The Impact of Multimorbidity Patterns on Changes in Physical Activity and Physical Capacity Among Older Adults Participating in a Year-Long Exercise Intervention

This study investigated the impact of multimorbidity patterns on physical activity and capacity outcomes over the course of a year-long exercise intervention, and on physical activity 1 year later. Participants were 314 physically inactive community-dwelling men and women aged 70-85 years, with no contraindications for exercise at baseline. Physical activity was self-reported. Physical capacity measurements included five-time chair-stand time, 6-minute walking distance, and maximal isometric knee-extension strength. The intervention included supervised and home-based strength, balance, and walking exercises. Multimorbidity patterns comprised physician-diagnosed chronic disease conditions as a predictor cluster and body mass index as a measure of obesity. Multimorbidity patterns explained 0%-12% of baseline variance and 0%-3% of the change in outcomes. The magnitude and direction of the impact of unique conditions varied by outcome, time point, and sex. Multimorbid older adults with no contraindications for exercise may benefit from multimodal physical training.

Social Mobility and Health-Related Quality of Life Trajectory Classes Among Older Women and Men

OBJECTIVES

Changes in socioeconomic status (SES) during life may impact health in old age. We investigated whether social mobility and childhood and adulthood SES are associated with trajectories of health-related quality of life (HrQoL) over a 17-year period.

METHODS

We used data from the Helsinki Birth Cohort Study (n = 2003, 46% men, mean age 61.5 years). Social mobility was derived from childhood SES, obtained from healthcare records, and register-based adulthood SES.

RESULTS

Logistic regression models showed that lower adulthood SES was associated with lower physical HrQoL trajectories. Among men low (OR 3.95, p < .001), middle (OR 2.20, p = .006), and declining lifetime SES (OR 2.41, p = .001) were associated with lower physical HrQoL trajectories compared to men with high SES. Socioeconomic status was not associated with mental HrQoL trajectories.

DISCUSSION

Declining SES during life course may have negative health consequences, while improving SES is potentially as beneficial as high SES to later-life health among men.

Pathways from childhood socioemotional characteristics and cognitive skills to midlife health behaviours

OBJECTIVE

This longitudinal study investigated the pathways from childhood socioemotional characteristics and cognitive skills to health behaviours in midlife. Methods: Participants in the Jyväskylä Longitudinal Study of Personality and Social Development (JYLS) were followed from age 8 (n = 369) to age 50 (n = 271). Outcomes included physical activity, smoking, alcohol consumption and body mass index (BMI) assessed at ages 36, 42 and 50. Predictors were socioemotional characteristics (behavioural activity, negative emotionality, and well-controlled behaviour) and parents' occupational status collected at age 8, cognitive skills (school success at age 14 and the highest education at age 27) and adulthood personality traits (extraversion, neuroticism and conscientiousness). Longitudinal path modelling was used for analyses. Results: Well-controlled behaviour and extraversion predicted physical activity in women. Behavioural activity predicted alcohol consumption in women and smoking in men. Negative emotionality was not directly connected to health behaviours. Adulthood neuroticism was associated with smoking in men and with alcohol-related problems in both men and women. There were some indirect paths from childhood socioemotional characteristics to midlife health behaviours through cognitive skills. None of the study variables predicted midlife BMI. Conclusions: Childhood socioemotional characteristics have some predictive value on midlife health behaviours, both directly and through cognitive skills.

Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2041639 .

Midlife cardiovascular health factors as predictors of retirement age, work-loss years, and years spent in retirement among older businessmen

Cardiovascular disease (CVD) is one of the leading causes of premature retirement. However, the relationship between CVD risk factors and workforce participation is not well known. We studied the relationship between midlife CVD risk, age at retirement, work-loss years, and survival in retirement. Middle-aged Finnish men (initial n = 3490, mean age = 47.8 years) were assessed for CVD risk factors and general health in the 1970s. They worked as business executives and provided information on their retirement status in the year 2000. Survival was followed up to the 9th decade of life with a follow-up of up to 44 years. Work-loss years were calculated as death or retirement occurring at age ≤ 65 years. Smoking, body mass index, and alcohol use were used as covariates, excluding models of CVD risk, which were adjusted for alcohol use only. Higher risk of 10-year fatal CVD was associated with 0.32 more years (relative risk < 1 vs. 1, covariate-adjusted β = 0.32, 95% CI = 0.13, 0.53) of work-loss. Higher risk of 5-year incident (covariate-adjusted time-constant HR = 1.32, 95% CI = 1.19, 1.47) and 10-year fatal (covariate-adjusted time-dependent HR = 1.55, 95% CI = 1.30, 1.85) CVD in midlife were associated with fewer years spent in retirement. Poorer self-rated health and physical fitness and higher levels of triglycerides were associated with increased hazard of earlier retirement, more work-loss years, and fewer years spent in retirement. Poorer health and greater midlife CVD risk may be associated with earlier exit from the workforce and fewer years spent in retirement. Management of CVD risk in midlife may support people to work longer.

Associations of polygenic inheritance of physical activity with aerobic fitness, cardiometabolic risk factors and diseases: the HUNT study

Physical activity (PA), aerobic fitness, and cardiometabolic diseases (CMD) are highly heritable multifactorial phenotypes. Shared genetic factors may underlie the associations between higher levels of PA and better aerobic fitness and a lower risk for CMDs. We aimed to study how PA genotype associates with self-reported PA, aerobic fitness, cardiometabolic risk factors and diseases. PA genotype, which combined variation in over one million of gene variants, was composed using the SBayesR polygenic scoring methodology. First, we constructed a polygenic risk score for PA in the Trøndelag Health Study (N = 47,148) using UK Biobank single nucleotide polymorphism-specific weights (N = 400,124). The associations of the PA PRS and continuous variables were analysed using linear regression models and with CMD incidences using Cox proportional hazard models. The results showed that genotypes predisposing to higher amount of PA were associated with greater self-reported PA (Beta [B] = 0.282 MET-h/wk per SD of PRS for PA, 95% confidence interval [CI] = 0.211, 0.354) but not with aerobic fitness. These genotypes were also associated with healthier cardiometabolic profile (waist circumference [B = -0.003 cm, 95% CI = -0.004, -0.002], body mass index [B = -0.002 kg/m2, 95% CI = -0.004, -0.001], high-density lipoprotein cholesterol [B = 0.004 mmol/L, 95% CI = 0.002, 0.006]) and lower incidence of hypertensive diseases (Hazard Ratio [HR] = 0.97, 95% CI = 0.951, 0.990), stroke (HR = 0.94, 95% CI = 0.903, 0.978) and type 2 diabetes (HR = 0.94, 95 % CI = 0.902, 0.970). Observed associations were independent of self-reported PA. These results support earlier findings suggesting small pleiotropic effects between PA and CMDs and provide new evidence about associations of polygenic inheritance of PA and intermediate cardiometabolic risk factors.

Physical and mental functioning trajectory classes among older adults and their association with specialized healthcare use

BACKGROUND

Sex-specific physical and mental functioning trajectory classification could offer a way of understanding the differences in healthcare use at older age.

METHODS

Using latent growth mixture models, sex-specific physical and mental functioning trajectory classes were formed for 1991 participants (mean age 61.5 years) of the Helsinki Birth Cohort Study. Physical and mental functioning were evaluated with the SF-36 survey conducted in clinical examinations in 2001-2004, 2011-2013, and 2017-2018. First and follow-up outpatient visits, emergency visits, and hospital days were extracted from a national register between the first clinical examination and the year 2017. We used regression models to examine the associations between healthcare use and trajectory classes.

RESULTS

Two physical and mental functioning trajectory classes, high and intermediate, were observed for both sexes. The intermediate physical functioning trajectory class was associated with higher utilization rates of all examined specialized healthcare services (fully-adjusted IRRs varying 1.36-1.58; 95% CI = 1.03-1.79, 95% CI = 1.21-2.05) compared to the high trajectory class. Relative to the high trajectory class, the intermediate mental trajectory class was associated with the use of first outpatient visits (fully-adjusted IRRs 1.17, 95% CI = 1.03-1.33 for men, and 1.16, 95% CI = 1.04-1.30 for women). The findings were similar among both sexes.

CONCLUSIONS

Compared to the high trajectory class, the intermediate physical functioning trajectory class was associated with greater specialized healthcare use and the intermediate mental trajectory class with first outpatient visits. Public health interventions should be considered to support functioning with aging.

Bidirectional associations between adiposity and physical activity: a longitudinal study from pre-puberty to early adulthood

Objective

This study aimed to investigate directional influences in the association between adiposity and physical activity (PA) from pre-puberty to early adulthood.

Methods

In the Calex-study, height, weight, body fat and leisure-time physical activity (LTPA) were measured at age11.2-years, 13.2-years and 18.3-years in 396 Finnish girls. Body fat was measured by dual-energy X-ray absorptiometry, calculating fat mass index (FMI) as total fat mass in kilograms divided by height in meters squared. LTPA level was evaluated using a physical activity questionnaire. In the European Youth Heart Study (EYHS), height, weight and habitual PA were measured at age 9.6-years, 15.7-years and 21.8-years in 399 Danish boys and girls. Habitual PA and sedentary behaviour were assessed with an accelerometer. Directional influences of adiposity and PA were examined using a bivariate cross-lagged path panel model.

