Upper and lower trunk accelerometer-based metrics during gait as predictors of physical function in older adults.

BackgroundHigher maximal- and explosive strength is associated with better physical function among older adults. Although the relationship between isometric maximal strength and physical function has been examined, few studies have included measures of isometric rate of force development (RFD) as a measure of explosive strength. Furthermore, little is known about the oldest old (>80 years), especially individuals who receive home care and use mobility devices. Therefore, the aim of this study was to examine the association between maximal- and explosive muscle strength with physical function in community-dwelling older adults receiving home care.MethodsAn exploratory cross-sectional analysis including 107 (63 females and 43 males) community-dwelling older adults [median age 86 (interquartile range 80–90) years] receiving home care was conducted. Physical function was measured with five times sit-to-stand (5TSTS), timed 8-feet-up-and-go (TUG-8ft), preferred-, and maximal gait speed. Maximal strength was assessed as maximal isometric voluntary contraction (MVC) and explosive strength as RFD of the knee extensors. We used linear regression to examine the associations, with physical function as dependent variables and muscle strength (MVC and RFD) as independent variables.ResultsMVC was significantly associated with 5TSST [standardized regression coefficient β = −0.26 95% CI (−0.45, −0.06)], TUG-8ft [−0.6 (−0.54, −0.17)], preferred gait speed [0.39 (0.22, 0.57)], and maximal gait speed [0.45 (0.27, 0.62)]. RFD was significantly associated with 5TSST [−0.35 (−0.54, −0.17)], TUG-8ft [−0.43 (−0.60, −0.27)], preferred gait speed [0.40 (0.22, 0.57)], and maximal gait speed [0.48 (0.31, 0.66)].ConclusionsHigher maximal- and explosive muscle strength was associated with better physical function in older adults receiving home care. Thus, maintaining and/or improving muscle strength is important for perseverance of physical function into old age and should be a priority.

Associations between difficulty in 6 basic activities of daily living and cognitive and lower extremity physical functions in older adults

Acute hospitalization can have catastrophic consequences for physical function and independence in older adults. The inability to regain function following a hospital stay is a strong predictor of re‐hospitalization and mortality. We have shown that nutritional interventions, exercise, and anabolic steroids independently increase muscle size and function, thus representing promising therapeutic strategies.The goal of this pilot study was to test the feasibility of interventions (placebo supplement (P), nutrition supplement (N, whey protein), progressive in‐home exercise + placebo (E+P), exercise + nutrition (E+N), or single testosterone injection (T)) to improve physical function in older adults following acute hospitalization.Subjects (>65 years) were recruited during hospitalization at UTMB Acute Care for Elders unit. Demographics and short physical performance battery (SPPB) were collected at hospital discharge and 1‐month post discharge.Mean baseline SPPB score was 6.6. At 1‐mo testing, interventions tended to enhance improvement in raw SPPB score (P: 1.3, N: 3.3, E+P: 2.2, E+N: 3.2, T: 2.3) and percent of subjects with a clinically meaningful improvement (蠅1 point) (P: 50%, N: 100%, E+P: 80%, E+N: 80%, T: 88%). Gait speed was low in all groups at baseline (0.60‐ 0.71 m/s). Interventions tended to augment gait speed at 1‐mo (P: 25%, N: 50%, E+P: 45%, E+N: 44%, T: 21%).These preliminary data (n=4‐8), from an ongoing clinical trial, indicate that interventions after acute hospitalization are feasible and can improve physical function in older adults.Dairy Research Institute (1229) and UTMB Claude D. Pepper OAIC (5P30‐ AG024832).

Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.

