Healthy Subjects Of Different Ages Research Articles

The Testament Definition Scale (TDS): Normative Data from the Italian Population and Clinical Usability in Neurodegenerative Diseases

ABSTRACT Ad-hoc forensic instruments have been developed for the contemporaneous or retrospective evaluation of testamentary capacity, among which the Testament Definition Scale (TDS), a short rating scale designed to evaluate and quantify the individual’s capacity to give an exhaustive definition of what a testament is. The aim of the study was to derive Italian normative values for the TDS in an adult sample and to provide preliminary evidence for its usability in neurological patients with cognitive decline. The TDS was administered to 341 healthy subjects of different ages (range= 30–92 years) and educational levels (range= 1–20 years), along with the Montreal Cognitive Assessment (MoCA) and the Frontal Assessment Battery (FAB), and to 6 adults with neurodegenerative diseases. In healthy subjects, TDS scores were associated with MoCA and FAB scores; education was the only significant predictor of TDS scores. In patients with neurodegenerative diseases, TDS scores can dissociate from MoCA and FAB scores. Normative data (cutoff and equivalent scores) for favoring the adoption of the TDS in the assessment of testamentary capacity are here provided.

High expression level of homocitrulline is correlated with seborrheic keratosis and skin aging

BackgroudHomocitrulline (Hcit), is involved in the pathological processes of some diseases. However, the role and function of Hcit (CBL) in human skin remains largely obscure. ObjectiveTo investigate the correlation of the level of Hcit in seborrheic keratosis, skin aging, and its clinical significance. MethodsImmunohistochemistry was used to analyze the level of Hcit in skin lesions of seborrheic keratosis (SK), unaffected skin (distant 0.5 centimeters from SK lesion), and normal skin of healthy subjects in the control group. ELISA test was used to detect the serum level of CBL in SK patients and healthy subjects of different ages. ResultsHcit was mainly localized in the nucleus of epidermal cells. In healthy control skin, the expression of Hcit increased with age and showed a positive correlation with age (the correlation coefficient was 0.806, p = 0.0002). The expressional level of Hcit in SK lesions was higher than that in healthy control skin (Z = −3.703, p = 0.0002). The serum level of CBL in healthy subjects and in SK patients increased with age (the correlation coefficient were 0.5763, p = 0.0032; 0.682, p = 0.004. respectively). The serum level of CBL in SK patients was higher than that in healthy subjects (Z = −2.19, p = 0.030). Study limitationsThe small serum sample size in the study. ConclusionThe high expressional level of Hcit is correlated with seborrheic keratosis and skin aging. HCit may be one of the potential biomarkers of skin aging.

Non-invasive Exhaled Breath and Skin Analysis to Diagnose Lung Cancer: Study of Age Effect on Diagnostic Accuracy.

Development of simple, fast, and non-invasive tests for lung cancer diagnostics is essential for clinical practice. In this paper, exhaled breath and skin were studied as potential objects to diagnose lung cancer. The influence of age on the performance of diagnostic models was studied. Gas chromatography in combination with mass spectrometry (MS) was used to analyze the exhaled breath of 110 lung cancer patients and 212 healthy individuals of various ages. Peak area ratios of volatile organic compounds (VOCs) were used for data analysis instead of VOC peak areas. Various machine learning algorithms were applied to create diagnostic models, and their performance was compared. The best results on the test data set were achieved using artificial neural networks (ANNs): classification of patients with lung cancer and young healthy volunteers: 88 ± 4% sensitivity and 83 ± 3% specificity; classification of patients with lung cancer and old healthy individuals: 81 ± 3% sensitivity and 85 ± 1% specificity. The difference between performance of models based on young and old healthy groups was minor. The results obtained have shown that metabolic dysregulation driven by the disease biology is too high, which significantly overlaps the age effect. The influence of tumor localization and histological type on exhaled breath samples of lung cancer patients was studied. Statistically significant differences between some parameters in these samples were observed. A possibility of assessing the disease status by skin analysis in the Zakharyin-Ged zones using an electronic nose based on the quartz crystal microbalance sensor system was evaluated. Diagnostic models created using ANNs allow us to classify the skin composition of patients with lung cancer and healthy subjects of different ages with a sensitivity of 69 ± 2% and a specificity of 68 ± 8% for the young healthy group and a sensitivity of 74 ± 7% and a specificity of 66 ± 6% for the old healthy group. Primary results of skin analysis in the Zakharyin-Ged zones for the lung cancer diagnosis have shown its utility, but further investigation is required to confirm the results obtained.

