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Desikan SK, Borrelli J, Gray VL, Kankaria AA, Terrin M, Lal BK. Asymptomatic Carotid Stenosis is Associated With Mobility Dysfunction: Results From the InChianti Study. Vasc Endovascular Surg 2025; 59:479-486. [PMID: 40017230 DOI: 10.1177/15385744251323434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2025]
Abstract
BackgroundOlder adults with mobility dysfunction are at risk for falls, hospitalization, and death. In an earlier pilot study, individuals with asymptomatic carotid artery stenosis (ACAS) demonstrated mobility dysfunction when compared to individuals without ACAS. We tested whether carotid stenosis affected mobility function in a larger community-dwelling cohort using the Invecchaire in Chianti (InCHIANTI) database.MethodsWe analyzed data from participants in the InCHIANTI study who completed a medical history, carotid duplex testing, and mobility function testing (Short Physical Performance Battery- SPPB). Participants with a history of stroke, transient ischemic attack, or carotid endarterectomy were excluded. 709 participants met inclusion criteria (116 ACAS, 593 no ACAS). Our analytic approach sought to evaluate the impact of stenosis on mobility after accounting for age, sex and cardiovascular risk factors. Age was stratified into 2 age-groups (65-74 and 75-84 years). Two-way ANOVA was used to test the effect of stenosis-group, age-group, and their interactions on SPPB score with sex as a covariate.ResultsStenosis-group (P = 0.0002), age-group (P < 0.0001), and the interaction between stenosis-group and age-group (P = 0.0008) significantly affected SPPB. Post-hoc testing showed that participants with ACAS demonstrated worse performance on the SPPB (9.81 ± 0.37) compared to those with no ACAS (11.10 ± 0.11) in the 65-74 years age-group (P < 0.0001).Conclusions65-74-year-old adults with ACAS performed significantly worse on the SPPB than those without ACAS. These results lend further support that ACAS may be associated with mobility dysfunction in older adults.
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Affiliation(s)
- Sarasijhaa K Desikan
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - James Borrelli
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
- Biomedical Engineering, Stevenson University, Owings Mills, MD, USA
| | - Vicki L Gray
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
| | - Aman A Kankaria
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
| | - Michael Terrin
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Brajesh K Lal
- Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Vascular Service, Veterans Affairs Medical Center, Baltimore, MD, USA
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Kitada T, Umegaki H, Akima H, Ishida K, Nakatochi M, Inoue A, Huang CH, Ando M, Onishi J, Kuzuya M. Effects of Weight-Bearing Resistance Training With Explosive Motions on the Rate of Force Development in Community-Dwelling Older Adults: A Randomized Controlled Trial. J Phys Act Health 2025; 22:706-715. [PMID: 40043717 DOI: 10.1123/jpah.2024-0431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 12/22/2024] [Accepted: 01/27/2025] [Indexed: 05/28/2025]
Abstract
BACKGROUND Eliminating risk factors for falls leads to reduction of the incidence of frailty. The recommended training program used only body weight resistance and no equipment to prepare for quick movements in daily living in community-dwelling older adults is unknown. Thus, we compared the effects of weight-bearing resistance training with (WEM) and without explosive motions (WOEM). METHODS Sixty older adults were randomly assigned to WEM and WOEM groups. The WEM group performed the concentric phase during repetitions quickly and the WOEM group performed it at traditional velocity. The designated training programs consisted of 8 events to train the whole body for 50 minutes twice a week for 12 weeks. The changes in the rate of force development of toe grip, single knee extension, and flexion from baseline to 12 weeks were measured. Between-group differences were analyzed for changes in each outcome variable. RESULTS Twenty-seven participants in the WEM group (70 [5] y) and 21 participants in the WOEM group (69 [4] y) completed the study. The change in the early rate of force development of toe grip from baseline to 12 weeks was significantly greater in the WEM group (0-30 ms: effect size = 0.53, 95% CI = 6.36-68.10, P = .049; 0-50 ms: effect size = 0.56, CI = 10.05-86.02, P = .046) than in the WOEM group. CONCLUSIONS Weight-bearing resistance training with explosive motions has the advantage of not being limited to tools and places. Therefore, it is more suitable than traditional repetition velocity training for quick movement by increasing rate of force development in community-dwelling older adults before they become frail.
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Affiliation(s)
- Tomoharu Kitada
- Faculty of Business Administration, Seijoh University, Tokai, Japan
- Institute of Innovation for Future Society, Nagoya University, Nagoya, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Akima
- Research Center of Health, Physical Fitness & Sports, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness & Sports, Nagoya University, Nagoya, Japan
| | - Masahiro Nakatochi
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Division of Data Science, Data Coordinating Center, Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Aiko Inoue
- Institute of Innovation for Future Society, Nagoya University, Nagoya, Japan
| | - Chi Hsien Huang
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Family Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Joji Onishi
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masafumi Kuzuya
- Meitetsu Hospital, Nagoya, Japan
- Nagoya University, Nagoya, Japan
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Chai Y, Gu Y, Wu X, Wang Y, Lin P, Ye Q, Li L. Chinese validation of "subjective motoric cognitive risk syndrome" screening tool in patients with coronary artery disease using Rasch analysis. FRONTIERS IN AGING 2025; 6:1505847. [PMID: 40443797 PMCID: PMC12119596 DOI: 10.3389/fragi.2025.1505847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Accepted: 05/05/2025] [Indexed: 06/02/2025]
Abstract
Objective Subjective motoric cognitive risk syndrome (MCR-S) is a well-established screening tool that has been validated for objective motoric cognitive risk syndrome (MCR-O) and predicted risk of incident dementia. MCR is associated with cardiovascular factors and coronary artery disease (CAD). MCR-S is crucial for remote cognitive screening but has only been validated in community settings so far. Our study aimed to validate a Chinese version of the MCR-S in CAD patients. Method The Chinese version of the MCR-S was obtained through a standardized forward-backward translation and cultural adaptation. 338 CAD patients were recruited. Traditional analysis based on classical test theory and Rasch analysis based on latent trait theory were performed on the MCR-S for validation. Receiver operating characteristic analysis was applied to determine the discriminative ability of MCR-S for the MCR-O in CAD patients. Results The MCR-S met the unidimensionality, lack of local dependency or disordered thresholds, and good fit value for each item of the Rasch model, the item-person map shows that the item's estimate of capacity is appropriate. MCR-S has good content validity, criterion-related validity, and test-retest reliability. An optimal cut-score of 4.6 on the MCR-S score was determined to have good sensitivity (79.2%) and specificity (71.3%) for MCR-O in CAD patients. Conclusion The Chinese version of MCR-S meets the requirements of the Rasch model and has good validity in CAD patients. The validated MCR-S cutoff can support long-term monitoring and early intervention for CAD patients at risk of MCR-O.
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Affiliation(s)
- Yiyi Chai
- Department of Nursing, Harbin Medical University, Harbin, China
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yanrong Gu
- Department of Nursing, Harbin Medical University, Harbin, China
| | - Xiaomin Wu
- Department of Nursing, Harbin Medical University, Harbin, China
| | - Yini Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ping Lin
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qingfang Ye
- Department of Basic Nursing, School of Nursing, Harbin Medical University, Daqing, China
| | - Ling Li
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Lusardi MM, Hamby V, Eckert S, Dring J. Development of an Annual Mobility Screen for Preclinical Mobility Limitation: Test Selection and Interpretation Guidelines. J Am Geriatr Soc 2025. [PMID: 40347228 DOI: 10.1111/jgs.19521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 04/14/2025] [Accepted: 04/20/2025] [Indexed: 05/12/2025]
Abstract
BACKGROUND Preclinical mobility limitation (PCML) is an emerging public health issue in the United States. A standardized assessment to identify those with PCML has not been established. A Task Force of the American Physical Therapy Association's Academy of Geriatric Physical Therapy (APTA Geriatrics) developed an evidence-based protocol for an Annual Mobility Screen (AMS) with the potential to meet this gap in practice. Early identification of PCML increases the potential for remediation, improved function, and a slower rate of decline. Because mobility is key for independence and quality of life, aging adults would value access to mobility screening. Physical therapists, experts in movement, are uniquely qualified to provide this service. METHODS This report reviews decision-making for the selection of test/measures and the development of an interpretation rationale for an AMS. Test selection criteria included ratio level measures (time, distance, repetition), time or equipment requirements, ability to predict adverse health events, and availability of reference values. RESULTS Four performance-based measures met inclusion criteria: self-selected and fast walking speed (overall mobility and functional reserve), 30 s Chair Stand (lower extremity muscle performance), Four Square Step test (dynamic balance stepping over low obstacles and changing direction), and Timed Up Go cognitive (ability to dual task while moving). Classification of mobility was based on normal distribution of performance across the population of aging adults as follows: PCML unlikely (at or above-0.5 SD or more from mean for age/gender), PCML likely (between -0.5 SD and - 1.0 SD from mean), and impending mobility limitation (-1 SD below the mean). CONCLUSION The AMS was developed to identify older adults with PCML. The reliability and validity of the AMS and its interpretation strategies will be evaluated as the screening protocol is piloted.
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Affiliation(s)
- Michelle M Lusardi
- Department of Physical Therapy & Human Movement Science, College of Health Professions, Sacred Heart University, Fairfield, Connecticut, USA
| | - Victoria Hamby
- School of Allied Health, College of Health Sciences, University of Louisiana Monroe, Monroe, Louisiana, USA
| | - Sterling Eckert
- Department of Physical Therapy, Angelo State University, San Angelo, Texas, USA
| | - Jason Dring
- Human Function, and Rehabilitation Sciences, School of Medicine and Health Science, George Washington University, Washington, District of Columbia, USA
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He J, Yang R, Zhong K, Wen C, Liu X, Wang Y, Zhong Q. Modification effect of healthy lifestyle among solid fuels and mild cognitive impairment in middle-aged and older adults: A prospective cohort study. Neurotoxicology 2025; 108:338-343. [PMID: 40349852 DOI: 10.1016/j.neuro.2025.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 04/16/2025] [Accepted: 04/30/2025] [Indexed: 05/14/2025]
Abstract
To explore the association between solid fuels and mild cognitive impairment (MCI) and the role of the healthy lifestyle score (HLS) in the association between solid fuels and MCI. Data were obtained from CHARLS from 2011 to 2020. A logistic regression model which assessed the impact of solid fuel use on MCI was applied. A full HLS was constructed to evaluate the interaction and joint effects of HLS with solid fuels. 11054 people were enclosed in this study and the proportion of the population using solid fuels is as high as 74.05 % for heating fuels and 56.53 % for cooking fuels. Results showed that solid fuel use was positively associated with the risk of MCI during cooking and heating, with 95 % confidence intervals (95 % CI) of 1.11 (1.00, 1.23) for cooking and 1.14 (1.00, 1.31) for heating. Further, a healthy BMI was beneficial in reducing the harmful effects of solid fuels. Solid fuel use was significantly associated with MCI among middle-aged and older Chinese adults. Our results also suggested that higher HLS is beneficial in reducing the risk of MCI from solid fuels. In this study, we are prompted to use cleaner fuels and ventilation equipment along with the need to develop effective HLS measures for interventions.
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Affiliation(s)
- Jie He
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Rui Yang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Kangkang Zhong
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Chuanting Wen
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Xuechun Liu
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yan Wang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Qi Zhong
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Ribeiro LW, Mielke GI, Doust J, Mishra GD. Two-decade health-related quality of life and performance on physical function tests in midaged women: findings from a prospective cohort study. J Clin Epidemiol 2025; 181:111730. [PMID: 40015487 DOI: 10.1016/j.jclinepi.2025.111730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2024] [Revised: 02/16/2025] [Accepted: 02/17/2025] [Indexed: 03/01/2025]
Abstract
OBJECTIVES Health-related quality of life (HRQoL) is more commonly measured in younger populations than objective physical function tests. However, associations between HRQoL and the performance on physical function tests are unclear. This study investigates the association between HRQoL measures across adulthood and performance on physical function tests in midaged women. METHODS Data were derived from 499 women born during 1973-1978 from the Menarche-to-PreMenopause Study, a substudy of the Australian Longitudinal Study on Women's Health. HRQoL was assessed every 3 years from ages 18-23 years to 40-45 years using the eight Short Form Health Survey subscales. Generalized estimating equation models examined the associations between HRQoL over 22 years and three performance tests at a mean age 44.6 years: handgrip strength (kg), chair rise (sec), and standing balance (sec). Worse performance was defined by the lowest tertile of the sample. RESULTS Several HRQoL subscales showed longitudinal associations with performance. Repeatedly lower scores on nearly all subscales were linked to worse chair rise performance, except for social functioning and mental health. Bodily pain was associated with all three tests; women reporting more pain across the 22-year follow-up showed 50% higher odds of worse chair rise and 30% higher odds of both worse handgrip strength and balance. Women with lower physical functioning scores had higher odds of worse grip (odds ratio 1.4, 95% CI 1.1-1.9) and worse chair rise performances (odds ratio 1.4, 95% CI 1.4-2.6). CONCLUSION This study showed poorer HRQoL from early-to-mid adulthood was associated with worse physical performance in midaged Australian women, particularly in the chair rise test.
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Affiliation(s)
- Leticia W Ribeiro
- Australian Women and Girls' Health Research (AWaGHR) Centre, School of Public Health, The University of Queensland, Brisbane Queensland 4006 Australia
| | - Gregore I Mielke
- Australian Women and Girls' Health Research (AWaGHR) Centre, School of Public Health, The University of Queensland, Brisbane Queensland 4006 Australia
| | - Jenny Doust
- Australian Women and Girls' Health Research (AWaGHR) Centre, School of Public Health, The University of Queensland, Brisbane Queensland 4006 Australia
| | - Gita D Mishra
- Australian Women and Girls' Health Research (AWaGHR) Centre, School of Public Health, The University of Queensland, Brisbane Queensland 4006 Australia.
