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Wing D, Eyler LT, Lenze EJ, Wetherell JL, Nichols JF, Meeusen R, Godino J, Shimony JS, Snyder AZ, Nishino T, Nicol GE, Nagels G, Roelands B. Fatness but Not Fitness Linked to BrainAge: Longitudinal Changes in Brain Aging during an Exercise Intervention. Med Sci Sports Exerc 2024; 56:655-662. [PMID: 38079309 PMCID: PMC10947938 DOI: 10.1249/mss.0000000000003337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024]
Abstract
PURPOSE Fitness, physical activity, body composition, and sleep have all been proposed to explain differences in brain health. We hypothesized that an exercise intervention would result in improved fitness and body composition and would be associated with improved structural brain health. METHODS In a randomized controlled trial, we studied 485 older adults who engaged in an exercise intervention ( n = 225) or a nonexercise comparison condition ( n = 260). Using magnetic resonance imaging, we estimated the physiological age of the brain (BrainAge) and derived a predicted age difference compared with chronological age (brain-predicted age difference (BrainPAD)). Aerobic capacity, physical activity, sleep, and body composition were assessed and their impact on BrainPAD explored. RESULTS There were no significant differences between experimental groups for any variable at any time point. The intervention group gained fitness, improved body composition, and increased total sleep time but did not have significant changes in BrainPAD. Analyses of changes in BrainPAD independent of group assignment indicated significant associations with changes in body fat percentage ( r (479) = 0.154, P = 0.001), and visceral adipose tissue (VAT) ( r (478) = 0.141, P = 0.002), but not fitness ( r (406) = -0.075, P = 0.129), sleep ( r (467) range, -0.017 to 0.063; P range, 0.171 to 0.710), or physical activity ( r (471) = -0.035, P = 0.444). With linear regression, changes in body fat percentage and VAT significantly predicted changes in BrainPAD ( β = 0.948, P = 0.003) with 1-kg change in VAT predicting 0.948 yr of change in BrainPAD. CONCLUSIONS In cognitively normal older adults, exercise did not appear to impact BrainPAD, although it was effective in improving fitness and body composition. Changes in body composition, but not fitness, physical activity, or sleep impacted BrainPAD. These findings suggest that focus on weight control, particularly reduction of central obesity, could be an interventional target to promote healthier brains.
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Affiliation(s)
- David Wing
- Herbert Wertheim School of Public Health; University of California, San Diego, CA
- Exercise and Physical Activity Resource Center (EPARC); University of California, San Diego, CA
| | - Lisa T. Eyler
- Department of Psychiatry, University of California, San Diego, CA
- Desert-Pacific Mental Illness Research, Education, and Clinical Center, San Diego Veterans Administration Healthcare System, San Diego, CA
| | - Eric J. Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Julie Loebach Wetherell
- Mental Health Service, VA San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California, San Diego, CA
| | - Jeanne F. Nichols
- Herbert Wertheim School of Public Health; University of California, San Diego, CA
- Exercise and Physical Activity Resource Center (EPARC); University of California, San Diego, CA
| | - Romain Meeusen
- Human Physiology & Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, BELGIUM
- Brubotics, Vrije Universiteit Brussel, Brussels, BELGIUM
| | - Job Godino
- Herbert Wertheim School of Public Health; University of California, San Diego, CA
- Exercise and Physical Activity Resource Center (EPARC); University of California, San Diego, CA
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Abraham Z. Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Ginger E. Nicol
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Guy Nagels
- Department of Neurology, UZ Brussel, Brussel, Belgium/Center for Neurosciences (C4N) Vrije Universiteit Brussel (VUB), Brussels, BELGIUM
| | - Bart Roelands
- Human Physiology & Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, BELGIUM
- Brubotics, Vrije Universiteit Brussel, Brussels, BELGIUM
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Bangen KJ, Calcetas AT, Thomas KR, Wierenga C, Smith CN, Bordyug M, Brenner EK, Wing D, Chen C, Liu TT, Zlatar ZZ. Greater accelerometer-measured physical activity is associated with better cognition and cerebrovascular health in older adults. J Int Neuropsychol Soc 2023; 29:859-869. [PMID: 36789631 PMCID: PMC10425574 DOI: 10.1017/s1355617723000140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Physical activity (PA) may help maintain brain structure and function in aging. Since the intensity of PA needed to effect cognition and cerebrovascular health remains unknown, we examined associations between PA and cognition, regional white matter hyperintensities (WMH), and regional cerebral blood flow (CBF) in older adults. METHOD Forty-three older adults without cognitive impairment underwent magnetic resonance imaging (MRI) and comprehensive neuropsychological assessment. Waist-worn accelerometers objectively measured PA for approximately one week. RESULTS Higher time spent in moderate to vigorous PA (MVPA) was uniquely associated with better memory and executive functioning after adjusting for all light PA. Higher MVPA was also uniquely associated with lower frontal WMH volume although the finding was no longer significant after additionally adjusting for age and accelerometer wear time. MVPA was not associated with CBF. Higher time spent in all light PA was uniquely associated with higher CBF but not with cognitive performance or WMH volume. CONCLUSIONS Engaging in PA may be beneficial for cerebrovascular health, and MVPA in particular may help preserve memory and executive function in otherwise cognitively healthy older adults. There may be differential effects of engaging in lighter PA and MVPA on MRI markers of cerebrovascular health although this needs to be confirmed in future studies with larger samples. Future randomized controlled trials that increase PA are needed to elucidate cause-effect associations between PA and cerebrovascular health.
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Affiliation(s)
- Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Amanda T Calcetas
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Kelsey R Thomas
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Christina Wierenga
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Christine N Smith
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
| | - Maria Bordyug
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Einat K Brenner
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - David Wing
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Conan Chen
- Center for Functional MRI and Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Thomas T Liu
- Center for Functional MRI and Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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Nagata JM, Alsamman S, Smith N, Yu J, Ganson KT, Dooley EE, Wing D, Baker FC, Pettee Gabriel K. Social epidemiology of Fitbit daily steps in early adolescence. Pediatr Res 2023; 94:1838-1844. [PMID: 37353663 PMCID: PMC10624619 DOI: 10.1038/s41390-023-02700-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 05/10/2023] [Accepted: 05/30/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Sociodemographic disparities in adolescent physical activity have been documented but mostly rely on self-reported data. Our objective was to examine differences in device-based step metrics, including daily step count (steps d-1), by sociodemographic factors among a diverse sample of 10-to-14-year-old adolescents in the US. METHODS We analyzed prospective cohort data from Year 2 (2018-2020) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 6460). Mixed-effects models were conducted to estimate associations of sociodemographic factors (sex, sexual orientation, race/ethnicity, household income, parental education, and parental marital status) with repeated measures of steps d-1 over the course of 21 days. RESULTS Participants (49.6% female, 39.0% racial/ethnic minority) accumulated an average of 9095.8 steps d-1. In mixed-effects models, 1543.6 more steps d-1 were recorded for male versus female sex, Black versus White race (328.8 more steps d-1), heterosexual versus sexual minority sexual orientation (676.4 more steps d-1), >$200,000 versus <$25,000 household income (1003.3 more steps d-1), and having married/partnered parents versus unmarried/unpartnered parents (326.3 more steps d-1). We found effect modification by household income for Black adolescents and by sex for Asian adolescents. CONCLUSIONS Given sociodemographic differences in adolescent steps d-1, physical activity guidelines should focus on key populations and adopt strategies optimized for adolescents from diverse backgrounds. IMPACT Sociodemographic disparities in physical activity have been documented but mostly rely on self-reported data, which can be limited by reporting and prevarication bias. In this demographically diverse sample of 10-14-year-old early adolescents in the U.S., we found notable and nuanced sociodemographic disparities in Fitbit steps per day. More daily steps were recorded for male versus female sex, Black versus White race, heterosexual versus sexual minority, >$100,000 versus <$25,000 household income, and having married/partnered versus unmarried/unpartnered parents. We found effect modification by household income for Black adolescents and by sex for Asian adolescents.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA.
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Natalia Smith
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Jiayue Yu
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, CA, USA
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla University of California, San Diego, La Jolla, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Funk-White M, Wing D, Eyler LT, Moore AA, Reas ET, McEvoy L. Neuroimaging-Derived Predicted Brain Age and Alcohol Use Among Community-Dwelling Older Adults. Am J Geriatr Psychiatry 2023; 31:669-678. [PMID: 36925380 DOI: 10.1016/j.jagp.2023.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVES Observational studies have suggested that moderate alcohol use is associated with reduced risk of dementia. However, the nature of this association is not understood. We investigated whether light to moderate alcohol use may be associated with slower brain aging, among a cohort of older community-dwelling adults using a biomarker of brain age based on structural neuroimaging measures. DESIGN Cross-sectional observational study. PARTICIPANTS Well-characterized members of a longitudinal cohort study who underwent neuroimaging. We categorized the 163 participants (mean age 76.7 ± 7.7, 60% women) into current nondrinkers, light drinkers (1-7 drinks/week) moderate drinkers (>7-14 drinks/week), or heavier drinkers (>14 drinks/week). MEASUREMENTS We calculated brain-predicted age using structural MRIs processed with the BrainAgeR program, and calculated the difference between brain-predicted age and chronological age (brain-predicted age difference, or brain-PAD). We used analysis of variance to determine if brain-PAD differed across alcohol groups, controlling for potential confounders. RESULTS Brain-PAD differed across alcohol groups (F[3, 150] = 4.02; p = 0.009) with heavier drinkers showing older brain-PAD than light drinkers (by about 6 years). Brain-PAD did not differ across light, moderate, and nondrinkers. Similar results were obtained after adjusting for potentially mediating health-related measures, and after excluding individuals with a history of heavier drinking. DISCUSSION Among this sample of healthy older adults, consumption of more than 14 drinks/week was associated with a biomarker of advanced brain aging. Light and moderate drinking was not associated with slower brain aging relative to non-drinking.
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Affiliation(s)
- Makaya Funk-White
- Interdisciplinary Research on Substance Use (MFW), University of California San Diego, La Jolla, CA
| | - David Wing
- Herbert Wertheim School of Public Health and Human Longevity Science (DW, LKM), University of California San Diego, La Jolla, CA
| | - Lisa T Eyler
- Department of Psychiatry (LTE), University of California San Diego, La Jolla, CA; Desert-Pacific Mental Illness Research (LTE), Education, and Clinical Center, VA San Diego Healthcare System, San Diego, CA
| | - Alison A Moore
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine (AAM), University of California San Diego, La Jolla, CA
| | - Emilie T Reas
- Department of Neurosciences (ETR), University of California San Diego, La Jolla, CA
| | - Linda McEvoy
- Herbert Wertheim School of Public Health and Human Longevity Science (DW, LKM), University of California San Diego, La Jolla, CA; Department of Radiology (LKM), University of California San Diego, La Jolla, CA
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Hyde ET, Gahagan S, Martinez SM, East P, Wing D, Burrows R, Burrows PC, Algarín C, Peirano P, Reyes S, Blanco E. Adolescent sedentary behavior and body composition in early adulthood: results from a cohort study. Pediatr Res 2023; 94:1209-1215. [PMID: 37130997 PMCID: PMC10524130 DOI: 10.1038/s41390-023-02616-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND This study investigates the cross-sectional and prospective associations between accelerometer-measured sedentary behavior and body composition from adolescence to early adulthood. METHODS Data from the Santiago Longitudinal Study were analyzed (n = 212). Sedentary time was measured at age 16 years, and body composition (body mass index [BMI], waist circumference, waist-to-height ratio [WHtR], fat mass percentage, and lean mass percentage) was examined at both age 16 and 23 years. Adjusted linear regression models estimated associations between sedentary time, sedentary bout duration, and body composition, overall and by sex. RESULTS In all analyses, mean sedentary bout duration was not associated with body composition. In cross-sectional analyses, more sedentary time during adolescence was significantly associated with lower BMI, waist circumference, WHtR, fat mass percentage, and higher lean mass percentage (p < 0.05). One standard deviation increase in daily sedentary time was prospectively associated with lower body mass index (β = -1.22 kg/m2, 95% CI: -2.02, -0.42), waist circumference (β = -2.39 cm, 95% CI: -4.03, -0.75), and WHtR (β = -0.014, 95% CI: -0.024, -0.004). Sedentary time at 16 years was not associated with changes in body composition from 16 to 23 years. CONCLUSIONS Sedentary behavior in adolescence is not adversely associated with body composition profiles in early adulthood. IMPACT Little is known about the effect of device-measured sedentary behavior on body composition during the transition from adolescence to early adulthood. Among participants in the Santiago Longitudinal Study, more accelerometer-measured sedentary time during adolescence was associated with lower BMI, waist circumference, and waist-to-height ratio in early adulthood though point estimates were generally small in magnitude. Sedentary behavior in adolescence was not detrimentally associated with healthy body composition profiles in early adulthood. Public health interventions aimed at reducing obesity rates could consider other behaviors, such as physical activity and healthy diet, instead of sitting time.
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Affiliation(s)
- Eric T Hyde
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA, USA
| | - Sheila Gahagan
- Academic General Pediatrics, Child Development, and Community Health, University of California, San Diego, San Diego, CA, USA
| | - Suzanna M Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Patricia East
- Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | - David Wing
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- Exercise and Physical Activity Resource Center, University of California, San Diego, San Diego, CA, USA
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | | | - Cecilia Algarín
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Patricio Peirano
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Sussanne Reyes
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Estela Blanco
- Centro de Investigación en Sociedad y Salud y Núcleo Milenio de Sociomedicina, Universidad Mayor, Santiago, Chile.
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Seaton MP, Nichols JF, Rauh MJ, Kado DM, Wetherell JL, Lenze EJ, Wing D. Associations of Lean Mass, Muscular Strength, and Physical Function with Trabecular Bone Score in Older Adults. J Clin Densitom 2023; 26:101370. [PMID: 37100686 DOI: 10.1016/j.jocd.2023.101370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION/BACKGROUND Trabecular bone score (TBS) is an indirect measurement of bone quality and microarchitecture determined from dual-energy X-ray absorptiometry (DXA) imaging of the lumbar spine. TBS predicts fracture risk independent of bone mass/density, suggesting this assessment of bone quality adds value to the understanding of patients' bone health. While lean mass and muscular strength have been associated with higher bone density and lower fracture risk among older adults, the literature is limited regarding the relationship of lean mass and strength with TBS. The purpose of this study was to determine associations of DXA-determined total body and trunk lean mass, maximal muscular strength, and gait speed as a measure of physical function, with TBS in 141 older adults (65-84 yr, 72.5 +/- 5.1 yr, 74% women). METHODOLOGY Assessments included lumbar spine (L1-L4) bone density and total body and trunk lean mass by DXA, lower body (leg press) and upper body (seated row) strength by one repetition maximum tests, hand grip strength, and usual gait speed. TBS was derived from the lumbar spine DXA scan. Multivariable linear regression determined the contribution of proposed predictors to TBS. RESULTS After adjusting for age, sex, and lumbar spine bone density, upper body strength significantly predicted TBS (unadjusted/adjusted R2= 0.16/ 0.11, β coefficient =0.378, p=0.005), while total body lean mass index showed a trend in the expected direction (β coefficient =0.243, p=0.053). Gait speed and grip strength were not associated with TBS (p>0.05). CONCLUSION Maximum strength of primarily back muscles measured as the seated row appears important to bone quality as measured by TBS, independent of bone density. Additional research on exercise training targeting back strength is needed to determine its clinical utility in preventing vertebral fractures among older adults.
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Affiliation(s)
- Margaret P Seaton
- University of California, Department of Neurological Surgery, San Francisco, CA, United States; Exercise and Physical Activity Resource Center (EPARC), Herbert Wertheim Graduate School of Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Jeanne F Nichols
- Exercise and Physical Activity Resource Center (EPARC), Herbert Wertheim Graduate School of Public Health, University of California, San Diego, La Jolla, CA, United States.
