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Militello R, Luti S, Gamberi T, Pellegrino A, Modesti A, Modesti PA. Physical Activity and Oxidative Stress in Aging. Antioxidants (Basel) 2024; 13:557. [PMID: 38790662 PMCID: PMC11117672 DOI: 10.3390/antiox13050557] [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: 04/02/2024] [Revised: 04/22/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
Biological aging, characterized by changes in metabolism and physicochemical properties of cells, has an impact on public health. Environment and lifestyle, including factors like diet and physical activity, seem to play a key role in healthy aging. Several studies have shown that regular physical activity can enhance antioxidant defense mechanisms, including the activity of enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase. However, intense or prolonged exercise can also lead to an increase in reactive oxygen species (ROS) production temporarily, resulting in oxidative stress. This phenomenon is referred to as "exercise-induced oxidative stress". The relationship between physical activity and oxidative stress in aging is complex and depends on various factors such as the type, intensity, duration, and frequency of exercise, as well as individual differences in antioxidant capacity and adaptation to exercise. In this review, we analyzed what is reported by several authors regarding the role of physical activity on oxidative stress in the aging process as well as the role of hormesis and physical exercise as tools for the prevention and treatment of sarcopenia, an aging-related disease. Finally, we reported what has recently been studied in relation to the effect of physical activity and sport on aging in women.
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Affiliation(s)
- Rosamaria Militello
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy; (R.M.); (S.L.); (T.G.)
| | - Simone Luti
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy; (R.M.); (S.L.); (T.G.)
| | - Tania Gamberi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy; (R.M.); (S.L.); (T.G.)
| | - Alessio Pellegrino
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (A.P.); (P.A.M.)
| | - Alessandra Modesti
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy; (R.M.); (S.L.); (T.G.)
| | - Pietro Amedeo Modesti
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (A.P.); (P.A.M.)
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Fielding RA, Atkinson EJ, Aversa Z, White TA, Heeren AA, Mielke MM, Cummings SR, Pahor M, Leeuwenburgh C, LeBrasseur NK. Biomarkers of Cellular Senescence Predict the Onset of Mobility Disability and Are Reduced by Physical Activity in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glad257. [PMID: 37948612 PMCID: PMC10851672 DOI: 10.1093/gerona/glad257] [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: 07/30/2023] [Indexed: 11/12/2023] Open
Abstract
Studies in mice and cross-sectional studies in humans support the premise that cellular senescence is a contributing mechanism to age-associated deficits in physical function. We tested the hypotheses that circulating proteins secreted by senescent cells are (i) associated with the incidence of major mobility disability (MMD), the development of persistent mobility disability (PMMD), and decrements in physical functioning in older adults, and (ii) influenced by physical activity (PA). Using samples and data obtained longitudinally from the Lifestyle Interventions in Elders Study clinical trial, we measured a panel of 27 proteins secreted by senescent cells. Among 1 377 women and men randomized to either a structured PA intervention or a healthy aging (HA) intervention, we observed significant associations between several senescence biomarkers, most distinctly vascular endothelial growth factor A (VEGFA), tumor necrosis factor receptor 1 (TNFR1), and matrix metallopeptidase 7 (MMP7), and the onset of both MMD and PMMD. Moreover, VEGFA, GDF15, osteopontin, and other senescence biomarkers were associated with reductions in short physical performance battery scores. The change in senescence biomarkers did not differ between PA and HA participants. In the whole cohort, higher levels of PA were associated with significantly greater reductions in 10 senescence-related proteins at 12 and/or 24 months. These data reinforce cellular senescence as a contributing mechanism of age-associated functional decline and the potential for PA to attenuate this hallmark of aging. Clinical Trials Registration Number: NCT01072500.
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Affiliation(s)
- Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Elizabeth J Atkinson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Zaira Aversa
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Thomas A White
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota, USA
| | - Amanda A Heeren
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Steven R Cummings
- Departments of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Research Institute, California Pacific Medical Center, San Francisco, California, USA
| | - Marco Pahor
- Institute on Aging, University of Florida, Gainesville, Florida, USA
| | | | - Nathan K LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
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Roe LS, Harrison S, Cawthon PM, Moored KD, Qiao YS, Ensrud K, Stone KL, Gabriel KP, Cauley JA. The association between daily sedentary and active bout frequency with mortality risk in older men using accelerometry. J Am Geriatr Soc 2023; 71:1547-1557. [PMID: 36656119 PMCID: PMC10266879 DOI: 10.1111/jgs.18234] [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: 06/26/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Time awake with advancing age is increasingly spent sedentary and has several negative health consequences. We examined associations between the frequency of daily sedentary and active bouts with all-cause mortality. METHODS Data are from 2816 men in the Osteoporotic Fractures in Men (MrOS) Study (mean age ± SD: 79.1 ± 5.2 years) with free-living activity monitor (SenseWear® Pro3 Armband) data (5.1 ± 0.3 days worn >90%) at the Year 7 visit (2007-2009). Sedentary bout frequency was defined as the number of sedentary bouts per day lasting 5+ min to activity of any intensity. Active bout frequency was defined as the number of active bouts per day lasting 5+ min to sedentary behavior. Sleep time was excluded from the analysis. Deaths were centrally adjudicated using death certificates. Cox proportional hazard models were used to separately examine associations between quartiles of sedentary (Q1 referent, <13.6 bouts/day) or active (Q1 referent, <5 bouts/day) bout frequency with mortality. RESULTS After 9.3 ± 3.8 years of follow-up, 1487 (52.8%) men died. Men averaged 16.8 ± 5.1 and 8.2 ± 4.2 sedentary and active bouts/day, respectively. After full covariate adjustment, each quartile reflecting more frequent sedentary bouts (Q4 vs. Q1 HR: 0.69, 95%CI: 0.58, 0.81, p-trend <0.001) was associated with lower mortality risk. Likewise, each quartile reflecting more frequent active bouts (Q4 vs. Q1 HR: 0.58, 95%CI: 0.49, 0.70, p-trend <0.001) was associated with lower mortality risk. Results for the sedentary bouts model remained significant after adjusting for total minutes per day in sedentary behavior (Q4 vs. Q1 HR: 0.63, 95%CI: 0.61, 0.86, p-trend = 0.001). The association between active bout frequency with mortality was attenuated after adjusting for total minutes per day active. CONCLUSIONS Regardless of total time spent sedentary, reducing duration of sedentary bouts with more frequent and shorter bouts may be a simple and feasible method to delay mortality risk among community-dwelling older men.
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Affiliation(s)
- Lauren S Roe
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stephanie Harrison
- California Pacific Medical Center, Research Institute, San Francisco, California, USA
| | - Peggy M Cawthon
- California Pacific Medical Center, Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Kyle D Moored
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yujia Susanna Qiao
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kristine Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Katie L Stone
- California Pacific Medical Center, Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jane A Cauley
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Wanigatunga AA, Chiu V, Cai Y, Urbanek JK, Mitchell CM, Miller ER, Christenson RH, Rebuck H, Michos ED, Juraschek SP, Walston J, Xue QL, Bandeen-Roche K, Appel LJ, Schrack JA. Patterns of Daily Physical Movement, Chronic Inflammation, and Frailty Incidence. Med Sci Sports Exerc 2023; 55:281-288. [PMID: 36170549 PMCID: PMC9840658 DOI: 10.1249/mss.0000000000003048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Low physical activity is a criterion of phenotypic frailty defined as an increased state of vulnerability to adverse health outcomes. Whether disengagement from daily all-purpose physical activity is prospectively associated with frailty and possibly modified by chronic inflammation-a pathway often underlying frailty-remains unexplored. METHODS Using the Study to Understand Fall Reduction and Vitamin D in You data from 477 robust/prefrail adults (mean age = 76 ± 5 yr; 42% women), we examined whether accelerometer patterns (activity counts per day, active minutes per day, and activity fragmentation [broken accumulation]) were associated with incident frailty using Cox proportional hazard regression. Baseline interactions between each accelerometer metric and markers of inflammation that include interleukin-6, C-reactive protein, and tumor necrosis factor-alpha receptor 1 were also examined. RESULTS Over an average of 1.3 yr, 42 participants (9%) developed frailty. In Cox regression models adjusted for demographics, medical conditions, and device wear days, every 30 min·d -1 higher baseline active time, 100,000 more activity counts per day, and 1% lower activity fragmentation was associated with a 16% ( P = 0.003), 13% ( P = 0.001), and 8% ( P < 0.001) lower risk of frailty, respectively. No interactions between accelerometer metrics and baseline interleukin-6, C-reactive protein, or tumor necrosis factor-alpha receptor 1 were detected (interaction P > 0.06 for all). CONCLUSIONS Among older adults who are either robust or prefrail, constricted patterns of daily physical activity (i.e., lower total activity minutes and counts, and higher activity fragmentation) were prospectively associated with higher risk of frailty but not modified by frailty-related chronic inflammation. Additional studies, particularly trials, are needed to understand if this association is causal.
