Long-term participation in community-based group resistance exercises delays the transition from robustness to frailty in older adults: a retrospective cohort study

Effect of participating in Kayoi-no-ba during the COVID-19 pandemic on frailty 1 year later in older adults

AIM

This study examined the short-term effects of participation in Kayoi-no-ba - community gathering places for residents to contribute to care prevention with the support of volunteers in Japan - on frailty status during the coronavirus disease 2019 (COVID-19) pandemic, based on a 1-year longitudinal study of older adults.

METHODS

Participants (n = 3899) were aged ≥65 years. At baseline, they were classified into four groups, based on their frequency of participation in Kayoi-no-ba before and after the COVID-19 pandemic: the nonparticipation group, the continued participation group, the interrupted participation group and the new participation group. Frailty status, assessed using the modified Kihon Checklist, was the dependent variable. A generalized linear mixed-effects model was used to compare frailty status changes after a 1-year follow up in the four groups.

RESULTS

The frailty prevalence at baseline was 30.8% in the nonparticipation group, and 37.2% in the participation group. The frailty prevalence in the participation group was significantly reduced at the 1-year follow up (-3.9 percentage points [95% CI -7.4, -0.5]), compared with that of the nonparticipation group. In subgroup analyses, the frailty prevalence was reduced at the 1-year follow up in the order of continued participation group (-4.5 percentage points [95% CI -8.9, -0.2]), new participation group (-4.0 percentage points [95% CI -12.9, 5.0]), and interrupted participation group (-2.4 percentage points [95% CI -9.1, 4.3]), compared with the nonparticipation group (P = 0.024 for trend).

CONCLUSIONS

Even during the COVID-19 pandemic, participation in Kayoi-no-ba was effective in preventing/reducing frailty. Thus, avoiding prolonged nonparticipation in Kayoi-no-ba might be important. Geriatr Gerontol Int 2025; 25: 598-605.

Long-term frailty and physical performance transitions in older people with type-2 diabetes. The MIDFRAIL randomized clinical study

AIMS

Type 2 diabetes (T2D) is associated with frailty in older people. We aim to explore changes in frailty status after ≥18 months of intervention.

METHODS

298 community-dwelling older adults (>70 years) participating in MIDFRAIL followed-up for 18-24 months were randomly allocated by trial site (cluster) to intervention IG (16-weeks resistance exercise program, nutritional-educational sessions, optimization of diabetes care), or usual care group (UCG). Frailty status was assessed by the Fried Frailty Phenotype criteria at baseline and final visit. Functional status was assessed by the SPPB in every visit. We used multivariate linear and logistic regression for continuous and dichotomous outcomes. This study was registered at Clinicaltrials.gov (NCT01654341).

RESULTS

Mean age was 77.7 (SD 5.54), 47% were male, 32.9% frail and 67.1% prefrail. The probability of improving the frailty status and decreasing the number of Fried's frailty criteria was higher in the IG than in the UCG (OR 2.6, 95%CI 1.3-5.4; p = 0.009 and OR 1.9; 95%CI 1.1-3.1; p = 0.02, respectively). IG participants more frequently improved ≥1 point in SPPB score (OR 1.85; 95%CI 1.09-3.12; p = 0.022). These benefits were mainly accounted for the prefrail participants.

CONCLUSIONS

The MIDFRAIL intervention improved frailty status and physical function at long-term follow-up in older people with T2D.

Development and validation of a prediction model for falls among older people using community-based data

This is the first study to employ multilevel modeling analysis to develop a predictive tool for falls in individuals who have participated in community group exercise over a year. The tool may benefit healthcare workers in screening community-dwelling older adults with various levels of risks for falls.

PURPOSE

The aim of this study was to develop a calculation tool to predict the risk of falls 1 year in the future and to find the cutoff value for detecting a high risk based on a database of individuals who participated in a community-based group exercise.

METHODS

We retrospectively reviewed a total of 7726 physical test and Kihon Checklist data from 2381 participants who participated in community-based physical exercise groups. We performed multilevel logistic regression analysis to estimate the odds ratio of falls for each risk factor and used the variance inflation factor to assess collinearity. We determined a cutoff value that effectively distinguishes individuals who are likely to fall within a year based on both sensitivity and specificity.

RESULTS

The final model included variables such as age, sex, weight, balance, standing up from a chair without any aid, history of a fall in the previous year, choking, cognitive status, subjective health, and long-term participation. The sensitivity, specificity, and best cutoff value of our tool were 68.4%, 53.8%, and 22%, respectively.

CONCLUSION

Using our tool, an individual's risk of falls over the course of a year could be predicted with acceptable sensitivity and specificity. We recommend a cutoff value of 22% for use in identifying high-risk populations. The tool may benefit healthcare workers in screening community-dwelling older adults with various levels of risk for falls and support physicians in planning preventative and follow-up care.

Prevalence and Associated Factors with Frailty Using the Kihon Checklist among Community-Dwelling Older Adults in Taiwan

Background and Objectives: Frailty in older adults is associated with adverse health outcomes. This study aimed to analyze the frailty status of community-dwelling older adults in Taiwan using the Kihon Checklist (KCL) and explore associations with demographic, physiological, and functional factors. Materials and Methods: In this cross-sectional study, 278 community-dwelling older adults were classified as robust, prefrail, or frail based on their KCL scores. Participants underwent physical fitness assessments including muscle strength and endurance tests, walking speed tests, and flexibility tests. One-way ANOVA and logistic regression analyses were used to examine differences and associations between frailty status and physical fitness indicators. Results: 36% of participants were robust, 47.1% prefrail, and 16.9% frail. The robust group significantly outperformed the prefrail and frail groups in the 30 s sit-to-stand test, 2.44 m sit-to-walk test, and walking speed (p < 0.001). The 2.44 m sit-to-walk test was a significant predictor of prefrailty (OR = 1.18, 95% CI = 1.02-1.36) after adjusting for other physical fitness indicators. Conclusions: Lower limb functional capacity, particularly in the 2.44 m sit-to-walk test, was significantly associated with pre-frailty among community-dwelling older adults in Taiwan. Early screening, the classification of frailty by the Kihon Checklist, and targeted interventions focusing on lower limb strength, endurance, and mobility are crucial for preventing and delaying frailty progression in older populations.