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States
| | - Deborah M Kado
- Stanford University, Geriatric Research Education and Clinical Center (GRECC), VA Palo Alto Health System, Palo Alto, CA, United States
| | - Julie Loebach Wetherell
- VA San Diego Healthcare System Mental Health Division and University of California, San Diego Department of Psychiatry, United States
| | - Eric J Lenze
- Washington University School of Medicine - Healthy Mind Lab, Department of Psychiatry, United States
| | - David Wing
- Exercise and Physical Activity Resource Center (EPARC), Herbert Wertheim Graduate School of Public Health, University of California, San Diego, La Jolla, CA, United States
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Wagenmakers MJ, Oudega ML, Klaus F, Wing D, Orav G, Han LKM, Binnewies J, Beekman ATF, Veltman DJ, Rhebergen D, van Exel E, Eyler LT, Dols A. BrainAge of patients with severe late-life depression referred for electroconvulsive therapy. J Affect Disord 2023; 330:1-6. [PMID: 36858270 DOI: 10.1016/j.jad.2023.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/28/2023] [Accepted: 02/12/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Severe depression is associated with accelerated brain aging. BrainAge gap, the difference between predicted and observed BrainAge, was investigated in patients with late-life depression (LLD). We aimed to examine BrainAge gap in LLD and its associations with clinical characteristics indexing LLD chronicity, current severity, prior to electroconvulsive therapy (ECT) and ECT outcome. METHODS Data was analyzed from the Mood Disorders in Elderly treated with Electroconvulsive Therapy (MODECT) study. A previously established BrainAge algorithm (BrainAge R by James Cole, (https://github.com/james-cole/brainageR)) was applied to pre-ECT T1-weighted structural MRI-scans of 42 patients who underwent ECT. RESULTS A BrainAge gap of 1.8 years (SD = 5.5) was observed, Cohen's d = 0.3. No significant associations between BrainAge gap, number of previous episodes, current episode duration, age of onset, depression severity, psychotic symptoms or ECT outcome were observed. LIMITATIONS Limited sample size. CONCLUSIONS Our initial findings suggest an older BrainAge than chronological age in patients with severe LLD referred for ECT, however with high degree of variability and direction of the gap. No associations were found with clinical measures. Larger samples are needed to better understand brain aging and to evaluate the usability of BrainAge gap as potential biomarker of prognosis an treatment-response in LLD. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02667353.
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Affiliation(s)
- Margot J Wagenmakers
- GGZ inGeest Specialized Mental Health Care, Psychiatry, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Mental Health, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety Psychosis Sleep and Stress, Amsterdam, the Netherlands.
| | - Mardien L Oudega
- GGZ inGeest Specialized Mental Health Care, Psychiatry, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Mental Health, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety Psychosis Sleep and Stress, Amsterdam, the Netherlands
| | - Federica Klaus
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; Department of Psychiatry, University of California San Diego, San Diego, USA
| | - David Wing
- Exercise and Physical Activity Resource Center (EPARC), Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego (UCSD), La Jolla, CA, USA
| | - Gwendolyn Orav
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Laura K M Han
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Julia Binnewies
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety Psychosis Sleep and Stress, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- GGZ inGeest Specialized Mental Health Care, Psychiatry, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Mental Health, Amsterdam, the Netherlands
| | - Dick J Veltman
- GGZ inGeest Specialized Mental Health Care, Psychiatry, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety Psychosis Sleep and Stress, Amsterdam, the Netherlands
| | - Didi Rhebergen
- Amsterdam Public Health Research Institute, Mental Health, Amsterdam, the Netherlands; GGZ Centraal Specialized Menthal Health Care, Amersfoort, the Netherlands
| | - Eric van Exel
- GGZ inGeest Specialized Mental Health Care, Psychiatry, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, San Diego, USA; Desert-Pacific MIRECC, VA San Diego Healthcare, San Diego, CA, USA
| | - Annemieke Dols
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands and Amsterdam UMC
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Hays Weeks CC, Moore AA, Allison M, Patrick K, Bondi MW, Nebeker C, Liu TT, Wing D, Higgins M, Hartman SJ, Rissman RA, Zlatar ZZ. The Independent Walking for Brain Health Intervention for Older Adults: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e42980. [PMID: 36535765 PMCID: PMC9972211 DOI: 10.2196/42980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Extensive research suggests that physical activity (PA) is important for brain and cognitive health and may help to delay or prevent Alzheimer's disease and related dementias. Most PA interventions designed to improve brain health in older adults have been conducted in laboratory, gym, or group settings that require extensive resources and travel to the study site or group sessions. Research is needed to develop novel interventions that leverage mobile health (mHealth) technologies to help older adults increase their engagement in PA in free-living environments, reducing participant burden and increasing generalizability of research findings. Moreover, promoting engagement in moderate-to-vigorous PA (MVPA) may be most beneficial to brain health; thus, using mHealth to help older adults increase time spent in MVPA in free-living environments may help to offset the burden of Alzheimer's disease and related dementias and improve quality of life in older age. OBJECTIVE We developed a novel PA intervention that leverages mHealth to help older adults achieve more minutes of MVPA independently. This pilot study was a 12-week randomized controlled trial to investigate the feasibility of providing just-in-time (JIT) feedback about PA intensity during free-living exercise sessions to help older adults meet current PA recommendations (150 minutes per week of MVPA). METHODS Participants were eligible if they were cognitively healthy English speakers aged between 65 and 80 years without major cardiovascular, neurologic, or mental health conditions; could ambulate independently; and undergo magnetic resonance imaging. Enrollment occurred from October 2017 to March 2020. Participants randomized to the PA condition received an individualized exercise prescription and an mHealth device that provided heart rate-based JIT feedback on PA intensity, allowing them to adjust their behavior in real time to maintain MVPA during exercise sessions. Participants assigned to the healthy aging education condition received a reading prescription consisting of healthy aging topics and completed weekly quizzes based on the materials. RESULTS In total, 44 participants were randomized to the intervention. A follow-up manuscript will describe the results of the intervention as well as discuss screening, recruitment, adverse events, and participants' opinions regarding their participation in the intervention. CONCLUSIONS The long-term goal of this intervention is to better understand how MVPA affects brain and cognitive health in the real world and extend laboratory findings to everyday life. This pilot randomized controlled trial was conducted to determine the feasibility of using JIT heart rate zone feedback to help older adults independently increase time spent in MVPA while collecting data on the plausible mechanisms of change (frontal and medial temporal cerebral blood flow and cardiorespiratory fitness) that may affect cognition (memory and executive function) to help refine a planned stage 2 behavioral trial. TRIAL REGISTRATION ClinicalTrials.gov NCT03058146; https://clinicaltrials.gov/ct2/show/NCT03058146. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42980.
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Affiliation(s)
| | - Alison A Moore
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Matthew Allison
- Department of Family Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Kevin Patrick
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Mark W Bondi
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Camille Nebeker
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Thomas T Liu
- Department of Radiology, University of California, San Diego, La Jolla, CA, United States
| | - David Wing
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Michael Higgins
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Robert A Rissman
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
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Nagata JM, Smith N, Alsamman S, Lee CM, Dooley EE, Kiss O, Ganson KT, Wing D, Baker FC, Gabriel KP. Association of Physical Activity and Screen Time With Body Mass Index Among US Adolescents. JAMA Netw Open 2023; 6:e2255466. [PMID: 36757695 PMCID: PMC9912127 DOI: 10.1001/jamanetworkopen.2022.55466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
IMPORTANCE The Physical Activity Guidelines Advisory Committee Scientific Report identified important research gaps to inform future guidance for adolescents, including limited evidence on the importance of sedentary behaviors (screen time) and their interactions with physical activity for adolescent health outcomes, including overweight and obesity. OBJECTIVE To identify the independent associations of physical activity and screen time categories, and the interactions between physical activity and screen time categories, with body mass index (BMI) and overweight and obesity in adolescents. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) Study collected from September 10, 2018, to September 29, 2020. Data were analyzed from July 8 to December 20, 2022. A total of 5797 adolescents aged 10 to 14 years from 21 racially and ethnically diverse study sites across the US were included in the analysis. EXPOSURES Categories of total step count per day (with 1000 to 6000 steps per day indicating low, >6000 to 12 000 steps per day indicating medium, and >12 000 steps per day indicating high), as measured by a wearable digital device (Fitbit), and categories of self-reported screen time hours per day (with 0 to 4 hours per day indicating low, >4 to 8 hours per day indicating medium, and >8 hours per day indicating high). MAIN OUTCOMES AND MEASURES Participant BMI was calculated as weight in kilograms divided by height in meters squared and converted into sex- and age-specific percentiles in accordance with the Centers for Disease Control and Prevention growth curves and definitions. Individuals were classified as having overweight or obesity if their BMI was in the 85th percentile or higher for sex and age. RESULTS Among 5797 adolescents included in the analytic sample, 50.4% were male, 61.0% were White, 35.0% had overweight or obesity, and the mean (SD) age was 12.0 (0.6) years. Mean (SD) reported screen time use was 6.5 (5.4) hours per day, and mean (SD) overall step count was 9246.6 (3111.3) steps per day. In models including both screen time and step count, medium (risk ratio [RR], 1.24; 95% CI, 1.12-1.37) and high (RR, 1.29; 95% CI, 1.16-1.44) screen time categories were associated with higher overweight or obesity risk compared with the low screen time category. Medium (RR, 1.19; 95% CI, 1.06-1.35) and low (RR, 1.30; 95% CI, 1.11-1.51) step count categories were associated with higher overweight or obesity risk compared with the high step count category. Evidence of effect modification between screen time and step count was observed for BMI percentile. For instance, among adolescents with low screen use, medium step count was associated with a 1.55 higher BMI percentile, and low step count was associated with a 7.48 higher BMI percentile. However, among those with high screen use, step count categories did not significantly change the association with higher BMI percentile (low step count: 8.79 higher BMI percentile; medium step count: 8.76 higher BMI percentile; high step count: 8.26 higher BMI percentile). CONCLUSIONS AND RELEVANCE In this cross-sectional study, a combination of low screen time and high step count was associated with lower BMI percentile in adolescents. These results suggest that high step count may not offset higher overweight or obesity risk for adolescents with high screen time, and low screen time may not offset higher overweight or obesity risk for adolescents with low step count. These findings addressed several research gaps identified by the Physical Activity Guidelines Advisory Committee Scientific Report and may be used to inform future screen time and physical activity guidance for adolescents.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Natalia Smith
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Christopher M. Lee
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Erin E. Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California
- School of Physiology, University of the Witwatersrand, Braamfontein, Johannesburg, South Africa
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10
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Nagata JM, Yu J, Dooley EE, Baker FC, Alsamman S, Wing D, Ganson KT, Pettee Gabriel K. Lower daily steps among U.S. adolescents during the COVID-19 pandemic: Objective findings from the Adolescent Brain Cognitive Development Study. Prev Med Rep 2023; 31:102095. [PMID: 36567744 PMCID: PMC9762097 DOI: 10.1016/j.pmedr.2022.102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA
| | - Jiayue Yu
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA
| | - Erin E. Dooley
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA
- School of Physiology, University of the Witwatersrand, 1 Jan Smuts Ave, Braamfontein, Johannesburg 2000, South Africa
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, 9500 Gilman Drive, Dept. 0811, La Jolla, CA 92093-081, USA
- Center for Wireless and Population Health Systems, University of California, San Diego 9500 Gilman Dr., La Jolla, CA 92093, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL 35233, USA
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McEvoy LK, Bergstrom J, Hagler DJ, Wing D, Reas ET. Elevated Pure Tone Thresholds Are Associated with Altered Microstructure in Cortical Areas Related to Auditory Processing and Attentional Allocation. J Alzheimers Dis 2023; 96:1163-1172. [PMID: 37955091 PMCID: PMC10793660 DOI: 10.3233/jad-230767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Hearing loss is associated with cognitive decline and increased risk for Alzheimer's disease, but the basis of this association is not understood. OBJECTIVE To determine whether hearing impairment is associated with advanced brain aging or altered microstructure in areas involved with auditory and cognitive processing. METHODS 130 participants, (mean 76.4±7.3 years; 65% women) of the Rancho Bernardo Study of Healthy Aging had a screening audiogram in 2003-2005 and brain magnetic resonance imaging in 2014-2016. Hearing ability was defined as the average pure tone threshold (PTA) at 500, 1000, 2000, and 4000 Hz in the better-hearing ear. Brain-predicted age difference (Brain-pad) was calculated as the difference between brain-predicted age based on a validated structural imaging biomarker of brain age, and chronological age. Regional diffusion metrics in temporal and frontal cortex regions were obtained from diffusion-weighted MRIs. Linear regression analyses adjusted for age, gender, education, and health-related measures. RESULTS PTAs were not associated with brain-PAD (β= 0.09; 95% CI: -0.084 to 0.243; p = 0.34). PTAs were associated with reduced restricted diffusion and increased free water diffusion primarily in right hemisphere temporal and frontal areas (restricted diffusion: βs = -0.21 to -0.30; 95% CIs from -0.48 to -0.02; ps < 0.03; free water: βs = 0.18 to 0.26; 95% CIs 0.01 to 0.438; ps < 0.04). CONCLUSIONS Hearing impairment is not associated with advanced brain aging but is associated with differences in brain regions involved with auditory processing and attentional control. It is thus possible that increased dementia risk associated with hearing impairment arises, in part, from compensatory brain changes that may decrease resilience.
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Affiliation(s)
- Linda K McEvoy
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Jaclyn Bergstrom
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Donald J Hagler
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - David Wing
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Emilie T Reas
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
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12
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Lenze EJ, Voegtle M, Miller JP, Ances BM, Balota DA, Barch D, Depp CA, Diniz BS, Eyler LT, Foster ER, Gettinger TR, Head D, Hershey T, Klein S, Nichols JF, Nicol GE, Nishino T, Patterson BW, Rodebaugh TL, Schweiger J, Shimony JS, Sinacore DR, Snyder AZ, Tate S, Twamley EW, Wing D, Wu GF, Yang L, Yingling MD, Wetherell JL. Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults: A Randomized Clinical Trial. JAMA 2022; 328:2218-2229. [PMID: 36511926 PMCID: PMC9856438 DOI: 10.1001/jama.2022.21680] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable with lifestyle interventions. OBJECTIVE To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improve cognitive function in older adults. DESIGN, SETTING, AND PARTICIPANTS This 2 × 2 factorial randomized clinical trial was conducted at 2 US sites (Washington University in St Louis and University of California, San Diego). A total of 585 older adults (aged 65-84 y) with subjective cognitive concerns, but not dementia, were randomized (enrollment from November 19, 2015, to January 23, 2019; final follow-up on March 16, 2020). INTERVENTIONS Participants were randomized to undergo the following interventions: MBSR with a target of 60 minutes daily of meditation (n = 150); exercise with aerobic, strength, and functional components with a target of at least 300 minutes weekly (n = 138); combined MBSR and exercise (n = 144); or a health education control group (n = 153). Interventions lasted 18 months and consisted of group-based classes and home practice. MAIN OUTCOMES AND MEASURES The 2 primary outcomes were composites of episodic memory and executive function (standardized to a mean [SD] of 0 [1]; higher composite scores indicate better cognitive performance) from neuropsychological testing; the primary end point was 6 months and the secondary end point was 18 months. There were 5 reported secondary outcomes: hippocampal volume and dorsolateral prefrontal cortex thickness and surface area from structural magnetic resonance imaging and functional cognitive capacity and self-reported cognitive concerns. RESULTS Among 585 randomized participants (mean age, 71.5 years; 424 [72.5%] women), 568 (97.1%) completed 6 months in the trial and 475 (81.2%) completed 18 months. At 6 months, there was no significant effect of mindfulness training or exercise on episodic memory (MBSR vs no MBSR: 0.44 vs 0.48; mean difference, -0.04 points [95% CI, -0.15 to 0.07]; P = .50; exercise vs no exercise: 0.49 vs 0.42; difference, 0.07 [95% CI, -0.04 to 0.17]; P = .23) or executive function (MBSR vs no MBSR: 0.39 vs 0.31; mean difference, 0.08 points [95% CI, -0.02 to 0.19]; P = .12; exercise vs no exercise: 0.39 vs 0.32; difference, 0.07 [95% CI, -0.03 to 0.18]; P = .17) and there were no intervention effects at the secondary end point of 18 months. There was no significant interaction between mindfulness training and exercise (P = .93 for memory and P = .29 for executive function) at 6 months. Of the 5 prespecified secondary outcomes, none showed a significant improvement with either intervention compared with those not receiving the intervention. CONCLUSIONS AND RELEVANCE Among older adults with subjective cognitive concerns, mindfulness training, exercise, or both did not result in significant differences in improvement in episodic memory or executive function at 6 months. The findings do not support the use of these interventions for improving cognition in older adults with subjective cognitive concerns. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02665481.