Background Some degree of cognitive decline is a normal, non-clinical part of aging. Physical exercise has been suggested as one strategy which may improve cognition in nondemented older adults. The findings of randomised, controlled trials conducted since the 1980s have been promising, but not unequivocal, and much remains to be understood about the relationship between exercise and cognition in older adults. There have also been suggestions that combining exercise and cognitive training may be beneficial. There has, however, been only one reported study comparing the benefits of exercise training, and combined exercise and cognitive training (Fabre, Chamari, Mucci, Masse-Biron, & Prefaut, 2002). While combined training was reported to be even more effective than exercise training alone for improving cognition in older adults, the study had some substantial limitations. Aims The overall aims of this thesis were to further explore the effect of exercise training on cognition in older adults, and to compare exercise training alone with combined exercise and cognitive training. Following a narrative review of the relevant literature, this thesis is presented in two parts. In Part One a randomized, controlled trial comparing the impact of exercise training, and combined exercise and cognitive training, on the cognitive functioning, physical functioning, functional performance, and psychological well-being of community dwelling older adults is presented. For Part One, there were three specific aims: (1) To assess the efficacy of a 16 week exercise program (relative to control), on measures of cognitive functioning, physical functioning, functional performance, and psychological well-being; (2) To compare the efficacy of the 16 week exercise program with that of a 16 week combined exercise and cognitive training program; and (3) To identify the physical, psychological and training factors associated with changes in cognitive and physical functioning from baseline to post-test. In Part Two a qualitative evaluation of older adults’ experiences and perceptions of exercise training, and combined exercise and cognitive training, is presented. Methods Thirty-nine community dwelling, older adults (aged between 60 and 80 years) were randomly allocated to one of three groups: Exercise, Combination or Control. Participants in the Exercise group attended three aerobic and strength training sessions per week for 16 weeks. Participants in the Combination group attended two aerobic and strength training sessions, and one cognitive training session, per week for 16 weeks. Participants in the Control group were contacted every four weeks. Assessments were conducted at baseline, post-test (16 weeks) and six-month follow-up (40 weeks). Measures of physical function, cognitive function, functional performance, and psychological wellbeing were collected, along with anthropometric and physiological measures. For the qualitative evaluation, participants from the Exercise and Combination groups provided written feedback to questions about their experiences of the two training programs and their perceptions of the outcomes. These qualitative data were collected after post-test. Results Significant within-group improvements in physical and cognitive function, from baseline to post-test, were seen in Exercise and Combination participants. Combination participants also showed significant within-group reductions in symptoms of anxiety and depression. There were, however, only a few significant between-group differences among Exercise and Control participants, and among Exercise and Combination participants. There were no significant within-group improvements in functional performance, from baseline to post-test, among Exercise or Combination participants. Six-month follow-up data were difficult to interpret, due to the paucity of between-group differences at post-test and the small sample size. There were several significant associations between physical, psychological and training factors, and changes in cognitive and physical functioning. The most pertinent finding was that baseline functioning was consistently associated with change, such that participants with low baseline scores were most likely to improve from baseline to post-test. In the qualitative evaluation participants reported positive experiences of the training programs and reported improvements in physical, cognitive, functional and psychological wellbeing. Participants also highlighted components of the programs which require improvement and made recommendations for future programs. Conclusions The results of this thesis provide some cautious support for the notion that exercise, and combined exercise and cognitive training, may result in small improvements in cognition, physical functioning, and psychological well-being in older adults. Some of the findings must be interpreted with caution, however, given the small sample size. More research is required into the functional (or ‘real world’) impact of this type of training, the long-term effects of training, and the factors associated with changes in cognitive and physical function. Based on these findings, recommendations for the development and implementation of future research were made. As the population ages and the public health burden attributable to aging increases, research into the development and efficacy of programs to enhance well-being and independence in older adults is of great importance.

Osteoporotic fracture is associated with restricted physical function and difficulties with activities of daily living (ADL). 2 Part of Physiotherapy Canada's special series on Bone Health, the systematic review by Wilhelm and colleagues was carried out to determine whether resistance exercise improves physical function and ADL in older adults with osteoporosis or osteopenia. Examples include performance of basic life activities (basic ADL) such as dressing, bathing, and walking and more complex life activities (called instrumental ADLs, IADL) such as meal preparation, shopping and transportation.'' 3( p.530-1) Wilhelm and colleagues calculated effect sizes for each selfreported physical function outcome but were unable to pool data. Based on the qualitative synthesis of five small trials of moderate quality (5-7 on the PEDro scale), they conclude that resistance exercises improve self-reported physical function in older adults with low bone mass. Their systematic review is one of the few sources of high-level evidence on how resistance exercise affects ADL in postmenopausal women with osteoporosis and osteopenia.

