Exercise In Older Adults Research Articles

Hippocampal blood flow rapidly and preferentially increases after a bout of moderate-intensity exercise in older adults with poor cerebrovascular health.

Over the course of aging, there is an early degradation of cerebrovascular health, which may be attenuated with aerobic exercise training. Yet, the acute cerebrovascular response to a single bout of exercise remains elusive, particularly within key brain regions most affected by age-related disease processes. We investigated the acute global and region-specific cerebral blood flow (CBF) response to 15minutes of moderate-intensity aerobic exercise in older adults (≥65years; n = 60) using arterial spin labeling magnetic resonance imaging. Within 0-6min post-exercise, CBF decreased across all regions, an effect that was attenuated in the hippocampus. The exercise-induced CBF drop was followed by a rebound effect over the 24-minute postexercise assessment period, an effect that was most robust in the hippocampus. Individuals with low baseline perfusion demonstrated the greatest hippocampal-specific CBF effect post-exercise, showing no immediate drop and a rapid increase in CBF that exceeded baseline levels within 6-12minutes postexercise. Gains in domain-specific cognitive performance postexercise were not associated with changes in regional CBF, suggesting dissociable effects of exercise on acute neural and vascular plasticity. Together, the present findings support a precision-medicine framework for the use of exercise to target brain health that carefully considers age-related changes in the cerebrovascular system.

The Effects of Creatine Supplementation on Markers of Muscle Damage and Inflammation Following Exercise in Older Adults: A Brief Narrative Review

Exercise induced muscle damage occurs following strenuous and unfamiliar exercise and results in biomarkers of muscle damage and inflammation in the circulation. Creatine (Cr) is a commonly utilized nutritional supplement which has been proposed to enhance post-exercise recovery and has been suggested to decrease exercise induced inflammation. Exercise is well recognized to be beneficial for older adults to maintain skeletal muscle mass and strength as well as promote health for other biological systems. However, older adults can experience chronic low-grade inflammation, sometimes referred to as ‘inflammaging’. Therefore, it may be prudent to limit post-exercise induced skeletal muscle damage and inflammation for the older adult population who may already be in a pro-inflammatory state and at risk of age-related muscle loss (sarcopenia). The purpose of this brief narrative review is to outline the current research on Cr and its effects on biomarkers of muscle damage and inflammation in older adults. Further, the review will suggest areas of research that are required to fully understand how Cr supplementation may affect muscle damage and inflammatory biomarkers in older adults who exercise.

Myokine Response to Resistance Exercise in Older Adults and the Similarities and Differences to Younger Adults: A Brief Narrative Review

Myokines are cytokines secreted from muscle during contraction and are implicated in autocrine, paracrine, and endocrine regulation of biological systems. It is postulated that myokines contribute to skeletal muscle adaptations in response to resistance exercise. Exercise, including resistance exercise, is an important factor in the management of maintaining skeletal muscle strength, mass, and function with aging. Sarcopenia is exacerbated with increased age and therefore, it is important to understand the potential underlying mechanisms whereby exercise may be beneficial in reducing the consequences of sarcopenia for older adults. Myokine secretion is one mechanism which is postulated to account for the benefits of exercise in aging muscle. The response of myokines to aerobic exercise in older adults have previously been reviewed; however, there is limited research focused on the response of myokines to resistance exercise. Therefore, the aim of this narrative review is to discuss the response of various myokines to an acute bout of resistance exercise and/or chronic resistance exercise training in older adults, compare the response between younger and older adults, and briefly outline the influence myokines may have on skeletal muscle adaptations.

