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Inskip M, Almendrales Rangel C, Njoku CM, Barnett F, Shih I, O’Neill L, Fiatarone Singh MA, Valenzuela T. The Frailty Reduction via Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results. Methods Protoc 2024; 7:26. [PMID: 38525784 PMCID: PMC10961770 DOI: 10.3390/mps7020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia-Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care. METHODS The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results. RESULTS 29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention's commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle-leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules. CONCLUSIONS The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care.
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Affiliation(s)
- Michael Inskip
- College of Healthcare Sciences, James Cook University, Townsville, QLD 4814, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Carolina Almendrales Rangel
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | | | - Fiona Barnett
- College of Healthcare Sciences, James Cook University, Townsville, QLD 4814, Australia
| | - Isabel Shih
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | | | - Maria A. Fiatarone Singh
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, USA
| | - Trinidad Valenzuela
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7550196, Chile
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Golledge J, Yip L, Venn A, Leicht AS, Jenkins JS, Fiatarone Singh MA, Reid CM, Ademi Z, Parmenter BJ, Moxon JV, Burton NW. Effect of Brief Counseling by Allied Health Professionals on Step Count of People With Peripheral Artery Disease: A Randomized Clinical Trial. JAMA Cardiol 2023; 8:394-399. [PMID: 36753250 PMCID: PMC9909571 DOI: 10.1001/jamacardio.2022.5437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/16/2022] [Indexed: 02/09/2023]
Abstract
Importance It is unclear how to effectively promote walking in people with peripheral artery disease (PAD). Objective To test whether brief counseling delivered by allied health professionals increases step count in participants with PAD. Design, Setting, and Participants In this randomized clinical trial, participants with symptomatic PAD were recruited from sites in Australia and randomly allocated 1:1 to the counseling intervention or an attention control. Data were collected from January 2015 to July 2021, and data were analyzed from March to November 2022. Interventions Two 1-hour face-to-face and two 15-minute telephone counseling sessions designed to increase walking. Main Outcomes and Measures The primary outcome was the between-group difference in change in daily step count estimated by accelerometer recordings over 7 days at baseline and 4 months, using imputation for missing values. Other outcomes at 4, 12, and 24 months included step count, 6-minute walk distance, and disease-specific and generic measures of health-related quality of life. Risk of major adverse limb events was assessed over 24 months. Results Of 200 included participants, 144 (72.0%) were male, and the mean (SD) age was 69.2 (9.3) years. The planned sample of 200 participants was allocated to the counseling intervention group (n = 102) or attention control group (n = 98). Overall, 198 (99.0%), 175 (87.5%), 160 (80.0%) and 143 (71.5%) had step count assessed at entry and 4, 12, and 24 months, respectively. There was no significant between-group difference in the primary outcome of change in daily step count over 4 months (mean steps, 415; 95% CI, -62 to 893; P = .07). Participants in the counseling group had significantly greater improvement in the secondary outcome of disease-specific Intermittent Claudication Questionnaire score at 4 months (3.2 points; 95% CI, 0.1-6.4; P = .04) and 12 months (4.3 points; 95% CI, 0.5-8.1; P = .03) but not at 24 months (1.2 points; 95% CI, -3.1 to 5.6; P = .57). Findings were similar for mean PAD Quality of Life Questionnaire component assessing symptoms and limitations in physical functioning (4 months: 1.5 points; 95% CI, 0.3-2.8; P = .02; 12 months: 1.8 points; 95% CI, 0.3-3.3; P = .02; 24 months: 1.3 points; 95% CI. -0.5 to 3.1; P = .16). There was no significant effect of the intervention on change in mean 6-minute walking distance (4 months: 9.3 m; 95% CI, -3.7 to 22.3; P = .16; 12 months: 13.8 m; 95% CI, -4.2 to 31.7; P = .13; 24 months: 1.2 m; 95% CI, -20.0 to 22.5; P = .91). The counseling intervention did not affect the rate of major adverse limb events over 24 months (12 [6.0%] in the intervention group vs 11 [5.5%] in the control group; P > .99). Conclusions and Relevance This randomized clinical trial found no significant effect of brief counseling on step count in people with PAD. Alternate interventions are needed to enable walking. Trial Registration Australian New Zealand Clinical Trials Registry Identifier: ACTRN12614000592640.
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Affiliation(s)
- Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia
- The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Australia
- The Australian Institute of Tropical Health and Medicine, Townsville, Australia
| | - Lisan Yip
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Alkira Venn
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Anthony S. Leicht
- The Australian Institute of Tropical Health and Medicine, Townsville, Australia
- Sport and Exercise Science, James Cook University, Townsville, Australia
| | - Jason S. Jenkins
- Department of Vascular Surgery, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Maria A. Fiatarone Singh
- Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
| | - Christopher M. Reid
- School of Population Health, Curtin University, Perth, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Belinda J. Parmenter
- Department of Exercise Physiology, School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney Australia
| | - Joseph V. Moxon
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia
- The Australian Institute of Tropical Health and Medicine, Townsville, Australia
| | - Nicola W. Burton
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
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Lang T, Daniel K, Inskip M, Mavros Y, Fiatarone Singh MA. Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial. Gerontol Geriatr Med 2023; 9:23337214231203472. [PMID: 37811133 PMCID: PMC10559724 DOI: 10.1177/23337214231203472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Objective: To investigate the effects of a dyadic intervention of mindfulness-based stress reduction (MBSR) for informal dementia caregivers and home-based balance and progressive resistance training (PRT) for their loved ones. Methods: The study was a two arm, randomized, controlled, single-blinded, parallel-group trial. Dyads were randomized to an intervention group: an 8-week MBSR course (daily) and an 8-week PRT and balance training (3 days/week) for their loved ones or a waiting list control group. Results: Nine dyads were randomized [caregivers: median age 75 (40-81) years, loved ones: 77 (73-88) years]. The intervention significantly improved caregiver mindfulness [relative effect size (95% confidence interval) 1.35 (-0.10, 2.81); p = .009] and functional mobility in their loved ones [mean difference (95% confidence interval) 1.53 (-3.09, 6.14)] with no significant effects on caregiver burden [relative effect size (95% confidence interval) 0.22 (-1.09, 1.54); p = .622]. Conclusion: The study appeared feasible in the home environment and future large and longer trials should test the efficacy of a more abbreviated MBSR intervention and to optimize adoption and sustain adherence over time. Trial registry name: HOMeCare: Caring for the Dementia Caregiver and their Loved One via the HOMeCare Exercise and Mindfulness for Health Program Trial URL: https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12617000347369 Registration number: ACTRN12617000347369.
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Affiliation(s)
- Tommy Lang
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kenneth Daniel
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Michael Inskip
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- College of Healthcare Sciences, Sport and Exercise Science, James Cook University, Townsville, QLD, Australia
| | - Yorgi Mavros
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Maria A. Fiatarone Singh
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
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Brodaty H, Heffernan M, Singh MAF, Valenzuela M, Lautenschlager NT, Anstey KJ, Sachdev PS, Jorm L, McNeil J, Maeder A, Ginige JA, Chau T, Jose JCS, Millard M, Welberry H. Maintain Your Brain: a 3‐year online randomized controlled trial to reduce cognitive decline in 55‐77 year olds. Alzheimers Dement 2022. [DOI: 10.1002/alz.061548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney Sydney NSW Australia
- Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney Sydney NSW Australia
- UNSW Sydney Sydney NSW Australia
| | | | | | | | | | - Kaarin J. Anstey
- University of New South Wales Sydney NSW Australia
- Neuroscience Research Australia Sydney NSW Australia
- UNSW Ageing Futures Institute Sydney NSW Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney Sydney NSW Australia
- Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney Sydney NSW Australia
- University of New South Wales Sydney NSW Australia
- Neuropsychiatric Institute (NPI), Euroa Centre, Prince of Wales Hospital Sydney NSW Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales Sydney NSW Australia
| | | | | | | | - Tiffany Chau
- Centre for Healthy Brain Ageing, University of New South Wales Sydney NSW Australia
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Inskip MJ, Mavros Y, Sachdev PS, Hausdorff JM, Hillel I, Singh MAF. Promoting independence in Lewy body dementia through exercise: the PRIDE study. BMC Geriatr 2022; 22:650. [PMID: 35945508 PMCID: PMC9361699 DOI: 10.1186/s12877-022-03347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Lewy body dementia (LBD) is an aggressive type of dementia of rapid, fluctuating disease trajectory, higher incidence of adverse events, and poorer functional independence than observed in Alzheimer’s disease dementia. Non-pharmacological treatments such as progressive, high-intensity exercise are effective in other neurological cohorts but have been scarcely evaluated in LBD. Methods The Promoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial was a non-randomised, non-blinded, crossover pilot trial involving older adults with LBD consisting of a baseline assessment, an 8-week wait-list, and an 8-week exercise intervention. The aims of this study were to evaluate the determinants of the primary outcome functional independence, as measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale, and the feasibility and preliminary efficacy of an exercise intervention on this outcome. Additionally, important clinical characteristics were evaluated to explore associations and treatment targets. The exercise intervention was supervised, clinic-based, high-intensity progressive resistance training (PRT), challenging balance, and functional exercises, 3 days/week. Results Nine participants completed the baseline cross-sectional study, of which five had a diagnosis of Parkinson’s disease dementia (PDD), and four dementia with Lewy Bodies (DLB). Six completed the exercise intervention (three PDD, three DLB). The cohort was diverse, ranging from mild to severe dementia and living in various residential settings. Greater functional independence at baseline was significantly associated with better physical function, balance, cognition, quality of life, muscle mass ratio, walking endurance, faster walking speed and cadence, and lower dementia severity (p < 0.05). Participants declined by clinically meaningful amounts in functional independence, cognition, physical function, muscle mass, and weight over the wait-list period (p < 0.05). Following exercise, participants improved by clinically meaningful amounts in functional independence, cognition, physical function, and strength (p < 0.05). Progressive, high intensity exercise was well-tolerated (> 80% adherence), and only one minor exercise-related adverse event occurred. Conclusions PRIDE is the first exercise trial conducted specifically within individuals diagnosed with LBD, and provides important insight for the design of larger, randomized trials for further evaluation of progressive, high-intensity exercise as a valuable treatment in LBD. Trial registration The PRIDE trial protocol has previously been prospectively registered (08/04/2016, ANZCTR: ACTRN12616000466448). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03347-2.
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Affiliation(s)
- Michael J Inskip
- Sport and Exercise Science, College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia. .,Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Yorgi Mavros
- Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, NSW, Australia
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience and Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Inbar Hillel
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Maria A Fiatarone Singh
- Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.,Hebrew SeniorLife, Boston, MA, USA
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Zhao RR, Mavros Y, Meiklejohn J, Anderberg KA, Singh N, Kay S, Baker MK, Wang Y, Climstein M, O'Sullivan A, De Vos N, Baune BT, Blair SN, Simar D, Singh MAF. Effect of High Intensity Power Training on Cognitive Function in Older Adults with Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Study. J Gerontol A Biol Sci Med Sci 2022; 77:1975-1985. [PMID: 35436329 PMCID: PMC9536451 DOI: 10.1093/gerona/glac090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Indexed: 12/04/2022] Open
Abstract
We sought to determine the effects of 12 months of power training on cognition, and whether improvements in body composition, muscle strength, and/or aerobic capacity (VO2peak) were associated with improvements in cognition in older adults with type 2 diabetes (T2D). Participants with T2D were randomized to power training or low-intensity sham exercise control condition, 3 days per week for 12 months. Cognitive outcomes included memory, attention/speed, executive function, and global cognition. Other relevant outcomes included VO2peak, strength, and whole body and regional body composition. One hundred and three adults with T2D (mean age 67.9 years; standard deviation [SD] 5.9; 50.5% women) were enrolled and analyzed. Unexpectedly, there was a nearly significant improvement in global cognition (p = .05) in the sham group relative to power training, although both groups improved over time (p < .01). There were significant interactions between group allocation and body composition or muscle strength in the models predicting cognitive changes. Therefore, after stratifying by group allocation, improvements in immediate memory were associated with increases in relative skeletal muscle mass (r = 0.38, p = .03), reductions in relative body fat (r = −0.40, p = .02), and increases in knee extension strength were directly related to changes in executive function (r = −0.41, p = .02) within the power training group. None of these relationships were present in the sham group (p > .05). Although power training did not significantly improve cognition compared to low-intensity exercise control, improvements in cognitive function in older adults were associated with hypothesized improvements in body composition and strength after power training.
