Function In Older Individuals Research Articles

Effect of hypertension on muscle strength, balance, and mobility in older adults

Purpose: Hypertension (HT) can exacerbate impaired blood pressure regulation and thus increase the risk of falls. The higher incidence of HT and impaired balance in older adults may lead to the hypothesis of an association between HT and physical function in older individuals. The purpose of this study was to investigate the effects of HT on muscle strength, balance, and mobility in older adults and the relationship between them. Methods: Sixty-one older adults were included in the study and individuals with systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg formed the Hypertensive group (n=31), while the others formed the Normotensive group (n=30). Quadriceps Femoris (QF) muscle strength was evaluated with a hand-held dynamometer, mobility was evaluated with the Timed Up and Go Test (TUG), balance performance was evaluated with the Nintendo Wii Fit Balance Board (NWBB), and physiological age was evaluated with Wii Fit Age (WFA). The systolic and diastolic blood pressure were measured before the balance test. Results: TUG and NWBB scores between groups were significantly better in the Normotensive group (p<0.05). In both Hypertensive and Normotensive groups, there was a negative correlation between QF muscle strength and TUG score, and a positive correlation between QF muscle strength and NWBB score (p<0.05). Conclusion: HT may worsen mobility and balance in older adults. Further studies are required to better understand HT and establish better appropriate interventions for older hypertensive adults.

An unexpected interaction between diabetes and cardiovascular diseases on cognitive function: A cross-sectional study

ObjectiveImpaired cognitive function in older individuals significantly affects quality of life. The interaction between comorbid diabetes and cardiovascular disease (CVD) and its impact on cognitive impairment remains unclear. MethodsThis study analyzed 2564 subjects from the National Health and Nutrition Examination Survey dataset. Cognitive function was measured using various scores, including CERAD Total Score, CERAD Delayed Recall Score (CDRS), Animal Fluency Total Score, and Digit Symbol Score. Multiple regression models were constructed to explore the relationship between different diseases and cognitive function, considering covariates such as age, sex, education, body mass index, alcohol intake, smoking, physical activity, kidney function, and hypertension. ResultsAfter adjusting for multiple factors, the presence of CVD, diabetes, or both showed a significant negative association with the total cognitive score. The CDRS was associated with both CVD and diabetes. The Digit Symbol score was associated with the presence of CVD, diabetes, or both. No significant differences were found between patients with diabetes and CVD in cognitive test results. An interaction between CVD and diabetes was observed in relation to the CDRS but not in other test scores or the total score. ConclusionThe individual impact of each disease on cognitive function was not significant. However, an interaction between CVD and diabetes was found when both diseases coexisted, specifically in relation to delayed learning ability.

Associations of Balance, Strength, and Gait Speed with Cognitive Function in Older Individuals over 60 Years: A Cross-Sectional Study

This research examined the association between the risk of falls and cognitive function in older individuals at risk of mild cognitive impairment. One hundred seventy-five older adults were included in 2021. Balance confidence was scored using the Activities-Specific Balance Confidence Scale (ABC), gait speed was assessed by the 4 m test, handgrip strength by a digital dynamometer, and balance by the Timed Up-and-Go Test (TUG). The Mini-Mental State Examination (MMSE), The Controlled Oral Word Association Test, and The Boston Naming Test short-version questionnaires assessed global cognitive function, verbal fluency, and language, respectively. A bivariate correlation analysis and multivariate linear regressions were applied, adjusting for confounders (BMI, sex, age, and educational level). Shorter time in the TUG and greater educational status were independently associated with improved scores on the MMSE. Lower age and greater educational status were independently associated with increased phonological fluency. Better ABC and performance on the TUG and higher educational attainment were independently associated with enhanced semantic fluency. Higher education level and gait speed were independently associated with increased language (all p < 0.05). Improved physical factors, such as gait speed, grip strength, balance, and balance confidence enhanced cognitive function, particularly global cognitive function, verbal fluency, and language, in individuals over 60, with education as a potential confounder.

Meta-Analysis on the Association between Echo Intensity, Muscle Strength, and Physical Function in Older Individuals.