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Taylor RA, Bakitas M, Wells R, Odom JN, Kennedy R, Williams GR, Frank J, Li P. Life-space mobility trajectory patterns and associated characteristics in older cancer survivors: a secondary data analysis. BMC Geriatr 2025; 25:297. [PMID: 40307713 PMCID: PMC12042436 DOI: 10.1186/s12877-025-05940-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Accepted: 04/11/2025] [Indexed: 05/02/2025] Open
Abstract
BACKGROUND Life-space mobility (LSM) measures the size of the real-world geographic area an individual purposely transverses in their daily life. While older cancer survivors often have declines in LSM that negatively affects their quality of life, independence, and social engagement the factors that predispose to adverse outcomes are unknown. Understanding different patterns of LSM and its decline can help identify those needing support. The purpose of this study was to identify: (1) LSM trajectory patterns and (2) factors associated with those patterns in older cancer survivors. METHODS This paper reports a secondary data analysis of 153 participants with cancer ≥ 65 years from the University of Alabama Study of Aging. LSM was assessed using the UAB Life-Space Assessment-Composite score (LSA-C) at study entry and every 6 months for 96 months (LSA-C < 60 = restricted LSM). LSM trajectory patterns based on the LSA-C were determined using group-based trajectory analysis. A classification tree analysis revealed factors that predicted the trajectory patterns. RESULTS Participants (n = 153) were a mean age of 76.1 (SD 6.33), mostly male (58%), White (58%), married (55%) or widowed (37%), and had a diagnosis of prostate (37.3%), breast (20.3%), or colon (11.8%) cancer. Three LSM trajectory patterns were identified: (1) high start and stable (37.3%) with unrestricted LSM (LSA-C = 81.2) at study entry, which remained stable over time, (2) high start progressive decline (27.5%) with unrestricted LSM (LSA-C = 78.0) at study entry that progressively declined, and (3) low start progressive decline (35.3%) with restricted LSM level (LSA-C = 42.0) at study entry, which progressively declined. Each pattern was associated with a unique set of demographic and clinical characteristics. Baseline physical performance score was the most important predictor of the LSM trajectory patterns. CONCLUSIONS Three distinct LSM trajectory patterns, each with unique demographic and clinical characteristics, were identified. Because older cancer survivors have distinct LSM patterns, interventions should be tailored to address specific characteristics and clinical needs. LSM measurement can contribute to assessment of older adults generally and should become part of standard assessment in older cancer survivors.
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Affiliation(s)
- Richard A Taylor
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, Al, USA.
- , 585 School of Nursing Building, 1701 University Boulevard, Birmingham, Al, 35294, USA.
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, Al, USA
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Al, USA
| | - Rachel Wells
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, Al, USA
| | - J Nicholas Odom
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, Al, USA
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Al, USA
| | - Richard Kennedy
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Al, USA
| | - Grant R Williams
- Department of Medicine, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Al, USA
| | - Jennifer Frank
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, Al, USA
| | - Peng Li
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, Al, USA
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Shahbaz SK, Mokhlesi A, Sadegh RK, Rahimi K, Jamialahmadi T, Butler AE, Kesharwani P, Sahebkar A. TLR/NLRP3 inflammasome signaling pathways as a main target in frailty, cachexia and sarcopenia. Tissue Cell 2025; 93:102723. [PMID: 39823704 DOI: 10.1016/j.tice.2025.102723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 12/28/2024] [Accepted: 01/03/2025] [Indexed: 01/20/2025]
Abstract
Mobility disability is a common condition affecting older adults, making walking and the performance of activities of daily living difficult. Frailty, cachexia and sarcopenia are related conditions that occur with advancing age and are characterized by a decline in muscle mass, strength, and functionality that negatively impacts health. Chronic low-grade inflammation is a significant factor in the onset and progression of these conditions. The toll-like receptors (TLRs) and the NLRP3 inflammasome are the pathways of signaling that regulate inflammation. These pathways can potentially be targeted therapeutically for frailty, cachexia and sarcopenia as research has shown that dysregulation of the TLR/NLRP3 inflammasome signaling pathways is linked to these conditions. Activation of TLRs with pathogen-associated molecular patterns (PAMPs or DAMPs) results in chronic inflammation and tissue damage by releasing pro-inflammatory cytokines. Additionally, NLRP3 inflammasome activation enhances the inflammatory response by promoting the production and release of interleukins (ILs), thus exacerbating the underlying inflammatory mechanisms. These pathways are activated in the advancement of disease in frail and sarcopenic individuals. Targeting these pathways may offer therapeutic options to reduce frailty, improve musculoskeletal resilience and prevent or reverse cachexia-associated muscle wasting. Modulating TLR/NLRP3 inflammasome pathways may also hold promise in slowing down the progression of sarcopenia, preserving muscle mass and enhancing overall functional ability in elderly people. The aim of this review is to investigate the signaling pathways of the TLR/NLRP3 inflammasome as a main target in frailty, cachexia and sarcopenia.
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Affiliation(s)
- Sanaz Keshavarz Shahbaz
- Cellular and Molecular Research Center, Research Institute for Prevention of Non-communicable Disease, Qazvin University of Medical Sciences, Qazvin, Iran; USERN Office, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Aida Mokhlesi
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran; Social Determinants of Health Research Center, Research Institute for Prevention of Non-communicable Disease, Qazvin University of Medical Sciences, Qazvin, Iran; USERN Office, Qazvin University of Medical Sciences, Qazvin, Iran; Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Roghaye Keshavarz Sadegh
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran; USERN Office, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Kimia Rahimi
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran; USERN Office, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Tannaz Jamialahmadi
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Amirhossein Sahebkar
- Center for Global health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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Yang J, Shang Y, Cao F, Ying H, Luo Y. Identify the direct and indirect impacts of the community built environment on the health of older adults. Front Public Health 2025; 13:1478337. [PMID: 40231175 PMCID: PMC11994447 DOI: 10.3389/fpubh.2025.1478337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Accepted: 03/17/2025] [Indexed: 04/16/2025] Open
Abstract
Background The global ageing population is increasing. As their physical functions deteriorate, older adults face not only physical health challenges but also mental health issues. Enhancing the health status of older adults is imperative to improve their quality of life. However, research on the health status of older adults living in the community is limited, and the association between the built environment and daily activities remains largely unexplored. Objective This study aimed to utilize structural equation modeling to (1) explore the interrelationships between the community built environment, daily activities of older adults, and their health, and (2) examine the interrelationships among their correlates. Methods For data collection, this study administered structured questionnaires to 494 community-dwelling older adults across ten representative urban communities in Fuzhou, China. The questionnaire comprised four validated sections: demographic characteristics, perceived community built environment features, daily activity and health outcomes. Data analysis employed structural equation modeling (SEM) using AMOS 27.0, with SPSS 27.0 for preliminary analyses, to examine both direct effects of built environment on health outcomes and indirect effects mediated through daily activities. Results Structural equation modeling revealed three pathways: Path 1 (community built environment →health of older adults), Path 2 (community built environment → daily exercise for older adults), and Path 3 (daily exercise for older adults →health of older adults). All three pathways were supported, indicating interaction among the factors. Conclusion The health status of older adults is influenced by their living environment and daily activities. An improved community built environment can enhance health status among older adults. Furthermore, daily activities serve as partial mediators between community built environments and health outcomes. Our methodology and findings offer valuable insights for optimizing community built environments to promote the health of older adults.
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Affiliation(s)
| | | | - Fengxiao Cao
- School of Architecture and Urban Planning, Fujian University of Technology, Fuzhou, China
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Morgan A, Tang A, Heisz J, Thabane L, Richardson J. Home-based high-intensity functional strength training (HIFST) for community-dwelling older adults with preclinical mobility limitations after a slip, trip, or fall: a pilot randomized controlled trial. Disabil Rehabil 2025:1-13. [PMID: 40165047 DOI: 10.1080/09638288.2025.2483470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 03/18/2025] [Accepted: 03/19/2025] [Indexed: 04/02/2025]
Abstract
PURPOSE To determine the feasibility and preliminary effects of a home-based 12-week high-intensity functional strength training (HIFST) intervention for community-dwelling older adults (≥55 years) experiencing preclinical mobility limitations after a slip, trip, or fall. MATERIALS AND METHODS Participants were randomized (1:1) to HIFST (interval-based strengthening using everyday movements) or a lower extremity stretching group. Both interventions were delivered virtually by a physiotherapist. Feasibility was assessed based on predetermined criteria for adherence, recruitment, retention, and safety. Preliminary effects on physical and cognitive functioning outcomes were assessed before and after the intervention. Exploratory analyses were also conducted to assess enjoyment throughout the intervention. RESULTS Twenty-four participants (mean age 67.5 years, 21 females) were randomized (12 in each group). All feasibility criteria were met; 86.1% of HIFST sessions were completed, 82.8% of eligible participants were enrolled, 91.7% of participants completed follow-up assessments, and no serious adverse events occurred. Exploratory analyses suggested benefits for HIFST on a self-reported mobility status, the Oral-Trails Making Test-B, and higher self-reported exercise enjoyment levels at several time points. CONCLUSIONS Home-based HIFST delivered virtually by a physiotherapist is feasible and results suggest beneficial effects which warrant further exploration in a larger fully powered trial.
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Affiliation(s)
- Ashley Morgan
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Jennifer Heisz
- Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- St. Joseph's Healthcare, Hamilton, Canada
- Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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11
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Meulemans L, Deboutte J, Seghers J, Delecluse C, Van Roie E. Age-related differences across the adult lifespan: a comparison of six field assessments of physical function. Aging Clin Exp Res 2025; 37:72. [PMID: 40055287 PMCID: PMC11889021 DOI: 10.1007/s40520-025-02965-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 02/10/2025] [Indexed: 03/12/2025]
Abstract
BACKGROUND Age-related declines in physical capabilities often result from decreased lower-limb muscle strength and power, which are measurable through field tests. Various tests can detect functional declines in older adults, but their responsiveness to age-related differences is less understood in those without substantial impairments. Therefore, this study evaluated and compared the ability of field tests to detect age-related changes in physical and muscle function across adulthood. METHODS 304 participants (52% female; 19-85 years) completed six field tests: handgrip strength (HGS), maximal gait speed (MGS) over a 10-m course, 5-repetition sit-to-stand power (STSP), timed up and go (TUG), countermovement jump (CMJ), and stair climbing power (SCP). Segmented regression analysis determined the relationship between age and field test performance, and identified the age at which the rate of decline increased. A multilevel linear mixed model compared decline rates between tests. RESULTS Before 60 years, SCP and CMJ were responsive to age-related differences (-0.70 to -0.81%/year, p < 0.05), whereas TUG and STSP (lower age-related decline, -0.18% to -0.52%/year, p < 0.05) and HGS and MGS (no significant age-related decline) exhibited lower responsiveness. After 60, most tests (except the STSP) demonstrated increased responsiveness to age-related differences, although these differences remain most pronounced in SCP and CMJ (-1.61 to -1.75%/year, p < 0.05). CONCLUSIONS These findings imply that most field tests are responsive to age-related declines in physical and/or muscle function after 60. In younger age groups, field tests that evaluate lower-limb power and have minimal ceiling effects, such as SCP and CMJ, should be prioritized.
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Affiliation(s)
- Lien Meulemans
- Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven, Tervuursevest 101 - bus 1501, Leuven, 3001, Belgium
| | - Jolien Deboutte
- Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven, Tervuursevest 101 - bus 1501, Leuven, 3001, Belgium
| | - Jan Seghers
- Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven, Tervuursevest 101 - bus 1501, Leuven, 3001, Belgium
| | - Christophe Delecluse
- Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven, Tervuursevest 101 - bus 1501, Leuven, 3001, Belgium
| | - Evelien Van Roie
- Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven, Tervuursevest 101 - bus 1501, Leuven, 3001, Belgium.
- Faculty of Rehabilitation Sciences, University of Hasselt, REVAL-Rehabilitation Research Center, Wetenschapspark 7, Diepenbeek, 3590, Belgium.
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12
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Isngadi I, Asmoro AA, Huda N, Siswagama TA, Rehatta NM, Chandra S, Sari D, Lestari MI, Senapathi TGA, Nurdin H, Wirabuana B, Pramodana B, Pradhana AP, Anggraeni N, Sikumbang KM, Halimi RA, Jasa ZK, Nasution AH, Mochamat M, Purwoko P. Preoperative Geriatric Characteristics Associated with Changes in Postoperative Cognitive Function and Quality of Life: A Prospective Observational Analytic Multicenter Study. Ann Geriatr Med Res 2025; 29:28-37. [PMID: 39262332 PMCID: PMC12010739 DOI: 10.4235/agmr.24.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/02/2024] [Accepted: 08/15/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Changes in cognitive function are associated with increased depression and decreased quality of life (QOL). This study aimed to determine the relationship between the characteristics of geriatric patients and anesthetic management with changes in postoperative cognitive function and QOL of geriatric patients undergoing elective surgery. METHODS This prospective observational analytic multicenter study included patients aged ≥60 years who underwent elective surgery in hospitals in Indonesia. We used the whole sampling method and performed follow-up 30 days after surgery. Data were analyzed using bivariate chi-square and multivariate regression tests with a confidence interval of 95% and α=5%. RESULTS Among the 933 geriatric patients included in this study 55.0%, females most (59.8%) received general anesthesia. Factors including age (p<0.001, B=-0.374, odds ratio [OR]=0.688), body mass index (BMI) (p<0.05, B=0.129, OR=1.138), and physical status based on American Society of Anesthesiologists (ASA) classification (p<0.001, B=-0.458, OR=0.633) were significantly associated with postoperative cognitive function. BMI (p<0.001, B=-0.218, OR=1.244), absence of comorbidities (p<0.05, B=-0.312, OR=0.732), regional anesthesia (p<0.05, B=0.606, OR=1.883), and changes in cognitive function (p<0.05, B=0.288, OR=1.334) were significantly correlated with changes in postoperative QOL. CONCLUSION Age, BMI, and ASA physical status were significantly associated with postoperative cognitive function in geriatric patients, whereas BMI, comorbidities, regional anesthesia, and changes in postoperative cognitive function were associated with QOL. These preoperative factors can predict postoperative cognitive function and QOL and may be useful during preoperative planning.