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Affiliation(s)
- Ren Ru Zhao
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,University of Longyan, Fujian, China.,Clinical Rehabilitation Research Group, Longyan Renmin Hospital, China
| | - Yorgi Mavros
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Jacinda Meiklejohn
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Kylie A Anderberg
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Nalin Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Shelley Kay
- Centre for Medical Psychology and Evidence Based Decision Making, Faculty of Medicine, University of Sydney, Camperdown, Australia
| | - Michael K Baker
- Research Ethics and Integrity, Australian Catholic University, Strathfield, Australia.,Clinical Exercise Physiology, School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, Australia
| | - Yi Wang
- Lipid Metabolism & Cardiometabolic Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Mike Climstein
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Australia
| | - Anthony O'Sullivan
- Department of Endocrinology, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Nathan De Vos
- The Centre for STRONG Medicine, Balmain Hospital, Australia
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.,Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia
| | - Steven N Blair
- Exercise Science Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - David Simar
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Maria A Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Sydney Medical School, University of Sydney, Camperdown, Australia.,Jean Mayer USDA Human Nutrition Research Centre on Aging, Tufts University, Boston, USA
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Sabeti N, O'Leary F, Flood VM, Valenzuela M, Radd‐Vagenas S, Noble Y, Rangel CA, Gracham A, Heffernan M, Sachdev PS, Brodaty H, Lautenschlager NT, Singh MAF. Association of the Mediterranean diet with cognition in a Western population. Alzheimers Dement 2021. [DOI: 10.1002/alz.051236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Neda Sabeti
- The University of Sydney Sydney NSW Australia
| | | | - Victoria M Flood
- The University of Sydney Sydney NSW Australia
- Westmead Hospital Westmead NSW Australia
| | | | | | - Yian Noble
- The University of Sydney Sydney NSW Australia
| | | | - Ali Gracham
- The University of Sydney Sydney NSW Australia
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Brodaty H, Heffernan M, Anstey KJ, Fiatarone Singh MA, Jorm L, Lautenschlager NT, Maeder A, McNeil J, Sachdev PS, Valenzuela M, Chau T. Maintain Your Brain trial: Early findings and lessons learned from adherence and compliance data. Alzheimers Dement 2021. [DOI: 10.1002/alz.053596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney Sydney NSW Australia
- University of New South Wales Sydney NSW Australia
| | | | - Kaarin J Anstey
- University of New South Wales Sydney NSW Australia
- 4. ARC Centre for Excellence in Population Ageing Research Sydney NSW Australia
- School of Psychology, University of New South Wales Sydney NSW Australia
- Neuroscience Research Australia Sydney NSW Australia
- UNSW Ageing Futures Institute Sydney NSW Australia
| | | | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales Sydney NSW Australia
| | - Nicola T Lautenschlager
- North Western Mental Health, Melbourne Health Parkville VIC Australia
- The University of Melbourne Parkville VIC Australia
- Melbourne Health Melbourne VIC Australia
- University of Western Australia Perth Australia
| | | | | | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney Sydney NSW Australia
- Prince of Wales Hospital Sydney Australia
- Neuropsychiatric Institute (NPI), Euroa Centre, Prince of Wales Hospital Sydney NSW Australia
| | | | - Tiffany Chau
- Centre for Healthy Brain Ageing, University of New South Wales Sydney NSW Australia
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Ghacham A, Noble Y, Rangel CA, Mavros Y, Radd‐Vagenas S, Sabeti N, Heffernan M, Brodaty H, Sachdev PS, Lautenschlager NT, Singh MAF, O'Leary F. The Mediterranean diet and physical activity: A cross‐sectional analysis of the Maintain Your Brain randomised controlled trial. Alzheimers Dement 2021. [DOI: 10.1002/alz.053379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ali Ghacham
- The University of Sydney Sydney NSW Australia
| | - Yian Noble
- The University of Sydney Sydney NSW Australia
| | | | | | | | - Neda Sabeti
- The University of Sydney Sydney NSW Australia
| | | | | | | | - Nicola T Lautenschlager
- North Western Mental Health, Melbourne Health Parkville VIC Australia
- The University of Melbourne Parkville VIC Australia
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Letnes JM, Berglund I, Johnson KE, Dalen H, Nes BM, Lydersen S, Viken H, Hassel E, Steinshamn S, Vesterbekkmo EK, Støylen A, Reitlo LS, Zisko N, Bækkerud FH, Tari AR, Ingebrigtsen JE, Sandbakk SB, Carlsen T, Anderssen SA, Singh MAF, Coombes JS, Helbostad JL, Rognmo Ø, Wisløff U, Stensvold D. Effect of 5 years of exercise training on the cardiovascular risk profile of older adults: the Generation 100 randomized trial. Eur Heart J 2021; 43:2065-2075. [PMID: 34746955 PMCID: PMC9156390 DOI: 10.1093/eurheartj/ehab721] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/09/2021] [Accepted: 10/01/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS The aim of this study was to compare the effects of 5 years of supervised exercise training (ExComb), and the differential effects of subgroups of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), with control on the cardiovascular risk profile in older adults. METHODS AND RESULTS Older adults aged 70-77 years from Trondheim, Norway (n = 1567, 50% women), able to safely perform exercise training were randomized to 5 years of two weekly sessions of HIIT [∼90% of peak heart rate (HR), n = 400] or MICT (∼70% of peak HR, n = 387), together forming ExComb (n = 787), or control (instructed to follow physical activity recommendations, n = 780). The main outcome was a continuous cardiovascular risk score (CCR), individual cardiovascular risk factors, and peak oxygen uptake (VO2peak). CCR was not significantly lower [-0.19, 99% confidence interval (CI) -0.46 to 0.07] and VO2peak was not significantly higher (0.39 mL/kg/min, 99% CI -0.22 to 1.00) for ExComb vs. control. HIIT showed higher VO2peak (0.76 mL/kg/min, 99% CI 0.02-1.51), but not lower CCR (-0.32, 99% CI -0.64 to 0.01) vs. control. MICT did not show significant differences compared to control or HIIT. Individual risk factors mostly did not show significant between-group differences, with some exceptions for HIIT being better than control. There was no significant effect modification by sex. The number of cardiovascular events was similar across groups. The healthy and fit study sample, and contamination and cross-over between intervention groups, challenged the possibility of detecting between-group differences. CONCLUSIONS Five years of supervised exercise training in older adults had little effect on cardiovascular risk profile and did not reduce cardiovascular events. REGISTRATION ClinicalTrials.gov: NCT01666340.
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Affiliation(s)
- Jon Magne Letnes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway.,Levanger Hospital, Nord-Trøndelag Health Trust, Kirkegata 2, Levanger 7600, Norway
| | - Ida Berglund
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Kristin E Johnson
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway.,Levanger Hospital, Nord-Trøndelag Health Trust, Kirkegata 2, Levanger 7600, Norway
| | - Bjarne M Nes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Hallgeir Viken
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Erlend Hassel
- Norwegian Armed Forces Occupational Health Service, Post Box 800, Lillehammer 2617, Norway.,Department of Thoracic Medicine, Clinic of Thoracic and Occupational Medicine, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Sigurd Steinshamn
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Thoracic Medicine, Clinic of Thoracic and Occupational Medicine, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Elisabeth Kleivhaug Vesterbekkmo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Asbjørn Støylen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Line S Reitlo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Nina Zisko
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Fredrik H Bækkerud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Atefe R Tari
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Jan Erik Ingebrigtsen
- Department of Sociology and Political Science, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Silvana B Sandbakk
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Teacher Education, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Trude Carlsen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Sigmund A Anderssen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Sognsveien 220, Oslo 0863, Norway
| | - Maria A Fiatarone Singh
- Sydney School of Health Sciences and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre St, Boston, MA 02131, USA
| | - Jeff S Coombes
- School of Human Movement and Nutrition Science, University of Queensland, Human Movement Studies Building, St Lucia QLD, Queensland 4067, Australia
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Øivind Rognmo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Human Movement Studies Building, St Lucia QLD, Queensland 4067, Australia
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
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11
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Mosalman Haghighi M, Mavros Y, Kay S, Simpson KA, Baker MK, Wang Y, Zhao RR, Meiklejohn J, Climstein M, O’Sullivan AJ, De Vos N, Baune BT, Blair SN, Simar D, Singh N, Schlicht J, Fiatarone Singh MA. The Effect of High-Intensity Power Training on Habitual, Intervention and Total Physical Activity Levels in Older Adults with Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Randomized Controlled Trial. Geriatrics (Basel) 2021; 6:geriatrics6010015. [PMID: 33567586 PMCID: PMC7930974 DOI: 10.3390/geriatrics6010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/20/2021] [Accepted: 02/02/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We examined the effect of power training on habitual, intervention and total physical activity (PA) levels in older adults with type 2 diabetes and their relationship to metabolic control. MATERIALS AND METHODS 103 adults with type 2 diabetes were randomized to receive supervised power training or sham exercise three times/week for 12 months. Habitual, intervention, and total PA, as well as insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c), were measured. RESULTS Participants were aged 67.9 ± 5.5 yrs, with well-controlled diabetes (HbA1c = 7.1%) and higher than average habitual PA levels compared to healthy peers. Habitual PA did not change significantly over 12 months (p = 0.74), and there was no effect of group assignment on change over time in habitual PA over 0-6 (p = 0.16) or 0-6-12 months (p = 0.51). By contrast, intervention PA, leg press tonnage and total PA increased over both 6- and 12-month timepoints (p = 0.0001), and these changes were significantly greater in the power training compared to the sham exercise group across timepoints (p = 0.0001). However, there were no associations between changes in any PA measures over time and changes in metabolic profile. CONCLUSION Structured high-intensity power training may be an effective strategy to enhance overall PA in this high-risk cohort.
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Affiliation(s)
- Marjan Mosalman Haghighi
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
- Correspondence: ; Tel.: +61-424971223
| | - Yorgi Mavros
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
| | - Shelley Kay
- Centre for Medical Psychology and Evidence Based Decision Making, Faculty of Medicine, University of Sydney, Camperdown 2050, Australia;
| | - Kylie A. Simpson
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
| | - Michael K. Baker
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield 2135, Australia;
| | - Yi Wang
- Lipid Metabolism & Cardiometabolic Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne 3004, Australia;
| | - Ren Ru Zhao
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
- Clinical Rehabilitation Research Centre, University of Longyan, Longyan 364012, China
| | - Jacinda Meiklejohn
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
| | - Mike Climstein
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
- School of Health and Human Sciences, Southern Cross University, Gold Coast 4225, Australia
| | - Anthony J. O’Sullivan
- Department of Endocrinology, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia;
| | - Nathan De Vos
- The Centre for STRONG Medicine, Balmain Hospital, Balmain 2041, Australia;
| | - Bernhard T. Baune
- Department of Psychiatry, University of Muenster, 48149 Muenster, Germany;
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne 3010, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville 3010, Australia
| | - Steven N. Blair
- Exercise Science Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - David Simar
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia;
| | - Nalin Singh
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
| | - Jeffrey Schlicht
- Department of Health Promotion and Exercise Sciences, Western Connecticut State University, Danbury, CT 06810, USA;
| | - Maria A. Fiatarone Singh
- Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; (Y.M.); (K.A.S.); (R.R.Z.); (J.M.); (M.C.); (N.S.); (M.A.F.S.)
- Sydney Medical School, University of Sydney, Camperdown 2050, Australia
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02129, USA
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12
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Huang XF, Li Z, De Guzman E, Robinson P, Gensler L, Ward MM, Rahbar MH, Lee M, Weisman MH, Macfarlane GJ, Jones GT, Klingberg E, Forsblad-d'Elia H, McCluskey P, Wakefield D, Coombes JS, Fiatarone Singh MA, Mavros Y, Vlahovich N, Hughes DC, Marzo-Ortega H, Van der Horste-Bruinsma I, O'Shea F, Martin TM, Rosenbaum J, Breban M, Jin ZB, Leo P, Reveille JD, Wordsworth BP, Brown MA. Genomewide Association Study of Acute Anterior Uveitis Identifies New Susceptibility Loci. Invest Ophthalmol Vis Sci 2021; 61:3. [PMID: 32492107 PMCID: PMC7415282 DOI: 10.1167/iovs.61.6.3] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose Acute anterior uveitis (AAU) is a common intraocular inflammatory disease. AAU occurs in 30% to 50% of patients with ankylosing spondylitis (AS), and both conditions are strongly associated with human leukocyte antigen (HLA)-B27, implying a shared etiology. This study aims to apply genomewide association study (GWAS) to characterize the genetic associations of AAU and their relationship to the genetics of AS. Methods We undertook the GWAS analyses in 2752 patients with AS with AAU (cases) and 3836 patients with AS without AAU (controls). There were 7,436,415 single-nucleotide polymorphisms (SNPs) available after SNP microarray genotyping, imputation, and quality-control filtering. Results We identified one locus associated with AAU at genomewide significance: rs9378248 (P = 2.69 × 10−8, odds ratio [OR] = 0.78), lying close to HLA-B. Suggestive association was observed at 11 additional loci, including previously reported AS loci ERAP1 (rs27529, P = 2.19 × 10−7, OR = 1.22) and NOS2 (rs2274894, P = 8.22 × 10−7, OR = 0.83). Multiple novel suggestive associations were also identified, including MERTK (rs10171979, P = 2.56 × 10−6, OR = 1.20), KIFAP3 (rs508063, P = 5.64 × 10−7, OR = 1.20), CLCN7 (rs67412457, P = 1.33 × 10−6, OR = 1.25), ACAA2 (rs9947182, P = 9.70 × 10−7, OR = 1.37), and 5 intergenic loci. The SNP-based heritability is approximately 0.5 for AS alone, and is much higher (approximately 0.7) for AS with AAU. Consistent with the high heritability, a genomewide polygenic risk score shows strong power in identifying individuals at high risk of either AS with AAU or AS alone. Conclusions We report here the first GWAS for AAU and identify new susceptibility loci. Our findings confirm the strong overlap in etiopathogenesis of AAU with AS, and also provide new insights into the genetic basis of AAU.