The use of ultrasonographic echo intensity (EI) to evaluate skeletal muscle quality and its effects on strength, explosive power, and physical function (PF) in older individuals remains unclear. This meta-analysis evaluated the associations among EI, muscle strength (MS), and PF in older individuals. We conducted a systematic search of the PubMed, Embase, Web of Science, SPORT Discus, and CINAHL databases through October 2022 to identify primary studies examining the association between EI and MS/PF. Effect sizes were computed using a random-effects model and presented using forest plots. Pearson correlation coefficient (r) and I2 statistics were used to measure heterogeneity. This meta-analysis included 24 patients. EI demonstrated a negative association with maximal strength (r=-0.351; 95% confidence interval [CI], -0.411 to -0.288; p<0.001) and explosive power (r=-0.342; 95% CI, -0.517 to -0.139; p=0.001) in older individuals. Handgrip strength also showed a significant negative correlation with EI (r=-0.361; 95% CI, -0.463 to -0.249; p<0.001). However, we observed only a small and non-significant negative association between EI and gait speed (r=-0.003; 95% CI, -0.083 to -0.077; p=0.943), and a weak non-significant correlation with the chair stand test (r=0.072; 95% CI, -0.045 to 0.187; p=0.227). Increased EI was associated with lower strength and power but not with gait speed or chair test performance in older individuals. Further large-sample studies with long-term follow-up are needed to improve frailty prediction and risk assessment in this population.

HEMOPEXIN’S RELATIONSHIP WITH MUSCLE QUALITY AND COGNITIVE FUNCTION IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT

Abstract The imminent increase in Alzheimer’s disease (AD) and dementia increases the need for effective prevention strategies. Increasig attention has been paid to exercise as a prevention strateg to promote cognitive health. Recently, the link between hemopexin which is secreted by atrophied skeletal muscle and cognitive function maintenance has been studied, but evidence remains inconclusive.This study examined the relationship between hemopexin, muscle mass, muscle quality (Phase Angle, PhA), and cognitive function (measured by Mini-Mental State Examination) among 377 cognitively impaired older adults (mean age = 83.5 years).TANITA (MC-780A-N) was used to measure body composition. The concentration of hemopexin in human plasma samples was measured using the HPX (Human) ELISA Kit (KA0481). In Pearson correlation analysis, hemopexin showed no significant correlation with muscle mass, quality, or cognitive function. Multivariate regression analysis revealed that lower PhA is significantly associated with poorer cognitive function (t-value=2.012, p< 0.05), but hemopexin and muscle mass were not significant. An interaction analysis indicated that the relationship between hemopexin and muscle quality was modified by sex (t-value=2.052, p< 0.05). In the multivariate analysis for females, hemopexin correlated negatively with muscle quality (t-value=-2.128, p< 0.05). This study shows that hemopexin, though not affecting cognitive function or muscle mass directly, may impact muscle quality, especially considering the link between AD in older women and atrophied muscle with hemopexin secretion. Hence, interventions focused on muscle quality might improve cognitive function in older individuals with cognitive impairment, possibly preventing dementia onset. Further studies are warranted to solidify these connections.

Quantitative estimate of cognitive resilience and its medical and genetic associations