Evaluation of the Effects of Pterygium and Aging on Limbal Structure Using Optical Coherence Tomography.

Previous studies suggest that regions of corneal limbus may possess structural differences. We aimed to investigate the limbal changes associated with pterygium and aging via optical coherence tomography (OCT). Palisades of Vogt epithelial thickness (POV-ET) and Bowman’s membrane epithelial thickness (BM-ET) were measured at the nasal, temporal, superior, and inferior quadrants of patients with pterygium and healthy subjects of different ages. Values were expressed as a ratio that functioned as an index used to evaluate the change of limbus. Ratio values determined for quadrants of the corneal limbus were correlated highly in young healthy subjects. Further, parameter values were significantly greater than those of elder healthy subjects. In young subjects, the temporal and superior quadrants of patients with pterygium were significantly lower than those of healthy subjects. Temporal and superior quadrants of elder pterygium patients affected by both pterygium and age were significantly lower than those of healthy subjects; however, the inferior quadrant of elderly pterygium patients was significantly higher than that of age-matched healthy subjects. Our findings revealed that the thickness of limbal epithelium was negatively correlated with age, while pterygium led to the thinning of the temporal and superior limbal epithelium and inferior limbal epithelial thickening.

Lower Limb Dynamic Activity Significantly Reduces Foot Skin Perfusion: Exploring Data with Different Optical Sensors in Age-Grouped Healthy Adults

Introduction: The human lower limb is widely used as a model to study in vivo microcirculatory physiology and pathophysiology. It is a preferential target for critical comorbidities (overweight, diabetes, and peripheral vascular disease). Movement and activity are consistently regarded as beneficial, but the related adaptive physiology is still poorly understood. Our goal was to better identify the foot microcirculatory changes after a regular walking gait activity in healthy subjects of different ages. Methods: Twelve healthy participants of both sexes, with normal BMI and Ankle-Brachial Index, were selected and grouped according to age – group I (21.0 ± 1 y.o.) and group II (55.8 ± 3 y.o.). The protocol involved 2 phases of 5-min duration each – phase 1, a static standing position, and phase 2, 5-min walking with a comfortable pace on a pre-established circuit. Perfusion changes were assessed in the dorsal region of both feet before (baseline, phase 1) and after (phase 2) the gait period by noninvasive optical technologies – laser Doppler flowmetry (LDF), photoplethysmography, and polarized spectroscopy (PSp). Comparative statistics were performed with a 95% confidence level. Results: All instruments detected an asymmetric nonsignificant perfusion between right and left feet during rest in all participants with values in females consistently lower than men. Older participants exhibited lower baseline values than the younger group. Gait evoked a perfusion reduction in all participants relative to phase 1 detected with all technologies, with statistically significant changes recorded with LDF (group I, p = 0.033, and group II, p = 0.028) and PSp (group II, p = 0.041). Furthermore, LDF revealed that gait significantly reduced perfusion velocity in the older group (p = 0.003). Corresponding changes in the younger group were present but discrete. Recovery to baseline levels was also slower in the older group. Discussion/Conclusions: Our results confirm that perfusion is age dependent and demonstrate the clinical relevance of simple dynamic activities such as gait. This reduction of the dorsal foot perfusion occurs in depth, being more pronounced with the movement intensity, suggesting a wide application potential in early diagnostics as for rehabilitation.

A New Noninvasive System for Clinical Pulse Wave Velocity Assessment: The Athos Device.

This paper presents a low cost, noninvasive, clinical-grade Pulse Wave Velocity evaluation device. The proposed system relies on a simultaneous acquisition of femoral and carotid pulse waves to improve estimation accuracy and correctness. The sensors used are two high precision MEMS force sensors, encapsulated in two ergonomic probes, and connected to the main unit. Data are then wirelessly transmitted to a standard laptop, where a dedicated graphical user interface (GUI) runs for analysis and recording. Besides the interface, the Athos system provides a Matlab algorithm to process the signals quickly and achieve a reliable PWV assessment. To better compare the results at the end of each analysis, a detailed report is generated, including all the relevant examination information (subject data, mean PTT, and obtained PWV). A pre-clinical study was conducted to validate the system by realizing several Pulse Wave Velocity measurements on ten heterogeneous healthy subjects of different ages. The collected results were then compared with those measured by a well-established and largely more expensive clinical device (SphygmoCor).