Heavy-load exercise in older adults activates vasculogenesis and has a stronger impact on muscle gene expression than in young adults

BackgroundA striking effect of old age is the involuntary loss of muscle mass and strength leading to sarcopenia and reduced physiological functions. However, effects of heavy-load exercise in older adults on diseases and functions as predicted by changes in muscle gene expression have been inadequately studied.MethodsThigh muscle global transcriptional activity (transcriptome) was analyzed in cohorts of older and younger adults before and after 12–13 weeks heavy-load strength exercise using Affymetrix microarrays. Three age groups, similarly trained, were compared: younger adults (age 24 ± 4 years), older adults of average age 70 years (Oslo cohort) and above 80 years (old BSU cohort). To increase statistical strength, one of the older cohorts was used for validation. Ingenuity Pathway analysis (IPA) was used to identify predicted biological effects of a gene set that changed expression after exercise, and Principal Component Analysis (PCA) was used to visualize differences in muscle gene expressen between cohorts and individual participants as well as overall changes upon exercise.ResultsYounger adults, showed few transcriptome changes, but a marked, significant impact was observed in persons of average age 70 years and even more so in persons above 80 years. The 249 transcripts positively or negatively altered in both cohorts of older adults (q-value < 0.1) were submitted to gene set enrichment analysis using IPA. The transcripts predicted increase in several aspects of “vascularization and muscle contractions”, whereas functions associated with negative health effects were reduced, e.g., “Glucose metabolism disorder” and “Disorder of blood pressure”. Several genes that changed expression after intervention were confirmed at the genome level by containing single nucleotide variants associated with handgrip strength and muscle expression levels, e.g., CYP4B1 (p = 9.2E-20), NOTCH4 (p = 9.7E-8), and FZD4 (p = 5.3E-7). PCA of the 249 genes indicated a differential pattern of muscle gene expression in young and elderly. However, after exercise the expression patterns in both young and old BSU cohorts were changed in the same direction for the vast majority of participants.ConclusionsThe positive impact of heavy-load strength training on the transcriptome increased markedly with age. The identified molecular changes translate to improved vascularization and muscular strength, suggesting highly beneficial health effects for older adults.

SIOG2022-0035 - State of research, feasibility, acceptability, and efficacy of remotely delivered exercises in older adults with cancer: A scoping review

SIOG2022-0035 - State of research, feasibility, acceptability, and efficacy of remotely delivered exercises in older adults with cancer: A scoping review

Effectiveness of Elastic Band Exercises on the Functional Fitness of Older Adults in Long-Term Care Facilities.

Population aging has caused a rise in the institutionalization, disability, and mortality rates of older adults worldwide. Older adults are able to engage in muscle training. Elastic band exercises can safely and effectively improve the upper and lower muscle strength and balance of older adults. This study was developed to examine the effects of a 3-month elastic band exercise program on the activities of daily living (ADLs), hand muscle strength, balance, and lower limb muscle strength of older adults living in institutional settings. This was a randomized controlled trial. Sixty-one participants were randomly sampled from two long-term care facilities (LTCFs) in northern Taiwan (31 participants in the experimental group and 30 participants in the control group). Both groups underwent pretesting concurrently. The experimental group participated in 3 months of elastic band exercises, whereas the control group participated in the routine exercise program in their LTCFs. All of the participants were tested 1 and 3 months after the intervention. The average ADL, hand muscle strength, balance, and lower limb muscle strength scores of participants in the experimental group had improved significantly more than those of the control group at posttest (all p s < .05). Elastic band exercises positively affect ADLs, hand muscle strength, balance, and lower limb muscle strength in older adults living in LTCFs. Moreover, the high benefit-to-cost ratio of these exercises helps lower the threshold of health promotion. We recommend including elastic band exercises in routine activities and designing different elastic band exercises for older adults at different proficiency levels. Furthermore, an elastic band exercise network should be established to improve the policy and implementation aspects of elastic band activities, raise awareness among community-dwelling and institutionalized older adults, and promote elastic band exercises to LTCFs nationwide.

Factors influencing commitment to maintaining long-term exercise in adults over the age of 50

This study explores the experiences of older adults pursuing an exercise routine for at least a decade to gain understanding of factors influencing serious commitment to long-term exercise. In-depth interviews were conducted with 26 participants (5 women and 21 men, aged 50–78 years). Results identified two types of older exercisers: lifelong maintainers and restarters. Lifelong maintainers showed five themes: practice systematically a core sport, strong history of formal sport participation in youth, maintained involvement despite life transitions and barriers, motivated by optimizing sport skills in a core sport, and personal growth. Restarters had five themes: practice various fitness/sport activities, history of high participation in informal sport in youth, restarted regular exercise after a break owing to life challenges, motivated by fears about health deterioration, and improving wellbeing. Results provide critical knowledge to inform fitness and health practitioners seeking to increase adherence to exercise in older adults.