BackgroundWe have proposed that cognitive resilience (CR) counteracts brain damage from Alzheimer’s disease (AD) or AD-related dementias such that older individuals who harbor neurodegenerative disease burden sufficient to cause dementia remain cognitively normal. However, CR traditionally is considered a binary trait, capturing only the most extreme examples, and is often inconsistently defined.MethodsThis study addressed existing discrepancies and shortcomings of the current CR definition by proposing a framework for defining CR as a continuous variable for each neuropsychological test. The linear equations clarified CR’s relationship to closely related terms, including cognitive function, reserve, compensation, and damage. Primarily, resilience is defined as a function of cognitive performance and damage from neuropathologic damage. As such, the study utilized data from 844 individuals (age = 79 ± 12, 44% female) in the National Alzheimer’s Coordinating Center cohort that met our inclusion criteria of comprehensive lesion rankings for 17 neuropathologic features and complete neuropsychological test results. Machine learning models and GWAS then were used to identify medical and genetic factors that are associated with CR.ResultsCR varied across five cognitive assessments and was greater in female participants, associated with longer survival, and weakly associated with educational attainment or APOE ε4 allele. In contrast, damage was strongly associated with APOE ε4 allele (P value < 0.0001). Major predictors of CR were cardiovascular health and social interactions, as well as the absence of behavioral symptoms.ConclusionsOur framework explicitly decoupled the effects of CR from neuropathologic damage. Characterizations and genetic association study of these two components suggest that the underlying CR mechanism has minimal overlap with the disease mechanism. Moreover, the identified medical features associated with CR suggest modifiable features to counteract clinical expression of damage and maintain cognitive function in older individuals.

Heart rate recovery after orthostatic challenge and cardiopulmonary exercise testing in older individuals: prospective multicentre observational cohort study

Impaired vagal function in older individuals, quantified by the 'gold standard' delayed heart rate recovery after maximal exercise (HRRexercise), is an independent predictor of cardiorespiratory capacity and mortality (particularly when HRR ≤12 beats min-1). Heart rate also often declines after orthostatic challenge (HRRorthostatic), but the mechanism remains unclear. We tested whether HRRorthostatic reflects similar vagal autonomic characteristics as HRRexercise. Prospective multicentre cohort study of subjects scheduled for cardiopulmonary exercise testing (CPET) as part of routine care. Before undergoing CPET, heart rate was measured with participants seated for 3 min, before standing for 3 min (HRRorthostatic). HRRexercise 1 min after the end of CPET was recorded. The primary outcome was the correlation between mean heart rate change every 10 s for 1 min after peak heart rate was attained on standing and after exercise for each participant. Secondary outcomes were HRRorthostatic and peak VO2 compared between individuals with HRRexercise <12 beats min-1. A total of 87 participants (mean age: 64 yr [95%CI: 61-66]; 48 (55%) females) completed both tests. Mean heart rate change every 10 s for 1 min after peak heart rate after standing and exercise was significantly correlated (R2=0.81; P<0.0001). HRRorthostatic was unchanged in individuals with HRRexercise ≤12 beats min-1 (n=27), but was lower when HRRexercise >12 beats min-1 (n=60; mean difference: 3 beats min-1 [95% confidence interval 1-5 beats min-1]; P<0.0001). Slower HRRorthostatic was associated with lower peak VO2 (mean difference: 3.7 ml kg-1 min-1 [95% confidence interval 0.7-6.8 ml kg-1 min-1]; P=0.039). Prognostically significant heart rate recovery after exhaustive exercise is characterised by quantitative differences in heart rate recovery after orthostatic challenge. These data suggest that orthostatic challenge is a valid, simple test indicating vagal impairment. researchregistry6550.

Serum transthyretin level and its relationship with cognitive function in community-dwelling older people: Cross sectional and longitudinal study

BackgroundSerum transthyretin (TTR) level has suggested association with mild cognitive impairment (MCI) and dementia. To clarify its usefulness as a biomarker of change in cognitive function in older individuals with normal cognitive function (NC) as a phenotype, we investigated the relationship between cognitive scores and TTR levels. We also investigated the involvement of TTR in the transition from NC to MCI. MethodsCognitive function was evaluated using Addenbrooke's Cognitive Examination-Revised (ACE-R). A cross-sectional study was conducted in community-dwelling older people (n = 211) with NC, MCI, or dementia according to ACE-R scores. A 32-month longitudinal study was then conducted (n = 29). ResultsMean TTR levels did not differ between the NC, MCI and dementia groups. Linear regression analysis showed a significant relationship in people with NC between TTR and ACE-R (β = -0.192; p < 0.001). Multiple regression analysis adjusted for stepwise procedure-selected covariates showed that TTR was significantly associated with ACE-R in people with NC (β = -0.130; p = 0.014). Furthermore, multiple regression analysis showed significant association between TTR level and memory (β = -0.584; p = 0.002) and with language (β = -0.743; p = 0.031) in people with NC. In the longitudinal study, mean TTR level at baseline in women with MCI was significantly higher than that in women with NC (p = 0.044). ConclusionsSerum TTR level is suggested to be associated with cognitive scores in people with NC and to be an indicator of progression from NC to MCI.