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Affiliation(s)
- Eric J. Lenze
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Michelle Voegtle
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - J. Philip Miller
- Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri
| | - Beau M. Ances
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - David A. Balota
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
| | - Deanna Barch
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Colin A. Depp
- VA San Diego Healthcare System Mental Health Division, San Diego, California
- Department of Psychiatry, University of California, San Diego
| | - Breno Satler Diniz
- The University of Connecticut Center on Aging & Department of Psychiatry, University of Connecticut School of Medicine, Farmington
| | - Lisa T. Eyler
- VA San Diego Healthcare System Mental Health Division, San Diego, California
- Department of Psychiatry, University of California, San Diego
| | - Erin R. Foster
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Torie R. Gettinger
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Denise Head
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Tamara Hershey
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Samuel Klein
- Department of Medicine and Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri
| | - Jeanne F. Nichols
- Herbert Wertheim School of Public Health, University of California, San Diego
| | - Ginger E. Nicol
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Bruce W. Patterson
- The University of Connecticut Center on Aging & Department of Psychiatry, University of Connecticut School of Medicine, Farmington
| | - Thomas L. Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, Missouri
| | - Julie Schweiger
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - David R. Sinacore
- Department of Physical Therapy, High Point University, High Point, North Carolina
| | - Abraham Z. Snyder
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Susan Tate
- Health Sciences, University of California, San Diego
| | - Elizabeth W. Twamley
- Department of Psychiatry, University of California, San Diego
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
| | - David Wing
- Herbert Wertheim School of Public Health, University of California, San Diego
| | - Gregory F. Wu
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Lei Yang
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Michael D. Yingling
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Julie Loebach Wetherell
- VA San Diego Healthcare System Mental Health Division, San Diego, California
- Department of Psychiatry, University of California, San Diego
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Wing D, Eyler LT, Lenze EJ, Wetherell JL, Nichols JF, Meeusen R, Godino JG, Shimony JS, Snyder AZ, Nishino T, Nicol GE, Nagels G, Roelands B. Fatness, fitness and the aging brain: A cross sectional study of the associations between a physiological estimate of brain age and physical fitness, activity, sleep, and body composition. Neuroimage: Reports 2022; 2:100146. [PMID: 36743444 PMCID: PMC9894084 DOI: 10.1016/j.ynirp.2022.100146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction Changes in brain structure and function occur with aging. However, there is substantial heterogeneity both in terms of when these changes begin, and the rate at which they progress. Understanding the mechanisms and/or behaviors underlying this heterogeneity may allow us to act to target and slow negative changes associated with aging. Methods Using T1 weighted MRI images, we applied a novel algorithm to determine the physiological age of the brain (brain-predicted age) and the predicted age difference between this physiologically based estimate and chronological age (BrainPAD) to 551 sedentary adults aged 65 to 84 with self-reported cognitive complaint measured at baseline as part of a larger study. We also assessed maximal aerobic capacity with a graded exercise test, physical activity and sleep with accelerometers, and body composition with dual energy x-ray absorptiometry. Associations were explored both linearly and logistically using categorical groupings. Results Visceral Adipose Tissue (VAT), Total Sleep Time (TST) and maximal aerobic capacity all showed significant associations with BrainPAD. Greater VAT was associated with higher (i.e,. older than chronological) BrainPAD (r = 0.149 p = 0.001)Greater TST was associated with higher BrainPAD (r = 0.087 p = 0.042) and greater aerobic capacity was associated with lower BrainPAD (r = - 0.088 p = 0.040). With linear regression, both VAT and TST remained significant (p = 0.036 and 0.008 respectively). Each kg of VAT predicted a 0.741 year increase in BrainPAD, and each hour of increased TST predicted a 0.735 year increase in BrainPAD. Maximal aerobic capacity did not retain statistical significance in fully adjusted linear models. Discussion Accumulation of visceral adipose tissue and greater total sleep time, but not aerobic capacity, total daily physical activity, or sleep quantity and/or quality are associated with brains that are physiologically older than would be expected based upon chronological age alone (BrainPAD).
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Affiliation(s)
- David Wing
- Herbert Wertheim School of Public Health and Human Longevity, University of California, San Diego, United States
- Exercise and Physical Activity Resource Center (EPARC), University of California, San Diego, United States
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, United States
- San Diego Veterans Administration Health Care System, San Diego, United States
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Julie Loebach Wetherell
- Mental Health Service, VA San Diego Healthcare System, United States
- Department of Psychiatry, University of California, San Diego, United States
| | - Jeanne F Nichols
- Herbert Wertheim School of Public Health and Human Longevity, University of California, San Diego, United States
- Exercise and Physical Activity Resource Center (EPARC), University of California, San Diego, United States
| | - Romain Meeusen
- Human Physiology & Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Job G Godino
- Herbert Wertheim School of Public Health and Human Longevity, University of California, San Diego, United States
- Exercise and Physical Activity Resource Center (EPARC), University of California, San Diego, United States
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Abraham Z Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Ginger E Nicol
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Guy Nagels
- Department of Neurology, UZ Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Bart Roelands
- Human Physiology & Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Funk‐White M, Wing D, Eyler LT, Moore AA, Reas ET, McEvoy LK. The Association between Brain Age and Alcohol Use. Alzheimers Dement 2022. [DOI: 10.1002/alz.069241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - David Wing
- University of California San Diego San Diego CA USA
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Wing D, Godino JG, Baker FC, Yang R, Chevance G, Thompson WK, Reuter C, Bartsch H, Wilbur A, Straub LK, Castro N, Higgins M, Colrain IM, de Zambotti M, Wade NE, Lisdahl KM, Squeglia LM, Ortigara J, Fuemmeler B, Patrick K, Mason MJ, Tapert SF, Bagot KS. Recommendations for Identifying Valid Wear for Consumer-Level Wrist-Worn Activity Trackers and Acceptability of Extended Device Deployment in Children. Sensors (Basel) 2022; 22:9189. [PMID: 36501894 PMCID: PMC9738818 DOI: 10.3390/s22239189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/16/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Self-reported physical activity is often inaccurate. Wearable devices utilizing multiple sensors are now widespread. The aim of this study was to determine acceptability of Fitbit Charge HR for children and their families, and to determine best practices for processing its objective data. METHODS Data were collected via Fitbit Charge HR continuously over the course of 3 weeks. Questionnaires were given to each child and their parent/guardian to determine the perceived usability of the device. Patterns of data were evaluated and best practice inclusion criteria recommended. RESULTS Best practices were established to extract, filter, and process data to evaluate device wear, r and establish minimum wear time to evaluate behavioral patterns. This resulted in usable data available from 137 (89%) of the sample. CONCLUSIONS Activity trackers are highly acceptable in the target population and can provide objective data over longer periods of wear. Best practice inclusion protocols that reflect physical activity in youth are provided.
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Grants
- U01DA041048 NIH HHS
- U01DA050989 NIH HHS
- U01DA051016 NIH HHS
- U01DA041022 NIH HHS
- U01DA051018, U01DA051037, U01DA050987, U01DA041174, U01DA041106, U01DA041117, U01DA041028, U01DA041134, U01DA050988, U01DA051039, U01DA041156, U01DA041025, U01DA041120, U01DA051038, U01DA041148, U01DA041093, U01DA041089, U24DA041123, U24DA041147. NIH HHS
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Affiliation(s)
- David Wing
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
| | - Job G. Godino
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Rongguang Yang
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | | | | | - Chase Reuter
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Hauke Bartsch
- Department of Computer Science, University of Bergen, 5007 Bergen, Norway
| | - Aimee Wilbur
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Lisa K. Straub
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Norma Castro
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Michael Higgins
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
| | - Ian M. Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | | | - Natasha E. Wade
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29208, USA
| | - Joseph Ortigara
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
| | - Bernard Fuemmeler
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Kevin Patrick
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
| | - Michael J. Mason
- Center for Behavioral Health Research, University of Tennessee, Knoxville, TN 37996, USA
| | - Susan F. Tapert
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Kara S. Bagot
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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16
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Donahue EK, Venkadesh S, Bui V, Tuazon AC, Wang RK, Haase D, Foreman RP, Duran JJ, Petkus A, Wing D, Higgins M, Holschneider DP, Bayram E, Litvan I, Jakowec MW, Van Horn JD, Schiehser DM, Petzinger GM. Physical activity intensity is associated with cognition and functional connectivity in Parkinson's disease. Parkinsonism Relat Disord 2022; 104:7-14. [PMID: 36191358 DOI: 10.1016/j.parkreldis.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cognitive impairment is common in Parkinson's disease (PD) and often leads to dementia, with no effective treatment. Aging studies suggest that physical activity (PA) intensity has a positive impact on cognition and enhanced functional connectivity may underlie these benefits. However, less is known in PD. This cross-sectional study examined the relationship between PA intensity, cognitive performance, and resting state functional connectivity in PD and whether PA intensity influences the relationship between functional connectivity and cognitive performance. METHODS 96 individuals with mild-moderate PD completed a comprehensive neuropsychological battery. Intensity of PA was objectively captured over a seven-day period using a wearable device (ActiGraph). Time spent in light and moderate intensity PA was determined based on standardized actigraphy cut points. Resting-state fMRI was assessed in a subset of 50 individuals to examine brain-wide functional connectivity. RESULTS Moderate intensity PA (MIPA), but not light PA, was associated with better global cognition, visuospatial function, memory, and executive function. Individuals who met the WHO recommendation of ≥150 min/week of MIPA demonstrated better global cognition, executive function, and visuospatial function. Resting-state functional connectivity associated with MIPA included a combination of brainstem, hippocampus, and regions in the frontal, cingulate, and parietal cortices, which showed higher connectivity across the brain in those achieving the WHO MIPA recommendation. Meeting this recommendation positively moderated the associations between identified functional connectivity and global cognition, visuospatial function, and language. CONCLUSION Encouraging MIPA, particularly the WHO recommendation of ≥150 min of MIPA/week, may represent an important prescription for PD cognition.
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Affiliation(s)
- Erin K Donahue
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA; Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, 90089, USA
| | - Siva Venkadesh
- Department of Psychology, University of Virginia, Charlottesville, VA, 22904, USA
| | - Vy Bui
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Angelie Cabrera Tuazon
- Veterans Administration San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA; Department of Psychiatry, University of California, San Diego, CA, 92093, USA
| | - Ryan K Wang
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Danielle Haase
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Ryan P Foreman
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Jared J Duran
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Andrew Petkus
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - David Wing
- Veterans Administration San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA; Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0811, USA
| | - Michael Higgins
- Veterans Administration San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA; Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0811, USA
| | - Daniel P Holschneider
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, 90089, USA; Department of Psychiatry & the Behavioral Sciences, University of Southern California, Los Angeles, CA, 90089, USA
| | - Ece Bayram
- Parkinson and Other Movement Disorder Center, Department of Neurosciences, University of California San Diego, California, 92092-0886, USA
| | - Irene Litvan
- Parkinson and Other Movement Disorder Center, Department of Neurosciences, University of California San Diego, California, 92092-0886, USA
| | - Michael W Jakowec
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - John Darrell Van Horn
- Department of Psychology, University of Virginia, Charlottesville, VA, 22904, USA; School of Data Science, University of Virginia, Charlottesville, VA, 22904, USA
| | - Dawn M Schiehser
- Veterans Administration San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA; Department of Psychiatry, University of California, San Diego, CA, 92093, USA
| | - Giselle M Petzinger
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
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17
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Seaton M, Wing D, Shen J, Rauh MJ, Kado D, Godino JG, Nichols JF. Associations Of Lean Mass And Muscular Strength With Trabecular Bone Score In Older Adults. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000875512.54241.9f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Wing D, Eyler L, Nichols J, Meeusen R, Godino J, Wetherell J, Shimony J, Snyder A, Lenze E, Orav G, Roelands B. Associations Of Visceral Adipose Tissue With Chronological And BrainAge. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000882264.00997.fa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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19
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Garbin A, Díaz J, Bui V, Morrison J, Fisher BE, Palacios C, Estrada-Darley I, Haase D, Wing D, Amezcua L, Jakowec MW, Kaplan C, Petzinger G. Promoting Physical Activity in a Spanish-Speaking Latina Population of Low Socioeconomic Status With Chronic Neurological Disorders: Proof-of-Concept Study. JMIR Form Res 2022; 6:e34312. [PMID: 35442197 PMCID: PMC9069293 DOI: 10.2196/34312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/17/2022] [Accepted: 02/19/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Physical activity (PA) is known to improve quality of life (QoL) as well as reduce mortality and disease progression in individuals with chronic neurological disorders. However, Latina women are less likely to participate in recommended levels of PA due to common socioeconomic barriers, including limited resources and access to exercise programs. Therefore, we developed a community-based intervention with activity monitoring and behavioral coaching to target these barriers and facilitate sustained participation in an exercise program promoting PA. OBJECTIVE The aim of this study was to determine the feasibility and efficacy of a community-based intervention to promote PA through self-monitoring via a Fitbit and behavioral coaching among Latina participants with chronic neurological disorders. METHODS We conducted a proof-of-concept study among 21 Spanish-speaking Latina participants recruited from the Los Angeles County and University of Southern California (LAC+USC) neurology clinic; participants enrolled in the 16-week intervention at The Wellness Center at The Historic General Hospital in Los Angeles. Demographic data were assessed at baseline. Feasibility was defined by participant attrition and Fitbit adherence. PA promotion was determined by examining change in time spent performing moderate-to-vigorous PA (MVPA) over the 16-week period. The effect of behavioral coaching was assessed by quantifying the difference in MVPA on days when coaching occurred versus on days without coaching. Change in psychometric measures (baseline vs postintervention) and medical center visits (16 weeks preintervention vs during the intervention) were also examined. RESULTS Participants were of low socioeconomic status and acculturation. A total of 19 out of 21 (90%) participants completed the study (attrition 10%), with high Fitbit wear adherence (mean 90.31%, SD 10.12%). Time performing MVPA gradually increased by a mean of 0.16 (SD 0.23) minutes per day (P<.001), which was equivalent to an increase of approximately 18 minutes in MVPA over the course of the 16-week study period. Behavioral coaching enhanced intervention effectiveness as evidenced by a higher time spent on MVPA on days when coaching occurred via phone (37 min/day, P=.02) and in person (45.5 min/day, P=.01) relative to days without coaching (24 min/day). Participants improved their illness perception (effect size g=0.30) and self-rated QoL (effect size g=0.32). Additionally, a reduction in the number of medical center visits was observed (effect size r=0.44), and this reduction was associated with a positive change in step count during the study period (P.=04). CONCLUSIONS Self-monitoring with behavioral coaching is a feasible community-based intervention for PA promotion among Latina women of low socioeconomic status with chronic neurological conditions. PA is known to be important for brain health in neurological conditions but remains relatively unexplored in minority populations. TRIAL REGISTRATION ClinicalTrials.gov NCT04820153; https://clinicaltrials.gov/ct2/show/NCT04820153.
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Affiliation(s)
- Alexander Garbin
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
- Veterans Affairs Eastern Colorado Geriatric Research, Education, and Clinical Center, Veterans Affairs Eastern Colorado Health Care System, Aurora, CO, United States
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jesús Díaz
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Vy Bui
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Janina Morrison
- Primary Care Internal Medicine, The Wellness Center, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, United States
| | - Beth E Fisher
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
- Department of Neurology, University of Southern California, Los Angeles, CA, United States
| | - Carina Palacios
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | | | - Danielle Haase
- Department of Neurology, University of Southern California, Los Angeles, CA, United States
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California at San Diego, San Diego, CA, United States
| | - Lilyana Amezcua
- Department of Neurology, University of Southern California, Los Angeles, CA, United States
| | - Michael W Jakowec
- Department of Neurology, University of Southern California, Los Angeles, CA, United States
| | - Charles Kaplan
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Giselle Petzinger
- Department of Neurology, University of Southern California, Los Angeles, CA, United States
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20
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Kaufmann C, Lee E, Wing D, Ancoli-Israel S, Depp C, Yoon HK, Eyler L. Finding a Composite Measure for Data From Wrist Actigraphy in Bipolar Disorder. Innov Aging 2021. [PMCID: PMC8679538 DOI: 10.1093/geroni/igab046.1307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Actigraphy can objectively measure sleep in studies on Bipolar Disorder (BD) where subjective sleep ratings might be influenced by affect. Actigraphy data are complex necessitating data reduction approaches. We created a composite score of actigraphy sleep metrics (total sleep time [TST], wake after sleep onset [WASO], and percent sleep [PS]) in BD. We computed z-scores of sleep measures for n=51 BD vs. n=80 healthy subjects and averaged scores. We examined associations with participant characteristics and used LASSO to identify metrics best explaining composite variability. Higher composite scores (better sleep) were seen in employed vs. unemployed (t=2.40, df=34, p=0.02), and correlated with higher medication load (r=0.41, p=0.004), lower mania symptomatology (r=-0.33, p=0.04) and lower interleukin (IL)-6 levels (r=-0.32, p=0.02). TST best explained variability in medication load and PS best explained employment, mania symptoms and IL-6. Given observed specificity of associations, selecting theory-driven sleep metrics may be more appropriate than a composite.
