Fitness In Older Adults Research Articles

Exploring the utility of bedside tests for predicting cardiorespiratory fitness in older adults.

Cardiorespiratory fitness (CRF) declines with advancing and has also, independent of age, been shown to be predictive of all-cause mortality, morbidity, and poor clinical outcomes. In relation to the older patient, there is a particular wealth of evidence highlighting the relationship between low CRF and poor surgical outcomes. Cardiopulmonary exercise testing (CPET) is accepted as the gold-standard measure of CRF. However, this form of assessment has significant personnel and equipment demands and is not feasible for those with certain age-associated physical limitations, including joint and cardiovascular comorbidities. As such, alternative ways to assess the CRF of older patients are very much needed. Sixty-four participants (45% female) with a median age of 74 (65-90) years were recruited to this study via community-based advertisements. All participants completed three tests of physical function: (1) a step-box test; (2) handgrip strength dynamometry; and (3) a CPET on a cycle ergometer; and also had their muscle architecture (vastus lateralis) assessed by B-mode ultrasonography to provide measures of muscle thickness, pennation angle, and fascicle length. Multivariate linear regression was then used to ascertain bedside predictors of CPET parameters from the alternative measures of physical function and demographic (age, gender, body mass index (BMI)) data. There was no significant association between ultrasound-assessed parameters of muscle architecture and measures of CRF. VO2peak was predicted to some extent from fast step time during the step-box test, gender, and BMI, leading to a model that achieved an R 2 of 0.40 (p < 0.001). Further, in aiming to develop a model with minimal assessment demands (i.e., using handgrip dynamometry rather than the step-box test), replacing fast step time with non-dominant HGS led to a model which achieved an R 2 of 0.36 (p < 0.001). Non-dominant handgrip strength combined with the step-box test parameter of fast step time and BMI delivered the most predictive model for VO2peak with an R 2 of 0.45 (p < 0.001). Our findings show that simple-to-ascertain patient characteristics and bedside assessments of physical function are able to predict CPET-derived CRF. Combined with gender and BMI, both handgrip strength and fast step time during a step-box test were predictive for VO2peak. Future work should apply this model to a clinical population to determine its utility in this setting and to explore if simple bedside tests are predictive of important clinical outcomes in older adults (i.e., post-surgical complications).

Effectiveness of Virtual Reality Exercise for Functional Fitness in Community-Dwelling Older Adults: A 12-Week Follow-Up Study

Several recent studies have used virtual reality (VR)-based exercise to enhance functional fitness in older adults. However, most of these studies exclusively focused on short-term intervention outcomes. Therefore, this study aimed to determine the effect of VR-based exercise on older adults’ retention of functional fitness after intervention and at follow-up.This study was a randomized controlled trial wherein older adults (mean age: 72.16 ± 4.9 years) were assigned to experimental ( n = 48) and control ( n = 50) groups. Experimental group participants engaged in VR exercise sessions for 75 to 90 minutes biweekly over 12 weeks. Control group participants did not participate in the intervention. Functional fitness was assessed using the Senior Fitness Test. Functional fitness changes were compared using a generalized estimating equation. Pre-, post-, and follow-up tests were conducted at weeks 1, 13, and 24, respectively. After VR-based training, the experimental group performed better in functional fitness tests, including upper body flexibility, lower body flexibility, upper body strength, cardiorespiratory fitness, balance, and agility, than the control group immediately after the intervention. Improvements in lower body flexibility, upper body strength, cardiorespiratory fitness, balance, and agility persisted in the experimental group for up to 12 weeks. This study demonstrates that VR-based training potentially improves community-dwelling older adults’ functional fitness. Its findings may support the future development of novel exercise technologies and serve as a reference for the implementation of physical health promotion strategies for older adults.