Distribution of ACE2, CD147, CD26, and other SARS-CoV-2 associated molecules in tissues and immune cells in health and in asthma, COPD, obesity, hypertension, and COVID-19 risk factors.

BackgroundMorbidity and mortality from COVID‐19 caused by novel coronavirus SARS‐CoV‐2 is accelerating worldwide, and novel clinical presentations of COVID‐19 are often reported. The range of human cells and tissues targeted by SARS‐CoV‐2, its potential receptors and associated regulating factors are still largely unknown. The aim of our study was to analyze the expression of known and potential SARS‐CoV‐2 receptors and related molecules in the extensive collection of primary human cells and tissues from healthy subjects of different age and from patients with risk factors and known comorbidities of COVID‐19.MethodsWe performed RNA sequencing and explored available RNA‐Seq databases to study gene expression and co‐expression of ACE2, CD147 (BSG), and CD26 (DPP4) and their direct and indirect molecular partners in primary human bronchial epithelial cells, bronchial and skin biopsies, bronchoalveolar lavage fluid, whole blood, peripheral blood mononuclear cells (PBMCs), monocytes, neutrophils, DCs, NK cells, ILC1, ILC2, ILC3, CD4+ and CD8+ T cells, B cells, and plasmablasts. We analyzed the material from healthy children and adults, and from adults in relation to their disease or COVID‐19 risk factor status.Results ACE2 and TMPRSS2 were coexpressed at the epithelial sites of the lung and skin, whereas CD147 (BSG), cyclophilins (PPIA andPPIB), CD26 (DPP4), and related molecules were expressed in both epithelium and in immune cells. We also observed a distinct age‐related expression profile of these genes in the PBMCs and T cells from healthy children and adults. Asthma, COPD, hypertension, smoking, obesity, and male gender status generally led to the higher expression of ACE2‐ and CD147‐related genes in the bronchial biopsy, BAL, or blood. Additionally, CD147‐related genes correlated positively with age and BMI. Interestingly, we also observed higher expression of CD147‐related genes in the lesional skin of patients with atopic dermatitis.ConclusionsOur data suggest different receptor repertoire potentially involved in the SARS‐CoV‐2 infection at the epithelial barriers and in the immune cells. Altered expression of these receptors related to age, gender, obesity and smoking, as well as with the disease status, might contribute to COVID‐19 morbidity and severity patterns.

P4130Age-related changes in pulmonary artery flow measured by non-invasive cardiac magnetic resonance imaging

Abstract Background Ageing, a major cardiovascular risk factor, is associated with increased arterial stiffness. The evaluation of physiological changes of the pulmonary artery (PA) wall in healthy subjects of different ages may be relevant in clinical practice. The aim of the present study was to investigate age-related changes of PA flow and elasticity by phase-contrast cardiovascular magnetic resonance (PC-CMR) in a population of patients without cardiovascular disease. Methods Nightly, apparently healthy subjects (20 to 70 years old, 58 males), underwent velocity-encoded CMR of the PA using a 1.5T system. The assessment of the PA flow and the arterial stiffness, using phase-contrast cardiovascular magnetic resonance (PC-CMR), was made non-invasively, by subtracting simultaneous forward flow and reversed flow velocity in the main PA. Data were divided in 2 groups, one with the subjects <45 years and the other >45 years. Comparisons were made between the young one (≤45 years, n=49) and the older subjects (>45 years, n=41). Results PA area increased significantly with age. Reversed flow volume and peak velocity also increased; the time until the start of reversed flow was shortened as age increased (p<0.01), while global flow and forward flow parameters remained unchanged. Ratio of peak velocity reversed flow to forward flow was strongly related to both age and arterial stiffness. A multivariate analysis was performed, in order to establish the correlation between PA stiffness and reversed flow parameters, adjusted for age, gender and body surface area. The independent variables of the peak velocity reversed flow reversed flow were age, PA diameter, right ventricular ejection fraction and right ventricular mass. Conclusion PA reversed flow parameters, including peak velocity flow and volume, measured by PC-CMR, increase significantly and show up earlier with ageing. Therefore, this assessment could be used in finding relevant markers of subclinical vascular aging.

