Function In Elderly People Research Articles

The association between physical characteristics of the ankle joint and the mobility performance in elderly people with type 2 diabetes mellitus

Previous studies showed that older adults with diabetes have a worse mobility performance as compared with those without diabetes. Studies also demonstrated that older adults with diabetes have weakened ankle muscle strength, reduced joint range in ankle dorsiflexion and worsened ankle joint proprioception as compared with control population. The purpose of the present study was to examine the relationship between the physical characteristics of the ankle joint and the mobility performance in older adults with type 2 diabetes. Older adults with type 2 diabetes (n=85) were recruited, and Timed Up and Go test (TUG) for mobility assessment was performed. Active ankle joint repositioning test was used for assessing the ankle joint proprioception sense; peak torque of ankle dorsiflexors and plantar flexors were tested by using a Cybex Norm dynamometer, and weight-bearing lunge test (WBLT) was used for assessing the stiffness of ankle dorsiflexion. Our results showed that age, body mass index (BMI), normalized peak torque of plantar flexors and dorsiflexors, active ankle joint repositioning test errors and the WBLT distance were significantly correlated with the TUG (all p<0.001). These ankle characteristics, together with the demographic data of the subjects, contributed 59.9% of the variance in the TUG by multiple regression analysis. Body mass, ankle plantar flexors strength and ankle joint proprioception are important factors contributing to the physical mobility of the older adults with type 2 diabetes.

The effects of physical exercise with music on cognitive function of elderly people: Mihama-Kiho project.

BackgroundPhysical exercise has positive effects on cognitive function in elderly people. It is unknown, however, if combinations of non-pharmaceutical interventions can produce more benefits than single ones. This study aimed to identify if physical exercise combined with music improves cognitive function in normal elderly people more than exercise alone.MethodsWe enrolled 119 subjects (age 65–84 years old). Forty subjects performed physical exercise (once a week for an hour with professional trainers) with musical accompaniment (ExM group), developed by YAMAHA Music Foundation; 40 subjects performed the same exercise without music (Ex group); 39 subjects were the control group (Cont group). Before and after the year-long intervention, each patient was assessed by neuropsychological batteries. MRIs were performed before and after intervention; the Voxel-based Specific Regional analysis system for Alzheimer's Disease (VSRAD) was used to assess medial temporal lobe atrophy.ResultsAnalysis of variance (ANOVA) was significant only in visuospatial function. The multiple comparison (ExM vs. Ex, ExM vs. Cont, Ex vs. Cont) was significant between the ExM and Cont group. Intra-group analyses before and after intervention revealed significant improvement in visuospatial function in the ExM group, and significant improvements in other batteries in all three groups. The VSRAD score significantly worsened in the ExM and Ex groups.ConclusionsPhysical exercise combined with music produced more positive effects on cognitive function in elderly people than exercise alone. We attributed this improvement to the multifaceted nature of combining physical exercise with music, which can act simultaneously as both cognitive and physical training.Trial RegistrationUMIN Clinical Trials Registry (UMIN-CTR) UMIN000012148

Pre-emptive or early adjuvant simvastatin therapy in elderly patients with infection and sepsis