Results

The temporal stability of BMI from pre-puberty to early adulthood was higher than the temporal stability of PA or physical inactivity over the same time period both in girls and boys. In the Calex-study, BMI and FMI at age 11.2-years were both directly associated with LTPA at age 13.2-years (β = 0.167, p = 0.005 and β = 0.167, p = 0.005, respectively), whereas FMI at age 13.2-years showed an inverse association with LTPA at age 18.3-years (β = - 0.187, p = 0.048). However, earlier LTPA level was not associated with subsequent BMI or FMI. In the EYHS, no directional association was found for physical inactivity, light-, moderate-, and vigorous-PA with BMI during the follow-up in girls. In boys, BMI at age 15.7-years was directly associated with moderate PA (β = 0.301, p = 0.017) at age 21.8-years, while vigorous PA at age 15.7-years showed inverse associations with BMI at age 21.8-years (β = - 0.185, p = 0.023).

Conclusion

Our study indicates that previous fatness level is a much stronger predictor of future fatness than level of leisure-time or habitual physical activity during adolescence. The directional associations between adiposity and physical activity are not clear during adolescence, and may differ between boys and girls depending on pubertal status.

The Development of Generativity in Middle Adulthood and the Beginning of Late Adulthood: A Longitudinal Study from Age 42 to 61

Previous studies have yielded mixed results regarding the development of generativity during adulthood. Longitudinal data were utilized to investigate the average development of generativity between the ages of 42 and 61 as well as individual differences in terms of its development. The study used data from the Jyväskylä Longitudinal Study of Personality and Social Development (JYLS) (initial N = 369). The data consisted of 291 individuals whose generativity scores, measured using the Generativity Scale, were available at age 42, 50, or 61. Rasch analysis was utilized to form a generativity measure. The development of generativity between the measurements was investigated in women and men using Bland–Altman plots and the latent change score model. The results showed that, on average, generativity decreased from age 42 to 61 in women and men; however, there were individual differences in the extent and direction of the change with age. The level of generativity at age 42 predicted the change occurring between ages 42 and 50 and ages 50 and 61. Furthermore, the change between ages 42 and 50 predicted the change occurring between ages 50 and 61. The more positive the baseline value or the earlier occurring change, the more negative the subsequent change. To conclude, despite the mean-level generativity decreases during middle and late adulthood, there was variance across individuals of the same age, who were followed for nearly two decades. The study emphasizes the importance of investigating individual differences in the development of generativity in adulthood.

Participant characteristics associated with the effects of a physical and cognitive training program on executive functions

Background

Physical and cognitive interventions have been shown to induce positive effects on older adults’ executive functioning. However, since participants with different background characteristics may respond differently to such interventions, we investigated whether training effects on executive functions were associated with sex, training compliance, and age. We also investigated if change in global cognition was associated with physical and cognitive training intervention-induced changes in executive functions.

Methods

Exploratory data from a randomized controlled trial were analyzed. Participants were 70–85-year-old men and women who received a 12-month physical (PT) or physical and cognitive training (PTCT) intervention. Measurements of executive functions related to inhibition (Stroop), set shifting (Trail Making Test B) and updating (Verbal Fluency) were performed at baseline and 12 months. Data were analyzed using a longitudinal linear path model for the two measurements occasion.

Results

Stroop improved significantly more in women and participants in the low compliance subgroup who received PTCT than in counterparts in the PT subgroup (difference –8.758, p = 0.001 and difference –8.405, p = 0.010, respectively). In addition, TMT B improved after the intervention in the low compliance PTCT subgroup and worsened in the corresponding PT subgroup (difference –15.034, p = 0.032). No other significant associations were observed.

Conclusion

Executive functions in women and in the participants, who only occasionally engaged in training showed greater improvement after the PTCT than PT intervention. However, the additional extra benefit gained from the PTCT intervention was uniquely expressed in each executive function measured in this study.

Menopause modulates the circulating metabolome: evidence from a prospective cohort study

AIMS

We studied the changes in the circulating metabolome and their relation to the menopausal hormonal shift in 17β-oestradiol and follicle-stimulating hormone levels among women transitioning from perimenopause to early postmenopause.

METHODS AND RESULTS

We analysed longitudinal data from 218 Finnish women, 35 of whom started menopausal hormone therapy during the study. The menopausal transition was monitored with menstrual diaries and serum hormone measurements. The median follow-up was 14 months (interquartile range: 8-20). Serum metabolites were quantified with targeted nuclear magnetic resonance metabolomics. The model results were adjusted for age, follow-up duration, education, lifestyle, and multiple comparisons. Menopause was associated with 85 metabolite measures. The concentration of apoB (0.17 standard deviation [SD], 99.5% confidence interval [CI] 0.03-0.31), very-low-density lipoprotein triglycerides (0.25 SD, CI 0.05-0.45) and particles (0.21 SD, CI 0.05-0.36), low-density lipoprotein (LDL) cholesterol (0.17 SD, CI 0.01-0.34) and particles (0.17 SD, CI 0.03-0.31), high-density lipoprotein (HDL) triglycerides (0.24 SD, CI 0.02-0.46), glycerol (0.32 SD, CI 0.07-0.58) and leucine increased (0.25 SD, CI 0.02-0.49). Citrate (-0.36 SD, CI -0.57 to -0.14) and 3-hydroxybutyrate concentrations decreased (-0.46 SD, CI -0.75 to -0.17). Most metabolite changes were associated with the menopausal hormonal shift. This explained 11% and 9% of the LDL cholesterol and particle concentration increase, respectively. Menopausal hormone therapy was associated with increased medium-to-large HDL particle count and decreased small-to-medium LDL particle and glycine concentration.

CONCLUSIONS

Menopause is associated with proatherogenic circulating metabolome alterations. Female sex hormones levels are connected to the alterations, highlighting their impact on women's cardiovascular health.

Longitudinal Associations of High-Volume and Vigorous-Intensity Exercise With Hip Fracture Risk in Men

Maintenance of vigorous exercise habits from young to old age is considered protective against hip fractures, but data on fracture risk in lifelong vigorous exercisers are lacking. This longitudinal cohort study examined the hazard of hip fractures in 1844 male former athletes and 1216 population controls and in relation to exercise volume and intensity in later years. Incident hip fractures after age 50 years were identified from hospital discharge register from 1972 to 2015. Exercise and covariate information was obtained from questionnaires administered in 1985, 1995, 2001, and 2008. Analyses were conducted using extended proportional hazards regression model for time-dependent exposures and effects. During the mean ± SD follow-up of 21.6 ± 10.3 years, 62 (3.4%) athletes and 38 (3.1%) controls sustained a hip fracture. Adjusted hazard ratio (HR) indicated no statistically significant difference between athletes and controls (0.84; 95% confidence interval [CI], 0.55-1.29). In subgroup analyses, adjusted HRs for athletes with recent high (≥15 metabolic equivalent hours [MET-h]/week) and low (<15 MET-h/week) exercise volume were 0.83 (95% CI, 0.46-1.48) and 1.04 (95% CI, 0.57-1.87), respectively, compared with controls. The adjusted HR was not statistically significant between athletes with low-intensity exercise (<6 METs) and controls (1.08; 95% CI, 0.62-1.85). Athletes engaging in vigorous-intensity exercise (≥6 METs at least 75 minutes/week) had initially 77% lower hazard rate (adjusted HR 0.23; 95% CI, 0.06-0.86) than controls. However, the HR was time-dependent (adjusted HR 1.04; 95% CI, 1.01-1.07); by age 75 years the HRs for the athletes with vigorous-intensity exercise reached the level of the controls, but after 85 years the HRs for these athletes increased approximately 1.3-fold annually relative to the controls. In conclusion, these data suggest that continuation of vigorous-intensity exercise is associated with lower HR of hip fracture up to old age. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients

Understanding speech is essential for adequate social interaction, and its functioning affects health, wellbeing, and quality of life (QoL). Untreated hearing loss (HL) is associated with reduced social activity, depression and cognitive decline. Severe and profound HL is routinely rehabilitated with cochlear implantation. The success of treatment is mostly assessed by performance-based outcome measures such as speech perception. The ultimate goal of cochlear implantation, however, is to improve the patient’s QoL. Therefore, patient-reported outcomes measures (PROMs) would be clinically valuable as they assess subjective benefits and overall effectiveness of treatment. The aim of this study was to assess the patient-reported benefits of unilateral cochlear implantation in an unselected Finnish patient cohort of patients with bilateral HL. The study design was a prospective evaluation of 118 patients. The patient cohort was longitudinally followed up with repeated within-subject measurements preoperatively and at 6 and 12 months postoperatively. The main outcome measures were one performance-based speech-in-noise (SiN) test (Finnish Matrix Sentence Test), and two PROMs [Finnish versions of the Speech, Spatial, Qualities of Hearing questionnaire (SSQ) and the Nijmegen Cochlear Implant Questionnaire (NCIQ)]. The results showed significant average improvements in SiN scores, from +0.8 dB signal-to-noise ratio (SNR) preoperatively to −3.7 and −3.8 dB SNR at 6 and12 month follow-up, respectively. Significant improvements were also found for SSQ and NCIQ scores in all subdomains from the preoperative state to 6 and 12 months after first fitting. No clinically significant improvements were observed in any of the outcome measures between 6 and 12 months. Preoperatively, poor SiN scores were associated with low scoring in several subdomains of the SSQ and NCIQ. Poor preoperative SiN scores and low PROMs scoring were significantly associated with larger postoperative improvements. No significant association was found between SiN scores and PROMs postoperatively. This study demonstrates significant benefits of cochlear implantation in the performance-based and patient-reported outcomes in an unselected patient sample. The lack of association between performance and PROMs scores postoperatively suggests that both capture unique aspects of benefit, highlighting the need to clinically implement PROMs in addition to performance-based measures for a more holistic assessment of treatment benefit.