BackgroundFunctional teeth are important for maintaining appropriate masticatory function and nutritional intake, affecting physical function in older adults. This study aimed to evaluate the association between number of functional teeth and physical function in community-dwelling older Korean adults.MethodsThis cross-sectional study was conducted among a total of 2,527 participants (mean age, 76.5 ± 3.9; 53.4% women) who were enrolled in the Korean Frailty and Aging Cohort Study (2016–2017). Participants were categorized based on the number of functional teeth into two groups: < 20 and ≥ 20 functional teeth. Functional teeth were defined as the remaining natural teeth with visible crowns, with or without restorations, prosthetic pontics, or dental implants on panoramic radiography. Physical function was assessed using handgrip strength, gait speed, five-times sit-to-stand test (5TSTS) duration, and the Short Physical Performance Battery (SPPB) score. Multivariate linear and logistic regression models were used to evaluate the association between number of functional teeth and physical function.ResultsOf all the participants, 869 (34.3%) had < 20 functional teeth. After full adjustment for sociodemographic factors, lifestyle, health condition, and oral health, an increase in one functional tooth was associated with a corresponding increase in gait speed (men: B = 0.002, p = 0.032; women: B = 0.002, p = 0.013) and SPPB (men: B = 0.019, p < 0.001; women: B = 0.018, p < 0.001) in both men and women. The time taken for the 5TSTS was shorter for an increase in one more functional tooth (men, B=-0.033, p = 0.006; women, B=-0.036, p = 0.021) in both men and women. An increase in one functional tooth was associated with a corresponding increase in handgrip strength only in men (men, B = 0.049, p = 0.009; women, B=-0.003, p = 0.814). The associations between < 20 functional teeth and low handgrip strength [odds ratio (OR) = 1.46, 95% confidence interval (CI): 1.03–2.06], long 5TSTS duration (OR = 1.47, 95% CI: 1.07–2.02), and low SPPB scores (OR = 1.64, 95% CI: 1.07–2.53) were significant in fully adjusted model compared with ≥ 20 functional teeth only in men.ConclusionsFewer functional teeth were associated with low physical function in older adults. Our results emphasize the importance of maintaining adequate functional teeth to preserve physical function in community-dwelling older adults.

BackgroundThe lifestyle intervention ProMuscle, which combines resistance exercise and an increased protein intake, was effective in improving muscle strength, muscle mass, and physical functioning in older adults. However, due to a growing shortage of health care professionals, the rapidly growing aging population cannot be personally guided in the future. Therefore, Uni2Move, a scalable web-based variant of ProMuscle, was designed to reach larger groups of older adults without putting additional burden on health care professionals.ObjectiveThe current study investigated the effects of a web-based lifestyle intervention on muscle strength, protein intake, and physical functioning in healthy older adults. In addition, we conducted a qualitative study to gather key insights of the participants involved, as little is known about older adults’ perceptions of web-based lifestyle interventions.MethodsA pre-post pilot study was conducted in the Netherlands. In the 24-week intervention, 19 healthy adults aged >55 years were included. They performed resistance training at home twice a week for 24 weeks via web-based workout videos. Videos (45‐60 minutes) were recorded by the fitness trainer and mainly focused on training leg muscles. In addition, older adults were advised on increasing protein intake via two web-based consultations by a dietitian in the first 12 weeks and via an e-learning course in the second 12 weeks. Intervention adherence and acceptance was measured in week 25. The 1 repetition maximum knee extension strength, repeated chair rise test, and protein intake were measured at baseline, week 13, and week 25. Linear mixed models were used to test differences over time. Semistructured interviews were used to gather experiences of participants. Atlas.ti version 22 was used to analyze the interviews.ResultsThe mean age of participants (n=19) at baseline was 69 (SD 7) years. The 1 repetition maximum knee extension strength and repeated chair rise test improved significantly during the 24-week intervention with a mean difference of 7.0 kg (95% CI 4.8-9.3; P<.001) and −1.2 seconds (95% CI −1.7 to −0.6; P<.001), respectively. Total protein intake per day did not change, whereas protein intake during breakfast had increased significantly after 13 weeks with a mean difference of 6.9 g (95% CI 1.1-12.7; P=.01). Qualitative research revealed that advantages of the program included no need to travel and exercising in their own environment. Disadvantages were the lack of physical interaction and no corrections by the trainer.ConclusionsThe results of the web-based exercise and nutrition intervention Uni2Move indicate potential improvements of muscle strength and physical functioning in healthy middle-aged and older adults. Providing such lifestyle interventions on the internet could reach an increased number of older adults, providing the opportunity to contribute to the health and independence of the rapidly growing aging population.