Bone Density And Quality After 4-months Of Resistance Exercise In Older Adults

Bone Density And Quality After 4-months Of Resistance Exercise In Older Adults

Enjoyment And Tolerance Of Exercise Intensity In Objectively Versus Subjectively Regulated Interval Exercise In Older Adults

High-intensity interval exercise (HIIE) has led to significant improvements in fitness in healthy and clinical populations, including older adults. Recent evidence suggests that treadmill based HIIE using subjectively regulated HIIE may be more practically applicable to the real world and generates a similar training load for older adults to heart rate regulated HIIE. According to the guidelines of the American College of Sports Medicine, information regarding exercise enjoyment and individual preference for and tolerance of exercise intensity should be considered when developing and modifying exercise prescriptions for successful exercise adherence. PURPOSE: To examine the associations of preference for and tolerance of exercise intensity with physiological performance and perceptual outcomes during single sessions of HIIE using either subjectively (SUB) or objectively (OBJ) prescribed exercise in a treadmill in apparently healthy older adults. METHODS: Fourteen participants (71 ± 9 yrs) completed the Physical Activity Enjoyment Scale to measure exercise enjoyment and Preference for and Tolerance of the Intensity of Exercise Questionnaire to measure Preference (PREF) and Tolerance (TOL). Participants underwent an incremental exercise test on a treadmill in order to prescribe the OBJ session. This was followed by two randomly assigned HIIE sessions wherein the intensity of the exercise was prescribed and regulated by either heart rate (OBJ) or ratings of perceived exertion (RPE; SUB). The HIIE bouts consisted of 10 cycles of 1-min intervals at 80-90% and 30-40% HRpeak and at 8-9 and 3-4 RPE values for the OBJ and SUB sessions, respectively. Oxygen consumption (VO2), speed, and incline were measured during the OBJ and SUB sessions. RESULTS: Enjoyment was positively associated with speed during the OBJ (r = .60, p = .02) and SUB (r = .84, p < .01) sessions, incline during the OBJ (r = .60, p.03) session, and VO2 during the SUB (r = .73, p < .01) session. PREF was not significantly associated with any of the outcomes. TOL was negatively associated with incline during the SUB session (r = -.51, p = .05). CONCLUSIONS: Enjoyment and TOL scores, through associations with speed and VO2 in subjectively-regulated HIIT sessions, may be important for personalizing and modifying exercise prescriptions in older adults.

O9-6 Shedding Light on men's health: Evaluating the impact and scalability of a community-based men's health promotion programme “Sheds for Life” in Irish Men's Sheds

BackgroundSheds for Life (SFL) is a ten-week health and wellbeing programme delivered in the community setting of Men's Sheds in Ireland that uses gender-sensitive approaches to engage typically hard-to-reach men (?Shedders') with health. SFL consists of a health check, core modules of physical activity (consisting of a walking programme or chair-based exercises for older adults), mental wellbeing, healthy eating and other elective wellbeing components. SFL is implemented across two phases with four regions per phase. The purpose of the research is to evaluate SFL using an implementation science approach to assess programme impact and implementation effectiveness with a view to enhancing its sustainability and scalability while also informing gender-sensitive strategies that engage hard-to-reach men with health and wellbeing.MethodsThis study is a hybrid typology ?effectiveness-implementation? design. A community-based participatory research, and mixed methods approach has been adopted to measure the effects of the SFL intervention on Shedders across implementation phases and identify and monitor implementation barriers and facilitators that can inform future sustainability and scale-up of SFL. Central to effective implementation of SFL is a partnership approach between the Irish Men's Sheds Association (IMSA) and other health-related partner organisations (POs). This research engages key stakeholders (at individual (Shedder), provider (POs) and organisational (IMSA) levels) and prioritises implementation outcomes. Purposive sampling is used to recruit a diverse sample of participants (Shedders n = 420 and SFL providers n = 20).ResultsFindings from phase 1 will inform phase 2 implementation. Preliminary physical activity outcome results from phase one across four regions (baseline to ten weeks) suggest days active per week increased from 3.07 to 4.32 days (p =.00) days walking increased from 4.29 to 5.28 days (p=.00) minutes walking per day increased from 33.31 to 38.15 (p=.005)ConclusionsPreliminary findings highlight the potential of the SFL initiative to address the increasing calls for gender-specific health promotion programmes that target lifestyle and health behaviour change in men. Shed settings are unique and effective in attracting men from more marginalised male subpopulations, reaching men who would typically not engage with health services.This study is funded by the Irish Research Council (ID: EBPPG/2018/256)