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Affiliation(s)
- Amal A. Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Venus Chiu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Yurun Cai
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA
| | | | - Christine M. Mitchell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Edgar R. Miller
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Heather Rebuck
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD
| | - Erin D. Michos
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Stephen P. Juraschek
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, MA
| | - Jeremy Walston
- Division of Geriatric Medicine, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Qian-Li Xue
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of Geriatric Medicine, Johns Hopkins University and Medical Institutions, Baltimore, MD
| | - Karen Bandeen-Roche
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of Geriatric Medicine, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lawrence J. Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, MD
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD
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Fanning J, Miller ME, Chen SH, Davids C, Kershner K, Rejeski WJ. Is Wrist Accelerometry Suitable for Threshold Scoring? A Comparison of Hip-Worn and Wrist-Worn ActiGraph Data in Low-Active Older Adults With Obesity. J Gerontol A Biol Sci Med Sci 2022; 77:2429-2434. [PMID: 34791237 PMCID: PMC9923693 DOI: 10.1093/gerona/glab347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Hip- and wrist-worn ActiGraph accelerometers are widely used in research on physical activity as they offer an objective assessment of movement intensity across the day. Herein we characterize and contrast key structured physical activities and common activities of daily living via accelerometry data collected at the hip and wrist from a sample of community-dwelling older adults. METHODS Low-active, older adults with obesity (age 60+ years) were fit with an ActiGraph GT3X+ accelerometer on their nondominant wrist and hip before completing a series of tasks in a randomized order, including sitting/standing, sweeping, folding laundry, stair climbing, ambulation at different intensities, and cycling at different intensities. Participants returned a week later and completed the tasks once again. Vector magnitude counts/second were time-matched during each task and then summarized into counts/minute (CPM). RESULTS Monitors at both wear locations similarly characterized standing, sitting, and ambulatory tasks. A key finding was that light home chores (sweeping, folding laundry) produced higher and more variable CPM values than fast walking via wrist ActiGraph. Regression analyses revealed wrist CPM values were poor predictors of hip CPM values, with devices aligning best during fast walking (R2 = 0.25) and stair climbing (R2 = 0.35). CONCLUSIONS As older adults spend a considerable portion of their day in nonexercise activities of daily living, researchers should be cautious in the use of simply acceleration thresholds for scoring wrist-worn accelerometer data. Methods for better classifying wrist-worn activity monitor data in older adults are needed.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Michael E Miller
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Shyh-Huei Chen
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Carlo Davids
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Kyle Kershner
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
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Newton RL, Beyl R, Hebert C, Harris M, Carter L, Gahan W, Carmichael O. A Physical Activity Intervention in Older African Americans: The PAACE Pilot Randomized Controlled Trial. Med Sci Sports Exerc 2022; 54:1625-1634. [PMID: 35522253 PMCID: PMC9488750 DOI: 10.1249/mss.0000000000002956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Older African Americans have low levels of physical activity, which increases the risk of aging-related health conditions. This study aimed to determine the effectiveness of, and satisfaction with, a community-engaged physical activity intervention targeting older African Americans. METHODS Fifty-six older African Americans were randomized to a successful aging group (SAG) or a physical activity group (PAG) for 12 wk. The PAG consisted of two weekly group exercise sessions and two to three home-based exercise sessions per week. The SAG consisted of weekly group educational sessions related to various aspects of healthy aging. Physical activity was measured by ActiGraph accelerometers and the Community Healthy Activities Model Program for Seniors Activities Questionnaire in both groups, and a Fitbit was continuously worn by PAG participants. RESULTS Group session attendance was 93% and 86% in the PAG and SAG, respectively. The increase in ActiGraph-derived steps per day (1085.3 ± 265.6 vs 34.7 ± 274.3; P = 0.008) and daily minutes of moderate-to-vigorous physical activity (MVPA; 6.2 ± 1.6 vs 0.3 ± 1.7; d = 0.68; P = 0.01), and self-reported Community Healthy Activities Model Program for Seniors Activities Questionnaire MVPA bouts (3.5 ± 0.77 vs 0.33 ± 0.79; P < 0.001) were significantly greater within the PAG than the SAG. ActiGraph-derived minutes of daily MVPA and steps as well as Fitbit-derived steps per day were significantly greater on days when PAG participants engaged in group sessions compared with days when they self-reported home-based exercise or no exercise ( P < 0.016). Participants in both study arms reported high levels of satisfaction (>4- on 5-point Likert scale). CONCLUSIONS The intervention increased physical activity, was well attended, and resulted in high satisfaction. Future studies should assess long-term sustainability in this population.
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Godhe M, Pontén M, Nilsson J, Kallings LV, Andersson EA. Reliability of the accelerometer to control the effects of physical activity in older adults. PLoS One 2022; 17:e0274442. [PMID: 36095032 PMCID: PMC9467325 DOI: 10.1371/journal.pone.0274442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 08/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Reliable physical activity measurements in community-dwelling older adults are important to determine effects of targeted health promotion interventions. Many exercise interventions aim to improve time spent sedentary (SED), in light-intensity-physical-activity (LPA) and moderate-to-vigorous-intensity-physical-activity (MVPA), since these parameters have independently proposed associations with health and longevity. However, many previous studies rely on self-reports which have lower validity compared to accelerometer measured physical activity patterns. In addition, separating intervention-effects from reactivity measurements requires sufficient test-retest reliability for accelerometer assessments, which is lacking in older adults.
Objectives
The study objective was to investigate the reliability of sensor-based PA-patterns in community-dwelling older adults. Furthermore, to investigate change over time of physical activity patterns and examine any compensatory-effect from the eight-week supervised exercise-intervention.
Methods
An exercise-group (n = 78, age-range:65-91yrs) performed two 1h-exercise sessions/week during eight-weeks. PA-pattern was assessed (using hip-worn accelerometers), twice before and once during the last-week of the intervention. A control-group (n = 43, age-range:65-88yrs) performed one pre-test and the end-test with no exercise-intervention. A dependent-t-test, mean-difference (95%-CI), limits-of-agreement and intraclass-correlation-coefficient-ICC were used between the two pre-tests. Repeated-measures-ANOVA were used to analyze any intervention-effects.
Results
The exercise-groups´ two pre-tests showed generally no systematic change in any PA- or SED-parameter (ICC ranged 0.75–0.90). Compared to the control group, the exercise intervention significantly (time x group-interaction, p<0.05) increased total-PA-cpm (exercise-group/control-group +17%/+7%) and MVPA-min/week (+41/-2min) and decreased %-of-wear-time for SED-total (-4.7%/-2.7%) and SED-bouts (-5.7%/-1.8%), and SED-bouts min/d (-46/-16min). At baseline level, no significant differences were found between the two groups for any parameter.
Conclusions
The current study presents a good test-retest-reliability of sensor-based-one-week-assessed-PA-pattern in older-adults. Participating in an 8-week supervised exercise intervention improved some physical activity and sedentary parameters compared to the control group. No compensatory-effect was noted in the intervention-group i.e., no decrease in any PA-parameter or increase in SED at End-test (in %-of-wear-time, min/day or total-PA).