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Affiliation(s)
| | - Ellen Lee
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States
| | - David Wing
- Center for Wireless and Population Health Systems, University of California San Diego, La Jolla, California, United States
| | | | - Colin Depp
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Lisa Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States
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21
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Lawhun Costello V, Chevance G, Wing D, Mansour-Assi SJ, Sharp S, Golaszewski NM, Young EA, Higgins M, Ibarra A, Larsen B, Godino JG. Impact of the COVID-19 Pandemic on Objectively Measured Physical Activity and Sedentary Behavior Among Overweight Young Adults: Yearlong Longitudinal Analysis. JMIR Public Health Surveill 2021; 7:e28317. [PMID: 34665759 PMCID: PMC8614391 DOI: 10.2196/28317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/18/2021] [Accepted: 10/14/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted multiple aspects of daily living, including behaviors associated with occupation, transportation, and health. It is unclear how these changes to daily living have impacted physical activity and sedentary behavior. OBJECTIVE In this study, we add to the growing body of research on the health impact of the COVID-19 pandemic by examining longitudinal changes in objectively measured daily physical activity and sedentary behavior among overweight or obese young adults participating in an ongoing weight loss trial in San Diego, California. METHODS Data were collected from 315 overweight or obese (BMI: range 25.0-39.9 kg/m2) participants aged from 18 to 35 years between November 1, 2019, and October 30, 2020, by using the Fitbit Charge 3 (Fitbit LLC). After conducting strict filtering to find valid data on consistent wear (>10 hours per day for ≥250 days), data from 97 participants were analyzed to detect multiple structural changes in time series of physical activity and sedentary behavior. An algorithm was designed to detect multiple structural changes. This allowed for the automatic identification and dating of these changes in linear regression models with CIs. The number of breakpoints in regression models was estimated by using the Bayesian information criterion and residual sum of squares; the optimal segmentation corresponded to the lowest Bayesian information criterion and residual sum of squares. To quantify the changes in each outcome during the periods identified, linear mixed effects analyses were conducted. In terms of key demographic characteristics, the 97 participants included in our analyses did not differ from the 210 participants who were excluded. RESULTS After the initiation of the shelter-in-place order in California on March 19, 2021, there were significant decreases in step counts (-2872 steps per day; 95% CI -2734 to -3010), light physical activity times (-41.9 minutes; 95% CI -39.5 to -44.3), and moderate-to-vigorous physical activity times (-12.2 minutes; 95% CI -10.6 to -13.8), as well as significant increases in sedentary behavior times (+52.8 minutes; 95% CI 47.0-58.5). The decreases were greater than the expected declines observed during winter holidays, and as of October 30, 2020, they have not returned to the levels observed prior to the initiation of shelter-in-place orders. CONCLUSIONS Among overweight or obese young adults, physical activity times decreased and sedentary behavior times increased concurrently with the implementation of COVID-19 mitigation strategies. The health conditions associated with a sedentary lifestyle may be additional, unintended results of the COVID-19 pandemic.
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Affiliation(s)
- Victoria Lawhun Costello
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Guillaume Chevance
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, United States.,Barcelona Institute for Global Health, Barcelona, Spain
| | - David Wing
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, CA, United States
| | - Shadia J Mansour-Assi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, United States
| | - Sydney Sharp
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Natalie M Golaszewski
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, United States
| | - Elizabeth A Young
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, United States
| | - Michael Higgins
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, United States.,Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, CA, United States
| | - Anahi Ibarra
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Britta Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Job G Godino
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, United States.,Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, CA, United States
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22
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Lisdahl KM, Tapert S, Sher KJ, Gonzalez R, Nixon SJ, Ewing SWF, Conway KP, Wallace A, Sullivan R, Hatcher K, Kaiver C, Thompson W, Reuter C, Bartsch H, Wade NE, Jacobus J, Albaugh MD, Allgaier N, Anokhin AP, Bagot K, Baker FC, Banich MT, Barch DM, Baskin-Sommers A, Breslin FJ, Brown SA, Calhoun V, Casey BJ, Chaarani B, Chang L, Clark DB, Cloak C, Constable RT, Cottler LB, Dagher RK, Dapretto M, Dick A, Do EK, Dosenbach NUF, Dowling GJ, Fair DA, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Garavan HP, Gee DG, Glantz MD, Glaser P, Gonzalez MR, Gray KM, Grant S, Haist F, Hawes S, Heeringa SG, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman EA, Howlett KD, Huber RS, Huestis MA, Hyde LW, Iacono WG, Isaiah A, Ivanova MY, James RS, Jernigan TL, Karcher NR, Kuperman JM, Laird AR, Larson CL, LeBlanc KH, Lopez MF, Luciana M, Luna B, Maes HH, Marshall AT, Mason MJ, McGlade E, Morris AS, Mulford C, Nagel BJ, Neigh G, Palmer CE, Paulus MP, Pecheva D, Prouty D, Potter A, Puttler LI, Rajapakse N, Ross JM, Sanchez M, Schirda C, Schulenberg J, Sheth C, Shilling PD, Sowell ER, Speer N, Squeglia L, Sripada C, Steinberg J, Sutherland MT, Tomko R, Uban K, Vrieze S, Weiss SRB, Wing D, Yurgelun-Todd DA, Zucker RA, Heitzeg MM. Substance use patterns in 9-10 year olds: Baseline findings from the adolescent brain cognitive development (ABCD) study. Drug Alcohol Depend 2021; 227:108946. [PMID: 34392051 PMCID: PMC8833837 DOI: 10.1016/j.drugalcdep.2021.108946] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND The Adolescent Brain Cognitive Development ™ Study (ABCD Study®) is an open-science, multi-site, prospective, longitudinal study following over 11,800 9- and 10-year-old youth into early adulthood. The ABCD Study aims to prospectively examine the impact of substance use (SU) on neurocognitive and health outcomes. Although SU initiation typically occurs during teen years, relatively little is known about patterns of SU in children younger than 12. METHODS This study aims to report the detailed ABCD Study® SU patterns at baseline (n = 11,875) in order to inform the greater scientific community about cohort's early SU. Along with a detailed description of SU, we ran mixed effects regression models to examine the association between early caffeine and alcohol sipping with demographic factors, externalizing symptoms and parental history of alcohol and substance use disorders (AUD/SUD). PRIMARY RESULTS At baseline, the majority of youth had used caffeine (67.6 %) and 22.5 % reported sipping alcohol (22.5 %). There was little to no reported use of other drug categories (0.2 % full alcohol drink, 0.7 % used nicotine, <0.1 % used any other drug of abuse). Analyses revealed that total caffeine use and early alcohol sipping were associated with demographic variables (p's<.05), externalizing symptoms (caffeine p = 0002; sipping p = .0003), and parental history of AUD (sipping p = .03). CONCLUSIONS ABCD Study participants aged 9-10 years old reported caffeine use and alcohol sipping experimentation, but very rare other SU. Variables linked with early childhood alcohol sipping and caffeine use should be examined as contributing factors in future longitudinal analyses examining escalating trajectories of SU in the ABCD Study cohort.
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Affiliation(s)
- Krista M Lisdahl
- University of Wisconsin, Milwaukee, WI, United States; Medical College of Wisconsin, Milwaukee, WI, United States.
| | - Susan Tapert
- University of California, San Diego, CA, United States
| | | | - Raul Gonzalez
- Florida International University, Miami, FL, United States
| | - Sara Jo Nixon
- University of Florida, Gainesville, FL, United States
| | | | - Kevin P Conway
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - Alex Wallace
- University of Wisconsin, Milwaukee, WI, United States
| | - Ryan Sullivan
- University of Wisconsin, Milwaukee, WI, United States
| | - Kelah Hatcher
- University of Wisconsin, Milwaukee, WI, United States
| | | | - Wes Thompson
- University of California, San Diego, CA, United States
| | - Chase Reuter
- University of California, San Diego, CA, United States
| | - Hauke Bartsch
- University of California, San Diego, CA, United States
| | | | | | - M D Albaugh
- University of Vermont, Burlington, VT, United States
| | - N Allgaier
- University of Vermont, Burlington, VT, United States
| | - A P Anokhin
- Washington University, St. Louis, MO, United States
| | - K Bagot
- University of California, San Diego, CA, United States; Icahn School of Medicine at Mount Sinai, United States
| | - F C Baker
- SRI International, Menlo Park, CA, United States
| | - M T Banich
- University of Colorado Boulder, CO, United States
| | - D M Barch
- Washington University, St. Louis, MO, United States
| | | | - F J Breslin
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - S A Brown
- University of California, San Diego, CA, United States
| | - V Calhoun
- Georgia State University, Atlanta, GA, United States
| | - B J Casey
- Yale University, New Haven, CT, United States
| | - B Chaarani
- University of Vermont, Burlington, VT, United States
| | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, United States
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, United States
| | | | - L B Cottler
- University of Florida, Gainesville, FL, United States
| | - R K Dagher
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - M Dapretto
- University of California, Los Angeles, CA, United States
| | - A Dick
- Florida International University, Miami, FL, United States
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, United States
| | | | - G J Dowling
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D A Fair
- University of Minnesota, Minneapolis, MN, United States
| | - P Florsheim
- University of Wisconsin, Milwaukee, WI, United States
| | - J J Foxe
- University of Rochester, Rochester, NY, United States
| | - E G Freedman
- University of Rochester, Rochester, NY, United States
| | - N P Friedman
- University of Colorado Boulder, CO, United States
| | - H P Garavan
- University of Vermont, Burlington, VT, United States
| | - D G Gee
- Yale University, New Haven, CT, United States
| | - M D Glantz
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - P Glaser
- Washington University, St. Louis, MO, United States
| | - M R Gonzalez
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, United States
| | - S Grant
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - F Haist
- University of California, San Diego, CA, United States
| | - S Hawes
- Florida International University, Miami, FL, United States
| | - S G Heeringa
- University of Michigan, Ann Arbor, MI, United States
| | - R Hermosillo
- Oregon Health & Science University, Portland, OR, United States
| | - M M Herting
- University of Southern California, Los Angeles, CA, United States
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, United States
| | - J K Hewitt
- University of Colorado Boulder, CO, United States
| | - C Heyser
- University of California, San Diego, CA, United States
| | - E A Hoffman
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - K D Howlett
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - R S Huber
- University of Utah, Salt Lake City, UT, United States
| | - M A Huestis
- University of California, San Diego, CA, United States; Thomas Jefferson University, Philadelphia, PA, United States
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, United States
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, United States
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - M Y Ivanova
- University of Vermont, Burlington, VT, United States
| | - R S James
- American Psychistric Association, United States
| | - T L Jernigan
- University of California, San Diego, CA, United States
| | - N R Karcher
- Washington University, St. Louis, MO, United States
| | - J M Kuperman
- University of California, San Diego, CA, United States
| | - A R Laird
- Florida International University, Miami, FL, United States
| | - C L Larson
- University of Wisconsin, Milwaukee, WI, United States
| | - K H LeBlanc
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M F Lopez
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M Luciana
- University of Minnesota, Minneapolis, MN, United States
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, United States
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, United States
| | - A T Marshall
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - M J Mason
- University of Tennessee, Knoxville, TN, United States
| | - E McGlade
- University of Utah, Salt Lake City, UT, United States
| | - A S Morris
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oklahoma State University, Stillwater, OK, United States
| | - C Mulford
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, United States
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, United States
| | - C E Palmer
- University of California, San Diego, CA, United States
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - D Pecheva
- University of California, San Diego, CA, United States
| | - D Prouty
- SRI International, Menlo Park, CA, United States
| | - A Potter
- University of Vermont, Burlington, VT, United States
| | - L I Puttler
- University of Michigan, Ann Arbor, MI, United States
| | - N Rajapakse
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - J M Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - M Sanchez
- Florida International University, Miami, FL, United States
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, United States
| | - J Schulenberg
- University of Michigan, Ann Arbor, MI, United States
| | - C Sheth
- University of Utah, Salt Lake City, UT, United States
| | - P D Shilling
- University of California, San Diego, CA, United States
| | - E R Sowell
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - N Speer
- University of Colorado Boulder, CO, United States
| | - L Squeglia
- Medical University of South Carolina, Charleston, SC, United States
| | - C Sripada
- University of Michigan, Ann Arbor, MI, United States
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, United States
| | - M T Sutherland
- Florida International University, Miami, FL, United States
| | - R Tomko
- Medical University of South Carolina, Charleston, SC, United States
| | - K Uban
- University of California, Irvine, CA, United States
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, United States
| | - S R B Weiss
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D Wing
- University of California, San Diego, CA, United States
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, United States
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Kaufmann CN, Lee EE, Wing D, Sutherland AN, Christensen C, Ancoli-Israel S, Depp CA, Yoon HK, Soontornniyomkij B, Eyler LT. Correlates of poor sleep based upon wrist actigraphy data in bipolar disorder. J Psychiatr Res 2021; 141:385-389. [PMID: 34329990 PMCID: PMC8722119 DOI: 10.1016/j.jpsychires.2021.06.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/17/2021] [Accepted: 06/16/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Wrist-worn actigraphy can objectively measure sleep, and has advantages over self-report, particularly for people with Bipolar Disorder (BD) for whom self-reports might be influenced by affect. Clinically useful data reduction approaches are needed to explore these complex data. METHODS We created a composite score of sleep metrics in BD based on 51 BD and 80 healthy comparison (HC) participants. Subjects wore an actigraph for up to 14 consecutive 24-h periods, and we assessed total sleep time (TST), wake after sleep onset (WASO), percent sleep (PS), and number of awakenings (NA). We focused on participants who had at least 5 nights of actigraphy data. We computed z-scores for within-person means of sleep measures for BD subjects versus HCs, which were averaged to create a composite measure. We correlated this composite with participant characteristics, and used LASSO regression to identify sleep measures best explaining variability in identified correlates. RESULTS Sleep measures and the composite did not differ between BDs and HCs; however, there was considerable variability in z-scores among those with BD. In BDs, the composite score was higher in women (t(49) = 2.28, p = 0.027) and those who were employed (t(34) = 2.34, p = 0.025), and positively correlated with medication load (r = 0.41, p = 0.003) while negatively correlated with Young Mania Rating Scale (YMRS; r = -0.35, p = 0.030). In LASSO regression, TST and NA best explained medication load while PS best explained employment and YMRS. CONCLUSION While a composite score of sleep metrics may provide useful information about sleep quality globally, our findings suggest that selection of theory-driven sleep measures may be more clinically meaningful.
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Affiliation(s)
- Christopher N. Kaufmann
- Division of Epidemiology and Data Science in Gerontology, Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, FL,Corresponding Author: Christopher N. Kaufmann, PhD, MHS, Assistant Professor, Division of Epidemiology and Data Science in Gerontology, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Rd, Gainesville, FL 32603, P: 323-528-2786,
| | - Ellen E. Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA,Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA,San Diego VA Healthcare System, La Jolla, CA, USA
| | - David Wing
- Center for Wireless and Population Health Systems, University of California San Diego, La Jolla, CA, USA
| | | | | | - Sonia Ancoli-Israel
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA,Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Colin A. Depp
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA,Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA,San Diego VA Healthcare System, La Jolla, CA, USA
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | | | - Lisa T. Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA,Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
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24
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Chaarani B, Hahn S, Allgaier N, Adise S, Owens MM, Juliano AC, Yuan DK, Loso H, Ivanciu A, Albaugh MD, Dumas J, Mackey S, Laurent J, Ivanova M, Hagler DJ, Cornejo MD, Hatton S, Agrawal A, Aguinaldo L, Ahonen L, Aklin W, Anokhin AP, Arroyo J, Avenevoli S, Babcock D, Bagot K, Baker FC, Banich MT, Barch DM, Bartsch H, Baskin-Sommers A, Bjork JM, Blachman-Demner D, Bloch M, Bogdan R, Bookheimer SY, Breslin F, Brown S, Calabro FJ, Calhoun V, Casey BJ, Chang L, Clark DB, Cloak C, Constable RT, Constable K, Corley R, Cottler LB, Coxe S, Dagher RK, Dale AM, Dapretto M, Delcarmen-Wiggins R, Dick AS, Do EK, Dosenbach NUF, Dowling GJ, Edwards S, Ernst TM, Fair DA, Fan CC, Feczko E, Feldstein-Ewing SW, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Friedman-Hill S, Fuemmeler BF, Galvan A, Gee DG, Giedd J, Glantz M, Glaser P, Godino J, Gonzalez M, Gonzalez R, Grant S, Gray KM, Haist F, Harms MP, Hawes S, Heath AC, Heeringa S, Heitzeg MM, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman E, Howlett K, Huber RS, Huestis MA, Hyde LW, Iacono WG, Infante MA, Irfanoglu O, Isaiah A, Iyengar S, Jacobus J, James R, Jean-Francois B, Jernigan T, Karcher NR, Kaufman A, Kelley B, Kit B, Ksinan A, Kuperman J, Laird AR, Larson C, LeBlanc K, Lessov-Schlagger C, Lever N, Lewis DA, Lisdahl K, Little AR, Lopez M, Luciana M, Luna B, Madden PA, Maes HH, Makowski C, Marshall AT, Mason MJ, Matochik J, McCandliss BD, McGlade E, Montoya I, Morgan G, Morris A, Mulford C, Murray P, Nagel BJ, Neale MC, Neigh G, Nencka A, Noronha A, Nixon SJ, Palmer CE, Pariyadath V, Paulus MP, Pelham WE, Pfefferbaum D, Pierpaoli C, Prescot A, Prouty D, Puttler LI, Rajapaske N, Rapuano KM, Reeves G, Renshaw PF, Riedel MC, Rojas P, de la Rosa M, Rosenberg MD, Ross MJ, Sanchez M, Schirda C, Schloesser D, Schulenberg J, Sher KJ, Sheth C, Shilling PD, Simmons WK, Sowell ER, Speer N, Spittel M, Squeglia LM, Sripada C, Steinberg J, Striley C, Sutherland MT, Tanabe J, Tapert SF, Thompson W, Tomko RL, Uban KA, Vrieze S, Wade NE, Watts R, Weiss S, Wiens BA, Williams OD, Wilbur A, Wing D, Wolff-Hughes D, Yang R, Yurgelun-Todd DA, Zucker RA, Potter A, Garavan HP. Baseline brain function in the preadolescents of the ABCD Study. Nat Neurosci 2021; 24:1176-1186. [PMID: 34099922 PMCID: PMC8947197 DOI: 10.1038/s41593-021-00867-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/30/2021] [Indexed: 02/05/2023]
Abstract
The Adolescent Brain Cognitive Development (ABCD) Study® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development.