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Affiliation(s)
- Isngadi Isngadi
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University–Dr. Saiful Anwar General Hospital, Malang, Indonesia
| | - Aswoco A. Asmoro
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University–Dr. Saiful Anwar General Hospital, Malang, Indonesia
| | - Nurul Huda
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University–Dr. Saiful Anwar General Hospital, Malang, Indonesia
| | - Taufiq A. Siswagama
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University–Dr. Saiful Anwar General Hospital, Malang, Indonesia
| | - Nancy M. Rehatta
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University–Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Susilo Chandra
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Indonesia–Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Djayanti Sari
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University–Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Mayang I. Lestari
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Sriwijaya University–Dr. Mohammed Hoesin General Hospital, Palembang, Indonesia
| | - Tjokorda G. A. Senapathi
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Udayana University–Sanglah General Hospital, Denpasar, Indonesia
| | - Haizah Nurdin
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Hasanuddin University–Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia
| | - Belindo Wirabuana
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University–Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Bintang Pramodana
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Indonesia–Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Adinda P Pradhana
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Udayana University–Sanglah General Hospital, Denpasar, Indonesia
| | - Novita Anggraeni
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Riau University–Arifin Achmad General Hospital, Riau, Indonesia
| | - Kenanga M. Sikumbang
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Lambung Mangkurat University–Ulin General Hospital, Banjarmasin, Indonesia
| | - Radian A. Halimi
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Padjadjaran University–Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Zafrullah K. Jasa
- Anesthesiology and Intensive Therapy Department, Faculty of Medicine, Syiah Kuala University/ Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
| | - Akhyar H. Nasution
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sumatera Utara–Dr. Adam Malik General Hospital, Medan, Indonesia
| | - Mochamat Mochamat
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Diponegoro University–Dr. Kariadi General Hospital, Semarang, Indonesia
| | - Purwoko Purwoko
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Sebelas Maret University-Dr. Moewardi General Hospital, Surakarta, Indonesia
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13
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Shafizadeh M, Hizan H, Davids K. Preservation of Temporal Organisation of Tennis Service Following Ageing in Recreational Players. Percept Mot Skills 2025:315125251324419. [PMID: 40010694 DOI: 10.1177/00315125251324419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2025]
Abstract
Background: Ageing leads to functional changes in body systems. Purpose: This study sought to examine the age-based differences in temporal patterning, temporal variability and temporal regularity of tennis service in older adults. Research design: cross-sectional study. Study sample: Participants of this study were volunteers from young (n = 10) and older (n = 11) adults who were self-defined as non-competitive, participating in tennis at a recreational (sub-elite) level for 2-3 days per week regularly. Data collection: They were asked to perform 20 trials of the same serves (flat, slice or top-spin) on a regular size court. The timing (duration) of the serve action was recorded and analysed, using a high-speed digital camera. Participants performed the tennis serves during their routine training sessions on a tennis court. They undertook a structured general (10min) and a specific warm-up routine (10min) before performing services. There was a 30-second rest period between trials. Results: Findings showed that there were no statistically significant differences between the two groups in temporal patterning, whereas the younger group performed the serves with higher variability and regularity/consistency than the older adults in some phases of the action. Conclusion: Older adults who participate recreationally in sports are able to preserve some functional organisation of perceptual-motor capacities, such as timing, due to long-term practice effects. The findings illustrate how sport participation may help maintain functional movement organisation following ageing to mitigate age-related declines in perception and action in late adulthood.
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Affiliation(s)
- Mohsen Shafizadeh
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, UK
| | - Hazun Hizan
- Faculty of Sport Science and Coaching, Sultan Idris Education University, Malaysia
| | - Keith Davids
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, UK
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14
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Saha P, Salmela J, Hiilamo A, Aho AL, Lallukka T. Physical functioning trajectories over statutory retirement: a finnish occupational cohort study. Arch Public Health 2025; 83:8. [PMID: 39789569 PMCID: PMC11720325 DOI: 10.1186/s13690-024-01483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/20/2024] [Indexed: 01/12/2025] Open
Abstract
BACKGROUND The association of workload and performance with physical functioning is recognised among the ageing public sector workforce. The characteristics of working conditions and social- and health-related factors associated with physical functioning after statutory retirement are still unknown. Also, previous studies on changes in physical functioning have not used a person-oriented approach. We examined physical functioning trajectories over statutory retirement and how social- and health-related factors are associated with them. Our aim was to identify distinct developmental trajectories of physical functioning over statutory retirement and to examine how social- (age, gender, marital status, education) and health-related (physical workload, self-reported sleep problems, alcohol consumption, smoking, fruit and vegetable (F&V) consumption, leisure-time physical activity (LTPA), and body mass index (BMI)) factors before retirement were associated with the identified trajectories. METHODS We used data from the Helsinki Health Study cohort. Participants consisted of 2736 employees of the City of Helsinki, Finland who retired during the follow-up. Growth mixture modelling was used to identify physical functioning trajectories and multinominal regression analyses to examine associations of social- and health-related factors with them. RESULTS Three distinct developmental patterns in physical functioning before and after retirement were found among ageing and retired employees. Lower educational level, sleep problems, physical inactivity, and obesity were associated with the trajectory groups of 'fast decreasing' and 'slowly increasing', compared to the 'stable high' trajectory. CONCLUSION The results suggest that poor social- and health-related factors are key risk factors associated with declining and lower-level physical functioning over the retirement period. Supporting healthy lifestyles among older employees might maintaining good physical functioning until retirement and beyond.
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Affiliation(s)
- Pauliina Saha
- Health Sciences Unit, Tampere University, Tampere, Finland
| | - Jatta Salmela
- Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Aapo Hiilamo
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Anna Liisa Aho
- Health Sciences Unit, Tampere University, Tampere, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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15
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Santin Y, Chiesa M, Alfonso A, Doghri Y, Kang R, Haidar F, Oreja-Fuentes P, Fousset O, Zahreddine R, Guardia M, Lemmel L, Rigamonti M, Rosati G, Florian C, Gauzin S, Guyonnet S, Rolland Y, de Souto Barreto P, Vellas B, Guiard B, Parini A. Computational and digital analyses in the INSPIRE mouse cohort to define sex-specific functional determinants of biological aging. SCIENCE ADVANCES 2024; 10:eadt1670. [PMID: 39671481 PMCID: PMC11641001 DOI: 10.1126/sciadv.adt1670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2024] [Accepted: 11/08/2024] [Indexed: 12/15/2024]
Abstract
Biological age, which reflects the physiological state of an individual, offers a better predictive value than chronological age for age-related diseases and mortality. Nonetheless, determining accurate functional features of biological age remains challenging due to the multifactorial nature of aging. Here, we established a unique mouse cohort comprising 1576 male and female outbred SWISS mice subjected or not to high-fat, high-sucrose diet to investigate multiorgan/system biological aging throughout adulthood. Comprehensive functional and biological phenotyping at ages of 6, 12, 18, and 24 months revealed notable sex-specific disparities in longitudinal locomotion patterns and multifunctional aging parameters. Topological data analysis enabled the identification of functionally similar mouse clusters irrespective of chronological age. Moreover, our study pinpointed critical functional markers of biological aging such as muscle function, anxiety characteristics, urinary patterns, reticulocyte maturation, cardiac remodeling and function, and metabolic alterations, underscoring muscle function as an early indicator of biological age in male mice.
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Affiliation(s)
- Yohan Santin
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | - Mattia Chiesa
- Bioinformatics and Artificial Intelligence Facility, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Amélie Alfonso
- Research Center on Animal Cognition (CRCA), Center of Integrative Biology (CBI), CNRS, University of Toulouse, UPS, Toulouse, France
| | - Yosra Doghri
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | - Ryeonshi Kang
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | - Fraha Haidar
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | - Pilar Oreja-Fuentes
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | - Occiane Fousset
- Research Center on Animal Cognition (CRCA), Center of Integrative Biology (CBI), CNRS, University of Toulouse, UPS, Toulouse, France
| | - Rana Zahreddine
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | - Mégane Guardia
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | - Lucas Lemmel
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
| | | | | | - Cédrick Florian
- Research Center on Animal Cognition (CRCA), Center of Integrative Biology (CBI), CNRS, University of Toulouse, UPS, Toulouse, France
| | - Sébastien Gauzin
- Research Center on Animal Cognition (CRCA), Center of Integrative Biology (CBI), CNRS, University of Toulouse, UPS, Toulouse, France
| | - Sophie Guyonnet
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- University of Toulouse III, Toulouse, France
- CERPOP Inserm UMR 1295, Toulouse, France
| | - Yves Rolland
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- University of Toulouse III, Toulouse, France
- CERPOP Inserm UMR 1295, Toulouse, France
| | - Philipe de Souto Barreto
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- University of Toulouse III, Toulouse, France
- CERPOP Inserm UMR 1295, Toulouse, France
| | - Bruno Vellas
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- University of Toulouse III, Toulouse, France
- CERPOP Inserm UMR 1295, Toulouse, France
| | - Bruno Guiard
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Research Center on Animal Cognition (CRCA), Center of Integrative Biology (CBI), CNRS, University of Toulouse, UPS, Toulouse, France
| | - Angelo Parini
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, University of Toulouse, UPS, Toulouse, France
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Fonseca C, Morgado B, Alves E, Ramos A, Silva MR, Pinho L, João A, Lopes M. The Functional Profile, Depressive Symptomatology, and Quality of Life of Older People in the Central Alentejo Region: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:2303. [PMID: 39595500 PMCID: PMC11593335 DOI: 10.3390/healthcare12222303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 11/07/2024] [Accepted: 11/13/2024] [Indexed: 11/28/2024] Open
Abstract
Background: Europe's aging population presents challenges such as a shrinking labor force, pressure on health services, and increased demand for long-term care. This study assesses the functional profile, depressive symptoms, and quality of life of older adults in the Central Alentejo region of Portugal. Methods: A cross-sectional, descriptive study was conducted with a convenience sample of 868 older adults in Portuguese long-term care facilities across the Évora district. A structured questionnaire collected sociodemographic data, elderly nursing core set patient information, a health questionnaire with nine responses, and WHO Quality of Life Assessment (short version) scores. Results: Nearly half of the participants needed assistance with care. Women (OR = 1.46) and those with cognitive impairment (OR = 10.83) had higher impaired functionality, while education (OR = 0.52) and being overweight (OR = 0.52) were inversely related to functional dependence. Quality of life scores ranged from 56.4 (physical) to 66.6 (environmental). Moderate depressive symptoms were found in 17.1% of participants, with 9% having moderately severe to severe symptoms. Higher dependence doubled the likelihood of depressive symptoms (OR = 2.18). Discussion and Conclusions: High rates of depression and functional dependence correlate with a low perception of quality of life, highlighting the need for research to promote and protect the health of older adults.
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Affiliation(s)
- César Fonseca
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal; (C.F.); (E.A.); (M.R.S.); (L.P.); (A.J.); (M.L.)
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- LA REAL, Associated Laboratory in Translation and Innovation Towards Global Health, University of Évora, 7000-801 Évora, Portugal
| | - Bruno Morgado
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal; (C.F.); (E.A.); (M.R.S.); (L.P.); (A.J.); (M.L.)
- Escola de Doctorat, Universitat Rovira i Virgili, 43005 Tarragona, Spain
| | - Elisabete Alves
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal; (C.F.); (E.A.); (M.R.S.); (L.P.); (A.J.); (M.L.)
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
| | - Ana Ramos
- Lisbon School of Nursing, 1600-190 Lisbon, Portugal;
- Nursing Research, Innovation and Development Centre of Lisbon, 1600-190 Lisbon, Portugal
| | - Maria Revés Silva
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal; (C.F.); (E.A.); (M.R.S.); (L.P.); (A.J.); (M.L.)
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
| | - Lara Pinho
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal; (C.F.); (E.A.); (M.R.S.); (L.P.); (A.J.); (M.L.)
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- LA REAL, Associated Laboratory in Translation and Innovation Towards Global Health, University of Évora, 7000-801 Évora, Portugal
| | - Ana João
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal; (C.F.); (E.A.); (M.R.S.); (L.P.); (A.J.); (M.L.)
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
| | - Manuel Lopes
- Comprehensive Health Research Centre, University of Évora, 7000-801 Évora, Portugal; (C.F.); (E.A.); (M.R.S.); (L.P.); (A.J.); (M.L.)
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- LA REAL, Associated Laboratory in Translation and Innovation Towards Global Health, University of Évora, 7000-801 Évora, Portugal
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17
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Baranes G, Hayek R, Gutman I, Frenkel-Toledo S, Springer S. Use of the Brief-BESTest partially instrumented with accelerometry to detect balance deterioration in middle-age. Aging Clin Exp Res 2024; 36:214. [PMID: 39520609 PMCID: PMC11550257 DOI: 10.1007/s40520-024-02868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 10/17/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND Most standardized balance tests cannot detect subtle balance deterioration in middle age, or identify those at higher risk for accelerated balance decline due to a ceiling effect. AIMS To determine whether the Brief Balance Evaluation Systems Test (Brief-BESTest), partially instrumented with accelerometry, can detect balance deterioration in middle age and identify individuals with poor balance. METHODS We studied young (25.3 ± 2.3 years), early middle-aged (47.7 ± 2.6 years), and late middle-aged adults (60.6 ± 3.6 years), with 25 participants in each age group. Subjects wore an accelerometer on their lower back while performing the Brief-BESTest. Balance measurements included the Brief-BESTest total and sub-measures scores, and postural sway during the Brief-BESTest standing tasks, calculated by the 95% confidence ellipse trajectory of the center of mass (COM-95% ellipse). RESULTS Compared to the two middle-aged groups, young adults had better total Brief-BESTest and sub-measures scores, apart from the Stability-in-Gait sub-measure, and less postural sway during the Sensory-Orientation sub-measure. The total Brief-BESTest scores as well as the Biomechanical-Constraints and Sensory-Orientation sub-measures differed also between early and late middle-aged adults. Both the Brief-BESTest total scores and the Sensory-Orientation postural sway values demonstrated increased variation with age, allowing to identify subjects with poor balance. A moderate negative correlation (r = -0.43) was found between the Brief-BESTest total score and the COM-95% ellipse size, and a moderate agreement (k = 0.56) in identifying subjects with poor performance in the early but not the late middle age group. CONCLUSIONS The Brief-BESTest test combined with accelerometry could be a suitable screening tool to identify middle-aged people with early balance deterioration and potentially identify those with poor balance and a possible higher risk for falls. Clinicians and policymakers can use our findings to implement balance assessment programs in patients < 65 years, leading to preventive strategies before the risk increases.
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Affiliation(s)
- Guy Baranes
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel
| | - Roee Hayek
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel
| | - Itai Gutman
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel
| | - Silvi Frenkel-Toledo
- Faculty of Health Sciences, Department of Physical Therapy, Brain and Motor Behavior Laboratory, Ariel University, Ariel, Israel
| | - Shmuel Springer
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel.
- Research Associate Canadian Center for Activity and Ageing, University of Western Ontario, London, ON, N6A 3K7, Canada.