Reduced Muscle Energetics And Fitness In Older Adults With Diabetes Independent Of Adiposity And Activity

Reduced Muscle Energetics And Fitness In Older Adults With Diabetes Independent Of Adiposity And Activity

Challenges and opportunity in mobility among older adults – key determinant identification

BackgroundAttention is focused on the health and physical fitness of older adults due to their increasing age. Maintaining physical abilities, including safe walking and movement, significantly contributes to the perception of health in old age. One of the early signs of declining fitness in older adults is limited mobility. Approximately one third of 70-year-olds and most 80-year-olds report restrictions on mobility in their apartments and immediate surroundings. Restriction or loss of mobility is a complex multifactorial process, which makes older adults prone to falls, injuries, and hospitalizations and worsens their quality of life while increasing overall mortality.ObjectiveThe objective of the study is to identify the factors that have had a significant impact on mobility in recent years and currently, and to identify gaps in our understanding of these factors. The study aims to highlight areas where further research is needed and where new and effective solutions are required.MethodsThe PRISMA methodology was used to conduct a scoping review in the Scopus and Web of Science databases. Papers published from 2007 to 2021 were searched in November 2021. Of these, 52 papers were selected from the initial 788 outputs for the final analysis.ResultsThe final selected papers were analyzed, and the key determinants were found to be environmental, physical, cognitive, and psychosocial, which confirms the findings of previous studies. One new determinant is technological. New and effective solutions lie in understanding the interactions between different determinants of mobility, addressing environmental factors, and exploring opportunities in the context of emerging technologies, such as the integration of smart home technologies, design of accessible and age-friendly public spaces, development of policies and regulations, and exploration of innovative financing models to support the integration of assistive technologies into the lives of seniors.ConclusionFor an effective and comprehensive solution to support senior mobility, the determinants cannot be solved separately. Physical, cognitive, psychosocial, and technological determinants can often be perceived as the cause/motivation for mobility. Further research on these determinants can help to arrive at solutions for environmental determinants, which, in turn, will help improve mobility. Future studies should investigate financial aspects, especially since many technological solutions are expensive and not commonly available, which limits their use.

Dual-task multicomponent exercise-cognitive intervention improved cognitive function and functional fitness in older adults.

Maintaining cognitive and physical function is essential to healthy aging. This study aims to investigate the effect of an exercise-cognitive dual-task program in Chinese language on cognitive function and functional fitness in older adults. Seventy adults aged 60-84years were conveniently assigned to one of the three groups: exercise-cognitive dual-task (EC) group (n = 28), exercise group (n = 22), and control group (n = 20). The EC group received a 90-min class including multicomponent exercise-cognitive dual-task twice a week. The exercise group received a 90-min class including multicomponent exercise twice a week. The control group maintained their regular level of physical activity and general lifestyle. Cognitive functions and functional fitness were measured before and after the 12-week intervention. The participants in the EC and exercise group significantly improved scores in Taiwanese Frontal Assessment Battery, the Chang Gung University Orthographical Fluency Test, and the Mini-Mental State Examination; however, those in the control group did not. The participants in the EC and exercise group showed significant increases in almost all functional fitness tests. The participants in the EC group showed significantly higher improvements in Chang Gung University Orthographical Fluency Test score and aerobic endurance than the exercise group and in Chang Gung University Orthographical Fluency Test score and lower body strength than the control group. In addition, the changes in Taiwanese Frontal Assessment Battery and Mini-Mental State Examination scores were significantly correlated with the changes in functional fitness. The dual-task intervention resulted in greater improvements in verbal fluency, endurance, and muscular strength than exercise alone and control.

Soft vs Hard Martial Arts for Improving Functional Fitness in Older Adults

Soft vs Hard Martial Arts for Improving Functional Fitness in Older Adults

Examining arts and creativity in later life and its impact on older people's health and wellbeing: a systematic review of the evidence.

There is a growing recognition of the contribution that participation in group-based arts and creativity interventions makes to our health and wellbeing. Despite this acknowledgement, more empirical investigation is required to more fully understand its impact. The aim of this mixed-method systematic review was to develop a better understanding of the evidence on the impact of arts and creativity on older people's physical and psychological health and wellbeing. Extensive searches of 14 electronic bibliographic databases were carried out using predefined search criteria for the period 2013-2020. Ninety-three studies were included within the review and appraised using the Mixed Methods Appraisal Tool (MMAT). Dance was the most common form of arts identified within studies, followed by music and singing. Dance was associated with improved balance, lower body physical strength, flexibility, and aerobic fitness in older adults. Promising evidence showed that music and singing on a regular basis were associated with improved cognitive function, quality of life, affective states and a sense of wellbeing in older adults. Preliminary evidence showed that visual and creative arts were associated with reduced feelings of loneliness, improved sense of community and social connectedness. Initial evidence showed that theatre and drama were associated with emotional wellbeing; however, more evidence is required in this area. The evidence shows that participation in group-based arts and creativity can have positive physical, mental, and social health impacts for older adults, ageing and for population health. These findings support the importance of participation in the arts for older adults, especially for the promotion of positive health and for the prevention, or mitigation, of ill health in later life for both public health and the arts and creativity agenda.