Asymmetry Index in Muscle Activations.

Gait asymmetry is typically evaluated using spatio-temporal or joint kinematics parameters. Only a few studies addressed the problem of defining an asymmetry index directly based on muscle activity, extracting parameters from surface electromyography (sEMG) signals. Moreover, no studies used the extraction of the muscle principal activations (activations that are necessary for accomplishing a specific motor task) as the base to construct an asymmetry index, less affected by the variability of sEMG patterns. The aim of this paper is to define a robust index to quantitatively assess the asymmetry of muscle activations during locomotion, based on the extraction of the principal activations. SEMG signals were analyzed combining statistical gait analysis (SGA) and a clustering algorithm that allows for obtaining the muscle principal activations. We evaluated the asymmetry levels of four lower limb muscles in: (1) healthy subjects of different ages (children, adults, and elderly); (2) different populations of orthopedic patients (adults with megaprosthesis of the knee after bone tumor resection, elderly subjects after total knee arthroplasty, and elderly subjects after total hip arthroplasty); and (3) neurological patients (children with hemiplegic cerebral palsy and elderly subjects affected by idiopathic normal pressure hydrocephalus). The asymmetry index obtained for each pathological population was then compared to that of age-matched controls. We found asymmetry levels consistent with the expected impact of the different pathologies on muscle activation during gait. This suggests that the proposed index can be successfully used in clinics for an objective assessment of the muscle activation asymmetry during locomotion.

Responders and non-responders to influenza vaccination: A DNA methylation approach on blood cells

Several evidences indicate that aging negatively affects the effectiveness of influenza vaccination. Although it is well established that immunosenescence has an important role in vaccination response, the molecular pathways underlying this process are largely unknown. Given the importance of epigenetic remodeling in aging, here we analyzed the relationship between responsiveness to influenza vaccination and DNA methylation profiles in healthy subjects of different ages. Peripheral blood mononuclear cells were collected from 44 subjects (age range: 19–90 years old) immediately before influenza vaccination. Subjects were subsequently classified as responders or non-responders according to hemagglutination inhibition assay 4–6 weeks after the vaccination. Baseline whole genome DNA methylation in peripheral blood mononuclear cells was analyzed using the Illumina® Infinium 450 k microarray. Differential methylation analysis between the two groups (responders and non-responders) was performed through an analysis of variance, correcting for age, sex and batch. We identified 83 CpG sites having a nominal p-value <.001 and absolute difference in DNA methylation of at least 0.05 between the two groups. For some CpG sites, we observed age-dependent decrease or increase in methylation, which in some cases was specific for the responders and non-responders groups. Finally, we divided the cohort in two subgroups including younger (age < 50) and older (age ≥ 50) subjects and compared DNA methylation between responders and non-responders, correcting for sex and batch in each subgroup. We identified 142 differentially methylated CpG sites in the young subgroup and 305 in the old subgroup, suggesting a larger epigenetic remodeling at older ages. Interestingly, some of the differentially methylated probes mapped in genes involved in immunosenescence (CD40) and in innate immunity responses (CXCL16, ULK1, BCL11B, BTC). In conclusion, the analysis of epigenetic landscape can shed light on the biological basis of vaccine responsiveness during aging, possibly providing new appropriate biomarkers of this process.

Gating mass cytometry data by deep learning.

