Abstract
The main purpose of this study was to explore similarities and differences in the association between two capabilities affecting the cardiorespiratory system (overall and multifactorial cardiorespiratory fitness and inspiratory muscle strength) and the health-related quality of life (HRQoL), in a group of active healthy seniors. Sixty-five individuals (age, 73.01 ± 5.27 years; 53 women) who participated regularly in a multicomponent training program completed the EuroQol 5D-5L questionnaire, the 6-min walking test (6MWT), and the maximum inspiratory pressure test (MIP). Non-parametric correlations (Spearman's rho) were conducted to analyze the association between HRQoL indices (EQindex and EQvas), MIP, and 6MWT, considering both, the whole sample and men and women separately. Furthermore, partial correlation was made by controlling age and sex. We found a moderate association between HRQoL and cardiorespiratory fitness (EQvas: r = 0.324, p = 0.009; EQindex: r = 0.312, p = 0.011). Considering sex, relationship EQvas-6MWT decrease to small (r = 0.275; p = 0.028) whereas EQindex-6MWT remained moderated (r = 0.425; p = 0.000). When we considered women and men separately, the association between HRQoL and 6MWT appeared only in women, while the observed strong trend (p = 0.051) toward a large and positive association between EQindex and MIP, mediated by the covariate age, appeared only in men. Conversely to the cardiorespiratory fitness, MIP is not a limiting factor of HRQoL in healthy active elderly. Moreover, MIP and HRQoL should be included in the assessment of exercise interventions because they provide different information about the cardiorespiratory system deterioration. Similarly, EQvas and EQindex confirm to be complementary in the assessment of HRQoL. Furthermore, like aging process is different for men and women, the association between MIP and cardiorespiratory fitness with HRQoL may behave differently, so keeping on research these associations could help to improve training programs for this population.
Highlights
Cardiorespiratory fitness (CRF) is a predictor of mortality and comorbidity, regardless of race and sex (DeFina et al, 2015; Strasser and Burtscher, 2018)
Higher functional capacity levels are related to higher health-related quality of life (HRQoL) (Ran et al, 2017; de Oliveira et al, 2019), and this is of paramount importance, especially in women, who display worse results on HRQoL and functional capacity than men of the same age due to a higher prevalence of disability and chronic conditions (Orfila et al, 2006)
On the one hand, considering the whole sample (Table 2), while the maximum inspiratory pressure test (MIP) showed no other association, we found the expected moderate association between HRQoL and CRF (EQvas: r = 0.324, p = 0.009; EQindex: r = 0.312, p = 0.011)
Summary
Cardiorespiratory fitness (CRF) is a predictor of mortality and comorbidity, regardless of race and sex (DeFina et al, 2015; Strasser and Burtscher, 2018). It has shown to be inversely related to cardiovascular disease as well as chronic pathologies that can affect healthy senior adults (DeFina et al, 2015; Bouaziz et al, 2018, 2019) This multifactorial predictor is severely affected by the aging process, which involves alterations and adaptations in all body systems (Vilaça et al, 2019), with special attention to the decline in muscle mass (Cruz-Jentoft et al, 2019) and muscle strength (Blasco-Lafarga et al, 2020). Shaw et al (2017) reviewed the epidemiology of sarcopenia attending to the similarities and differences between the patterns of variation with age, gender, geography, time, and individual risk factors They conclude that the rate of decline in muscle mass is much less rapid than the rate in muscle strength. Already in 1994, Enright pointed out that inspiratory muscle strength was 30% higher in men than in women, and men losses were larger (Enright et al, 1994)
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