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13
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Brodaty H, Heffernan M, Andrews G, Anstey KJ, Singh MAF, Jorm L, Lautenschlager NT, Maeder A, McNeil J, Sachdev PS, Valenzuela M. Internet based multicomponent interventions to prevent cognitive decline: The Maintain Your Brain trial. Alzheimers Dement 2020. [DOI: 10.1002/alz.044180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA) University of New South Wales (UNSW) Sydney Sydney Australia
- UNSW Sydney Sydney Australia
- Dementia Centre for Research Collaboration (DCRC) UNSW Sydney Sydney Australia
| | - Megan Heffernan
- Centre for Healthy Brain Ageing University of New South Wales Sydney Australia
| | | | | | | | - Louisa Jorm
- Centre for Big Data Research in Health University of New South Wales Sydney Australia
| | | | | | | | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA) University of New South Wales (UNSW) Sydney Sydney Australia
| | - Michael Valenzuela
- The Regenerative Neuroscience Group Brain and Mind Centre Sydney Australia
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14
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Stensvold D, Viken H, Steinshamn SL, Dalen H, Støylen A, Loennechen JP, Reitlo LS, Zisko N, Bækkerud FH, Tari AR, Sandbakk SB, Carlsen T, Ingebrigtsen JE, Lydersen S, Mattsson E, Anderssen SA, Fiatarone Singh MA, Coombes JS, Skogvoll E, Vatten LJ, Helbostad JL, Rognmo Ø, Wisløff U. Effect of exercise training for five years on all cause mortality in older adults-the Generation 100 study: randomised controlled trial. BMJ 2020; 371:m3485. [PMID: 33028588 PMCID: PMC7539760 DOI: 10.1136/bmj.m3485] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the effect of five years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (70-77 years). DESIGN Randomised controlled trial. SETTING General population of older adults in Trondheim, Norway. PARTICIPANTS 1567 of 6966 individuals born between 1936 and 1942. INTERVENTION Participants were randomised to two sessions weekly of high intensity interval training at about 90% of peak heart rate (HIIT, n=400), moderate intensity continuous training at about 70% of peak heart rate (MICT, n=387), or to follow the national guidelines for physical activity (n=780; control group); all for five years. MAIN OUTCOME MEASURE All cause mortality. An exploratory hypothesis was that HIIT lowers mortality more than MICT. RESULTS Mean age of the 1567 participants (790 women) was 72.8 (SD 2.1) years. Overall, 87.5% of participants reported to have overall good health, with 80% reporting medium or high physical activity levels at baseline. All cause mortality did not differ between the control group and combined MICT and HIIT group. When MICT and HIIT were analysed separately, with the control group as reference (observed mortality of 4.7%), an absolute risk reduction of 1.7 percentage points was observed after HIIT (hazard ratio 0.63, 95% confidence interval 0.33 to 1.20) and an absolute increased risk of 1.2 percentage points after MICT (1.24, 0.73 to 2.10). When HIIT was compared with MICT as reference group an absolute risk reduction of 2.9 percentage points was observed (0.51, 0.25 to 1.02) for all cause mortality. Control participants chose to perform more of their physical activity as HIIT than the physical activity undertaken by participants in the MICT group. This meant that the controls achieved an exercise dose at an intensity between the MICT and HIIT groups. CONCLUSION This study suggests that combined MICT and HIIT has no effect on all cause mortality compared with recommended physical activity levels. However, we observed a lower all cause mortality trend after HIIT compared with controls and MICT. TRIAL REGISTRATION ClinicalTrials.gov NCT01666340.
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Affiliation(s)
- Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Hallgeir Viken
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Sigurd L Steinshamn
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
- Department of Thoracic Medicine, Clinic of Thoracic and Occupational Medicine, St Olavs University Hospital, Trondheim, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Department of Cardiology, St Olavs University Hospital, Trondheim, Norway
| | - Asbjørn Støylen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
- Department of Cardiology, St Olavs University Hospital, Trondheim, Norway
| | - Jan P Loennechen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
- Department of Cardiology, St Olavs University Hospital, Trondheim, Norway
| | - Line S Reitlo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Nina Zisko
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Fredrik H Bækkerud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Atefe R Tari
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Silvana B Sandbakk
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Trude Carlsen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Jan E Ingebrigtsen
- Department of Sociology and Political Science, Faculty of Social Sciences and Technology Management, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Erney Mattsson
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Sigmund A Anderssen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Maria A Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| | - Eirik Skogvoll
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
- Department of Anaesthesia and Intensive Care Medicine, St Olavs University Hospital, Trondheim, Norway
| | - Lars J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Øivind Rognmo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
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15
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Hildebrand JM, Kauppi M, Majewski IJ, Liu Z, Cox AJ, Miyake S, Petrie EJ, Silk MA, Li Z, Tanzer MC, Brumatti G, Young SN, Hall C, Garnish SE, Corbin J, Stutz MD, Di Rago L, Gangatirkar P, Josefsson EC, Rigbye K, Anderton H, Rickard JA, Tripaydonis A, Sheridan J, Scerri TS, Jackson VE, Czabotar PE, Zhang JG, Varghese L, Allison CC, Pellegrini M, Tannahill GM, Hatchell EC, Willson TA, Stockwell D, de Graaf CA, Collinge J, Hilton A, Silke N, Spall SK, Chau D, Athanasopoulos V, Metcalf D, Laxer RM, Bassuk AG, Darbro BW, Fiatarone Singh MA, Vlahovich N, Hughes D, Kozlovskaia M, Ascher DB, Warnatz K, Venhoff N, Thiel J, Biben C, Blum S, Reveille J, Hildebrand MS, Vinuesa CG, McCombe P, Brown MA, Kile BT, McLean C, Bahlo M, Masters SL, Nakano H, Ferguson PJ, Murphy JM, Alexander WS, Silke J. A missense mutation in the MLKL brace region promotes lethal neonatal inflammation and hematopoietic dysfunction. Nat Commun 2020; 11:3150. [PMID: 32561755 PMCID: PMC7305203 DOI: 10.1038/s41467-020-16819-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 05/27/2020] [Indexed: 12/13/2022] Open
Abstract
MLKL is the essential effector of necroptosis, a form of programmed lytic cell death. We have isolated a mouse strain with a single missense mutation, MlklD139V, that alters the two-helix 'brace' that connects the killer four-helix bundle and regulatory pseudokinase domains. This confers constitutive, RIPK3 independent killing activity to MLKL. Homozygous mutant mice develop lethal postnatal inflammation of the salivary glands and mediastinum. The normal embryonic development of MlklD139V homozygotes until birth, and the absence of any overt phenotype in heterozygotes provides important in vivo precedent for the capacity of cells to clear activated MLKL. These observations offer an important insight into the potential disease-modulating roles of three common human MLKL polymorphisms that encode amino acid substitutions within or adjacent to the brace region. Compound heterozygosity of these variants is found at up to 12-fold the expected frequency in patients that suffer from a pediatric autoinflammatory disease, chronic recurrent multifocal osteomyelitis (CRMO).
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Affiliation(s)
- Joanne M Hildebrand
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia. .,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Maria Kauppi
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Ian J Majewski
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Zikou Liu
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Allison J Cox
- Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Sanae Miyake
- Department of Biochemistry, Toho University School of Medicine, Ota-ku, Tokyo, 143-8540, Japan
| | - Emma J Petrie
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Michael A Silk
- Department of Biochemistry and Molecular Biology, Bio21 Institute, University of Melbourne, Melbourne, VIC, 3052, Australia.,Computational Biology and Clinical Informatics, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Zhixiu Li
- Translational Genomics Group, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology (QUT) at Translational Research Institute, Brisbane, Australia
| | - Maria C Tanzer
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, 82152, Germany
| | - Gabriela Brumatti
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Samuel N Young
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Cathrine Hall
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Sarah E Garnish
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Jason Corbin
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Michael D Stutz
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR, 97006, USA
| | - Ladina Di Rago
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Pradnya Gangatirkar
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Emma C Josefsson
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Kristin Rigbye
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Holly Anderton
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - James A Rickard
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,The Royal Melbourne Hospital, Melbourne, VIC, 3050, Australia
| | - Anne Tripaydonis
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,The Royal Melbourne Hospital, Melbourne, VIC, 3050, Australia
| | - Julie Sheridan
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Thomas S Scerri
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Victoria E Jackson
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Peter E Czabotar
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Jian-Guo Zhang
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Leila Varghese
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,Ludwig Institute for Cancer Research and de Duve Institute, Brussels, Belgium
| | - Cody C Allison
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Marc Pellegrini
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Gillian M Tannahill
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,GSK Medicines Research Centre, Stevenage, UK
| | - Esme C Hatchell
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Tracy A Willson
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Dina Stockwell
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Carolyn A de Graaf
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Janelle Collinge
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Adrienne Hilton
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
| | - Natasha Silke
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Sukhdeep K Spall
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Diep Chau
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,CSL Limited, Parkville, VIC, 3052, Australia
| | - Vicki Athanasopoulos
- Department of Immunology and Infectious Disease and Centre for Personalised Immunology (NHMRC Centre for Research Excellence), John Curtin School of Medical Research, Australian National University, Canberra, Australia.,Centre for Personalised Immunology (CACPI), Shanghai Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Donald Metcalf
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Ronald M Laxer
- Division of Rheumatology, The Hospital for Sick Children and the University of Toronto, Toronto, ON, Canada
| | - Alexander G Bassuk
- Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA.,Department of Neurology, University of Iowa Carver College of Medicine and the Iowa Neuroscience Institute, Iowa City, IA, USA
| | - Benjamin W Darbro
- Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Maria A Fiatarone Singh
- Faculty of Health Sciences and Sydney Medical School, University of Sydney, Sydney, Australia
| | - Nicole Vlahovich
- Department of Sports Medicine, Australian Institute of Sport, Bruce, ACT, Australia
| | - David Hughes
- Department of Sports Medicine, Australian Institute of Sport, Bruce, ACT, Australia
| | - Maria Kozlovskaia
- Department of Sports Medicine, Australian Institute of Sport, Bruce, ACT, Australia.,Faculty of Health, University of Canberra, Canberra, Australia
| | - David B Ascher
- Department of Biochemistry and Molecular Biology, Bio21 Institute, University of Melbourne, Melbourne, VIC, 3052, Australia.,Computational Biology and Clinical Informatics, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Klaus Warnatz
- Department of Internal Medicine, Clinic for Rheumatology and Clinical Immunology, Medical Center -University of Freiburg, Faculty of Medicine, Freiburg, 79106, Germany.,Center for Chronic Immunodeficiency, Medical Center -University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Nils Venhoff
- Department of Internal Medicine, Clinic for Rheumatology and Clinical Immunology, Medical Center -University of Freiburg, Faculty of Medicine, Freiburg, 79106, Germany
| | - Jens Thiel
- Department of Internal Medicine, Clinic for Rheumatology and Clinical Immunology, Medical Center -University of Freiburg, Faculty of Medicine, Freiburg, 79106, Germany
| | - Christine Biben
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Stefan Blum
- Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - John Reveille
- Memorial Hermann Texas Medical Centre, Houston, TX, USA
| | - Michael S Hildebrand
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, VIC, 3084, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | - Carola G Vinuesa
- Department of Immunology and Infectious Disease and Centre for Personalised Immunology (NHMRC Centre for Research Excellence), John Curtin School of Medical Research, Australian National University, Canberra, Australia.,Centre for Personalised Immunology (CACPI), Shanghai Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Pamela McCombe
- The University of Queensland, UQ Centre for Clinical Research, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - Matthew A Brown
- Translational Genomics Group, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology (QUT) at Translational Research Institute, Brisbane, Australia.,NIHR Biomedical Research Centre, Kings College, London, UK
| | - Benjamin T Kile
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.,Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Catriona McLean
- Department of Anatomical Pathology, The Alfred Hospital, Prahran, VIC, 3181, Australia
| | - Melanie Bahlo
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Seth L Masters
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Hiroyasu Nakano
- Department of Biochemistry, Toho University School of Medicine, Ota-ku, Tokyo, 143-8540, Japan
| | - Polly J Ferguson
- Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - James M Murphy
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Warren S Alexander
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia. .,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.
| | - John Silke
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia. .,Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia.
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16
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Inskip M, Mavros Y, Sachdev PS, Fiatarone Singh MA. Interrupting the trajectory of frailty in dementia with Lewy bodies with anabolic exercise, dietary intervention and deprescribing of hazardous medications. BMJ Case Rep 2020; 13:13/4/e231336. [PMID: 32341088 PMCID: PMC7202785 DOI: 10.1136/bcr-2019-231336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
An 87-year-old man with dementia with Lewy bodies, living in residential aged care, exhibited rapid functional decline and weight loss associated with injurious falls over 9 months. Independent clinicians (geriatrician and exercise physiologist) assessed him during an extended wait-list period prior to his commencement of a pilot exercise trial. The highly significant role of treatable factors including polypharmacy, sarcopenia and malnutrition as contributors to frailty and rapid functional decline in this patient are described. The results of a targeted intervention of deprescribing, robust exercise and increased caloric intake on his physical and neuropsychological health status are presented. This case highlights the need to aggressively identify and robustly treat reversible contributors to frailty, irrespective of advanced age, progressive ‘untreatable’ neurodegenerative disease and rapidly deteriorating health in such individuals. Frailty is not a contraindication to robust exercise; it is, in fact, one of the most important reasons to prescribe it.