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18
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Eladl HM, Ali OI, Abdelraouf OR, Ibrahim ZM, Bin Sheeha B, Alabas AM, Alzare SH, Amin WM. The Additional Effect of Neurodynamic Slump and Suboccipital Muscle Inhibition to Passive Stretching of the Short Hamstring: A Single-Blind, Randomized Controlled Trial. Healthcare (Basel) 2024; 12:2152. [PMID: 39517364 PMCID: PMC11545579 DOI: 10.3390/healthcare12212152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 10/22/2024] [Accepted: 10/25/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND/OBJECTIVES Hamstring shortening is a significant musculoskeletal condition affecting the posture and mobility of the spine and lower extremities. This study examined the impact of incorporating neurodynamic slump stretch and suboccipital muscle inhibition into passive static stretching on hamstring flexibility in individuals with short hamstrings. METHODS 117 female participants were classified into three groups: the control group, which received passive static stretch of the hamstring muscle; the neurodynamic slump group, which received neurodynamic slump stretch with passive static stretch; and the suboccipital muscle inhibition group, which received suboccipital muscle inhibition with passive static stretch, for three sessions a week, 10 min each, for four weeks. The outcome measures were the popliteal angle test (PAT), straight leg raising (SLR) test, and forward bending test (FBT) at baseline, immediately following the first session and after four weeks. RESULTS Statistically significant differences were found within groups (p < 0.001) for all outcome measures. Between the groups, there was a more significant improvement in the PAT and the SLR tests, favoring the neurodynamic slump and suboccipital muscle inhibition groups in comparison with the passive static stretch group (p < 0.001) with no significant difference between the two groups after the first session and at four weeks of treatment. However, the FBT showed no significant differences immediately following the first session or at four weeks of treatment (p > 0.05). CONCLUSIONS This study found that incorporating neurodynamic slump stretch and suboccipital muscle inhibition into passive static stretch techniques effectively treats short hamstrings in healthy individuals.
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Affiliation(s)
- Hadaya M. Eladl
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Science, Jouf University, Sakaka 2014, Saudi Arabia; (H.M.E.); (A.M.A.)
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Olfat Ibrahim Ali
- Physical Therapy Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia; (O.I.A.); (O.R.A.)
- Departement of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Osama R. Abdelraouf
- Physical Therapy Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia; (O.I.A.); (O.R.A.)
| | - Zizi M. Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | - Bodor Bin Sheeha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | - Alaa Mohammed Alabas
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Science, Jouf University, Sakaka 2014, Saudi Arabia; (H.M.E.); (A.M.A.)
| | - Sara H. Alzare
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Science, Jouf University, Sakaka 2014, Saudi Arabia; (H.M.E.); (A.M.A.)
| | - Wafaa Mahmoud Amin
- Department of Physical Therapy, College of Nursing and Health Sciences, Jazan University, Jazan 45142, Saudi Arabia;
- Basic Science Departement for Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt
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19
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Rezaei A, Bhat SG, Cheng CH, Pignolo RJ, Lu L, Kaufman KR. Age-related changes in gait, balance, and strength parameters: A cross-sectional study. PLoS One 2024; 19:e0310764. [PMID: 39441815 PMCID: PMC11498712 DOI: 10.1371/journal.pone.0310764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 09/05/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Longevity is increasing worldwide due to improvements in healthcare and living standards. Aging is often associated with disability and multiple health concerns. To address these challenges, effective interventions are essential. This study investigated potential age-related declines in gait, balance, and strength. We also sought to assess any relationships between these three parameters and explore potential differences between women and men. METHODS Healthy individuals over 50 years of age were recruited for this cross-sectional study. Upper extremity (grip) strength and lower extremity (knee) strength of the dominant side were measured. Static balance was performed on the force plate in different situations each for 30 seconds: bilateral stance with eyes open, bilateral stance with eyes closed, as well as dominant leg and non-dominant leg unilateral stance with eyes open. Gait was measured during level walking using an optical motion capture system. Additionally, the dynamic stability margin (DSM) was calculated for the level walking trials. RESULTS The study results indicated that gait parameters were not significantly affected by age (p≥0.12), while knee and grip strength, along with several balance parameters, showed a significant decline with age. All individuals were able to maintain their bipedal balance, but their center of pressure movement increased significantly by age (p≤0.028). Z-scores were calculated to compare significant age parameters. Unipedal stance time was found to be the most affected by age compared to other contributing factors (p≤0.001). The duration of unipedal balance showed the most significant change per decade (non-dominant: -0.62 SDs; dominant: -0.53 SDs), while strength measures exhibited the lowest amount of change per decade (grip strength: -0.34 SDs; knee strength: -0.26 SDs). Sex differences were observed exclusively in strength parameters, with no discernible impact on the decline in balance parameters. CONCLUSIONS These findings suggest that the duration of unipedal stance can serve as a reliable and gender-independent measure of neuromuscular aging for both elderly male and female subjects.
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Affiliation(s)
- Asghar Rezaei
- Department of Orthopedic Surgery, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America
| | - Sandesh G. Bhat
- Department of Orthopedic Surgery, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, United States of America
| | - Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Linkou, Taoyuan, Taiwan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Robert J. Pignolo
- Department of Medicine, Divisions of Geriatric Medicine and Gerontology, Endocrinology and Hospital Internal Medicine, and the Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Lichun Lu
- Department of Orthopedic Surgery, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America
| | - Kenton R. Kaufman
- Department of Orthopedic Surgery, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America
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20
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Liljegren M, Bengtsson A, Lindahl G, Wijk H. Older Adults' Needs and Wishes for Contact With the Outdoors at Residential Care Facilities: Implications for Theory and Practice. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:132-149. [PMID: 39444333 DOI: 10.1177/19375867241276296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024]
Abstract
Aim: This qualitative study aimed to explore needs and wishes of older adults concerning their perceived need for contact with outdoor environments at residential care facilities (RCFs) and what implications it has for theory and practice. Background: There is increased awareness of the importance of health-promoting everyday environments for persons with special needs. Therefore, it is important to include the experiences of older adults at RCFs in research. Methods: Twelve older adults from three Swedish RCFs participated in semistructured walking interviews. Results: Two categories were identified concerning the needs and wishes of older adults for contact with outdoor environments. The first category, Outdoor environments as part of everyday life, describes aspects of normality linked to outdoor stays at RCFs. The second category, Getting outdoors in practice, describes supportive and hindering aspects of outdoor stays, as well as accessibility regarding different body positions and access to personal support. Conclusion: It was found in this study that the needs and wishes of older adults are important to consider to increase their opportunities for outdoor stays. Their needs and wishes could also be included in briefs and programs for the design and planning of new construction or refurbishment of RCFs. The results of the study can serve as the basis for further discussions concerning older adults' outdoor stays and the accessibility of outdoor environments. Further, the results are intended to facilitate practical knowledge that is useful for care workers and managers at RCFs and to support decision makers, property developers, architects, and planners.
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Affiliation(s)
- Madeleine Liljegren
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Anna Bengtsson
- Department of People and Society, The Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Göran Lindahl
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
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21
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Leroux A, Cui E, Smirnova E, Muschelli J, Schrack JA, Crainiceanu CM. NHANES 2011-2014: Objective Physical Activity Is the Strongest Predictor of All-Cause Mortality. Med Sci Sports Exerc 2024; 56:1926-1934. [PMID: 38949152 PMCID: PMC11402588 DOI: 10.1249/mss.0000000000003497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
INTRODUCTION Objectively measured physical activity (PA) is a modifiable risk factor for mortality. Understanding the predictive performance of PA is essential to establish potential targets for early intervention to reduce mortality among older adults. METHODS The study used a subset of the National Health and Nutrition Examination Survey (NHANES) 2011-2014 data consisting of participants 50 to 80 yr old ( n = 3653, 24297.5 person-years of follow-up, 416 deaths). Eight accelerometry-derived features and 14 traditional predictors of all-cause mortality were compared and ranked in terms of their individual and combined predictive performance using the 10-fold cross-validated concordance (C) from Cox regression. RESULTS The top 3 predictors of mortality in univariate analysis were PA related: average Monitor-Independent Movement Summary (MIMS) in the 10 most active hours (C = 0.697), total MIMS per day (C = 0.686), and average log-transformed MIMS in the most 10 active hours of the day (C = 0.684), outperforming age (C = 0.676) and other traditional predictors of mortality. In multivariate regression, adding objectively measured PA to the top performing model without PA variables increased concordance from C = 0.776 to C = 0.790 ( P < 0.001). CONCLUSIONS These findings highlight the importance of PA as a risk marker of mortality and are consistent with prior studies, confirming the importance of accelerometer-derived activity measures beyond total volume.
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Affiliation(s)
- Andrew Leroux
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO
| | - Erjia Cui
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Ekaterina Smirnova
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - John Muschelli
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Jennifer A. Schrack
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Ciprian M. Crainiceanu
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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22
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Shuman V, VanSwearingen JM, Perera S, Mangione KK, Freburger JK, Brach JS. Characteristics associated with gait speed improvements from walking interventions for older adults: A responder analysis. Gait Posture 2024; 114:263-269. [PMID: 39427359 DOI: 10.1016/j.gaitpost.2024.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 09/06/2024] [Accepted: 10/13/2024] [Indexed: 10/22/2024]
Abstract
BACKGROUND Some older adults benefit to a great degree from walking interventions and others experience little improvement. Understanding the personal characteristics associated with greater treatment response to different interventions could assist clinicians in providing patients with matched interventions to optimize both outcomes and resource use. RESEARCH QUESTION What personal characteristics are associated with improved gait speed for older adults participating in walking interventions? METHODS This was a secondary analysis of 236 older adults from a trial comparing "Standard" (lower-extremity strength and walking endurance) to "Plus" (additional task-specific training for walking) interventions on gait speed in older adults (≥65 years). Predictors included sociodemographic characteristics, health status, physical performance, and self-reported function. We fitted linear regression models to 12-week change in gait speed. RESULTS Predictors of improved gait speed in Standard group included: younger age (β=-0.015), lower BMI (β=-0.005), slower gait speed (β=-0.015), longer Figure 8 Walk time (β=0.010), and higher Late Life Function and Disability Instrument scores (β=0.003). The parsimonious set of multivariable predictors were never married (β=0.081), not a caregiver (β=0.208), no cancer history (β=-0.052), slower chair rise times (β=0.010), slower gait speed (β=-0.021), and better overall function and disability (β=0.006). Predictors of improved gait speed in Plus group included: lower BMI (β=-0.004), farther Six-Minute Walk distance (β=0.014), and greater modified Gait Efficacy Scale (β=0.002). The parsimonious set of multivariable predictors were increased age (β=0.026), no cardiovascular disease (β=0.137), greater total physical activity counts per day (β=0.003), slower baseline gait speed (β=-0.072), and longer Six-Minute Walk distance (β=0.054). SIGNIFICANCE Those with the combination of suboptimal physical performance and strong self-report of function may benefit from standard strength and conditioning. Individuals may best respond to task-specific training when health status and physical performance are suboptimal and not overtly compromised. Matching interventions with personal characteristics may enhance efficacy of treatments to improve walking in older adults.
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Affiliation(s)
- Valerie Shuman
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
| | | | - Subashan Perera
- Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Janet K Freburger
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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23
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Ji Y, Cho J, Xiang X. Activity Limitations and Depression Among Middle-Aged and Older Adults in China: The Moderating Impact of Assistance Adequacy. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:1013-1029. [PMID: 38600793 DOI: 10.1080/01634372.2024.2340739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 04/04/2024] [Indexed: 04/12/2024]
Abstract
This study aimed to examine the risk and protective factors associated with depression in middle-aged and older Chinese adults with activity limitations. Data were obtained from the 2018 Wave 4 Survey of the China Health and Retirement Longitudinal Study. In the logistic regression analysis, health and functioning, losing a child, and a perceived lack of future assistance with daily activities increased the odds of depression. Conversely, receiving adequate assistance with daily activities lessened the depressive impacts of activity limitations, as indicated by a significant interaction effect. Enhanced long-term support for individuals with disabilities is necessary to improve mental health.
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Affiliation(s)
- Yuanyuan Ji
- School of Management, Nanjing Audit University Jinshen College, Nanjing, China
| | - Joonyoung Cho
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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24
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Elliott J, Green J. Are physical activity and everyday mobility independently associated with quality of life at older age? AGING AND HEALTH RESEARCH 2024; 4:None. [PMID: 39309682 PMCID: PMC11413527 DOI: 10.1016/j.ahr.2024.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 08/16/2024] [Accepted: 08/27/2024] [Indexed: 09/25/2024] Open
Abstract
Background Physical activity and everyday mobility are concepts that overlap but tend to be located in different disciplinary fields. We used the English Longitudinal Study of Ageing (ELSA) to: identify whether physical activity and everyday mobility are separate constructs at younger (60-69) and/or older (>=70) age bands, and for men and women; derive measures of the two constructs from variables in the ELSA; and assess whether they are independently associated with quality of life (QoL). Methods We derived composite measures for physical activity and everyday mobility from ELSA variables. 'Physical Activity' combined items recording directly-measured activity for movement (walk-speed) and self-report measures of physical mobility difficulties and amount of vigorous, moderate and mild physical activity undertaken. 'Everyday Mobility' combined self-report responses about activities likely to involve leaving the house. QoL was measured using the 'CASP-19' scale. Using Wave 9 of ELSA (data collection in 2018-2020), we used a factor analysis to explore the constructs, and a regression analysis to examine associations with QoL. Results The factor analysis confirmed that these were discrete constructs, which explained between them 36% of the variance. This was robust across age bands, and in factor analyses for men and women separately. The regression analysis identified that lower physical activity and everyday mobility are independently associated with lower QoL, when controlling for a range of contextual variables including age. Conclusions Findings suggest that a social model of QoL at older age should focus on the broader mobility determinants of QoL as well as individual levels of physical activity.
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Affiliation(s)
- Jane Elliott
- International Inequalities Institute, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
- Department of Social and Political Sciences, Philosophy and Anthropology, University of Exeter, Exeter EX4 4RJ, UK
| | - Judith Green
- Wellcome Centre for Cultures & Environments of Health, University of Exeter, Exeter, UK
- Department of Social and Political Sciences, Philosophy and Anthropology, University of Exeter, Exeter EX4 4RJ, UK
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25
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Rusu ME, Bigman G, Ryan AS, Popa DS. Investigating the Effects and Mechanisms of Combined Vitamin D and K Supplementation in Postmenopausal Women: An Up-to-Date Comprehensive Review of Clinical Studies. Nutrients 2024; 16:2356. [PMID: 39064799 PMCID: PMC11279569 DOI: 10.3390/nu16142356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/11/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Aging is a complex process and a significant risk factor for chronic diseases. Menopause, a component of aging in women, is associated with several important cardiometabolic conditions including metabolic syndrome, osteoporosis, and cardiovascular diseases. Menopausal women could benefit from preventative strategies that may decrease morbidity and mortality and improve their quality of life. Vitamins D and K are essential nutrients required for bone health, immune function, and reducing cardiovascular risks, yet their synergistic effect is less understood in aging women. This is the first comprehensive review to summarize the evidence found in randomized clinical trials of the beneficial effects of vitamin D and K co-treatment in postmenopausal women. In our literature search across key electronic databases such as Cochrane, PubMed, and Ovid, we identified 31 pertinent studies. Overall, significant findings indicate that the combined intake of vitamins D and K may positively affect cardiovascular and bone health in postmenopausal women, emphasizing the importance of maintaining a healthy diet rich in vegetables and fermented dairy products. Given the challenges in obtaining all necessary nutrients solely through the diet, vitamin D and K supplements are recommended for postmenopausal women to promote healthy aging and well-being.
