Community-dwelling Older Women Research Articles

Interaction Between Sarcopenic Obesity and Nonlocomotive Physical Activity on the Risk of Depressive Symptoms in Community-Dwelling Older Adult Japanese Women.

This study aimed to investigate the interaction between sarcopenic obesity and locomotive and nonlocomotive physical activity (PA) on the risk of depressive symptoms in community-dwelling older Japanese women. Participants were 143 community-dwelling older women aged 64-94years. PA was measured using a three-axis accelerometer. Participants were classified according to two levels of total, locomotive, and nonlocomotive PA. Depressive symptoms were assessed by a self-administered survey consisting of the 15-item Japanese version of the Geriatric Depression Scale (GDS-15-J). The interaction between sarcopenic obesity groups and total or locomotive PA did not affect GDS-15-J scores. However, the interaction between sarcopenic obesity groups and nonlocomotive PA significantly affected GDS-15-J scores (p < .05). Moreover, sarcopenic obesity in the low PA group had significantly higher GDS-15-J scores compared with sarcopenic obesity in the high PA group (p < .05). We concluded that sarcopenic obesity combined with low nonlocomotive PA may exacerbate depressive symptoms in older women.

The Prevalence and Association Between Social Support and Physical Activity Among the Rural Community-Dwelling Older Women in a Southeast Asian Country.

While physical activity ensures healthy aging, rural community-dwelling older women tend to be more physically inactive compared with their counterparts in Malaysia. As social support is one of the key determinants of physical activity, this retrospective, cross-sectional study investigated the prevalence of physical activity and its association with social support among 1,221 rural community-dwelling older women in Kuala Pilah, Negeri Sembilan, Malaysia. The prevalence of physical activity among older women was 45.1% with the highest prevalence reported for housework domain (52.3%). The total mean Duke Social Support index score was 27.24 ± 3.40. Multivariate analysis reported age, employment status, and income level to demonstrate significant association with the physical activity after adjusting for confounders. Older women with an increase in social interaction score were more likely (odds ratio = 1.22; 95% confidence interval [1.10, 1.34]; p < .001) to have high physical activity when adjusted for sociodemographic, health, mental health, and physical disability. Contrarily, older women with an increase in one subjective social support score were less likely (odds ratio = 0.91; 95% confidence interval [0.87, 0.96]; p < .001) to have high physical activity when adjusted for confounders. The findings were insightful to tailor interventions on promoting social support for physical activity enhancement among older women.

Impact of spinal sagittal malalignment on locomotive syndrome and physical function in community-dwelling middle aged and older women

BackgroundAdult spinal deformity has a substantially debilitating effect on older people’s physical and mental health. However, the impact of sagittal malalignment on locomotive syndrome (LS), sarcopenia, and physical function in community-dwelling older women has not yet been clarified. This study aimed to investigate the association between these factors in community-dwelling middle aged and older women.MethodsA total of 361 women were recruited from participants performing aquatic exercises in a rural area of Japan. The body mass index, skeletal muscle mass index, trunk muscle mass, spinal inclination angle (SIA), grip strength, timed up-and-go test (TUG), maximum stride of the participants, and one-leg standing time were measured. Low back pain (LBP)- and health-related quality of life (HRQOL) were evaluated using the Oswestry Disability Index (ODI) and the Short-Form 8 questionnaire. Associations between the global sagittal alignment using SIA and investigating parameters were analyzed.ResultsThe prevalence of sarcopenia was 3.6%. The prevalence of LS (stages 1, 2, and 3) was 43.8% (158 of 361), and the number of participants in each LS stage was 203 (stage 0), 95 (stage 1), 28 (stage 2), and 35 (stage 3). The SIA was significantly correlated with the 25-question geriatric locomotive function scale (r′ = 0.292, p < 0.001), ODI (r′ = 0.267, p < 0.001), and TUG (r′ = 0.453, p < 0.001) after adjusting for age. In the receiver-operating characteristic curve analysis, the cutoff values of SIA for LS ≥ stage 2 and ODI ≥ 20% were 5°.ConclusionsLBP-related QOL and physical performance were significantly associated with global sagittal alignment. Global sagittal alignment was correlated with the three-stage category of LS. The spinal inclination of 5° was a cutoff value to predict exacerbation of mobility function and HRQOL status.