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Affiliation(s)
- Michael Inskip
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia .,Sport and Exercise Science, College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Yorgi Mavros
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Perminder Singh Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Maria A Fiatarone Singh
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.,The University of Sydney, Sydney Medical School, Camperdown, New South Wales, Australia.,Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
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17
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Golledge J, Leicht AS, Yip L, Rowbotham SE, Pinchbeck J, Jenkins JS, Clapperton R, Dally-Watkins M, Fiatarone Singh MA, Mavros Y, Noble Y, Haghighi MM, Hollings M, Parmenter BJ, Burton NW. Relationship Between Disease Specific Quality of Life Measures, Physical Performance, and Activity in People with Intermittent Claudication Caused by Peripheral Artery Disease. Eur J Vasc Endovasc Surg 2020; 59:957-964. [PMID: 32336621 DOI: 10.1016/j.ejvs.2020.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/13/2020] [Accepted: 02/07/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aims of this study were firstly to assess the correlation between disease specific measures of quality of life (QOL) and physical performance and activity, and secondly to identify demographic, clinical, functional, and physical activity measures independently associated with QOL in people with intermittent claudication. METHODS This was a cross sectional observational study of 198 people with intermittent claudication caused by peripheral artery disease who were recruited prospectively. QOL was assessed with the intermittent claudication questionnaire (ICQ) and the eight-theme peripheral artery disease quality of life questionnaire. Physical performance was assessed with the six minute walk test (6MWT) and short physical performance battery (SPPB), and an accelerometer was used to measure seven day step count. The associations between QOL scores and 6MWT distance, SPPB scores and seven day step count were examined using Spearman Rho's (ρ) correlation and multivariable linear regression. RESULTS ICQ scores were significantly correlated with 6MWT distance (ρ = 0.472, p < .001), all four SPPB scores (balance ρ = 0.207, p = .003; gait speed ρ = 0.303, p < .001; chair stand ρ = 0.167, p = .018; total ρ = 0.265, p < .001), and seven day step count (ρ = 0.254, p < .001). PADQOL social relationships and interactions (ρ = 0.343, p < .001) and symptoms and limitations in physical functioning (ρ = 0.355, p < .001) themes were correlated with 6MWT distance. The 6MWT distance was independently positively associated with ICQ and both PADQOL theme scores (ICQ: B 0.069, p < .001; PADQOL social relationships and interactions: B 0.077, p < .001; PADQOL symptoms and limitations in physical functioning: B 0.069, p < .001). CONCLUSION Longer 6MWT distance independently predicted better physical and social aspects of QOL in people with intermittent claudication supporting its value as an outcome measure.
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Affiliation(s)
- Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Australian Institute of Tropical Medicine, Townsville, Queensland, Australia; The Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia.
| | - Anthony S Leicht
- Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia
| | - Lisan Yip
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Australian Institute of Tropical Medicine, Townsville, Queensland, Australia
| | - Sophie E Rowbotham
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Australian Institute of Tropical Medicine, Townsville, Queensland, Australia; The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, 4029, Australia; Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jenna Pinchbeck
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Australian Institute of Tropical Medicine, Townsville, Queensland, Australia
| | - Jason S Jenkins
- Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Roslyn Clapperton
- The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, 4029, Australia; Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Matthew Dally-Watkins
- The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, 4029, Australia; Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Maria A Fiatarone Singh
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, The University of Sydney School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, Australia; Hinda and Arthur Marcus Institute for Ageing Research, Boston, MA, USA
| | - Yorgi Mavros
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, The University of Sydney School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, Australia
| | - Yian Noble
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, The University of Sydney School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, Australia
| | - Marjan M Haghighi
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, The University of Sydney School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, Australia
| | - Matthew Hollings
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, The University of Sydney School of Health Sciences, Faculty of Medicine and Health, Lidcombe, New South Wales, Australia
| | - Belinda J Parmenter
- Department of Exercise Physiology, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
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18
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Inskip M, Mavros Y, Sachdev PS, Fiatarone Singh MA. Promoting independence in Lewy body dementia through exercise (PRIDE) study: Protocol for a pilot study. Contemp Clin Trials Commun 2019; 16:100466. [PMID: 31701040 PMCID: PMC6831670 DOI: 10.1016/j.conctc.2019.100466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022] Open
Abstract
Background Lewy Body dementia (LBD) is the second most prevalent neurodegenerative dementia. This form of dementia is notable for an aggressive disease course consisting of a combination of cognitive, Parkinsonian, affective, and physiological symptoms that significantly increase morbidity and mortality, and decrease life expectancy in this population compared to more common dementias. Additionally, those diagnosed with LBD are often excluded from trials evaluating exercise in similar diseases such as Alzheimer's disease or Parkinson's disease due to the complexity and concurrency of motor and cognitive symptoms. Consequently, there is scarce research evaluating the effect of exercise on individuals with LBD. Methods The PRomoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial is a novel non-randomised, crossover pilot study consisting of an 8-week wait-list usual care period, followed by an 8-week exercise intervention targeting progressive resistance and balance training. The trial aim is to evaluate the effect of exercise on the primary outcome of functional independence and secondary outcomes including cognitive, physical, psychosocial and quality of life measures in people living with LBD and their caregivers. The intervention involves 3 supervised 1-h sessions per week (24 sessions in total) administered by an Accredited Exercise Physiologist in a clinical facility at the University of Sydney in Lidcombe, Australia. Discussion The PRIDE study is the first controlled trial to evaluate a robust exercise intervention within a LBD cohort and will provide crucial information required to inform robust future clinical trials. Trial registration Australia and New Zealand Trial Register (ANZCTR): ACTRN12616000466448; Key words: Lewy body; dementia; exercise; anabolic; functional independence.
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Affiliation(s)
- Michael Inskip
- The University of Sydney Faculty of Health Sciences, Discipline of Exercise and Sports Science, Cumberland Campus, Lidcombe, NSW, 2141, Australia
- Corresponding author. Office K220, The University of Sydney, Faculty of Health Sciences, Cumberland Campus, Lidcombe, NSW, 2141, Australia.
| | - Yorgi Mavros
- The University of Sydney Faculty of Health Sciences, Discipline of Exercise and Sports Science, Cumberland Campus, Lidcombe, NSW, 2141, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW, 2031, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick, NSW, 2031, Australia
| | - Maria A. Fiatarone Singh
- The University of Sydney Faculty of Health Sciences, Discipline of Exercise and Sports Science, Cumberland Campus, Lidcombe, NSW, 2141, Australia
- The University of Sydney, Sydney Medical School, Sydney, 2006, Australia
- Hebrew SeniorLife, Roslindale, MA, 02131, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, 02155, USA
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19
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Walton CC, Lampit A, Boulamatsis C, Hallock H, Barr P, Ginige JA, Brodaty H, Chau T, Heffernan M, Sachdev PS, Fiatarone Singh MA, Valenzuela M. Design and Development of the Brain Training System for the Digital "Maintain Your Brain" Dementia Prevention Trial. JMIR Aging 2019; 2:e13135. [PMID: 31518277 PMCID: PMC6715098 DOI: 10.2196/13135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 02/05/2019] [Accepted: 02/09/2019] [Indexed: 12/20/2022] Open
Abstract
Background Dementia is the leading cause of disability worldwide, and interventions aimed at reducing the prevalence and burden of the disease are urgently needed. Maintain Your Brain (MYB) is a randomized controlled trial of a multimodal digital health intervention targeting modifiable dementia risk factors to combat cognitive decline and potentially prevent dementia. In addition to behavioral modules targeting mood, nutrition, and physical exercise, a new Brain Training System (BTS) will deliver computerized cognitive training (CCT) throughout the trial to provide systematic, challenging, and personally adaptive cognitive activity. Objective This paper aimed to describe the design and development of BTS. Methods BTS has been designed with a central focus on the end user. Raw training content is provided by our partner NeuroNation and delivered in several innovative ways. A baseline cognitive profile directs selection and sequencing of exercises within and between sessions and is updated during the 10-week 30-session module. Online trainers are available to provide supervision at different levels of engagement, including face-to-face share-screen coaching, a key implementation resource that is triaged by a “red flag” system for automatic tracking of user adherence and engagement, or through user-initiated help requests. Individualized and comparative feedback is provided to aid motivation and, for the first time, establish a social support network for the user based on their real-world circle of friends and family. Results The MYB pilot was performed from November 2017 to March 2018. We are currently analyzing data from this pilot trial (n=100), which will make up a separate research paper. The main trial was launched in June 2018. Process and implementation data from the first training module (September to November 2018) are expected to be reported in 2019 and final trial outcomes are anticipated in 2022. Conclusions The BTS implemented in MYB is focused on maximizing adherence and engagement with CCT over the short and long term in the setting of a fully digital trial, which, if successful, could be delivered economically at scale. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618000851268; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=370631&isReview=true
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Affiliation(s)
- Courtney Campbell Walton
- School of Psychology, University of Queensland, Brisbane, Australia.,Regenerative Neuroscience Group, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Amit Lampit
- Regenerative Neuroscience Group, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia.,Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christos Boulamatsis
- Regenerative Neuroscience Group, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, Australia
| | - Harry Hallock
- Regenerative Neuroscience Group, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Polly Barr
- Regenerative Neuroscience Group, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jeewani Anupama Ginige
- School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Tiffany Chau
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Megan Heffernan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Perminder Singh Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
| | - Maria A Fiatarone Singh
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, Sydney Medical School, University of Sydney, Sydney, Australia.,Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States.,Hebrew Senior Life, Boston, MA, United States
| | - Michael Valenzuela
- Regenerative Neuroscience Group, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
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Shariat A, Najafabadi MG, Ansari NN, Cleland JA, Singh MAF, Memari AH, Honarpishe R, Hakakzadeh A, Ghaffari MS, Naghdi S. The effects of cycling with and without functional electrical stimulation on lower limb dysfunction in patients post-stroke: A systematic review with meta-analysis. NeuroRehabilitation 2019; 44:389-412. [PMID: 31227660 DOI: 10.3233/nre-182671] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND One of the leading causes of disability in the world with enormous economic burden is stroke. OBJECTIVE To quantify the effectiveness of different protocols of cycling with/without functional electrical stimulation on functional mobility after stroke. METHODS Multiple databases were searched till 2018. Data extraction was performed using a pre-determined data collection form. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation. RESULTS A total of 14 trials satisfied eligibility criteria and were included. Cycling had a positive effect on the 6-meter walking test performance (SMD, 0.41; 95% CI, 0.11 -0.71; I2 = 0% ) compared with no or placebo intervention (control). Compared with control, cycling had a positive effect on 10-meter walking speed (SMD, 0.30; 95% CI, 0.05 -0.55; I2 = 0% ), and on balance based on the Berg score (SMD, 0.32; 95% CI, 0.06 -0.57; I2 = 49% ). Cycling with functional electrical stimulation had a positive effect on balance (SMD, 1.48; 95% CI, 0.99 -1.97; I2 = 91% ) compared with cycling alone. CONCLUSIONS It appears that cycling has a positive effect on walking speed, walking ability and balance. Functional electrical stimulation combined with cycling has positive effects on balance beyond cycling alone.
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Affiliation(s)
- Ardalan Shariat
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Ghayour Najafabadi
- Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maria A Fiatarone Singh
- University of Sydney, Faculty of Health Sciences, Sydney, Australia
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University and Hebrew SeniorLife, Boston, MA, USA
| | - Amir-Hossein Memari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roshanak Honarpishe
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Hakakzadeh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Selk Ghaffari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Heffernan M, Andrews G, Fiatarone Singh MA, Valenzuela M, Anstey KJ, Maeder AJ, McNeil J, Jorm L, Lautenschlager NT, Sachdev PS, Ginige JA, Hobbs MJ, Boulamatsis C, Chau T, Cobiac L, Cox KL, Daniel K, Flood VM, Guerrero Y, Gunn J, Jain N, Kochan NA, Lampit A, Mavros Y, Meiklejohn J, Noble Y, O’Leary F, Radd-Vagenas S, Walton CC, Brodaty H. Maintain Your Brain: Protocol of a 3-Year Randomized Controlled Trial of a Personalized Multi-Modal Digital Health Intervention to Prevent Cognitive Decline Among Community Dwelling 55 to 77 Year Olds. J Alzheimers Dis 2019; 70:S221-S237. [PMID: 30475762 PMCID: PMC6700632 DOI: 10.3233/jad-180572] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Maintain Your Brain (MYB) is a randomized controlled trial of an online multi-modal lifestyle intervention targeting modifiable dementia risk factors with its primary aim being to reduce cognitive decline in an older age cohort. METHODS MYB aims to recruit 8,500 non-demented community dwelling 55 to 77 year olds from the Sax Institute's 45 and Up Study in New South Wales, Australia. Participants will be screened for risk factors related to four modules that comprise the MYB intervention: physical activity, nutrition, mental health, and cognitive training. Targeting risk factors will enable interventions to be personalized so that participants receive the most appropriate modules. MYB will run for three years and up to four modules will be delivered sequentially each quarter during year one. Upon completing a module, participants will continue to receive less frequent booster activities for their eligible modules (except for the mental health module) until the end of the trial. DISCUSSION MYB will be the largest internet-based trial to attempt to prevent cognitive decline and potentially dementia. If successful, MYB will provide a model for not just effective intervention among older adults, but an intervention that is scalable for broad use.