Mass cytometry or CyTOF is an emerging technology for high-dimensional multiparameter single cell analysis that overcomes many limitations of fluorescence-based flow cytometry. New methods for analyzing CyTOF data attempt to improve automation, scalability, performance and interpretation of data generated in large studies. Assigning individual cells into discrete groups of cell types (gating) involves time-consuming sequential manual steps, untenable for larger studies. We introduce DeepCyTOF, a standardization approach for gating, based on deep learning techniques. DeepCyTOF requires labeled cells from only a single sample. It is based on domain adaptation principles and is a generalization of previous work that allows us to calibrate between a target distribution and a source distribution in an unsupervised manner. We show that DeepCyTOF is highly concordant (98%) with cell classification obtained by individual manual gating of each sample when applied to a collection of 16 biological replicates of primary immune blood cells, even when measured across several instruments. Further, DeepCyTOF achieves very high accuracy on the semi-automated gating challenge of the FlowCAP-I competition as well as two CyTOF datasets generated from primary immune blood cells: (i) 14 subjects with a history of infection with West Nile virus (WNV), (ii) 34 healthy subjects of different ages. We conclude that deep learning in general, and DeepCyTOF specifically, offers a powerful computational approach for semi-automated gating of CyTOF and flow cytometry data. Our codes and data are publicly available at https://github.com/KlugerLab/deepcytof.git. yuval.kluger@yale.edu. Supplementary data are available at Bioinformatics online.

A preliminary study for quantitative assessment of upper limb proprioception.

Proprioception, or sense of position and movement of the body, strongly correlates with motor recovery of the hemiplegic arm. The evaluation of the awareness of the location of joints in space involves measuring the accuracy of joint-angle replication. Robotic devices allow an accurate manipulation of joint movements necessary to assess proprioceptive status. This study evaluated the proprioceptive performance of healthy subjects by mean of the H-Man, a planar robot designed for upper-limb rehabilitation to gather preliminary normative data for neurorehabilitation applications. Twelve participants were equally divided into Aged and Young groups and were asked to indicate when their dominant hand position matched a predefined target in the contralateral, sagittal and ipsilateral direction. Results indicated a better performance for movements towards the contralateral target in terms of both absolute and signed error while there was not a significant effect of age group. Error variability was not affected by the target location and participants' age. The present study established preliminary proprioceptive metrics that could assist in providing information about the normal range of proprioceptive acuity of healthy subjects of different age.

Reference values for time- and frequency-domain heart rate variability measures

The analysis of heart rate variability (HRV) has become an established procedure in recent decades. Because there are no appropriate reference values available, HRV findings can still only be compared within a group or in individuals in longitudinal studies. The objectives of the present study were to examine a group of healthy subjects of different ages and sexes and to identify reference values for common HRV parameters. Long-term 24-hour electrocardiograms of 695 voluntary subjects were recorded by using a 2-channel Holter system over a period of 24 hours during daily activities. Reference values for men and women in 10-year age groups were calculated for standard deviation of NN intervals, root mean square of successive differences of NN intervals, standard deviation of the average of all consecutive 5-minute NN intervals, percentage of consecutive NN intervals that deviate from one another by more than 50 ms, low-frequency power normalized unit, high-frequency power normalized unit, low frequency/high frequency ratio, SD1, and SD2. The 5th and 95th percentiles were given for each sex and for the age groups 20-30, 30-40, 40-50, and 50-60 years. We observed a consistent decrease in HRV measures with increasing age as well as a sex dependency of HRV findings. We studied a large group of healthy subjects and identified reference values for commonly used HRV measures for 24-hour ECG measurements. The reference values differed considerably from the values published in 1996 in the Guidelines of the Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. In the future, steps should be taken to expand the database and define reference values for the age groups under 20 and over 60 years. It would be desirable to obtain reference values for short-term recordings (eg, 5-minute recordings) as well.

Airways oxidative stress, lung function and cognitive impairment in aging

An altered balance of oxidants/antioxidants is one of the pathological mechanisms of many age-dependent disorders. We aimed to investigate the age-related airways oxidative stress, using non invasive, safe and repeatable techniques; to evaluate the correspondence between systemic and local oxidative stress in healthy subjects of different age ranges; to analyse the correlation between systemic and local oxidative stress with lung function and with cognitive impairment. Thirty consecutive healthy high school graduated subjects (8 M, 22 F), divided in three ranges of age (< 35; between 35 and 60; > 60 years) were enrolled. All subjects underwent oxygen free radicals and exhaled nitric oxide measurement (by the diacron reactive oxygen metabolites test and by a rapid-response chemiluminescence nitric oxide analyzer), lung function tests, and cognitive impairment scales (Mini Mental State Examination and Geriatric Depression Scale). A significant increase of oxygen free radicals, exhaled nitric oxide, and Geriatric Depression Scale score and a significant decrease of forced expiratory volume in 1 second and forced expiratory vital capacity from younger to older subjects were identified. Moreover, the significant positive correlation between oxygen free radicals and exhaled nitric oxide, and between oxygen free radicals and exhaled nitric oxide with Geriatric Depression Scale score were found. The significant negative correlation between forced expiratory volume in 1 second and oxygen free radicals or exhaled nitric oxide was also demonstrated. Our data supports the role of progressive local oxidative stress in damaging the lung function and in inducing depression symptoms.