Effects of Water-Based Exercise on Cardiometabolic-Related Proteins and Physical Fitness in Older Adults

Effects of Water-Based Exercise on Cardiometabolic-Related Proteins and Physical Fitness in Older Adults

Effect of Chair Suryanamaskar with Strength Training on Functional Fitness in Frail Older Adults: A Research Protocol for a Randomised Controlled Trial

Introduction: Physical frailty is a syndrome characterised by deterioration in multiple physiological domains, including muscle mass and strength, flexibility, balance, neuromuscular coordination, and cardiovascular function. Evidence suggests that regular exercise provides substantial health benefits, reducing the risk of many chronic diseases and medical costs, especially for frail older adults. However, the effect of exercise on functional status in this population is not well explored. Need of the study: Population aging in India is rapidly accelerating, and frailty is a significant clinical condition associated with aging. Frailty increases the risk of institutionalisation, morbidity, and mortality. Regular exercise has been shown to improve functional fitness in older adults, but exercises performed while standing unaided can be challenging for individuals with compromised balance and mobility. Chair Suryanamaskar, a form of exercise performed while seated, may be an alternative mode of exercise for this population. Although aerobic and resistance exercises have shown benefits, there is growing interest in exploring the potential benefits of a multicomponent intervention for frail older adults. Aim: The aim of this study is to investigate the effect of chair Suryanamaskar with strength training on functional fitness in community-dwelling frail older adults. Materials and Methods: The study will be conducted from March 2021 to March 2024. This two-group parallel singleblind randomised controlled trial will take place at MAEER's Physiotherapy College in TalegaonDabhade, Maharashtra, India. Approximately 400 older adults will be screened for frailty using the Short Physical Performance Battery (SPPB) test. Participants with an SPPB score ≤7 will be considered frail and a total of 108 participants aged 65-84 years will be recruited based on inclusion and exclusion criteria. The participants will be equally divided into two groups (54 participants in each group) using computer-generated random tables. The experimental group (group A) will receive a 45-minute Chair Suryanamaskar with strength training protocol three times a week for 12 weeks. Before the study begins, participants will have two practice sessions of 20 minutes each to become familiar with Chair Suryanamaskar. The control group (group B) will participate in two 20-minute health education program sessions and receive weekly telephonic follow-ups to monitor for adverse events. Additionally, a health education program booklet will be provided. The primary outcome of the study is the Senior Fitness Test (SFT). Assessments will be conducted at baseline (0 weeks) and post-intervention (12 weeks). Intentionto-treat analyses with mixed linear modeling will be used for statistical analysis.

Higher levels of physical activity is associated with better walking ability and fall-related fitness of older adults during COVID-19 in China

This study analyzed the relationship of physical activity levels with walking ability and fall-related fitness in older adults in the Henan Provence, China. Physical activity levels of 288 older adults were assessed using the short form of the International Physical Activity Questionnaire. The participants were divided into low (LPAG, n = 81), moderate (MPAG, n = 106), and high physical activity groups (HPAG, n = 101). The 10-m walking test (10MWT), 3-m backward walking (3MBW), and Berg Balance Scale (BBS) were used to evaluate walking ability. Thirty seconds Sit to Stand Test (30SST), Time up and Go Test (TUGT), and figure-of-8 walk test (8WT) were evaluated for fall-related fitness. One-way ANOVA was used to detect between group differences, whilst Pearson’s correlation was used to evaluate the relationship between total physical activity level and the measured variables. Logistic regression analyses were used to compute the odds ratios (ORs) of LPAG and MPAG relative to HPAG. There were significant differences between the groups for walking ability, 10MWT (p &lt; 0.01), 3MBW, and BBS (p &lt; 0.01), and also for variables of fall-related fitness, TUGT (p &lt; 0.01), and 8WT (p &lt; 0.01). Total physical activity levels had significant correlations with all variables except 30SST. In the walking ability, OR for 10MWT was 2.42 and 2.53 times for the LPAG compared to that for HPAG by model 1 and model 2. OR for BBS was 3.24 and 3.54 times for the LPAG and 9.31 and 9.65 times for the MPAG compared to for the HPAG by model 1 and model 2. In the fall-related fitness, OR for 8WT was 14.09 and 16.76 times for the LPAG compared to that for HPAG. High levels of physical activity are positively correlated with good walking ability and fall-related fitness. Increasing physical activity levels can reduce the risks associated with impaired walking ability and fall-related fitness.