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Affiliation(s)
- Manne Godhe
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- * E-mail: ,
| | - Marjan Pontén
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Johnny Nilsson
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lena V. Kallings
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Eva A. Andersson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Cabral DF, Santos VS, Silva MJG, Leite GF, Mesquita APB, Pascual-Leone A, Cahalin LP, Batiston AP, Oliveira ACA, Gomes-Osman J. Recommending Physical Activity to Your Aging Patients? What Clinicians Need to Know to Increase Adherence From the Older Adult Perspective. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:923221. [PMID: 36189000 PMCID: PMC9397884 DOI: 10.3389/fresc.2022.923221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
A wealth of scientific evidence supports that being physically active may prevent or delay the onset of cognitive impairment and dementia. However, a critical barrier is that while most clinicians recommend physical activity (PA) and older adults recognize its health benefits, most older adults fail to regularly practice PA. Thus, it is necessary to explore and disseminate knowledge on how to help clinicians truly partner with people and help them to change their behavior and become more active. Clinical and scientific efforts are underway to establish dose-specific PA recommendations for cognitive brain health. However, an important knowledge gap is how to develop effective strategies to increase PA adherence in aging. To better understand the perspective of older adults, we undertook a mixed-method study on sixty-five sedentary older adults at risk for cognitive decline. Participants answered a questionnaire battery related to PA engagement, and a subcohort participated in a remote focus group. Our findings revealed four main themes: First, age and aging are determinants in PA practice. Second, maintaining both an active mind and autonomy are priorities, but planned PA is not usually related as part of being “active.” Third, motivational challenges in PA engagement were noted. And fourth, they emphasized a call for tailored recommendations. Therefore, we present a multidimensional model of PA adherence to maximize brain health in older adults and suggest a tool kit and key questions to effectively screen sedentary aging adults and translate current guidelines into the needs of the individual by using behavior change strategies.
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Affiliation(s)
- Danylo F. Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
- Research Group on Human Aging, Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Brazil
| | - Vinicius S. Santos
- Research Group on Human Aging, Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Brazil
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Maria Jasmine G. Silva
- Research Group on Human Aging, Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Brazil
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Gabriela F. Leite
- Research Group on Human Aging, Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Brazil
| | - Ana Paula B. Mesquita
- Research Group on Human Aging, Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Brazil
| | - Alvaro Pascual-Leone
- Guttmann Brain Health Institute, Institut Universitari de Neurorehabilitació, Barcelona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
- Linus Health, Waltham, MA, United States
| | - Lawrence P. Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
| | | | - Augusto C. A. Oliveira
- Research Group on Human Aging, Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Brazil
| | - Joyce Gomes-Osman
- Linus Health, Waltham, MA, United States
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
- *Correspondence: Joyce Gomes-Osman
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Cabral DF, Santos VS, Pereira OTT, Silva MJ, Pascual-Leone A, Rundek T, Loewenstein DA, Kirk-Sanchez N, Oliveira ACA, Gomes-Osman J. Feasibility and Preliminary Efficacy of a Multimodal Approach to Increase Physical Activity in Older Adults With Memory Complaints: The Education for Action Study. J Aging Phys Act 2022; 30:204-216. [PMID: 34412033 PMCID: PMC8857299 DOI: 10.1123/japa.2020-0484] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 11/18/2022]
Abstract
In this randomized controlled pilot trial, the authors explored the feasibility, technology compliance, and preliminary efficacy of the Education for Action (EDU-ACT), a multimodal intervention combining evidence-based strategies of physical activity (PA) education and coaching in PA levels over 4 weeks between EDU-ACT and control groups. The authors also assessed pre-post changes in neurocognitive function, functional mobility and dual-task performance, sleep and quality of life. Thirty-two sedentary older adults with memory complaints (age = 66 ± 5.3) completed the study (EDU-ACT = 18 and control = 14). The EDU-ACT adherence rate was 95%, and compliance of daily PA reporting was, on average, 22.7 days (94.6%). The EDU-ACT group demonstrated a significantly greater number of steps, processing speed, and dual-task performance when compared with controls (p < .05). In this study, a multimodal, evidence-based, low-cost intervention was feasible, well-accepted, with high adherence and compliance rates, and effective at promoting clinically meaningful increases in PA, for at least 1 month postintervention, in older adults with memory complaints.
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Affiliation(s)
- Danylo F. Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, 5915 Ponce de Leon Blvd, 5th Floor, Coral Gables, FL, 33146
- Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Alagoas, Brazil
| | - Vinicius S. Santos
- Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Alagoas, Brazil
| | - Oceano T. T. Pereira
- Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Alagoas, Brazil
| | - Maria J. Silva
- Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Alagoas, Brazil
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston MA, USA
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Rosindale, MA, USA
- Guttmann Brain Health Institute, Barcelona, Spain
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | | | - Neva Kirk-Sanchez
- Department of Physical Therapy, University of Miami Miller School of Medicine, 5915 Ponce de Leon Blvd, 5th Floor, Coral Gables, FL, 33146
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | - Augusto C. A. Oliveira
- Department of Physical Therapy, Alagoas State University of Health Sciences, Maceió, Alagoas, Brazil
| | - Joyce Gomes-Osman
- Department of Physical Therapy, University of Miami Miller School of Medicine, 5915 Ponce de Leon Blvd, 5th Floor, Coral Gables, FL, 33146
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
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10
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Single skeletal muscle fiber mechanical properties: a muscle quality biomarker of human aging. Eur J Appl Physiol 2022; 122:1383-1395. [DOI: 10.1007/s00421-022-04924-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/23/2022] [Indexed: 12/25/2022]
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11
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Wanigatunga AA, Cai Y, Urbanek JK, Mitchell CM, Roth DL, Miller ER, Michos ED, Juraschek SP, Walston J, Xue QL, Appel LJ, Schrack JA. Objectively measured patterns of daily physical activity and phenotypic frailty. J Gerontol A Biol Sci Med Sci 2021; 77:1882-1889. [PMID: 34562073 DOI: 10.1093/gerona/glab278] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Self-reported low physical activity is a defining feature of phenotypic frailty but does not adequately capture physical activity performed throughout the day. This study examined associations between accelerometer-derived patterns of routine daily physical activity and frailty. METHODS Wrist accelerometer and frailty data from 638 participants (mean age 77 (SD=5.5) years; 44% women) were used to derive five physical activity metrics: active minutes/day, sedentary minutes/day, total activity counts/day, activity fragmentation (reciprocal of the average active bout length) and sedentary fragmentation (reciprocal of the average sedentary bout length). Robust, pre-frail and frail statuses were identified using the physical frailty phenotype defined as having 0, 1-2, or ≥3 of the following criterion: weight loss, exhaustion, slowness, self-reported low activity, and weakness. Frailty was collapsed into not frail (robust and prefrail) and frail, and each frailty criteria was dichotomized. Multiple logistic regression was used to model each accelerometer metric. Separate frailty criteria and interactions with age and sex were also examined. RESULTS With higher amounts and intensity of daily activity (more active minutes, fewer sedentary minutes, higher activity counts) and lower activity fragmentation, the odds of frailty were lower compared to robust/prefrail states (p<0.02 for all). For interactions, only an age by sedentary fragmentation interaction on the odds of frailty was observed (p=0.01). For each separate criteria, accelerometer metrics were associated with odds of slowness, low activity, and weakness. CONCLUSION Less favorable patterns of objectively measured daily physical activity are associated with frailty and the components of slowness, low self-reported activity, and weakness.
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Affiliation(s)
- Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA
| | - Yurun Cai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jacek K Urbanek
- Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Christine M Mitchell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Edgar R Miller
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Erin D Michos
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Stephen P Juraschek
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, Massachusetts, USA
| | - Jeremy Walston
- Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Qian-Li Xue
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lawrence J Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.,Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA
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12
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Association of Physical Activity With Maximal and Submaximal Tests of Exercise Capacity in Middle- and Older-Aged Adults. J Aging Phys Act 2021; 30:271-280. [PMID: 34407506 DOI: 10.1123/japa.2020-0439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/23/2021] [Accepted: 05/03/2021] [Indexed: 11/18/2022]
Abstract
Although physical activity (PA) is an important determinant of exercise capacity, the association between these constructs is modest. The authors investigated the associations of self-reported and objectively measured PA with maximal and submaximal tests of exercise capacity. Participants aged ≥40 years (N = 413; 49.6% female) completed a PA questionnaire, wore a uniaxial accelerometer (5.2 ± 1.1 days), and performed maximal (cardiopulmonary exercise test [CPET]) and submaximal (long-distance corridor walk) tests with indirect calorimetry (oxygen consumption, V˙O2). Linear regression models were fitted to assess the variation in exercise capacity explained (partial eta squared, η2) by PA variables. Accelerometer-measured vigorous (η2 = 22% female; η2 = 16% male) and total PA (η2 = 17% female; η2 = 13% male) explained the most variance in CPET V˙O2 (p < .001). All η2 values were lower for long-distance corridor walk V˙O2 (η2 ≤ 11%). Age contributed more to CPET V˙O2 than any PA variable in males (η2 = 32%), but not in females (η2 = 19%). Vigorous and total PA play important roles in CPET V˙O2 in mid to late life.