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Affiliation(s)
- Megan Heffernan
- Centre for Healthy Brain Ageing, University of New South Wales, Australia
| | - Gavin Andrews
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales, Australia
| | - Maria A. Fiatarone Singh
- Sydney Medical School, University of Sydney, Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
- Hebrew SeniorLife and Jean Meyer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA USA
| | - Michael Valenzuela
- Sydney Medical School, University of Sydney, Australia
- Brain and Mind Centre, University of Sydney, Australia
| | | | - Anthony J. Maeder
- College of Nursing & Health Sciences, Flinders University, Australia
| | | | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Australia
| | - Nicola T. Lautenschlager
- University of Melbourne, Australia
- North Western Mental Health, Melbourne Health, Melbourne, Australia
| | | | | | - Megan J. Hobbs
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales, Australia
| | | | - Tiffany Chau
- Centre for Healthy Brain Ageing, University of New South Wales, Australia
| | | | - Kay L. Cox
- Medical School, University of Western Australia, Perth, Australia
| | - Kenneth Daniel
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Victoria M. Flood
- Faculty of Health Sciences, University of Sydney, Australia
- Western Sydney Local Health District, Westmead Hospital, Australia
| | - Yareni Guerrero
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Jane Gunn
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Nidhi Jain
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Nicole A. Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Australia
| | - Amit Lampit
- Brain and Mind Centre, University of Sydney, Australia
- University of Melbourne, Australia
| | - Yorgi Mavros
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Jacinda Meiklejohn
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Yian Noble
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Fiona O’Leary
- Nutrition and Dietetics Group, School of Life and Environmental Science, Faculty of Science & The Charles Perkins Centre, University of Sydney, Australia
| | - Sue Radd-Vagenas
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
| | - Courtney C. Walton
- Brain and Mind Centre, University of Sydney, Australia
- School of Psychology, University of Queensland, Melbourne, Australia
| | - Maintain Your Brain Collaborative Team
- Centre for Healthy Brain Ageing, University of New South Wales, Australia
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales, Australia
- Sydney Medical School, University of Sydney, Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia
- Brain and Mind Centre, University of Sydney, Australia
- School of Psychology, University of New South Wales, Australia
- College of Nursing & Health Sciences, Flinders University, Australia
- Monash University, Australia
- Centre for Big Data Research in Health, University of New South Wales, Australia
- University of Melbourne, Australia
- Western Sydney University, Australia
- CSIRO Health and Biosecurity
- Medical School, University of Western Australia, Perth, Australia
- Faculty of Health Sciences, University of Sydney, Australia
- Western Sydney Local Health District, Westmead Hospital, Australia
- Nutrition and Dietetics Group, School of Life and Environmental Science, Faculty of Science & The Charles Perkins Centre, University of Sydney, Australia
- North Western Mental Health, Melbourne Health, Melbourne, Australia
- Department of General Practice, University of Melbourne, Melbourne, Australia
- School of Psychology, University of Queensland, Melbourne, Australia
- Hebrew SeniorLife and Jean Meyer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA USA
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Australia
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22
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Radd-Vagenas S, Fiatarone Singh MA, Daniel K, Noble Y, Jain N, O'Leary F, Mavros Y, Heffernan M, Meiklejohn J, Guerrero Y, Chau T, Sachdev PS, Brodaty H, Flood VM. Validity of the Mediterranean Diet and Culinary Index (MediCul) for Online Assessment of Adherence to the 'Traditional' Diet and Aspects of Cuisine in Older Adults. Nutrients 2018; 10:E1913. [PMID: 30518078 PMCID: PMC6315571 DOI: 10.3390/nu10121913] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/16/2018] [Accepted: 11/28/2018] [Indexed: 02/07/2023] Open
Abstract
The Mediterranean diet is associated with multiple health benefits. Yet, no tool has been specifically developed to assess adherence to the 'traditional' Mediterranean diet and cuisine within a Western cohort, and validated for online use. We tested the reliability and validity of online administration of the Mediterranean Diet and Culinary Index (MediCul) among middle-aged and older adults. Participants were recruited in January⁻March 2017 from the 45 and Up Study, completing MediCul twice. Test-retest reliability was assessed using the paired t-test, intra-class correlation coefficient (ICC) and Bland-Altman plot. Validity was tested against a three-day food record (FR)-derived MediCul score using Bland-Altman and nutrient trends across the MediCul score tertiles. Participants (n = 84; 60% female; 65.4 years (SD = 5.9)), were overweight (BMI 26.1; SD = 4.0) with 1.7 (SD = 1.5) chronic illnesses/conditions. Sequential MediCul tool scores were 56.1/100.0 and 56.8/100.0, respectively (t = -1.019; p = 0.311). Reliability via ICC (ICC = 0.86, 95% CI: 0.789, 0.910, p < 0.0001) and Bland-Altman was good. In Bland-Altman validity analyses, the tool over-reported FR MediCul score by 5.6 points with no systematic bias ((y = 8.7 - 0.06*x) (95% CI: -0.278, 0.158, p = 0.584)). Nutrient trends were identified for MediCul consistent with expected Mediterranean patterns. Online MediCul administration demonstrated good reliability and moderate validity for assessing adherence to a 'traditional' Mediterranean pattern among older Australians.
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Affiliation(s)
- Sue Radd-Vagenas
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
| | - Maria A Fiatarone Singh
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
- The University of Sydney, Sydney Medical School, Camperdown, NSW 2006, Australia and Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
| | - Kenneth Daniel
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
| | - Yian Noble
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
| | - Nidhi Jain
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
| | - Fiona O'Leary
- The University of Sydney, Nutrition and Dietetics Group, School of Life and Environmental Science, Faculty of Science and The Charles Perkins Centre, Camperdown, NSW 2006, Australia.
| | - Yorgi Mavros
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
| | - Megan Heffernan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW 2031, Australia.
| | - Jacinda Meiklejohn
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
| | - Yareni Guerrero
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
| | - Tiffany Chau
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW 2031, Australia.
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW 2031, Australia.
- Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW 2031, Australia.
- Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Victoria M Flood
- The University of Sydney, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Faculty of Health Sciences, Lidcombe, NSW 2141, Australia.
- Western Sydney Local Health District, Westmead Hospital, Westmead, NSW 2145, Australia.
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23
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Heffernan M, Andrews G, Anstey KJ, Fiatarone Singh MA, Jorm L, Maeder A, McNeil J, Lautenschlager NT, Sachdev PS, Valenzuela M, Brodaty H. P3‐577: RISK FACTORS FOR DEMENTIA IN 55‐75‐YEAR‐OLDS ENROLLED IN A PILOT STUDY FOR MAINTAIN YOUR BRAIN, AN INTERNET PREVENTATIVE INTERVENTION. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Megan Heffernan
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | | | | | | | - Louisa Jorm
- Centre for Big Data Research in HealthUniversity of New South WalesSydneyAustralia
| | | | | | | | | | | | - Henry Brodaty
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
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24
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Kovacevic A, Mavros Y, Heisz JJ, Fiatarone Singh MA. The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep Med Rev 2018; 39:52-68. [DOI: 10.1016/j.smrv.2017.07.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 06/04/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022]
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25
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Radd-Vagenas S, Duffy SL, Naismith SL, Brew BJ, Flood VM, Fiatarone Singh MA. Effect of the Mediterranean diet on cognition and brain morphology and function: a systematic review of randomized controlled trials. Am J Clin Nutr 2018; 107:389-404. [PMID: 29566197 DOI: 10.1093/ajcn/nqx070] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 12/13/2017] [Indexed: 12/11/2022] Open
Abstract
Background Observational studies of the Mediterranean diet suggest cognitive benefits, potentially reducing dementia risk. Objective We performed the first published review to our knowledge of randomized controlled trials (RCTs) investigating Mediterranean diet effects on cognition or brain morphology and function, with an additional focus on intervention diet quality and its relation to "traditional" Mediterranean dietary patterns. Design We searched 9 databases from inception (final update December 2017) for RCTs testing a Mediterranean compared with alternate diet for cognitive or brain morphology and function outcomes. Results Analyses were based on 66 cognitive tests and 1 brain function outcome from 5 included studies (n = 1888 participants). The prescribed Mediterranean diets varied considerably between studies, particularly with regards to quantitative food advice. Only 8/66 (12.1%) of individual cognitive outcomes at trial level significantly favored a Mediterranean diet for cognitive performance, with effect sizes (ESs) ranging from small (0.32) to large (1.66), whereas 2 outcomes favored controls. Data limitations precluded a meta-analysis. Of 8 domain composite cognitive scores from 2 studies, the 3 (Memory, Frontal, and Global function) from PREDIMED (PREvención con DIeta MEDiterránea) were significant, with ESs ranging from 0.39 to 1.29. A posttest comparison at a second PREDIMED site found that the Mediterranean diet modulates the effect of several genotypes associated with dementia risk for some cognitive outcomes, with mixed results. Finally, the risk of low-plasma brain-derived neurotrophic factor was reduced by 78% (OR = 0.22; 95% CI: 0.05, 0.90) in those who consumed a Mediterranean diet compared to control diet at 3 y in this trial. There was no benefit of the Mediterranean diet for incident cognitive impairment or dementia. Conclusions Five RCTs of the Mediterranean diet and cognition have been published to date. The data are mostly nonsignificant, with small ESs. However, the significant improvements in cognitive domain composites in the most robustly designed study warrant additional research.
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Affiliation(s)
- Sue Radd-Vagenas
- Faculty of Health Sciences, Healthy Brain Ageing Program, Brain and Mind Centre, Charles Perkins Centre, Woolcock Institute of Medical Research, Central Clinical School, Faculty of Medicine, and Charles Perkins Centre, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Shantel L Duffy
- Healthy Brain Ageing Program, Brain and Mind Centre, 3Charles Perkins Centre, Woolcock Institute of Medical Research, Central Clinical School, Faculty of Medicine, and 4Charles Perkins Centre, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, Woolcock Institute of Medical Research, Central Clinical School, Faculty of Medicine, and Charles Perkins Centre, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, 3Charles Perkins Centre, Woolcock Institute of Medical Research, Central Clinical School, Faculty of Medicine, and 4Charles Perkins Centre, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Bruce J Brew
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Peter Duncan Neurosciences Unit; St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, Sydney, NSW, Australia
| | - Victoria M Flood
- Faculty of Health Sciences, Healthy Brain Ageing Program, Brain and Mind Centre, Charles Perkins Centre, Woolcock Institute of Medical Research, Central Clinical School, Faculty of Medicine, and Charles Perkins Centre, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Western Sydney Local Health District, Westmead Hospital, Westmead, NSW, Australia
| | - Maria A Fiatarone Singh
- Faculty of Health Sciences, Healthy Brain Ageing Program, Brain and Mind Centre, Charles Perkins Centre, Woolcock Institute of Medical Research, Central Clinical School, Faculty of Medicine, and Charles Perkins Centre, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
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26
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Zhao RR, O'Sullivan AJ, Fiatarone Singh MA. Exercise or physical activity and cognitive function in adults with type 2 diabetes, insulin resistance or impaired glucose tolerance: a systematic review. Eur Rev Aging Phys Act 2018; 15:1. [PMID: 29387262 PMCID: PMC5776769 DOI: 10.1186/s11556-018-0190-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/04/2018] [Indexed: 12/11/2022] Open
Abstract
Background Diabetes is an important risk factor for cognitive impairment. Although some studies suggest that physical exercise can minimize age-related cognitive declines or improve brain morphology or function, benefits in diabetes or impaired glucose tolerance are unclear. Therefore, our aim was to evaluate the efficacy of exercise or physical activity on cognition in adults with type 2 diabetes, insulin resistance or impaired glucose tolerance. Methods An electronic search for studies published from the earliest record until February 2017 was conducted using Medline, EMBASE, SPORTDiscus, CINAHL, and PsycINFO. Any experimental or observational study designs were included, as long as they were conducted in individuals of any age with type 2 diabetes, insulin resistance or impaired glucose tolerance, and they directly examined exercise/physical activity effects on cognitive outcomes or the relationship between changes in cognition and changes in either insulin resistance and glucose homeostasis. Study quality was assessed using the PEDro scale; data on participant and intervention characteristics and outcomes were extracted. Results Six studies enrolling 2289 participants met the eligibility criteria. Quality was modest and effect sizes variable and mostly small or negligible. Overall, four of the six studies (67%) reported significant benefits of greater exercise/physical activity participation for some aspects of cognition, but only 26% of cognitive outcomes were significant across all trials. Clinical improvements in insulin resistance/glucose homeostasis were related to improvements in cognitive function in three studies. Overall results were inconsistent, with benefits varying across exercise types and cognitive domains. Conclusions Literature does not provide evidence that physical activity or exercise interventions contribute to a better cognitive function in patients with type 2 diabetes or impaired glucose tolerance. Large-scale, long-term, robust randomized controlled trials are required to determine if exercise improves cognition in this high-risk cohort, and to investigate putative mechanistic links between cognition, body composition, metabolism, and inflammation in diabetes and related metabolic syndromes.
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Affiliation(s)
- Ren Ru Zhao
- 1Exercise, Health, and Performance Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW 2141 Australia.,4Clinical Rehabilitation Centre, University of Longyan, Longyan, Fujian Province 364012 China
| | | | - Maria A Fiatarone Singh
- 1Exercise, Health, and Performance Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW 2141 Australia.,2Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Center on Aging at Tufts University, Boston, MA USA
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27
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Chan D, Green S, Fiatarone Singh MA, Barnard R, Bonder CS, Cheema BS. Effect of intradialytic resistance training on pulse wave velocity and associated cardiovascular disease biomarkers in end stage renal disease. Nephrology (Carlton) 2017; 23:1055-1062. [PMID: 29265637 DOI: 10.1111/nep.13212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2017] [Indexed: 11/29/2022]
Abstract
AIMS Cardiovascular disease (CVD) is the leading cause of mortality in patients with end-stage renal disease (ESRD) receiving maintenance haemodialysis treatment. This study investigated the effect of a 12-week intradialytic progressive resistance training (PRT) intervention on pulse wave velocity (PWV) and associated haemodynamic, anthropometric, and hematologic outcomes in patients with ESRD. METHODS Twenty-two patients with ESRD (59% men, 71.3 ± 11.0 years) were recruited. Supervised PRT (three sets of 11 exercises) was prescribed three times per week during routine dialysis. The primary outcome was brachial-ankle PWV via applanation tonometry. Secondary outcomes included augmentation index, brachial and aortic blood pressures, endothelial progenitor cells, C-reactive protein, blood lipids and anthropometrics. RESULTS The intradialytic PRT regimen resulted in no significant change in PWV between control and intervention periods [mean difference = 0 (95% CI = -0.1 to 0.1); P = 0.58]. Similarly, no significant change was noted in any secondary outcome measures between the control and intervention periods. Post-hoc analyses limited to high adherers (≥75% attendance; n = 11) did not differ from the primary analysis, indicating no dose-response effect of our intervention. CONCLUSION Our 12-week PRT intervention did not change PWV or any secondary outcomes. Future studies should determine if higher dosages of intradialytic PRT (i.e. longer duration and/or higher intensity) can be applied as a method to improve arterial stiffness to potentially reduce cardiovascular disease and associated mortality this cohort.
