, Nicosia 2417, Cyprus
| | - Eleni Andreou
- Department of Life and Health Sciences, University of Nicosia, Nicosia 2417, Cyprus; (P.S.S.); (E.A.); (G.A.)
| | - George Aphamis
- Department of Life and Health Sciences, University of Nicosia, Nicosia 2417, Cyprus; (P.S.S.); (E.A.); (G.A.)
| | - Marios Pantzaris
- The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus;
| | - Melina Ioannou
- Noesis Cognitive Center, Materia Group, Nicosia 2221, Cyprus;
| | | | - Christoforos D. Giannaki
- Department of Life and Health Sciences, University of Nicosia, Nicosia 2417, Cyprus; (P.S.S.); (E.A.); (G.A.)
- University of Nicosia Research Foundation, Nicosia 2417, Cyprus
- The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus;
| |
Collapse
|
33
|
Comparative effects of high-intensity interval training with combined training on physical function markers in obese postmenopausal women: a randomized controlled trial. ACTA ACUST UNITED AC 2019; 26:1242-1249. [DOI: 10.1097/gme.0000000000001399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
34
|
Imran TF, Orkaby A, Chen J, Selvaraj S, Driver JA, Gaziano JM, Djoussé L. Walking pace is inversely associated with risk of death and cardiovascular disease: The Physicians' Health Study. Atherosclerosis 2019; 289:51-56. [PMID: 31450014 PMCID: PMC6743067 DOI: 10.1016/j.atherosclerosis.2019.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 07/21/2019] [Accepted: 08/15/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Walking pace is increasingly being used to assess functional status in ambulatory settings. METHODS We conducted a prospective analysis within the Physicians' Health Study to examine whether walking pace is associated with mortality and incident cardiovascular disease (fatal or nonfatal myocardial infarction, coronary artery bypass grafting and percutaneous transluminal coronary angioplasty). Participants included 21,919 male physicians with a mean age of 67.8 ± 9.0 years. RESULTS After a median follow-up of 9.4 years (IQR: 7.9-10.3), 3906 deaths and 2487 incident CVD events occurred. In a multivariable Cox proportional hazards model adjusting for age, body mass index, smoking, exercise frequency, and prevalent hypertension, diabetes mellitus, heart failure, peripheral vascular disease, cancer, and total weekly walking time, hazard ratios for mortality were 0.72 (95% CI: 0.64-0.81) for walking pace of 2-2.9mph, 0.63 (95% CI: 0.55-0.73) for walking pace of 3-3.9mph and 0.63 (95% CI: 0.48-0.83) for walking pace of ≥4mph compared to the group that reported not walking regularly (p trend <0.0001). Similar findings were observed for incident CVD: HRs were 0.88 (95% CI: 0.75-1.03) for a walking pace of 2-2.9mph, 0.75 (95% CI: 0.63-0.89) for a walking pace of 3-3.9mph and 0.70 (0.53-0.94) for a walking pace of ≥4mph compared to the group that reported not walking regularly (p trend 0.0001). These associations persisted after excluding those who exercised regularly. CONCLUSION We found that walking pace is inversely associated with risk of mortality and CVD among US male physicians.
Collapse
Affiliation(s)
- Tasnim F Imran
- Boston Medical Center, Boston University School of Medicine, 72 E Concord St, Boston, MA, 02118, USA; Boston Veterans Affairs Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA.
| | - Ariela Orkaby
- Boston Veterans Affairs Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA
| | - Jiaying Chen
- Boston Veterans Affairs Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA
| | - Senthil Selvaraj
- Boston Veterans Affairs Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA
| | - Jane A Driver
- Boston Veterans Affairs Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA
| | - J Michael Gaziano
- Boston Veterans Affairs Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA
| | - Luc Djoussé
- Boston Veterans Affairs Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA
| |
Collapse
|
35
|
Role of Inflammatory Cell Subtypes in Heart Failure. J Immunol Res 2019; 2019:2164017. [PMID: 31565659 PMCID: PMC6745095 DOI: 10.1155/2019/2164017] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/25/2019] [Indexed: 02/07/2023] Open
Abstract
Inflammation is a well-known feature of heart failure. Studies have shown that while some inflammation is required for repair during injury and is protective, prolonged inflammation leads to myocardial remodeling and apoptosis of cardiac myocytes. Various types of immune cells are implicated in myocardial inflammation and include neutrophils, macrophages, eosinophils, mast cells, natural killer cells, T cells, and B cells. Recent clinical trials have targeted inflammatory cascades as therapy for heart failure with limited success. A better understanding of the temporal course of the infiltration of the different immune cells and their contribution to the inflammatory process may improve the success for therapy. This brief review outlines the major cell types involved in heart failure, and some of their actions are summarized in the supplementary figure.