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13
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Liu F, Wanigatunga AA, Schrack JA. Assessment of Physical Activity in Adults using Wrist Accelerometers. Epidemiol Rev 2021; 43:65-93. [PMID: 34215874 DOI: 10.1093/epirev/mxab004] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 11/12/2022] Open
Abstract
The health benefits of physical activity have been widely recognized, yet traditional measures of physical activity including questionnaires and category-based assessments of volume and intensity provide only broad estimates of daily activities. Accelerometers have advanced epidemiologic research on physical activity by providing objective and continuous measurement of physical activity in free-living conditions. Wrist-worn accelerometers have become especially popular due to low participant burden. However, the validity and reliability of wrist-worn devices for adults have yet to be summarized. Moreover, accelerometer data provide rich information on how physical activity is accumulated throughout the day, but only a small portion of these rich data have been utilized by researchers. Lastly, new methodological developments that aim to overcome some of the limitations of accelerometers are emerging. The purpose of this review is to provide an overview of accelerometry research, with a special focus on wrist-worn accelerometers. We describe briefly how accelerometers work, summarize the validity and reliability of wrist-worn accelerometers, discuss the benefits of accelerometers including measuring light-intensity physical activity, and discuss pattern metrics of daily physical activity recently introduced in the literature. A summary of large-scale cohort studies and randomized trials that implemented wrist-worn accelerometry is provided. We conclude the review by discussing new developments and future directions of research using accelerometers, with a focus on wrist-worn accelerometers.
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Affiliation(s)
- Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, United States
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14
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Liu F, Wanigatunga AA, Kuo PL, Zipunnikov V, Simonsick EM, Ferrucci L, Schrack JA. Association between walking energetics and fragmented physical activity in mid-to-late life. J Gerontol A Biol Sci Med Sci 2021; 76:e281-e289. [PMID: 33963748 DOI: 10.1093/gerona/glab127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Physical activity becomes increasingly fragmented with age, which may be an early marker of functional decline. Energetic cost of walking and energy capacity are also linked with functional decline, but their associations with activity fragmentation, and the potential modifying roles of total daily physical activity and age, remains unclear. METHODS 493 participants (50-93 years) from the Baltimore Longitudinal Study of Aging underwent measures of: energetic cost of usual-paced overground walking (ml/kg/m), energy demand during slow walking (ml/kg/min) on a treadmill (0.67 m/s, 0% grade),m/s, 0% grade), and average peak walking energy expenditure (ml/kg/min) during a fast-paced 400-m walk. A ratio of slow walking to peak walking energy expenditure ("cost-to-capacity ratio") was calculated. Activity fragmentation was quantified as an active-to-sedentary transition probability (ASTP) using Actiheart accelerometer data. Linear regression models with ASTP as the dependent variable were used to test whether poorer energy cost and capacity were associated with higher ASTP and whether the associations differed by daily physical activity or age. RESULTS After adjusting for demographics, body composition, comorbidities and daily physical activity, every 10% higher cost-to-capacity ratio was associated with 0.4% greater ASTP (p=0.005). This association was primarily driven by the least active participants (pinteraction=0.023). Peak walking energy expenditure was only associated with ASTP among participants aged ≥70 years. CONCLUSIONS Higher cost-to-capacity ratio and lower energy capacity may manifest as more fragmented physical activity, especially among those less active or aged ≥70 years. Future studies should examine whether an increasing cost-to-capacity ratio or declining energy capacity predicts subsequent activity fragmentation.
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Affiliation(s)
- Fangyu Liu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amal A Wanigatunga
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Pei-Lun Kuo
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Vadim Zipunnikov
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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15
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Rosen P, Dohrn I, Hagströmer M. Latent profile analysis of physical activity and sedentary behavior with mortality risk: A 15‐year follow‐up. Scand J Med Sci Sports 2020; 30:1949-1956. [DOI: 10.1111/sms.13761] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/18/2020] [Accepted: 06/26/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Philip Rosen
- Department of Neurobiology, Care Sciences, and Society (NVS) Division of Physiotherapy Karolinska Institutet Huddinge Sweden
| | - Ing‐Mari Dohrn
- Department of Neurobiology, Care Sciences, and Society (NVS) Division of Physiotherapy Karolinska Institutet Huddinge Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences, and Society (NVS) Division of Physiotherapy Karolinska Institutet Huddinge Sweden
- Medical unit, Occupational Therapy and Physiotherapy Karolinska University HospitalAllied Health Professional Function Stockholm Sweden
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16
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Thomas E, Bianco A, Tabacchi G, Marques da Silva C, Loureiro N, Basile M, Giaccone M, Sturm DJ, Şahin FN, Güler Ö, Gómez-López M, López Sánchez GF, Pajaujiene S, Zuoziene IJ, Rada A, Alesi M, Palma A. Effects of a Physical Activity Intervention on Physical Fitness of schoolchildren: The Enriched Sport Activity Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051723. [PMID: 32155773 PMCID: PMC7084442 DOI: 10.3390/ijerph17051723] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 11/17/2022]
Abstract
Background: Physical fitness in youth is a predictor of health in adulthood. The main objective of the present study was to understand if an enriched sport activity program could increase physical fitness in a population of schoolchildren. Methods: In a sample of 672 children aged 10.0 ± 1.90 years, different motor skills were tested by the 1 kg and 3 kg ball throw (BT), the standing broad jump (SBJ), the 30 m sprint (30mS), the leger shuttle run (LSR), the illinois agility test (IGT), and the quadruped test (QT). Within the controlled-trial, the intervention group (ESA) underwent an additional warm-up protocol, which included cognitive enhancing elements, for 14 weeks while the control group continued with ordinary exercise activity. Results: A significant increase was present regarding the 1 kg and 3 kg BT, the SBJ, the 30mS, and the IGT, while no significant difference was shown regarding the QT and the LSR in the ESA group between pre and post intervention. In the control group, no differences were present for any test except for the QT and the LSR post-test. Conclusion: A 14-week structured physical intervention had moderate effects regarding throwing, jumping, sprinting, and agility in a sample of schoolchildren.
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Affiliation(s)
- Ewan Thomas
- Department of Psychological, Pedagogical, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (E.T.); (A.B.); (G.T.); (M.A.); (A.P.)
| | - Antonino Bianco
- Department of Psychological, Pedagogical, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (E.T.); (A.B.); (G.T.); (M.A.); (A.P.)
| | - Garden Tabacchi
- Department of Psychological, Pedagogical, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (E.T.); (A.B.); (G.T.); (M.A.); (A.P.)
| | - Carlos Marques da Silva
- CIEQV-Life Quality Research Centre, Escola Superior de Desporto de Rio Maior-IPSANTAREM, Av. Dr. Mário Soares, 20413 RIO Maior, Portugal; (C.M.d.S.); (N.L.)
| | - Nuno Loureiro
- CIEQV-Life Quality Research Centre, Escola Superior de Desporto de Rio Maior-IPSANTAREM, Av. Dr. Mário Soares, 20413 RIO Maior, Portugal; (C.M.d.S.); (N.L.)
| | - Michele Basile
- University of Palermo Sport Center (CUS Palermo), Via Altofonte, 80, 90129 Palermo, Italy; (M.B.); (M.G.)
| | - Marcello Giaccone
- University of Palermo Sport Center (CUS Palermo), Via Altofonte, 80, 90129 Palermo, Italy; (M.B.); (M.G.)