Retirement as a predictor of physical functioning trajectories among older businessmen

BACKGROUND

Associations between retirement characteristics and consequent physical functioning (PF) are poorly understood, particularly in higher socioeconomic groups, where postponing retirement has had both positive and negative implications for PF.

METHODS

Multiple assessments of PF, the first of which at the mean age of 73.3 years, were performed on 1709 men who were retired business executives and managers, using the RAND-36/SF-36 instrument, between 2000 and 2010. Questionnaire data on retirement age and type of pension was gathered in 2000. Five distinct PF trajectories were created using latent growth mixture modelling. Mortality- and covariate-adjusted multinomial regression models were used to estimate multinomial Odds Ratios (mOR) on the association between retirement characteristics and PF trajectories.

RESULTS

A one-year increase in retirement age was associated with decreased likelihood of being classified in the 'consistently low' (fully adjusted mOR = 0.82; 95%CI = 0.70, 0.97; P = 0.007), 'intermediate and declining' (mOR = 0.89; 95%CI = 0.83, 0.96; P = 0.002), and 'high and declining' (mOR = 0.92; 95%CI = 0.87, 0.98; P = 0.006) trajectories, relative to the 'intact' PF trajectory. Compared to old age pensioners, disability pensioners were more likely to be classified in the 'consistently low' (mOR = 23.77; 95% CI 2.13, 265.04; P = 0.010), 'intermediate and declining' (mOR = 8.24; 95%CI = 2.58, 26.35; P < 0.001), and 'high and declining' (mOR = 2.71; 95%CI = 1.17, 6.28; P = 0.020) PF trajectories, relative to the 'intact' PF trajectory.

CONCLUSIONS

Among executives and managers, older age at retirement was associated with better trajectories of PF in old age. Compared to old age pensioners, those transitioning into disability and early old age pensions were at risk of having consistently lower PF in old age.

Associations of neuroticism with falls in older adults: do psychological factors mediate the association?

OBJECTIVES

Neuroticism predicts falls in older people. In addition, concern about falling and depressive symptoms are associated with fall risk. This study examined whether concern about falling and depressive symptoms mediate the association between neuroticism and falls.

METHOD

Cross-sectional data on 314 community-dwelling people aged 70-85 years were utilized. Neuroticism was assessed with a short modified form of the Eysenck Personality Inventory. Indoor and outdoor falls during the past year were self-reported. Concern about falling was assessed with the Falls Efficacy Scale-International and depressive symptoms with the Geriatric Depression Scale-15. Path modeling was used to examine the associations between variables.

RESULTS

Mediating pathways linking neuroticism and falls were found: neuroticism was positively associated with concern about falling, which was subsequently linked to indoor falls (indirect effect β = 0.34, p = 0.002) and recurrent outdoor falls (β = 0.19, p = 0.045). Moreover, a pathway from neuroticism to indoor falls through depressive symptoms was also found (β = 0.21, p = 0.054). In other words, higher neuroticism was associated with higher concern about falling and depressive symptoms, both of which were linked to falls. The associations were independent of age, sex, use of psychotropic, chronic diseases, persistent pain, physical performance, physical activity, and executive functioning that are known risk factors for falls.

DISCUSSION

The results indicate that concern about falling and depressive symptoms mediate the association between neuroticism and falling. Longitudinal studies are needed to confirm the causality of the findings and to examine the potential to reduce falls by targeting concern about falling and depressive symptoms among older adults higher in neuroticism.

Effects of Physical and Cognitive Training on Falls and Concern about Falling in Older Adults: Results from a Randomized Controlled Trial

Background

The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults.

Methods

This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70–85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cognitive training. The outcome was the rate of falls over the 12-month intervention (PTCT, n = 151 and PT, n = 155) and 12-month postintervention follow-up (PTCT, n = 143 and PT, n = 148). Falls were ascertained from monthly diaries. Exploratory outcomes included the rate of injurious falls, faller/recurrent faller/fall-related fracture status, and concern about falling.

Results

Estimated incidence rates of falls per person-year were 0.8 (95% confidence interval [CI] 0.7–1.1) in the PTCT and 1.1 (95% CI 0.9–1.3) in the PT during the intervention and 0.8 (95% CI 0.7–1.0) versus 1.0 (95% CI 0.8–1.1), respectively, during the postintervention follow-up. There was no significant difference in the rate of falls during the intervention (incidence rate ratio [IRR] = 0.78; 95% CI 0.56–1.10, p = .152) or in the follow-up (IRR = 0.83; 95% CI 0.59–1.15, p = .263). No significant between-group differences were observed in any exploratory outcomes.

Conclusion

A yearlong PTCT intervention did not result in a significantly lower rate of falls or concern about falling than PT alone in older community-dwelling adults.

Clinical Trial Registration

ISRCTN52388040

Interactive effects of aging and aerobic capacity on energy metabolism-related metabolites of serum, skeletal muscle, and white adipose tissue

Aerobic capacity is a strong predictor of longevity. With aging, aerobic capacity decreases concomitantly with changes in whole body metabolism leading to increased disease risk. To address the role of aerobic capacity, aging, and their interaction on metabolism, we utilized rat models selectively bred for low and high intrinsic aerobic capacity (LCRs/HCRs) and compared the metabolomics of serum, muscle, and white adipose tissue (WAT) at two time points: Young rats were sacrificed at 9 months of age, and old rats were sacrificed at 21 months of age. Targeted and semi-quantitative metabolomics analysis was performed on the ultra-pressure liquid chromatography tandem mass spectrometry (UPLC-MS) platform. The effects of aerobic capacity, aging, and their interaction were studied via regression analysis. Our results showed that high aerobic capacity is associated with an accumulation of isovalerylcarnitine in muscle and serum at rest, which is likely due to more efficient leucine catabolism in muscle. With aging, several amino acids were downregulated in muscle, indicating more efficient amino acid metabolism, whereas in WAT less efficient amino acid metabolism and decreased mitochondrial β-oxidation were observed. Our results further revealed that high aerobic capacity and aging interactively affect lipid metabolism in muscle and WAT, possibly combating unfavorable aging-related changes in whole body metabolism. Our results highlight the significant role of WAT metabolism for healthy aging.

The effects of a physical and cognitive training intervention vs. physical training alone on older adults' physical activity: A randomized controlled trial with extended follow-up during COVID-19

BACKGROUND

Executive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown.

METHODS

Data from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70-85 years old community-dwelling men and women from Jyväskylä, Finland. PT (n = 159) included supervised resistance, walking and balance training, home-exercises and self-administered moderate activity. PTCT (n = 155) included PT and cognitive training targeting executive functions on a computer program. Physical activity was assessed with a one-item, seven-scale question. Executive functions were assessed with color-word Stroop, Trail Making Test (TMT) B-A and Letter Fluency. Changes in physical activity were modeled with multinomial logistic models and the impact of executive functions on physical activity with latent change score models.

RESULTS

No significant group-by-time interaction was observed for physical activity (p>0.1). The subjects were likely to select an activity category higher than baseline throughout the study (pooled data: B = 0.720-1.614, p<0.001-0.046). Higher baseline Stroop predicted higher physical activity through all subsequent time-points (pooled data: B = 0.011-0.013, p = 0.015-0.030). Higher baseline TMT B-A predicted higher physical activity at 6m (pooled data: B = 0.007, p = 0.006) and during COVID-19 (B = 0.005, p = 0.030). In the PT group, higher baseline Letter Fluency predicted higher physical activity at 12m (B = -0.028, p = 0.030) and follow-up (B = -0.042, p = 0.002).

CONCLUSIONS

Cognitive training did not have additive effects over physical training alone on physical activity, but multicomponent training and higher executive function at baseline may support adaptation to and maintenance of a physically active lifestyle among older adults.

The association between epigenetic clocks and physical functioning in older women: a three-year follow-up

Background

Epigenetic clocks are composite markers developed to predict chronological age or mortality risk from DNA methylation (DNAm) data. The present study investigated the associations between 4 epigenetic clocks (Horvath’s and Hannum’s DNAmAge and DNAm GrimAge and PhenoAge) and physical functioning during a 3-year follow-up.

Method

We studied 63- to 76-year-old women (N = 413) from the Finnish Twin Study on Aging. DNAm was measured from blood samples at baseline. Age acceleration (AgeAccel), that is, discrepancy between chronological age and DNAm age, was determined as residuals from linear model. Physical functioning was assessed under standardized laboratory conditions at baseline and at follow-up. A cross-sectional analysis was performed with path models, and a longitudinal analysis was conducted with repeated measures linear models. A nonrandom missing data analysis was performed.

Results

In comparison to the other clocks, GrimAgeAccel was more strongly associated with physical functioning. At baseline, GrimAgeAccel was associated with lower performance in the Timed Up and Go (TUG) test and the 6-minute walk test. At follow-up, significant associations were observed between GrimAgeAccel and lowered performance in the TUG, 6-minute and 10-m walk tests, and knee extension and ankle plantar flexion strength tests.