지역사회기반 여성 노인의 호흡 근력과 신체 근력 및 근육량의 상관관계 연구

Purpose: This study aimed to indirectly assess physical strength and muscle mass to determine the level of respiratory muscle strength in community-based older women. Methods: A total of 30 women aged 65 years or older were included in this study. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and grip strength were measured. Timed up and go test, five times sit-to-stand test (FTSST), one-minute sit-to-stand test (1MSTST), and bioelectrical impedance analysis (BIA) were performed. Subsequently, a correlation analysis was performed between the measured data and respiratory muscle strength. Results: MIP was significantly correlated with pulmonary function parameters, including FVC, FEV1, FTSST score, 1MSTST score, and body mass index (BMI) measured by BIA. MEP was significantly correlated with FEV1/FVC, FTSST score, 1MSTST score, and BMI. Conclusion: A significant correlation was observed between respiratory muscle strength and FTSST score, 1MSTST score, and BMI in community-dwelling older women. Further studies are needed to predict respiratory muscle strength levels based on leg muscle strength and BMI and to manage respiratory muscle health in community-dwelling older individuals.

Inflammatory biomarkers at different stages of Sarcopenia in older women

In recent years, studies have found that Sarcopenia alters inflammatory biomarkers. However, the behavior of inflammatory biomarkers at different stages of Sarcopenia is not well understood. This study aimed to compare a broad panel of inflammatory biomarkers in older women at different stages of Sarcopenia. The study included 71 Brazilian community-dwelling older women. Muscle Strength was assessed by using handgrip strength (Jamar dynamometer). The Short Physical Performance Battery (SPPB) was performed to assess the physical performance, and body composition was assessed by DEXA. Sarcopenia was diagnosed and classified according to the EWGSOP2 criteria. Blood was drawn, and inflammatory biomarkers associated with Sarcopenia (IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, TNF, adiponectin, leptin, resistin, BDNF, sTNFr-1 and sTNFr-2) was analysed. After diagnosis and classification of sarcopenia, 45% of women did not present Sarcopenia (NS, N = 32), 23.9% were diagnosed with Sarcopenia Probable (SP, N = 17), 19,7% with Sarcopenia Confirmed (SC, N = 14), and 11.3% with Severe Sarcopenia (SS, N = 8). The analysis of inflammatory biomarkers revealed that the more advanced the stage of Sarcopenia, the higher the levels of BDNF, IL-8, sTNFr-1, and sTNFr-2. The assessment of BDNF, IL-8, sTNFr-1, and sTNFr-2 levels may be an adjuvant tool in diagnosis and severity classification of Sarcopenia in older Brazilian women.

Spectrochemical analysis of blood combined with chemometric techniques for detecting osteosarcopenia

Among several complications related to physiotherapy, osteosarcopenia is one of the most frequent in elderly patients. This condition is limiting and quite harmful to the patient’s health by disabling several basic musculoskeletal activities. Currently, the test to identify this health condition is complex. In this study, we use mid-infrared spectroscopy combined with chemometric techniques to identify osteosarcopenia based on blood serum samples. The purpose of this study was to evaluate the mid-infrared spectroscopy power to detect osteosarcopenia in community-dwelling older women (n = 62, 30 from patients with osteosarcopenia and 32 healthy controls). Feature reduction and selection techniques were employed in conjunction with discriminant analysis, where a principal component analysis with support vector machines (PCA–SVM) model achieved 89% accuracy to distinguish the samples from patients with osteosarcopenia. This study shows the potential of using infrared spectroscopy of blood samples to identify osteosarcopenia in a simple, fast and objective way.