| | - David J. Sturm
- Department of School of Sport and Health Sciences, Professorship of Educational Science in Sport and Health, Technical University of Munich, Uptown Munich Campus D, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany;
| | - Fatma Neşe Şahin
- Department of Sport and Health, Faculty of Sport Sciences, Ankara University, Golbaşı Yerleşkesi Spor Bilimleri Fakültesi, Golbaşı, 06830 Ankara, Turkey;
- Correspondence:
| | - Özkan Güler
- Department of Sport and Health, Faculty of Sport Sciences, Ankara University, Golbaşı Yerleşkesi Spor Bilimleri Fakültesi, Golbaşı, 06830 Ankara, Turkey;
| | - Manuel Gómez-López
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, Calle Argentina, s/n., 30720 Murcia, Spain; (M.G.-L.); (G.F.L.S.)
| | - Guillermo F. López Sánchez
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, Calle Argentina, s/n., 30720 Murcia, Spain; (M.G.-L.); (G.F.L.S.)
| | - Simona Pajaujiene
- Department of Coaching Science, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania; (S.P.); (I.J.Z.)
| | - Ilona Judita Zuoziene
- Department of Coaching Science, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania; (S.P.); (I.J.Z.)
| | - Ante Rada
- Faculty of Kinesiology, University of Split, Teslina 6, 21000 Split, Croatia;
| | - Marianna Alesi
- Department of Psychological, Pedagogical, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (E.T.); (A.B.); (G.T.); (M.A.); (A.P.)
| | - Antonio Palma
- Department of Psychological, Pedagogical, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (E.T.); (A.B.); (G.T.); (M.A.); (A.P.)
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17
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Ghitea TC, Vlad S, Birle D, Tit DM, Lazar L, Nistor-Cseppento C, Behl T, Bungau S. The influence of diet therapeutic intervention on the sarcopenic index of patients with metabolic syndrome. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:470-478. [PMID: 34084239 DOI: 10.4183/aeb.2020.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction The published data showed the importance of metabolic control in preventing complications in metabolic syndrome (MS) and the role of nutritional medical therapy in glycemic control and in the control of dyslipidemia, hypertension, weight loss/normalization (in overweight or malnourished subjects). Objectives This study follows the evolution of sarcopenic index (SI) and other clinical parameters (body mass index (BMI), homeostasis evaluation index (HOMA index)) correlated with MS after diet therapy or diet therapy combined with sports, in patients with MS. Patients and methods Our research was conducted during 12 months, on 110 patients >18 years of age, with HOMA index>2, divided into three groups: control group (CG, N=20), diet therapy group (DTG, N=58), diet therapy and sports group (DTSG, N=32). HOMA index for insulin resistance was calculated as the product of resting plasma insulin (in microunits/milliliter) and plasma glucose (in millimoles/liter), divided by 22.5. SI was determined using BIA, as being the ratio between muscle mass and fat mass, measured in cm2/m2. Results A significant decrease of BMI (p<0.05) in DTG (from 31.63 to 24.50) and DTSG (from 30.18 to 24.17) vs. CG was observed (Pearson coefficient r=0.281, p<0.001). Weight status changed significantly (p<0.05) in the high-risk patients. There was a significant decrease of HOMA index (p<0.05) in DTG (from 5.93 to 2.57), DTSG (from 3.93 to 2.23), and in CG an increase was observed (from 3.15 to 3.37). Conclusion The best results in the prevention/ treatment of sarcopenia in MS patients were obtained for DTSG, which benefited from both the positive effect of diet and physical activity.
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Affiliation(s)
- T C Ghitea
- University of Oradea, Faculty of Medicine and Pharmacy, Dept. of Pharmacy, Oradea, Romania
| | - S Vlad
- Dept. of Surgery Disciplines, Oradea, Romania
| | - D Birle
- Faculty of Socio-Human Sciences, Dept. of Psychology, Oradea, Romania
| | - D M Tit
- University of Oradea, Faculty of Medicine and Pharmacy, Dept. of Pharmacy, Oradea, Romania
| | - L Lazar
- Dept. of Psycho-neurosciences and Recovery, Oradea, Romania
| | | | - T Behl
- Chitkara University, Chitkara College of Pharmacy, Dept. of Pharmacology, Punjab, India
| | - S Bungau
- University of Oradea, Faculty of Medicine and Pharmacy, Dept. of Pharmacy, Oradea, Romania
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18
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Schrack JA, Kuo PL, Wanigatunga AA, Di J, Simonsick EM, Spira AP, Ferrucci L, Zipunnikov V. Active-to-Sedentary Behavior Transitions, Fatigability, and Physical Functioning in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 74:560-567. [PMID: 30357322 DOI: 10.1093/gerona/gly243] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND With aging, daily physical activity (PA) becomes less frequent and more fragmented. Accumulation patterns of daily PA-including transitions from active-to-sedentary behaviors-may provide important insights into functional status in older, less active populations. METHODS Participants of the Baltimore Longitudinal Study of Aging (n = 680, 50% male, aged 27-94 years) completed a clinical assessment and wore an Actiheart accelerometer. Transitions between active and sedentary states were modeled as a probability (Active-to-Sedentary Transition Probability [ASTP]) defined as the reciprocal of the average PA bout duration. Cross-sectional associations between ASTP and gait speed (m/s), fatigability (rating-of-perceived-exertion [RPE]), 400 m time (seconds), and expanded short physical performance battery score were modeled using linear and logistic regression, adjusted for chronic conditions. Further analyses explored the utility of ASTP over-and-above total daily PA. RESULTS In continuous models, each 0.10-unit higher ASTP was associated slower gait (β = -0.06 m/s, SE = 0.01), higher fatigability (β = 0.60 RPE, SE = 0.12), slower 400 m time (β = 16.31 s, SE = 2.70), and lower functioning (β = -0.13 expanded short physical performance battery score, SE = 0.03; p < .001). In categorical analyses, those in the highest tertile of ASTP were >2 times more likely to have high fatigability (rating of perceived exertion ≥10), slow 400 m time (>300 seconds) and reduced functional performance (expanded short physical performance battery score < 3.07) than those in the lowest tertile (p < .01). Further analyses demonstrated ASTP provided additional insight into functional outcomes beyond total daily PA. CONCLUSION Fragmented daily PA-as measured by ASTP-is strongly linked with measures of health and functional status and may identify those at risk of high fatigability and reduced functional performance over and above traditional PA metrics.
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Affiliation(s)
- Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Pei-Lun Kuo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Junrui Di
- Department of Biostatistics, Baltimore, Maryland
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Adam P Spira
- Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
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19
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Chang AH, Lee J, Song J, Price LL, Lee AC, Reid KF, Fielding RA, Driban JB, Harvey WC, Wang C. Association between Pre-Intervention Physical Activity Level and Treatment Response to Exercise Therapy in Persons with Knee Osteoarthritis - An Exploratory Study. ACR Open Rheumatol 2019; 1:104-112. [PMID: 31763622 PMCID: PMC6857980 DOI: 10.1002/acr2.1013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective Examine whether pre‐intervention physical activity (PA) level is associated with achieving a positive treatment response of pain and/or function improvement after a 12‐week exercise intervention in participants with knee osteoarthritis (OA). Methods We performed a secondary analysis of a randomized, single‐blind comparative effectiveness trial showing similar treatment effects between Tai Chi mind‐body exercise and standard physical therapy intervention for knee OA. Baseline PA was assessed by a Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and, in a subsample, by tri‐axial accelerometers. The Outcome Measures in Rheumatoid Arthritis Clinical Trials–Osteoarthritis Research Society International (OMERACT‐OARSI) dichotomous responder criteria was used for clinically meaningful improvement at follow‐up. Associations between baseline self‐reported PA by the CHAMPS questionnaire and outcomes of responders vs. nonresponders (reference group) were assessed using logistic regressions, adjusting for demographic covariates. We compared objectively measured PA by accelerometry between responders vs. nonresponders using Wilcoxon tests. Results Our sample consisted of 166 participants with knee OA who completed both baseline and 12‐week postintervention evaluations: mean age 60.7 year (SD 10.5), body mass index 32.4 kg/m2 (6.9), 119 (72%) women, and 138 (83%) OMERACT‐OARSI responders. Neither time spent in total PA [odds ratio (OR) 1.00; 95% confidence interval (CI) 0.96, 1.03] nor time in moderate‐to‐vigorous PA (OR 1.01; 95% CI 0.93, 1.09) at pre‐intervention were associated with being a responder. Similar findings were observed in 42 accelerometry sub‐cohort participants. Conclusion Pre‐intervention PA levels (subjective report or objective measurement) were not associated with individuals achieving favorable treatment outcomes after a 12‐week exercise intervention, which suggests that regardless of pre‐intervention PA level, individuals will likely benefit from structured exercise interventions.