Robotic suit-based exercises can be safely used for older adults. However, the effects of performing and discontinuing such programs on physical function remain unknown. We examined the long-term effects of a 5-week robotic suit-based exercise program on physical function in older adults with low fitness and assess the impact of exercise discontinuation during a 5-month follow-up period. We conducted a follow-up analysis of a completed randomized controlled trial. Community-dwelling older adults (n = 75, mean age = 74.7 ± 4.4years) participated in a 5-week hybrid assistive limb robotic suit-based exercise program. We measured six physical function tests (gait speed at usual pace, five times sit-to-stand test, timed up and go test, functional reach test, two-step test, and grip strength), and the five-question Geriatric Locomotive Function Scale score. Evaluations were conducted at baseline, postintervention, and after the 5-month follow-up. Participants were stratified into those who continued exercising during the follow-up at the intervention facility (facility-attending group) and those who discontinued (nonattending group). Significant improvements were observed postintervention in all physical function, especially gait speed (effect size: Cohen's d = 1.7), which remained higher than baseline after the follow-up period (Cohen's d = 1.2). Most physical function declined during the follow-up period. However, participants in the facility-attending group maintained their physical function levels, with no significant decline in most measures. Hybrid assistive limb-based exercise improved physical function, especially gait speed. Continuous exercise postintervention is essential to maintain these improvements.

Background/Objective: Although there are many reports on the association between cognitive and physical functions in older adults, little information is available on those aged ≥75 years. Therefore, this study aimed to determine whether mild cognitive impairment (MCI) in older adults over 75 years who live in independent senior housing is associated with physical function. Methods: In this study, 271 participants (174 women and 97 men) with a mean age of 85.4 ± 4.7 years were included. Cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment; a score < 26 confirmed MCI. MCI was an objective variable in univariate and multivariable logistic regression analyses. Physical function was measured using hand grip strength, normal and maximum gait speeds, and the 30 s chair stand test. Physical function was an explanatory variable adjusted for age and divided into tertiles (high, middle, and low) based on sex. The significance level was set at 5%. Results: There were 170 participants (63%) with MCI. Compared to the non-MCI group, the MCI group had significantly higher age and significantly lower normal and maximum gait speeds and 30 s chair stand test values Age-adjusted univariate analyses in women showed higher MCI rates in the low-fitness group than in the high-fitness group for maximum gait speed and 30 s chair stand test values. No variables were associated with MCI in men. Conclusions: MCI may be associated with physical function in women and older adults over 75 years who live in independent senior housing.

Background/objectives: Cognitive decline and loss of physical function are common concerns in older adults, with limited effective interventions available. This study aimed to assess the impact of pomegranate extract (PE) supplementation on cognitive and physical function in older adults aged 55–70 years. Methods: A randomised, double-blind placebo-controlled trial was conducted with 86 participants, who were assigned to receive either PE (740 mg) or a placebo (maltodextrin) daily for 12 weeks. Cognitive function was assessed using computerised tests (Corsi, digit span, Wisconsin Card Sorting Test (WCST), Tower of Hanoi, Stroop test and Rey auditory verbal learning test). Physical function was measured through assessments of standing balance, gait speed, chair sit to stand and grip strength. Results: There was a significant effect of treatment and time on WCST performance (F (1,2) = 2.718, p = 0.05), while trends towards better outcomes in the PE group were noted for digit span, Tower of Hanoi and Stroop tests. Physical function did not seem to be affected by the intervention, but results may have been limited by the high baseline physical activity levels and full mobility of the older adults. Conclusions: This was the first study to examine the effect of PE on cognitive and physical function over a duration of 12 weeks. Findings suggest that PE supplementation has potential in improving cognitive function and may offer a promising approach to preventing cognitive decline in ageing adults. Further controlled and well-designed long-term studies are needed to establish the long-term effects of PE on cognitive and physical health, along with the mechanisms of action involved.

BackgroundOlder adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways.PurposeThe objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach.MethodsA systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software.ResultsOur search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011).ConclusionThis meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function.PROSPERO registration number*PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.