Diuretic use and risk of falls in older women with urinary incontinence

ObjectiveTo determine the association between diuretic use and falls in community-dwelling older women with urinary incontinence (UI). MethodsWe conducted an analytic cross-sectional study using patients’ electronic medical records. Patients were women with UI, 65 years or older seen at a urogynecology clinic between January 1, 2018 and September 30, 2019. We used logistic regression analysis to explore the associations between falls and diuretic use. ResultsThe study included 108 women, mean age of 75.2 ±7.5 years. Twenty-two (20%) reported one or more falls within the past year and 32 (30%) were diuretic users. Fall prevalence in diuretic users and non-users were 25% (8/32) and 18.4% (14/76), respectively. Diuretic use was not associated with falls (OR = 0.74, 95%CI = 0.22-2.52). Post-hoc analysis revealed inadequate sample size. ConclusionsDiuretics use may not be a risk factor for falls in ambulatory older women with UI. A larger sample will be needed to confirm.

Combined exercise and nutrition intervention for older women with spinal sarcopenia: an open-label single-arm trial

PurposeSpinal sarcopenia is a multifactorial disorder associated with atrophy and fatty changes in paraspinal muscles. Interventional studies for spinal sarcopenia are limited. We aimed to evaluate the effectiveness of a combined exercise and nutrition intervention for the treatment of spinal sarcopenia.Methods35 community-dwelling older women diagnosed with spinal sarcopenia in a previous cohort study were included. The 12-week combined intervention consisted of back extensor strengthening exercises and protein supplementation. The following outcomes were measured at baseline (week 0), after the intervention (week 12), and follow-up (week 24): conventional variables of sarcopenia (appendicular skeletal muscle mass, handgrip strength, 6-meter gait speed, and short physical performance battery); lumbar extensor muscle mass; lumbar extensor muscle volume and signal intensity; back extensor isokinetic strength; and back performance scale. We used the intention-to-treat analysis method, and repeated measures analysis of variance was used to analyze the data.ResultsOf the total 35 potential participants, 26 older women participated in the study (mean age 72.5 ± 4.0 years old). After 12 weeks of combined exercise and nutrition intervention, there were no changes in the appendicular skeletal muscle mass, lumbar extensor muscle mass, volume, or signal intensity. Handgrip strength and back extensor isokinetic strength did not change significantly. Short physical performance battery significantly increased (P = 0.042) from 11.46 ± 0.86 to 11.77 ± 0.53 at week 12 and 11.82 ± 0.40 at week 24. The back performance scale sum score also significantly improved (P = 0.034) from 2.68 ± 1.81 to 1.95 ± 1.21 at week 12 and 2.09 ± 1.34 at week 24.ConclusionThe combined exercise and nutrition intervention for community-dwelling older women with spinal sarcopenia could be feasible and helpful in improving the physical performance as well as back performance.

Relationships between locomotive and non-locomotive MVPA and 'ikigai' in older Japanese adults.

This study aimed to investigate the relationship between physical activity (PA) of moderate to vigorous intensity (MVPA) and ikigai in older Japanese adults. We evaluated the amount of PA using an activity meter equipped with a three-axis accelerometer. The measured activities were classified into locomotive PA and non-locomotive PA to clarify not only the relationship between MVPA and ikigai, but the types of activities that lead to increased ikigai as well. Participants were 86 community-dwelling older adult Japanese men and women. Measurement items included basic information (age, sex, BMI, and the number of underlying diseases), PA, Self-completed Occupational Performance Index (SOPI), and ikigai (the K-1 Scale). Confounding factors presumed to be related to ikigai were also elicited from previous studies. Associations of ikigai into three groups (high, middle, and low) with PA were analyzed by group comparisons and multivariate analyses. The comparison of PA indices among the high, middle, and low ikigai groups revealed that non-locomotive MVPA is significantly associated with ikigai (p < 0.05). In multiple comparisons, the low ikigai group was significantly and negatively affected by non-locomotive MVPA (p < 0.05) compared to the middle and high ikigai groups. Furthermore, in a multivariate analysis with ikigai as the dependent variable and sex, age, locomotive MVPA, and non-locomotive MVPA as independent variables, only non-locomotive MVPA (p < 0.05) was associated. These results suggest that non-locomotive MVPA is effective in enhancing ikigai.