BackgroundThe incidence, severity, morbidity, and mortality associated with sepsis increases with age, and statin treatment improves outcomes during infection. We characterised the effect of age and acute infection on key neutrophil functions, assessed whether physiologically relevant doses of simvastatin altered neutrophil functions, and, if benefits were seen, when statins could be used during septic infection. MethodsNeutrophils extracted from the whole blood of healthy volunteers and patients with a lower respiratory tract infection (LRTI), pneumonia, or sepsis were assessed for migratory accuracy, phagocytosis, and production of neutrophil extracellular traps (NET) before and after in-vitro treatment with simvastatin. In addition, neutrophil function was assessed in healthy elderly volunteers, who were receiving simvastatin (80 mg/day for 2 weeks) or placebo as part of a crossover, double-blind, randomised controlled trial. Here we present data for neutrophil migration. FindingsNeutrophils from healthy volunteers (n=70, aged 21–94 years) showed preserved chemokinesis (random movement) but reduced chemotaxis (directed migration) (r2=−0·48, p<0·0001) towards the chemo-attractant interleukin 8. Neutrophil chemotaxis, measured as mean difference (MD) in migration, decreased in volunteers aged over 65 years (comparison ≤35 years vs ≥65, MD 1·25 μm/min, p=0·02). Elderly patients with a LRTI (n=10, age 24–73), pneumonia (n=5, 66–73), or severe sepsis (n=22, 23–89) showed a progressive decrease in neutrophil chemotaxis compared with healthy controls (LRTI, MD 0·7 μm/min, p=0·04; pneumonia, 1·1 μm/min, p=0·02; sepsis 1·6 μm/min, p=0·01) with neutrophils associated with sepsis unable to perform targeted chemotaxis. Improvements in chemotaxis to baseline values were seen after recovery in patients who survived their illness. In-vitro treatment with simvastatin (1μM) of neutrophils taken from healthy elderly patients restored old neutrophil chemotaxis to that of young cells. Simvastatin also restored neutrophil migration in older patients with LRTI and pneumonia to baseline values but not in patients with sepsis. 2 weeks of oral simvastatin in healthy elderly volunteers (≥65 years, n=20) increased the accuracy of neutrophil migration in vitro (MD 1·68 μm/min, p=0·02) replicating in-vitro work. InterpretationNeutrophil function in elderly people is compromised in health, and deteriorates further during infective episodes in accordance with the severity of the disease. Migratory accuracy can be improved with short-term in-vitro simvastatin therapy in health and mild infection but not in sepsis. Our data suggest that statin therapy might be a preventive or an early adjuvant intervention rather than a treatment in established sepsis. We are testing in a clinical trial whether simvastatin 80 mg for 7 days modifies neutrophil responses in elderly patients with pneumonia and sepsis. FundingBritish Journal of Anaesthesia, Royal College of Anaesthetists.

Cognitive and physical training for the elderly: Evaluating outcome efficacy by means of neurophysiological synchronization

Recent neuroscientific research has demonstrated that both healthy and pathological aging induces alterations in the co-operative capacity of neuronal populations in the brain. Both compensatory and neurodegenerative mechanisms contribute to neurophysiological synchronization patterns, which provide a valuable marker for age-related cognitive decline. In this study, we propose that neuroplasticity-based training may facilitate coherent interaction of distant brain regions and consequently enhance cognitive performance in elderly people. If this is true, this would make neurophysiological synchronization a valid outcome measure to assess the efficacy of non-pharmacological interventions to prevent or delay age-related cognitive decline. The present study aims at providing an objective, synchronization-based tool to assess cognitive and/or physical interventions, adopting the notion of Relative Wavelet Entropy. This mathematical model employs a robust and parameter-free synchronization metric. By using data mining techniques, a distance value was computed for all participants so as to quantify the proximity of their individual profile to the mean group synchronization increase. In support of our hypothesis, results showed a significant increase in synchronization, for four electrode pairs, in the intervention group as compared to the active control group. It is concluded that the novel introduction of neurophysiological synchronization features could be used as a valid and reliable outcome measure; while the distance-based analysis could provide a reliable means of evaluating individual benefits.

Funcionamiento sexual en personas mayores: influencia de la edad y de factores psicosexuales

