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Physical Activity Reduces the Incidence of Sarcopenia in Middle-Aged Adults

Purpose of the ResearchThe aim of this study was to investigate associations between physical activity and risk of sarcopenia in middle-aged adults.MethodsThis was a longitudinal study based on a subset of UK Biobank data consisting of 1,918 participants (902 men and 1,016 women, mean age 56 years) who had no sarcopenia at baseline based on the criteria of European Working Group on Sarcopenia in Older People (EWGSOP2). The participants were assessed again after 6 years at follow-up, and were categorized into no sarcopenia, probable sarcopenia, or sarcopenia using EWGSOP2. Physical activity was assessed at baseline using 7-day acceleration data that were analysed to obtain physical activity dose at different intensities. Multinominal logistic regression was employed to examine the association between the incidence of sarcopenia and physical activity dose, between baseline and follow up, controlled for other factors at baseline including age, sex, BMI, smoking status, intake of alcohol, vitamin D and calcium, history of rheumatoid arthritis, osteoarthritis, secondary osteoporosis, and type 2 diabetes.ResultsAmong the 1918 participants with no sarcopenia at baseline, 230 (69 men and 161 women) developed probable sarcopenia and 37 (14 men and 23 women) developed sarcopenia at follow-up. Logistic regression models showed that increase in physical activity dose at moderate-to-vigorous intensity significantly reduced the risk of sarcopenia (odds ratio=0.368, p<0.05), but not probable sarcopenia (odds ratio=0.974, p>0.05), while physical activity dose at light or very light activity intensity were not associated with the risk of sarcopenia or probable sarcopenia (p>0.05).ConclusionsPhysical activity at moderate-to-vigorous intensity could reduce risk of sarcopenia in middle-aged adults.

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Instruments and Measurement Scales for Cognitive Frailty in Midlife: A Systematic Literature Review from 2013 to 2023

This study is a systematic review addressing cognitive frailty, measurement instruments, and their impact on comprehensive care for older adults between 2013 and 2023. It seeks to identify findings on the distribution of studies in relation to year, country of publication, and methodology employed, as well as the instruments available to measure cognitive frailty and the scientific evidence supporting its assessment in midlife. We included studies published between 2013 and 2023 that addressed the topic of cognitive frailty and measurement instruments in midlife, excluding papers that did not provide primary data. A systematic search was performed in Scopus, PubMed, Web of Science, and Science Direct databases. The risk of bias was assessed using the Cochrane tool. Twenty-one studies were identified, of which three presented new instruments for measuring cognitive frailty, eleven focused on the validation and comparison of psychometric properties, and seven examined the assessment of frailty in midlife. Research on instruments for measuring cognitive frailty has grown in the last five years, concentrating on high- and upper-middle-income countries, with a quantitative and cross-sectional methodological approach. Validation and cross-cultural adaptation of scales such as FRAIL and the Tilburg Frailty Indicator predominate, demonstrating efficacy and validity in community settings. Only three studies validate Frailty Indices using longitudinal data in middle-aged population. The review highlights the efficacy and validity of existing instruments, as well as the growth in cognitive frailty research. Strengths include growing research and instrument validation; however, it is limited to high- and upper-middle-income countries. The review suggests increased attention to cognitive frailty, with new instruments incorporating cognitive components, which could improve assessment in midlife.

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Identification of Barriers and Facilitators to the Use of a New Pain Assessment Mobile Health Application by Family Carers of People with Dementia: A Qualitative Study

This study identified potential barriers and facilitators to the implementation of a medical device in the form of a mobile health (mHealth) application, (app) called PainChek®, by family carers of individuals with dementia in the Australian community setting. Focus groups and a phone interview took place with family carers and healthcare professionals. Data were analysed thematically. 6 family carers and 8 healthcare professionals participated across 2 focus groups and 1 phone interview. Themes related to the user, innovation/PainChek®, and contextual factors were identified. Barriers to use included age, physical limitations, cost, technical issues, misinterpretation of how PainChek® works, and influence of family. Facilitators included a willingness to use mHealth Apps and previous experience. Some themes acted as both barriers and facilitators depending on the situation such as the healthcare team's acceptance. Targeted interventions and support strategies, leveraging facilitators are essential to overcome barriers related to user, intervention, and context and to enhance successful PainChek® implementation, thereby improving pain management in individuals with dementia. Future research is recommended to develop effective implementation strategies to utilise the facilitators and overcome the barriers to improve the implementation of PainChek®.

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Open Access