Collapse
|
36
|
Bradley SM, Michos ED, Miedema MD. Physical Activity, Fitness, and Cardiovascular Health: Insights From Publications in JAMA Network Open. JAMA Netw Open 2019; 2:e198343. [PMID: 31441931 DOI: 10.1001/jamanetworkopen.2019.8343] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Steven M Bradley
- Associate Editor
- Minneapolis Heart Institute Foundation, Minneapolis Heart Institute, Minneapolis, Minnesota
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Michael D Miedema
- Minneapolis Heart Institute Foundation, Minneapolis Heart Institute, Minneapolis, Minnesota
| |
Collapse
|
37
|
Wogksch MD, Howell CR, Wilson CL, Partin RE, Ehrhardt MJ, Krull KR, Brinkman TM, Mulrooney DA, Hudson MM, Robison LL, Ness KK. Physical fitness in survivors of childhood Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort. Pediatr Blood Cancer 2019; 66:e27506. [PMID: 30362255 PMCID: PMC6344300 DOI: 10.1002/pbc.27506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND There are limited data describing fitness and associated health-related quality of life (HRQoL) in survivors of childhood Hodgkin lymphoma (HL). PROCEDURE Fitness was evaluated among 336 adult survivors of childhood-onset HL treated at St. Jude Children's Research Hospital and 327 controls who never had childhood cancer. The controls were frequency matched on age, sex, and race. Associations were examined between chronic disease and fitness and between fitness and HRQoL using a multivariable linear and logistic regression. RESULTS Male survivors had lower endurance (6-min walk [6MW] distance 604.4 ± 7.9 m vs 637.0 ± 7.5 m, P < 0.01), and worse neuropathy (modified Total Neuropathy Score [mTNS] 2.7 ± 0.2 vs 1.4 ± 0.2, P < 0.01) compared to controls. Female survivors had lower endurance (6MW distance 564.5 ± 6.9 m vs 590.6 ± 7.0 m, P < 0.01), quadriceps strength (145.7 ± 4.0 vs 163.4 ± 4.0 N·m per kilogram, P < 0.01), and worse neuropathy (mTNS 3.2 ± 0.2 vs 1.4 ± 0.3, P < 0.01) compared to controls. Moderate, severe/disabling, or life-threatening (grades 2-4) neurological conditions were associated with impaired quadriceps strength (odds ratio [OR] 2.94, 99% confidence interval [CI] 1.24-6.96) and impaired endurance (OR 2.96, 99% CI 1.28-6.69). Cardiovascular (OR 2.36, 99% CI 1.00-5.61) and pulmonary (OR 2.78, 99% CI 1.30-5.94) conditions were associated with impaired endurance. Quadriceps strength (β -6.44 ± 2.01, P < 0.01), endurance (β -4.63 ± 1.54, P < 0.01), and neuropathy (β -4.98 ± 1.14, P < 0.01) were associated with a lower physical component summary on the HRQoL. CONCLUSION Survivors of childhood HL, particularly those with neurological, cardiac, and pulmonary chronic conditions, are at risk for impaired fitness and HRQoL.