Foods and Nutrients at Risk for Insufficient Intake by Community-Dwelling Healthy Older Women Eating Alone and Together in Japan-A Preliminary Finding.

Eating alone and poor dental status have been reported to influence dietary intake in older adults. First, we compared nutrient and food intake and dental markers between women eating alone and together, who participated in a home health management program conducted by Kanazawa Medical University. The results showed the significantly higher intake of fresh fruit and some micro-nutrients and a lower decayed, missing, and filled teeth (DMFT) index (better dental status) in women eating alone after adjusting for age, suggesting that dental status may mediate the association between commensality and dietary intake. Then, we investigated nutrients and foods at risk for insufficient intake and associated with increasing dental markers. The risks for the insufficient intake of protein and n-3 and n-6 polyunsaturated fatty acids (PUFAs) were significantly increased with an increasing DMFT index. The risk for n-3 PUFA intake also increased with increasing numbers of missing teeth in women. Foods at risk for insufficient consumption included beans for women with an increasing DMFT index and green and yellow vegetables, fresh fruits, and meat and fish for women with increasing numbers of missing teeth. These findings suggest that good health management, including the treatment of decayed teeth, is important for the prevention of malnutrition in community-dwelling healthy older women.

Relationships between sarcopenia, nutrient intake, and gut microbiota in Chinese community-dwelling older women

BackgroundThe relationship among gut microbiota, sarcopenia components, and influencing factors in female sarcopenic patients has been poorly investigated. MethodsFemale participants completed questionnaires of physical activity and dietary frequency and were assessed for the presence of sarcopenia by the Asian Working Group of Sarcopenia 2019 (AWGS 2019) criteria. Fecal samples were collected from 17 sarcopenia and 30 non-sarcopenia subjects for 16S sequencing and short chain fatty acid (SCFA) detection. ResultsThe prevalence of sarcopenia was 19.20% among 276 participants. The dietary protein, fat, dietary fiber, vitamin B1, niacin, vitamin E, phosphorus, magnesium, iron, zinc, and cooper intake of sarcopenia were all remarkably low. In addition, the richness of gut microbiota (Chao1 and ACE indexes) was considerably reduced in sarcopenic patients, and the sarcopenic gut microbiota and its metabolite were decreased in Firmicutes/Bacteroidetes, Agathobacter, Dorea and Butyrate and were enriched in Shigella and Bacteroides. Correlation analysis showed that Agathobacter and Acetate were positively correlated with grip strength and gait speed, respectively, and Bifidobacterium was negatively correlated with grip strength and appendicular skeletal muscle index (ASMI). Moreover, the protein intake was positively related to Bifidobacterium. ConclusionsThis cross-sectional study revealed the alterations of gut microbiota composition, SCFA, and nutrient intake in women with sarcopenia and their relation to sarcopenic components. These results provide insights into further studies on the role of nutrition and gut microbiota in sarcopenia and its use as a therapeutic approach.

Predictive ability of a self-rated fall risk assessment tool in community-dwelling older women

