Physical Function In Older Adults Research Articles

Postural change, gait, and physical function in older adults

In a more clinical setting, abrupt posture change may be used to determine the presence of orthostatic hypotension, a hemodynamic response with relationships to physical function. Certain gait features and physical function performance are also associated with risk of falling in older adults. However, the extent to which posture change is associated with subsequent gait and physical function has received little attention in the literature. This study aims to determine the effects of posture change on spatiotemporal parameters of gait and Timed Up-and-Go (TUG) performance. Methods. Forty-two volunteers (age 73.21 ± 6.22 years) participated in the study. A custom Tekscan Strideway (Tekscan, Boston, MA.) gait system was used to measure gait velocity (VEL), cadence (CAD), stride length (SL), and percent of time spent in active propulsion (AP). Dependent t-tests were used to compare TUG time, VEL, CAD, SL and AP after at least 10 mins of seated rest and supine rest. Results. Time to complete the TUG was significantly slower after supine rest compared to seated (11.47 ± 0.51 and 10.01 ± 0.33 s, respectively, p<0.001); VEL was significantly slower after supine rest compared to seated (0.888 ± 0.042 and 1.049 ± 0.033 m/s, respectively, p=0.003); CAD was significantly slower after supine rest compared to seated (111.21 ± 2.87 and 120.97 ± 2.56spm, respectively, p=0.001); and AP was significantly lower after supine rest compared to seated (56.87 ± 4.76 and 70.79 ± 4.05 %, respectively, p<0.001). No significant differences were detected in stride length between conditions. Conclusions. Among this sample of older adults, standing from a supine posture is associated with spatiotemporal gait parameters consistent with a risk for falling and aging. Additionally, TUG performance worsens significantly after supine rest. Future studies could explore the sensitivity and specificity of falls risk screening after supine rest.

High-Impact Pain Is Associated With Epigenetic Aging Among Middle-Aged and Older Adults: Findings From the Health and Retirement Study.

Chronic pain has been associated with accelerated biological aging, which may be related to epigenetic alterations. We evaluated the association of high-impact pain (ie, pain that limits activities and function) with epigenetic aging, a measure of biological aging, in a nationally representative sample of middle-aged and older adults in the United States. Cross-sectional analysis of adults 50 years of age and older from the 2016 Health and Retirement Study. Epigenetic aging was derived from 13 epigenetic clocks based on DNA methylation patterns that predict aging correlates of morbidity and mortality. Ordinary least squares regressions were performed to test for differences in the epigenetic clocks, adjusting for the complex survey design, as well as biological, social, and behavioral factors. The analysis consisted of 3855 adults with mean age of 68.5 years, including 59.8% with no pain and 25.8% with high-impact pain. Consistent with its operational definition, high-impact pain was associated with greater functional and activity limitations. High-impact pain was associated with accelerated epigenetic aging compared to no pain, as measured via second (Zhang, PhenoAge, GrimAge) and third (DunedinPoAm) generation epigenetic clocks. Additionally, GrimAge was accelerated in high-impact pain as compared to low-impact pain. High-impact pain is associated with accelerated epigenetic aging among middle-aged and older adults in the United States. These findings highlight aging-associated epigenetic alterations in high-impact chronic pain and suggest a potential for epigenetic therapeutic approaches for pain management and the preservation of physical function in older adults.

Reliability and concurrent validity of 30-s and 5-time sit-to-stand tests in older adults with knee osteoarthritis.

Sit-to-stand (STS) movement is fundamental in daily life. STS tasks have been used to assess lower limb muscle strength, balance control, and functional abilities in various populations, but limited information is available on their use in older individuals with knee osteoarthritis. We here examined the intra-rater, inter-rater, and test-retest reliability of the 30-s and 5-time STS tests, and calculated the standard error of measurement (SEM) and minimal detectable change (MDC). Moreover, we explored the concurrent validity of these tests by analysing their correlation with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis. This cross-sectional study included 60 older participants diagnosed with knee osteoarthritis. Baseline demographic information and data on pain, stiffness, and physical function using the modified Western Ontario and McMaster Universities Osteoarthritis (WOMAC) were obtained. Participants performed the 30-s and 5-time STS tests as well as knee muscle strength assessment using a hand-held dynamometer. After 1week, 30 participants were reassessed to evaluate test-retest reliability. The 30-s and 5-time STS tests had excellent intra-, inter-, and test-retest reliability (intraclass correlation coefficients: 0.990-1.000, 0.996-0.999, and 0.841-0.853, respectively) with a large SEM and MDC. Both STS tests significantly correlated with knee extensor and flexor strength and all modified WOMAC domains (Pearson's correlation coefficients: 0.28-0.61, p < 0.05). The 30-s and 5-time STS tests are reliable assessment tools and correlate with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis. Key Points • The 30-s and 5-time STS test can serve as surrogate measures in various aspects of knee health, including muscle strength, pain levels, stiffness, and overall physical function, in older adults with knee osteoarthritis. • Both these STS tests are dependable tools, accessible for both experienced and inexperienced assessors to administer effectively.