Collapse
Affiliation(s)
- Matthew D. Wogksch
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Carrie R. Howell
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Carmen L. Wilson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Robyn E. Partin
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Matthew J. Ehrhardt
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Daniel A. Mulrooney
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| |
Collapse
|
38
|
van de Vijver PL, Wielens H, Slaets JPJ, van Bodegom D. Vitality club: a proof-of-principle of peer coaching for daily physical activity by older adults. Transl Behav Med 2018; 8:204-211. [PMID: 29325113 DOI: 10.1093/tbm/ibx035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Many age-related diseases can be prevented or delayed by daily physical activity. Unfortunately, many older adults do not perform physical activity at the recommended level. Professional interventions do not reach large numbers of older adults for a long period of time. We studied a peer-coach intervention, in which older adults coach each other, that increased daily physical activity of community dwelling older adults for over 6 years. We studied the format and effects of this peer coach intervention for possible future implementation elsewhere. Through interviews and participatory observation we studied the format of the intervention. We also used a questionnaire (n = 55) and collected 6-min walk test data (n = 261) from 2014 to 2016 to determine the motivations of participants and effects of the intervention on health, well-being and physical capacity. Vitality Club is a self-sustainable group of older adults that gather every weekday to exercise coached by an older adult. Members attend on average 2.5 days per week and retention rate is 77.5% after 6 years. The members perceived improvements in several health measures. In line with this, the 6-min walk test results of members of this Vitality Club improved with 21.7 meters per year, compared with the decline of 2-7 meters per year in the general population. This Vitality Club is successful in durably engaging its members in physical activity. The members perceive improvements in health that are in line with improvements in a physical function test. Because of the self-sustainable character of the intervention, peer coaching has the potential to be scaled up at low cost and increase physical activity in the increasing number of older adults.
Collapse
Affiliation(s)
- Paul L van de Vijver
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Joris P J Slaets
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.,Center for Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - David van Bodegom
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
39
|
Anawalt BD, Page ST. Testosterone therapy and physical function. Lancet Diabetes Endocrinol 2018; 6:839-840. [PMID: 30366565 DOI: 10.1016/s2213-8587(18)30202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Bradley D Anawalt
- Department of Medicine, University of Washington, Seattle, WA 98119, USA
| | - Stephanie T Page
- Department of Medicine, University of Washington, Seattle, WA 98119, USA.
| |
Collapse
|
40
|
Marron MM, Ives DG, Boudreau RM, Harris TB, Newman AB. Racial Differences in Cause-Specific Mortality Between Community-Dwelling Older Black and White Adults. J Am Geriatr Soc 2018; 66:1980-1986. [PMID: 30277581 PMCID: PMC6366626 DOI: 10.1111/jgs.15534] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To understand which causes of death are higher in black than white community-dwelling older adults and determine whether differences in baseline risk factors explain racial differences in mortality. DESIGN Longitudinal cohort study (Health, Aging, and Body Composition Study). SETTING Pittsburgh, Pennsylvania; and Memphis, Tennessee. PARTICIPANTS Black and white men and women aged 70 to 79 during recruitment (N=3,075; 48% men, 42% black) followed for a median of 13 years. MEASUREMENTS A committee of physicians adjudicated cause of death, which was categorized as cardiovascular disease (CVD), stroke, cancer, dementia, pulmonary, infection, kidney, or other causes. Using competing risks regression, we examined whether known risk factors at baseline (demographic characteristics, smoking, body mass index, chronic diseases, physical function, cognition) could explain racial differences in cause-specific mortality risk. RESULTS During follow-up, 1,991 (65%) participants died. Black participants died at higher rates from cancer (hazard ratio (HR)=1.36, 95% confidence interval (CI)=1.14-1.63), kidney disease (HR=2.09, 95% CI=1.16-3.74), stroke (HR=1.31, 95% CI=0.98-1.76); and CVD (HR=1.16, 95% CI=0.98-1.37). Poorer physical and cognitive performance at baseline among black participants explained most of the racial difference in risks of dying from kidney disease, stroke, and CVD but not cancer. When examining types of cancer deaths, black participants died at higher rates from multiple myeloma, pancreatic cancer, and prostate cancer, which baseline risk factors did not explain either. CONCLUSION Factors contributing to poorer physical and cognitive performance in similarly aged black men and women could be targets to reduce excess mortality from CVD, stroke, and kidney disease. More work is needed to identify factors contributing to cancer mortality disparities.