Body, Meanings, and Physical Exercise in Older Adults: The Qualitative Perspective of Frequent Gym-Goers

It is known that rates of participation in sports and physical activities among older adults decrease as they get older. This article focuses on the experience of the aging body at the gym, and it is one of the few that focuses on a little-studied group of frequent gym-goers. Based on an ethnographic work of more than two years in Amsterdam, I explain the goals of three older adults who frequently work out, what their relationships with the gym and their bodies are, and why they are interested in training in gyms. This article seeks to contribute to discourses on health, sport, and aging and, at the same time, to explain some of the advantages of qualitative studies in understanding the experience of aging and training in gyms.

Does Real-time Online Physical Exercise Improve Physical Fitness in Seniors?

ABSTRACT The need to interrupt in-person physical exercise due to the COVID-19 pandemic required the design of alternatives. Thus, the aim was to evaluate the effectiveness of an 8-month online physical exercise on physical fitness and body composition in community-dwelling older adults. This is a non-randomized controlled trial comprising 62 older adults (74.59 ± 5.79 years, 59.7% women) distributed in an exercise group (EG) that executed an 8-month online physical exercise (three sessions/week, multicomponent regime), or control group (CG). Changes in groups over time were modeled using a linear mixed model. The EG did not improve physical fitness nor body composition. After adjustments for age, sex, and body fat, there was a minimal significant benefit for lower body strength favoring the EG [group*time interaction 1.55 (0.65); p = .020]. In conclusion, online physical exercise did not improve but maintained overall physical fitness. The in-person physical exercise for older adults must be re-opened as soon as this population is going to be protected from COVID-19.

Musculoskeletal Biomarkers Response to Exercise in Older Adults.

Exercise is an essential component of any good health style, being particularly important for older adults to counteract the effects of aging, including sarcopenia and osteoporosis, which can result in lower fall probability. Exercise programs for older adults are especially designed for that population. A rigorous evaluation of those programs is necessary to assure most benefit is achieved. Serum biomarkers of proteins intrinsic to musculoskeletal homeostasis could contribute objectively to the assessment of the benefits of exercise. In this work, in addition to the usual physical fitness and balance tests, ELISA assays quantified the serum levels of six proteins and one polysaccharide important for the homeostasis of muscle (troponin T and alpha-actinin), tendon/ligament (tenomodulin), cartilage (cartilage oligomeric matrix protein and hyaluronan) and bone (osteocalcin and sclerostin), before and after 8 weeks of an exercise program tailored to older adults, Stay Strong Stay Healthy, offered at a Community Center and at an Independent Senior Living facility. Statistical significance was determined by non-parametric tests (Wilcoxon Signed Ranks and Mann-Whitney U). Physical fitness and balance improved as expected along with a significant decrease in sclerostin, pointing to less inhibition of bone deposition. However, when considering each type of dwelling separately, older adults always saw a significant decrease of the isoform of troponin T associated with fast-twitch muscles, suggesting that daily levels of physical activity may also have a role in the benefit of older adults from exercise.

Sleep Quality and Quality of Life Among Older Adults During COVID-19 Pandemic: A Cross-Sectional Study.