BackgroundFalls are a substantial health problem among older adults. An accessible and reliable tool for assessing individual fall risk is needed.AimsThe predictive ability of a one-page self-rated fall risk assessment form (KaatumisSeula® [KS]) was evaluated among older women in its current form.MethodsA subsample (n = 384) of community-living older women (aged 72–84 years) participating in the Kuopio Fall Prevention Study (KFPS) completed the KS form. Participants’ falls were prospectively registered for 12 months with SMS messages. Their group status and form-based fall risk category were compared to the verified fall events during the KFPS intervention. Negative binomial regression and multinomial regression analyses were used. Physical performance measurements (single leg stance, leg extension strength and grip strength) were used as covariates.ResultsDuring the follow-up, 43.8% of women fell at least once. Among the fallers, 76.8% had at least one self-determined injurious fall, and 26.2% had falls requiring medical attention. According to KS, 7.6% of the women had low fall risk, 75.0% moderate, 15.4% substantial, and only 2.1% high fall risk. Women in the “moderate fall risk” group had 1.47-fold (95% CI 0.74–2.91; nonsignificant), in “substantial fall risk” 4.00-fold (1.93–8.3; p < 0.001) and in “high fall risk” 3.00-fold (0.97–9.22; nonsignificant) higher risk of falls compared to the “low fall risk” group. Performance in physical tests did not account for future falls.ConclusionsThe KS form proved to be a feasible tool for self-administered fall risk assessment with moderate predictive ability.Trial registrationClinicalTrials.gov identifier: NCT02665169, date of first registration 27/01/2016.

TReating Incontinence for Underlying Mental and Physical Health (TRIUMPH): a study protocol for a multicenter, double-blinded, randomized, 3-arm trial to evaluate the multisystem effects of pharmacologic treatment strategies for urgency-predominant urinary incontinence in ambulatory older women

BackgroundUrgency-type urinary incontinence affects one in four older community-dwelling women and overlaps with other common aging-associated health syndromes such as cognitive impairment, physical mobility impairment, and depression. Observational studies have raised concern about potentially higher rates of delirium and dementia in older adults taking anticholinergic bladder medications, but few prospective data are available to evaluate the effects of these and other pharmacologic treatments for urgency incontinence on cognition and other multisystem functional domains important to older women.MethodsThe TRIUMPH study is a randomized, double-blinded, 3-arm, parallel-group trial comparing the multisystem effects of anticholinergic versus beta-3-adrenergic agonist bladder therapy and versus no active bladder anti-spasmodic pharmacotherapy in older women with urgency incontinence. Women aged 60 years and older (target N = 270) who have chronic urgency-predominant urinary incontinence and either normal or mildly impaired cognition at baseline are recruited from the community by investigators based in northern California, USA. Participants are randomized in equal ratios to take identically encapsulated oral anticholinergic bladder therapy (in the form of tolterodine 2 mg extended release [ER]), oral beta-3 adrenergic agonist bladder therapy (mirabegron 25 mg ER), or placebo daily for 24 weeks, with the option of participant-directed dose titration (to tolterodine 4 mg ER, mirabegron 50 mg ER, or matching placebo daily). Participants also receive patient-oriented information and instructions about practicing first-line behavioral management strategies for incontinence. The primary outcome is change in composite cognitive function over 24 weeks assessed by a comprehensive battery of cognitive tests, with a secondary exploration of the persistence of change at 36 weeks. Secondary outcomes include changes over 24 and 36 weeks in domain-specific cognitive function; frequency, severity, and impact of urgency-associated urinary symptoms; physical function and balance; sleep quality and daytime sleepiness; psychological function; and bowel function.DiscussionThe TRIUMPH trial addresses the need for rigorous evidence to guide counseling and decision-making for older women who are weighing the potential multisystem benefits and risks of pharmacologic treatments for urgency incontinence in order to preserve their day-to-day functioning, quality of life, and independence in older age.Trial registrationClinicalTrials.gov NCT05362292. Registered on May 5, 2022.

Impaired muscle function, including its decline, is related to greater long-term late-life dementia risk in older women.