ObjectiveTo examine the prevalence of changes in sexual functioning in both men and women older than 55 years. In addition, we analysed the effect of age, sexual assertiveness, sexual attitudes and partner violence on sexual functioning. Material and methodThere were 405 individuals (48.4% men and 51.6% women) with ages ranging from 55 to 80 years old, selected by a non-probabilistic sampling, who answered the validated Spanish versions of the MGH-SFQ, HISA, SOS, HISF and ISA assessment tools. ResultsSome difficulties in sexual functioning were reported by 39% of men and 58% of women. In men, age negatively predicted sexual functioning (β=−.29), while initiation sexual assertiveness (β=.26) and no shyness/refusal (β=.17) positively predicted it. In women, age was also negatively associated with sexual functioning (β=−.41). In addition, no shyness/refusal (β=.17), positive attitude towards sexual fantasies (β=.26), no physical partner violence (β=−.20) and the interaction between age and positive attitudes towards sexual fantasies (β=.21) were predictors of sexual functioning. ConclusionsWomen show a greater prevalence of sexual dysfunction; however, such problems are not necessarily linked to sexual dissatisfaction. Age, sexual assertiveness and sexual attitudes, along with psychological abuse in the case of women, are predictors of sexual functioning in elderly people.

Effect of age on test performance in community dwelling elderly people: 6 minutes walk test and ten steps test

The data available in literature for test performance in elderly people are less and insufficient for use as a basis of comparison. The aim of the study was to investigate age related changes in functional performance tests and to determine criterion values depending on age in older adults who are functioning independently in the community.

Muscle performance, body fat, pain and function in the elderly with arthritis

Objective: To correlate muscule performance, body composition, pain and joint function in elderly people with gonarthrosis. Method: 21 elderly patients were submitted to bioelectrical impedance analysis, dynamometry associated with electromyographic (EMG) evaluation of isometric knee extension, in addition to pain assessment by the Numeric Pain Intensity Scale and function assessment, by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis (OA) questionnaire. Correlations were checked by the Pearson's correlation coefficient. Results: The sample characteristics were mean age 67.36 ± 4.21 years old, body fat percentage 40.57±6.15%, total WOMAC score 43.27 ± 16.32%, and maximum strength 19.95 ± 6.99 kgF. Pain during movement showed a statistical association with WOMAC physical activity domain (r = 0.47) and its general score (r = 0.51); pain intensity at night presented association with WOMAC stiffness domain (r = 0.55), in addition to the negative correlation with the slope values of the Medium Frequency of the EMG signal (r = - 0.57). Conclusion: pain intensity is correlated to functional incapacity in elderly people with knee OA and to a greater expression of fatigue in EMG signal. Levels of Evidence III, Study of non consecutive patients

Physical performance, balance, mobility, and muscle strength decline at different rates in elderly people.

[Purpose] The aim of this study was to verify the decline in functionality of elderly people. [Subjects and Methods] The study subjects comprised 152 individuals (96 women; 56 men) divided into 3 groups: G1 (60 to 69 years, n=53); G2 (70 to 79 years, n=65); and G3 (80 years or older, n=34). Physical performance, balance, mobility, and muscle strength were assessed using Short Physical Performance Battery (SPPB), Berg Balance Scale (BERG), Timed Up and Go (TUG) test, and leg press test, respectively. Comparison among age-stratified groups (G1, G2 and G3) and between genders were examined using analysis of variance with Tukey’s test as a post hoc test or the Kruskal-Wallis test with Bonferroni correction. [Results] SPPB and BERG scores decreased significantly in comparison between G1 and G3, and between G2 and G3 in women. TUG and leg press scores decreased significantly in comparison between G1 and G3 and between G2 and G3. [Conclusion] People in their 60s and 70s have similar functional characteristics (physical performance, balance, mobility and muscle strength for both genders), and functionality starts to decline when people are in their 80s.