Although home confinement reduces the number of SARS-CoV-2 infections, it may negatively impact the psychological and physical health of older adults. The present study attempted to describe the quality of life (QoL) of older adults before and during the COVID-19 outbreak, focusing on evaluating QoL, physical activity, sitting time, and sleep quality during home confinement. The present study was conducted in 1,063 older adults (91 % females) enrolled in a Brazilian social program. They were interviewed for QoL (EQ-5D), physical activity (international physical activity questionnaire-short), and sleep quality [Pittsburgh sleep quality index (PSQI)] after 11.6 ± 2.4 weeks of confinement. Logistic regression confirmed changes in QoL. The QoL (86.5 ± 14.7) decreased significantly during confinement (66.0 ± 21.0; P < 0.001), whereas the PSQI global score was 6.8 ± 3.9 points. Older adults spent 18.7 ± 29.8 min/day in moderate to vigorous physical activity, whereas they spent 325.5 ± 144.4 min/day sitting. The PSQI global score [odds ratio (OR): 1.10], sitting time (OR: 1.001), and diseases (OR: 1.23) were significantly associated with low QoL (P < 0.05). Confinement has a deleterious effect on QoL, which is influenced by quality of sleep, sitting time, and disease. Awareness regarding the significance of sleep and physical exercise in older adults can mitigate the damage to their health during confinement.

Immersive Virtual Reality Exergames to Promote the Well-being of Community-Dwelling Older Adults: Protocol for a Mixed Methods Pilot Study.

BackgroundDespite the proven benefits of exercise in older adults, challenges such as access and motivation can deter their engagement. Interactive virtual reality (VR) games combined with exercise (exergames) are a plausible strategy to encourage physical activity among this population. However, there has been little research on the feasibility, acceptability, and potential benefits of deploying at-home VR exergames among community-dwelling older adults.ObjectiveThe objectives of this study are to estimate the feasibility, usability, and acceptability of a co-designed VR exergame in community-dwelling older adults; examine intervention feasibility and assessment protocols for a future large-scale trial; and provide pilot data on outcomes of interest (physical activity, exercise self-efficacy, mood, cognition, perception, and gameplay metrics).MethodsThe study will be a remote, 6-week intervention comprising an experimental and a control group. A sample of at least 12 community-dwelling older adults (with no or mild cognitive impairment) will be recruited for each group. Both groups will follow the same study procedures and assessment methods. However, the experimental group will engage with a co-designed VR exergame (Seas The Day) thrice weekly for approximately 20 minutes using the Oculus Quest 2 (Facebook Reality Labs) VR headset. The control group will read (instead of playing Seas The Day) thrice weekly for approximately 20 minutes over the 6-week period. A mixed methods evaluation will be used. Changes in physical activity, exercise self-efficacy, mood, cognition, and perception will be compared before and after acute data as well as before and after the 6 weeks between the experimental (exergaming) and control (reading) groups. Qualitative data from postintervention focus groups or interviews and informal notes and reports from all participants will be analyzed to assess the feasibility of the study protocol. Qualitative data from the experimental group will also be analyzed to assess the feasibility, usability, and acceptability of at-home VR exergames and explore perceived facilitators of and barriers to uptaking VR systems among community-dwelling older adults.ResultsThe screening and recruitment process for the experimental group started in May 2021, and the data collection process will be completed by September 2021. The timeline of the recruitment process for the control group is September 2021 to December 2021. We anticipate an estimated adherence rate of ≥80%. Challenges associated with VR technology and the complexity of remote assessments are expected.ConclusionsThis pilot study will provide important information on the feasibility, acceptability, and usability of a custom-made VR exergaming intervention to promote older adults’ well-being. Findings from this study will be useful to inform the methodology, design, study procedures, and assessment protocol for future large-scale trials of VR exergames with older adults as well as deepen the understanding of remote deployment and at-home use of VR for exercise in older adults.International Registered Report Identifier (IRRID)DERR1-10.2196/32955

Impact of a new and remote diagnosis of heart disease on exercise behavior in older adults