Applicability of the seated step test for assessing thigh muscle sarcopenia in older individuals

Assessment of lower limb muscle mass and related functions in older individuals is important because of their essential role in maintaining locomotion and activities of daily living. Therefore, a simple and reliable method for assessing these parameters should be established. The seated step test is easy and safe and can be used to assess lower limb agility; however, its relationship to skeletal muscle mass and function remains unknown. The present study aimed to investigate the relationships between the seated step test and lower limb muscle mass and function. For the analysis, we included 85 participants aged 73.1 ± 6.0 years. The participants performed an alternate up-down leg step test for 10 s while seated in a chair. Lower limb muscle mass was measured using bioimpedance analysis. Skeletal muscle mass index (SMI) was calculated using the following equation: lower limb muscle mass (kg) / height2 (m2). As the muscle functional parameters, we measured the isometric knee extension peak torque (KEPT), knee flexion peak torque (KFPT), and rate of torque development (RTD) for isometric knee extension in all participants. The seated step test score had a significant relationship with KEPT, KFPT, and SMI, but not with RTD. In the single regression analysis, the seated step test significantly predicted KEPT, KFPT, and SMI. These results suggest that up-down seated step test can be a reliable method to estimate lower limb muscle size and function in older individuals.

Establishing a common metric for physical function: Linking SARC-F and PROMIS® physical function

IntroductionAligned with the increasing need for standardized assessment of physical function in older individuals with cancer and other conditions, several patient-reported outcome measures (PROMs) have been developed and published. The aim of this study is to link the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls questionnaire (SARC-F), and the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Physical Function Short Form 8c (PROMIS PF 8c), and make their scores convertible, in order to expand the use of both instruments in research and inform clinicians and researchers about the interchangeability of critical cut-off scores. Materials and MethodsThe sample included 300 participants recruited from an online panel. Participants were included if they had received a cancer diagnosis from a clinician and reported receiving anti-cancer treatment. We conducted five linking procedures and selected an optimal one to generate the crosswalk table between the two measures. ResultsThe linked T scores of all five methods showed acceptably small mean differences from the observed T scores, and the standard deviation (SD), and root-mean-squared deviation (RMSD) of the differences were generally similar across all methods. After comparing across all statistics, the Stocking-Lord approach was considered as the optimal approach to compute the crosswalk table for converting SARC-F raw scores to PROMIS PF 8c scores. The crosswalk table shows that the SARC-F cut-off value of 4 between healthy versus symptomatic with a corresponding score of 37 fell in the range of moderate physical function limitation from 30 to 39 on the PROMI PF 8c T score metric. DiscussionThe linkage in this study has potential for improving clinical and research activities for people with cancer and perhaps others with a similar range of physical function. It facilitates the interpretability in scores of both measures on a common metric anchored on general population for further group-level analysis. Researchers can use this crosswalk to harmonize data collected from either instrument without requiring all cohorts to administer the same instrument for a prospective data collection or retrospective data analysis purpose or for a cross-study effectiveness study.

Evaluation of balance and executive function relationships in older individuals.

Executive function is an important cognitive factor in gait and balance control. Weakening of balance system components and executive functions due to aging may affect walking and balance and increase the risk of falling. The present study aimed to investigate the relationship between balance and executive function in older individuals and the contributions of physical activity and depression to this relationship. A total of 84 healthy individuals aged 60 and over were included in the study. In the study, the Timed Up and Go Test (TUG), Mini Balance Evaluation Systems Test (Mini-BESTest), Digit Symbol Substitution Test (DSST), Trail Making Test A and B (TMT A and TMT B), Physical Activity Scale for the Elderly (PASE), and Geriatric Depression Scale (GDS) were applied. The Mini-BESTest and TUG correlated with DSST, TMT A, and TMT B. GDS was correlated with TUG. PASE was correlated with Mini-BESTest and TUG. Executive functions differed according to education level; DSST, TMT B, and GDS were effective in fall history. There was a significant relationship between balance and executive function. It was found that balance and walking speed increased as executive function skills increased. Depression and physical activity are associated with balance and gait speed. Balance and executive functions are related to each other, and physical activity and depression contribute to this relationship. In order to protect against the negative effects of aging, cognitive and physical training can be performed to prevent balance and executive function declines.