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Affiliation(s)
- Danwin Chan
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Simon Green
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Maria A Fiatarone Singh
- Exercise, Health & Performance Faculty Research Group, Faculty of Health Sciences and Sydney Medical School, University of Sydney, Sydney, Australia.,Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Center on Aging at Tufts University, Boston, Massachusetts, USA
| | - Robert Barnard
- Centre for Physical Activity in Ageing, Central Adelaide Local Health Network, Adelaide, Australia
| | - Claudine S Bonder
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, South Australia, Australia
| | - Birinder S Cheema
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia.,The National Institute of Complementary Medicine, Sydney, New South Wales, Australia
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28
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Taing CY, Gibson AA, Colagiuri S, Vita P, Cardona-Morrell M, Bauman A, Moore M, Williams M, Milat A, Hony J, Lin S, Gwizd M, Fiatarone Singh MA. Primary analysis of the Mandarin-speaking sub-study within the Sydney diabetes prevention program. Diabetes Res Clin Pract 2017; 132:118-126. [PMID: 28834772 DOI: 10.1016/j.diabres.2017.07.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/21/2017] [Accepted: 07/26/2017] [Indexed: 12/16/2022]
Abstract
AIM There is strong and consistent evidence from large scale randomised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet quality, increases physical activity and achieves weight loss in people at risk. Worldwide, the prevalence of type 2 diabetes is increasing in individuals of Chinese descent. Culturally tailored programs are required to address the risk in the Chinese population. This paper analyses effectiveness of a culturally tailored community-based lifestyle modification program (Sydney Diabetes Prevention Program (SDPP)) targeting Mandarin speakers. The SDPP was a 12 month translational study aiming to promote increased physical activity and dietary changes. Effectiveness was assessed through the improvement of anthropometric, metabolic, physical activity and dietary outcomes and number of goals met. METHODS Seventy-eight Mandarin-speaking participants at a high risk (Australian Diabetes Risk, AUSDRISK≥15) of developing diabetes were recruited for this study. RESULTS In this cohort, waist circumference, total cholesterol and fat intake significantly improved at the 12-month review. In comparison to the English-speaking stream, the Mandarin-speaking stream achieved fewer improvements in outcomes and goals. CONCLUSION The SDPP was not effective in reducing the risk factors associated with developing type 2 diabetes in this cohort of high risk Mandarin-speaking individuals living in Sydney.
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Affiliation(s)
- Cecilia Y Taing
- The University of Sydney, Exercise, Health and Performance Faculty Research Group, Lidcombe, NSW 2141, Australia.
| | - Alice A Gibson
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney, NSW 2006, Australia; The University of Sydney, Charles Perkins Centre, Sydney, NSW 2006, Australia
| | - Stephen Colagiuri
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney, NSW 2006, Australia; The University of Sydney, Charles Perkins Centre, Sydney, NSW 2006, Australia
| | - Philip Vita
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney, NSW 2006, Australia
| | - Magnolia Cardona-Morrell
- The University of New South Wales, The Simpson Centre for Health Services Research, South Western Sydney Clinical School, Sydney, NSW 1466, Australia
| | - Adrian Bauman
- The University of Sydney, Charles Perkins Centre, Sydney, NSW 2006, Australia; The University of Sydney, Prevention Research Collaboration, School of Public Health, Sydney, NSW 2006, Australia
| | - Michael Moore
- Inner West Sydney Medicare Local, Ashfield, NSW 2131, Australia
| | - Mandy Williams
- South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
| | - Andrew Milat
- New South Wales Ministry of Health, North Sydney, NSW 2060, Australia; The University of Sydney, Sydney Medical School, Sydney, NSW 2006, Australia
| | - Jacky Hony
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney, NSW 2006, Australia
| | - Sophia Lin
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney, NSW 2006, Australia
| | - Melissa Gwizd
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney, NSW 2006, Australia
| | - Maria A Fiatarone Singh
- The University of Sydney, Exercise, Health and Performance Faculty Research Group, Lidcombe, NSW 2141, Australia; The University of Sydney, Charles Perkins Centre, Sydney, NSW 2006, Australia; The University of Sydney, Sydney Medical School, Sydney, NSW 2006, Australia; Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Center on Aging at Tufts University, Boston, MA 02111, USA
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Brodaty H, Heffernan M, Fiatarone Singh MA, Valenzuela M, Andrews G, Lautenschlager NT, Anstey KJ, Maeder A, Jorm L, McNeil J, Ginige A, Chau T, Sachdev PS. [F4–05–01]: MAINTAIN YOUR BRAIN
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A RANDOMISED CONTROLLED TRIAL OF AN INTERNET‐BASED MULTI‐COMPONENT LIFESTYLE INTERVENTION TO PREVENT COGNITIVE DECLINE AND DEMENTIA. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Henry Brodaty
- UNSW SydneySydneyAustralia
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
- University of SydneySydneyAustralia
- The University of SydneyCamperdownAustralia
- University of New South WalesSydneyAustralia
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Valenzuela M, Broadhouse KM, Suo C, Fiatarone Singh MA, Gates N, Wen W, Sachdev PS, Brodaty H, Jain N, Wilson G, Meiklejohn J, Singh N, Baune BT, Baker M, Foroughi N, Wang Y, Mavros Y. [IC‐03–01]: WHAT HAPPENS TO THE HIPPOCAMPUS 12 MONTHS AFTER TRAINING? LONGITUDINAL LINEAR MIXED‐EFFECTS MODEL ANALYSIS OF MILD COGNITIVE IMPAIRMENT IN THE SMART TRIAL. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Chao Suo
- Monash UniversityMelbourneAustralia
| | | | | | - Wei Wen
- Centre for Healthy Brain Ageing, School of PsychiatryUniversity of New South WalesSydneyAustralia
| | - Perminder S. Sachdev
- University of New South WalesSydneyAustralia
- Centre for Healthy Brain Ageing, School of PsychiatryUniversity of New South WalesSydneyAustralia
- Neuropsychiatric Institute, Prince of Wales HospitalRandwickAustralia
| | - Henry Brodaty
- University of New South WalesSydneyAustralia
- UNSW SydneySydneyAustralia
| | | | | | | | | | | | - Michael Baker
- Australian Catholic UniversityStrathfieldSydneyAustralia
| | | | - Yi Wang
- University of SydneySydneyAustralia
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Affiliation(s)
- Wendy A Rogers
- Department of Philosophy and Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | - Maria A Fiatarone Singh
- Health and Performance Research Group, Faculty of Health Sciences, University of Sydney, NSW, Australia
| | - Jacob Lavee
- Department of Cardiac Surgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Rogers WA, Fiatarone Singh MA, Lavee J. Papers based on data concerning organs from executed prisoners should not be published: Response to Zheng and Yan. Liver Int 2017; 37:771-772. [PMID: 28453920 DOI: 10.1111/liv.13366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Wendy A Rogers
- Department of Philosophy and Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | - Maria A Fiatarone Singh
- Health and Performance Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Jacob Lavee
- Department of Cardiac Surgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Burton NW, Ademi Z, Best S, Fiatarone Singh MA, Jenkins JS, Lawson KD, Leicht AS, Mavros Y, Noble Y, Norman P, Norman R, Parmenter BJ, Pinchbeck J, Reid CM, Rowbotham SE, Yip L, Golledge J. Efficacy of brief behavioral counselling by allied health professionals to promote physical activity in people with peripheral arterial disease (BIPP): study protocol for a multi-center randomized controlled trial. BMC Public Health 2016; 16:1148. [PMID: 27829449 PMCID: PMC5103607 DOI: 10.1186/s12889-016-3801-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/01/2016] [Indexed: 01/24/2023] Open
Abstract
Background Physical activity is recommended for people with peripheral arterial disease (PAD), and can improve walking capacity and quality of life; and reduce pain, requirement for surgery and cardiovascular events. This trial will assess the efficacy of a brief behavioral counselling intervention delivered by allied health professionals to improve physical activity in people with PAD. Methods This is a multi-center randomised controlled trial in four cities across Australia. Participants (N = 200) will be recruited from specialist vascular clinics, general practitioners and research databases and randomised to either the control or intervention group. Both groups will receive usual medical care, a written PAD management information sheet including advice to walk, and four individualised contacts from a protocol-trained allied health professional over 3 months (weeks 1, 2, 6, 12). The control group will receive four 15-min telephone calls with general discussion about PAD symptoms and health and wellbeing. The intervention group will receive behavioral counselling via two 1-h face-to-face sessions and two 15-min telephone calls. The counselling is based on the 5A framework and will promote interval walking for 3 × 40 min/week. Assessments will be conducted at baseline, and 4, 12 and 24 months by staff blinded to participant allocation. Objectively assessed outcomes include physical activity (primary), sedentary behavior, lower limb body function, walking capacity, cardiorespiratory fitness, event-based claudication index, vascular interventions, clinical events, cardiovascular function, circulating markers, and anthropometric measures. Self-reported outcomes include physical activity and sedentary behavior, walking ability, pain severity, and health-related quality of life. Data will be analysed using an intention-to-treat approach. An economic evaluation will assess whether embedding the intervention into routine care would likely be value for money. A cost-effectiveness analysis will estimate change in cost per change in activity indicators due to the intervention, and a cost-utility analysis will assess change in cost per quality-adjusted life year. A full uncertainty analysis will be undertaken, including a value of information analysis, to evaluate the economic case for further research. Discussion This trial will evaluate the efficacy and cost-effectiveness of a brief behavioral counselling intervention for a common cardiovascular disease with significant burden. Trial registration ACTRN 12614000592640 Australian New Zealand Clinical Trials Registry. Registration Date 4 June 2014. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3801-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicola W Burton
- The University of Queensland School of Human Movement & Nutrition Sciences, St Lucia, Brisbane, QLD, 4072, Australia
| | - Zanfina Ademi
- University of Basel Institute of Pharmaceutical Medicine, Basel, Switzerland.,University of Monash Department of Epidemiology and Preventive Medicine, Melbourne, 3004, VIC, Australia
| | - Stuart Best
- Queensland Research Centre for Peripheral Vascular Disease; College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Maria A Fiatarone Singh
- Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, 2141, Australia
| | - Jason S Jenkins
- Vascular Surgery The Royal Brisbane and Women's Hospital, Herston, QLD, 4059, Australia
| | - Kenny D Lawson
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2753, Australia.,Centre for Research Excellence in Chronic Disease Prevention, Australian Institute for Public Health and Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia
| | - Anthony S Leicht
- Sport and Exercise Science, College of Healthcare Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Yorgi Mavros
- Exercise, Health and Performance Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, 2141, Australia
| | - Yian Noble
- Exercise, Health and Performance Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, 2141, Australia
| | - Paul Norman
- Surgery Fremantle Hospital, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Richard Norman
- School of Public Health, Curtin University, Perth, WA, 6845, Australia
| | - Belinda J Parmenter
- Department of Exercise Physiology, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Jenna Pinchbeck
- Queensland Research Centre for Peripheral Vascular Disease; College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Christopher M Reid
- School of Public Health, Curtin University, Perth, WA, 6845, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Sophie E Rowbotham
- The University of Queensland School of Medicine, Herston, QLD, 4006, Australia.,The Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia
| | - Lisan Yip
- Queensland Research Centre for Peripheral Vascular Disease; College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease; College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia. .,Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, QLD, 4811, Australia.