Collapse
Affiliation(s)
- Megan M. Marron
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Diane G. Ives
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | | | - Tamara B. Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, MD
| | - Anne B. Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
- Departments of Medicine and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
41
|
Straight CR, Berg AC, Reed RA, Johnson MA, Evans EM. Reduced body weight or increased muscle quality: Which is more important for improving physical function following exercise and weight loss in overweight and obese older women? Exp Gerontol 2018; 108:159-165. [PMID: 29679690 DOI: 10.1016/j.exger.2018.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/06/2018] [Accepted: 04/16/2018] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to examine the relative contributions of changes in muscle quality and body composition to changes in lower-extremity physical function (LEPF) following a 6-month exercise and weight loss intervention in overweight and obese older women. Thirty-eight overweight and obese (BMI = 30.0 ± 4.4 kg/m2) older (age = 69.3 ± 4.1 y) women completed 6 months of multicomponent exercise (cardiorespiratory, resistance, balance and flexibility training) and weight loss (hypocaloric diet that reduced energy intake by ~500 kcal/d). Body composition was measured via dual-energy X-ray absorptiometry and muscle quality (N-m/kg) was defined as maximal concentric isokinetic knee torque divided by upper-leg lean mass. The standardized scores of four objective measures of physical function were summed to yield a composite LEPF Z-score. At 6 months, there were significant reductions in body weight (-9.6 ± 3.5%, p < 0.01), absolute fat mass (-6.8 ± 2.4 kg, p < 0.01) and relative adiposity (-4.9 ± 2.1%, p < 0.01). There were also improvements in both muscle quality (+1.6 ± 1.8 N-m/kg, p < 0.01) and individual measures of LEPF (11-57%, p < 0.01). Multivariate linear regression indicated that increased muscle quality was the strongest independent predictor of an improvement in LEPF Z-score (standardized β = 0.64, p < 0.01) and explained 34% of the variance. A reduction in body weight also predicted an improvement in LEPF, independent of the change in muscle quality. In conclusion, muscle quality can be increased in the presence of clinically meaningful weight loss, and is the primary determinant of improved physical function in overweight/obese older women.
Collapse
Affiliation(s)
- Chad R Straight
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA.
| | - Alison C Berg
- Department of Foods and Nutrition, University of Georgia, 300 Carlton Street, Athens, GA 30602, USA.
| | - Rachelle A Reed
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA.
| | - Mary Ann Johnson
- Department of Foods and Nutrition, University of Georgia, 115 DW Brooks Dr., Athens, GA 30602, USA.
| | - Ellen M Evans
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA.
| |
Collapse
|
42
|
Suzuki FS, Evangelista AL, Teixeira CVLS, Paunksnis MRR, Rica RL, Evangelista RAGDT, João GA, Doro MR, Sita DM, Serra AJ, Figueira Junior AJ, Alonso AC, Peterson M, Bocalini DS. EFFECTS OF A MULTICOMPONENT EXERCISE PROGRAM ON THE FUNCTIONAL FITNESS IN ELDERLY WOMEN. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182401179669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Aging is inevitable and irreversible, but with the advancement of technology, life expectancy is increasing every year, bringing proposals for various interventions to improve the quality of life. One such intervention is physical exercise programs. Objectives: To investigate the impact of multicomponent training in circuits on functional autonomy parameters in elderly women. Methods: Elderly were recruited and distributed in two groups: trained (N = 16) and non-trained (N = 15). Those in the trained group performed 75-minute training sessions twice a week over a 56-week period. The resistance training included upper and lower limbs with a relative intensity of 70% of 1RM, exercises using body weight, stretching and specific tasks for agility, performed in a circuit form and totaling three passages. Participants underwent functional autonomy (FA) assessment by the protocol of the Latin American Developmental Group for Maturity, the 6-minute walk test (T6M), and the sit-and-reach (SR) test. Results: The trained group had a significant decrease in body weight (p=0.02) and body mass index (p=0.015). Significant improvements (p=0,009) were also observed in FA, SR, and T6M after the intervention Compared with the untrained group, the trained group also obtained significant differences in all functional parameters analyzed. Conclusion: A long-term multicomponent training program conducted on a circuit and applied twice a week was enough to improve multiple components of the functional autonomy of elderly women. Level of Evidence II; Prognostic studies - Investigating the effect of a patient characteristic on the outcome of disease.