Cross-cultural validation of the Lower Extremity Functional Scale in Serbian postmenopausal women with knee osteoarthritis.

Translation and cross-cultural validation of the Serbian version of the Lower Extremity Functional Scale (Srb-LEFS). This prospective cross-sectional study initially included 186 postmenopausal women aged 60 to 75 years who underwent an x-ray examination of both knees, along with body mass, body height, waist circumference, knee range of motion, and blood pressure measurements. The laboratory analyses included the evaluation of fasting glucose levels and lipid profile. All participants completed the LEFS, Lequesne index, and 36-Item Short-Form Survey-RAND. The analyses revealed good internal consistency (α = 0.95), good test-retest reliability, and a two-factor structure of the Srb-LEFS. Concurrent validity analysis confirmed a significant positive correlation between Srb-LEFS scores and the 36-Item Short-Form Survey-RAND Physical Functioning subscale ( r = 0.889, P < 0.0001), the Lequesne index ( r = -0.976, P < 0.0001), and the Numeric Rating Scale for pain ( r = -0.762, P < 0.0001). Convergent validity analyses revealed a statistically significant negative correlation between the Srb-LEFS scores and age ( r = -0.25, P = 0.006), body mass index ( r = -0.31, P < 0.01), and waist circumference ( r = -0.37, P < 0.0001). The Srb-LEFS scores were statistically significantly higher among participants that reported moderate physical activity levels, as well as those that had fewer comorbidities, minor structural knee damage, greater knee range of motion, and greater quadriceps femoris muscle strength. The Serbian version of the LEFS is feasible, valid, and reliable for use in both clinical practice and clinical studies to assess self-reported physical functioning in older individuals with knee osteoarthritis.

Association between serum lipid levels and lower-extremity functions in older adults with and without Alzheimer's dementia in South Korea: A cross-sectional analysis

PurposeOlder adults with Alzheimer's dementia (AD) experience lower-extremity dysfunction. High serum lipid levels are a risk factor for AD. We investigated the association between serum lipid levels and lower-extremity function in older individuals with and without AD. MethodsIn this cross-sectional study, we enrolled 33,185 senior citizens (aged 66 years) who participated in the National Geriatric Screening Program, sampled from the Korean National Health Insurance Service-National Health Screening Cohort Database, between 2009 and 2015. Participants were dichotomized into 1) an AD group comprising individuals with the International Classification of Diseases, Tenth Revision, diagnostic codes F00, F00.0–F00.9, and G30, G30.0–G30.9; and 2) a control group comprising individuals without AD.Differences in the Timed Up and Go and One-Leg Standing results among the three levels (low, moderate, and high) of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol were evaluated between the groups. Logistic regression analysis was performed to estimate the odds of gait disorder considering clinical and lifestyle variables. ResultsIn participants with low LDL-C levels, increased LDL-C levels correlated with higher gait speed. In the AD group, balancing time with eyes open (BT-EO) was inversely correlated with TG levels in participants with low TG levels. In the control group, BT-EO was negatively correlated with TC levels in participants with low TC levels. ConclusionSerum lipid levels were significantly correlated with lower-extremity function in participants with and without AD but not with gait disorder in participants with AD.

Sports Participation Promotes Beneficial Adaptations in the Erythrocyte Guanylate Nucleotide Pool in Male Athletes Aged 20-90 Years.