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Affiliation(s)
- Marius Emil Rusu
- Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Galya Bigman
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Alice S. Ryan
- Baltimore Veterans Affairs Medical Center, Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Baltimore Geriatric Research, Education and Clinical Center, Veterans Affairs Maryland Health Care System, Baltimore, MD 21201, USA
| | - Daniela-Saveta Popa
- Department of Toxicology, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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Fry D, McIntire RK, Kondo MC. Understanding perceived park access and physical activity among older adults: A structural equation modeling approach. Health Place 2024; 88:103258. [PMID: 38759578 DOI: 10.1016/j.healthplace.2024.103258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/16/2024] [Accepted: 04/26/2024] [Indexed: 05/19/2024]
Abstract
Parks can provide a low-cost setting for safe physical activity, but older adults are underrepresented among park users in the United States. Using data from a population-representative survey in 2015 and 2018 among adults aged 60 years and older living in Philadelphia, we tested whether perceived access was a mechanism by which objectively-measured park access predicted self-reported physical activity. After controlling for individual-level factors and neighborhood characteristics, we found a statistically significant pathway from overall park area and within-park tree canopy to increased physical activity, mediated by perceived park access. These results highlight the importance of tree canopy for older adult park access and physical activity.
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Affiliation(s)
- Dustin Fry
- USDA Forest Service Northern Research Station, Philadelphia Field Station, 100 N 20th Street Ste 405, Philadelphia, PA, 19103, USA.
| | - Russell K McIntire
- Lehigh University College of Health, Department of Community and Population Health, USA
| | - Michelle C Kondo
- USDA Forest Service Northern Research Station, Philadelphia Field Station, 100 N 20th Street Ste 405, Philadelphia, PA, 19103, USA
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Luppa M, Pabst A, Löbner M, Mallon T, Brettschneider C, Hajek A, Heser K, Kleineidam L, Weyerer S, Werle J, Pentzek M, Weeg D, Mösch E, Wiese B, Oey A, Wagner M, Maier W, Scherer M, König HH, Riedel-Heller SG. Age-specific risk factors of depression among the oldest-old - evidence from the multicenter AgeCoDe-AgeQualiDe study. Front Psychiatry 2024; 15:1367225. [PMID: 38919640 PMCID: PMC11196990 DOI: 10.3389/fpsyt.2024.1367225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/13/2024] [Indexed: 06/27/2024] Open
Abstract
Purpose The present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups. Methods Data were derived from a prospective multicenter cohort study conducted in primary care - the AgeCoDe/AgeQualiDe study. In total, 2,436 patients 75 years and older were followed from baseline to ninth follow-up. To assess depressive symptoms, the short version of the Geriatric Depression Scale (GDS-15, cutoff score 6) was used. Age-specific competing risk regressions were performed to analyze risk factors for incident depressive symptoms in different age groups (75 to 79, 80 to 84, 85+ years), taking into account the accumulated mortality. Results The age-specific incidence rate of depression was 33 (95% CI 29-38), 46 (95% CI 40-52) and 63 (95% CI 45-87) per 1,000 person years for the initial age groups 75 to 79, 80 to 84 and 85+ years, respectively. In competing risk regression models, female sex, mobility as well as vision impairment, and subjective cognitive decline (SCD) were found to be risk factors for incident depression for age group 75 to 79, female sex, single/separated marital status, mobility as well as hearing impairment, and SCD for age group 80 to 84, and mobility impairment for age group 85+. Conclusion Depressive symptoms in latest life are common and the incidence increases with increasing age. Modifiable and differing risk factors across the highest age groups open up the possibility of specifically tailored prevention concepts.
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Affiliation(s)
- Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg, Eppendorf, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg, Eppendorf, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg, Eppendorf, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty, Mannheim, Germany
| | - Michael Pentzek
- Institute of Family Practice (ifam), Medical Faculty, University of Duisburg, Essen, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg, Eppendorf, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg, Eppendorf, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
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Sahoo DP, Sahoo SS, Nirala SK, Rath RS, Agarwal N, Panda M, Kakkar R, Pandey S, Singh CM, Joshi HS, Nath B. Validation of the Indian (Hindi) version of the life-space assessment scale among community-dwelling older adults: a multicentric cross-sectional study. BMC Geriatr 2024; 24:500. [PMID: 38844833 PMCID: PMC11157764 DOI: 10.1186/s12877-024-05072-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The Life-Space Assessment (LSA) is an instrument that measures mobility in older adults as they reach different areas, defined as life-spaces extending from home to beyond towns or regions. The purpose of the study was to develop the Hindi version of the LSA (LSA- H) and to investigate the validity and reliability of the Hindi version as well as its cultural adaptation. METHODS A cross-sectional study of two hundred forty-five older adults participated in the study from four different study practice areas. Following forward backwards translation, the LSA-H was developed, and the scores were correlated with those of the Activities-Specific Balance Confidence Scale Hindi (ABC- H), the Physical Health Subscale of the WHO-BREF Questionnaire and the Geriatric Depression Scale: Short Form Hindi (GDS-SFH) to test the criterion and concurrent validity. RESULTS The mean score and standard deviation of the LSA-H questionnaire were 56.53 ± 35.99, those of the Physical Health Subscale of the WHO-BREF instrument were 18.54 ± 7.87, those of the GDS-SFH questionnaire were 6.95 ± 4.21 and those of the ABC- H questionnaire were 54.40 ± 28.96. The Pearson correlation coefficient (r) between the LSA-H score and ABC-H score was 0.707 (p value < 0.0001), that between the LSA-H score and the Physical Health Subscale of the WHO-BREF was 0.766 (p value < 0.0001), and that between the LSA-H score and GDS-SFG score was - 0.674 (p value < 0.0001). CONCLUSION This study demonstrated that the Hindi version of the LSA is a valid and reliable instrument for assessing living space among older adults in the Hindi language in an Indian population. Furthermore, the LSA-H was significantly correlated with other health assessment tools in terms of functional mobility, general health status and mental well-being.
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Affiliation(s)
- Durgesh Prasad Sahoo
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India.
| | - Soumya Swaroop Sahoo
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Santosh Kumar Nirala
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Rama Shankar Rath
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Neeraj Agarwal
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Meely Panda
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Rakesh Kakkar
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Sanjay Pandey
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - C M Singh
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Hari Shanker Joshi
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Bhola Nath
- Dept. of Community Medicine, All India Institute of Medical Sciences, Raebareli, India
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Gudenkauf LM, Hathaway CA, Carroll JE, Small BJ, Li X, Hoogland AI, Castro E, Armaiz-Pena GN, Oswald LB, Jim HS, Tworoger SS, Gonzalez BD. Inequities in the Impacts of Hurricanes and Other Extreme Weather Events for Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2024; 33:771-778. [PMID: 38385842 PMCID: PMC11147728 DOI: 10.1158/1055-9965.epi-23-1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/12/2024] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
In this minireview, we examine the impacts of hurricanes and other extreme weather events on cancer survivors, focusing on structural and social determinants of health. We briefly explore influences on biological, psychosocial, and behavioral outcomes and discuss risk and resilience factors in cancer survivorship during and after hurricanes. Our goal is to inform future directions for research that can identify areas in which we can most efficiently improve cancer outcomes and inform changes in health systems, clinical practice, and public health policies. This timely minireview provides researchers and clinicians with an overview of challenges and opportunities for improving disaster preparedness and response for cancer survivors.
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Affiliation(s)
- Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | | | - Judith E. Carroll
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, CA, United States
| | - Brent J. Small
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Eida Castro
- School of Behavior and Brain Sciences, Ponce Health Sciences University, Ponce, PR, United States
| | - Guillermo N. Armaiz-Pena
- Department of Basic Sciences, Division of Pharmacology, School of Medicine, Ponce Health Sciences University, Ponce, PR, United States
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
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Ide K, Yamato Y, Hasegawa T, Yoshida G, Hanada M, Banno T, Arima H, Oe S, Yamada T, Watanabe Y, Kurosu K, Hoshino H, Niwa H, Togawa D, Matsuyama Y. Implications of the diagnosis of locomotive syndrome stage 3 for long-term care. Osteoporos Sarcopenia 2024; 10:89-94. [PMID: 39035232 PMCID: PMC11260008 DOI: 10.1016/j.afos.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/10/2024] [Accepted: 05/06/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives Locomotive syndrome stage 3 (LS3), which has been established recently, may imply a greater need for care than LS stage 0 (LS0), LS stage 1 (LS1), and LS stage 2 (LS2). The relationship between LS3 and long-term care in Japan is unclear. Therefore, this study aimed to examine this relationship. Methods A total of 531 patients (314 women and 217 men; mean age, 75 years) who were not classified as requiring long-term care and underwent musculoskeletal examinations in 2012 were grouped according to their LS stage. Group L comprised patients with LS3 and Group N comprised those with LS0, LS1, and LS2. We compared these groups according to their epidemiology results and long-term care requirements from 2013 to 2018. Results Fifty-nine patients (11.1%) were diagnosed with LS3. Group L comprised more patients (50.8%) who required long-term care than Group N (17.8%) (P < 0.001). Group L also comprised more patients with vertebral fractures and knee osteoarthritis than Group N (33.9% vs 19.5% [P = 0.011] and 78% vs 56.4% [P < 0.001], respectively). A Cox proportional hazards model and Kaplan-Meier analysis revealed a significant difference in the need for nursing care between Groups L and N (log-rank test, P < 0.001; hazard ratio, 2.236; 95% confidence interval, 1.451-3.447). Conclusions Between 2012 and 2018, 50% of patients with LS3 required nursing care. Therefore, LS3 is a high-risk condition that necessitates interventions. Approaches to vertebral fractures and osteoarthritis of the knee could be key.
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Affiliation(s)
- Koichiro Ide
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Yu Yamato
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomohiko Hasegawa
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Go Yoshida
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Mitsuru Hanada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomohiro Banno
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Hideyuki Arima
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Shin Oe
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Tomohiro Yamada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Yuh Watanabe
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Kenta Kurosu
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
| | - Hironobu Hoshino
- Department of Orthopaedic Surgery, Fujieda Municipal General Hospital, 4-1, Surugadai, Fujieda, Shizuoka, 426-0077, Japan
| | - Haruo Niwa
- Department of General Medicine, Toyonemura Medical Office, 24-1 Naganoda Kamikurogawa, Toyone-mura, Kitashitara-gun, Aichi, 449-0404, Japan
| | - Daisuke Togawa
- Department of Orthopaedic Surgery, Kindai University Nara Hospital, 1248-1 Otodacho, Ikoma, Nara, 630-0293, Japan
| | - Yukihiro Matsuyama
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka, 431-3125, Japan
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Shakya I, Beck LF, Cordier L, Dugan S, Underwood Y, Bergen G. Special Report from the CDC: Evaluating the dissemination of CDC's MyMobility Plan: Findings and lessons learned. JOURNAL OF SAFETY RESEARCH 2024; 89:354-360. [PMID: 38858060 PMCID: PMC11936463 DOI: 10.1016/j.jsr.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Age-related changes (e.g., cognitive, physiologic) can affect an individual's mobility and increase risks for falls and motor-vehicle crashes, which are leading causes of injuries and injury deaths among older Americans. To address this issue, CDC developed MyMobility Plan (MMP) products to help older adults make plans to reduce injury risks and promote safe mobility. In 2019, MMP products were disseminated to older adults and partner organizations. Dissemination strategies consisted of digital and print distribution and partner outreach. METHODS To assess dissemination efforts, a process (or implementation) evaluation was conducted from January to June 2019. Data were collected for 17 indicators (e.g., counts of webpage visits, product downloads, social media posts). Key informant interviews were conducted with partners, and qualitative analyses of interview data were undertaken to identify key themes related to their dissemination experiences. RESULTS Findings showed the dissemination resulted in 13,425 product downloads and print copy orders and reached almost 155,000 individuals through email subscriber lists, websites, webinars, and presentations. It is unknown what proportion of these individuals were older adults. Social media metrics were higher than expected, and 58 partners promoted products within their networks. Partner interviews emphasized the need for guidance on dissemination, collaboration with local partners, and integration of the products within a program model to ensure broader reach to and use by older adults. CONCLUSIONS The evaluation of the dissemination campaign identified strategies that were successful in creating exposure to the MMP and others that could improve reach in the future. Those strategies include meaningful and early partner engagement for dissemination. PRACTICAL APPLICATIONS Building in evaluation from the start can facilitate development of appropriate data collection measures to assess project success. Engaging partners as active disseminators in the planning stages can help increase the reach of public health tools and resources.
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Affiliation(s)
- Iju Shakya
- Oak Ridge Institute for Science and Education, ORISE Fellow, Oak Ridge, TN, United States; Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laurie F Beck
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - LeShaundra Cordier
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Susan Dugan
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yamile Underwood
- 2M Research. Contractor, Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gwen Bergen
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
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Hernandes ECR, Aliberti MJR, Guerra RO, Ferriolli E, Perracini MR. Intrinsic capacity and hospitalization among older adults: a nationally representative cross-sectional study. Eur Geriatr Med 2024; 15:843-852. [PMID: 38491314 DOI: 10.1007/s41999-024-00933-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/04/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Monitoring intrinsic capacity (IC) in community-dwelling older people can be potentially used to alert for adverse health outcomes. However, whether there is an association between IC and hospitalization has yet to be fully explored. This study aimed to investigate the association of the IC composite measure and its 5 domains with hospitalization in the previous year and length of hospital stay. METHODS We conducted cross-sectional analyses using data from a representative sample of community-dwelling adults (≥ 65 years). We assessed the IC domains (vitality, locomotor, cognitive, sensory, and psychological) using validated self-reported information and performance tests. We calculated standardized estimated scores (z scores) for IC composite measure and domains and conducted multivariate logistic and ordinal regressions. The primary outcomes were hospitalizations in the previous year and length of hospital stay. RESULTS In a sample of 5354 participants (mean age = 73 ± 6 years), we found that participants with high IC composite z scores were less likely to have experienced hospitalization in the previous year (OR = 0.51; 95% CI = 0.44-0.58). Among those who were hospitalized, high IC scores were associated with short stays (OR = 0.87; 95% CI = 0.80-0.95). Cognitive and psychological domains were associated with hospitalizations, and the locomotor domain was related to length of hospital stay. The vitality domain was associated with both outcomes. CONCLUSION IC as a composite measure was associated with previous hospitalizations and length of stay. IC can help clinicians identify older people prone to adverse outcomes, prompting preventive integrated care interventions.
