Function In Older Women Research Articles

Combining a high DHA multi-nutrient supplement with aerobic exercise: Protocol for a randomised controlled study assessing mobility and cognitive function in older women

There is a complex interplay between cognition and gait in older people, with declines in gait speed coexisting with, or preceding cognitive decline. Omega-3 fatty acids, B vitamins, vitamin E, phosphatidylserine, and Ginkgo Biloba show promise in preserving mobility and cognitive function in older adults. Exercise benefits mobility and there is evidence suggesting positive interactions between exercise and omega-3 fatty acids on physical and cognitive function in older adults. Non-frail or pre-frail females aged ≥60 years are included in a randomized placebo controlled study. Intervention groups are: high DHA multi-nutrient supplement and exercise, placebo supplement and exercise, high DHA multi-nutrient supplement, and placebo supplement. Dietary supplementation is 24 weeks. The exercise intervention, two cycle ergometer classes per week, is for the final 12 weeks. The primary outcome is habitual walking speed, secondary outcomes include gait variables under single and dual task, five times sit to stand, verbal and spatial memory, executive function, interference control and health related quality of life. Blood fatty acids, serum homocysteine, dietary intake, physical activity, and verbal intelligence are measured to assess compliance and control for confounding factors. The study is registered at www.clinicaltrials.gov (NCT03228550).

Dietary nitrate intake is associated with muscle function in older women.

BackgroundIn younger individuals, dietary nitrate supplementation has been shown to improve short‐term vascular and muscle function. The role of higher habitual nitrate intake as part of a typical diet on muscle function in ageing has not been investigated. A cross‐sectional study of relationships between dietary nitrate and measures of muscle function in older community‐dwelling Australian women (n = 1420, ≥70 years) was undertaken.MethodsParticipants completed a semi‐quantitative food frequency questionnaire assessing dietary intake over the previous year. Total nitrate from vegetables and non‐vegetable sources was calculated from a validated instrument that quantified the nitrate content of food recorded within the food frequency questionnaire. Handgrip strength and timed‐up‐and‐go (TUG) were assessed, representing muscle strength and physical function, respectively. Cut‐points for weak grip strength (<22 kg) and slow TUG (>10.2 s) were selected due to their association with adverse outcomes. Linear and logistic regressions were used to examine the relationship between total nitrate intake and muscle function measures.ResultsMean ± standard deviation (SD) total nitrate intake was 79.5 ± 31.2 mg/day, of which 84.5% came from vegetables. Across the unadjusted tertiles of nitrate intake (<64.2 mg/day; 64.2 to <89.0 mg/day; ≥89.0 mg/day), women in the highest tertile had a 4% stronger grip strength and a 5% faster TUG performance compared with the lowest tertile. In multivariable‐adjusted models, each SD higher nitrate intake (31.2 mg/day) was associated with stronger grip strength (per kilogram, β 0.31, P = 0.027) and faster TUG (per second, β −0.27, P = 0.001). The proportion of women with weak grip strength (<22 kg) or slow TUG (>10.2 s) was 61.0% and 36.9%, respectively. Each SD higher nitrate intake (31.2 mg/day) was associated with lower odds for weak grip strength (OR 0.84, 95% CI 0.74–0.95, P = 0.005) and slow TUG (OR 0.86, 95% CI 0.76–0.98, P = 0.021). Compared with women in the lowest tertile of nitrate intake, women in the highest nitrate intake tertile had lower odds for weak grip strength (OR 0.65, 95% CI 0.49–0.87, P trend=0.004) and slow TUG (OR 0.72, 95% CI 0.53–0.97, P trend = 0.044).ConclusionsThis investigation highlights potential benefits of nitrate‐rich diets on muscle strength and physical function in a large cohort of older women. Considering poor muscle strength and physical function is associated with a range of adverse health outcomes such as falling, fractures, cardiovascular disease, and mortality, increasing dietary nitrate, especially though vegetable consumption may be an effective way to limit age‐related declines in muscle function.