The guanine nucleotide pool (GTP, guanosine-5'-triphosphate; GDP, guanosine-5'-diphosphate, and GMP, guanosine-5'-monophosphate) is an essential energy donor in various biological processes (eg protein synthesis and gluconeogenesis) and secures several vital regulatory functions in the human body. The study aimed to predict the trends of age-related changes in erythrocyte guanine nucleotides and examine whether competitive sport and related physical training promote beneficial adaptations in erythrocyte guanylate concentrations. The study included 86 elite endurance runners (EN) aged 20-81 years, 58 sprint-trained athletes (SP) aged 21-90 years, and 62 untrained individuals (CO) aged 20-68 years. The concentration of erythrocyte GTP and total guanine nucleotides (TGN) were highest in the SP group, lower in the EN group, and lowest in the CO group. Both athletic groups had higher guanylate energy charge (GEC) values than the CO group (p = 0.012). Concentrations of GTP, TGN, and GEC value significantly decreased, while GDP and GMP concentrations progressively increased with age. Such a profile of change suggests a deterioration of the GTP-related regulatory function in older individuals. Our study explicitly shows that lifelong sports participation, especially of sprint-oriented nature, allows for maintaining a higher erythrocyte guanylate pool concentration, supporting cells' energy metabolism, regulatory and transcription properties, and thus more efficient overall body functioning.

Short-term beetroot juice supplementation improves muscle speed and power but does not reduce blood pressure or oxidative stress in 65–79 y old men and women

We have previously demonstrated that acute ingestion of inorganic nitrate (NO3−)-rich beetroot juice (BRJ), a source of nitric oxide (NO) via the NO3− → nitrite (NO2−) → NO pathway, can improve muscle speed and power in older individuals. It is not known, however, whether this effect is maintained or perhaps even enhanced with repeated ingestion, or if tolerance develops as with organic nitrates, e.g., nitroglycerin. Using a double-blind, placebo-controlled, crossover design, we therefore studied 16 community-dwelling older (age 71 ± 5 y) individuals after both acute and short-term (i.e., daily for 2 wk) BRJ supplementation. Blood samples were drawn and blood pressure was measured periodically during each ∼3 h experiment, with muscle function determined using isokinetic dynamometry. Acute ingestion of BRJ containing 18.2 ± 6.2 mmol of NO3− increased plasma NO3− and NO2− concentrations 23 ± 11 and 2.7 ± 2.1-fold over placebo, respectively. This was accompanied by 5 ± 11% and 7 ± 13% increases in maximal knee extensor speed (Vmax) and power (Pmax), respectively. After daily supplementation for 2 wk, BRJ ingestion elevated NO3− and NO2− levels 24 ± 12 and 3.3 ± 4.0-fold, respectively, whereas Vmax and Pmax were 7 ± 9% and 9 ± 11% higher than baseline. No changes were observed in blood pressure or in plasma markers of oxidative stress with either acute or short-term NO3− supplementation. We conclude that both acute and short-term dietary NO3− supplementation result in similar improvements in muscle function in older individuals. The magnitudes of these improvements are sufficient to offset the decline resulting from a decade or more of aging and are therefore likely to be clinically significant.

Brain-derived estrogen: a critical player in maintaining cognitive health of aged female rats, possibly involving GPR30

Brain-derived estrogen is an endogenous neuroprotective agent, whether and how might this protective function with aging, especially postmenopausal drops in circulating estrogen, remain unclear. We herein subjected 6, 14, and 18 Mon female rats to mimic natural aging, and found that estrogen synthesis is more active in the healthy aged brain, as evidenced by the highest levels of mRNA and protein expression of aromatase, the key enzyme of E2 biosynthesis, among the three groups. Aromatase knockout in forebrain neurons (FBN-Aro-/-) impaired hippocampal and cortical neurons, and cognitive function in 18 Mon rats, compared to wild-type controls. Furthermore, estrogen nuclear receptors (ERα/β) displayed opposite changes, with a significant ERα decrease and ERβ increase, while membrane receptor GPR30 expressed stably in hippocampus during aging. Intriguingly, GPR30, but not ERα and ERβ, was decreased by FBN-Aro-/-. The results indicate that GPR30 is more sensitive to brain local E2 synthesis. Our findings provide evidence of a critical role for brain-derived estrogen in maintaining healthy brain function in older individuals, possibly involving GPR30.