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Affiliation(s)
- Alison H Chang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jungwha Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jing Song
- Rheumatology Division, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA and Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.,Center for Complementary and Integrative Medicine; Division of Rheumatology, Allergy & Immunology; Tufts Medical Center, Boston, MA, USA
| | - Augustine C Lee
- Center for Complementary and Integrative Medicine; Division of Rheumatology, Allergy & Immunology; Tufts Medical Center, Boston, MA, USA
| | - Kieran F Reid
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Jeffrey B Driban
- Center for Complementary and Integrative Medicine; Division of Rheumatology, Allergy & Immunology; Tufts Medical Center, Boston, MA, USA
| | - William C Harvey
- Center for Complementary and Integrative Medicine; Division of Rheumatology, Allergy & Immunology; Tufts Medical Center, Boston, MA, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine; Division of Rheumatology, Allergy & Immunology; Tufts Medical Center, Boston, MA, USA
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20
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von Rosen P, Dohrn IM, Hagströmer M. Association between physical activity and all-cause mortality: A 15-year follow-up using a compositional data analysis. Scand J Med Sci Sports 2019; 30:100-107. [PMID: 31581345 DOI: 10.1111/sms.13561] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/18/2019] [Accepted: 09/23/2019] [Indexed: 01/07/2023]
Abstract
The association between the composition of movement behaviors and mortality risk, acknowledging the composition nature of daily time data, is limited explored. The aim was to investigate how the composition of time spent in sedentary behaviors (SB), light intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) is associated with all-cause mortality, in a cohort with 15 years follow-up time, using compositional data analysis. Eight hundred fifty-one participants (56% women, mean age 53 years) provided objectively assessed physical activity data using an ActiGraph accelerometer and were followed for 15 years. Association of daily time composition of movement behaviors with risk of mortality was explored using compositional data analysis and hazard ratios (HR) of mortality were estimated based on a cox regression model. A significant (P < .001) positive association between time spent in SB relative to time in other behaviors and a significant (P = .018) negative association between time spent in LIPA relative to time in other behaviors, with all-cause mortality, were found. Substituting time spent in LIPA or MVPA with time in SB increased the hazard for all-cause mortality, with greater effect found for MVPA (20 minutes replacement; HR 1.26, 95% CI 1.04-1.52) than for LIPA (20 minutes replacement; HR 1.06, 95% CI 0.65-1.73). In a public health perspective, it is recommended to substitute SB with either LIPA or MVPA, but for individuals with little time spent in MVPA, the most important message may be to try to maintain that behavior.
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Affiliation(s)
- Philip von Rosen
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Huddinge, Sweden
| | - Ing-Mari Dohrn
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Huddinge, Sweden.,Allied Health Professional Function, Function area Occupational Therapy and Physiotherapy, Karolinska University Hosptial, Stockholm, Sweden.,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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21
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Wanigatunga AA, Di J, Zipunnikov V, Urbanek JK, Kuo PL, Simonsick EM, Ferrucci L, Schrack JA. Association of Total Daily Physical Activity and Fragmented Physical Activity With Mortality in Older Adults. JAMA Netw Open 2019; 2:e1912352. [PMID: 31577355 PMCID: PMC6777397 DOI: 10.1001/jamanetworkopen.2019.12352] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/12/2019] [Indexed: 01/14/2023] Open
Abstract
Importance Fragmented daily physical activity may be a sign of physiological decline that provides more powerful insight into impending mortality than total daily activity. Objective To compare and contrast the association between total daily activity and activity fragmentation, which encompasses activity bouts and duration, and mortality risk. Design, Setting, and Participants In this cohort study, accelerometer data from 2007 through 2015 and mortality data from 2007 through 2017 were collected from 548 adults aged 65 years and older participating in the Baltimore Longitudinal Study of Aging. The dates of analysis were November 2016 to June 2019, with data collected through December 31, 2017. Using Cox proportional hazards regression, the association between accelerometer-derived patterns of physical activity and mortality was estimated after adjusting for demographic characteristics, lifestyle factors, and comorbidities. Exposures Minute-by-minute physical activity data were collected over a 24-hour, 7-day period (excluding times between 11:00 pm and 4:59 am) using an accelerometer. Each minute was labeled either active or sedentary, and 5 features of accelerometer data were extracted: total daily activity (defined as any activity performed throughout the day), activity fragmentation (defined as an active-to-sedentary transition probability), and 3 measures of activity bouts (<5, 5-10, and ≥10 active minutes). Main Outcomes and Measures All-cause mortality. Results Among 548 well-functioning older adults (mean [SD] age, 75.8 [7.2] years; 262 [47.8%] women), 61 participants (11.1%) died. Total daily physical activity was not associated with mortality risk (hazard ratio [HR], 0.90 [95% CI, 0.75-1.08]; P = .28). However, more fragmented physical activity patterns were associated with greater mortality risk (HR, 1.49 [95% CI, 1.02-2.19]; P = .04) after adjusting for age, sex, race/ethnicity, body mass index, smoking history, employment, self-reported health, grip strength, usual gait speed, comorbidities, and device wear time. In addition, more frequently engaging in activity bouts lasting less than 5 minutes was associated with greater mortality risk (HR, 1.28 [95% CI, 1.01-1.61]; P = .04), whereas activity bouts of 5 to 10 minutes (HR, 0.99 [95% CI, 0.58-1.69]; P = .97) and 10 minutes or longer (HR, 0.81 [95% CI, 0.65-1.01]; P = .06) were not associated with mortality risk. Conclusions and Relevance In this cohort study of well-functioning adults aged 65 years and older, fragmented daily physical activity, particularly activity bouts lasting less than 5 minutes, was associated with greater mortality risk. These findings suggest that activity fragmentation in older adults may precede declines in functional capability and overall physical activity that typically indicate impending mortality.
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Affiliation(s)
- Amal A. Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland
| | - Junrui Di
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Now with Pfizer, Cambridge, Massachusetts
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jacek K. Urbanek
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland
- Division of Geriatric Medicine, Johns Hopkins University and Medical Institutions, Baltimore, Maryland
| | - Pei-Lun Kuo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | | | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
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22
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Reid KF, Laussen J, Bhatia K, Englund DA, Kirn DR, Price LL, Manini TM, Liu CK, Kowaleski C, Fielding RA. Translating the Lifestyle Interventions and Independence for Elders Clinical Trial to Older Adults in a Real-World Community-Based Setting. J Gerontol A Biol Sci Med Sci 2019; 74:924-928. [PMID: 30010808 PMCID: PMC6521918 DOI: 10.1093/gerona/gly152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 07/04/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Lifestyle Interventions and Independence for Elders (LIFE) clinical trial demonstrated that a structured program of physical activity (PA) reduced mobility-disability in older adults by up to 28%. It remains unknown whether the benefits of LIFE PA can be translated to older adults at risk for mobility-disability in real-world community-based settings. To address this knowledge gap, we conducted the ENhancing independence using Group-based community interventions for healthy AGing in Elders (ENGAGE) pilot study and examined the safety, feasibility, and preliminary effectiveness of translating LIFE PA to a community-based senior center. METHODS Forty older adults with severe lower extremity functional limitations (age: 76.9 ± 7.3 years; body mass index: 32.7 ± 8 kg/m2; 85% female; short physical performance battery score: 6.3 ± 2.2) were randomized to 24 weeks of PA or a health education control intervention. RESULTS Community-based PA was safe (serious adverse events: PA vs health education, 0:2; nonserious adverse events: PA vs health education, 3:1) and participants successfully adhered to the PA intervention (65.2%). Compared to health education, PA participants who attended ≥25% of scheduled visits had meaningful and sustained short physical performance battery improvements at follow-up (between group short physical performance battery score differences: ~0.7 units). CONCLUSIONS ENGAGE has demonstrated the preliminary safety, feasibility, and effectiveness of LIFE PA in a real-world community-based setting. Larger-scale translational studies are needed to further disseminate the benefits of LIFE PA to vulnerable older adults in a variety of community-based settings.