Effects of Elastic Resistance Training on Functional Performance and Myokines in Older Women—A Randomized Controlled Trial

ObjectivesTo investigate the short- and long-term effects of elastic resistance training (ERT) on physical performance, inflammatory markers, and myokines in older women living in a nursing home. DesignA randomized controlled trial, with 12 weeks of ERT intervention. Setting and participantsNursing home. Twenty female nursing home residents (mean age = 84 ± 8 years) were randomized into 2 groups: the training group (n = 11), and the control group (n = 9). MeasuresMuscle mass was estimated with bioelectrical impedance, and the functional test Short Physical Performance Battery (SPPB) was performed, whereas handgrip strength and plasma concentration of myokines and inflammatory markers were measured before and after the intervention period. Additional blood samples were also taken after the fourth ERT session. A mixed model (group × time) analysis of variance was applied to determine the effect on primary and secondary outcomes. ResultsAfter 1 exercise session, the training group showed a significant increase in brain-derived neurotrophic factor (BDNF) (P = .04) and a decrease in interleukin (IL)-8 (P = .01) plasma concentration. After 12 weeks of intervention, the results showed a significant group × time effects for the SPPB total score (P < .01), as well as gait speed (P = .04), chair rise (P < .01), and BDNF concentration (P = .02). However, there were no significant interactions for grip strength, IL-15, IL-8, resistin, glucose, and C-reactive protein (P ≥ .06). Conclusions/ImplicationsThe present study emphasizes the clinical impact of moderate-intensity ERT on mobility and functional performance in older women. The results indicate that an increase in exercise-induced peripheral BDNF may have a protective role in the preservation of muscular function in older women. Incorporating ERT into nursing homes could be a feasible preventive strategy to counteract functional deterioration.

Effects of Different Models of Water-Based Resistance Training on Muscular Function of Older Women

ABSTRACTPurpose: To compare the effects of three water-based resistance trainings on neuromuscular parameters of older women. Method: Thirty-six women were randomized to groups: simple set of 30 seconds (1 × 30 s, 66.41 ± 4.71 years, n = 12), multiple sets of 10 seconds (3 × 10 s, 66.50 ± 4.74 years, n = 11), and simple set of 10 seconds (1 × 10 s, 65.23 ± 3.93 years, n = 13). Maximal isometric strength concomitantly with neuromuscular activity during extension and flexion knee was evaluated. In the same exercises, rate of force development at different time intervals was measured. Finally, functional capacity was assessed. Results: All trainings promoted similar improvements in the rate of force develpment of extension (effect size RFD 50 ms: 1 × 30 s .49, 3 × 10 s .67, 1 × 10 s .65; ES RFD 100 ms: 1 × 30 s .76, 3 × 10 s .80, 1 × 10 s .63; ES RFD 250 ms: 1 × 30 s .31, 3 × 10 s .49, 1 × 10 s .37) and flexion knee (ES RFD 50 ms: 1 × 30 s .59, 3 × 10 s .31, 1 × 10 s .48; ES RFD 100 ms: 1 × 30 s .41, 3 × 10 s .44, 1 × 10 s .42; ES RFD 250 ms: 1 × 30 s .57, 3 × 10 s .36, 1 × 10 s .43; ES RFD maximal: 1 × 30 s .63, 3 × 10 s .23, 1 × 10 s .26), however only the 3 × 10 s group improved the performance in the 8-foot up-and-go test (ES 3 × 10 s: .93, 1 × 30: .39, 1 × 10 s: .23). There was a maintenance of the isometric force and neuromuscular activity, except for the activity of the rectus femoris that showed an increase after training in all groups (ES 3 × 10 s: .04, 1 × 30: .36, 1 × 10 s: .50). Conclusion: Water-based resistance training using simple or multiple sets promotes the same gains in rapid strength, however only multiple sets induced improvement on functional capacity.

Age at natural menopause and physical function in older women from Albania, Brazil, Colombia and Canada: A life-course perspective

ObjectiveGrip strength and gait speed are objective measures of physical function, which in turn is an indicator of biological aging. We evaluate the association between age at natural menopause (ANM) and physical functioning in a sample of postmenopausal women drawn from the International Mobility in Aging Study (IMIAS). Study DesignRetrospective cohort study of 775 women aged 65–74, from Albania, Brazil, Colombia and Canada, who had experienced natural menopause. Main outcome measuresGait speed and grip strength were obtained following standardized protocols. The association between self-reported ANM (<40, 40–44, 45–49, 50–54 and ≥55) and gait speed (m/s) and grip strength (kg) was assessed by linear regression analyses adjusting for several life-course economic and reproductive exposures, height, BMI and smoking. ResultsOverall, women with ANM ≥ 55 had higher gait speed than those with ANM 50–54 (β = 0.05; 95%CI: 0.01, 0.10). Women with ANM < 40 had significantly lower grip strength compared with all other groups (β= −2.58; 95%CI: −4.43, −0.74). In region-specific analyses, ANM was associated with grip strength in Albania and Latin America and with gait speed in Albania only. No associations were observed in Canada. ConclusionsANM is associated with markers of physical functioning. Differences across study sites suggest that women in socially disadvantaged areas may reach menopause with different physiological reserves than those from more advantaged settings, leading to greater losses in muscle strength in postmenopausal years. More work comparing distinct populations is needed to better understand the underlying mechanisms.