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Mavros Y, Gates N, Wilson GC, Jain N, Meiklejohn J, Brodaty H, Wen W, Singh N, Baune BT, Suo C, Baker MK, Foroughi N, Wang Y, Sachdev PS, Valenzuela M, Fiatarone Singh MA. Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training. J Am Geriatr Soc 2016; 65:550-559. [DOI: 10.1111/jgs.14542] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Yorgi Mavros
- Exercise Health and Performance Faculty Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
| | - Nicola Gates
- Centre for Healthy Brain Ageing; School of Psychiatry; University of New South Wales; Sydney New South Wales Australia
| | - Guy C. Wilson
- Exercise Health and Performance Faculty Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
| | - Nidhi Jain
- Exercise Health and Performance Faculty Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
| | - Jacinda Meiklejohn
- Exercise Health and Performance Faculty Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing; School of Psychiatry; University of New South Wales; Sydney New South Wales Australia
- Dementia Collaborative Research Centre; University of New South Wales; Sydney New South Wales Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing; School of Psychiatry; University of New South Wales; Sydney New South Wales Australia
- Neuropsychiatric Institute; Prince of Wales Hospital; Sydney New South Wales Australia
| | - Nalin Singh
- Exercise Health and Performance Faculty Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
| | - Bernhard T. Baune
- Department of Psychiatry; School of Medicine; University of Adelaide; Adelaide South Australia Australia
| | - Chao Suo
- Centre for Healthy Brain Ageing; School of Psychiatry; University of New South Wales; Sydney New South Wales Australia
- Regenerative Neuroscience Group; Brain and Mind Research Institute; University of Sydney; Sydney New South Wales Australia
- Monash Clinical and Imaging Neuroscience; School of Psychology and Psychiatry; Monash University; Sydney New South Wales Australia
| | - Michael K. Baker
- Exercise Health and Performance Faculty Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
- School of Exercise Science; Australian Catholic University; Strathfield Sydney New South Wales Australia
| | - Nasim Foroughi
- Clinical and Rehabilitation Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
| | - Yi Wang
- Department of Medicine and the Diabetes Center; University of California; San Francisco California
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing; School of Psychiatry; University of New South Wales; Sydney New South Wales Australia
- Dementia Collaborative Research Centre; University of New South Wales; Sydney New South Wales Australia
| | - Michael Valenzuela
- Regenerative Neuroscience Group; Brain and Mind Research Institute; University of Sydney; Sydney New South Wales Australia
| | - Maria A. Fiatarone Singh
- Exercise Health and Performance Faculty Research Group; Faculty of Health Sciences; University of Sydney; Lidcombe Sydney New South Wales Australia
- Hebrew SeniorLife; Boston Massachusetts
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging; Tufts University; Boston Massachusetts
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Mavros Y, O'Neill E, Connerty M, Bean JF, Broe K, Kiel DP, Maclean D, Taylor A, Fielding RA, Singh MAF. Oxandrolone Augmentation of Resistance Training in Older Women: A Randomized Trial. Med Sci Sports Exerc 2016; 47:2257-67. [PMID: 25899102 DOI: 10.1249/mss.0000000000000690] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Sarcopenia is disproportionately present in older women with disability, and optimum treatment is not clear. We conducted a double-blind, randomized, placebo-controlled trial to determine whether oxandrolone administration in elderly women improves body composition or physical function beyond that which occurs in response to progressive resistance training (PRT). METHODS Twenty-nine sedentary women (age 74.9 ± 6.8 yr; 5.9 ± 2.8 medications per day) were randomized to receive high-intensity PRT (three times a week for 12 wk) combined with either oxandrolone (10 mg·d(-1)) or an identical placebo. Peak strength was assessed for leg press, chest press, triceps, knee extension, and knee flexion. Power was assessed for leg press and chest press. Physical function measures included static and dynamic balance, chair rise, stair climb, gait speed, and 6-min walk test. Body composition was assessed using dual energy x-ray absorptiometry. RESULTS Oxandrolone treatment augmented increases in lean tissue for the whole body (2.6 kg; 95% confidence interval (CI), 1.0-4.2 kg; P = 0.003), arms (0.3 kg; 95% CI, 0.1-0.5 kg; P = 0.001), legs (0.8 kg; 95% CI, 0.1-1.4 kg; P = 0.018), and trunk (1.4 kg; 95% CI, 0.4-2.3 kg; P = 0.004). Oxandrolone also augmented loss of fat tissue of the whole body (-1 kg; 95% CI, -1.6 to -0.4; P = 0.002), arms (-0.2 kg; 95% CI, -0.5 to -0.02 kg; P = 0.032), legs (-0.4 kg; 95% CI, -0.6 to -0.1; P = 0.009), and tended to reduce trunk fat (-0.4 kg; 95% CI, -0.9 to 0.04; P = 0.07). Improvements in muscle strength and power, chair stand, and dynamic balance were all significant over time (P < 0.05) but not different between groups (P > 0.05). CONCLUSIONS Oxandrolone improves body composition adaptations to PRT in older women over 12 wk without augmenting muscle function or functional performance beyond that of PRT alone.
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Affiliation(s)
- Yorgi Mavros
- 1Exercise Health and Performance Faculty Research Group, University of Sydney, Sydney, AUSTRALIA; 2Institute for Aging Research, Hebrew SeniorLife, Boston, MA; 3Spaulding Rehabilitation Hospital, Boston, MA; 4Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; 5New England GRECC, Boston VA Healthcare System, Boston, MA; 6Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; 7Oncology Clinical Research, Takeda, Boston, MA; 8Novartis Institutes for BioMedical Research, Cambridge, MA; 9Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; and 10Sydney Medical School, University of Sydney, Sydney, AUSTRALIA
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Inskip M, Mavros Y, Sachdev PS, Fiatarone Singh MA. Exercise for Individuals with Lewy Body Dementia: A Systematic Review. PLoS One 2016; 11:e0156520. [PMID: 27258533 PMCID: PMC4892610 DOI: 10.1371/journal.pone.0156520] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/16/2016] [Indexed: 11/30/2022] Open
Abstract
Background Individuals with Lewy body Dementia (LBD), which encompasses both Parkinson disease dementia (PDD) and Dementia with Lewy Bodies (DLB) experience functional decline through Parkinsonism and sedentariness exacerbated by motor, psychiatric and cognitive symptoms. Exercise may improve functional outcomes in Parkinson’s disease (PD), and Alzheimer’s disease (AD). However, the multi-domain nature of the LBD cluster of symptoms (physical, cognitive, psychiatric, autonomic) results in vulnerable individuals often being excluded from exercise studies evaluating physical function in PD or cognitive function in dementia to avoid confounding results. This review evaluated existing literature reporting the effects of exercise interventions or physical activity (PA) exposure on cluster symptoms in LBD. Methods A high-sensitivity search was executed across 19 databases. Full-length articles of any language and quality, published or unpublished, that analysed effects of isolated exercise/physical activity on indicative Dementia with Lewy Bodies or PD-dementia cohorts were evaluated for outcomes inclusive of physical, cognitive, psychiatric, physiological and quality of life measures. The protocol for this review (Reg. #: CRD42015019002) is accessible at http://www.crd.york.ac.uk/PROSPERO/. Results 111,485 articles were initially retrieved; 288 full articles were reviewed and 89.6% subsequently deemed ineligible due to exclusion of participants with co-existence of dementia and Parkinsonism. Five studies (1 uncontrolled trial, 1 randomized controlled trial and 3 case reports) evaluating 16 participants were included. Interventions were diverse and outcome homogeneity was low. Habitual gait speed outcomes were measured in 13 participants and increased (0.18m/s, 95% CI -0.02, 0.38m/s), exceeding moderate important change (0.14m/s) for PD cohorts. Other outcomes appeared to improve modestly in most participants. Discussion Scarce research investigating exercise in LBD exists. This review confirms exercise studies in PD and dementia consistently exclude LBD participants. Results in this cohort must be treated with caution until robustly designed, larger studies are commissioned to explore exercise efficacy, feasibility and clinical relevance.
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Affiliation(s)
- Michael Inskip
- Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, 2141, Australia
- * E-mail:
| | - Yorgi Mavros
- Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, 2141, Australia
| | - Perminder S. Sachdev
- CHeBA (Centre for Healthy Brain Ageing), School of Psychiatry, University of New South Wales, Randwick, New South Wales, 2031, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, 2031, Australia
| | - Maria A. Fiatarone Singh
- Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, 2141, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, 2006, Australia
- Hebrew SeniorLife, Roslindale, Massachusetts, 02131, United States of America
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, 02155, United States of America
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Bauman A, Merom D, Bull FC, Buchner DM, Fiatarone Singh MA. Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological Evidence, Prevalence, and Interventions to Promote “Active Aging”. GERONT 2016; 56 Suppl 2:S268-80. [DOI: 10.1093/geront/gnw031] [Citation(s) in RCA: 380] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Hagstrom AD, Marshall PWM, Lonsdale C, Papalia S, Cheema BS, Toben C, Baune BT, Fiatarone Singh MA, Green S. The effect of resistance training on markers of immune function and inflammation in previously sedentary women recovering from breast cancer: a randomized controlled trial. Breast Cancer Res Treat 2016; 155:471-82. [DOI: 10.1007/s10549-016-3688-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/20/2016] [Indexed: 01/11/2023]
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Simpson KA, Mavros Y, Kay S, Meiklejohn J, de Vos N, Wang Y, Guo Q, Zhao R, Climstein M, Baune BT, Blair S, O'Sullivan AJ, Simar D, Singh N, Singh MAF. Graded Resistance Exercise And Type 2 Diabetes in Older adults (The GREAT2DO study): methods and baseline cohort characteristics of a randomized controlled trial. Trials 2015; 16:512. [PMID: 26554457 PMCID: PMC4640163 DOI: 10.1186/s13063-015-1037-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 10/27/2015] [Indexed: 12/16/2022] Open
Abstract
Background Type 2 diabetes (T2D) is projected to affect 439 million people by 2030. Medical management focuses on controlling blood glucose levels pharmacologically in a disease that is closely related to lifestyle factors such as diet and inactivity. Physical activity guidelines include aerobic exercise at intensities or volumes potentially unreachable for older adults limited by many co-morbidities. We aim to show for the first time the efficacy of a novel exercise modality, power training (high-velocity, high-intensity progressive resistance training or PRT), in older adults with T2D as a means for improving glycemic control and targeting many associated metabolic and physiological outcomes. Eligibility criteria included community-dwelling men and women previously diagnosed with T2D who met the current definition of metabolic syndrome according to the International Diabetes Federation. Participants were randomized to a fully supervised power training intervention or sham exercise control group for 12 months. Intervention group participants performed whole body machine-based power training at 80%1RM, 3 days per week. The control group undertook the same volume of non-progressive, low-intensity training. Participants were assessed at baseline, 6 months and 12 months and followed for a further 5 years, during which time participants were advised to exercise at moderate-high intensity. Glycemic control (HbA1c) and insulin resistance as measured by the homeostatic model assessment 2 (HOMA2-IR) were the primary outcomes of the trial. Outcome assessors were blinded to group assignment and participants were blinded to the investigators’ hypothesis regarding the most effective intervention. Results We recruited 103 participants (48.5 % women, 71.6 ± 5.6 years). Participants had 5.1 ± 1.8 chronic diseases, had been diagnosed with T2D for 8 ± 6 years and had a body mass index (BMI) of 31.6 ± 4.0 kg/m2. Fasting glucose and insulin were 7.3 ± 2.4 mmol/L and 10.6 ± 6.3 mU/L, respectively. HbA1c was 54 ± 12 mmol/mol. Eighty-six participants completed the 12-month assessment and follow-up is ongoing. This cohort had a lower-than-expected dropout (n = 14, 14 %) over the 12-month intervention period. Conclusions Power training may be a feasible adjunctive therapy for improving glycemic control for the growing epidemic of T2D in older adults. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12606000436572 (24 September 2006).
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Affiliation(s)
- Kylie A Simpson
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Yorgi Mavros
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Shelley Kay
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Jacinda Meiklejohn
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Nathan de Vos
- The Center for STRONG Medicine, Balmain Hospital, 29 Booth St, Balmain, NSW, 2041, Australia.
| | - Yi Wang
- San Francisco, Diabetes Center, University of California, Box 0540, 513 Parnassus Ave 1119, San Francisco, CA, 94143-0540, USA.
| | - Qianyu Guo
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Renru Zhao
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Mike Climstein
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Bernard T Baune
- Discipline of Psychiatry, The University of Adelaide, Level 4, Eleanor Harrold Building, Royal Adelaide Hospital, Adelaide, SA, 5005, Australia.
| | - Steven Blair
- Department of Exercise Science, Public Health Research Building, University of South Carolina, 921 Assembly St, Columbia, SC, 29208, USA.
| | - Anthony J O'Sullivan
- Department of Medicine, University of New South Wales, St George and Sutherland Clinical School, St George Hospital, Gray St, Kogarah, NSW, 2217, Australia.
| | - David Simar
- Faculty of Medicine, Metabolic Disorders Research Group, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Nalin Singh
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia.
| | - Maria A Fiatarone Singh
- Faculty of Health Science, Exercise, Health and Performance Faculty Research Group, University of Sydney, 75 East St, Lidcombe, NSW, 2750, Australia. .,Sydney Medical School, University of Sydney, Sydney, NSW, 2000, Australia. .,Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA, USA.
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Fiatarone Singh MA, Gates N, Saigal N, Wilson GC, Meiklejohn J, Brodaty H, Wen W, Singh N, Baune BT, Suo C, Baker MK, Foroughi N, Wang Y, Sachdev PS, Valenzuela M. Reply to the Letter to the Editor by O'Caoimh et al. J Am Med Dir Assoc 2015; 16:999-1001. [PMID: 26420493 DOI: 10.1016/j.jamda.2015.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Maria A Fiatarone Singh
- Exercise, Health, and Performance Faculty Research Group, Faculty of Health Sciences, Sydney Medical School, The University of Sydney, Lidcombe, New South Wales, Australia; Hebrew SeniorLife, Boston, Massachusetts; Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
| | - Nicola Gates
- Private Neuropsychology Practice, Mosman, New South Wales, Australia
| | - Nidhi Saigal
- Exercise Health and Performance, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Guy C Wilson
- Exercise Health and Performance, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Jacinda Meiklejohn
- Exercise Health and Performance, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Henry Brodaty
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Wei Wen
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Center for Healthy Aging (CHeBA), NPI, Euroa Center, Prince of Wales Hospital Randwick, New South Wales, Australia
| | - Nalin Singh
- Royal Prince Alfred and Balmain Hospital, Balmain, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Bernhard T Baune
- Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Chao Suo
- Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Michael K Baker
- Exercise Health and Performance, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia; Australian Catholic University, New South Wales, Australia
| | - Nasim Foroughi
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Yi Wang
- Department of Medicine and the Diabetes Center, University of California at San Francisco, San Francisco, California
| | - Perminder S Sachdev
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Center for Healthy Ageing (CHeBA), NPI, Euroa Center, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Michael Valenzuela
- Regenerative Neuroscience Group, Brain and Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
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Stensvold D, Viken H, Rognmo Ø, Skogvoll E, Steinshamn S, Vatten LJ, Coombes JS, Anderssen SA, Magnussen J, Ingebrigtsen JE, Fiatarone Singh MA, Langhammer A, Støylen A, Helbostad JL, Wisløff U. A randomised controlled study of the long-term effects of exercise training on mortality in elderly people: study protocol for the Generation 100 study. BMJ Open 2015; 5:e007519. [PMID: 25678546 PMCID: PMC4330327 DOI: 10.1136/bmjopen-2014-007519] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Epidemiological studies suggest that exercise has a tremendous preventative effect on morbidity and premature death, but these findings need to be confirmed by randomised trials. Generation 100 is a randomised, controlled study where the primary aim is to evaluate the effects of 5 years of exercise training on mortality in an elderly population. METHODS AND ANALYSIS All men and women born in the years 1936-1942 (n=6966), who were residents of Trondheim, Norway, were invited to participate. Between August 2012 and June 2013, a total of 1567 individuals (790 women) were included and randomised to either 5 years of two weekly sessions of high-intensity training (10 min warm-up followed by 4×4 min intervals at ∼90% of peak heart rate) or, moderate-intensity training (50 min of continuous work at ∼70% of peak heart rate), or to a control group that followed physical activity advice according to national recommendations. Clinical examinations, physical tests and questionnaires will be administered to all participants at baseline, and after 1, 3 and 5 years. Participants will also be followed up by linking to health registries until year 2035. ETHICS AND DISSEMINATION The study has been conducted according to the SPIRIT statement. All participants signed a written consent form, and the study has been approved by the Regional Committee for Medical Research Ethics, Norway. Projects such as this are warranted in the literature, and we expect that data from this study will result in numerous papers published in world-leading clinical journals; we will also present the results at international and national conferences. TRIAL REGISTRATION NUMBER Clinicaltrials.gov NCT01666340.