Global brain venous oxygenation is associated with cardiorespiratory fitness in older adults

AbstractBackgroundT2‐Relaxation‐Under‐Spin‐Tagging (TRUST) is an MRI technique which allows for the measurement of brain blood oxygenation. Global venous oxygenation has been shown to decrease over the course of life and may prove useful as a measure of brain aging. No studies to date have examined the association between cardiovascular fitness and brain venous oxygenation.MethodGlobal venous oxygenation (Yv) and cardiorespiratory fitness were measured in sixteen older adults. Yv was measured from voxels within the superior sagittal sinus (SSS) using the TRUST sequence. The four voxels with the highest measured signal had their intensities averaged within each volume of the sequence. These values were fitted to an exponential function to yield a quantitative T2 and an estimate of Yv. Cardiorespiratory fitness was measured as the VO2 peak (mL/kg/min) during a cardiopulmonary exercise test to maximal capacity or volitional termination following the Cornell modified Bruce protocol.ResultUsing a linear regression with age and sex as covariates (F = 4.410, p = .31), Yv was shown to associate significantly with peak VO2 (b = .444, p = .020). Yv did not differ between male and female participants (t = 1.758, p = .101), and did not appear to associate independently with age (R = .182, p = .499). However, our sample was small and only included older adults.ConclusionThis study shows for the first time that whole body cardiorespiratory fitness is associated with global brain venous oxygenation. Future work will examine the utility of this neuroimaging biomarker to monitor changes in fitness with measures of cognitive aging

Impacts of surgical mask wearing on cardiopulmonary fitness using a six-minute walk test among older adults with hypertension.

This study aims to investigate the impacts of surgical mask wearing on cardiopulmonary fitness using a six-minute walk test (6MWT) among older adults with hypertension. The 45 older adults with hypertension volunteers were recruited and randomized into a no mask wearing condition and a surgical mask wearing condition. All volunteers were investigated through submaximal exercise testing using a 6MWT. Cardiopulmonary parameters were measured before and after performing a 6MWT. The results indicate post performance on the 6MWT for both the with and without surgical mask conditions significantly increased systolic blood pressure, heart rate, respiratory rate, and oxygen saturation (SpO2) when compared to before performing a 6MWT. However, surgical masks resulted in no differences to systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, SpO2, and 6MWT distance when compared to no masks. In contrast, the surgical mask condition significantly increased perceived exertion when compared with the no mask condition (p < 0.05). This study indicates that surgical masks did not have an impact on cardiopulmonary fitness in older adults with hypertension.

A hierarchy of correlates for objectively measured physical activity, sedentary time, and physical fitness in older adults: A CHAID analysis

ABSTRACT The aging process reflects, in many cases, not only a decline in physical activity (PA) and physical fitness (PF), but also an increase in overall levels of sedentary time (ST). In order to hierarchically identify the most powerful correlates related to low and high levels of objectively assessed PA, ST, and PF during the late adulthood, a total of 2666 older adults were cross-sectionally evaluated. Multidimensional correlates were obtained through interview. Using chi-squared automatic detection analysis to identify the cluster of correlates with most impact on PA (<21.4 min/day), ST (≥8 h/day), and PF (<33.3th percentile), was found that the most likely subgroup to be physically inactive consisted of widowers not owning a computer and sport facilities in the neighbourhood (94.7%), while not being widowed, reporting to have a family that exercises and a computer at home (54.3%) represented the subgroup less likely to be inactive. Widowers without sidewalks in the neighbourhood were the most sedentary group (91.0%), while being a married woman and reporting to have space to exercise at home (40%) formed the most favourable group of correlates regarding ST. Men reporting a financial income <500€ and physical problems frequently formed the group with the lowest PF level (70.3%). In contrast, the less likely subgroup to have low levels of PF level consisted of having a financial income ≥1000€ and a computer at home (3.4%). Future interventions should target widowers with limited accessibility to computer and urban/sport-related infrastructures, as well as impaired older adults with low financial income. Highlights Chi-squared automatic interaction detection was used to identify and hierarchise correlates of objectively measured physical activity, sedentary time, and fitness. Widowers not having a computer at home and sport facilities in the neighbourhood were the most likely to be physically inactive, while not being widowed, having a family that exercises and a computer at home represented the subgroup less likely to be physically inactive. The most likely to be classified as sedentary were widowers without sidewalks in the neighbourhood, while the most favourable group of correlates regarding ST was formed by married women and reporting to have space to exercise at home. Individuals with a low financial income and physical problems comprised the population subgroup with the lowest PF levels, while having a medium-high financial income and a computer at home represented the less likely subgroup to have low levels of PF.