Conclusions

The DNAm GrimAge, a novel estimate of biological aging, associated with decline in physical functioning over the 3-year follow-up in older women. However, associations between chronological age and physical function phenotypes followed similar pattern. Current epigenetic clocks do not provide strong benefits in predicting the decline of physical functioning at least during a rather short follow-up period and restricted age range.

Perceived Opportunities for Physical Activity and Willingness to Be More Active in Older Adults with Different Physical Activity Levels

This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, moderate, and high) were assessed via questionnaires. Multinomial logistic regression showed that physical activity moderated the association between poor opportunity and willingness to increase PA. Among those with moderate PA, poor opportunity for PA increased the odds of willingness to be a lot more active (multinomial odds ratio, mOR 3.90, 95% confidence interval 2.21-6.87) than not wanting to be more active compared to those perceiving good opportunities. Associations were similar at high PA levels (p < 0.001), but were not found at low PA levels. Those with moderate or high PA wish to increase their activity particularly when the perceived opportunities for activity are not optimal. Among those with low PA, perceived opportunities are not associated with a perceived need to increase physical activity. Increasing equity in physical activity in old age requires provision of support and opportunities at every level of physical activity.

Regular Strength and Sprint Training Counteracts Bone Aging: A 10-Year Follow-Up in Male Masters Athletes

Cross-sectional and interventional studies suggest that high-intensity strength and impact-type training provide a powerful osteogenic stimulus even in old age. However, longitudinal evidence on the ability of high-intensity training to attenuate age-related bone deterioration is currently lacking. This follow-up study assessed the role of continued strength and sprint training on bone aging in 40- to 85-year-old male sprinters (n = 69) with a long-term training background. Peripheral quantitative computed tomography (pQCT)-derived bone structural, strength, and densitometric parameters of the distal tibia and tibia midshaft were assessed at baseline and 10 years later. The groups of well-trained (actively competing, sprint training including strength training ≥2 times/week; n = 36) and less-trained (<2 times/week, no strength training, switched to endurance training; n = 33) athletes were formed according to self-reports at follow-up. Longitudinal changes in bone traits in the two groups were examined using linear mixed models. Over the 10-year period, group-by-time interactions were found for distal tibia total bone mineral content (BMC), trabecular volumetric bone mineral density (vBMD), and compressive strength index, and for mid-tibia cortical cross-sectional area, medullary area, total BMC, and BMC at the anterior and posterior sites (polar mass distribution analysis) (p < 0.05). These interactions reflected maintained (distal tibia) or improved (mid-tibia) bone properties in the well-trained and decreased bone properties in the less-trained athletes over the 10-year period. Depending on the bone variable, the difference in change in favor of the well-trained group ranged from 2% to 5%. The greatest differences were found in distal tibia trabecular vBMD and mid-tibia posterior BMC, which remained significant (p < 0.05) after adjustment for multiple testing. In conclusion, our longitudinal findings indicate that continued strength and sprint training is associated with maintained or even improved tibial properties in middle-aged and older male sprint athletes, suggesting that regular, intensive exercise counteracts bone aging. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

The Scales of Psychological Well-Being - a validation, usability and test-retest study among community-dwelling older people in Finland

Objectives: To validate the Finnish version of the 42-item Scales of Psychological Well-Being among community-dwelling older people. The study also examined the test-retest reliability and usability, i.e. user experience, of the scales in this age group.Method: The 42-item version of the SPWB was administered as part of a face-to-face interview among 968 men and women aged 75, 80 or 85 years. The subsample for test-retest analyses comprised 42 participants, who in addition to 11 interviewers also answered questions concerning the usability of the scales. Exploratory and confirmatory factor analyses, Cronbach's alpha coefficients, Pearson and intra-class correlation coefficients, and Kendal's Tau B were used in the analyses.Results: The factor analyses did not support the theory-based six-factor structure of the scales. The Cronbach's alphas showed high internal consistency reliability for the total scale, but modest for the subscales. The intercorrelations between the subscales were moderate. The total score and the subscale scores of the SPWB correlated positively with quality of life and life satisfaction, and negatively with depressive symptoms. The interviewers reported that while most of the participants responded to the scales without marked difficulties, others could only answer after clarifications of some statements.Discussion: The reliability of the 42-item version of the SPWB was modest. The factor structure was inconsistent among the three age groups studied, but the scales were feasible to use. The current results call for further methodological consideration to optimize assessment of eudaimonic well-being in old age.

Body Weight, Physical Activity, and Risk of Cancer in Lynch Syndrome

Simple Summary

Lifestyle modifies cancer risk in the general public. How lifestyle modifies cancer risk in individuals carrying the inherited pathogenic gene variants in DNA mismatch repair genes (Lynch syndrome) remains understudied. We conducted a retrospective study with cancer register data to investigate associations between body weight, physical activity, and cancer risk among Finnish Lynch syndrome carriers (n = 465, 54% women). The results of our study indicated that longitudinal weight gain increases cancer risk, whereas being highly physically active during adulthood could decrease cancer risk in men. Further, women were observed to be less prone to lifestyle-related risk factors than men. The results emphasize the role of weight maintenance and high-intensity physical activity throughout the lifespan, especially in men with Lynch syndrome.

Abstract

Lynch syndrome (LS) increases cancer risk. There is considerable individual variation in LS cancer occurrence, which may be moderated by lifestyle factors, such as body weight and physical activity (PA). The potential associations of lifestyle and cancer risk in LS are understudied. We conducted a retrospective study with cancer register data to investigate associations between body weight, PA, and cancer risk among Finnish LS carriers. The participants (n = 465, 54% women) self-reported their adulthood body weight and PA at 10-year intervals. Overall cancer risk and colorectal cancer (CRC) risk was analyzed separately for men and women with respect to longitudinal and near-term changes in body weight and PA using extended Cox regression models. The longitudinal weight change was associated with an increased risk of all cancers (HR 1.02, 95% CI 1.00–1.04) and CRC (HR 1.03, 1.01–1.05) in men. The near-term weight change was associated with a lower CRC risk in women (HR 0.96, 0.92–0.99). Furthermore, 77.6% of the participants retained their PA category over time. Men in the high-activity group had a reduced longitudinal cancer risk of 63% (HR 0.37, 0.15–0.98) compared to men in the low-activity group. PA in adulthood was not associated with cancer risk among women. These results emphasize the role of weight maintenance and high-intensity PA throughout the lifespan in cancer prevention, particularly in men with LS.

Effects of physical and cognitive training on gait speed and cognition in older adults: A randomized controlled trial

Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12-month physical and cognitive training (PTCT) on gait speed, dual-task cost in gait speed, and executive functions (EFs) compared with physical training (PT) (ISRCTN52388040). Community-dwelling older adults, who did not meet physical activity recommendations, were recruited (n = 314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2-3 times weekly), and moderate aerobic activity 150 min/week in bouts of >10 min. PTCT included the PT and computer training (CT) on EFs 15-20 min, 3-4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6-min walking distance, dual-task cost in gait speed, and EF (Stroop and Trail Making B-A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59%-72% in PT and 62%-77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT-PT, 0.02; 95%CI -0.03, 0.08), walking distance (-3.8; -16.9, 9.3) or dual-task cost (-0.22; -1.74, 1.30). Stroop improvement was greater after PTCT than PT (-6.9; -13.0, -0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF's, complementing physical training with targeted cognitive training provides additional benefit.

Retirement age and type as predictors of frailty: a retrospective cohort study of older businessmen

OBJECTIVES

To study the association between retirement characteristics and frailty in a homogenous population of former business executives.

DESIGN

Cross-sectional cohort study using data from the Helsinki Businessmen Study.

SETTING

Helsinki, Finland.

PARTICIPANTS

1324 Caucasian men, born in 1919-1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires.

PRIMARY AND SECONDARY OUTCOME MEASURES

Frailty assessed according to a modified phenotype definition at mean age 73.3 years.

RESULTS

Mean age at retirement was 61.3 years (SD 4.3) and 37.1% had retired due to old age. The prevalence of frailty was lowest among men retiring at ages 66-67 years but increased among those who worked up to age 70 years or older. Compared with men who retired before age 55 years, those retiring at ages 58-69 years were at decreased risk of frailty in old age relative to non-frailty (adjusted ORs 0.07-0.29, p<0.05). Compared with men who transitioned into old age retirement, those who retired due to disability were at increased risk of prefrailty (adjusted OR 1.53, 95% CI 1.01 to 2.32) and frailty (adjusted OR 3.52, 95% CI 1.97 to 6.29), relative to non-frailty.

CONCLUSION

Exiting working life early and continuing to be occupationally active until age 70 years and older were both associated with increased risk of frailty among the men. Promotion of longer work careers could, however, promote healthier ageing, as the lowest prevalence of frailty was observed in former business executives who retired at ages 66-67 years.

Mortality Risk Among Older People Who Did Versus Did Not Sustain a Fracture: Baseline Prefracture Strength and Gait Speed as Predictors in a 15-Year Follow-Up

BACKGROUND

Physiological reserve, as indicated by muscle strength and gait speed, may be especially determinant of survival in people who are exposed to a health stressor. We studied whether the association between strength/speed and mortality risk would be stronger in the time period after a fracture compared to other time periods.