Tissue Doppler Imaging Limitations for Evaluating the Diastolic Function in Elderly People

Results: The group consisted of 56 subjects (70.1 ± 6.6 years), 23 (41.1%) in the GC and 33 (58.9%) in the HAS. Except for LV hypertrophy, more frequent in the HAS group compared to HG (34.4% versus 4.8% respectively; p=0.017), all structural echocardiographic findings were similar. Tissue Doppler analysis revealed no differences between the groups (septal e’: 8.0 ± 1.5 vs. 7.2 ± 1.9 cm/s; p=0.083 and lateral e’: 9.8 ± 2.2 versus 8.7 ± 2.0 cm/s; p=0.074, respectively, for GC and HAS). A longer E‑wave deceleration time was observed for HAS group (253 ± 62 versus 208 ± 36 ms in GC; p=0.003). Conclusion: In the analysis of diastolic function in elderly, tissue Doppler imaging was not able to discriminate hypertensive individuals, with the greatest potential for the occurrence of diastolic dysfunction, to the non‑hypertensive individuals.The E‑wave deceleration time proved to be a valuable parameter in this population. (Arq Bras Cardiol: Imagem cardiovasc. 2014;27(3):184‑190)

Interactions between plasma concentrations of folate and markers of vitamin B12status with cognitive performance in elderly people not exposed to folic acid fortification: the Hordaland Health Study

A combination of high folate with low vitamin B12 plasma status has been associated with cognitive impairment in a population exposed to mandatory folic acid fortification. The objective of the present study was to examine the interactions between plasma concentrations of folate and vitamin B12 markers in relation to cognitive performance in Norwegian elderly who were unexposed to mandatory or voluntary folic acid fortification. Cognitive performance was assessed by six cognitive tests in 2203 individuals aged 72-74 years. A combined score was calculated using principal component analysis. The associations of folate concentrations, vitamin B12 markers (total vitamin B12, holotranscobalamin (holoTC) and methylmalonic acid (MMA)) and their interactions in relation to cognitive performance were evaluated by quantile regression and least-squares regression, adjusted for sex, education, apo-ɛ4 genotype, history of CVD/hypertension and creatinine. Cross-sectional analyses revealed an interaction (P=0·009) between plasma concentrations of folate and vitamin B12 in relation to cognitive performance. Plasma vitamin B12 concentrations in the lowest quartile (<274pmol/l) combined with plasma folate concentrations in the highest quartile (>18·5nmol/l) were associated with a reduced risk of cognitive impairment compared with plasma concentrations in the middle quartiles of both vitamins (OR 0·22, 95% CI 0·05, 0·92). The interaction between folate and holoTC or MMA in relation to cognitive performance was not significant. In conclusion, this large study population unexposed to mandatory folic acid fortification showed that plasma folate, but not plasma vitamin B12, was associated with cognitive performance. Among the elderly participants with vitamin B12 concentrations in the lower range, the association between plasma folate and cognitive performance was strongest.

An fMRI study on the effects of jaw-tapping movement on memory function in elderly people with memory disturbances

IntroductionMild cognitive impairment (MCI) is distinguishable from the memory loss associated with normal aging and may represent an early stage of Alzheimer's disease. This study sought to determine whether jaw-tapping could be a useful exercise to improve memory function by observing changes in brain activity. MethodologyTwelve subjects with subjective memory complaints (SMC group) and thirteen MCI patients (MCI group) participated in a prospective functional magnetic resonance imaging (fMRI) study. All subjects performed jaw-tapping and n-back memory tasks during blood oxygen level dependent (BOLD) fMRI. Measurements were made before and after home practice of the jaw-tapping exercise for 4 weeks. Pre- and post-test fMRI data were analyzed using statistical parametric maps of brain activation. ResultsThe SMC and the MCI groups showed improvement in the memory task after 4 weeks of jaw-tapping training. In the SMC group, more brain regions were activated overall, including the prefrontal, temporal, and precuneus regions related to memory function. Although fewer brain regions were activated in the MCI group compared to the SMC group, brain activity increased in the MCI group after 4 weeks of training. ConclusionJaw-tapping movement could be a useful exercise for improving memory and cognitive function in elderly people with memory disturbance by stimulating brain regions related to these functions.