Impaired muscle function has been identified as a risk factor for declining cognitive function and cardiovascular health, both of which are risk factors for late-life dementia (after 80years of age). We examined whether hand grip strength and timed-up-and-go (TUG) performance, including their change over 5years, were associated with late-life dementia events in older women and whether any associations provided independent information to Apolipoprotein E ℇ 4 (APOE ℇ 4) genotype. Grip strength and TUG were assessed in community-dwelling older women (mean±SD; age 75.0±2.6years) at baseline (n=1225) and 5years (n=1052). Incident 14.5-year late-life dementia events (dementia-related hospitalization/death) were obtained from linked health records. Cardiovascular risk factors (Framingham Risk Score), APOE genotyping, prevalent atherosclerotic vascular disease and cardiovascular-related medications were evaluated at baseline. These were included in multivariable-adjusted Cox-proportional hazards models assessing the relationship between muscle function measures and late-life-dementia events. Over follow-up, 207 (16.9%) women had a late-life dementia event. Compared with women with the highest grip strength (Quartile [Q] 4, 25.8kg), those with the lowest grip strength (Q1, 16.0kg) had greater hazard for a late-life dementia event (HR 2.27 95% CI 1.54-3.35, P<0.001). For TUG, the slowest women (Q4, 12.4 vs. Q1, 7.4s) also recorded a greater hazard for a late-life dementia event (HR 2.10 95% CI 1.42-3.10, P=002). Weak hand grip (<22kg) or slow TUG (>10.2s) provided independent information to the presence of an APOE ℇ 4 allele (n=280, 22.9%). Compared with women with no weakness and no APOE ℇ 4 allele, those with weakness and APOE ℇ 4 allele had a greater hazard (HR 3.19 95% CI 2.09-4.88, P<0.001) for a late-life dementia event. Women presenting with slowness and the APOE ℇ 4 allele also recorded a greater hazard for a late-life dementia event (HR 2.59 95% CI 1.64-4.09, P<0.001). For 5-year muscle function changes, compared with women with the lowest performance decrement (Q1), those with the largest decrement (Q4) had higher hazards for a late-life dementia event (grip strength HR 1.94 95% CI 1.22-3.08, P=0.006; TUG HR 2.52 95% CI 1.59-3.98, P<0.001) over the next 9.5years. Weaker grip strength and slower TUG, and a greater decline over 5years, were significant risk factors for a late-life-dementia event in community-dwelling older women, independent of lifestyle and genetic risk factors. Incorporating muscle function measures as part of dementia screening appears useful to identify high-risk individuals who might benefit from primary prevention programmes.

Musculoskeletal Fitness for Identifying Low Physical Function in Older Women.

This cross-sectional study aimed to analyze the relevance of musculoskeletal fitness for identifying low physical functioning in community-dwelling older women. Sixty-six older women (73.62 ± 8.23 yrs old) performed a musculoskeletal fitness assessment of the upper and lower limbs. A handheld dynamometer was used to evaluate upper-limb muscle strength through a handgrip (HG) test. Lower-limb power and force were assessed from a two-leg countermovement vertical jump (VJ) on a ground reaction force platform. Physical functioning was assessed subjectively using the Composite Physical Function (CPF) questionnaire and objectively by daily step count measured by accelerometry and gait speed/agility assessed by the 8-Foot Up-and-Go (TUG) test. Logistic regressions and ROC curves were carried out to define odds ratios and ideal cutoff values for discriminatory variables. VJ power showed the ability to identify low physical functioning when evaluated through the CPF (14 W/kg, 1011 W), gait speed/agility (15 W/kg, 800 W), or daily accumulated steps (17 W/kg). Considering that VJ power was normalized for body mass, the increase of 1 W/kg corresponds to a decrease of 21%, 19%, or 16% in the chance of low physical functioning when expressed by these variables, respectively. HG strength and VJ force did not show a capacity to identify low physical functioning. The results suggest that VJ power is the only marker of low physical functioning when considering the three benchmarks: perception of physical ability, capacity for mobility, and daily mobility.

Feasibility and Effectiveness of a Novel Intervention Integrating Physical Therapy Exercise and Dance Movement Therapy on Fall Risk in Community-Dwelling Older Women: A Randomized Pilot Study.