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Affiliation(s)
- Elisângela Cristina Ramos Hernandes
- Masters' and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesáreo Galeno, 448, Tatuapé, São Paulo, 03071-000, Brazil
| | - Márlon Juliano Romero Aliberti
- Laboratorio de Investigaçao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas, Disciplina de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Research Institute, Hospital Sirio-Libanes, São Paulo, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Eduardo Ferriolli
- Laboratorio de Investigaçao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas, Disciplina de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Monica Rodrigues Perracini
- Masters' and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesáreo Galeno, 448, Tatuapé, São Paulo, 03071-000, Brazil.
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.
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Simon KE, Russell K, Mondino A, Yang CC, Case BC, Anderson Z, Whitley C, Griffith E, Gruen ME, Olby NJ. A randomized, controlled clinical trial demonstrates improved owner-assessed cognitive function in senior dogs receiving a senolytic and NAD+ precursor combination. Sci Rep 2024; 14:12399. [PMID: 38811634 PMCID: PMC11137034 DOI: 10.1038/s41598-024-63031-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024] Open
Abstract
Age-related decline in mobility and cognition are associated with cellular senescence and NAD + depletion in dogs and people. A combination of a novel NAD + precursor and senolytic, LY-D6/2, was examined in this randomized controlled trial. Seventy dogs with mild to moderate cognitive impairment were enrolled and allocated into placebo, low or full dose groups. Primary outcomes were change in cognitive impairment measured with the owner-reported Canine Cognitive Dysfunction Rating (CCDR) scale and change in activity measured with physical activity monitors. Fifty-nine dogs completed evaluations at the 3-month primary endpoint, and 51 reached the 6-month secondary endpoint. There was a significant difference in CCDR score across treatment groups from baseline to the primary endpoint (p = 0.02) with the largest decrease in the full dose group. No difference was detected between groups using in house cognitive testing. There were no significant differences between groups in changes in measured activity. The proportion of dogs that improved in frailty and owner-reported activity levels and happiness was higher in the full dose group than other groups, however this difference was not significant. Adverse events occurred equally across groups. All groups showed improvement in cognition, frailty, and activity suggesting placebo effect and benefits of trial participation. We conclude that LY-D6/2 improves owner-assessed cognitive function over a 3-month period and may have broader, but more subtle effects on frailty, activity and happiness as reported by owners.
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Affiliation(s)
- Katherine E Simon
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Katharine Russell
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Southeast Veterinary Neurology, Miami, FL, USA
| | - Alejandra Mondino
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Chin-Chieh Yang
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Beth C Case
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Zachary Anderson
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Christine Whitley
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Emily Griffith
- Department of Statistics, College of Sciences, North Carolina State University, Raleigh, NC, USA
| | - Margaret E Gruen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
- Comparative Medicine Institute, NC State University, Raleigh, NC, USA.
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de Lima ML, de Oliveira AA, Carneiro MAS, Silva SHA, de Queiroz Freitas AC, de Souza LRMF, Nomelini RS, Souza MVC, de Oliveira Assumpção C, Orsatti FL. Intramuscular adipose tissue, muscle area, and power as predictors of performance in breast cancer survivors. Support Care Cancer 2024; 32:380. [PMID: 38789606 DOI: 10.1007/s00520-024-08595-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 05/20/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE The decline in physical performance, assessed by physical tests such as the timed up and go (TUG) test, is a consequence of reduced physiological reserves at higher levels of a hierarchical process. This occurs due to changes in muscle architecture, including atrophy and fat infiltration into the muscles, which in turn lead to changes in muscle function, resulting in reduced muscle strength and power and, consequently, affecting physical performance. This study investigated predictive factors for physical performance in breast cancer survivor (BCS), focusing on intramuscular adipose tissue (IMAT), quadríceps muscle area (QMA), and muscular power. METHODS This observational, analytical, and cross-sectional study included 23 women without a history of cancer (age, 58.5 ± 8.3 years; BMI, 27.2 ± 5.1 kg/m2) and 56 BCS (age, 58.5 ± 8.3 years; BMI, 27.2 ± 5.1 kg/m2). QMA and IMAT were assessed using computed tomography images. Muscular power and physical performance were measured using the 5-repetition sit-to-stand and TUG tests, respectively. RESULTS IMAT (r = 0.4, P < 0.01) and muscular power (r = - 0.4, P < 0.01) were associated with TUG performance in BCS, whereas QMA (r = - 0.22, P = 0.10) showed no significant association. QMA (r = 0.55, P < 0.01) was associated with muscular power, while no significant association was found between IMAT and muscular power (r = - 0.05, P = 0.73). Age explained 19% (P < 0.01) of TUG performance variability. Adding muscular power increased explanatory power by 12% (P < 0.01), and including IMAT further increased it by 7% (P = 0.02) for TUG performance. Collectively, age, muscular power, and IMAT accounted for 38% of the performance variance in the TUG test (age, B = 0.06, P = 0.043; muscular power, B = - 0.01, P = 0.002; IMAT, B = - 0.05, P = 0.020). CONCLUSIONS Our findings suggest that IMAT and muscular power predict the physical performance of BCS, while QMA does not have the same predictive capability.
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Affiliation(s)
- Mariana Luíza de Lima
- Applied Physiology, Nutrition and Exercise Research Group (PhyNER), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro (UFTM), Avenida Tutunas, 490, Uberaba, Minas Gerais, 38061-500, Brazil
| | - Anselmo Alves de Oliveira
- Department of Physical Education, University Center of the Plateau of Araxá, Araxá, Minas Gerais, Brazil
| | - Marcelo A S Carneiro
- Applied Physiology, Nutrition and Exercise Research Group (PhyNER), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro (UFTM), Avenida Tutunas, 490, Uberaba, Minas Gerais, 38061-500, Brazil
| | - Sebastião Henrique Assis Silva
- Applied Physiology, Nutrition and Exercise Research Group (PhyNER), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro (UFTM), Avenida Tutunas, 490, Uberaba, Minas Gerais, 38061-500, Brazil
| | - Augusto Corrêa de Queiroz Freitas
- Applied Physiology, Nutrition and Exercise Research Group (PhyNER), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro (UFTM), Avenida Tutunas, 490, Uberaba, Minas Gerais, 38061-500, Brazil
| | | | - Rosekeila Simões Nomelini
- Department of Ginecology and Obstetrics, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Markus Vinícius Campos Souza
- Applied Physiology, Nutrition and Exercise Research Group (PhyNER), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro (UFTM), Avenida Tutunas, 490, Uberaba, Minas Gerais, 38061-500, Brazil
- Department of Sport Science, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Cláudio de Oliveira Assumpção
- Applied Physiology, Nutrition and Exercise Research Group (PhyNER), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro (UFTM), Avenida Tutunas, 490, Uberaba, Minas Gerais, 38061-500, Brazil
- Department of Sport Science, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Fábio Lera Orsatti
- Applied Physiology, Nutrition and Exercise Research Group (PhyNER), Exercise Biology Research Lab (BioEx), Federal University of Triangulo Mineiro (UFTM), Avenida Tutunas, 490, Uberaba, Minas Gerais, 38061-500, Brazil.
- Department of Sport Science, Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
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Santagnello SB, Martins FM, de Oliveira Junior GN, de Sousa JDFR, Nomelini RS, Murta EFC, Orsatti FL. Resistance Training-Induced Gains in Muscle Strength and Power Mediate the Improvement in Walking Speed in Middle-Aged Women Who Are Breast Cancer Survivors. J Strength Cond Res 2024; 38:773-782. [PMID: 38354372 DOI: 10.1519/jsc.0000000000004020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
ABSTRACT Santagnello, SB, Martins, FM, de Oliveira Junior, GN, de Sousa, JdeFR, Nomelini, RS, Murta, EFC, and Orsatti, FL. Resistance training-induced gains in muscle strength and power mediate the improvement in walking speed in middle-aged women who are breast cancer survivors. J Strength Cond Res 38(4): 773-782, 2024-(a) Ascertain whether lower muscle mass, strength (1 repetition maximum [1RM]), and power (Pmax) in middle-aged women who are breast cancer survivors (BCS), when compared with women of a similar age never diagnosed with cancer (WNC), are related with lower walking speed (WS). (b) Ascertain whether changes in WS are associated with changes in muscle mass, 1RM, and (or) Pmax after resistance training (RT) in middle-aged BCS. A cross-section study was performed. Twenty WNC and 21 BCS were evaluated for lean mass of legs (LLM), 1RM (knee extension), muscle quality index (MQI = 1RM/LLM), Pmax (maximum muscle power-knee extension), and fast WS (10 and 400-meters). Randomized clinical trial was performed. The BCS were randomly divided into the control group ( n = 9) and the RT group ( n = 11). Breast cancer survivors exhibited lower 1RM (24.2%, p ˂ 0.001), Pmax (30.6%, p ˂ 0.001), MQI (22.2%, p = 0.001), and WS (10-m = 17.0%, p ˂ 0.001 and 400-m = 10.5%, p = 0.002) than WNC. Resistance training increased 1RM (31.6%, p = 0.001), MP (29.0%, p = 0.012), MQI (28.5%, p = 0.008), and WS (10-m = 9.4%, p = 0.009 and 400-m = 6.2%, p = 0.006) in BCS. The changes in WS were positively associated with 1RM (10-m = 68%, p = 0.001 and 400-m = 37%, p = 0.036) and Pmax (10-m = 56%, p = 0.005 and 400-m = 40%, p = 0.027) and MQI (10-m = 63%, p = 0.043 and 400-m = 37%, p = 0.035). Resistance training-induced gains in muscle strength and power mediate the improvement in WS in middle-aged BCS. Resistance training is an effective strategy to improve WS in middle-aged BCS.
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Affiliation(s)
- Samarita Beraldo Santagnello
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Fernanda Maria Martins
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Gersiel Nascimento de Oliveira Junior
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Jairo de Freitas Rodrigues de Sousa
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Rosekeila Simões Nomelini
- Research Institute of Oncology, Department of Gynecology and Obstetrics, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil; and
| | - Eddie Fernando Candido Murta
- Research Institute of Oncology, Department of Gynecology and Obstetrics, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil; and
| | - Fábio Lera Orsatti
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
- Department of Sport Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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Porto JM, Pieruccini-Faria F, Bandeira ACL, Bôdo JS, Abreu DCCD. Physical activity components associated with gait parameters in community-dwelling older adults. J Bodyw Mov Ther 2024; 38:67-72. [PMID: 38763617 DOI: 10.1016/j.jbmt.2023.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 10/07/2023] [Accepted: 11/19/2023] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To investigate the association between components of physical activity and spatiotemporal gait parameters in community-dwelling older adults. METHODS Cross-sectional study with 134 independent community-dwelling older adults. A questionnaire was applied to obtain information related to the components of physical activity (frequency, duration, modality, and history of physical activity in the life course) and the GAITRite System was used to quantify gait parameters. Three MANOVA models adjusted for potential confounders were conducted to identify associations between components of physical activity (predictors) and gait performance (outcome). RESULTS Higher weekly frequency but not daily hours of physical activity and sports practice (tennis, boxing, football, volleyball, and tai chi) were significantly associated with better gait performance, specifically gait speed and stride length. CONCLUSION Understanding the most effective components of physical activity to maintain functional capacity and independence in community-dwelling older adults, allowing for active aging, is essential for formulating more effective strategies.
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Affiliation(s)
- Jaqueline Mello Porto
- Program in Rehabilitation and Functional Performance, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
| | - Frederico Pieruccini-Faria
- Research Associate, Gait & Brain Lab, Lawson Health Research Institute, London, ON, Canada; Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, University of Western Ontario, London, ON, Canada
| | - Anne Caroline Lima Bandeira
- Program in Rehabilitation and Functional Performance, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Julia Silveira Bôdo
- Physical Therapy Program, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
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Batista PP, Perracini MR, do Carmo Correia de Lima M, de Amorim JSC, Pereira DS, Pereira LSM. Risk of sarcopenia and mobility of older adults during the COVID-19 pandemic: the longitudinal data from the REMOBILIZE study. Aging Clin Exp Res 2024; 36:80. [PMID: 38546804 PMCID: PMC10978643 DOI: 10.1007/s40520-024-02720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND We assessed whether clinical, functional and behavioral factors were associated with the decrease in mobility trajectories reported in older people at risk of sarcopenia (RS) and without risk of sarcopenia (NRS) during COVID-19 pandemic. METHODS We prospectively analyzed mobility trajectories reported in older adults with RS and NRS over 16-month follow-up (Remobilize study). The self-perceived risk of sarcopenia and mobility were assessed using the SARC-F and the Life-Space Assessment (LSA) tools, respectively. Gender, age, comorbidities, pain, functional limitation, physical activity (time spent in walking; min/week), and sitting time (ST; hours/day) were assessed. We used a multilevel model to determine changes in mobility between groups and over time. RESULTS Mobility was lower in RS than in NRS. Older people at RS, who were women, aged 70-79 years and 80 years or older, inactive, and with moderate to severe functional limitation experienced reduced mobility trajectories reported over the pandemic. For older people at NRS, trajectories with reduce mobility reported were experienced by women with comorbidities, for those with insufficient walking time and aged 70-79 years; aged 70-79 years and with ST between 5 and 7 hours/day; for those with insufficient walking time and increased ST; and for those with pain and increased ST. CONCLUSION Mobility trajectories reported in older people at risk of sarcopenia were negatively influenced by insufficient level of physical inactivity and pre-existing moderate to severe functional limitation. Health and social interventions should be target to avoid mobility limitation during and after the COVID-19 pandemic.
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Affiliation(s)
- Patricia Parreira Batista
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil.
| | - Monica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Maria do Carmo Correia de Lima
- Master's and Doctoral Programs in Gerontology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Daniele Sirineu Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil
| | - Leani Souza Máximo Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6.627. Pampulha, Belo Horizonte, MG, Brazil
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, MG, Brazil
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Jiroumaru T, Hyodo Y, Mori K, Hattori T, Wachi M, Shichiri N, Fujikawa T. Relationship between respiratory muscle strength and dynamic balance in older persons requiring care or support: Focusing on the maximal single step length test and maximal double step length test as dynamic balance indices. Gait Posture 2024; 109:64-69. [PMID: 38281431 DOI: 10.1016/j.gaitpost.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/10/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Falls are a major health problem. The relationship between dynamic balance related to falls and respiratory muscle strength related to sarcopenia and frailty is poorly understood. RESEARCH QUESTION How do dynamic balance measures, such as maximal single step length test (MSL) and maximal double step length test (MDST), and respiratory muscle strength measures, such as maximal inspiratory (PImax) and maximal expiratory (PEmax), related to the requirement for long-term care or support in older people who live in the community? METHODS This was a cross-sectional study of 39 older people (17 men, 22 women) aged ≥ 65 years community-dwelling who were certified as requiring long-term care or support under the Japanese system. The participants' PImax, PEmax, MSL, and MDST results were recorded. The measurement data were evaluated using Pearson's correlation coefficients and multiple regression analysis. RESULTS MDST showed a positive correlation with PImax (r = 0.430, p = 0.006) but no correlation with PEmax. MSL showed no correlation with PImax or PEmax. A positive correlation was found between MDST and MSL (r = 0.851, p < 0.001), and multiple regression analysis with MDST as the dependent variable and PImax and MST as independent variables showed significant differences for MSL (p < 0.001) and PImax (p = 0.027). SIGNIFICANCE In older people requiring long-term care or support, MDST had a greater association with inspiratory muscle strength compared with MSL. These results suggest the importance of inspiratory muscle strength training and MDST assessment in the prevention of falls in older people requiring long-term care or support.