Physical function in older adults: Impacts of past and present physical activity behaviors.

While physical activity (PA) may counteract age-related functional decline and loss of independence at old age, to what extent physical function is influenced by past or present PA behaviors is currently unclear. Therefore, the aim of the study was to examine relationships between both past and present PA behaviors and components of physical function in older women. A physical function score based on the 6-minute walk test, squat jump, and single-leg-stance balance was aggregated in 60 older women (65-70years). Present PA behavior was assessed by accelerometry (Actigraph) and past leisure-time PA was self-reported, where times in sports-related activities and in walking were analyzed separately. Analysis of differences in physical function across tertiles of PA behaviors was adjusted by DXA-derived fat mass. Physical activity level at present age and engagements in sports-related activities before retirement age, excluding walking, were both associated (P<0.05) to physical function. Time spent in PA of at least moderate intensity was associated with physical function (P<0.05), whereas no corresponding relationships to either sedentary time or time in light intensity PA were observed. In conclusion, PA behaviors at present age and engagement in sports-related activities performed during adulthood are both related to physical function in older women. Being physically active at old age infers beneficial effects on physical function, even in individuals with a past or present sedentary lifestyle, which supports public health efforts aiming at increasing daily time in PA of at least moderate intensity to preserve physical function in older women.

Frailty and Pulmonary Function in Older Women

See the Reply by Son et al.

Relationship of muscle function to circulating myostatin, follistatin and GDF11 in older women and men

BackgroundMyostatin, its inhibitor follistatin, and growth/differentiation factor 11 (GDF11) have been proposed as factors that could potentially modify biological aging. The study aimed to test whether there is a relationship between these plasma circulating proteins and muscle strength, power and optimal shortening velocity (υopt) of older adults.MethodsThe cross-sectional study included 56 women and 45 men aged 60 years and older. Every participant underwent examination which included anthropometric and bioimpedance analysis measurements, functional and cognitive performance tests, muscle strength of upper and lower extremities, muscle power testing with two different methods and blood analyses.ResultsWomen had higher plasma levels of myostatin and GDF11 than men. Men had higher plasma level of follistatin than women. In women, plasma level of myostatin was negatively correlated with left handgrip strength and υopt. Follistatin was negatively correlated with maximum power output (Pmax), power relative to kg of body mass (Pmax∙kg− 1) (friction-loaded cycle ergometer) and power at 70% of the 1-repetition maximum (1RM) strength value (P70%) of leg press (Keiser pneumatic resistance training equipment), and positively correlated with the Timed Up & Go (TUG) test. GDF11 was negatively correlated with body mass, body mass index, waist circumference, fat mass and the percentage of body fat. In men, there were no significant correlations observed between circulating plasma proteins and muscle function measures.ConclusionsThe circulating plasma myostatin and follistatin are negatively associated with muscle function in older women. There is stronger relationship between these proteins and muscle power than muscle strength. GDF11 has a higher association with the body mass and composition than muscle function in older women.

Functional Decline and Resilience in Older Women Receiving Adjuvant Chemotherapy for Breast Cancer.