Background and objectivesResistance training is widely recommended for managing sarcopenia, but evidence on optimal prescriptions remains limited. This study aimed to assess the effects of different resistance training prescriptions on strength, function, and muscle mass in older adults with sarcopenia.MethodsWe searched PubMed, Embase, Web of Science, and CENTRAL to June 2025. Eligible studies were RCTs in adults aged ≥ 60 with sarcopenia, comparing resistance training with usual care or no intervention, and reporting outcomes on strength, physical function, or muscle mass. Risk of bias was assessed using RoB 2. Meta-analyses were conducted using the meta package in R, and Bayesian dose–response models were fitted using the brms package.ResultsTwenty-four randomized controlled trials involving 951 participants were included. Random-effects model showed that resistance training significantly improved handgrip strength, gait speed, knee extension strength, timed up and go test (TUG) and and five-times sit-to-stand test (5STS) performance. However, no significant improvements were observed in the short physical performance battery (SPPB), appendicular skeletal muscle mass index and appendicular skeletal muscle mass. Subgroup analyses revealed significant differences across resistance type, frequency, and setting, although meta-regression identified no significant sources of heterogeneity. A nonlinear Bayesian random-effects model suggested an optimal dose of 1220 MET-min/week for improving handgrip strength, while a minimal effective dose of 600 MET-min/week may suffice to achieve clinically meaningful improvements in gait speed.ConclusionResistance training probably improves muscle strength and physical function in older adults with sarcopenia. However, improvements in grip strength, gait speed, TUG, 5STS, and SPPB did not exceed their MID thresholds, indicating little to no clinical benefit. Resistance type and training frequency were key effect modifiers. Individualized resistance programs within the optimal dose range, emphasizing higher frequency and appropriate resistance types, may help optimize outcomes.Graphical abstractSupplementary InformationThe online version contains supplementary material available at 10.1007/s40520-025-03235-w.

Aging negatively impacts cognitive function and physical function in older adults. Physical activity may protect or improve the brain and physical functions that are crucial for multiple health outcomes in older adults, whereas obesity may negatively impact these outcomes. PURPOSE: To examine the association between cognitive function with BMI and physical function in underactive older adults. METHODS: Baseline data were examined from sedentary older adults (N=31; age=70.3±3.7 years; BMI=28.8±4.6 kg/m2) prior to engaging in a 12-month physical activity intervention. Assessments included height, weight, physical function, and cognitive function. Cognitive function was assessed using the Modified Mini-Mental State (3MS) examination and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Physical function performance was assessed using the time to complete the 400-Meter Walk Test (minutes). RESULTS: Average time to complete the 400-meter walk was 6.3±1.0 minutes, which was modestly associated with BMI (r=0.312, p=0.088). The 3MS Total Score (94.7±3.7) was not significantly correlated with BMI (r=-.158; p=.397) or 400-Meter Walk Test performance (r=-.152; p=.415). Similarly, the RBANS Sum of Index Score (209.0±21.1) was not significantly correlated with BMI (r=-.297; p=.105) or 400-Meter Walk Test performance (r=-.164; p=.378). When examining this relationship by cognitive domain, a higher BMI was associated with a poorer RBANS Immediate Memory Index Score (r=-.412; p=.021). We also observed that worse performance on the 400-Meter Walk Test was associated with poorer RBANS Immediate Memory Index Score (r=-.314; p=.08). Neither BMI nor 400-Meter Walk performance were significantly associated with RBANS Visuospatial/Constructional Index, Language Index, Attention Index, or Delayed Memory Index scores. CONCLUSION: Findings reveal that RBANS Immediate Memory Index score was inversely associated with both BMI and physical function in sedentary older adults. This may suggest that both obesity and poor physical function negatively impact immediate memory performance in older adults. Future studies to investigate whether and how physical therapeutics may enhance short-term memory function in older adults are warranted. Supported by UPMC Enterprises

In this study, a systematic review was conducted to examine suicidal ideation in older adults in relation to physical function and body composition in older men and women aged 60 years and older. Articles published between January 2013 and September 2023 were identified using the keywords suicidal ideation, physical function, and body composition, written in English. The search was conducted if they were empirical papers, published in scientific journals, written in English or Spanish language and that evaluated the relationship between suicidal ideation, physical function and body composition in older adults. Eighteen cross-sectional studies and one clinical trial met the eligibility criteria. Most were conducted in South Korea. The relationship between suicidal ideation, physical function in older adults was positive and significant in men, but not in women. On the other hand, the relationship between body composition resulting from body mass index (BMI) and suicidal ideation was not shown to be a significant predictor. This study provided valuable information on the importance of preventing the loss of physical function, such as gait speed, muscle strength, and basic activities of daily living (BADL) and instrumental activities of daily living (IADL), in preventing suicidal ideation in older adults. This finding is important because physical function can be treated or mediated by therapeutic interventions.