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Exercise is an important factor in the primary and secondary prevention of heart disease. However, few data are available on predictors of exercise in older adults, especially the impact of a new and remote diagnosis of heart disease (NHDD and RHDD, respectively) on exercise behavior. It is possible that the motivational impact of a NHDD may be more powerful than a RHDD in promoting exercise in older persons. Purpose The purpose of this study was to examine predictors of exercise in older adults using the Health and Retirement Survey (HRS), a prospective, nationally representative household survey examining retirement and health among older persons in the United States that is repeated every two years. We hypothesized that older persons with a NHDD and RHDD will be more likely to exercise. Methods Data from respondents who were age 55 or older in 1998 were grouped using three waves of the HRS (1998, 2000, and 2002) which provided three distinct person-wave observations for each respondent, yielding 38,634 respondent person-wave observations (9,629 with RHDD and 1,689 with NHDD) with a mean age of 70±9 years (55% female). Logistic regression models were developed to examine the predictors of exercise while controlling for a variety of demographic and health related variables. Results A NHDD was the strongest positive predictor (odds ratio=1.195, p&amp;lt;0.01; 95% CI=1.054-1.355) while a RHDD was not a significant predictor of exercise in older adults (odds ratio=1.034, p=0.31; 95% CI=.969-1.105). No significant difference in demographic, co-morbid conditions, or perceived health was observed between older adults with a NHDD and RHDD. Conclusions A NHDD was a strong positive predictor of exercise in older adults. A RHDD was not a significant predictor of exercise, suggesting that the motivation impact of a heart disease diagnosis lessens over time and secondary prevention efforts such as cardiac rehabilitation continue to be of importance. Long-term programming for maintenance of exercise in older persons with a RHDD appears to be particularly important and requires further investigation.

Comparison of the effects of Tai Chi and general aerobic exercise on weight, blood pressure and glycemic control among older persons with depressive symptoms: a randomized trial

BackgroundBlood pressure and glycemic control are associated with the management of depressive symptoms in patients with depression. Previous studies have demonstrated that both Tai Chi and aerobic exercise have positive effects on blood pressure and glycemic control. Few studies have compared the physiological effects of Tai Chi versus aerobic exercise in older adults with depressive symptoms. The objective of this study was to compare the effects of Tai Chi and aerobic exercise on weight, body mass index, blood pressure and glycosylated hemoglobin (HbA1c) level in older persons with mild to moderate-severe depressive symptoms.MethodsA randomized controlled trial was performed. The older persons (age ≥ 60 years old) with depressive symptoms were recruited. Then, participants were randomly allocated to the Tai Chi group and the aerobic exercise group received a 12-week 24-movement Yang’s Tai Chi intervention and aerobic exercise, respectively. Data collection occurred at baseline and after completion of the interventions (week 12).ResultsA total of 238 participants with mild to moderate-to-severe depressive symptoms were included in the final analysis, including 120 in the Tai Chi group and 118 in the aerobic exercise group. The difference in weight and body mass index in the Tai Chi group was 2.0 kg (Z = -4.930, P < 0.001) and 0.77 kg/m2 (Z = -5.046, P < 0.001) higher than that in the aerobic exercise group, respectively. After the 12-week intervention, the systolic pressure and diastolic pressure in the Tai Chi group were 5.50 mmHg (Z = -2.282, P = 0.022) and 8.0 mmHg (Z = -3.360, P = 0.001) lower than that in the aerobic exercise group, respectively. The difference in HbA1c level in the Tai Chi group was 0.50% higher than that in the aerobic exercise group (Z = -4.446, P < 0.001).ConclusionThis study showed that Tai Chi exercise was more effective in improving blood pressure and HbA1c level than general aerobic exercise. It suggested that Tai Chi might be an effective approach for the management of blood pressure and long-term glucose control in older persons with depressive symptoms.Trial registrationTrial registration: ChiCTR, ChiCTR2100042534. Registration date: 23/01/2021, http://www.chictr.org.cn/showproj.aspx?proj=120602.