To analyze self-reported changes in physical function in older women with breast cancer receiving adjuvant chemotherapy. Secondary analysis of the Cancer and Leukemia Group B (CALGB) 49907 prospective randomized clinical trial. CALGB institutions in the United States. Women aged 65 and older with Stage I to III breast cancer enrolled in CALGB 49907 who had physical function data from before and after receipt of adjuvant chemotherapy (N=256; mean age 71.5, range 65-85). Participants were administered the physical function subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire before chemotherapy, at the end of chemotherapy, and 12 months after chemotherapy initiation. Functional decline was defined as a more than 10-point decrease from baseline at each time point. Resilience was defined as return to within 10 points of baseline. Multivariable regression was used to examine pretreatment characteristics associated with physical function changes. Of 42% of participants who had physical function decline from before to the end of chemotherapy, 47% recovered by 12 months (were resilient). Almost one-third experienced functional decline from before chemotherapy to 12 months later. Pretreatment fatigue was a risk factor for functional decline from before to the end of chemotherapy (P=.02). Risk factors for functional decline at 12 months included pretreatment dyspnea (P=.007) and being unmarried (P=.01). Functional decline was common in older women receiving adjuvant chemotherapy for breast cancer in a clinical trial. Although half recovered their physical function, one-third had a clinically meaningful decline at 12 months. Strategies are needed to prevent functional decline in older adults receiving chemotherapy. J Am Geriatr Soc 67:920-927, 2019.

Effects of protein supplement in combination with resistance training on body composition and physical function in middle aged and older women with knee osteoarthritis

Knee osteoarthritis (KOA) and age are both associated with an increased risk of lower lean muscle mass (i.e., sarcopenia), which may lead to physical difficulty or functional limitation. Protein supplement (PS) combined with resistance exercise training (RET) improves body composition and strength gains in elder individuals. It remains unclear whether PS augments lean mass and strength gains of older patient with KOA undergoing RET. The purpose of this study is to identify the effect of PS plus RET on body composition and physical function in older women with KOA. Eligible female participants who are older than 55 years old and have a diagnosis of KOA are assigned to either experimental group (PS) or control group (placebo supplement). Both groups receive RET twice a week for a total of 12 weeks. Outcome measures includes analysis of body composition using bioelectrical impedance method, hand and leg strength, lower limb mobility (distance of functional forward reach, duration of single leg stance; timed sit-to-stand test, timed 10-m walk; timed up-and-go test, 30-s timed chair rise), physical activity using International Physical Activity Questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index score. All measures are tested before (baseline) and after RET (posttest). Analysis of covariance is also performed, using the pretest measures of both groups as the covariates, to test differences in post-test between the two groups. Sixteen patients in the experimental group (mean age 63.4 ± 7.6 y) and 16 in the control group (mean age 62.9 ± 8.7 y) completed the study. A statistically significant improvement of all measures was observed in both groups after intervention (all P < .05), and the experimental group exhibited a significantly superior improvement compared with the control group ( P < .05). Combing PS and RET exerted benefits on body composition, muscle strength, and physical capacity in older women with KOA.

Normal Bone Microstructure and Density But Worse Physical Function in Older Women Treated with Selective Serotonin Reuptake Inhibitors, a Cross-Sectional Population-Based Study

Depression in the elderly is today often treated with selective serotonin reuptake inhibitors (SSRIs) because of their favorable adverse effect profile. However, treatment with SSRIs is associated with increased risk of fractures. Whether this increased risk depends on reduced bone strength or increased fall risk due to reduced physical function is not certain. The aim was therefore to investigate if treatment with SSRIs is associated with impaired bone microstructure, bone density, or physical function in older women. From an ongoing population-based study, 1057 women (77.7 ± 1.5 years) were included. Validated questionnaires were used to assess information regarding medical history, medications, smoking, mental and physical health, and physical activity. Physical function was measured using clinically used tests: timed up and go, walking speed, grip strength, chair stand test, and one leg standing. Bone mineral density (BMD) was measured at the hip and spine with dual-energy X-ray absorptiometry (Hologic Discovery A). Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT; XtremeCT). Treatment with SSRIs was associated with higher BMD at the femoral neck, total hip, and lumbar spine, whereas no associations were found for any HR-pQCT-derived measurements. The use of SSRIs was associated with lower grip strength, walking speed, and fewer chair stand rises. These associations were valid also after adjustments for known risk factors for falls. Treatment with SSRIs was, independently of covariates, associated with worse physical function without any signs of inferior bone geometry and microstructure.