The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation Analysis.

Simple SummaryAging is associated with vulnerability in terms of a natural decline of most physiological systems, and, consequently, physical function (PF) performance (e.g., cardiorespiratory performance, muscle strength, flexibility, speed, balance) decreases. Adequate physical activity (PA) levels are essential to maintaining or increasing PF performance, directly influencing gait speed (GS). Having a fast GS increases the older adult’s capacity to perform daily tasks safely and remain autonomous at an advanced age. Our study aimed to explore the mediating role of PF in the relationship between PA and GS in a large sample of older adults from the north of Brazil. Regarding the PA-total level, the analysis showed that a fast GS was partially mediated by approximately 19% by a better PF performance. PF partially mediated the association between PA-sport and GS in approximately 9%, and PF partially mediated the association between PA-leisure and GS in 46%. We observed a significant and negative association between PA-housework and GS. Thus, PF partially mediated the association in about 9% of cases. Consequently, our study suggests that among older adults, PF plays a crucial role in mediating the association between PA and GS levels in the vulnerable aging population.Adequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project “Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas” (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.

Effects Of 8-week Walking Exercise On Gait Ability And Physical Fitness In Older Adults

Effects Of 8-week Walking Exercise On Gait Ability And Physical Fitness In Older Adults

A Guide to the Assessment of Function and Fitness in Older Adults

Apply It! After finishing this article, the reader will: • Understand the components of an integrated assessment to be used with older adults. • Understand the screening process and interpret the data to reveal health risks. • Learn the procedures for functional fitness assessments including the Senior Fitness, Gait Speed, Functional Reach, Timed Up-and-Go, and Dual-Task Testing.

Does nutritional status influence the effects of a multicomponent exercise programme on body composition and physical fitness in older adults with limited physical function?

ABSTRACT Physical exercise effects and ageing on fitness may be influenced by nutritional status. This study investigates the effects of a 6-month multicomponent exercise training (MCT) on nutritional status and evaluates if this type of exercise could affect differently body composition and physical fitness depending on the nutritional status of older adults with decreased functional capacity. Ninety-three participants (80.4 ± 6.0 y) were divided into control (n = 45) and intervention (n = 48) groups. The intervention consisted of a 6-month multicomponent training. Comparisons between changes in body composition and fitness during the 6-months were performed between individuals at risk of malnutrition and those well-nourished, according to the Mini Nutritional Assessment. Model mixed-effect analyses were used to investigate differences after the 6 months of MCT between groups. Well-nourished participants compared with those at risk of malnutrition had higher: arm (13.4 ± 3.5 vs 14.3 ± 33.6 repetitions) and leg strength (9.0 ± 3.0 vs 11.1 ± 3.3 repetitions), maximum walking speed (31.6 ± 13.1 vs 23.7 ± 6.3s), agility (11.9 ± 5.8 vs 8.3 ± 2.1s), and aerobic capacity (31.6 ± 13.1 vs 23.7 ± 6.3 m), at baseline. After the training, those without risk of malnutrition in CON decreased their nutritional status (−1.7 + 0.7 points). Those well-nourished that performed the intervention decreased total fat mass (−1.0 ± 0.3 kg) and body fat percentage (−1.2 ± 0.4%). Both groups of training improved similarly in all tests, except for balance, in which the well-nourished showed improvements of 6.3 ± 1.9s. These results underline the usefulness of MCT in improving physical fitness regardless of nutritional status and preventing nutritional status detriment in well-nourished older adults, who are fitter and benefit more, in terms of body composition. Trial registration: ClinicalTrials.gov identifier: NCT03831841. Highlights Multicomponent exercise programme seems to be effective in delaying detriments in the nutritional status of well-nourished people. Well-nourished older people obtain more benefits in body composition from the multicomponent exercise than those at risk of malnutrition, decreasing adiposity. The positive effect of multicomponent exercise was observed in physical fitness independently of nutritional status.