Effectiveness of home-based exercise for improving physical activity, quality of life and function in older adults after hospitalisation: A systematic review and meta-analysis

Objective To determine if home-based exercise programmes for older adults after hospitalisation are effective at improving physical activity, quality of life, activities of daily living (ADL) and mobility compared to no intervention, standard care or centre-based exercise. Methods Databases were searched from inception to March 2022. Randomised controlled trials which included home-based exercise in older adults recently discharged from hospital were included. The primary outcome was physical activity. Secondary outcomes were quality of life, ADL performance, mobility, adverse events and hospital readmissions. Two reviewers independently selected relevant studies and extracted data. Quantitative synthesis with meta-analyses using a random-effects model and qualitative synthesis were performed. Results Ten trials (PEDro score 6-8) were included. Three trials reported on physical activity but meta-analysis was not possible due to heterogeneity. Home-based exercise was more effective than no intervention at improving ADL performance (SMD 0.60, 95% CI 0.03 to 1.17); and standard care at improving quality of life (SMD 0.30, 95% CI 0.11 to 0.49) and mobility (SMD 0.23, 95% CI 0.00 to 0.45). Few and minor adverse events were associated with home-based exercise. Conclusion Based on individual trials, home-based exercise has the potential to improve physical activity compared to no intervention or standard care. Meta-analyses indicate that home-based exercise is more effective than no intervention at improving activities of daily living performance, and standard care at improving mobility and quality of life. It is unclear if home-based exercise is more effective than centre-based exercise at improving these outcomes.

Effect of Structured, Moderate Exercise on Kidney Function Decline in Sedentary Older Adults

Observational evidence suggests that higher physical activity is associated with slower kidney function decline; however, to our knowledge, no large trial has evaluated whether activity and exercise can ameliorate kidney function decline in older adults. To evaluate whether a moderate-intensity exercise intervention can affect the rate of estimated glomerular filtration rate per cystatin C (eGFRCysC) change in older adults. This ancillary analysis of the Lifestyle Interventions and Independence For Elders randomized clinical trial enrolled 1199 community-dwelling, sedentary adults aged 70 to 89 years with mobility limitations and available blood specimens. The original trial was conducted across 8 academic centers in the US from February 2010 through December 2013. Data for this study were analyzed from March 29, 2021, to February 28, 2022. Structured, 2-year, partially supervised, moderate-intensity physical activity and exercise (strength, flexibility) intervention compared with a health education control intervention with 2-year follow-up. Physical activity was measured by step count and minutes of moderate-intensity activity using accelerometers. The primary outcome was change in eGFRCysC. Rapid eGFRCysC decline was defined by the high tertile threshold of 6.7%/y. Among the 1199 participants in the analysis, the mean (SD) age was 78.9 (5.2) years, and 800 (66.7%) were women. At baseline, the 2 groups were well balanced by age, comorbidity, and baseline eGFRCysC. The physical activity and exercise intervention resulted in statistically significantly lower decline in eGFRCysC over 2 years compared with the health education arm (mean difference, 0.96 mL/min/1.73 m2; 95% CI, 0.02-1.91 mL/min/1.73 m2) and lower odds of rapid eGFRCysC decline (odds ratio, 0.79; 95% CI, 0.65-0.97). Results of this ancillary analysis of a randomized clinical trial showed that when compared with health education, a physical activity and exercise intervention slowed the rate of decline in eGFRCysC among community-dwelling sedentary older adults. Clinicians should consider targeted recommendation of physical activity and moderate-intensity exercise for older adults as a treatment to slow decline in eGFRCysC. ClinicalTrials.gov Identifier: NCT01072500.

Potential Role of Blood Flow Restricted Exercise for Older Adults

Sarcopenia is the age-related loss of muscle mass and strength which is associated with the loss of physical performance, lower quality of life, and other negative health outcomes. Resistance training (RT) is a recognized method to increase muscle strength and mass, however some older adults may be limited in their ability to perform RT with traditionally recommended higher-loads. Occluding blood flow to a limb, commonly referred to as muscle blood flow restriction (MBFR), has been investigated as an adjunct to RT to elicit muscle strength and hypertrophy adaptations while utilizing lower-loads of resistance as compared to traditional training recommendations. This technique could be of particular interest for older adults who may be limited in their ability to otherwise complete RT due to health reasons or may be debilitated due to a lack of muscle mass and strength. The aim of this narrative review is to discuss the current literature investigating the use of MBFR with and without a combination of exercise, in older adults and its effects on skeletal muscle strength, hypertrophy, and physical function.