METHODS

Participants were population-based sample of 157 men and 325 women aged 75 and 80 years at baseline. Maximal 10-m gait speed and maximal isometric grip and knee extension strength were tested at the baseline before the fracture. Subsequent fracture incidence and mortality were followed up for 15 years. Cox regression analysis was used to estimate fracture time-stratified effects of gait speed and muscle strength on mortality risk in three states: (i) nonfracture state, (ii) the first postfracture year, and (iii) after the first postfracture year until death/end of follow-up.

RESULTS

During the follow-up, 20% of the men and 44% of the women sustained a fracture. In both sexes, lower gait speed and in women lower knee extension strength was associated with increased mortality risk in the nonfracture state. During the first postfracture year, the mortality risk associated with slower gait and lower strength was increased and higher than in the nonfracture state. After the first postfracture year, mortality risk associated with lower gait speed and muscle strength attenuated.

CONCLUSIONS

Lower gait speed and muscle strength were more strongly associated with mortality risk after fracture than during nonfracture time, which may indicate decreased likelihood of recovery.

Testing a physical education-delivered autonomy supportive intervention to promote leisure-time physical activity in lower secondary school students: the PETALS trial

Background

Inadequate physical activity in young people is associated with several physical and mental health concerns. Physical education (PE) is a potentially viable existing network for promoting physical activity in this population. However, little research has been conducted on whether PE teachers can influence students’ engagement in leisure-time physical activity. The present study therefore examined the efficacy of an intervention aimed at increasing PE teachers’ autonomy support on students’ leisure-time physical activity (the PETALS trial). The intervention was guided by the trans-contextual model (TCM) explaining the processes by which PE teachers’ provision of autonomy support during PE promotes students’ motivation and engagement in physical activity in their leisure time.

Methods

The study adopted a cluster-randomized, waitlist control intervention design with randomization by school. Participants were PE teachers (N = 29, 44.83%female; M age = 42.83, SD = 9.53 yrs) and their lower secondary school students (N = 502, 43.82%female; M age = 14.52, SD = 0.71 yrs). We measured TCM constructs, including perceived autonomy support, autonomous motivation in PE and leisure time, beliefs and intentions towards leisure-time physical activity, and physical activity behavior at baseline, post-intervention, and at one-, three-, and six-months. Study hypotheses were tested through a series of ANOVAs and structural equation models using post-intervention and one-month follow-up data.

Results

We found no changes in TCM constructs or physical activity behavior in either group at post-intervention or at 1 month. Path analyses supported two propositions of the TCM as change variables: perceived autonomy support had a significant effect on autonomous motivation in PE and autonomous motivation in PE had a significant effect on autonomous motivation in leisure time. Although we found a direct effect of autonomous motivation in leisure time on physical activity, we did not find support for the third premise of the TCM that autonomous motivation in leisure time indirectly affects physical activity through beliefs and intentions.

Conclusions

Current findings did not support the efficacy of the PETALS intervention at changing physical activity behavior and TCM constructs. More research is required to determine whether the TCM predictive validity is supported when other model variables are manipulated through experimental and intervention studies.

Trial registration

ISRCTN, ISRCTN39374060. Registered 19 July 2018. Prospectively registered.

Accelerometer-measured and self-reported physical activity in relation to extraversion and neuroticism: a cross-sectional analysis of two studies

BACKGROUND

Personality reflects relatively stable and pervasive tendencies in feeling, thinking and behaving. While previous studies have found higher extraversion and lower neuroticism to be linked to higher self-reported physical activity levels, larger studies using accelerometer-measured physical activity are lacking. This study investigated the cross-sectional associations of extraversion and neuroticism with both accelerometer-measured and self-reported physical activity and the role of these personality traits in possible discrepancies between these two measures of physical activity among Finnish adults.

METHODS

Two community-dwelling samples were used in this study: a) 47-55-yr-old women (n = 1098) and b) 70-85-yr-old women and men (n = 314). In both samples, extraversion and neuroticism were assessed by the 19-item short form of the Eysenck Personality Inventory. Physical activity was assessed with hip-worn tri-axial accelerometers and self-reported questions. Regression analyses were adjusted by age, BMI and education.

RESULTS

In the middle-aged women, neuroticism was negatively associated with accelerometer-measured leisure time moderate-to-vigorous physical activity (β = -.07, p = .036) and with self-reported physical activity (β = -.08, p = .021), while extraversion was positively associated with self-reported physical activity (β = .10, p = .005). No associations of extraversion or neuroticism with physical activity were found in the older men and women. Older adults who scored high in neuroticism reported less physical activity than what was measured by accelerometers (β = -.12, p = .039). Extraversion was not associated with discrepancy between self-reported and accelerometer-measured leisure time physical activity in either sample.

CONCLUSIONS

Neuroticism was associated with lower leisure-time physical activity levels and extraversion with higher self-reported physical activity among middle-aged women. Neuroticism and extraversion were unrelated to physical activity among older adults, but older adults with high neuroticism seemed to underreport their physical activity level. The role of personality in the discrepancy between self-reported and device-based physical activity warrants further research.

Physical function and lean body mass as predictors of bone loss after hip fracture: a prospective follow-up study

Background

Predictors of bone deterioration after hip fracture have not been well characterized. The aim of this study was to examine the associations of physical function and lean body mass (LBM) with loss of bone density and strength in older people recovering from a hip fracture.

Methods

A total of 81 over 60-year-old, community-dwelling men and women operated for a hip fracture participated in this 1-year prospective follow-up study. Distal tibia total volumetric bone mineral density (vBMD_TOT, mg/cm³) and compressive strength index (BSI, g²/cm⁴) and mid-tibia cortical vBMD (vBMD_CO, mg/cm³) and bending strength index (SSI, mm³) were assessed in both legs by peripheral quantitative computed tomography (pQCT) at baseline (on average 10 weeks after fracture) and at 12 months. At baseline, LBM was measured with a bioimpedance device and physical function with the Short Physical Performance Battery (SPPB) and perceived difficulty in walking outdoors. Robust multivariable linear regression models were used to estimate the associations of physical function and LBM with the change in bone parameters at 12-months.

Results

The mean change in distal tibia vBMD_TOT and BSI in both legs ranged from − 0.9 to − 2.5%. The change in mid-tibia vBMD_CO and SSI ranged from − 0.5 to − 2.1%. A lower SPPB score, difficulty in walking outdoors and lower LBM predicted greater decline in distal tibia vBMD_TOT in both legs. A lower SPPB score and difficulty in walking outdoors were also associated with a greater decline in distal tibia BSI in both legs. At the midshaft site, a lower SPPB score and lower LBM were associated with greater decline in SSI on the fractured side.

Conclusions

Older hip fracture patients with low physical function and lower LBM may be at risk for greater decline in tibia bone properties during the first post-fracture year. Acknowledgement of the risk factors could assist in developing interventions and care to promote bone health and overall recovery.

Trial registration

ISRCTN, ISRCTN53680197. The trial was registered retrospectively but before the recruitment was completed. Registered March 3, 2010.

Muscle and bone mass in middle-aged women: role of menopausal status and physical activity

BACKGROUND

Women experience drastic hormonal changes during midlife due to the menopausal transition. Menopausal hormonal changes are known to lead to bone loss and potentially also to loss of lean mass. The loss of muscle and bone tissue coincide due to the functional relationship and interaction between these tissues. If and how physical activity counteracts deterioration in muscle and bone during the menopausal transition remains partly unresolved. This study investigated differences between premenopausal, early perimenopausal, late perimenopausal, and postmenopausal women in appendicular lean mass (ALM), appendicular lean mass index (ALMI), femoral neck bone mineral density (BMD) and T score. Furthermore, we investigated the simultaneous associations of ALM and BMD with physical activity in the above-mentioned menopausal groups.

METHODS

Data from the Estrogen Regulation of Muscle Apoptosis study were utilized. In total, 1393 women aged 47-55 years were assigned to premenopausal, early perimenopausal, late perimenopausal, and postmenopausal groups based on follicle-stimulating hormone concentration and bleeding diaries. Of them, 897 were scanned for ALM and femoral neck BMD by dual-energy X-ray absorptiometry and ALMI (ALM/height² ) and neck T scores calculated. Current level of leisure-time physical activity was estimated by a validated self-report questionnaire and categorized as sedentary, low, medium, and high.

RESULTS

Appendicular lean mass, appendicular lean mass index, femoral neck bone mineral density, and and T score showed a significant linear declining trend across all four menopausal groups. Compared with the postmenopausal women, the premenopausal women showed greater ALM (18.2, SD 2.2 vs. 17.8, SD 2.1, P < 0.001), ALMI (6.73, SD 0.64 vs. 6.52, SD 0.62, P < 0.001), neck BMD (0.969, SD 0.117 vs. 0.925, SD 0.108, P < 0.001), and T score (-0.093, SD 0.977 vs -0.459, SD 0.902, P < 0.001). After adjusting for potential confounding pathways, a higher level of physical activity was associated with greater ALM among the premenopausal [β = 0.171; confidence interval (CI) 95% 0.063-0.280], late perimenopausal (β = 0.289; CI 95% 0.174-0.403), and postmenopausal (β=0.278; CI 95% 0.179-0.376) women. The positive association between femoral neck BMD and level of physical activity was significant only among the late perimenopausal women (β = 0.227; CI 95% 0.097-0.356).