Development of causal interactions between systolic blood pressure and inter-beat intervals in adolescents.

Systolic blood pressure (SBP) changes control the cardiac inter-beat intervals (IBI) duration via baroreflex. Conversely, SBP is influenced by IBI via non-baroreflex mechanisms. Both causal pathways (feedback - baroreflex and feedforward - non-baroreflex) form a closed loop of the SBP - IBI interaction. The aim of this study was to assess the age-related changes in the IBI - SBP interaction. We have non-invasively recorded resting beat-to-beat SBP and IBI in 335 healthy subjects of different age, ranging from 11 to 23 years. Using a linear autoregressive bivariate model we obtained gain (Gain(SBP,IBI), used traditionally as baroreflex sensitivity) and coherence (Coh(SBP,IBI)) of the SBP-IBI interaction and causal gain and coherence in baroreflex (Gain(SBP->IBI), Coh(SBP->IBI) and coherence in non-baroreflex (Coh(IBI->SBP)) directions separately. A non-linear approach was used for causal coupling indices evaluation (C(SBP->IBI), C(IBI->SBP)) quantifying the amount of information transferred between signals. We performed a correlation to age analysis of all measures. Coh(IBI->SBP) and C(IBI->SBP) were higher than Coh(SBP->IBI) and C(SBP->IBI), respectively. Gain(SBP,IBI) increased and Coh(SBP->IBI) decreased with age. The coupling indices did not correlate with age. We conclude that the feedforward influence dominated at rest. The increase of Gain(SBP,IBI) with age was not found in the closed loop model. A decrease of Coh(SBP->IBI) could be related to a change in the cardiovascular control system complexity during maturation.

Chronographic Imprint of Age-Induced Alterations in Heart Rate Dynamical Organization.

Beat-to-beat changes in the heart period are transformed into a network of increments between subsequent RR-intervals, which enables graphical descriptions of short-term heart period variability. Three types of such descriptions are considered: (1) network graphs arising from a set of vertices and directed edges, (2) contour plots of adjacency matrices A, representing the networks and transition matrices T, resulting from A, and (3) vector plots of gradients of the matrices A and T. Two indices are considered which summarize properties of A and T: the approximate deceleration capacity and the entropy rate. The method, applied to time series of nocturnal RR-intervals recorded from healthy subjects of different ages, reveals important aspect of changes in the autonomic activity caused by biological aging. Independent of the subject’s age, following accelerations, a pendulum-like dynamics appears. With decelerations, this dynamics develops in line with the subject’s age. This aging transition can be graphically visualized by vectors connecting the maxima of the transition probabilities of T, which, metaphorically, resemble a chronometer or the hands of a clock.

Estimation of temporal gait parameters using Bayesian models on acceleration signals

The purpose of this study is to develop a system capable of performing calculation of temporal gait parameters using two low-cost wireless accelerometers and artificial intelligence-based techniques as part of a larger research project for conducting human gait analysis. Ten healthy subjects of different ages participated in this study and performed controlled walking tests. Two wireless accelerometers were placed on their ankles. Raw acceleration signals were processed in order to obtain gait patterns from characteristic peaks related to steps. A Bayesian model was implemented to classify the characteristic peaks into steps or nonsteps. The acceleration signals were segmented based on gait events, such as heel strike and toe-off, of actual steps. Temporal gait parameters, such as cadence, ambulation time, step time, gait cycle time, stance and swing phase time, simple and double support time, were estimated from segmented acceleration signals. Gait data-sets were divided into two groups of ages to test Bayesian models in order to classify the characteristic peaks. The mean error obtained from calculating the temporal gait parameters was 4.6%. Bayesian models are useful techniques that can be applied to classification of gait data of subjects at different ages with promising results