Effects of Increased Preload on Cardiac Function in Younger vs Older Women

PURPOSE: Limitations in cardiac preload and/or compliance could underlie diminished stroke volume and ventricular remodeling adaptations to endurance exercise in older women. The present study tested the hypothesis that attenuated cardiac function in older women persists during acute increases in preload, both at rest and during exercise. METHODS: Nine younger (Y, 21-28 y) and ten older (O, 61-73 y) healthy, non-endurance trained women were studied 1) at rest in the supine and seated positions, and 2) during graded upright cycle ergometer exercise (20, 40, 60 and 80% of VO2peak), both before and after acute plasma volume (PV) expansion (via IV infusion of 5% albumin; 10ml/kg). Cardiac responses to postural change, exercise, and PV expansion were measured using echocardiography (rest and low intensity exercise) and open circuit C2H2 (exercise). RESULTS: Under resting normovolemic conditions, stroke volume (SV) was augmented in the supine (vs. upright) posture in both Y (61±9 vs. 52±8 ml/beat, P<0.05) and O (55±10 vs. 49±7 ml/beat, P<0.05) women. Hypervolemia augmented supine SV further in Y (68±4 ml/beat, P<0.05 vs. normovolemia), but not in O (55±10 ml/ beat, P>0.05 vs. normovolemia) women. These resting postural and hypervolemic effects were mediated by changes in end diastolic volume, and not secondary to age group differences in the extent of PV expansion (averaged +16% and +13% in Y and O, respectively) or estimated filling pressures (E/E’). E/A ratio during peak resting preload conditions (i.e., supine hypervolemia), moreover, was positively associated with VO2peak in Y, but not in O women. During upright exercise, hypervolemia increased SV an average of 15 ml/beat across all 4 work intensities in Y women (p<0.05 vs. normovolemia). This was in contrast to O women, who exhibited very small increases in SV during hypervolemic exercise (i.e., <5 ml/beat). CONCLUSIONS: Healthy older women appear to have a reduced ability (relative to younger women) to utilize acute increases in preload to raise left ventricular stroke volume, including during large muscle exercise. These findings likely reflect the combined effects of exceptional lusitropic function in younger women, and a less compliant ventricle in the aged female heart.

Increased Quadriceps Muscle Attenuation Correlates With Reduced Cellular And Whole Muscle Function In Older Women

Increased Quadriceps Muscle Attenuation Correlates With Reduced Cellular And Whole Muscle Function In Older Women

Effects of elastic band exercise on lean mass and physical capacity in older women with sarcopenic obesity: A randomized controlled trial

Sarcopenia is associated with loss of muscle mass as well as an increased risk of physical disability in elderly people. This study was aimed to investigate the effect of elastic band resistance training (ERT) on muscle mass and physical function in older women with sarcopenic obesity. A randomized controlled trial with an intention-to-treat analysis was conducted. A total of 56 women (mean ± SD age 67.3 ± 5.1 years) were randomly assigned to the experimental group receiving 12 weeks of ERT and to the control group receiving no exercise intervention. Lean mass (measured using a dual-energy X-ray absorptiometer), physical capacity (assessed using the global physical capacity score), and a 36-item short form questionnaire were conducted at the baseline examination (T0), as well as the 3-month (T1) and 9-month followups (T2). At T1 and T2, the between-group difference was measured in total skeletal mass relative to T0, with mean differences of 0.70 kg (95% CI 0.12–1.28; P < 0.05) and 0.72 kg (95% CI 0.21–1.23; P < 0.01), respectively. Similar results were found in muscle quality, physical capacity, and physical function outcomes. The ERT exerted a significant beneficial effect on muscle mass, muscle quality, and physical function in older women with sarcopenic obesity.

Vertebral fractures and their association with health-related quality of life, back pain and physical function in older women

SummaryStudies investigating prevalent vertebral fracture (VF) diagnosed using densitometry-based VF assessment (VFA) and associations with physical function, assessed by performance-based measures, are lacking. In this population-based study of 1027 older women, we found that prevalent VF, identified by VFA, was associated with inferior physical health, back pain and inferior physical function.PurposeSeveral studies have investigated the associations between health-related quality of life (HRQL) and back pain with prevalent VF, detected by spine radiographs, but just a few have been population-based and have used vertebral fracture assessment (VFA) for diagnosing VF. The aims of this study were to investigate associations between prevalent VF, detected by VFA, with HRQL, back pain and physical function, and investigate if also mild VFs were associated with these clinical parameters.MethodsOne thousand twenty-seven women aged 75–80 years participated in this population-based cross-sectional study. VF was identified by VFA using dual-energy X-ray absorptiometry. HRQL was assessed by SF-12, back pain during the past 12 months using a questionnaire, and physical function was tested with one leg standing (OLS), Timed Up and Go (TUG), walking speed, 30-s chair stand test and maximum grip strength.ResultsPhysical health (Physical Component Summary, PCS), derived from SF-12, was worse (43.5 ± 11.3 vs. 46.2 ± 10.5, p < 0.001) and back pain more frequent in women with any VF than in women without (69.0 vs. 59.9%, p = 0.008). PCS and physical function (OLS, 30-s chair stand test), were significantly worse for mild VF compared to no VF (43.8 ± 10.9 vs. 46.2 ± 10.5, p < 0.001, 12.7 ± 9.9 vs. 15.3 ± 10.4 s, p = 0.038, 10.7 ± 3.2 vs. 11.4 ± 3.4 times, p = 0.021, respectively). In multivariable adjusted linear regression models, VF prevalence was associated with PCS (β = − 0.079, p = 0.007), TUG (β = 0.067, p = 0.021), walking speed (β = − 0.071, p = 0.009) and 30-s chair stand test (β = − 0.075, p = 0.012).ConclusionsIn conclusion, prevalent VF, diagnosed by VFA, was associated with inferior physical health, back pain and inferior physical function, indicating VFA is useful for diagnosing clinically relevant vertebral fractures. Also, mild VF was associated with inferior physical health and inferior physical function.