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Affiliation(s)
- B Chaarani
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| | - S Hahn
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - N Allgaier
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Adise
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M M Owens
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A C Juliano
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D K Yuan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H Loso
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A Ivanciu
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M D Albaugh
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Dumas
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Mackey
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Laurent
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M Ivanova
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D J Hagler
- University of California, San Diego, La Jolla, CA, USA
| | - M D Cornejo
- Institute of Physics UC, Pontificia Universidad Catolica de Chile, Pontificia, Chile
| | - S Hatton
- University of California, San Diego, La Jolla, CA, USA
| | - A Agrawal
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - L Aguinaldo
- University of California, San Diego, La Jolla, CA, USA
| | - L Ahonen
- University of Pittsburgh, Pittsburgh, PA, USA
| | - W Aklin
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - A P Anokhin
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Arroyo
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S Avenevoli
- National Institute of Mental Health, Bethesda, MD, USA
| | - D Babcock
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - K Bagot
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F C Baker
- SRI International, Menlo Park, CA, USA
| | - M T Banich
- University of Colorado, Boulder, CO, USA
| | - D M Barch
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H Bartsch
- Haukeland University Hospital, Bergen, Norway
| | | | - J M Bjork
- Virginia Commonwealth University, Richmond, VA, USA
| | - D Blachman-Demner
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - M Bloch
- National Cancer Institute, Bethesda, MD, USA
| | - R Bogdan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - F Breslin
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - S Brown
- University of California, San Diego, La Jolla, CA, USA
| | - F J Calabro
- University of Pittsburgh, Pittsburgh, PA, USA
| | - V Calhoun
- University of Colorado, Boulder, CO, USA
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | | | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, USA
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - K Constable
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R Corley
- University of Colorado, Boulder, CO, USA
| | | | - S Coxe
- Florida International University, Miami, FL, USA
| | - R K Dagher
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - A M Dale
- University of California, San Diego, La Jolla, CA, USA
| | - M Dapretto
- University of California, Los Angeles, CA, USA
| | | | - A S Dick
- Florida International University, Miami, FL, USA
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, USA
| | - N U F Dosenbach
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - G J Dowling
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - S Edwards
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - T M Ernst
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Fair
- Oregon Health & Science University, Portland, OR, USA
| | - C C Fan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - E Feczko
- Oregon Health & Science University, Portland, OR, USA
| | | | | | - J J Foxe
- University of Rochester, Rochester, NY, USA
| | | | | | | | | | - A Galvan
- University of California, Los Angeles, CA, USA
| | - D G Gee
- Yale University, New Haven, CT, USA
| | - J Giedd
- University of California, San Diego, La Jolla, CA, USA
| | - M Glantz
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Glaser
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Godino
- University of California, San Diego, La Jolla, CA, USA
| | - M Gonzalez
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - R Gonzalez
- Florida International University, Miami, FL, USA
| | - S Grant
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, USA
| | - F Haist
- University of California, San Diego, La Jolla, CA, USA
| | - M P Harms
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - S Hawes
- Florida International University, Miami, FL, USA
| | - A C Heath
- University of California, San Diego, La Jolla, CA, USA
| | - S Heeringa
- University of Michigan, Ann Arbor, MI, USA
| | | | - R Hermosillo
- Oregon Health & Science University, Portland, OR, USA
| | - M M Herting
- University of Southern California, Los Angeles, CA, USA
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, USA
| | - J K Hewitt
- University of Colorado, Boulder, CO, USA
| | - C Heyser
- University of California, San Diego, La Jolla, CA, USA
| | - E Hoffman
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K Howlett
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R S Huber
- University of Utah, Salt Lake City, UT, USA
| | - M A Huestis
- Thomas Jefferson University, Philadelphia, PA, USA
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, USA
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, USA
| | - M A Infante
- University of California, San Diego, La Jolla, CA, USA
| | - O Irfanoglu
- National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Iyengar
- National Endowment for the Arts, Washington DC, USA
| | - J Jacobus
- University of California, San Diego, La Jolla, CA, USA
| | - R James
- Virginia Commonwealth University, Richmond, VA, USA
| | - B Jean-Francois
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - T Jernigan
- University of California, San Diego, La Jolla, CA, USA
| | - N R Karcher
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - A Kaufman
- National Cancer Institute, Bethesda, MD, USA
| | - B Kelley
- National Institute of Justice, Washington DC, USA
| | - B Kit
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - A Ksinan
- Virginia Commonwealth University, Richmond, VA, USA
| | - J Kuperman
- University of California, San Diego, La Jolla, CA, USA
| | - A R Laird
- Florida International University, Miami, FL, USA
| | - C Larson
- University of Wisconsin, Milwaukee, WI, USA
| | - K LeBlanc
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - C Lessov-Schlagger
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - N Lever
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Lewis
- University of Pittsburgh, Pittsburgh, PA, USA
| | - K Lisdahl
- University of Wisconsin, Milwaukee, WI, USA
| | - A R Little
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Lopez
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Luciana
- University of Minnesota, Minneapolis, MN, USA
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, USA
| | - P A Madden
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Makowski
- University of California, San Diego, La Jolla, CA, USA
| | - A T Marshall
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - M J Mason
- University of Tennessee, Knoxville, TN, USA
| | - J Matochik
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | | | - E McGlade
- University of Utah, Salt Lake City, UT, USA
| | - I Montoya
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - G Morgan
- National Cancer Institute, Bethesda, MD, USA
| | - A Morris
- Oklahoma State University, Stillwater, OK, USA
| | - C Mulford
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Murray
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, USA
| | - M C Neale
- Virginia Commonwealth University, Richmond, VA, USA
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, USA
| | - A Nencka
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Noronha
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S J Nixon
- University of Florida, Gainesville, FL, USA
| | - C E Palmer
- University of California, San Diego, La Jolla, CA, USA
| | - V Pariyadath
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - W E Pelham
- Florida International University, Miami, FL, USA
| | | | - C Pierpaoli
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - A Prescot
- University of Utah, Salt Lake City, UT, USA
| | - D Prouty
- SRI International, Menlo Park, CA, USA
| | | | - N Rajapaske
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | | | - G Reeves
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - M C Riedel
- Florida International University, Miami, FL, USA
| | - P Rojas
- Florida International University, Miami, FL, USA
| | - M de la Rosa
- Florida International University, Miami, FL, USA
| | | | - M J Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Sanchez
- Florida International University, Miami, FL, USA
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, USA
| | - D Schloesser
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | | | - K J Sher
- University of Missouri, Columbia, MO, USA
| | - C Sheth
- University of Utah, Salt Lake City, UT, USA
| | - P D Shilling
- University of California, San Diego, La Jolla, CA, USA
| | - W K Simmons
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - E R Sowell
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - N Speer
- University of Colorado, Boulder, CO, USA
| | - M Spittel
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - L M Squeglia
- Medical University of South Carolina, Charleston, SC, USA
| | - C Sripada
- University of Michigan, Ann Arbor, MI, USA
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Striley
- University of Florida, Gainesville, FL, USA
| | | | - J Tanabe
- University of Colorado, Boulder, CO, USA
| | - S F Tapert
- University of California, San Diego, La Jolla, CA, USA
| | - W Thompson
- University of California, San Diego, La Jolla, CA, USA
| | - R L Tomko
- Medical University of South Carolina, Charleston, SC, USA
| | - K A Uban
- University of California, Irvine, CA, USA
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, USA
| | - N E Wade
- University of California, San Diego, La Jolla, CA, USA
| | - R Watts
- Yale University, New Haven, CT, USA
| | - S Weiss
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - B A Wiens
- University of Florida, Gainesville, FL, USA
| | - O D Williams
- Florida International University, Miami, FL, USA
| | - A Wilbur
- SRI International, Menlo Park, CA, USA
| | - D Wing
- University of California, San Diego, La Jolla, CA, USA
| | - D Wolff-Hughes
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - R Yang
- University of California, San Diego, La Jolla, CA, USA
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, USA
| | - A Potter
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H P Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
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Webster DE, Tummalacherla M, Higgins M, Wing D, Ashley E, Kelly VE, McConnell MV, Muse ED, Olgin JE, Mangravite LM, Godino J, Kellen MR, Omberg L. Smartphone-Based VO2max Measurement With Heart Snapshot in Clinical and Real-world Settings With a Diverse Population: Validation Study. JMIR Mhealth Uhealth 2021; 9:e26006. [PMID: 34085945 PMCID: PMC8214186 DOI: 10.2196/26006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/04/2021] [Accepted: 04/12/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Maximal oxygen consumption (VO2max) is one of the most predictive biometrics for cardiovascular health and overall mortality. However, VO2max is rarely measured in large-scale research studies or routine clinical care because of the high cost, participant burden, and requirement for specialized equipment and staff. OBJECTIVE To overcome the limitations of clinical VO2max measurement, we aim to develop a digital VO2max estimation protocol that can be self-administered remotely using only the sensors within a smartphone. We also aim to validate this measure within a broadly representative population across a spectrum of smartphone devices. METHODS Two smartphone-based VO2max estimation protocols were developed: a 12-minute run test (12-MRT) based on distance measured by GPS and a 3-minute step test (3-MST) based on heart rate recovery measured by a camera. In a 101-person cohort, balanced across age deciles and sex, participants completed a gold standard treadmill-based VO2max measurement, two silver standard clinical protocols, and the smartphone-based 12-MRT and 3-MST protocols in the clinic and at home. In a separate 120-participant cohort, the video-based heart rate measurement underlying the 3-MST was measured for accuracy in individuals across the spectrum skin tones while using 8 different smartphones ranging in cost from US $99 to US $999. RESULTS When compared with gold standard VO2max testing, Lin concordance was pc=0.66 for 12-MRT and pc=0.61 for 3-MST. However, in remote settings, the 12-MRT was significantly less concordant with the gold standard (pc=0.25) compared with the 3-MST (pc=0.61), although both had high test-retest reliability (12-MRT intraclass correlation coefficient=0.88; 3-MST intraclass correlation coefficient=0.86). On the basis of the finding that 3-MST concordance was generalizable to remote settings whereas 12-MRT was not, the video-based heart rate measure within the 3-MST was selected for further investigation. Heart rate measurements in any of the combinations of the six Fitzpatrick skin tones and 8 smartphones resulted in a concordance of pc≥0.81. Performance did not correlate with device cost, with all phones selling under US $200 performing better than pc>0.92. CONCLUSIONS These findings demonstrate the importance of validating mobile health measures in the real world across a diverse cohort and spectrum of hardware. The 3-MST protocol, termed as heart snapshot, measured VO2max with similar accuracy to supervised in-clinic tests such as the Tecumseh (pc=0.94) protocol, while also generalizing to remote and unsupervised measurements. Heart snapshot measurements demonstrated fidelity across demographic variation in age and sex, across diverse skin pigmentation, and between various iOS and Android phone configurations. This software is freely available for all validation data and analysis code.
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Affiliation(s)
| | | | - Michael Higgins
- Exercise and Physical Activity Resource Center, University of California at San Diego, San Diego, CA, United States
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California at San Diego, San Diego, CA, United States
| | - Euan Ashley
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, United States
| | - Valerie E Kelly
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Michael V McConnell
- Stanford University School of Medicine, Stanford, CA, United States.,Google Health, Palo Alto, CA, United States
| | - Evan D Muse
- Scripps Research Translational Institute and Scripps Clinic, La Jolla, CA, United States
| | - Jeffrey E Olgin
- Division of Cardiology and the Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, United States
| | | | - Job Godino
- Exercise and Physical Activity Resource Center, University of California at San Diego, San Diego, CA, United States.,Scripps Research Translational Institute and Scripps Clinic, La Jolla, CA, United States
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Wing D, Godino JG, Vo A, Moran R, Graham S, Nichols JF. Quantification of Scan Analysis Errors in GE Lunar DXA Visceral Adiposity in Adults. J Clin Densitom 2021; 24:287-293. [PMID: 32709552 DOI: 10.1016/j.jocd.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 11/25/2022]
Abstract
Utilization of dual-energy X-ray absorptiometry is increasing in clinical settings and the fitness industry as a viable tool to assess total and regional body composition, including visceral adiposity. Previous research using small samples (<50) has described several pitfalls in patient positioning, scan acquisition, and/or analysis that alter regional body composition values. Our aim was to quantify the largest probable error in measures of total, android, gynoid, and visceral fat caused by incorrect placement of the head cut-line, in a large sample of adults. Total body images (N = 436) from 196 women and 67 men (20-85 years) scanned on a GE Lunar Prodigy densitometer were analyzed using enCORE software in 2 ways: (1) placing the head cut-line just beneath the bony protuberance of the chin according to manufacturer recommendation (correct method); (2) placing the head cut-line at the lowest point below the chin and just above the soft tissue at the shoulders (incorrect method). All other cut-lines were fixed. Mean differences in adiposity were examined using Lin's concordance correlation coefficient; equality of means and variances were evaluated using Bradley-Blackwood F-tests. The limits of agreement were displayed as Bland-Altman plots and calculated as the mean difference ±1.96 times the standard deviation of the difference. Correlation coefficients for paired comparisons of adiposity for correct vs incorrect cut-line placement ranged from 0.983-0.999 for all variables (all p < 0.001). Significant mean differences were 172 ± 130, 201 ± 168, 65 ± 122, and -143 ± 336 g for android, gynoid, visceral, and total fat mass, respectively (all p < 0.0001). These differences exceeded our site's least significant change in 66%, 37%, 29%, and 4% of participant scans for android, gynoid, visceral, and total fat mass, respectively. Our findings underscore the importance of careful review of the manufacturer's auto analysis and consistency in conducting serial scans to ensure accurate and precise measures of regional body fat.
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Affiliation(s)
- David Wing
- Exercise and Physical Activity Resource Center (EPARC), Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA; UCSD Bone Densitometry School, La Jolla, CA, USA
| | - Job G Godino
- Exercise and Physical Activity Resource Center (EPARC), Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA
| | - Anh Vo
- Exercise and Physical Activity Resource Center (EPARC), Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA
| | - Ryan Moran
- Exercise and Physical Activity Resource Center (EPARC), Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA; UCSD Bone Densitometry School, La Jolla, CA, USA
| | - Sarah Graham
- Exercise and Physical Activity Resource Center (EPARC), Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA; Department of Psychiatry, UCSD, La Jolla, CA, USA; Sam and Rose Stein Institute for Research on Aging, UCSD, La Jolla, CA, USA
| | - Jeanne F Nichols
- Exercise and Physical Activity Resource Center (EPARC), Department of Family Medicine and Public Health, University of California, San Diego (UCSD), La Jolla, CA, USA; UCSD Bone Densitometry School, La Jolla, CA, USA.