CONCLUSIONS

Skeletal muscle and bone losses were associated with the menopausal transition. A higher level of physical activity during the different menopausal phases was beneficial, especially for skeletal muscle. Menopause-related hormonal changes predispose women to sarcopenia and osteoporosis and further to mobility disability and fall-related fractures in later life. New strategies are needed to promote physical activity among middle-aged women. Longitudinal studies are needed to confirm these results.

Structure of self-rated health among the oldest old: Analyses in the total population and those living with dementia

No previous study has explored the structure of self-rated health (SRH), a measure holding strong predictive value for future health events, in the oldest old or in individuals with dementia. The aim was to construct a structural equation model of SRH for oldest old in general and for oldest old with dementia, and to explore direct and indirect associations between health-related factors and SRH. Cross-sectional data from the Vitality 90+, a population-based study in the city of Tampere, Finland, was used. Data were gathered by a mailed questionnaire in 2014. Altogether 1299 nonagenarians, of which 408 had self-reported dementia or cognitive decline, were included. Structural equation models were constructed for all participants and separately for participants with dementia. Diseases (heart disease, stroke, diabetes, arthritis, hip fracture, cancer and dementia for the model for all), dizziness, hearing, vision, mobility, activities of daily living, fatigue, depression and SRH were included in the models. Among all participants, fatigue, depression, problems in mobility, dizziness, deficits in vision and heart disease were directly associated with poor SRH. Among participants with dementia, only fatigue, dizziness and deficits in vision were directly associated with poor SRH. Among all participants, dementia and arthritis were indirectly associated with poor SRH through problems in mobility, depression and fatigue. Among the oldest old, the effects of diseases on SRH were mainly manifested through the consequences of diseases, namely fatigue, dizziness, deficits in vision and problems in mobility. Depression has an important direct and indirect role, and dementia and arthritis an important indirect role in the structure of SRH. Dementia weakens many of the direct and indirect associations for SRH.

•

First study to explore structure of self-rated health in oldest old and persons with dementia.

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Fatigue, depression, mobility, dizziness, vision and heart disease directly affect health-rating in oldest old.

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Dementia, depression and arthritis affect health rating indirectly through various routes in oldest old.

•

Dementia weakens many of the associations between objective indicators of health with self-rated health.

Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial

OBJECTIVES

The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital.

DESIGN

Randomized controlled trial.

SETTING

Home and community.

PARTICIPANTS

Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention (n = 59) or a control (standard care, n = 58) group.

INTERVENTION

The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counseling, and standard care.

MEASUREMENTS

Physical activity and sedentary time were assessed using an accelerometer and a single question. Mobility was evaluated with the Short Physical Performance Battery, self-reported use of a walking aid, and ability to negotiate stairs and walk outdoors. Intervention effects were analyzed with generalized estimating equations.

RESULTS

Daily physical activity was 127 ± 78 minutes/day and 121 ± 70 at baseline and 167 ± 81 and 164 ± 72 at six months in the intervention and control group, respectively; mean difference of 3.4 minutes (95% confidence interval (CI) = -20.3 to 27.1). In addition, no significant between-group differences were shown in physical performance.

CONCLUSION

The rehabilitation program was not superior to standard care for increasing physical activity or improving physical performance. Mobility-limited older people who had recently returned home from hospital would have needed a longer and more frequently monitored comprehensive geriatric intervention.

Counselling for physical activity, life-space mobility and falls prevention in old age (COSMOS): protocol of a randomised controlled trial

INTRODUCTION

The most promising way to promote active life years in old age is to promote regular participation in physical activity (PA). Maintaining lower extremity muscle function with good balance has been associated with fewer falls and the need of help from others. This article describes the design and intervention of a randomised controlled trial (RCT) investigating the effectiveness of a health and PA counselling programme on life-space mobility and falls rates in community-dwelling older adults at the Health Kiosk and/or Service Centre.

METHODS AND ANALYSIS

Community-dwelling men and women (n=450) aged 65 years and over with early phase mobility limitation will be recruited to a 24-month RCT with a 24-month follow-up. Participants will be randomly allocated into either a health and PA counselling group (intervention) or relaxation group (control intervention). All participants will receive five group specific face-to-face counselling sessions and 11 phone calls. The counselling intervention will include individualised health counselling, strength and balance training, and guidance to regular PA. The control group will receive relaxation exercises. Outcomes will be assessed at baseline, 12, 24 and 48 months. Primary outcomes are average life-space mobility score and falls rates. Life-space mobility will be assessed by a validated questionnaire. Falls rates will be recorded from fall diaries. Secondary outcomes are data on fall-induced injuries and living arrangements, number of fallers, fracture risk, mean level of PA, physical performance, quality of life, mood, cognition, balance confidence and fear of falling. Data will be analysed using the intention-to-treat principle. Cost-effectiveness of the programme will be analysed. Ancillary analyses are planned in participants with greater adherence.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the Ethics Committee of the Tampere University Hospital (R15160). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences.

TRIAL REGISTRATION

ISRCTN65406039; Pre-results.

Midlife Cardiovascular Status and Old Age Physical Functioning Trajectories in Older Businessmen

OBJECTIVES

The associations between cardiovascular disease (CVD) risk and later physical functioning have been observed, but only a few studies with follow-up into old age are available. We investigated the association between cardiovascular status in midlife and physical functioning trajectories in old age.

DESIGN

Prospective cohort study.

SETTING

Helsinki Businessmen Study.

PARTICIPANTS

We studied white men born between 1919 and 1934 in the Helsinki Businessmen Study (HBS, initial n = 3490).

MEASUREMENTS

Three CVD status groups were formed based on clinical measurements carried out in 1974: signs of CVD (diagnosed clinically or with changes in ECG, chronic disease present or used medication, n = 563); healthy and low CVD risk (n = 593) and high CVD risk (n = 1222). Of them, 1560 men had data on physical functioning from at least one of four data collection waves between 2000-2010. Ten questions from the RAND-36 (SF-36) survey were used to construct physical functioning trajectories with latent class growth mixture models. Mortality was accounted for in competing risk models.

RESULTS

A five-class solution provided the optimal number of trajectories: "intact," "high stable," "high and declining," "intermediate and declining," and "consistently low" functioning. Compared with low CVD risk, high CVD risk in midlife decreased the risk of being classified into the intact (fully adjusted β = -3.98; standard error = 2.0; P = .046) relative to the consistently low physical functioning trajectory. Compared with low CVD risk, those with signs of CVD were less likely to follow the intact, high stable, or high and declining relative to the consistently low trajectory (all P < .018).

CONCLUSION

Among businessmen, a more favorable CVD profile in midlife was associated with better development of physical functioning in old age. J Am Geriatr Soc 67:2490-2496, 2019.

Longevity-related molecular pathways are subject to midlife "switch" in humans

Emerging evidence indicates that molecular aging may follow nonlinear or discontinuous trajectories. Whether this occurs in human neuromuscular tissue, particularly for the noncoding transcriptome, and independent of metabolic and aerobic capacities, is unknown. Applying our novel RNA method to quantify tissue coding and long noncoding RNA (lncRNA), we identified ~800 transcripts tracking with age up to ~60 years in human muscle and brain. In silico analysis demonstrated that this temporary linear "signature" was regulated by drugs, which reduce mortality or extend life span in model organisms, including 24 inhibitors of the IGF-1/PI3K/mTOR pathway that mimicked, and 5 activators that opposed, the signature. We profiled Rapamycin in nondividing primary human myotubes (n = 32 HTA 2.0 arrays) and determined the transcript signature for reactive oxygen species in neurons, confirming that our age signature was largely regulated in the "pro-longevity" direction. Quantitative network modeling demonstrated that age-regulated ncRNA equaled the contribution of protein-coding RNA within structures, but tended to have a lower heritability, implying lncRNA may better reflect environmental influences. Genes ECSIT, UNC13, and SKAP2 contributed to a network that did not respond to Rapamycin, and was associated with "neuron apoptotic processes" in protein-protein interaction analysis (FDR = 2.4%). ECSIT links inflammation with the continued age-related downwards trajectory of mitochondrial complex I gene expression (FDR < 0.01%), implying that sustained inhibition of ECSIT may be maladaptive. The present observations link, for the first time, model organism longevity programs with the endogenous but temporary genome-wide responses to aging in humans, revealing a pattern that may ultimately underpin personalized rates of health span.