Post-fatigue recovery of power, postural control and physical function in older women.

Low muscle power, particularly at high velocities, has been linked to poor physical function in older adults. Any loss in muscle power following fatiguing exercise or daily activities could impact physical function and postural control until power has fully recovered. To test the overall hypothesis that a common task such as walking can result in prolonged power loss and decreased physical function and balance, 17 healthy older (66–81 years) women completed a 32-min walking test (32MWT) designed to induce neuromuscular fatigue, followed by 60min of recovery (60R). Fatigue and recovery of knee extensor muscle power (3 velocities) were quantified by dynamometry. Function was quantified by chair rise time and postural control by measures of center of pressure (COP) range (mm) and velocity (mm·s-1) during quiet stance. Power declined at all velocities by 8–13% 2min following the 32MWT (p≤0.02) and remained depressed by 8–26% at 60R (p≤0.04). Postural control decreased following the 32MWT, indicated by increased COP range in the anterior-posterior (AP, p<0.01) direction and a trend in the medial-lateral (ML) direction (p = 0.09), and returned to baseline by 60R (p≥0.10). COP velocity was unchanged immediately following the 32MWT, but at 60R was lower in ML (p = 0.03) and tended to be reduced in AP (p = 0.07). Changes in high-velocity power (270°·s-1) were associated with altered postural control (p = 0.02) and chair rise performance (p≤0.03). These results provide evidence of long-duration neuromuscular changes following fatigue in healthy older women that may place them at increased risk for functional deficits during everyday mobility tasks.

Fall risk and function in older women after gynecologic surgery

Purpose of studyTo examine change in balance-related fall risk and daily functional abilities in the first 2 post-operative weeks and up to 6 weeks after gynecologic surgery. Materials and methodsProspective cohort study in gynecologic surgery patients age 65 and older. Balance confidence (Activities-specific Balance Confidence Scale) and functional status (basic and instrumental activities of daily living) were recorded pre- and post-operatively daily for 1 week and twice the second week. Physical performance balance and functional mobility were measured pre- and 1 week post-operatively using the Tinetti Fall Risk Scale, Timed Up and Go, and 6-Minute Walk test. Measures were repeated 6 weeks after surgery. Non-parametric tests for paired data were used comparing scores baseline to post-operative (POD) 7 and to POD 42. ResultsMedian age was 72 years (range 65–88). Fall risk was elevated during the first 2 post-operative weeks, greatest on the median discharge day, POD 2 (p<0.01). Balance performance and functional mobility at 1 week were significantly lower than baseline (p<0.01). Functional abilities declined, including new dependence in medication management at home in 22% of these independent and cognitively intact women. ConclusionsAfter gynecologic surgery, older women’s fall risk is highest on POD 2 and remains elevated from baseline for 2 weeks. Functional limitations in the early home recovery period include the anticipated (bathing, cooking, etc.) and some unanticipated (medication management) ones. This information may help with post-operative discharge planning.