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Affiliation(s)
- Takumi Jiroumaru
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, 7 Nishinokyohigashitoganocho, Kyoto Nakagyo-ku, Kyoto 604-8418, Japan.
| | - Yutaro Hyodo
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Kenji Mori
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Tomoka Hattori
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Michio Wachi
- Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
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Yuan Y, Chamberlin KW, Li C, Luo Z, Simonsick EM, Kucharska-Newton A, Chen H. Olfaction and Mobility in Older Adults. JAMA Otolaryngol Head Neck Surg 2024; 150:201-208. [PMID: 38236595 PMCID: PMC10797520 DOI: 10.1001/jamaoto.2023.4375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024]
Abstract
Importance Decreased mobility is a hallmark of aging. Olfactory dysfunction is common in older adults and may be associated with declines in mobility. Objective To determine whether poor olfaction was associated with faster declines in mobility in older adults. Design, Setting, and Participants This cohort study included 2500 participants from the Health, Aging, and Body Composition Study. Participants completed the Brief Smell Identification Test during the year 3 clinical visit (1999-2000) and were followed for up to 7 years. A data analysis was conducted between January and July 2023. Exposures Olfaction was defined as good (test score, 11-12), moderate (9-10), hyposmia (7-8), or anosmia (0-6). Main Outcomes and Measures Mobility was measured using the 20-m usual and fast walking tests in clinical visit years 3 to 6, 8, and 10 and the 400-m fast walking test in years 4, 6, 8, and 10. Results The primary analyses included 2500 participants (1292 women [51.7%]; 1208 men [48.3%]; 960 Black [38.4%] and 1540 White [61.6%] individuals; mean [SD] age, 75.6 [2.8] years). Multivariate-adjusted analyses showed that poor olfaction was associated with slower walking speed at baseline and a faster decline over time. Taking the 20-m usual walking test as an example, compared with participants with good olfaction, the speed at baseline was 0.027 (95% CI, 0-0.053) m/s slower for those with hyposmia and 0.034 (95% CI, 0.005-0.062) m/s slower for those with anosmia. Longitudinally, the annual decline was 0.004 (95% CI, 0.002-0.007) m/s/year faster for those with hyposmia and 0.01 (95% CI, 0.007-0.013) m/s/year faster for those with anosmia. Similar results were obtained for the 20-m and 400-m fast walking tests. Further, compared with participants with good olfaction, the odds of being unable to do the 400-m test were 2.02 (95% CI, 1.17-3.48) times higher for those with anosmia at the year 8 visit and 2.73 (95% CI, 1.40-5.35) times higher at year 10. Multiple sensitivity and subgroup analyses supported the robustness and generalizability of the findings. Conclusion and Relevance The results of this cohort study suggest that poor olfaction is associated with a faster decline in mobility in older adults. Future studies should investigate underlying mechanisms and potential health implications.
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Affiliation(s)
- Yaqun Yuan
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
| | - Keran W. Chamberlin
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
| | - Chenxi Li
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
| | - Eleanor M. Simonsick
- Laboratory of Epidemiology and Population Science, Intramural Research Program of the National Institutes of Health, National Institute on Aging, Bethesda, Maryland
| | - Anna Kucharska-Newton
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
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Tomaz GG, Souza MVC, Carneiro MADS, Lima MLD, Assumpção CO, Orsatti FL. Propulsive forces and muscle activation during gait: comparisons between premenopausal and postmenopausal midlife women. Menopause 2024; 31:194-201. [PMID: 38350040 DOI: 10.1097/gme.0000000000002318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
OBJECTIVE The aim of this study was to investigate whether there is a reduction in propulsive force during gait in postmenopausal women compared with premenopausal women. METHODS Forty-four women (21 premenopausal and 23 postmenopausal women) aged 40 to 55 years were selected. The ability to reach peak propulsive forces was assessed during the step execution test. The test was performed at the usual speed on 2 nonconsecutive days, with two attempts per day, using a force platform. Four temporal parameters were defined and calculated: initiation phase, preparation phase, swing phase, and total time. Peak force (anteroposterior and vertical) and time to reach peak force were obtained in both preparation and swing phases. The rate of force development was defined as peak force divided by time to reach peak force. RESULTS The postmenopausal women group presented a longer time in the preparation phase (540.6 ± 77 ms vs 482.5 ± 93 ms, P = 0.024) and consequently a longer total time in the step execution test (1,191 ± 106.4 ms vs 1,129 ± 114.3 ms, P = 0.045). There were differences between the groups for the rate of force development in the anteroposterior (postmenopausal women, 142.5 ± 38.1 N/s vs premenopausal women, 174.7 ± 70.5 N/s; P = 0.022) and vertical directions in the preparation phase (postmenopausal women, 102.7 ± 62.3 N/s vs premenopausal women, 145.3 ± 71 N/s; P = 0.012). No significant differences ( P > 0.05) were found in force, time to peak force, and rate of force development during the swing phase. In addition, there were no observed differences in surface electromyography of the medial and lateral gastrocnemius muscles during the preparation phase and swing phase of the step execution test between the two groups. CONCLUSIONS Postmenopausal women exhibited lower ability to generate propulsive force rapidly (rates of force development) in both the anteroposterior and vertical directions during the preparation phase of gait compared with premenopausal women. This indicates that postmenopausal women experience a reduction in propulsive force during gait.
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Affiliation(s)
- Giovanni Gondim Tomaz
- From the Applied Physiology, Nutrition and Exercise Research Group, Exercise Biology Research Lab, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | - Marcelo Augusto da Silva Carneiro
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Mariana Luíza de Lima
- From the Applied Physiology, Nutrition and Exercise Research Group, Exercise Biology Research Lab, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
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Kalu ME, Rayner D, Nwachukwu EC, Ibekaku MC, Ndukaku M, Ekezie UC, Ezema CI, Ikele C, Bhatt V, McArthur C. Comparison of Self-Reported and Capacity-Based Measures of Mobility in Community-Dwelling Older Adults in Nigeria: The Mediating Role of Age, Cognitive Status, and Chronic Conditions. Innov Aging 2024; 8:igae026. [PMID: 38628823 PMCID: PMC11020311 DOI: 10.1093/geroni/igae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Indexed: 04/19/2024] Open
Abstract
Background and Objectives Although the association between self-reported and capacity-based mobility outcomes is prominently researched, the pathways through which self-reported measures affect capacity-based measures remains poorly understood. Therefore, our study examines the association between self-reported and capacity-based mobility measures and explores which mobility determinants mediate the association in Nigerian community-dwelling older adults. Research Design and Methods This cross-sectional study included 169 older adults [mean age (SD) = 67.7 (7.0)]. Capacity-based mobility outcomes included the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), and the 10-Meter Walk Test (10mWT), whereas the self-reported mobility outcomes included the Lower Extremity Functional scale (LEFS), the Life Space Questionnaire (LSQ), and the Mänty Preclinical Mobility scale (inability to walk 2 km, 0.5 km, or climb a flight of stairs). Spearman's correlations were conducted to examine the relationship between self-reported and capacity-based mobility measures, whereas structural equation modeling was used to determine the mediators. Results The correlation between SPPB and LEFS (rho = 0.284) and 0.5 km (rho = -0.251) were fair, whereas the correlation between SPPB and inability to walk 2 km (rho = -0.244) and inability to climb a flight of stairs (rho = -0.190) were poor. Similarly, correlations between 6MWT and the LEFS (rho = 0.286), inability to walk 2 km (rho = -0.269), and 0.5 km (rho = -0.303) were fair. The 6WMT was poorly correlated with inability to climb one flight of stairs (rho = -0.233). The LSQ was not correlated with SPPB or 10mWT. Age was the only significant mediator, whereas the number of chronic conditions and cognitive status were not. Discussion and Implications The correlation between self-reported and capacity-based mobility outcomes in older adults in Nigeria is lower than those in developed countries. Our analysis provides a foundation to explore mobility determinants that could be predictive mediators for mobility outcomes, making meaningful contributions to explaining mobility complexities.
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Affiliation(s)
- Michael E Kalu
- Faculty of Health, School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- Emerging Researchers and Professionals in Ageing—African Network, Toronto, Canada
| | - Daniel Rayner
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Science, McMaster University, Hamilton, Canada
| | - Ernest C Nwachukwu
- Emerging Researchers and Professionals in Ageing—African Network, Toronto, Canada
| | - Michael C Ibekaku
- Emerging Researchers and Professionals in Ageing—African Network, Toronto, Canada
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Miracle Ndukaku
- Emerging Researchers and Professionals in Ageing—African Network, Toronto, Canada
| | - Uduonu C Ekezie
- Emerging Researchers and Professionals in Ageing—African Network, Toronto, Canada
- Department of Medical Rehabilitation, Faculty of Health Science and Technology, University of Nigeria, Enugu Campus, Nigeria
| | - Charles I Ezema
- Department of Medical Rehabilitation, Faculty of Health Science and Technology, University of Nigeria, Enugu Campus, Nigeria
| | - Chioma Ikele
- Department of Medical Rehabilitation, Faculty of Health Science and Technology, University of Nigeria, Enugu Campus, Nigeria
| | - Vidhi Bhatt
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
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Araya AX, Iriarte E, De Oliveira G, Baeza MJ, Jankowski C. Factors Related to the Need for Informal Care Among Community-Dwelling Older Adults in Chile. J Gerontol Nurs 2024; 50:43-52. [PMID: 38290095 DOI: 10.3928/00989134-20240111-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
PURPOSE To identify factors contributing to the need for informal care among community-dwelling older adults with functional impairment in Chile. METHOD A secondary data analysis was conducted using cross-sectional data from 540 Chilean older adults aged ≥60 years (mean age = 72.2 years, SD = 6.22 years). RESULTS Informal care need was reported by 24.3% (n = 131) of participants. Among the variables that most influenced the need for informal care among older adults were hospitalization in the past 1 year, functionality, comorbidities, and multidimensional frailty (all p < 0.05). CONCLUSION This study identified factors that clinicians and nurses should be aware of when caring for this population to prevent or manage the need for informal care. [Journal of Gerontological Nursing, 50(2), 43-52.].
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Stolz E, Mayerl H, Muniz-Terrera G, Gill TM. Terminal Decline in Physical Function in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glad119. [PMID: 37148208 PMCID: PMC10733182 DOI: 10.1093/gerona/glad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND It is currently unclear whether (and when) physical function exhibits a terminal decline phase, that is, a substantial acceleration of decline in the very last years before death. METHODS 702 deceased adults aged 70 years and older from the Yale PEP Study provided 4 133 measurements of physical function (Short Physical Performance Battery, SPPB) up to 20 years before death. In addition, continuous gait and chair rise subtest scores (in seconds) were assessed. Generalized mixed regression models with random change points were used to estimate the onset and the steepness of terminal decline in physical function. RESULTS Decline accelerated in the last years of life in all 3 measures of physical function. The onset of terminal decline occurred 1 year before death for the SPPB, and at 2.5 and 2.6 years before death for chair rise and gait speed test scores, respectively. Terminal declines in physical function were 6-8 times steeper than pre-terminal declines. Relative to those whose condition leading to death was frailty, participants who died from dementia and cancer had an up to 6 months earlier and 3 months later onset of terminal decline in SPPB, respectively. CONCLUSIONS Terminal decline in physical function among older adults is comparable to the more established terminal decline phenomenon in cognition. Our results provide additional evidence of late-life rapid decline in physical function due to impending death.
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Affiliation(s)
- Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Hannes Mayerl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Graciela Muniz-Terrera
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Manning KM, Hall KS, Sloane R, Magistro D, Rabaglietti E, Lee CC, Castle S, Kopp T, Giffuni J, Katzel L, McDonald M, Miyamoto M, Pearson M, Jennings SC, Bettger JP, Morey MC. Longitudinal analysis of physical function in older adults: The effects of physical inactivity and exercise training. Aging Cell 2024; 23:e13987. [PMID: 37681737 PMCID: PMC10776115 DOI: 10.1111/acel.13987] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
Lack of exercise contributes to systemic inflammation and is a major cause of chronic disease. The long-term impact of initiating and sustaining exercise in late life, as opposed to sustaining a sedentary lifestyle, on whole-body health measures such as physical performance is not well known. This is an exploratory study to compare changes in physical performance among older adults initiating exercise late in life versus inactive older adults. Data from two observational cohorts were included in this analysis, representing two activity groups. The Active group cohort comprises older adults (n = 318; age 72.5 ± 7.2 years) enrolled in a supervised exercise program, "Gerofit." The inactive group comprises older adults (n = 146; age 74.5 ± 5.5 years) from the Italian study "Act on Ageing" (AOA) who self-reported being inactive. Participants in both groups completed physical performance battery at baseline and 1-year including: 6-min walk test, 30-s chair stand, and timed up-and-go. Two-sample t-tests measured differences between Gerofit and AOA at baseline and 1-year across all measures. Significant between-group effects were seen for all performance measures (ps = 0.001). The AOA group declined across all measures from baseline to 1 year (range -18% to -24% change). The Gerofit group experienced significant gains in function for all measures (range +10% to +31% change). Older adults who initiated routine, sustained exercise were protected from age-related declines in physical performance, while those who remained sedentary suffered cumulative deficits across strength, aerobic endurance, and mobility. Interventions to reduce sedentary behaviors and increase physical activity are both important to promote multi-system, whole-body health.