Effects of a Home-Based Physical Rehabilitation Program on Tibial Bone Structure, Density, and Strength After Hip Fracture: A Secondary Analysis of a Randomized Controlled Trial

Weight‐bearing physical activity may decrease or prevent bone deterioration after hip fracture. This study investigated the effects of a home‐based physical rehabilitation program on tibial bone traits in older hip fracture patients. A population‐based clinical sample of men and women operated for hip fracture (mean age 80 years, 78% women) was randomly assigned into an intervention (n = 40) and a standard care control group (n = 41) on average 10 weeks postfracture. The intervention group participated in a 12‐month home‐based rehabilitation intervention, including evaluation and modification of environmental hazards, guidance for safe walking, nonpharmacological pain management, motivational physical activity counseling, and a progressive, weight‐bearing home exercise program comprising strengthening exercises for the lower legs, balance training, functional exercises, and stretching. All participants received standard care. Distal tibia (5% proximal to the distal end plate) compressive bone strength index (BSI; g²/cm⁴), total volumetric BMD (vBMD_TOT; mg/cm³), and total area (CSA_TOT; mm²), as well as midtibia (55%) strength–strain index (SSI; mm³), cortical vBMD (vBMD_CO; mg/cm³), and ratio of cortical to total area (CSA_CO/CSA_TOT) were assessed in both legs by pQCT at baseline and at 3, 6, and 12 months. The intervention had no effect (group × time) on either the distal or midtibial bone traits. At the distal site, BSI of both legs, vBMD_TOT of the fractured side, and CSA_TOT of the nonfractured side decreased significantly over time in both groups 0.7% to 3.1% (12 months, p < 0.05). At the midshaft site, CSA_CO/CSA_TOT and SSI of both legs, and vBMD_CO of the fractured leg, decreased significantly over time in both groups 1.1% to 1.9% (12 months, p < 0.05). Trabecular and cortical bone traits of the tibia on the fractured and the nonfractured side deteriorated throughout follow‐up. The home‐based physical rehabilitation intervention aimed at promoting mobility recovery was unable to prevent bone deterioration in older people after hip fracture. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Does sex hormone-binding globulin cause insulin resistance during pubertal growth?

BACKGROUND

The directional influences between serum sex hormone-binding globulin (SHBG), adiposity and insulin resistance during pubertal growth remain unclear. The aim of this study was to investigate bidirectional associations between SHBG and insulin resistance (HOMA-IR) and adiposity from childhood to early adulthood.

METHODS

Participants were 396 healthy girls measured at baseline (age 11.2 years) and at 1, 2, 4 and 7.5 years. Serum concentrations of estradiol, testosterone and SHBG were determined by ELISA, glucose and insulin by enzymatic photometry, insulin-like growth factor 1 (IGF-1) by time-resolved fluoroimmunoassays, whole-body fat mass by dual-energy X-ray absorptiometry and HOMA-IR were determined by homeostatic model assessment. The associations were examined using cross-lagged path models.

RESULTS

In a cross-lagged path model, SHBG predicted HOMA-IR before menarche β = -0.320 (95% CI: -0.552 to -0.089), P = 0.007, independent of adiposity and IGF-1. After menarche, no directional effect was found between SHBG and insulin resistance or adiposity.

CONCLUSIONS

Our results suggest that in early puberty, decline in SHBG predicts development of insulin resistance, independent of adiposity. However, after menarche, no directional influences between SHBG, adiposity and insulin resistance were found, suggesting that observational associations between SHBG, adiposity and insulin resistance in pubertal children may be subject to confounding. Further research is needed to understand the underlying mechanisms of the associations between SHBG and cardiometabolic risk markers in peripubertal children.

Leisure-time physical activity and DNA methylation age-a twin study

Background

Epigenetic clocks may increase our understanding on human aging and how genetic and environmental factors regulate an individual aging process. One of the most promising clocks is Horvath’s DNA methylation (DNAm) age. Age acceleration, i.e., discrepancy between DNAm age and chronological age, tells us whether the person is biologically young or old compared to his/her chronological age. Several environmental and lifestyle factors have been shown to affect life span. We investigated genetic and environmental predictors of DNAm age in young and older monozygotic (MZ) and dizygotic (DZ) twins with a focus on leisure time physical activity.

Results

Quantitative genetic modeling revealed that the relative contribution of non-shared environmental factors was larger among older compared with younger twin pairs [47% (95% CI 35, 63) vs. 26% (95% CI: 19, 35), p < 0.001]. Correspondingly, genetic variation accounted for less of the variance in older [53% (95% CI 37, 65)] compared with younger pairs [74% (95% CI 65, 82)].

We tested the hypothesis that leisure time physical activity is one of the non-shared environmental factors that affect epigenetic aging. A co-twin control analysis with older same-sex twin pairs (seven MZ and nine DZ pairs, mean age 60.4 years) who had persistent discordance in physical activity for 32 years according to reported/interviewed physical-activity data showed no differences among active and inactive co-twins, DNAm age being 60.7 vs. 61.8 years, respectively [between-group mean-difference: − 1.17 (95%CI − 3.43,1.10)]. Results from the younger cohort of twins supported findings that LTPA is not associated with DNAm age acceleration.

Conclusions

In older subjects, a larger amount of variance in DNAm age acceleration was explained by non-shared environmental factors compared to young individuals. However, leisure time physical activity during adult years has at most a minor effect on DNAm age acceleration. This is consistent with recent findings that long-term leisure time physical activity in adulthood has little effect on mortality after controlling for genetic factors.

Normal weight obesity and physical fitness in Chinese university students: an overlooked association

BACKGROUND

The primary aim of this study was to examine the associations of normal weight obesity (NWO) with physical fitness in Chinese university students. As a secondary aim, we assessed whether possible differences in physical fitness between students classified as NWO and normal weight non-obese (NWNO) were mediated by skeletal muscles mass.

METHODS

A total of 383 students (205 males and 178 females, aged 18-24 years) from two universities volunteered to participate in this study. Body height and weight were measured by standard procedures and body composition was assessed by bio-impedance analysis (InBody 720). NWO was defined by a BMI of 18.5-23.9 kg/m2 and a body fat percentage of > 20% or > 30% in male and female students, respectively. Physical fitness was measured using a 10-min intermittent endurance running test (Andersen test), countermovement jumps (CMJ) and a 5 × 5 m shuttle run test (5mSR). The level of leisure time physical activity (PA) was assessed by a questionnaire.

RESULTS

13.7% of male and 27.5% of female students were classified as NWO. Compared to NWNO, students classified as NWO showed a significantly poorer performance in the Andersen test (males: 1146 ± 70 m vs. 1046 ± 95 m, females: 968 ± 61 m vs. 907 ± 67 m, p < 0.001), CMJ (males: 55.0 ± 7.6 cm vs. 44.9 ± 7.5 cm, females: 39.8 ± 8.0 cm vs. 33.7 ± 5.9 cm, p < 0.001) and 5mSR (males: 18.7 ± 1.0 s vs. 20.0 ± 0.9 s, females: 21.1 ± 1.1 s vs. 22.4 ± 1.3 s, p < 0.001), respectively. The lower levels of physical fitness in NWO were partially explained by lower skeletal muscle mass (p < 0.001) both in male and female students.

CONCLUSIONS

NWO was associated with poorer physical fitness and the relationship was partially mediated by lower skeletal muscle mass. The study indicated that attention should be paid for the potential hidden health risk in university students with normal body mass index but excessive fat mass.

Associations between the dimensions of perceived togetherness, loneliness, and depressive symptoms among older Finnish people

OBJECTIVES

We studied the associations between perceived togetherness, depressive symptoms, and loneliness over a six-month period among 222 people aged 75-79 who reported loneliness or depressive mood at baseline.

METHOD

The present cross-lagged models utilized baseline and six-month follow-up data of a randomized controlled trial that examined the effects of a social intervention on loneliness and depression (ISRCTN78426775). Dimensions of perceived togetherness, i.e. attachment, social integration, guidance, alliance, nurturance, and reassurance of worth, were measured with the Social Provisions Scale, depressive symptoms with a short form of the Geriatric Depression Scale, and loneliness with a single item.

RESULTS

After controlling for baseline loneliness and depressive symptoms, baseline higher attachment in all participants and baseline higher opportunity for nurturance in the social intervention group predicted lower depressive mood at follow-up. No cross-lagged associations between the dimensions of perceived togetherness at baseline and loneliness at follow-up were observed. In addition, depressive symptoms and loneliness at baseline tended to negatively predict the dimensions of perceived togetherness at follow-up.

DISCUSSION

Depressive symptoms and loneliness appear to be precursor for perceived togetherness, rather than dimensions of perceived togetherness to be antecedents of loneliness and depressiveness among older people.

Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial

Background

Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70–85-year-old community-dwelling sedentary or at most moderately physically active men and women.

Methods

Community-dwelling sedentary or at most moderately physically active, men and women living in the city of Jyväskylä will be recruited and randomized into physical training (PT) and physical and cognitive training (PTCT). The 12-month interventions include supervised training sessions and home exercises. Both groups attend physical training intervention, which follows the current physical activity guidelines. The PTCT group performes also a web-based computer program targeting executive functions. Outcomes will be assessed at baseline and at 6 and 12 months thereafter. Falls data are collected during the interventions and the subsequent one-year follow-up. The primary outcome is 10-m walking speed. Secondary outcomes include 6-min walking distance, dual-task cost in walking speed, fall incidence and executive function assessed with color Stroop and Trail Making A and B tests. Explanatory outcomes include e.g. body composition and bone characteristics, physical performance, physical activity, life-space mobility, fall-related self-efficacy, emotional well-being and personality characteristics.

Discussion

The study is designed to capture the additive and possible synergistic effects of physical and cognitive training. When completed, the study will provide new knowledge on the effects of physical and cognitive training on the prevention of walking limitations and rate of falls in older people. The expected results will be of value in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact.

Trial registration

ISRCTN52388040.

Perceived burden among spouse, adult child, and parent caregivers

AIMS

To identify what factors are associated with the caregiver burden of spouse caregivers, adult child caregivers, and parent caregivers.

BACKGROUND

Caregivers often feel stressed and perceive caregiving as a burden. The caregiver burden has been little studied from the perspective of the personal relationship between caregiver and care recipient.