Hydrotherapy improves pain and function in older women with knee osteoarthritis: a randomized controlled trial

BackgroundCurrently, there is poor evidence of the effect of hydrotherapy alone on patients with hip or knee osteoarthritis. ObjectivesThe study aimed to assess the impact of hydrotherapy on pain, function, and muscle function in older women with knee osteoarthritis. MethodsA randomized controlled trial was conducted to evaluate the efficacy of hydrotherapy in women with knee osteoarthritis. Seventy-three women aged 65 and older were randomized to hydrotherapy (n=36) or a control group (n=37). The hydrotherapy group received the intervention program in a heated pool (twice per week for six weeks) and an educational protocol while the control group received an educational protocol only. Primary outcomes (before and post-treatment) were pain intensity (0–100) and function (0–100), assessed with the WOMAC questionnaire. Secondary outcomes (before and post-treatment) were knee extensor and knee flexor muscle performance (strength, power, and endurance), assessed by an isokinetic dynamometer. The magnitude of change between the groups for the outcomes was calculated using linear regression models adjusted by baseline outcome values. ResultsThe hydrotherapy group had better outcomes for pain (adjusted mean difference=11 points, 95% CI: 3–18) and function (adjusted mean difference=12 points, 95% CI: 5–18). Patients receiving hydrotherapy had better performance for knee flexor and extensor strength, knee flexor power, and knee extensor endurance. ConclusionOlder women with knee osteoarthritis are likely to have benefits from a course of hydrotherapy exercises.Registry of clinical trials (Trial number RBR-8F57KR) – http://www.ensaiosclinicos.gov.br/rg/RBR-8f57kr/.

Trend Analysis of Water-based Exercise on Pain and Physical Function in Older, Community-dwelling Women with Osteoarthritis in South Korea : A Systematic Review

The aim of this study was to systematically review the scientific literature describing the effects of water-based exercise on pain and physical function in older, community-dwelling women with osteoarthritis in South Korea. Older people often experience osteoarthritis, which is characterized by reduced muscle and bone density; water-based exercise has been used to reduce pain and improve physical function in these individuals. Despite evidence from many countries supporting the benefits of water- based exercise for alleviating osteoarthritis, there is no collated information on this topic in South Koreans or on medical insurance coverage for water-based exercise programs in South Korea. The PubMed, SCOPUS, Korea Science Korean Studies Service System, National Assembly Library of Korea, and Research Information Sharing Service databases and the Physiotherapy Evidence Database (PEDro) were systematically searched for relevant studies published between January1995 and December 2016. The following search terms were used: ‘water exercise’, ‘older’, ‘osteoarthritis’, ‘ pain’, ‘physical function’, and ‘South Korea’. Study quality was determined by using the PEDro scale. Seven of the 256 retrieved articles met the inclusion criteria. Analysis of the results of the selected studies indicated that water-based exercise reduced pain and improved physical function in older, community-dwelling women with osteoarthritis in South Korea. This review documents the positive effects of water-based exercise on osteoarthritis-related pain and physical function in older women in South Korea. The findings presented indicate that water-based exercise could be helpful for older women with osteoarthritis and should be considered as a means of reducing pain and increasing physical function in standard clinical research programs.

Cellular Senescence Biomarker p16INK4a+ Cell Burden in Thigh Adipose is Associated With Poor Physical Function in Older Women.

Ample evidence implicates cellular senescence as a contributor to frailty and functional decline in rodents, but considerable effort remains to translate these findings to human aging. We quantified senescence biomarker p16INK4a-expressing cells in thigh adipose tissue obtained from older women previously enrolled in a 5-month resistance training intervention, with or without caloric restriction (RT ± CR, n = 11 baseline, 8 pre-post-intervention pairs). Women in this subsample were older (72.9 ± 3.4 y) and overweight/obese (body mass index: 30.6 ± 2.4 kg/m2). p16INK4a+ cells were identified from 12 to 20 random visual fields/sample at 20× magnification (immunohistochemical, nuclear staining) and were present in all adipose samples. Cross-sectional associations were observed between p16INK4a+ cell burden and physical function, including grip strength (r = -0.74), 400-m walk time (r = 0.74), 4-m gait speed (r = -0.73), and self-perceived mobility (r = -0.78) (p ≤ .05). These relationships remained significant after independent adjustments for age and adiposity (p ≤ .05). p16INK4a+ cell abundance was lower following the intervention (pre: 5.47 ± 3.4%, post: 2.17 ± 1.1% count p16INK4a+ cells, p ≤ .05). These results provide proof-of-concept that p16INK4a+ cells in thigh adipose are associated with physical function, and may be sensitive to change with RT ± CR in overweight/obese older women.