Aging-Related Mechanisms Contribute to Corticosteroid Insensitivity in Elderly Asthma.

Asthma in elderly populations is an increasing health problem that is accompanied by diminished lung function and frequent exacerbations. As potent anti-inflammatory drugs, corticosteroids are commonly used to reduce lung inflammation, improve lung function, and manage disease symptoms in asthma. Although effective for most individuals, older patients are more insensitive to corticosteroids, making it difficult to manage asthma in this population. With the number of individuals older than 65 continuing to increase, it is important to understand the distinct mechanisms that promote corticosteroid insensitivity in the aging lung. In this review, we discuss corticosteroid insensitivity in asthma with an emphasis on mechanisms that contribute to persistent inflammation and diminished lung function in older individuals.

Myonuclear dynamics with age and exercise: shaping up for a good time.

Myonuclear dynamics with age and exercise: shaping up for a good time.

Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults

BackgroundThere is conflicting evidence regarding the role of angiotensin-converting enzyme inhibitors and physical function. While some studies show improvements in muscle strength and physical function, others show no significant difference or decreased performance. This ambiguity could be due to differential effects of angiotensin-converting enzyme inhibitor subtypes which can be categorized as centrally or peripherally-acting based upon their ability to cross the blood-brain barrier.ObjectiveThe objective of this study is to compare physical performance measures among angiotensin-converting enzyme inhibitor subtype users.MethodsDesign: Cross-sectional Setting: Ambulatory Participants: Performed in 364 participants in the Health and Retirement Study cohort who were ≥ 65 years (median age (IQR) 74.00 (69–80) years. Measurements: Average difference in hand grip (kg), gait speed(m/s) and peak expiratory flow (L/min).ResultsCompared to participants on a peripherally-acting angiotensin-converting enzyme inhibitor (113 (31%)), those on a centrally-acting agent (251(69%)) had stronger grip strength 28.9 ±1.0 vs 26.3±1.0, p=.011 and higher peak expiratory flow rates 316.8±130.4 vs. 280.0±118.5, p=.011 in unadjusted analysis. After multiple adjustments the difference in PEF remained statistically significant (Estimate(CI) 26.5, 95% CI 2.24, 50.5, p = 0.032).ConclusionOur results suggest that in older adults the use of centrally-acting angiotensin-converting enzyme inhibitors compared to a peripherally acting angiotensin-converting enzyme inhibitors was associated with better lung function in older individuals.

Hub structure in functional network of EEG signals supporting high cognitive functions in older individuals.

Maintaining high cognitive functions is desirable for "wellbeing" in old age and is particularly relevant to a super-aging society. According to their individual cognitive functions, optimal intervention for older individuals facilitates the maintenance of cognitive functions. Cognitive function is a result of whole-brain interactions. These interactions are reflected in several measures in graph theory analysis for the topological characteristics of functional connectivity. Betweenness centrality (BC), which can identify the "hub" node, i.e., the most important node affecting whole-brain network activity, may be appropriate for capturing whole-brain interactions. During the past decade, BC has been applied to capture changes in brain networks related to cognitive deficits arising from pathological conditions. In this study, we hypothesized that the hub structure of functional networks would reflect cognitive function, even in healthy elderly individuals. To test this hypothesis, based on the BC value of the functional connectivity obtained using the phase lag index from the electroencephalogram under the eyes closed resting state, we examined the relationship between the BC value and cognitive function measured using the Five Cognitive Functions test total score. We found a significant positive correlation of BC with cognitive functioning and a significant enhancement in the BC value of individuals with high cognitive functioning, particularly in the frontal theta network. The hub structure may reflect the sophisticated integration and transmission of information in whole-brain networks to support high-level cognitive function. Our findings may contribute to the development of biomarkers for assessing cognitive function, enabling optimal interventions for maintaining cognitive function in older individuals.