This pilot study presents a novel fall prevention intervention that integrates physical therapy exercise (PTE) and dance movement therapy (DMT) to address both physical and emotional fall risk factors, as well as factors influencing adherence to treatment. The aim of this study was to examine the feasibility and effectiveness of the intervention in a sample of eight older women (median = 86 [81.25-90.75] years) from a day center for senior citizens. The intervention, based on the Otago Exercise Program and DMT techniques, aimed to address the emotional experience during physical exercise. Participants were randomly assigned to either a PTE+DMT intervention group (n = 5) or a PTE control group (n = 3). A pre-post intervention battery of physical and emotional fall risk assessments, therapist-patient bond, and home exercise adherence was conducted. Non-parametric tests results showed significant improvement in the PTE+DMT group in measures of balance and fear of falling compared to the PTE group. However, no other significant differences were found between the groups in terms of falls-related psychological concerns, self-perceived health status, therapist-patient bond, and home exercise adherence. These findings demonstrate the feasibility and potential benefits of an intervention that integrates both physical and emotional aspects to reduce fall risk in older adults, and provide a basis for further studies and modifications in the research protocol.

Functional brain changes in sarcopenia: evidence for differential central neural mechanisms in dynapenic older women

BackgroundThe European Working Group on Sarcopenia in Older People (EWGSOP2) recently revised its definition and diagnostic criteria for sarcopenia, placing muscle strength at the forefront. The pathogenesis of dynapenia (or low muscle strength) is still not fully understood, but there is emerging evidence that central neural factors constitute critical determinants.MethodsOur cross-sectional study included 59 community-dwelling older women (mean age 73.1 ± 4.9 years). Participants underwent detailed skeletal muscle assessments for muscle strength defined by handgrip strength and chair rise time measurements using the recently published EWGSOP2 cut-off points. Functional magnetic resonance imaging (fMRI) was assessed during the performance of a cognitive dual-task paradigm, consisting of a baseline, two single-tasks (motor and arithmetic) and one dual-task (motor and arithmetic combined).ResultsForty-seven percent (28/59) of participants were classified as dynapenic. fMRI results revealed a differential recruitment of motor circuits in the brain during the dual-task condition in dynapenic as compared with non-dynapenic participants. In particular, while the brain activity during the single-tasks did not differ between the two groups, only during the dual-task non-dynapenic participants showed significant increased activation in dorsolateral prefrontal and premotor cortex, and in supplementary motor area as compared to dynapenic participants.ConclusionOur results point to a dysfunctional involvement of brain networks associated with motor control in dynapenia in a multi-tasking paradigm. A better knowledge of the link between dynapenia and brain functions could provide new impulses in the diagnosis and interventions for sarcopenia.

Method for Activity Sleep Harmonization (MASH): a novel method for harmonizing data from two wearable devices to estimate 24-h sleep–wake cycles