A Clinical Review of the Association of Thyroid Stimulating Hormone and Cognitive Impairment

Clinical and subclinical hypothyroidism as well as overt hyperthyroidism in middle-aged and elderly adults are both associated with decreased cognitive functioning as memory, reaction time, and visuospatial organization. Subclinical hyperthyroidism (SH) or low serum concentrations of TSH concentrations have been associated with dementia in previous epidemiological studies, but the association in the elderly has not been established. There is little or no consensus regarding how thyroid function is associated with cognitive performance in the elderly. In this focused review, we have performed an examination between eleven studies from the last five years examining the association between thyroid function and cognitive performance in elderly people, a group who is overrepresented among individuals with minor abnormalities in serum TSH and thyroid hormone concentration. Six of the studies showed a consistent finding of an association between SH with cognitive impairment or dementia. In general, taking into account the largest and most powerfully designed studies, there is a strong body of evidence supporting the association between SH and cognitive impairment. The scarce number of publications on these topics indicates the need of more research especially regarding longitudinal and interventional studies thus hopefully enabling confirmation or rejection of causality between TSH abnormalities and dementia.

Epicardial fat and changes in cognitive function in elderly people

Epicardial fat and changes in cognitive function in elderly people

Six-year prospective evaluation of cognitive performance in elderly people with bipolar disorder

Six-year prospective evaluation of cognitive performance in elderly people with bipolar disorder

Áhrif 6 mánaða fjölþættrar þjálfunar á hreyfigetu, vöðvakraft, þol og líkamsþyngdarstuðul eldri einstaklinga - Eru áhrif þjálfunar sambærileg hjá konum og körlum?

Good functional performance in elderly people greatly improves their changes of independence and well-being. Conversely, bad functional performance can impair their capability of managing the activities of daily life.. The main goal of this study was to investigate the effects of a 6-months' multimodal training intervention on the physical performance of males and females, possible gender differences and the outcome 6 and 12 months after its completion. This study examined 71-90 year old healthy seniors (n=117) participating in the AGES Reykjavik Study. It was a randomized and controlled cross-over trial, conducted in three 6-months' phases (time-points). After enrollment and baseline assessments, the study group was divided in two. Group 1 received 6-months' training while group 2 served as a control. In the second 6 months' phase, group 1 received no formal training while group 2 did. In the third phase, neither group received training. The groups' physical conditions were assessed after each phase. After 6-months' training, 32% improvement was seen in physical activity among males (p<0.001) and 39% among females (p<0.001). In physical performance, 5% improvement was seen for males (p<0.01) and 7% for females (p<0.001). Strength increased by 8% for males (p<0.001) and 13% for females (p<0.001). For both sexes, about 10% increase was seen in dynamic balance in the 8-foot up-and-go test (p<0.001) and 5-6% in walking distance for both sexes in the six minutes walking test (p<0.001). For both sexes, body mass index decreased by about 2% (p<0.001). No difference was seen between the sexes.in the training results. Both sexes retained long-term effects of the training on physical performance and dynamic balance for at least 12 months. Multimodal training intervention has positive effects on physical performance in older individuals, the sexes respond similarly to the training and retain achieved improvement for at least 12 months. The research indicates that moderate and systemic training for this age group could be a part of conventional health service for this age group.

Effects of whey proteins and carbohydrates on the efficacy of resistance training in elderly people: double blind, randomised controlled trial

A few previous studies indicate that protein supplementation increases gains in muscle mass and strength during a resistance exercise program. The purpose of this study was to investigate whether whey protein supplementation results in greater increases in lean body mass, muscle strength and physical function in elderly individuals during 12 weeks of resistance exercise when compared to isocaloric carbohydrate supplementation. A total of 161 men and women, 65-91 years old, participated in a randomized, controlled, double-blind intervention study, involving dietary supplementation and a 12-week resistance exercise program, designed to increase muscle mass and strength of all major muscle groups. Participants exercised three times a week and received either 20 g of whey protein (n=83) or isocaloric carbohydrate (n=78) in liquid form immediately after each workout. Data were obtained at baseline and end point. The primary outcomes, lean body mass, strength and physical function increased significantly during the course of the study. Type of dietary supplementation did not influence gains in lean body mass (P=0.365), quadriceps strength (P=0.776) or performance during a 6-min walk (P=0.726) or a timed up-and-go test (P=0.151). Twenty participants discontinued the intervention. Ingestion of 20 g of whey protein immediately after resistance exercise three times per week, does not lead to greater gains in lean body mass, strength and physical function in elderly people with sufficient energy and protein intakes when compared to isocaloric carbohydrate.