The assessment of balance and gait after programmed therapeutic exercises in elderly

Introduction: People over the age of 50 begin to show manifestations of reduced balance and instability, and as a result, simple activities such as standing or getting up from a chair may become limited or impossible. Therapeutic strengthening exercises can increase muscle strength and improve mobility, as well as the physical functioning of the elderly. The aim of this study was to evaluate therapeutic exercise on balance and gait in elderly. Methods: The prospective study included two groups of 130 respondents over the age of 65 who had come to the “Center for Healthy Aging Novo Sarajevo.” Using the Performance-Oriented Mobility Assessment (POMA) test, we assessed mobility performance. We tested the respondents at the beginning, in the middle and in the end of the research, which lasted 6 months. Results: In the control group, the required time increased by 2.04%. The largest improvement within POMA B was recorded in the examined Group B and it was 12.67 %, while in the examined Group A, the improvement was only 5.07%. Within POMA G, the largest improvement was also recorded in the examined Group B and it was 6.82%, while in the examined Group B, this improvement was 4.14%. Conclusion: Both strengthening and antigravity therapeutic exercises improve the level of physical fitness in older adults, although therapeutic antigravity exercises had a better impact on the level of physical activity.

Change in Latent Gray-Matter Structural Integrity Is Associated With Change in Cardiovascular Fitness in Older Adults Who Engage in At-Home Aerobic Exercise.

In aging humans, aerobic exercise interventions have been found to be associated with more positive or less negative changes in frontal and temporal brain areas, such as the anterior cingulate cortex (ACC) and hippocampus, relative to no-exercise control conditions. However, individual measures such as gray-matter (GM) probability may afford less reliable and valid conclusions about maintenance or losses in structural brain integrity than a latent construct based on multiple indicators. Here, we established a latent factor of GM structural integrity based on GM probability assessed by voxel-based morphometry, magnetization transfer saturation, and mean diffusivity. Based on this latent factor, we investigated changes in structural brain integrity during a six-month exercise intervention in brain regions previously reported in studies using volumetric approaches. Seventy-five healthy, previously sedentary older adults aged 63–76 years completed an at-home intervention study in either an exercise group (EG; n = 40) or in an active control group (ACG; n = 35). Measures of peak oxygen uptake (VO2peak) taken before and after the intervention revealed a time-by-group interaction, with positive average change in the EG and no reliable mean change in the ACG. Significant group differences in structural brain integrity changes were observed in the right and left ACC, right posterior cingulate cortex (PCC), and left juxtapositional lobule cortex (JLC). In all instances, average changes in the EG did not differ reliably from zero, whereas average changes in the ACG were negative, pointing to maintenance of structural brain integrity in the EG, and to losses in the ACG. Significant individual differences in change were observed for right ACC and left JLC. Following up on these differences, we found that exercising participants with greater fitness gains also showed more positive changes in structural integrity. We discuss the benefits and limitations of a latent-factor approach to changes in structural brain integrity, and conclude that aerobic fitness interventions are likely to contribute to brain maintenance in old age.

Introducing the v-RFA, a voice assistant-based geriatric assessment

A well-established tool for assessing fitness in older adults with cancer is geriatric assessment (GA) [1]. We developed a web-based electronic Rapid Fitness Assessment (eRFA) [1,2] to assess preoperative fitness. While 90% of our patients expressed a strong preference for completing the eRFA instead of the paper-based GA, approximately 50% of them used some degree of assistance to complete the eRFA. Not surprisingly, our preliminary data shows that frailer patients used more assistance. This finding is important as non-completion of GA tools such as the eRFA may result in undiagnosed or undertreated frailty, which would have a negative impact on outcomes.