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Affiliation(s)
- Kieran F Reid
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Jonathan Laussen
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Karan Bhatia
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Davis A Englund
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Dylan R Kirn
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Christine K Liu
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
- Section of Geriatrics, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Christopher Kowaleski
- City of Somerville Council on Aging, Health and Human Services Department, Somerville, Massachusetts
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
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23
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Schrack JA, Leroux A, Fleg JL, Zipunnikov V, Simonsick EM, Studenski SA, Crainiceanu C, Ferrucci L. Using Heart Rate and Accelerometry to Define Quantity and Intensity of Physical Activity in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 73:668-675. [PMID: 29509832 DOI: 10.1093/gerona/gly029] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Indexed: 11/13/2022] Open
Abstract
Background Physical activity (PA) prevents disease and promotes longevity; yet, few older adults meet the recommended daily guidelines. Wearable PA and heart rate monitors provide the opportunity to define age-related differences in the absolute and relative intensity of daily activities, and provide insight into the underlying factors influencing PA in older adults. Methods Participants in the Baltimore Longitudinal Study of Aging (n = 440, 52% male, aged 31 to 88 years) completed a clinical assessment and wore an Actiheart monitor in the free-living environment. The association between age and minutes per day in sedentary, light, moderate, and vigorous PA was assessed using relative intensity, as defined by heart rate reserve, and absolute intensity using activity count thresholds. Results In cross-sectional analyses, time spent in sedentary and light activities as defined by relative intensity did not differ across age (p > 0.05), whereas time spent in moderate and vigorous relative PA was higher for each 1 year increase in age (p < .01). Using absolute intensity PA thresholds, older adults registered fewer activity counts per day with more sedentary time and lesser amounts of light, moderate, and vigorous PA (p < .05). Persons with higher relative and lower absolute PA intensity had poorer functional performance and higher subclinical disease indicators. Conclusions These findings suggest that time spent in moderate or higher intensity activities may not be lower with age after considering changes in physiology, functional ability, and subclinical disease burden and highlight the need for more age- and ability-specific PA research to inform future interventions and public health guidelines.
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Affiliation(s)
- Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | - Andrew Leroux
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jerome L Fleg
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eleanor M Simonsick
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | | | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland
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24
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Wanigatunga AA, Gill TM, Marsh AP, Hsu FC, Yaghjyan L, Woods AJ, Glynn NW, King AC, Newton RL, Fielding RA, Pahor M, Manini TM. Effect of Hospitalizations on Physical Activity Patterns in Mobility-Limited Older Adults. J Am Geriatr Soc 2019; 67:261-268. [PMID: 30452084 PMCID: PMC6613645 DOI: 10.1111/jgs.15631] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/15/2018] [Accepted: 09/03/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the effect of hospitalizations on patterns of sedentary and physical activity time in mobility-limited older adults randomized to structured physical activity or health education. DESIGN Secondary analysis of investigator-blinded, parallel-group, randomized trial conducted at 8 U.S. centers between February 2010 and December 2013. PARTICIPANTS Sedentary men and women aged 70 to 89 at baseline who wore a hip-fitted accelerometer 7 consecutive days at baseline and 6, 12, and 24 months after randomization (N=1,341). MEASUREMENTS Participants were randomized to a physical activity (PA; n = 669) intervention that included aerobic, resistance, and flexibility training or to a health education (HE; n = 672) intervention that consisted of workshops on older adult health and light upper-extremity stretching. Accelerometer patterns were characterized as bouts of sedentary (<100 counts/min; ≥1, ≥10, ≥30, ≥60 minute lengths) and activity (≥100 counts/min; ≥1, ≥2, ≥5, ≥10 minute lengths) time. Each participant was categorized as having 0, 1 to 3, or 4 or more cumulative hospital days before each accelerometer assessment. RESULTS Hospitalization increased sedentary time similarly in both intervention groups (8 min/d for 1-3 cumulative hospital days and 16 min/d for ≥4 cumulative hospital days). Hospitalization was also associated with less physical activity time across all bouts of less than 10 minutes (≥1: -7 min/d for 1-3 cumulative hospital days, -16 min/d for ≥4 cumulative hospital days; ≥2: -5 min/d for 1-3 cumulative hospital days, -11 min/d for ≥4 cumulative hospital days; ≥5: -3 min/d for 1-3 cumulative hospital days, -4 min/d for ≥4 cumulative hospital days). There was no evidence of recovery to prehospitalization levels (time effect p >.41). PA participants had less sedentary time in bouts of less than 30 minutes than HE participants (-8 to -10 min/d) and more total activity (+3 to +6 min/d), although hospital-related changes were similar between the intervention groups (interaction effect p >.26). CONCLUSION Participating in a PA intervention before hospitalization had expected benefits, but participants remained susceptible to hospitalization's detrimental effects on their daily activity levels. There was no evidence of better activity recovery after hospitalization. J Am Geriatr Soc 67:261-268, 2019.
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Affiliation(s)
- Amal A. Wanigatunga
- Department of Epidemiology & Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | - Thomas M. Gill
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Anthony P. Marsh
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - Fang-Chi Hsu
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida
| | - Adam J. Woods
- Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida
| | - Nancy W. Glynn
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Abby C. King
- Department of Health Research & Policy and Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Robert L. Newton
- Population and Public Health, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Roger A. Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Marco Pahor
- Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida
| | - Todd M. Manini
- Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida
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25
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Physical activity fragmentation as a potential phenotype of accelerated aging. Oncotarget 2019; 10:807-809. [PMID: 30783511 PMCID: PMC6368227 DOI: 10.18632/oncotarget.26631] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 01/19/2019] [Indexed: 11/25/2022] Open
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26
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Oliveira JRS, Mohamed JS, Myers MJ, Brooks MJ, Alway SE. Effects of hindlimb suspension and reloading on gastrocnemius and soleus muscle mass and function in geriatric mice. Exp Gerontol 2018; 115:19-31. [PMID: 30448397 DOI: 10.1016/j.exger.2018.11.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/09/2018] [Accepted: 11/14/2018] [Indexed: 12/21/2022]
Abstract
Reloading of atrophied muscles after hindlimb suspension (HLS) can induce muscle injury and prolong recovery after disuse in old rats, especially in fast contracting muscles. Less is known about the responses in mice and whether fast and slow muscles from geriatric mice will respond in a similar fashion to HLS unloading and recovery (HLS + R). Furthermore, while slow muscles undergo atrophy with disuse, they typically are more resistant to sarcopenia than fast contracting muscles. Geriatric (28 mo. of age) male C57BL/6 mice were randomly placed into 3 groups. These included HLS for 14 days n = 9, and HLS followed by 14 days of reloading recovery (HLS + R; n = 9), or normal ambulatory cage controls (n = 9). Control mice were not exposed to unloading. Electrically evoked maximal muscle function was assessed in vivo in anesthetized mice at baseline, after 14 days of HLS or HLS + R. As expected, HLS significantly reduced body weight, wet weight of gastrocnemius and soleus muscles and in vivo maximal force. There were no differences in vivo fatigability of the plantar flexor muscles and overall fiber size. There were only minor fiber type distribution and frequency distribution of fiber sizes that differ between HLS + R and control gastrocnemius and soleus muscles. Soleus muscle wet weight had recovered to control levels after reloading, but type I/IIA fibers in the soleus muscles were significantly smaller after HLS + R than control muscles. In contrast, gastrocnemius muscle wet weight did not recover to control levels after reloading. Plantar flexion muscle force (primarily influenced by the gastrocnemius muscles) did not recover in HLS + R conditions as compared to HLS conditions and both were lower than control force production signaling for apoptosis, autophagy and anabolic markers were not different between control and HLS + R gastrocnemius and soleus muscles in geriatric mice. These results suggest that molecular signaling does not explain attenuated ability to regain muscle wet weight, fiber size or muscle force production after HLS in geriatric mice. It is possible that fluid shifts, reduced blood flow, or shortened muscle fibers which failed to regain control lengths contributed to the attenuation of muscle wet weight after HLS and reloading and this affected force production. Further work is needed to determine if altered/loss of neural activity contributed to the inability of geriatric mice to regain gastrocnemius muscle weight and function after HLS and reloading.