DESIGN

Cross-sectional study.

METHODS

A random sample of 4,000 caregivers in Finland was drawn in 2014 and those who remained either spouse, adult child, or parent caregivers at data collection were included in the analysis (N = 1,062). Data collection included recipients' characteristics. Caregivers' perceived burden was measured using the Caregivers of Older People in Europe index. General linear models were used to explain perceived caregiver burden.

RESULTS

Care recipients' low level of cognitive function was associated with greater perceived burden. Higher quality of support was associated with lower perceived burden among female and male spouse caregivers, daughter caregivers, and mother caregivers. Low cognitive function explained 3-6% and high quality of support 2-5% of the total variation in the burden explained by the models, which ranged between 45-55%.

CONCLUSION

Because cognitive challenges of care recipient are associated with greater perceived burden and high quality of support with lower burden among most of the caregiver groups, high-quality tailored nursing interventions will be needed especially for the caregivers of the most frail care recipients.

Feasibility and psychometric properties of the Finnish version of the measure of processes of care for adults

OBJECTIVE:

To assess the psychometric properties and feasibility of the Finnish translation of the measure of processes of care for adults (MPOC-A) when used in an inpatient rehabilitation setting.

DESIGN:

A feasibility study.

SETTINGS:

Inpatient rehabilitation settings.

SUBJECTS:

A total of 858 people with severe neurological disabilities, musculoskeletal problems, and mental disorders were recruited to the study.

METHODS:

The MPOC-A questionnaire is a self-administered questionnaire consisting of 34 items in five-factorial domains. The construct validity of the translated questionnaire was evaluated using confirmatory factor analysis. To compare the fit of the model to the fit of the independent null-model Comparative Fit Index was used. Internal consistency for the total scale and subscales was calculated using Cronbach's alpha reliability coefficient.

RESULTS:

A total of 554 people, mean age 52 years (SD = 9), participated in the study. Most of the responders had musculoskeletal problems ( n = 328, 57%). The respondents rated the client-centeredness in rehabilitation service as moderate ( m = 5.40, SD = 0.81). The five-factor and the one-factor model fitted the data well according to all three indices. Internal consistency showed high reliability between the one-factor and five-factor models for all except one domain (0.49-0.93). The mean for Person Infit for the people with neurological disabilities was higher than for the other two groups ( m = 1.77, SD = 1.32) indicating less predictable response patterns in this group.

CONCLUSION:

The results confirm the appropriate psychometric properties of the Finnish version of the MPOC-A, especially for people with musculoskeletal problems and those with mental health disorders.

Long-term leisure-time physical activity and other health habits as predictors of objectively monitored late-life physical activity - A 40-year twin study

Moderate-to-vigorous physical activity (MVPA) in old age is an important indicator of good health and functional capacity enabling independent living. In our prospective twin cohort study with 616 individuals we investigated whether long-term physical activity assessed three times, in 1975, 1982 and 1990 (mean age 48 years in 1990), and other self-reported health habits predict objectively measured MVPA measured with a hip-worn triaxial accelerometer (at least 10 hours per day for at least 4 days) 25 years later (mean age of 73 years). Low leisure-time physical activity at younger age, higher relative weight, smoking, low socioeconomic status, and health problems predicted low MVPA in old age in individual-based analyses (altogether explaining 20.3% of the variation in MVPA). However, quantitative trait modeling indicated that shared genetic factors explained 82% of the correlation between baseline and follow-up physical activity. Pairwise analyses within monozygotic twin pairs showed that only baseline smoking was a statistically significant predictor of later-life MVPA. The results imply that younger-age physical activity is associated with later-life MVPA, but shared genetic factors underlies this association. Of the other predictors mid-life smoking predicted less physical activity at older age independent of genetic factors.

Effect of a social intervention of choice vs. control on depressive symptoms, melancholy, feeling of loneliness, and perceived togetherness in older Finnish people: a randomized controlled trial

OBJECTIVES

This study examined effects of a social intervention on depressive symptoms, melancholy, loneliness, and perceived togetherness in community-dwelling Finnish older people.

METHOD

Promotion of mental well-being in older people (GoodMood; ISRCTN78426775) was a single-blinded randomized control trial lasting 1.5 years. Two hundred and twenty-three persons aged 75-79 years reporting symptoms of loneliness or melancholy were randomized into intervention and control groups. The intervention group was allowed to choose among supervised exercise, social activity, or personal counseling. Follow-up measurements were conducted at the end of 6-month intervention, and at 3, 6, and 12 months post intervention.

RESULTS

Number of depressive symptoms remained unchanged, while loneliness and melancholy decreased in both the intervention and control groups during the study (p < 0.001). Social integration increased in the intervention group but not in controls (p = 0.041). Attachment and guidance increased in both groups (p < 0.001).

CONCLUSION

The intervention did not alleviate depressed mood. Positive changes over time were observed in loneliness, feelings of melancholy, attachment, and guidance but these occurred independently of the intervention. Our secondary analysis suggests that the intervention increased perceived social integration. In sum, the effects of the intervention were moderate only and did not expedite further overcoming depressive mood or loneliness.

Developing an Assessment Method of Active Aging: University of Jyvaskyla Active Aging Scale

Objective: To develop an assessment method of active aging for research on older people. Method: A multiphase process that included drafting by an expert panel, a pilot study for item analysis and scale validity, a feedback study with focus groups and questionnaire respondents, and a test–retest study. Altogether 235 people aged 60 to 94 years provided responses and/or feedback. Results: We developed a 17-item University of Jyvaskyla Active Aging Scale with four aspects in each item (goals, ability, opportunity, and activity; range 0-272). The psychometric and item properties are good and the scale assesses a unidimensional latent construct of active aging. Discussion: Our scale assesses older people’s striving for well-being through activities pertaining to their goals, abilities, and opportunities. The University of Jyvaskyla Active Aging Scale provides a quantifiable measure of active aging that may be used in postal questionnaires or interviews in research and practice.

Genetic and Environmental Effects on Telomere Length and Lung Function: A Twin Study

Background

The purpose of the study was to estimate the heritability of leukocyte telomere length (LTL) and lung function and to examine whether LTL and lung function share genetic or environmental effects in common.

Methods

386 monozygotic and dizygotic Finnish twin sisters (age 68.4±3.4 years) were included. Relative LTL was determined from peripheral blood DNA by qPCR. Lung function measures of FEV1, FVC, FEV1/FVC, and PEF were derived from spirometry. Genetic modeling was performed with MPlus statistical software.

Results

Univariate analysis revealed that in LTL, 62% (95% confidence interval 50-72) of the variance was explained by additive genetic and 38% (28-50) by unique environmental factors. For FEV1, FVC, and PEF, the corresponding estimates were 65%-67% for additive genetic and 33%-35% for unique environmental factors. Across the sample, the phenotypic correlation between LTL and FEV1 was modest (r = .104, p = .041). Bivariate correlated factors model revealed that the genetic correlation between LTL and FEV1 was .18 (-0.19 to 0.64) and environmental correlation was -.10 (-0.84 to 0.55).

Conclusions

Both LTL and lung function variables are moderately to highly genetically determined. The associations between LTL and the lung function variables were weak. However, the positive genetic correlation point estimate gave minor suggestions that, in a larger sample, genetic factors in common might play a role in the phenotypic correlation between LTL and FEV1. Future studies with larger samples are needed to confirm these preliminary findings.

Effects of a 20-week high-intensity strength and sprint training program on tibial bone structure and strength in middle-aged and older male sprint athletes: a randomized controlled trial

This randomized, controlled, high-intensity strength and sprint training trial in middle-aged and older male sprint athletes showed significant improvements in mid-tibial structure and strength. The study reveals the adaptability of aging bone, suggesting that through a novel, intensive training stimulus it is possible to strengthen bones during aging.

INTRODUCTION

High-load, high-speed and impact-type exercise may be an efficient way of improving bone strength even in old age. We evaluated the effects of combined strength and sprint training on indices of bone health in competitive masters athletes, who serve as a group of older people who are likely to be able to participate in vigorous exercise of this kind.

METHODS

Seventy-two men (age 40-85) were randomized into an experimental (EX, n = 40) and a control (CTRL, n = 32) group. EX participated in a 20-week program combining heavy and explosive strength exercises with sprint training. CTRL maintained their usual, run-based sprint training schedules. Bone structural, strength and densitometric parameters were assessed by peripheral QCT at the distal tibia and tibial midshaft.

RESULTS

The intervention had no effects on distal tibia bone traits. At the mid-tibia, the mean difference in the change in cortical thickness (Th_CO) in EX compared to CTRL was 2.0% (p = 0.007). The changes in structure and strength were more pronounced in the most compliant athletes (training adherence >75%). Compared to CTRL, total and cortical cross-sectional area, Th_CO, and the area and density-weighted moments of inertia for the direction of the smallest flexural rigidity (I _minA , I _minD ) increased in EX by 1.6-3.2% (p = 0.023-0.006). Polar mass distribution analysis revealed increased BMC at the anteromedial site, whereas vBMD decreased (p = 0.035-0.043).

CONCLUSIONS

Intensive strength and sprint training improves mid-tibia structure and strength in middle-aged and older male sprint athletes, suggesting that in the presence of high-intensity loading exercise, the adaptability of the bone structure is maintained during aging.