Rectus femoris (RF) ultrasound for the assessment of muscle mass in older people

BackgroundSimple and reliable methods to evaluate muscle mass in older people are lacking. AimTo evaluate ultrasound as a measure of RF muscle mass and quality in healthy subjects of different ages and gender, assessing its concordance with dual energy X-ray densitometry (DEXA) and association with muscle strength and walking capacity. MethodsWe selected 54 adults of both genders, aged 20–55 years and 51 adults older than 60 years. Ultrasound images of the RF were obtained at the mid-thigh to measure its thickness and ultrasonographic density using a GE Logiq e equipment. Body composition was assessed by DEXA. Quadriceps isometric strength and 12 minutes’ walk were also measured and gender specific t scores for older adults were calculated using the values obtained in adults. ResultsRF ultrasound measurements correlated significantly with lean body mass assessed by DEXA (Double energy X-ray absorptiometry). The concordance between both measures was also adequate. Older people had lower muscle mass and worse ultrasound parameters than adults. Older males with a t score for quadriceps strength of −2 or less, had a significantly higher RF grayscale density. Older males with a 12 minutes’ walk t score of −2 or less and old males and females with a walking speed of 1m/s or less had a lower RF thickness. DiscussionThere is a good concordance between RF ultrasound and DEXA. ConclusionsAssessment of RF using ultrasound appears to be a reliable and accurate method to evaluate muscle mass in older people.

Normative Data for an Instrumental Assessment of the Upper-Limb Functionality

Upper-limb movement analysis is important to monitor objectively rehabilitation interventions, contributing to improving the overall treatments outcomes. Simple, fast, easy-to-use, and applicable methods are required to allow routinely functional evaluation of patients with different pathologies and clinical conditions. This paper describes the Reaching and Hand-to-Mouth Evaluation Method, a fast procedure to assess the upper-limb motor control and functional ability, providing a set of normative data from 42 healthy subjects of different ages, evaluated for both the dominant and the nondominant limb motor performance. Sixteen of them were reevaluated after two weeks to perform test-retest reliability analysis. Data were clustered into three subgroups of different ages to test the method sensitivity to motor control differences. Experimental data show notable test-retest reliability in all tasks. Data from older and younger subjects show significant differences in the measures related to the ability for coordination thus showing the high sensitivity of the method to motor control differences. The presented method, provided with control data from healthy subjects, appears to be a suitable and reliable tool for the upper-limb functional assessment in the clinical environment.

Does the Incremental Shuttle Walking Test require maximal effort in healthy subjects of different ages?

ObjectiveTo evaluate if the Incremental Shuttle Walking Test (ISWT) requires maximal effort in healthy subjects of different ages. DesignCross-sectional. SettingUniversity-based research laboratory. Participants331 healthy subjects separated into six groups according to age: G1, 18 to 28 years; G2, 29 to 39 years; G3, 40 to 50 years; G4, 51 to 61 years; G5, 62 to 72 years and; G6, 73 to 83 years. Main outcome measuresTwo ISWTs were performed and participants were permitted to run and to exceed 12 levels during the test, if necessary. Heart rate (HR) and symptoms of dyspnoea and fatigue were recorded before and after the test, and the percentage of age-predicted maximal HR (HRmax) was calculated. Maximal effort was defined as HRmax >90% of age-predicted HRmax. ResultsAlmost 31% of the subjects exceeded 12 levels in the ISWT. At the end of the test, all groups presented a median [interquartile range] HR greater than 90% of HRmax (G1: 100 [95 to 104]; G2: 100 [96 to 105]; G3: 103 [97 to 108]; G4: 99 [91 to 106]; G5: 96 [87 to 106] and G6: 96 [91 to 109]% HRmax). Regarding symptoms, all groups showed higher values after the test (P<0.05). A multiple logistic regression analysis identified female gender, older age and a lower HR before the test as determinants of not achieving 90% of HRmax at the end of the test. ConclusionsThe ISWT requires maximal effort in healthy individuals, but for that it is necessary to extend the test beyond twelve levels. Female gender, older age and lower heart rate before the test are the determinants of not reaching maximal effort.