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Affiliation(s)
- Dorthe Stensvold
- KG Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Hallgeir Viken
- KG Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Øivind Rognmo
- KG Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eirik Skogvoll
- St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sigurd Steinshamn
- KG Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Thoracic Medicine, St Olavs Hospital, Trondheim University Hospital,Trondheim, Norway
| | - Lars J Vatten
- KG Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jeff S Coombes
- School of Human Movement Studies, University of Queensland, Queensland, Australia
| | - Sigmund A Anderssen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Jon Magnussen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Erik Ingebrigtsen
- Institute for Science in Sport, Norwegian University of Science and Technology, Trondheim, Norway
| | - Maria A Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
- Hebrew Senior Life, Boston, Massachusetts, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA
| | - Arnulf Langhammer
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asbjørn Støylen
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Cardiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jorunn L Helbostad
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic for Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- KG Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Fiatarone Singh MA, Gates N, Saigal N, Wilson GC, Meiklejohn J, Brodaty H, Wen W, Singh N, Baune BT, Suo C, Baker MK, Foroughi N, Wang Y, Sachdev PS, Valenzuela M. The Study of Mental and Resistance Training (SMART) Study—Resistance Training and/or Cognitive Training in Mild Cognitive Impairment: A Randomized, Double-Blind, Double-Sham Controlled Trial. J Am Med Dir Assoc 2014; 15:873-80. [DOI: 10.1016/j.jamda.2014.09.010] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
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Pascoe AR, Fiatarone Singh MA, Edwards KM. The effects of exercise on vaccination responses: a review of chronic and acute exercise interventions in humans. Brain Behav Immun 2014; 39:33-41. [PMID: 24126151 DOI: 10.1016/j.bbi.2013.10.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 10/03/2013] [Accepted: 10/03/2013] [Indexed: 12/15/2022] Open
Abstract
Vaccination programs, although feted for success in reducing infectious disease morbidity and mortality, are limited by vaccine efficacy, which is particularly problematic in populations with reduced immune function. Exercise has been identified as a behavioural factor that can improve immune function in some settings and cohorts, and therefore, in the setting of vaccination, it may serve as an adjuvant for immune responses. Here, we summarise the body of evidence that has investigated the effects of chronic or acute exercise interventions on vaccination responses. A systematic search of the literature was conducted including six major databases. Randomised control trials (RCTs), cross-sectional and observational studies that involved a variety of population samples and that employed any modality or intensity of acute exercise or chronic training prior to vaccine administration and measured any immune response were included. Twenty trials met the inclusion criteria for this review. Nine studies investigated the effect of acute exercise on the immune response to vaccination, whilst the remaining eleven studies investigated the effect of chronic exercise. Most of the current published literature suggests that exposure to either acute or chronic exercise significantly augments the immune response to vaccination. The clinical importance of this adjuvant action of exercise, if any, as well as variability in responsiveness across different cohorts, dose-response relationships and the optimal exercise modality to employ for this indication deserve further study.
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Affiliation(s)
- April R Pascoe
- Faculty of Health Sciences, Exercise Health and Performance Research Group, University of Sydney, Lidcombe, Australia
| | - Maria A Fiatarone Singh
- Faculty of Health Sciences, Exercise Health and Performance Research Group, University of Sydney, Lidcombe, Australia; Faculty of Medicine, University of Sydney, Lidcombe, Australia
| | - Kate M Edwards
- Faculty of Health Sciences, Exercise Health and Performance Research Group, University of Sydney, Lidcombe, Australia.
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Mavros Y, Kay S, Simpson KA, Baker MK, Wang Y, Zhao RR, Meiklejohn J, Climstein M, O'Sullivan AJ, de Vos N, Baune BT, Blair SN, Simar D, Rooney K, Singh NA, Fiatarone Singh MA. Reductions in C-reactive protein in older adults with type 2 diabetes are related to improvements in body composition following a randomized controlled trial of resistance training. J Cachexia Sarcopenia Muscle 2014; 5:111-20. [PMID: 24687180 PMCID: PMC4053559 DOI: 10.1007/s13539-014-0134-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 01/27/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Reductions in skeletal muscle mass and increased adiposity are key elements in the aging process and in the pathophysiology of several chronic diseases. Systemic low grade inflammation associated with obesity has been shown to accelerate the age-related decline in skeletal muscle. The aim of this investigation was to determine the effects of 12 months of progressive resistance training (PRT) on systemic inflammation, and whether reductions in systemic inflammation were associated with changes in body composition. We hypothesized that reductions in systemic inflammation following 12 months of PRT in older adults with type 2 diabetes would be associated with reductions in adiposity and increases in skeletal muscle mass. METHODS Participants (n = 103) were randomized to receive either PRT or sham-exercise, 3 days a week for 12 months. C-reactive protein (CRP) was used to assess systemic inflammation. Skeletal muscle mass and total fat mass were determined using bioelectrical impedance. RESULTS Twelve months of PRT tended to reduce CRP compared to sham exercise (β = -0.25, p = 0.087). Using linear mixed-effects models, the hypothesized relationships between body composition adaptations and CRP changes were significantly stronger for skeletal muscle mass (p = 0.04) and tended to be stronger for total fat mass (p = 0.07) following PRT when compared to sham-exercise. Using univariate regression models, stratified by group allocation, reductions in CRP were associated with increases in skeletal muscle mass (p = 0.01) and reductions in total fat mass (p = 0.02) in the PRT group, but not in the sham-exercise group (p = 0.87 and p = 0.32, respectively). CONCLUSIONS We have shown for the first time that reductions in systemic inflammation in older adults with type 2 diabetes following PRT were associated with increases in skeletal muscle mass. Furthermore, reductions in CRP were associated with reductions in adiposity, but only when associated with PRT. Lifestyle interventions aimed at reducing systemic inflammation in older adults with type 2 diabetes should therefore incorporate anabolic exercise such as PRT to optimize the anti-inflammatory benefits of favorable body composition adaptations.
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Affiliation(s)
- Yorgi Mavros
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia,
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Parmenter BJ, Raymond J, Dinnen P, Lusby RJ, Fiatarone Singh MA. Response to Raphael Mendes Ritti Dias. J Am Geriatr Soc 2014; 62:996-7. [PMID: 24828940 DOI: 10.1111/jgs.12803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Belinda J Parmenter
- Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, Exercise Physiology Unit, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Abstract
OBJECTIVES Cognitive impairments associated with aging and dementia are major sources of burden, deterioration in life quality, and reduced psychological well-being (PWB). Preventative measures to both reduce incident disease and improve PWB in those afflicted are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, there is very limited information regarding the relationships between early cognitive changes and memory concern, and life quality and PWB in adults with MCI; furthermore, PWB outcomes are too commonly overlooked in intervention trials. The purpose of this study was therefore to empirically test a theoretical model of PWB in MCI in order to inform clinical intervention. METHODS Baseline data from a convenience sample of 100 community-dwelling adults diagnosed with MCI enrolled in the Study of Mental Activity and Regular Training (SMART) trial were collected. A series of regression analyses were performed to develop a reduced model, then hierarchical regression with the Baron Kenny test of mediation derived the final three-tiered model of PWB. RESULTS Significant predictors of PWB were subjective memory concern, cognitive function, evaluations of quality of life, and negative affect, with a final model explaining 61% of the variance of PWB in MCI. DISCUSSION Our empirical findings support a theoretical tiered model of PWB in MCI and contribute to an understanding of the way in which early subtle cognitive deficits impact upon PWB. Multiple targets and entry points for clinical intervention were identified. These include improving the cognitive difficulties associated with MCI. Additionally, these highlight the importance of reducing memory concern, addressing low mood, and suggest that improving a person's quality of life may attenuate the negative effects of depression and anxiety on PWB in this cohort.
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Affiliation(s)
- Nicola Gates
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CheBA), University of New South Wales, Sydney, NSW, Australia
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Michael Valenzuela
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Perminder S Sachdev
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CheBA), University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Maria A Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Sydney Medical School, The University of Sydney, Lidcombe, NSW, Australia
- Hebrew SeniorLife, Boston, MA, and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Baker MK, Corrêa APS, Schaan BD, Meiklejohn J, Wilson G, Saigal N, Fiatarone Singh MA. Heart Rate Variability Increases After Maximal Dynamic Strength Testing In Older Adults. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000496134.70047.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Parmenter BJ, Raymond J, Fiatarone Singh MA. The effect of exercise on fitness and performance-based tests of function in intermittent claudication: a systematic review. Sports Med 2014; 43:513-24. [PMID: 23539309 DOI: 10.1007/s40279-013-0038-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Exercise is a widely accepted treatment known to improve walking ability in persons with peripheral arterial disease (PAD); however, it has not been confirmed as to whether exercise improves fitness and performance-based function and, consequently, performance of activities of daily living (ADL). This systematic review aims to identify whether any mode of structured exercise improves physical fitness or performance-based tests of function and whether improvement in walking ability is related to an improvement in these outcomes. DATA SOURCES AND STUDY SELECTION Eligible studies included randomized controlled trials (RCTs) using an exercise intervention for the treatment of intermittent claudication with fitness (including the 6-min walk (6MW), aerobic capacity, shuttle and muscle strength) tests and performance-based tests of function as the outcomes. STUDY APPRAISAL AND METHODS: Assessment of study quality was performed using a modified version of the Physiotherapy Evidence Database Scale (PEDro). Relative effect sizes, mean differences (MDs) and 95 % confidence intervals were calculated and adjusted via Hedges' bias-corrected for small sample sizes. Regression analyses were performed to establish relationships between walking ability and fitness outcomes. RESULTS Twenty-four RCTs met the inclusion criteria: 19 aerobic training interventions and 5 progressive resistance training (PRT). In total 924 participants (71 % male) were studied; with few participants over 75 years of age and the mean ankle brachial index was mean ± standard deviation (SD) 0.66 ± 0.06. The most common outcome measured was aerobic capacity (52 % of trials), which improved by 8.3 % ± 8.7 % on average. Although there were no significant relationships, up to 16 % of the variance in walking distances can be explained by changes in walking economy. Muscle strength was measured in only five trials, improving by 42 % ± 74 % on average. There was a strong significant relationship between change in plantar flexor muscle strength and change in initial claudication time (r = 0.99; p = 0.001) and absolute claudication time (r = 0.75; p = 0.05) measured on a treadmill across trials measuring this muscle group. The 6MW distance was measured in only 14 % of trials. Walking and PRT significantly improved 6MW initial claudication distance (MD range 52-129 m) and total walking distance (MD range 36-108 m) in studies that measured this outcome. Only one trial assessed performance-based tests of function, and they did not improve significantly. CONCLUSION Although data are limited, there is a strong significant relationship between plantar flexor muscle strength and treadmill walking ability. More research is needed to assess improvements in walking economy at specific timepoints and whether this translates to improvements in claudication outcomes and measurements pertaining to muscle strength. Future trials should focus on interventions that improve lower limb muscle strength and assess muscle strength, power and endurance across a variety of lower extremity muscle groups in order to understand these relationships further. The 6MW, muscle strength and performance-based tests of function such as chair stand, balance scale, stair climb and gait speed are understudied in PAD. Future trials should examine the effects of exercise on performance-based tests of function, which may predict actual ADL performance and incident disability.
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Affiliation(s)
- Belinda J Parmenter
- Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.
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Abstract
PURPOSE OF REVIEW Lifestyle factors play a role in both the genesis and recovery from fragility fracture. The purpose of this review is to summarize recent evidence for exercise and nutrition in the management of hip fracture. RECENT FINDINGS Recent randomized controlled trials of exercise have primarily consisted of isolated resistance training or multimodal home-based programs. More robust, long-term, or supervised training is generally associated with greater clinical benefits, including muscle strength, mobility, and function. Recent nutritional interventions have included multinutrient supplements, nutritional counseling and support, and vitamin D/calcium supplementation. Isolated nutritional interventions have not consistently shown significant impact on long-term outcomes after hip fracture, although improvements in body weight, biochemical indices, complication rates, and mobility have been reported. Overall, there is marked heterogeneity in the robustness of responses seen to hip fracture treatment studies. Few large, long-term, multicomponent interventions with clinically relevant outcomes of functional independence, need for residential care, mortality, and quality of life have been reported. SUMMARY Evidence-based approaches to hip fracture should include comprehensive risk-factor assessment and treatment for sarcopenia/dynapenia, balance impairment, undernutrition of protein, energy, vitamin D and calcium, depression, cognitive impairment, sensory impairment, social isolation, and comorbid illness with exercise, nutrition and other modalities.
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Affiliation(s)
- Maria A Fiatarone Singh
- aExercise and Sport Science, Faculty of Health Sciences bSydney Medical School cUniversity of Sydney, New South Wales, Australia
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