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Affiliation(s)
- João Ricardhis S Oliveira
- Interuniversity Exchange Undergraduate Program, CAPES Foundation, Universidade Federal de Pernambuco, Recife, PE 50670-901, Brazil; Laboratory of Muscle Biology and Sarcopenia, Division of Exercise Physiology, Dept. of Human Performance & Applied Exercise Science, West Virginia University School of Medicine, Morgantown, WV 26506, United States of America
| | - Junaith S Mohamed
- Department of Clinical Laboratory Sciences, University of Tennessee Health Sciences Center, Memphis, TN 38163, United States of America; Laboratory of Muscle Biology and Sarcopenia, Division of Exercise Physiology, Dept. of Human Performance & Applied Exercise Science, West Virginia University School of Medicine, Morgantown, WV 26506, United States of America
| | - Matthew J Myers
- Laboratory of Muscle Biology and Sarcopenia, Division of Exercise Physiology, Dept. of Human Performance & Applied Exercise Science, West Virginia University School of Medicine, Morgantown, WV 26506, United States of America
| | - Matthew J Brooks
- Laboratory of Muscle Biology and Sarcopenia, Division of Exercise Physiology, Dept. of Human Performance & Applied Exercise Science, West Virginia University School of Medicine, Morgantown, WV 26506, United States of America
| | - Stephen E Alway
- Dept. of Physical Therapy, College of Health Professions, University of Tennessee Health Sciences Center, Memphis, TN 38163, United States of America; Department of Physiology, College of Medicine, University of Tennessee Health Sciences Center, Memphis, TN 38163, United States of America; Laboratory of Muscle Biology and Sarcopenia, Division of Exercise Physiology, Dept. of Human Performance & Applied Exercise Science, West Virginia University School of Medicine, Morgantown, WV 26506, United States of America.
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27
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Wanigatunga AA, Manini TM, Cook DR, Katula J, Fielding RA, Kramer AF, Verghese J, Rapp SR, Sink KM, King AC, Buford TW, Anton S, Nadkarni N, Jennings JM, Reid K, Espeland MA, Gill TM, Pahor M, Nocera JR. Community-Based Activity and Sedentary Patterns Are Associated With Cognitive Performance in Mobility-Limited Older Adults. Front Aging Neurosci 2018; 10:341. [PMID: 30498440 PMCID: PMC6249499 DOI: 10.3389/fnagi.2018.00341] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 10/10/2018] [Indexed: 01/07/2023] Open
Abstract
Over the last few decades, considerable evidence shows that greater levels of aerobic exercise and cardiovascular fitness benefit cognitive performance. However, the degree to which free-living activity in community settings is related to cognitive performance remains unclear, particularly in older adults vulnerable to disability. Also, it is unknown whether the manner in which daily physical activity (PA) and sedentary time are accumulated throughout the day is associated with cognition. Cross-sectional associations between accelerometer-characterized PA and sedentary patterns and cognitive performance were examined in 1,274 mobility-limited older adults. Percent time spent in various bout lengths of PA (≥1, ≥2, and ≥5 min) and sedentary (≥1, ≥30, and ≥60 min) was defined as the number of minutes registered divided by total wear time × 100. Percent time was then tertiled for each bout length. Multiple linear regression models were used to estimate the associations between accelerometer bout variables and separate cognitive domains that included processing speed (Digit Symbol Coding; DSC), immediate and delayed recall (Hopkins Verbal Learning Test; HVLT), information processing and selective attention (Flanker), working memory (n-back), reaction time (switch and non-switch reaction time), and a composite score that averaged results from all cognitive tests. After adjusting for demographics, behavioral factors, and morbid conditions, more time spent in PA was associated with higher DSC for all bout lengths (p < 0.03 for all). Higher PA was associated with higher HVLT and global cognition scores but only for longer bout lengths (p < 0.05 for all). The association was largely driven by participants who spent the lowest amount of time performing activity while awake (p < 0.04). An inverse linear relationship was observed between total sedentary time and DSC (p = 0.02), but not for other measures of cognition. These results suggest that, while higher PA was associated with higher cognitive performance, PA’s association with memory was sensitive to bout duration. The time, but not the manner, spent in sedentary behaviors showed a minor association with executive function. Further research is warranted to characterize longitudinal changes in daily activity and sedentary patterns as potential biophysical markers of cognitive status in older adults.
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Affiliation(s)
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Delilah R Cook
- Division of Public Health Sciences, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Jeffrey Katula
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Arthur F Kramer
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Joe Verghese
- Department of Neurology and Medicine, Albert Einstein of Yeshiva University, Bronx, NY, United States
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Kaycee M Sink
- Department of Internal Medicine (Gerontology/Geriatrics), Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Abby C King
- Stanford University School of Medicine, Stanford, CA, United States
| | - Thomas W Buford
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Steve Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Neelesh Nadkarni
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Janine M Jennings
- Department of Psychology, Wake Forest University, Winston-Salem, NC, United States
| | - Kieran Reid
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Thomas M Gill
- Yale School of Medicine, New Haven, CT, United States
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Joe R Nocera
- Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA, United States.,Division of Physical Therapy, Emory University, Atlanta, GA, United States.,Department of Neurology, Emory University, Atlanta, GA, United States
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28
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Bailly L, d'Arripe-Longueville F, Fabre R, Emile M, Valbousquet J, Ferré N, Colson S, Pradier C. Impact of improved urban environment and coaching on physical condition and quality of life in elderly women: a controlled study. Eur J Public Health 2018; 29:5098720. [PMID: 30239667 DOI: 10.1093/eurpub/cky192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Physical activity can slow the ageing process and preserve autonomy in the elderly. The aim of this study was to assess the combined impact of an organized urban walking circuit and individual coaching on women senior citizens' physical well-being and quality of life. METHODS Insufficiently physically active women >65 years were included in a quasi-experimental trial. Active arm: District with improved urban environment (IUE). Control arm: District without improved urban environment (WIUE). In each district, subjects were randomly allocated to receive coaching (C+ vs. C-). The main outcome measures were endurance, physical activity score, flexibility, quality of life, physical self-esteem, ageing exercise stereotypes, functional health and perceived health at baseline, three (M3) and six (M6) months. RESULTS Fifty-two insufficiently physically active women were included, 23 in IUE and 29 in WIUE. Groups were comparable at baseline. At M3, endurance and physical activity score significantly improved compared with baseline in the IUE group and in the C+ group while no statistically significant change was observed for the WIUE group and the C- group. Moreover, endurance score was higher in the IUE group, whether coupled with coaching or not. After the coaching was removed, the IUE group regresses to baseline overall and the WIUE shows a decrement in endurance. CONCLUSION Our study highlights the positive impact of an improved environment and of individual coaching on the level of physical activity and quality of life of insufficiently physically active elderly women.
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Affiliation(s)
- L Bailly
- Université Côte d'Azur, LAMHESS, Nice, France
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | | | - R Fabre
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | - M Emile
- Université Côte d'Azur, LAMHESS, Nice, France
| | - J Valbousquet
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | - N Ferré
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | - S Colson
- Université Côte d'Azur, LAMHESS, Nice, France
| | - C Pradier
- Université Côte d'Azur, LAMHESS, Nice, France
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
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29
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Nicklas BJ. No Expiration Date on the Association Between Physical Activity and Mortality. J Am Geriatr Soc 2018; 66:850-852. [PMID: 29319876 DOI: 10.1111/jgs.15243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Barbara J Nicklas
- School of Medicine, Wake Forest University, Winston-Salem, North Carolina
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