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Walker RL, Greenwood-Hickman MA, Bellettiere J, LaCroix AZ, Wing D, Higgins M, Richmire K, Larson EB, Crane PK, Rosenberg DE. Associations between physical function and device-based measures of physical activity and sedentary behavior patterns in older adults: moving beyond moderate-to-vigorous intensity physical activity. BMC Geriatr 2021; 21:216. [PMID: 33789584 PMCID: PMC8011072 DOI: 10.1186/s12877-021-02163-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Research supports that moderate-to-vigorous intensity physical activity (MVPA) is key to prolonged health and function. Among older adults, substantial changes to MVPA may be infeasible, thus a growing literature suggests a shift in focus to whole-day activity patterns. Methods With data from 795 older adults aged 65–100 in the Adult Changes in Thought Activity Monitoring study, we used linear regression to estimate associations between ActiGraph and activPAL measured activity patterns – including light intensity physical activity, steps, standing, and sedentary behaviors – and physical function as measured by a short Performance-based Physical Function (sPPF) score (range 0–12), a composite score based on three standardized physical performance tasks: gait speed, timed chair stands, and grip strength. We examined whether relationships persisted when controlling for MVPA or differed across age, gender, or quartiles of MVPA. Results In models unadjusted for MVPA, a 1-standard deviation (SD) increment of daily sitting (1.9 h more), mean sitting bout duration (8 min longer average), or time spent in sedentary activity (1.6 h more) was associated with ~ 0.3–0.4 points lower mean sPPF score (all p < 0.05). A 1-SD increment in daily steps (~ 3500 more steps) was associated with ~ 0.5 points higher mean sPPF score (95% CI: 0.22 to 0.73). MVPA adjustment attenuated all relationships. The association between physical function and steps was strongest among adults aged 75+; associations of worse function with greater sedentary behavior were more pronounced in participants with the lowest levels of MVPA. Conclusions We found associations between function and activity metrics other than MVPA in key subgroups, findings that support research on broader activity patterns and may offer ideas regarding practical intervention opportunities for improving function in older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02163-4.
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Affiliation(s)
- Rod L Walker
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.
| | | | - John Bellettiere
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Andrea Z LaCroix
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - David Wing
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Michael Higgins
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - KatieRose Richmire
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Paul K Crane
- University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
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Rosenberg D, Walker R, Greenwood-Hickman MA, Richmire K, Bellettiere J, Wing D, LaCroix A. Patterns of Sedentary Behavior in a Community-Based Cohort of Older Adults. Innov Aging 2020. [PMCID: PMC7742997 DOI: 10.1093/geroni/igaa057.2862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Few epidemiologic studies have examined device-measured sitting patterns by demographics and health status. The Adult Changes in Thought (ACT) study is an on-going epidemiologic study of adults age ≥65 years. We conducted a sub-study that added a thigh-worn activPAL device and sleep logs for 7 days to the measurement protocol. A total of 997 had valid wear time (≥4 days with 10-20 hours of data per day) and covariate data. activPAL sedentary pattern measures included number of sitting bouts lasting 30 minutes or more and mean sitting bout duration. On average, participants (56% female, 57% > age 75, 89% non-Hispanic white) sat in bouts lasting 17 minutes (SD = 12) and had 5.9 (SD = 1.7) bouts of sitting lasting 30 minutes or more. Participants who were older, were male, had obesity, had worse self-rated health, had depression, and had difficulty walking had longer sitting bouts and more prolonged bouts.
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Affiliation(s)
- Dori Rosenberg
- Kaiser Permanente Washington, Seattle, Washington, United States
| | - Rod Walker
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, United States
| | | | - KatieRose Richmire
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, United States
| | - John Bellettiere
- University of California San Diego, La Jolla, California, United States
| | - David Wing
- University of California San Diego, La Jolla, California, United States
| | - Andrea LaCroix
- University of California San Diego, La Jolla, California, United States
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29
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Godino JG, Wing D, de Zambotti M, Baker FC, Bagot K, Inkelis S, Pautz C, Higgins M, Nichols J, Brumback T, Chevance G, Colrain IM, Patrick K, Tapert SF. Performance of a commercial multi-sensor wearable (Fitbit Charge HR) in measuring physical activity and sleep in healthy children. PLoS One 2020; 15:e0237719. [PMID: 32886714 PMCID: PMC7473549 DOI: 10.1371/journal.pone.0237719] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/31/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE This study sought to assess the performance of the Fitbit Charge HR, a consumer-level multi-sensor activity tracker, to measure physical activity and sleep in children. METHODS 59 healthy boys and girls aged 9-11 years old wore a Fitbit Charge HR, and accuracy of physical activity measures were evaluated relative to research-grade measures taken during a combination of 14 standardized laboratory- and field-based assessments of sitting, stationary cycling, treadmill walking or jogging, stair walking, outdoor walking, and agility drills. Accuracy of sleep measures were evaluated relative to polysomnography (PSG) in 26 boys and girls during an at-home unattended PSG overnight recording. The primary analyses included assessment of the agreement (biases) between measures using the Bland-Altman method, and epoch-by-epoch (EBE) analyses on a minute-by-minute basis. RESULTS Fitbit Charge HR underestimated steps (~11.8 steps per minute), heart rate (~3.58 bpm), and metabolic equivalents (~0.55 METs per minute) and overestimated energy expenditure (~0.34 kcal per minute) relative to research-grade measures (p< 0.05). The device showed an overall accuracy of 84.8% for classifying moderate and vigorous physical activity (MVPA) and sedentary and light physical activity (SLPA) (sensitivity MVPA: 85.4%; specificity SLPA: 83.1%). Mean estimates of bias for measuring total sleep time, wake after sleep onset, and heart rate during sleep were 14 min, 9 min, and 1.06 bpm, respectively, with 95.8% sensitivity in classifying sleep and 56.3% specificity in classifying wake epochs. CONCLUSIONS Fitbit Charge HR had adequate sensitivity in classifying moderate and vigorous intensity physical activity and sleep, but had limitations in detecting wake, and was more accurate in detecting heart rate during sleep than during exercise, in healthy children. Further research is needed to understand potential challenges and limitations of these consumer devices.
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Affiliation(s)
- Job G. Godino
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, California, United States of America
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California, United States of America
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, California, United States of America
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California, United States of America
| | | | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California, United States of America
| | - Kara Bagot
- Department of Psychiatry, University of California, San Diego, La Jolla, California, United States of America
| | - Sarah Inkelis
- Department of Psychiatry, University of California, San Diego, La Jolla, California, United States of America
| | - Carina Pautz
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, California, United States of America
| | - Michael Higgins
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, California, United States of America
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California, United States of America
| | - Jeanne Nichols
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, California, United States of America
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California, United States of America
| | - Ty Brumback
- Department of Psychological Science, Northern Kentucky University, Highland Heights, Kentucky, United States of America
| | - Guillaume Chevance
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, California, United States of America
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California, United States of America
| | - Ian M. Colrain
- Center for Health Sciences, SRI International, Menlo Park, California, United States of America
| | - Kevin Patrick
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla, California, United States of America
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, California, United States of America
| | - Susan F. Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, California, United States of America
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30
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Rosenberg D, Walker R, Greenwood-Hickman MA, Bellettiere J, Xiang Y, Richmire K, Higgins M, Wing D, Larson EB, Crane PK, LaCroix AZ. Device-assessed physical activity and sedentary behavior in a community-based cohort of older adults. BMC Public Health 2020; 20:1256. [PMID: 32811454 PMCID: PMC7436994 DOI: 10.1186/s12889-020-09330-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 08/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Few studies characterize older adult physical activity and sitting patterns using accurate accelerometer and concurrent posture measures. In this descriptive paper, we report accelerometer data collection protocols, consent rates, and physical behavior measures from a population-based cohort study (Adult Changes in Thought, ACT). METHODS The ACT study holds enrollment steady at approximately 2000 members of Kaiser Permanente Washington aged 65+ without dementia undergoing detailed biennial assessments. In 2016 the ACT-Activity Monitor (ACT-AM) sub-study was initiated to obtain data from wearing activPAL and ActiGraph devices for 7 days following regular biennial visits. We describe the methods protocol of ACT-AM and present characteristics of people who did and did not consent to wear devices. We compute inverse probability of response weights and incorporate these weights in linear regression models to estimate means and 95% confidence intervals (CI) of device-based pattern metrics, adjusted for wear time and demographic factors, and weighted to account for potential selection bias due to device-wear consent. RESULTS Among 1885 eligible ACT participants, 56% agreed to wear both devices (mean age 77 years, 56% female, 89% non-Hispanic white, 91% with post-secondary education). On average, those who agreed to wear devices were younger and healthier. Estimated mean (95% CI) activPAL-derived sitting, standing, and stepping times were 10.2 h/day (603-618 min/day), 3.9 h/day (226-239 min/day), and 1.4 h/day (79-84 min/day), respectively. Estimated mean ActiGraph derived sedentary (Vector Magnitude [VM] < =18 counts/15 s), light intensity (VM 19-518 counts/15 s), and moderate-to-vigorous intensity (VM > 518 counts/15 s) physical activity durations were 9.5 h/day (565-577 min/day), 4.5 h/day (267-276 min/day), and 1.0 h/day (59-64 min/day). Participants who were older, had chronic conditions, and were unable to walk a half-mile had higher sedentary time and less physical activity. CONCLUSIONS Our recruitment rate demonstrates the feasibility of cohort participants to wear two devices that measure sedentary time and physical activity. Data indicate high levels of sitting time in older adults but also high levels of physical activity using cut-points developed for older adults. These data will help researchers test hypotheses related to physical behavior and health in older adults in the future.
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Affiliation(s)
- Dori Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.
| | - Rod Walker
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | | | - John Bellettiere
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Yunhua Xiang
- University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA
| | - KatieRose Richmire
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Michael Higgins
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - David Wing
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
| | - Paul K Crane
- University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA
| | - Andrea Z LaCroix
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
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Wetherell JL, Ripperger HS, Voegtle M, Ances BM, Balota D, Bower ES, Depp C, Eyler L, Foster ER, Head D, Hershey T, Hickman S, Kamantigue N, Klein S, Miller JP, Yingling MD, Nichols J, Nicol GE, Patterson BW, Rodebaugh TL, Shimony JS, Snyder A, Stephens M, Tate S, Uhrich ML, Wing D, Wu GF, Lenze EJ. Mindfulness, Education, and Exercise for age-related cognitive decline: Study protocol, pilot study results, and description of the baseline sample. Clin Trials 2020; 17:581-594. [PMID: 32594789 DOI: 10.1177/1740774520931864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS Age-related cognitive decline is a pervasive problem in our aging population. To date, no pharmacological treatments to halt or reverse cognitive decline are available. Behavioral interventions, such as physical exercise and Mindfulness-Based Stress Reduction, may reduce or reverse cognitive decline, but rigorously designed randomized controlled trials are needed to test the efficacy of such interventions. METHODS Here, we describe the design of the Mindfulness, Education, and Exercise study, an 18-month randomized controlled trial that will assess the effect of two interventions-mindfulness training plus moderate-to-vigorous intensity exercise or moderate-to-vigorous intensity exercise alone-compared with a health education control group on cognitive function in older adults. An extensive battery of biobehavioral assessments will be used to understand the mechanisms of cognitive remediation, by using structural and resting state functional magnetic resonance imaging, insulin sensitivity, inflammation, and metabolic and behavioral assessments. RESULTS We provide the results from a preliminary study (n = 29) of non-randomized pilot participants who received both the exercise and Mindfulness-Based Stress Reduction interventions. We also provide details on the recruitment and baseline characteristics of the randomized controlled trial sample (n = 585). CONCLUSION When complete, the Mindfulness, Education, and Exercise study will inform the research community on the efficacy of these widely available interventions improve cognitive functioning in older adults.
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Affiliation(s)
- Julie Loebach Wetherell
- VA San Diego Healthcare System, San Diego, CA, USA.,University of California San Diego, San Diego, CA, USA
| | - Hayley S Ripperger
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Michelle Voegtle
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - David Balota
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Emily S Bower
- University of California San Diego, San Diego, CA, USA
| | - Colin Depp
- VA San Diego Healthcare System, San Diego, CA, USA.,University of California San Diego, San Diego, CA, USA
| | - Lisa Eyler
- University of California San Diego, San Diego, CA, USA
| | - Erin R Foster
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.,Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Denise Head
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.,Mallinckrodt Institute of Radiology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Tamara Hershey
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.,Mallinckrodt Institute of Radiology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Samuel Klein
- Center for Human Nutrition, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - J Philip Miller
- Division of Biostatistics, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Michael D Yingling
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Ginger E Nicol
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Bruce W Patterson
- Center for Human Nutrition, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Abraham Snyder
- Mallinckrodt Institute of Radiology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Mary Stephens
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Susan Tate
- University of California San Diego, San Diego, CA, USA
| | - Mary L Uhrich
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.,Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - David Wing
- University of California San Diego, San Diego, CA, USA
| | - Gregory F Wu
- Department of Neurology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.,Department of Pathology and Immunology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Eric J Lenze
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Abstract
Purpose Cardiorespiratory fitness (CRF), broadly defined as the body’s ability to utilize oxygen, is a well-established prognostic marker of health, but it is not routinely measured. This may be due to the difficulty of acquiring high-quality CRF measures. The purpose of this study was to independently determine the validity of the Fitbit Charge 2’s measure of CRF (Fitbit CRF). Methods Sixty-five healthy adults between the ages of 18 and 45 yr (55% female, 45% male) were recruited to undergo gold standard V˙O2max testing and wear a Fitbit Charge 2 continuously for 1 wk during which they were instructed to complete a qualifying outdoor run to derive the Fitbit CRF (units: mL·kg−1·min−1). This measure was compared with V˙O2max measures (units: mL·kg−1·min−1) epoched at 15 and 60 s. Results Bland–Altman analyses revealed that Fitbit CRF had a positive bias of 1.59 mL·kg−1·min−1 compared with laboratory data epoched at 15 s and 0.30 mL·kg−1·min−1 compared with data epoched at 60 s (n = 60). F statistics (2.09; 0.08) and P values (0.133; 0.926) from Bradley–Blackwood tests for the concordance of Fitbit CRF with 15- and 60-s laboratory data, respectively, support the null hypothesis of equal means and variances, indicating there is concordance between the two measures. Mean absolute percentage error was less than 10% for each comparison. Conclusions The Fitbit Charge 2 provides an acceptable level of validity when measuring CRF in young, healthy, and fit adults who are able to run. Further research is required to determine if it is a potentially useful tool in clinical practice and epidemiological research to quantify, categorize, and longitudinally track risk for adverse outcomes.
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Affiliation(s)
- Katharine Klepin
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, San Diego, CA
| | - Michael Higgins
- Exercise and Physical Activity Resource Center, University of California, San Diego, San Diego, CA
| | - Jeanne Nichols
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA.,Exercise and Physical Activity Resource Center, University of California, San Diego, San Diego, CA
| | - Job G Godino
- Exercise and Physical Activity Resource Center, University of California, San Diego, San Diego, CA.,Center for Wireless and Population Health Systems, University of California, San Diego, San Diego, CA
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Folta SC, Paul L, Nelson ME, Strogatz D, Graham M, Eldridge GD, Higgins M, Wing D, Seguin-Fowler RA. Changes in diet and physical activity resulting from the Strong Hearts, Healthy Communities randomized cardiovascular disease risk reduction multilevel intervention trial. Int J Behav Nutr Phys Act 2019; 16:91. [PMID: 31653260 PMCID: PMC6815048 DOI: 10.1186/s12966-019-0852-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/30/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Women living in rural areas face unique challenges in achieving a heart-healthy lifestyle that are related to multiple levels of the social-ecological framework. The purpose of this study was to evaluate changes in diet and physical activity, which are secondary outcomes of a community-based, multilevel cardiovascular disease risk reduction intervention designed for women in rural communities. METHODS Strong Hearts, Healthy Communities was a six-month, community-randomized trial conducted in 16 rural towns in Montana and New York, USA. Sedentary women aged 40 and older with overweight and obesity were recruited. Intervention participants (eight towns) attended twice weekly exercise and nutrition classes for 24 weeks (48 total). Individual-level components included aerobic exercise, progressive strength training, and healthy eating practices; a civic engagement component was designed to address social and built environment factors to support healthy lifestyles. The control group (eight towns) attended didactic healthy lifestyle classes monthly (six total). Dietary and physical activity data were collected at baseline and post-intervention. Dietary data were collected using automated self-administered 24-h dietary recalls, and physical activity data were collected by accelerometry and self-report. Data were analyzed using multilevel linear regression models with town as a random effect. RESULTS At baseline, both groups fell short of meeting many recommendations for cardiovascular health. Compared to the control group, the intervention group realized significant improvements in intake of fruit and vegetables combined (difference: 0.6 cup equivalents per day, 95% CI 0.1 to 1.1, p = .026) and in vegetables alone (difference: 0.3 cup equivalents per day, 95% CI 0.1 to 0.6, p = .016). For physical activity, there were no statistically significant between-group differences based on accelerometry. By self-report, the intervention group experienced a greater increase in walking MET minutes per week (difference: 113.5 MET-minutes per week, 95% CI 12.8 to 214.2, p = .027). CONCLUSIONS Between-group differences in dietary and physical activity behaviors measured in this study were minimal. Future studies should consider how to bolster behavioral outcomes in rural settings and may also continue to explore the value of components designed to enact social and environmental change. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02499731. Registered 16 July 2015.