Collapse
|
43
|
Real benefit of a protective factor against dementia: Importance of controlling for death. Example of sport practice. PLoS One 2017; 12:e0174950. [PMID: 28414760 PMCID: PMC5393553 DOI: 10.1371/journal.pone.0174950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 03/18/2017] [Indexed: 11/19/2022] Open
Abstract
Objectives To analyse the impact of a risk factor on several epidemiological indicators of death and dementia; the example of sport practice is presented. Methods A population of 3670 non-demented subjects living at home and aged 65 and older from the PAQUID study were followed for 22 years. Sport practice was documented at baseline. Dementia (according to DSM-III-R criteria) and death were assessed at each visit. Analyses were performed with an Illness-Death model, providing results on the risks of dementia and death, probabilities and life expectancies. Results A total of 743 subjects (20.2%) participated in regular sport practice. During the follow-up, the proportion of death was lower in the elderly people practicing sport (EPPS), whereas the proportion of incident dementia cases was the same. The adjusted model showed a decreased risk of dementia (HR = 0.84 (0.72–1.00)) and of death for non-demented subjects (HR = 0.61 (0.51–0.71)) for EPPS but a similar risk of death with dementia in both sport groups. The probability of remaining alive without dementia was higher in EPPS, whereas the probability of dying was lower. The mean lifetime without dementia was 3 years higher for the EPPS, but the mean lifetime with dementia was the same. Discussion A preventive measure on a protective factor that is more effective for preventing death than dementia could lead to an increased lifetime without dementia; however, the number of demented cases may remain unchanged, even if the risk of developing dementia is reduced. This dynamic is important to forecast the need for health care and social services for the elderly.
Collapse
|
44
|
Georgiopoulou VV, Kalogeropoulos AP, Chowdhury R, Binongo JNG, Bibbins-Domingo K, Rodondi N, Simonsick EM, Harris T, Newman AB, Kritchevsky SB, Butler J. Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults: The Health ABC Study. Am J Prev Med 2017; 52:144-153. [PMID: 27856115 PMCID: PMC5253312 DOI: 10.1016/j.amepre.2016.08.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/29/2016] [Accepted: 08/29/2016] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Data on the association between exercise capacity and risk for heart failure (HF) in older adults are limited. METHODS This study examined the association of exercise capacity, and its change over time, with 10-year mortality and incident HF in 2,935 participants of the Health, Aging, and Body Composition Study without HF at baseline (age, 73.6 [SD=2.9] years; 52.1% women; 41.4% black; 58.6% white). This cohort was initiated in 1997-1998 and exercise capacity was evaluated with a long-distance corridor walk test (LDCW) at baseline and Year 4. Outcomes were collected in 2007-2008 and initial analysis performed in 2014. RESULTS Ten-year incident HF for completers (n=2,245); non-completers (n=331); and those excluded from LDCW for safety reasons (n=359) was 11.4%, 19.2%, and 23.0%, respectively. The corresponding 10-year mortality was 27.9%, 41.1%, and 42.4%. In models accounting for competing mortality, the adjusted subhazard ratio for HF was 1.37 (95% CI=1.00, 1.88; p=0.049) in non-completers and 1.41 (95% CI=1.06, 1.89; p=0.020) in those excluded versus completers. Non-completers (adjusted hazard ratio, 1.49; 95% CI=1.21, 1.84; p<0.001) and those excluded (hazard ratio, 1.27; 95% CI=1.04, 1.55; p=0.016) had elevated mortality. In adjusted models, LDCW performance variables were associated mainly with mortality. Only 20-meter walking speed and resting heart rate retained prognostic value for HF. Longitudinal changes in LDCW did not predict subsequent incident HF or mortality. CONCLUSIONS Completing an LDCW is strongly associated with lower 10-year mortality and HF risk in older adults. Therefore, walking capacity may serve as an early risk marker.