BackgroundDaily 24-h sleep–wake cycles have important implications for health, however researcher preferences in choice and location of wearable devices for behavior measurement can make 24-h cycles difficult to estimate. Further, missing data due to device malfunction, improper initialization, and/or the participant forgetting to wear one or both devices can complicate construction of daily behavioral compositions. The Method for Activity Sleep Harmonization (MASH) is a process that harmonizes data from two different devices using data from women who concurrently wore hip (waking) and wrist (sleep) devices for ≥ 4 days.MethodsMASH was developed using data from 1285 older community-dwelling women (ages: 60–72 years) who concurrently wore a hip-worn ActiGraph GT3X + accelerometer (waking activity) and a wrist-worn Actiwatch 2 device (sleep) for ≥ 4 days (N = 10,123 days) at the same time. MASH is a two-tiered process using (1) scored sleep data (from Actiwatch) or (2) one-dimensional convolutional neural networks (1D CNN) to create predicted wake intervals, reconcile sleep and activity data disagreement, and create day-level night-day-night pairings. MASH chooses between two different 1D CNN models based on data availability (ActiGraph + Actiwatch or ActiGraph-only). MASH was evaluated using Receiver Operating Characteristic (ROC) and Precision-Recall curves and sleep–wake intervals are compared before (pre-harmonization) and after MASH application.ResultsMASH 1D CNNs had excellent performance (ActiGraph + Actiwatch ROC-AUC = 0.991 and ActiGraph-only ROC-AUC = 0.983). After exclusions (partial wear [n = 1285], missing sleep data proceeding activity data [n = 269], and < 60 min sleep [n = 9]), 8560 days were used to show the utility of MASH. Of the 8560 days, 46.0% had ≥ 1-min disagreement between the devices or used the 1D CNN for sleep estimates. The MASH waking intervals were corrected (median minutes [IQR]: − 27.0 [− 115.0, 8.0]) relative to their pre-harmonization estimates. Most correction (− 18.0 [− 93.0, 2.0] minutes) was due to reducing sedentary behavior. The other waking behaviors were reduced a median (IQR) of − 1.0 (− 4.0, 1.0) minutes.ConclusionsImplementing MASH to harmonize concurrently worn hip and wrist devices can minimizes data loss and correct for disagreement between devices, ultimately improving accuracy of 24-h compositions necessary for time-use epidemiology.

Association between asymmetric dimethylarginine and sarcopenia in community-dwelling older women

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelium nitric oxide synthesis and causes endothelial dysfunction that may be related to sarcopenia. However, the association between ADMA and sarcopenia has not been studied. We evaluated the correlations between plasma ADMA levels and sarcopenia in community-dwelling older women. In total, 144 community-dwelling older women participated in this study. Plasma ADMA levels were measured using a competitive enzyme-linked immunosorbent assay. Skeletal muscle mass, measured in terms of bioimpedance and grip strength, was used to assess sarcopenia. Plasma ADMA levels were significantly higher in participants with sarcopenia than in those without sarcopenia. Through receiver-operating characteristic curve analysis, the cutoff value of plasma ADMA level for sarcopenia was estimated at 0.57 μM. Sarcopenia was significantly more prevalent in participants with higher plasma ADMA levels than in those with lower plasma ADMA levels. According to logistic regression analysis, the crude odds ratio of higher plasma ADMA levels in participants with sarcopenia was 4.57 (95% confidence interval, 1.82–11.47; p = 0.001). Reductions in the skeletal muscle mass index over 2 years were significantly greater in participants with higher plasma ADMA levels. In conclusion, plasma ADMA levels were significantly associated with sarcopenia in community-dwelling older women.

Challenges, Concerns, and Experiences of Community-Dwelling Older Women with Chronic Low Back Pain—A Qualitative Study in Hong Kong, China

Although chronic low back pain (CLBP) is known to negatively affect multiple aspects of the lives of older people, prior qualitative studies mainly focused on the lived experiences of older people with CLBP in Western countries. Given cultural and contextual differences and poor understanding of CLBP in older women with CLBP, it is important to better understand the concerns and lived experiences of Chinese older women with CLBP. The current study aimed to investigate the experiences, challenges, concerns, and coping strategies of older women with CLBP in Hong Kong. A total of 15 community-dwelling older women with CLBP aged ≥60 years were recruited from a physiotherapy clinic or a community center for semi-structured interviews. The interviews were audio recorded and transcribed 'verbatim'. The transcription was imported to NVivo 12 software. Thematic analysis was conducted using Braun and Clarke's method. Five themes were identified: (1) physical impacts of CLBP on daily life; (2) psychological influences of CLBP; (3) management of CLBP; (4) family support; and (5) social activities and support. Negative physical and psychosocial impacts of CLBP were common among older women, and they adopted diverse pain management strategies, although some of their treatment options were influenced by the Chinese culture. Misbeliefs and responses of family and friends also affected their management strategies. Elderly community centers are a significant source of social support for older women with CLBP, making it an ideal platform for establishing self-help groups to facilitate their self-management of CLBP.