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Affiliation(s)
- Sara C. Folta
- Friedman School of Nutrition, Tufts University, Boston, MA 02111 USA
| | - Lynn Paul
- College of Education, Health and Human Development, Montana State University, Bozeman, MT 59717 USA
| | - Miriam E. Nelson
- Friedman School of Nutrition, Tufts University, Boston, MA 02111 USA
| | - David Strogatz
- Center for Rural Community Health, Bassett Research Institute, Cooperstown, NY 13326 USA
| | - Meredith Graham
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853 USA
| | | | - Michael Higgins
- Exercise and Physical Activity Resource Center, University of California, La Jolla, San Diego, CA 92093-0811 USA
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, La Jolla, San Diego, CA 92093-0811 USA
| | - Rebecca A. Seguin-Fowler
- Department of Nutrition and Food Science College of Agriculture and Life Sciences, Texas A&M University, College Station, Texas, TX 77843 USA
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Kaufmann CN, Nakhla MZ, Lee EE, Yoon HK, Wing D, Depp CA, Eyler LT. Inaccuracy between subjective reports and objective measures of sleep duration and clinical correlates in bipolar disorder. J Affect Disord 2019; 250:226-230. [PMID: 30870772 PMCID: PMC6662606 DOI: 10.1016/j.jad.2019.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/25/2019] [Accepted: 03/03/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Sleep disturbances are common in bipolar disorder (BD) and are often assessed by self-report at clinic visits over the course of BD treatment. Self-report may be subject to recall bias based upon current mood/affect states. This study sought to identify the degree of inaccuracy between subjective and objective measures of sleep duration in those with and without BD, and to assess the demographic and clinical correlates of this inaccuracy. METHODS Thirty-one individuals with BD and 54 healthy control (HC) participants reported on the number of hours slept a night over the past month and subsequently completed up to 14 days/nights of wrist actigraphy which provided an objective measure of sleep duration. We compared the subjective rating to the average of all nights of objective sleep duration, and correlated the magnitude of inaccuracy with demographic and clinical characteristics in the BD and HC groups. RESULTS On average, both BD and HC groups overestimated their sleep, and there were no differences in inaccuracy between groups. In the BD group, greater inaccuracy was associated with lower functioning, even after controlling individually for objective and subjective sleep measures. LIMITATIONS Cross-sectional study, only focus on sleep duration, and less severe bipolar symptoms of sample. CONCLUSIONS Inaccuracy in reports of sleep duration was associated with lower functioning among BD patients. Better identifying discrepancies in reports of sleep duration in clinical practice could help in more efficient monitoring and management of BD symptoms.
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Affiliation(s)
- Christopher N. Kaufmann
- Division of Geriatrics and Gerontology, Department of Medicine, University of California San Diego, La Jolla, CA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Marina Z. Nakhla
- San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology
| | - Ellen E. Lee
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University College of Medicine, South Korea
| | - David Wing
- Center for Wireless and Population Health Systems, University of California San Diego, La Jolla, CA
| | - Colin A. Depp
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Lisa T. Eyler
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA,Department of Psychiatry, University of California San Diego, La Jolla, CA
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Lo BK, Graham ML, Folta SC, Paul LC, Strogatz D, Nelson ME, Parry SA, Carfagno ME, Wing D, Higgins M, Seguin RA. Examining the Associations between Walk Score, Perceived Built Environment, and Physical Activity Behaviors among Women Participating in a Community-Randomized Lifestyle Change Intervention Trial: Strong Hearts, Healthy Communities. Int J Environ Res Public Health 2019; 16:E849. [PMID: 30857189 PMCID: PMC6427661 DOI: 10.3390/ijerph16050849] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/02/2019] [Accepted: 03/06/2019] [Indexed: 11/16/2022]
Abstract
Little is known about the relationship between perceived and objective measures of the built environment and physical activity behavior among rural populations. Within the context of a lifestyle-change intervention trial for rural women, Strong Hearts, Healthy Communities (SHHC), we examined: (1) if Walk Score (WS), an objective built environment measure, was associated with perceived built environment (PBE); (2) if WS and PBE were associated with moderate-to-vigorous physical activity (MVPA); and (3) if MVPA changes were modified by WS and/or PBE. Accelerometers and questionnaires were used to collect MVPA and PBE. Bivariate analyses and linear mixed models were used for statistical analyses. We found that WS was positively associated with perceived proximity to destinations (p < 0.001) and street shoulder availability (p = 0.001). MVPA was generally not associated with WS or PBE. Compared to controls, intervention group participants increased MVPA if they lived in communities with the lowest WS (WS = 0), fewer perceived walkable destinations, or extremely safe perceived traffic (all p < 0.05). Findings suggest that WS appears to be a relevant indicator of walkable amenities in rural towns; results also suggest that the SHHC intervention likely helped rural women with the greatest dearth of built environment assets to improve MVPA.
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Affiliation(s)
- Brian K Lo
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - Meredith L Graham
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Lynn C Paul
- College of Education, Health and Human Development, Montana State University, Bozeman, MT 59717, USA.
| | | | | | - Stephen A Parry
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - Michelle E Carfagno
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, CA 92093, USA.
| | - Michael Higgins
- Exercise and Physical Activity Resource Center, University of California, San Diego, CA 92093, USA.
| | - Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
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Groessl EJ, Maiya M, Schmalzl L, Wing D, Jeste DV. Yoga to prevent mobility limitations in older adults: feasibility of a randomized controlled trial. BMC Geriatr 2018; 18:306. [PMID: 30541474 PMCID: PMC6291934 DOI: 10.1186/s12877-018-0988-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/21/2018] [Indexed: 12/19/2022] Open
Abstract
Background The loss of mobility during aging impacts independence and leads to further disability, morbidity, and reduced life expectancy. Our objective was to examine the feasibility and safety of conducting a randomized controlled trial of yoga for older adults at risk for mobility limitations. Methods Sedentary older adults (n = 46; age 60–89) were recruited and randomized to either yoga or a health education comparison group. Yoga sessions (60-min) occurred 2x weekly, and 90-min health education sessions occurred weekly, for 10 weeks. The primary outcomes were recruitment rate, intervention attendance, and retention at assessments. Adverse event rates and participant satisfaction were also measured. Physical performance measures of gait, balance, and strength and self-report outcome measures were administered at baseline and 10-weeks. Results Recruitment lasted 6 months. Retention of participants at the 10-week follow-up was high (89% - performance measures; 98% - self-report questionnaires). Attendance was good with 82% of yoga and 74% of health education participants attending at least 50% of the sessions. No serious adverse events were reported. Patient satisfaction with the interventions was high. The mean effect size for the physical performance measures was 0.35 with some over 0.50. The mean effect size for self-report outcome measures was 0.36. Conclusions Results indicate that it is feasible to conduct a larger RCT of yoga for sedentary older adults at risk for mobility problems. The yoga and comparison interventions were safe, well accepted, and well attended. Effect sizes suggest yoga may have important benefits for this population and should be studied further. Trial Registration ClinicalTrials # NCT03544879; Retrospectively registered 4 June, 2018.
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Affiliation(s)
- Erik J Groessl
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr. #0994, La Jolla, CA, 92093, USA. .,HSR&D, VA San Diego Healthcare System, San Diego, CA, USA. .,UCSD Stein Institute for Research on Aging, La Jolla, CA, USA.
| | - Meghan Maiya
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr. #0994, La Jolla, CA, 92093, USA
| | - Laura Schmalzl
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr. #0994, La Jolla, CA, 92093, USA.,College of Science and Integrative Health, Southern California University of Health Sciences, Whittier, CA, USA
| | - David Wing
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr. #0994, La Jolla, CA, 92093, USA.,UCSD Exercise and Physical Activity Resource Center (EPARC), La Jolla, CA, USA
| | - Dilip V Jeste
- UCSD Stein Institute for Research on Aging, La Jolla, CA, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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Melchor JC, Khalil A, Wing D, Schleussner E, Surbek D. Prediction of preterm delivery in symptomatic women using PAMG-1, fetal fibronectin and phIGFBP-1 tests: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2018; 52:442-451. [PMID: 29920825 DOI: 10.1002/uog.19119] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/31/2018] [Accepted: 06/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To assess the accuracy of placental alpha microglobulin-1 (PAMG-1), fetal fibronectin (fFN) and phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1) tests in predicting spontaneous preterm birth (sPTB) within 7 days of testing in women with symptoms of preterm labor, through a systematic review and meta-analysis of the literature. The test performance of each biomarker was also assessed according to pretest probability of sPTB ≤ 7 days. METHODS The Cochrane, MEDLINE, PubMed and ResearchGate bibliographic databases were searched from inception until October 2017. Cohort studies that reported on the predictive accuracy of PAMG-1, fFN and phIGFBP-1 for the prediction of sPTB within 7 days of testing in women with symptoms of preterm labor were included. Summary receiver-operating characteristics (ROC) curves and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and positive (LR+) and negative (LR-) likelihood ratios were generated using indirect methods for the calculation of pooled effect sizes with a bivariate linear mixed model for the logit of sensitivity and specificity, with each diagnostic test as a covariate, as described by the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. RESULTS Bivariate mixed model pooled sensitivity of PAMG-1, fFN and phIGFBP-1 for the prediction of sPTB ≤ 7 days was 76% (95% CI, 57-89%), 58% (95% CI, 47-68%) and 93% (95% CI, 88-96%), respectively; pooled specificity was 97% (95% CI, 95-98%), 84% (95% CI, 81-87%) and 76% (95% CI, 70-80%) respectively; pooled PPV was 76.3% (95% CI, 69-84%) (P < 0.05), 34.1% (95% CI, 29-39%) and 35.2% (95% CI, 31-40%), respectively; pooled NPV was 96.6% (95% CI, 94-99%), 93.3% (95% CI, 92-95%) and 98.7% (95% CI, 98-99%), respectively; pooled LR+ was 22.51 (95% CI, 15.09-33.60) (P < 0.05), 3.63 (95% CI, 2.93-4.50) and 3.80 (95% CI, 3.11-4.66), respectively; and pooled LR- was 0.24 (95% CI, 0.12-0.48) (P < 0.05), 0.50 (95% CI, 0.39-0.64) and 0.09 (95% CI, 0.05-0.16), respectively. The areas under the ROC curves for PAMG-1, fFN and phIGFBP-1 for sPTB ≤ 7 days were 0.961, 0.874 and 0.801, respectively. CONCLUSIONS In the prediction of sPTB within 7 days of testing in women with signs and symptoms of preterm labor, the PPV of PAMG-1 was significantly higher than that of phIGFBP-1 or fFN. Other diagnostic accuracy measures did not differ between the three biomarker tests. As prevalence affects the predictive performance of a diagnostic test, use of a highly specific assay for a lower-prevalence syndrome such as sPTB may optimize management. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- J C Melchor
- Cruces University Hospital (UPV/EHU), BioCruces Health Research Institute, Vizcaya, Spain
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - D Wing
- Formerly of the University of California, Irvine, Orange, CA, USA
| | - E Schleussner
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - D Surbek
- Department of Obstetrics and Gynecology, University Hospital, Inselspital, University of Bern, Bern, Switzerland
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Steiner ME, Wing D, Walley KC, Manoukian O, Perez-Viloria M, Okajima S, Nazarian A. Hyperflexion and Femoral Interference Screw Insertion in ACL Reconstruction. Orthop J Sports Med 2018; 6:2325967118788810. [PMID: 30109240 PMCID: PMC6083757 DOI: 10.1177/2325967118788810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: In anatomic anterior cruciate ligament (ACL) reconstructions produced with flexible reamers and no knee hyperflexion, it is unknown whether knee hyperflexion is necessary for femoral interference screw insertion. Purpose: To compare femoral screw-graft divergence in anatomic ACL reconstructions with endoscopic interference screws placed without knee hyperflexion and with the use of flexible versus rigid screwdrivers. Study Design: Controlled laboratory study. Methods: Ten matched pairs of cadaveric knees had bone-tendon-bone graft ACL reconstructions with anatomic femoral tunnels. The knees were flexed to 90°. Femoral interference screws (7 × 20 mm) were placed in pairs of knees: in 1 knee with a flexible screwdriver and in the opposite knee with a rigid screwdriver. Graft-screw divergence was imaged with computed tomography scans and tested with cyclic and static biomechanical tests. Results: The mean screw-graft divergence was 12.07° ± 4.04° with the rigid screwdriver and 10.68° ± 3.23° with the flexible screwdriver (P = .35). The cyclic tests with screws placed by a rigid screwdriver had a mean increase in displacement of 0.56 ± 0.20 mm. For screws placed with the flexible screwdriver, the mean increase in displacement was 0.58 ± 0.32 mm (P = .66). Yield load was 393.3 ± 95.1 N for screws placed by a rigid screwdriver and 408.2 ± 119.0 N for screws inserted with the flexible screwdriver (P = .78). Maximum load was 523.1 ± 88.7 N for screws placed by a rigid screwdriver and 467.1 ± 107.3 N for screws inserted with the flexible screwdriver (P = .09). Conclusion: With either a rigid or a flexible screwdriver, there were no significant effects on screw divergence or fixation strength. Clinical Relevance: Knees can be kept at 90° during endoscopic femoral interference screw insertion. The use of a traditional rigid or flexible screwdriver will not affect screw-graft divergence or fixation strength.
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Affiliation(s)
- Mark E Steiner
- Department of Orthopedic Surgery Sports Section, New England Baptist Hospital, Boston, Massachusetts, USA
| | - David Wing
- Department of Orthopedic Surgery Sports Section, New England Baptist Hospital, Boston, Massachusetts, USA
| | - Kempland C Walley
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Ohan Manoukian
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Miguel Perez-Viloria
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Stephen Okajima
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Ara Nazarian
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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McDaniels-Davidson C, Davis A, Wing D, Macera C, Lindsay SP, Schousboe JT, Nichols JF, Kado DM. Kyphosis and incident falls among community-dwelling older adults. Osteoporos Int 2018; 29:163-169. [PMID: 29018904 DOI: 10.1007/s00198-017-4253-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
UNLABELLED Hyperkyphosis commonly affects older persons and is associated with morbidity and mortality. Many have hypothesized that hyperkyphosis increases fall risk. Within this prospective study of older adults, kyphosis was significantly associated with incident falls over 1 year. Measures of hyperkyphosis could enhance falls risk assessments during primary care office visits. INTRODUCTION To determine the association between four measures of kyphosis and incident and injurious falls in older persons. METHODS Community-dwelling adults aged 65 and older (n = 72) residing in southern California were invited to participate in a prospective cohort study. Participants had kyphosis assessed four ways. Two standing measures included a flexicurve ruler placed against the back to derive a kyphotic index and the Debrunner kyphometer, a protractor used to measure the kyphotic angle in degrees. Two lying measures included the blocks method (number of 1.7 cm blocks needed to achieve a neutral head position while lying supine) and traditional Cobb angle calculation derived from DXA based lateral vertebral assessment. Baseline demographic, clinical, and other health information (including a timed up and go (TUG) test) were assessed at a clinic visit. Participants were followed monthly through email or postcard for 1 year, with falls outcomes confirmed through telephone interview. RESULTS Mean age was 77.8 (± 7.1) among the 52 women and 20 men. Over 12 months, 64% of participants experienced at least one incident fall and 35% experienced an injurious fall. Each standard deviation increase in kyphosis resulted in more than doubling the adjusted odds of an incident fall, even after adjusting for TUG. Odds of injurious falls were less consistent across measures; after adjusting for TUG, only the blocks method was associated with injurious falls. CONCLUSIONS Each kyphosis measure was independently associated with incident falls. Findings were inconsistent for injurious falls; the blocks measure suggested the strongest association. If these findings are replicated, the blocks measure could be incorporated into office visits as a quick and efficient tool to identify patients at increased fall risk.