Collapse
Affiliation(s)
| | | | - Ritam Chowdhury
- Department of Biostatistics, Harvard University, Boston, Massachusetts; Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| | - José Nilo G Binongo
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| | - Kirsten Bibbins-Domingo
- Department of Medicine and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Nicolas Rodondi
- Department of General Internal Medicine, University of Bern, Bern, Switzerland
| | - Eleanor M Simonsick
- Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Tamara Harris
- Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Anne B Newman
- Departments of Medicine and Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Stephen B Kritchevsky
- Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University, Winston Salem, North Carolina
| | - Javed Butler
- Department of Medicine, Division of Cardiology, Stony Brook University, Stony Brook, New York
| | | |
Collapse
|
45
|
Kuller LH, Lopez OL, Becker JT, Chang Y, Newman AB. Risk of dementia and death in the long-term follow-up of the Pittsburgh Cardiovascular Health Study-Cognition Study. Alzheimers Dement 2016; 12:170-183. [PMID: 26519786 PMCID: PMC4744537 DOI: 10.1016/j.jalz.2015.08.165] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/30/2015] [Accepted: 08/26/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Increasing life expectancy has resulted in a larger population of older individuals at risk of dementia. METHODS The Cardiovascular Health Study-Cognition Study followed 532 participants from 1998-99 (mean age 79) to 2013 (mean age 93) for death and dementia. RESULTS Risk of death was determined by extent of coronary artery calcium, high-sensitivity cardiac troponin, brain natriuretic peptide, and white matter grade. Significant predictors of dementia were age, apolipoprotein-E4, vocabulary raw score, hippocampal volume, ventricular size, cognitive performance, and number of blocks walked. By 2013, 160 of 532 were alive, including 19 cognitively normal. Those with normal cognition had higher grade education, better cognition test scores, greater hippocampal volume, faster gait speed, and number of blocks walked as compared with survivors who were demented. DISCUSSION Few survived free of dementia and disability. Prevention and delay of cognitive decline for this older population is an imperative.
Collapse
Affiliation(s)
- Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - James T Becker
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yuefang Chang
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anne B Newman
- Department of Epidemiology, Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
46
|
Brown DM, Goljanek-Whysall K. microRNAs: Modulators of the underlying pathophysiology of sarcopenia? Ageing Res Rev 2015; 24:263-73. [PMID: 26342566 DOI: 10.1016/j.arr.2015.08.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/15/2015] [Accepted: 08/31/2015] [Indexed: 12/25/2022]
Abstract
Skeletal muscle homeostasis depends on an intricate balance between muscle hypertrophy, atrophy and regeneration. As we age, maintenance of muscle homeostasis is perturbed, resulting in a loss of muscle mass and function, termed sarcopenia. Individuals with sarcopenia exhibit impaired balance, increased falls (leading to subsequent injury) and an overall decline in quality of life. The mechanisms mediating sarcopenia are still not fully understood but clarity in our understanding of the precise pathophysiological changes occurring during skeletal muscle ageing has improved dramatically. Advances in transcriptomics has highlighted significant deregulation in skeletal muscle gene expression with ageing, suggesting epigenetic alterations may play a crucial and potentially causative role in the skeletal muscle ageing process. microRNAs (miRNAs, miRs), novel regulators of gene expression, can modulate many processes in skeletal muscle, including myogenesis, tissue regeneration and cellular programming. Expression of numerous evolutionary conserved miRNAs is disrupted in skeletal muscle with age. Given that a single miRNA can simultaneously affect the functionality of multiple signaling pathways, miRNAs are potent modulators of pathophysiological changes. miRNA-based interventions provide a promising new therapeutic strategy against alterations in muscle homeostasis. The aim of this review is two-fold; firstly to outline the latest understanding of the pathophysiological alterations impacting the deregulation of skeletal muscle mass and function with ageing, and secondly, to highlight the mounting evidence for a role of miRNAs in modulating muscle mass, and the need to explore their specific role in sarcopenia.
Collapse
Affiliation(s)
- David M Brown
- Medical Research Council-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Katarzyna Goljanek-Whysall
- Medical Research Council-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
| |
Collapse
|