Les incapacités fonctionnelles des personnes âgées vivant à domicile à Bobo-Dioulasso, Burkina Faso

In sub-Saharan Africa, very little research has been conducted on moderate to severe disabilities affecting mobility, communication and mental function in elderly people living at home. The studies that have been conducted have not always described the broader social context, a key factor for understanding and interpreting results. This study was conducted in Burkina Faso and was designed to fill the gaps in our understanding of disability in these areas. A cross-sectional descriptive study was conducted in Bobo-Dioulasso among the elderly population (aged 60 and above). Functional status was assessed using the Functional Autonomy Measurement System (SMAF). Data analysis was performed using Stata software. Interviews were conducted with a systematic random sample of 351 elderly adults. Moderate to severe functional disability or the need for supervision or assistance were related to mobility in 10% of cases, to mental function in 28% of cases and to communication in 37% of cases. The need for assistance varied according to the different activities or items in each domain. The rates of disability in this study were higher than those found in previous studies, which have often assessed severe disabilities. All individuals affected by disability stated that they had a stable support network to manage their disability. Families were found to be the primary source of support. The results can be explained by the social context. A good visibility of moderate to severe disabilities should contribute to the development of effective policies to provide care and support to the elderly.

A Meta-analysis of the Effect of Walking Exercise on Lower Limb Muscle Endurance, Whole Body Endurance and Upper Body Flexibility in Elders

The purpose of this study was to determine whether walking exercise improved physical function in elderly people using meta-analysis. Medical and nursing literature databases were searched to identify the studies on the effectiveness of walking exercise on physical function. In the databases, there were 16 articles reporting 21 interventions. Overall effect sizes for three outcome variables, elders' physical function in lower limb muscle endurance, whole body endurance and upper body flexibility, were calculated. Effects of study characteristics on outcome variables were analyzed. The meta-analysis showed that walking exercise generally had positive effects on CST (chair stand test), 6MW (6 min walking), and SRT (standing or sitting reach test) with overall weighted effect sizes of 1.06, 0.41 and 0.29 respectively. This study also showed that the chronic disease status of the elders, intervention methods, and type of residence had different effects on CST, 6MW and SRT. The results indicate that walking exercise improves physical function in elders. Walking exercise which can be done at any time and any location is indeed a very effective exercise for elderly people.

Occupational activity and cognitive reserve: implications in terms of prevention of cognitive aging and Alzheimer&amp;rsquo;s disease

This paper investigates the relationship between the concept of activity (including both professional and nonprofessional) and cognitive functioning among older European individuals. In this research, we used data collected during the first wave of SHARE (Survey on Health, Ageing and Retirement in Europe), and a measurement approach known as stochastic frontier analysis, derived from the economic literature. SHARE includes a large population (n > 25,000) geographically distributed across Europe, and analyzes several dimensions simultaneously, including physical and mental health activity. The main advantages of stochastic frontier analysis are that it allows estimation of parametric function relating cognitive scores and driving factors at the boundary and disentangles frontier noise and distance to frontier components, as well as testing the effect of potential factors on these distances simultaneously. The analysis reveals that all activities are positively related to cognitive functioning in elderly people. Our results are discussed in terms of prevention of cognitive aging and Alzheimer’s disease, and regarding the potential impact that some retirement programs might have on cognitive functioning in individuals across Europe.

How Aging Affects T Lymphocyte-Mediated Immunity

EDITORIAL article Front. Immunol., 24 September 2013Sec. T Cell Biology Volume 4 - 2013 | https://doi.org/10.3389/fimmu.2013.00296