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Affiliation(s)
- C McDaniels-Davidson
- San Diego State University/University of California, San Diego | Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA, USA.
| | - A Davis
- San Diego State University/University of California, San Diego | Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA, USA
| | - D Wing
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - C Macera
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - S P Lindsay
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - J T Schousboe
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
- Park Nicollet Osteoporosis Center and Institute for Research and Education, Minneapolis, MN, USA
| | - J F Nichols
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - D M Kado
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
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Yamamoto J, Bergstrom J, Davis A, Wing D, Schousboe JT, Nichols JF, Kado DM. Trunk lean mass and its association with 4 different measures of thoracic kyphosis in older community dwelling persons. PLoS One 2017; 12:e0174710. [PMID: 28369088 PMCID: PMC5378351 DOI: 10.1371/journal.pone.0174710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The causes of age-related hyperkyphosis (HK) include osteoporosis, but only 1/3 of those most severely affected have vertebral fractures, suggesting that there are other important, and potentially modifiable causes. We hypothesized that muscle mass and quality may be important determinants of kyphosis in older persons. METHODS We recruited 72 persons >65 years to participate in a prospective study designed to evaluate kyphosis and fall risk. At the baseline visit, participants had their body composition measures completed using Dual Energy X-ray Absorptiometry (DXA). They had kyphosis measured in either the standing [S] or lying [L] position: 1) Cobb angle from DXA [L]; 2) Debrunner kyphometer [S]; 3) architect's flexicurve ruler [S]; and 4) blocks method [L]. Multivariable linear/logistic regression analyses were done to assess the association between each body composition and 4 kyphosis measures. RESULTS Women (n = 52) were an average age of 76.8 (SD 6.7) and men 80.5 (SD 7.8) years. They reported overall good/excellent health (93%), the average body mass index was 25.3 (SD 4.6) and 35% reported a fall in the past year. Using published cut-offs, about 20-30% were determined to have HK. For the standing assessments of kyphosis only, after adjusting for age, sex, weight and hip BMD, persons with lower TLM were more likely to be hyperkyphotic. CONCLUSIONS Lower TLM is associated with HK in older persons. The results were stronger when standing measures of kyphosis were used, suggesting that the effects of muscle on thoracic kyphosis are best appreciated under spinal loading conditions.
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Affiliation(s)
- J. Yamamoto
- University of Hawaii, Honolulu, Hawaii, United States of America
| | - J. Bergstrom
- University of California, San Diego, La Jolla, California, United States of America
| | - A. Davis
- University of California, San Diego, La Jolla, California, United States of America
| | - D. Wing
- University of California, San Diego, La Jolla, California, United States of America
| | - J. T. Schousboe
- Park Nicollet Osteoporosis Center and Institute for Research and Education, Minneapolis, Minnesota, United States of America
| | - J. F. Nichols
- University of California, San Diego, La Jolla, California, United States of America
| | - D. M. Kado
- University of California, San Diego, La Jolla, California, United States of America
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Wang H, Blanco E, Algarín C, Peirano P, Burrows R, Reyes M, Wing D, Godino JG, Gahagan S. Weight Status and Physical Activity: Combined Influence on Cardiometabolic Risk Factors Among Adolescents, Santiago, Chile. Glob Pediatr Health 2016; 3:2333794X16674561. [PMID: 27803943 PMCID: PMC5077069 DOI: 10.1177/2333794x16674561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 12/26/2022] Open
Abstract
We tested the independent and combined influence of overweight/obesity and meeting moderate to vigorous physical activity (MVPA) guidelines (≥60 minutes per day) on cardiometabolic risk factors among healthy adolescents. We measured anthropometry, blood pressure, fasting lipids, and activity by accelerometer in 223 adolescents. They were categorized as overweight/obese versus normal weight and meeting the World Health Organization guidelines for MVPA per day. Adolescents were 16.8 years, 41% overweight/obese, 30% met MVPA guidelines, 50% low high-density lipoprotein, 22% high triglycerides, 12% high blood pressure, and 6% high fasting glucose. Controlling for sex, overweight/obese adolescents who did not meet MVPA guidelines had 4.0 and 11.9 increased odds for elevated triglycerides and systolic blood pressure, respectively, compared to normal weight adolescents who met MVPA guidelines. Overweight/obese and normal weight adolescents who met MVPA guidelines did not differ in cardiometabolic risk factors. Among overweight/obese adolescents, being physically active attenuated the likelihood of high triglycerides and systolic blood pressure.
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Affiliation(s)
- Helen Wang
- University of California San Diego, La Jolla, CA, USA
| | - Estela Blanco
- University of California San Diego, La Jolla, CA, USA
| | | | | | | | | | - David Wing
- University of California San Diego, La Jolla, CA, USA
| | - Job G Godino
- University of California San Diego, La Jolla, CA, USA
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Tran TH, Wing D, Davis A, Bergstrom J, Schousboe JT, Nichols JF, Kado DM. Correlations among four measures of thoracic kyphosis in older adults. Osteoporos Int 2016; 27:1255-1259. [PMID: 26475287 PMCID: PMC5332161 DOI: 10.1007/s00198-015-3368-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/06/2015] [Indexed: 02/02/2023]
Abstract
SUMMARY There are many ways to measure thoracic kyphosis ranging from simple clinical to more complex assessments. We evaluated the correlation among four commonly used kyphosis measures: Cobb angle, Debrunner kyphometer, kyphotic index, and the blocks method. Each measure was correlated with the others, confirming high clinical and research applicability. INTRODUCTION The purpose of this study was to assess the associations among four commonly used measures of thoracic kyphosis in older adults. METHODS Seventy two men and women aged 65-96 were recruited from the San Diego community. Four kyphosis measures were assessed in the same person during a baseline clinic visit. Two measures were done in the lying (L) and two in the standing (ST) position: (1) Cobb angle calculated from dual X-Ray absorptiometry (DXA) images (L), (2) Debrunner kyphometer (DK) angle measured by a protractor (ST), (3) kyphotic index (KI) calculated using an architect's flexicurve ruler (ST), and (4) the blocks method involving counting the number of 1.7 cm-thick blocks required to achieve a neutral head position while lying flat on the DXA table (L). Spearman rank correlation coefficients were used to determine the strength of the association between each kyphosis measure. RESULTS Using the Cobb angle as the gold standard, the blocks method demonstrated the lowest correlation (r(s) = 0.63, p < 0.0001), the Debrunner method had a moderate correlation (r(s) = 0.65, p < 0.0001), and the kyphotic index had the highest correlation (r(s) = 0.68, p < 0.0001). The correlation was strongest between the kyphotic index and the Debrunner kyphometer (r(s) = 0.76, p < 0.0001). CONCLUSION In older men and women, all four measures of thoracic kyphosis were significantly correlated with each other, whether assessed in the lying or standing position. Thus, any of these measures demonstrate both potential clinical and research utility.
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Affiliation(s)
- T H Tran
- Department of Family Medicine and Public Health, University of California at San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - D Wing
- Department of Family Medicine and Public Health, University of California at San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - A Davis
- Department of Family Medicine and Public Health, University of California at San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - J Bergstrom
- Department of Family Medicine and Public Health, University of California at San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - J T Schousboe
- Park Nicollet Osteoporosis Center and Institute for Research and Education, Minneapolis, MN, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - J F Nichols
- Department of Family Medicine and Public Health, University of California at San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - D M Kado
- Department of Family Medicine and Public Health, University of California at San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA.
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
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Hill LL, Nichols J, Wing D, Waalen J, Friedman E. Training on Exercise is Medicine® Within an Integrative Medicine Curriculum. Am J Prev Med 2015; 49:S278-84. [PMID: 26477904 DOI: 10.1016/j.amepre.2015.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/17/2015] [Accepted: 08/27/2015] [Indexed: 10/22/2022]
Abstract
Physicians are increasingly approached by individuals seeking integrative approaches to health care and well-being. Many integrative modalities include a physical activity component. Patients seek guidance from primary and specialty care providers on the safe and effective incorporation of these modalities into their lifestyle. Physicians and other health professionals receive very limited training in the clinical applications of exercise science. This paper reports on a curriculum designed to teach health professionals key exercise constructs for application to clinical practice for prevention and management of lifestyle-related disease, and incorporating the curriculum into a preventive medicine residency training program. The course was developed in 2012-2013, data collected in 2013-2015, and analysis was done in 2015. Six modules were developed as part of a 24-hour course. Each module included didactic, laboratory, and case examples. The modules included energetics, exercise and cardiorespiratory health, bone health, obesity and sarcopenia, balance and fall prevention, and behavior change and the use of technologies. The delivery was found feasible for all three components, delivered in 2-4-hour segments. The incorporation into the residency curriculum was feasible, efficacious, well received, and easily incorporated into the existing curriculum. This comprehensive curriculum has the potential to close the gap in medical school, residency, graduate, nursing, and integrative curricula on this important topic. Current practitioners would benefit in primary care and geriatric settings. This curriculum would also be useful for cross-disciplinary researchers, including public health, health behaviors, and integrative medicine practitioners.
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Affiliation(s)
- Linda L Hill
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
| | - Jeanne Nichols
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California
| | - David Wing
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California
| | - Jill Waalen
- The Scripps Research Institute, La Jolla, California
| | - Elizabeth Friedman
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California
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Montoya JL, Wing D, Knight A, Moore DJ, Henry BL. Development of an mHealth Intervention (iSTEP) to Promote Physical Activity among People Living with HIV. J Int Assoc Provid AIDS Care 2015; 14:471-5. [PMID: 26307212 DOI: 10.1177/2325957415601505] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A randomized controlled trial is being conducted in the United States to test the efficacy of a personalized interactive mobile health intervention (iSTEP) designed to increase physical activity (PA) and improve neurocognitive functioning among HIV-positive persons. This article describes an initial qualitative study performed to develop iSTEP for the HIV-positive population, including assessment of PA barriers and facilitators. Two focus groups, with 9 and 12 unique HIV-positive individuals, respectively, were administered to evaluate barriers limiting PA and potential iSTEP content created to encourage greater PA. Group discussions revealed prominent PA barriers, including HIV symptoms (neuropathy, lipoatrophy), antiretroviral medication effects, and fatigue; significant PA facilitators included self-monitoring and family support. Participants provided feedback on strategies to increase PA and expressed positive support for a mobile intervention adapted to personal priorities. These findings will assist the development of novel PA interventions focused on treating the epidemic of HIV-associated neurocognitive disorders.
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Affiliation(s)
- Jessica L Montoya
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - David Wing
- Department of Family and Preventive Medicine, School of Medicine, Exercise and Physical Activity Resource Center (EPARC), University of California, San Diego, San Diego, CA, USA
| | - Adam Knight
- Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Brook L Henry
- Department of Psychiatry, School of Medicine, University of California, San Diego, San Diego, CA, USA
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Higgins MD, Gallagher D, Wing D, Nichols J. Improved Intrinsic Motivation When Listening to Mixed Music While Running. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478728.05208.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Reves R, Heilig CM, Tapy JM, Bozeman L, Kyle RP, Hamilton CD, Bock N, Narita M, Wing D, Hershfield E, Goldberg SV. Intermittent tuberculosis treatment for patients with isoniazid intolerance or drug resistance. Int J Tuberc Lung Dis 2015; 18:571-80. [PMID: 24903795 DOI: 10.5588/ijtld.13.0304] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Twenty tuberculosis (TB) clinics in the United States and Canada. OBJECTIVE To evaluate the efficacy and safety of a 6-month intermittent regimen of rifampin (RMP), pyrazinamide (PZA) and ethambutol (EMB) in human immunodeficiency virus (HIV) negative patients with culture-confirmed pulmonary or extra-pulmonary tuberculosis and either isoniazid (INH) resistance or INH intolerance. DESIGN Patients were enrolled in a single-arm clinical trial to receive intermittent dosing after at least 14 initial daily doses of RMP+PZA+EMB. Treatment was continued twice (BIW) or thrice weekly (TIW) per physician/patient preference for a total of 6 months, with 2 years of follow-up for relapse after treatment. RESULTS From 1999 to 2004, 98 patients were enrolled, 78 with reported INH resistance and 20 with INH intolerance. BIW dosing was used in 77 and TIW in 21. Study treatment was completed in 73 (74%). Reasons for discontinuation were hepatic adverse events (n= 12), other adverse effects (n= 3) and other reasons (n= 10). Failure (n= 1) and relapse (n= 2) occurred in 3 (3.5%, 95%CI 1.2-9.8) of 86 patients eligible for efficacy analysis, all occurring in patients with cavitary, acid-fast bacilli smear-positive pulmonary TB. CONCLUSIONS Intermittent RMP+PZA+EMB appears to be effective in HIV-negative patients, but the regimen is poorly tolerated, possibly due to the prolonged use of PZA. Alternative regimens of lower toxicity are needed.
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Affiliation(s)
- R Reves
- Denver Public Health Department, Denver, Colorado, USA
| | - C M Heilig
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J M Tapy
- Denver Public Health Department, Denver, Colorado, USA
| | - L Bozeman
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - R P Kyle
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - C D Hamilton
- Family Health International 360, Durham, North Carolina, USA
| | - N Bock
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M Narita
- University of Washington, Seattle, Washington, USA
| | - D Wing
- South Texas-Audie Murphy VA Hospital Research Collaboration, Harlingen, Texas, USA
| | - E Hershfield
- University of Manitoba, Winnipeg, Manitoba, Canada
| | - S V Goldberg
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Ellis K, Kerr J, Godbole S, Lanckriet G, Wing D, Marshall S. A random forest classifier for the prediction of energy expenditure and type of physical activity from wrist and hip accelerometers. Physiol Meas 2014; 35:2191-203. [PMID: 25340969 DOI: 10.1088/0967-3334/35/11/2191] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Wrist accelerometers are being used in population level surveillance of physical activity (PA) but more research is needed to evaluate their validity for correctly classifying types of PA behavior and predicting energy expenditure (EE). In this study we compare accelerometers worn on the wrist and hip, and the added value of heart rate (HR) data, for predicting PA type and EE using machine learning. Forty adults performed locomotion and household activities in a lab setting while wearing three ActiGraph GT3X+ accelerometers (left hip, right hip, non-dominant wrist) and a HR monitor (Polar RS400). Participants also wore a portable indirect calorimeter (COSMED K4b2), from which EE and metabolic equivalents (METs) were computed for each minute. We developed two predictive models: a random forest classifier to predict activity type and a random forest of regression trees to estimate METs. Predictions were evaluated using leave-one-user-out cross-validation. The hip accelerometer obtained an average accuracy of 92.3% in predicting four activity types (household, stairs, walking, running), while the wrist accelerometer obtained an average accuracy of 87.5%. Across all 8 activities combined (laundry, window washing, dusting, dishes, sweeping, stairs, walking, running), the hip and wrist accelerometers obtained average accuracies of 70.2% and 80.2% respectively. Predicting METs using the hip or wrist devices alone obtained root mean square errors (rMSE) of 1.09 and 1.00 METs per 6 min bout, respectively. Including HR data improved MET estimation, but did not significantly improve activity type classification. These results demonstrate the validity of random forest classification and regression forests for PA type and MET prediction using accelerometers. The wrist accelerometer proved more useful in predicting activities with significant arm movement, while the hip accelerometer was superior for predicting locomotion and estimating EE.
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Affiliation(s)
- Katherine Ellis
- Department of Electrical and Computer Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0407, USA
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Wing D, Prausnitz MR, Buono MJ. Skin pretreatment with microneedles prior to pilocarpine iontophoresis increases sweat production. Clin Physiol Funct Imaging 2013; 33:436-40. [DOI: 10.1111/cpf.12053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 04/15/2013] [Indexed: 01/04/2023]
Affiliation(s)
- David Wing
- San Diego State University; San Diego; CA; USA
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Wing D, McClintock R, Plumlee D, Rathke M, Burnett T, Lyons B, Buono MJ. Does anticipatory sweating occur prior to fluid consumption? Int J Physiol Pathophysiol Pharmacol 2012; 4:45-50. [PMID: 22461956 PMCID: PMC3312462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 02/15/2012] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to examine if anticipatory sweating occurs prior to fluid consumption in dehydrated subjects. It was hypothesized that there would first be an anticipatory response to the sight of water, and then with drinking, a second response caused by mechanical stimulation of oropharyngeal nerves. Dehydrated subjects (n=19) sat in a heat chamber for 30 minutes. At minute 15, a resistance hygrometer capsule was attached and sweat rate was measured every 3 seconds. At minute 35:00, a researcher entered the room with previously measured water (2 ml/kg euhydrated body weight). At minute 35:30, the subject was allowed to drink. Data collection continued for 5 minutes post consumption. As expected, 16 of the 19 subjects responded to oropharyngeal stimuli with increased sweat rate. However, the new finding was that a majority (12 of 19) also showed an anticipatory sweating response prior to fluid consumption. Subjects were divided into 4 groups based on the magnitude of the sweating response. Strong responders' (n=4) anticipatory response accounted for 50% or more of the total change in sweat rate. Moderate responders' (n=4) anticipatory response accounted for 20%-49%. Weak responders' (n=4) anticipatory response accounted for 6-20%. Finally, non-responders (n=7) showed no anticipatory response. Although previously noted anecdotally in the literature, the current study is the first to demonstrate that measurable anticipatory sweating occurs prior to fluid intake in dehydrated subjects in a significant percentage of the population. Such data suggests that cerebral input, like oropharyngeal stimulation, can temporarily remove the dehydration-induced inhibition of sweating.
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Affiliation(s)
- David Wing
- San Diego State University San Diego, CA, USA
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