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Affiliation(s)
- Kenneth M. Manning
- Geriatric Research, Education, and Clinical CenterVA Health Care SystemDurhamNorth CarolinaUSA
| | - Katherine S. Hall
- Geriatric Research, Education, and Clinical CenterVA Health Care SystemDurhamNorth CarolinaUSA
- Department of Medicine, Center for the Study of Aging/Claude D. Pepper Older Americans Independence CenterDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Richard Sloane
- Geriatric Research, Education, and Clinical CenterVA Health Care SystemDurhamNorth CarolinaUSA
- Department of Medicine, Center for the Study of Aging/Claude D. Pepper Older Americans Independence CenterDuke University Medical CenterDurhamNorth CarolinaUSA
| | | | | | - Cathy C. Lee
- Geriatric Research, Education, and Clinical CenterVA Greater Los Angeles Healthcare SystemLos AngelesCaliforniaUSA
- David Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Steven Castle
- Geriatric Research, Education, and Clinical CenterVA Greater Los Angeles Healthcare SystemLos AngelesCaliforniaUSA
- David Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | | | - Jamie Giffuni
- Geriatric Research, Education and Clinical CenterVA Maryland Health Care SystemBaltimoreMarylandUSA
| | - Leslie Katzel
- Geriatric Research, Education and Clinical CenterVA Maryland Health Care SystemBaltimoreMarylandUSA
- School of MedicineUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Michelle McDonald
- Geritaric Rehabilitation and Clinical CenterVA Pacific Health Care SystemHonoluluHawaiiUSA
| | - Miles Miyamoto
- Geritaric Rehabilitation and Clinical CenterVA Pacific Health Care SystemHonoluluHawaiiUSA
| | - Megan Pearson
- Geriatric Research, Education, and Clinical CenterVA Health Care SystemDurhamNorth CarolinaUSA
| | - Stephen C. Jennings
- Geriatric Research, Education, and Clinical CenterVA Health Care SystemDurhamNorth CarolinaUSA
| | - Janet Prvu Bettger
- Department of Orthopedic SurgeryDuke University Medical CenterDurhamNorth CarolinaUSA
- Roybal CenterDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Miriam C. Morey
- Geriatric Research, Education, and Clinical CenterVA Health Care SystemDurhamNorth CarolinaUSA
- Department of Medicine, Center for the Study of Aging/Claude D. Pepper Older Americans Independence CenterDuke University Medical CenterDurhamNorth CarolinaUSA
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McMurran CE, Wang Y, Mak JKL, Karlsson IK, Tang B, Ploner A, Pedersen NL, Hägg S. Advanced biological ageing predicts future risk for neurological diagnoses and clinical examination findings. Brain 2023; 146:4891-4902. [PMID: 37490842 PMCID: PMC10690013 DOI: 10.1093/brain/awad252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/15/2023] [Accepted: 07/04/2023] [Indexed: 07/27/2023] Open
Abstract
Age is a dominant risk factor for some of the most common neurological diseases. Biological ageing encompasses interindividual variation in the rate of ageing and can be calculated from clinical biomarkers or DNA methylation data amongst other approaches. Here, we tested the hypothesis that a biological age greater than one's chronological age affects the risk of future neurological diagnosis and the development of abnormal signs on clinical examination. We analysed data from the Swedish Adoption/Twin Study of Aging (SATSA): a cohort with 3175 assessments of 802 individuals followed-up over several decades. Six measures of biological ageing were generated: two physiological ages (created from bedside clinical measurements and standard blood tests) and four blood methylation age measures. Their effects on future stroke, dementia or Parkinson's disease diagnosis, or development of abnormal clinical signs, were determined using survival analysis, with and without stratification by twin pairs. Older physiological ages were associated with ischaemic stroke risk; for example one standard deviation advancement in baseline PhenoAgePhys or KDMAgePhys residual increased future ischaemic stroke risk by 29.2% [hazard ratio (HR): 1.29, 95% confidence interval (CI) 1.06-1.58, P = 0.012] and 42.9% (HR 1.43, CI 1.18-1.73, P = 3.1 × 10-4), respectively. In contrast, older methylation ages were more predictive of future dementia risk, which was increased by 29.7% (HR 1.30, CI 1.07-1.57, P = 0.007) per standard deviation advancement in HorvathAgeMeth. Older physiological ages were also positively associated with future development of abnormal patellar or pupillary reflexes, and the loss of normal gait. Measures of biological ageing can predict clinically relevant pathology of the nervous system independent of chronological age. This may help to explain variability in disease risk between individuals of the same age and strengthens the case for trials of geroprotective interventions for people with neurological disorders.
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Affiliation(s)
- Christopher E McMurran
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Yunzhang Wang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
| | - Jonathan K L Mak
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
| | - Ida K Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
| | - Bowen Tang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
| | - Sara Hägg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm SE 171 77, Sweden
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Rice J, Li LC, Davis JC, Pahor M, Madden K, Wei N, Wong H, Skelton DA, McCormick S, Falck RS, Barha CK, Rhodes RE, Loomba S, Sadatsafavi M, Liu-Ambrose T. Supporting physical activity for mobility in older adults with mobility limitations (SuPA Mobility): study protocol for a randomized controlled trial. Trials 2023; 24:769. [PMID: 38017467 PMCID: PMC10685660 DOI: 10.1186/s13063-023-07798-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Limited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15-24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient physical activity. Evidence shows that increasing physical activity by 50 min of moderate intensity physical activity in sedentary older adults with mobility limitations can improve mobility and reduce the incidence of mobility disability. To maximize the healthy life span of older adults, it is necessary to find effective and efficient interventions that can be delivered widely to prevent mobility limitations, increase physical activity participation, and improve quality of life in older adults. We propose a randomized controlled trial to assess the effect of a physical activity health coaching intervention on mobility in older adults with mobility limitations. METHODS This randomized controlled trial among 290 (145 per group) community-dwelling older adults with mobility limitations, aged 70-89 years old, will compare the effect of a physical activity health coaching intervention versus a general healthy aging education program on mobility, as assessed with the Short Physical Performance Battery. The physical activity health coaching intervention will be delivered by exercise individuals who are trained in Brief Action Planning. The coaches will use evidence-based behavior change techniques including goal-setting, action planning, self-monitoring, and feedback to improve participation in physical activity by a known dose of 50 min per week. There will be a total of 9 health coaching or education sessions delivered over 26 weeks with a subsequent 26-week follow-up period, wherein both groups will receive the same duration and frequency of study visits and activities. DISCUSSION The consequences of limited mobility pose a significant burden on the quality of life of older adults. Our trial is novel in that it investigates implementing a dose of physical activity that is known to improve mobility in older adults utilizing a health coaching intervention. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration System: NCT05978336; registered on 28 July 2023.
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Affiliation(s)
- Jordyn Rice
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Linda C Li
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Jennifer C Davis
- University of British Columbia-Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - Marco Pahor
- University of Florida, Gainesville, FL, 32611, USA
| | - Kenneth Madden
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Nathan Wei
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Hubert Wong
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Dawn A Skelton
- Glasgow Caledonian University, Cowcaddens Rd, Glasgow, G4 0BA, UK
| | - Sioban McCormick
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Ryan S Falck
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Cindy K Barha
- University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Ryan E Rhodes
- University of Victoria, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada
| | - Sohail Loomba
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Mohsen Sadatsafavi
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Teresa Liu-Ambrose
- University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada.
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47
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Lai A, Morgan A, Richardson J, Griffith LE, Kuspinar A, Smith-Turchyn J. Pre-Clinical Mobility Limitation (PCML) Outcomes in Rehabilitation Interventions for Middle-Aged and Older Adults: A Scoping Review. Can J Aging 2023:1-12. [PMID: 37981438 DOI: 10.1017/s0714980823000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Abstract
Individuals with pre-clinical mobility limitation (PCML) are at a high risk of future functional loss and progression to disability. The purpose of this scoping review was to provide a comprehensive understanding of PCML intervention studies in middle-aged and older adults. We present the interventions that have been tested or planned, describe how they have been conducted and reported, identify the knowledge gaps in current literature, and make recommendations about future research directions. An initial search of 2,291 articles resulted in 14 articles that met criteria for inclusion. Findings reveal that: (1) there is limited published work on PCML interventions, especially in middle-aged populations; and (2) the complexity and variety of PCML measures make it difficult to compare findings across PCML studies. Despite the diversity of measures, this review provides preliminary evidence that rehabilitation interventions on PCML help to delay or prevent disability progression.
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Affiliation(s)
- Aiping Lai
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ashley Morgan
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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48
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Cerfoglio S, Lopomo NF, Capodaglio P, Scalona E, Monfrini R, Verme F, Galli M, Cimolin V. Assessment of an IMU-Based Experimental Set-Up for Upper Limb Motion in Obese Subjects. SENSORS (BASEL, SWITZERLAND) 2023; 23:9264. [PMID: 38005650 PMCID: PMC10674635 DOI: 10.3390/s23229264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
In recent years, wearable systems based on inertial sensors opened new perspectives for functional motor assessment with respect to the gold standard motion capture systems. The aim of this study was to validate an experimental set-up based on 17 body-worn inertial sensors (Awinda, Xsens, The Netherlands), addressing specific body segments with respect to the state-of-the art system (VICON, Oxford Metrics Ltd., Oxford, UK) to assess upper limb kinematics in obese, with respect to healthy subjects. Twenty-three obese and thirty healthy weight individuals were simultaneously acquainted with the two systems across a set of three tasks for upper limbs (i.e., frontal arm rise, lateral arm rise, and reaching). Root Mean Square error (RMSE) was computed to quantify the differences between the measurements provided by the systems in terms of range of motion (ROM), whilst their agreement was assessed via Pearson's correlation coefficient (PCC) and Bland-Altman (BA) plots. In addition, the signal waveforms were compared via one-dimensional statistical parametrical mapping (SPM) based on a paired t-test and a two-way ANOVA was applied on ROMs. The overall results partially confirmed the correlation and the agreement between the two systems, reporting only a moderate correlation for shoulder principal rotation angle in each task (r~0.40) and for elbow/flexion extension in obese subjects (r = 0.66), whilst no correlation was found for most non-principal rotation angles (r < 0.40). Across the performed tasks, an average RMSE of 34° and 26° was reported in obese and healthy controls, respectively. At the current state, the presence of bias limits the applicability of the inertial-based system in clinics; further research is intended in this context.
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Affiliation(s)
- Serena Cerfoglio
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (S.C.); (M.G.); (V.C.)
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
| | - Nicola Francesco Lopomo
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, Italy; (N.F.L.); (R.M.)
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, 10126 Turin, Italy
| | - Emilia Scalona
- Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, 25123 Brescia, Italy;
| | - Riccardo Monfrini
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, Italy; (N.F.L.); (R.M.)
| | - Federica Verme
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (S.C.); (M.G.); (V.C.)
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (S.C.); (M.G.); (V.C.)
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
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Kim H, Kim G, Kim Y, Ha J. The Effects of ICT-Based Interventions on Physical Mobility of Older Adults: A Systematic Literature Review and Meta-Analysis. Int J Clin Pract 2023; 2023:5779711. [PMID: 38020536 PMCID: PMC10656205 DOI: 10.1155/2023/5779711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/06/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Systematic literature review and meta-analysis were conducted to integrate and analyze intervention studies dealing with the effects of information and communications technology- (ICT-) based interventions on the physical mobility of older adults in the community. The PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for studies published from January 2000 to December 2022. We used the Risk of Bias 2 (RoB 2) tool to evaluate the quality of the randomized controlled studies in the systematic review. The meta-analysis was performed using a random-effects model. The model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for both effect measures. I2 tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = -0.33, 95% CI: -0.57 to -0.10, p=0.005, I2 = 74.7%). A sensitivity analysis was performed on subgroups, and interventions were found to be effective in improving TUG in the exergame group (SMD = -0.40, 95% CI: -0.72 to -0.08, p < 0.001, I2 = 75.0%) and in the exergame with virtual reality (VR) group (SMD = -0.33, 95% CI: -1.01 to 0.35, p < 0.001, I2 = 91.0%) but both groups showed high heterogeneity. A meta-analysis was also performed on Short Physical Performance Battery (SPPB) but statistically significant results were not found (SMD = -0.19, 95% CI: -0.61 to 0.23, p=0.375, I2 = 87.7%). For the Berg Balance Scale (BBS), the post-intervention scores were significantly better than baseline (SMD = 1.52, 95% CI: 0.48 to 2.57, p=0.004, I2 = 93.5%). However, the number of studies included in the meta-analysis was small and heterogeneity was high, so follow-up studies are needed. This study confirmed that exergames, telecommunication, e-health, information applications, and robots were used as effective ICT-based interventions for improving the physical mobility of older adults. It is necessary to develop and apply more diverse ICT-based interventions that will prevent impairments of mobility and encourage older adults to live more independently, with a higher quality of life, based on extensive research on ICT-based interventions.
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Affiliation(s)
- Hyori Kim
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Gahye Kim
- College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Yeonghun Kim
- Robotics Lab, Hyundai Motor Company, Uiwang 16082, Republic of Korea
| | - Jiyeon Ha
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon 16499, Republic of Korea
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50
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Yeoh WL, Choi J, Loh PY, Saito S, Muraki S. Users' adaptations to the proportional speed control of a motorised walker. Disabil Rehabil Assist Technol 2023; 18:1431-1440. [PMID: 34941465 DOI: 10.1080/17483107.2021.2017031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Speed control is commonly used to regulate the forces applied by motorised walkers (MW) and there are often situations where the speed targeted deviates from the preferred walking speed of its users, such as when encouraging higher walking speeds and due to safety consideration. This study investigates the effects of different MW's target speeds on the selected walking speeds, force applied, perceived exertion, and gait of MW users during steady-state walking. MATERIALS AND METHODS The spatiotemporal gait parameters and perceived exertion of twenty young healthy participants were measured as they walked at a comfortable, self-selected speed using a MW as it was controlled to target forward speeds of 0.6, 0.8, 1.0, 1.2, and 1.4 m s-1 as well as when no assistive force was applied by the MW. RESULTS On average, users would walk slower when their "No Assist" walking speed is higher than the MW's speed target and vice versa. Additionally, the force applied to the MW is proportional to the difference in speed, either faster or slower, when compared to "No Assist". CONCLUSION The user's exertion and the energy used by the MW are both minimised when target speed is close to the preferred walking speed of the user. Additionally, these findings suggest that the speed target can be used to change the walking speed of users but only to a certain extend and at the cost of higher perceived exertion.Implications for rehabilitationThe larger the difference between the target speed of the MW and the preferred walking speed of the user, the more likely the user is to push or pull on the MW.Users would push or pull on the MW with a force proportional to the difference from their preferred walking speed even when matching the MW's target speed.Users can be encouraged to walk at higher than preferred speeds, even though this would come at the cost of higher perceived exertion.
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Affiliation(s)
| | - Jeewon Choi
- Faculty of Design, Kyushu University, Fukuoka, Japan
| | - Ping Yeap Loh
- Faculty of Design, Kyushu University, Fukuoka, Japan
| | - Seiji Saito
- Faculty of Computer Science and Systems Engineering, Okayama Prefectural University, Okayama, Japan
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