Preventive role of community-level social capital in the need for long-term care and impairment in instrumental activities of daily living: a multilevel analysis

BACKGROUND

Individual-level social capital is an important determinant of older adults' long-term care needs; however, there is scant evidence regarding community-level social capital. Therefore, we investigated the association between community-level social capital and the prevalence of the need for long-term care among older adults.

METHODS

Between January and February 2018, a cross-sectional survey was conducted among all older adults (n = 13,558) aged 65 to 74 years in a rural municipality in Japan (total population, n = 72,833). A self-reported questionnaire was used to identify community-level social capital, comprising civic participation, social cohesion, and reciprocity. A multilevel logistic regression analysis was performed to estimate the odds ratios of the need for long-term care and a decline in social activity competence as assessed by instrumental activities of daily living. For the analysis, the community levels were divided into 76 voting districts and adjusted for daily life, lifestyle, socioeconomic status, health conditions, and the three social capital subscale scores at the individual level.

RESULTS

After adjusting for the covariates, we observed a tendency that a higher community level of reciprocity was associated with a lower prevalence of long-term care needs (OR: 0.86, 95% confidence interval: 0.75-1.00), whereas a high community level of social cohesion was associated with a significantly reduced decline in instrumental activities of daily living (OR per standard deviation increase: 0.87, 95% confidence interval: 0.79-0.96). No significant association was found with civic participation. Similarly, individual-level social capital was associated with the need for long-term care and decline in instrumental activities of daily living.

CONCLUSIONS

Our findings suggest that good community-level reciprocity or social cohesion as well as good individual social capital status may help prevent the need for long-term care among older adults.

Acute and chronic functional and traditional resistance training improve muscular fitness in young males via the AMPK/PGC-1α/irisin signaling pathway

BACKGROUND

In this study, we aimed to investigate the effects of acute and chronic resistance training of varying intensities on molecular responses and their association with muscular fitness in a cohort of young males who participated in this intervention study.

METHODS

Young males (19-28 years) with no prior training experience underwent a six-week program consisting of two distinct modalities of resistance training. The participants were randomly divided into a functional resistance training group (FRT; n = 9; participants performed 4-5 sets of 20 repetitions maximum (RM) at 40% 1RM) or a traditional resistance training group (TRT; n = 9; participants performed 4-5 sets of 12 RM at 70% 1RM). Both protocols entailed training three days per week for six weeks. Blood samples were obtained before, immediately after an acute bout of training, and after the six-week training program to determine alterations in molecular responses. Muscular fitness analysis and anthropometric measurements were conducted before and after the six-week training program.

RESULTS

After the six-week training program, the lean body mass of participants in both TRT and FRT groups was significantly increased (p < 0.05), whereas body fat percentage and fat mass were significantly decreased solely in the FRT group (p < 0.05). All muscular fitness variables were significantly increased in both groups (p < 0.01), with no difference between the two groups. Additionally, in the TRT group, serum levels of AMP-activated protein kinase (AMPK) were significantly increased following acute training and six weeks of resistance training, whereas in the FRT group, no significant increase in serum levels of AMPK was observed. In both groups, serum levels of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), irisin, and insulin-like growth factor-1 were significantly increased. Moreover, myostatin was significantly decreased following acute training and six weeks of resistance training (p < 0.05), with no difference between the two groups. Furthermore, a significant correlation was observed between barbell back squat and certain molecular variables.

CONCLUSIONS

Overall, our study indicates that acute and chronic resistance training of varying intensities are effective changing molecular responses, the chronic FRT and TRT improve muscular fitness in young males through the AMPK/PGC-1α/irisin signaling pathway.

TRIAL REGISTRATION

Chinese Clinical Trial Registry: ChiCTR2200059775 (11/05/2022).

Associations between physical function, falls, and the fear of falling among older adults participating in a community-based physical exercise program: A longitudinal multilevel modeling study

OBJECTIVES

Exercises that target muscle strength, balance, and gait prevent falls in older people. Moreover, exercise may reduce fear of falling by improving physical function. Many studies have examined the risk factors for falls and fear of falling separately. However, few studies have examined the associations between physical function, falls, and fear of falling simultaneously. This study aimed to identify the key physical functions influencing falls and fear of falling.

DESIGN

Longitudinal observational study SETTING AND PARTICIPANTS: This study included 2,397 older adults (women: 82.8%, mean age: 74.3 ± 8.0 years) who participated in community-based physical exercise.

METHODS

Physical functions such as muscle strength, balance, gait speed, and flexibility were measured regularly during the program. A questionnaire regarding falls and fear of falling was also administered simultaneously. Multilevel modeling was used to investigate the association between physical function and falls and fear of falling.

RESULTS

The prevalence of falls and fear of falling at enrolment were 27.1% and 49.8%, respectively. Statistical analyses revealed that (1) falls were significantly associated with balance, age, fall history, fear of falling, and duration of participation; (2) fear of falling was significantly associated with muscle strength, balance, gait speed, age, and fall history. Long-term participation was significantly associated with an improvement in balance.

CONCLUSIONS AND IMPLICATIONS

The risk factors for falls and fear of falling were different. Our research showed the importance of including balance training in all prevention programs.