Digital Peer-Supported App Intervention to Promote Physical Activity Among Community-Dwelling Older Adults: Nonrandomized Controlled Trial.

The use of mobile apps has promoted physical activity levels. Recently, with an increasing number of older adults accessing the internet, app-based interventions may be feasible in older populations. Peer support-based interventions have become a common method for promoting health-related behavior change. To our knowledge, the feasibility of using digital peer support apps (DPSAs) to increase physical activity among older adults and its impact on physical activity and physical function have not been investigated. This study aims to assess the feasibility of using DPSAs in older adults and to assess changes in physical activity and physical function in DPSA users. We conducted a nonrandomized controlled trial of older adults aged ≥65 years. We recruited participants for 2 distinct 12-week programs designed to increase physical activity. Participants could choose between an intervention group (app program and exercise instruction) or a control group (exercise instruction only). DPSA creates a group chat for up to 5 people with a common goal, and participants anonymously post to each other in the group. Once a day, participants posted a set of their step counts, photos, and comments on a group chat box. The intervention group used the DPSA after receiving 2 face-to-face lectures on its use. The participants were characterized using questionnaires, accelerometers, and physical function assessments. The feasibility of the DPSA was assessed using retention and adherence rates. Physical activity was assessed using accelerometers to measure the daily step count, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sedentary behavior. Physical function was assessed using grip strength and the 30-second chair-stand test. The participants in the intervention group were more frequent users of apps, were more familiar with information and communication technology, and had a higher baseline physical activity level. The retention and adherence rates for the DPSA intervention were 88% (36/41) and 87.7%, respectively, indicating good feasibility. Participants in the intervention group increased their step count by at least 1000 steps and their MVPA by at least 10 minutes using the DPSA. There was a significant difference in the interaction between groups and intervention time points in the daily step count and MVPA (step count, P=.04; duration of MVPA, P=.02). The DPSA increased physical activity, especially in older adults with low baseline physical activity levels. The feasibility of DPSA was found to be good, with the intervention group showing increases in daily steps and MVPA. The effects of DPSA on step count, physical activity, and physical function in older adults with low baseline physical activity should be investigated using randomized controlled trials.

The relationship and pathways between resting-state EEG, physical function, and cognitive function in older adults

ObjectiveBased on resting-state electroencephalography (EEG) evidence, this study aimed to explore the relationship and pathways between EEG-mediated physical function and cognitive function in older adults with cognitive impairment.MethodsA total of 140 older adults with cognitive impairment were recruited, and data on their physical function, cognitive function, and EEG were collected. Pearson correlation analysis, one-way analysis of variance, linear regression analysis, and structural equation modeling analysis were conducted to explore the relationships and pathways among variables.ResultsFP1 theta (effect size = 0.136, 95% CI: 0.025–0.251) and T4 alpha2 (effect size = 0.140, 95% CI: 0.057–0.249) were found to significantly mediate the relationship. The direct effect (effect size = 0.866, 95% CI: 0.574–1.158) and total effect (effect size = 1.142, 95% CI: 0.848–1.435) of SPPB on MoCA were both significant.ConclusionHigher physical function scores in older adults with cognitive impairment were associated with higher cognitive function scores. Left frontal theta and right temporal alpha2, as key observed indicators, may mediate the relationship between physical function and cognitive function. It is suggested to implement personalized exercise interventions based on the specific physical function of older adults, which may delay the occurrence and progression of cognitive impairment in older adults with cognitive impairment.

Metaverse technologies in managing frailty among older individuals: A systematic review

Introduction: Frailty, characterized by declines in physical, psychological, and social functions, presents challenges to aging populations. While multicomponent exercise programs have shown efficacy, accessibility can be limited. Virtual Reality (VR) technologies, including Metaverse integration, show promise for frailty management. Studies have demonstrated positive impacts from VR on physical function in older adults, but research on Metaverse technologies specifically for frailty remains limited. Aim: This systematic review aimed to explore the utilization of Metaverse technology in frailty management among older individuals. Methods: The systematic review adhered to PRISMA guidelines, searching databases for studies from January 2013 to December 2023. Inclusion criteria focused on Metaverse use for frailty in individuals ≥ 65 years old. Two researchers screened articles, leading to the evaluation of full-text papers. Results: Despite screening 35 articles, none were suitable for data extraction, indicating a gap in the literature regarding the application of Metaverse technologies to frailty management. Conclusion: While Metaverse technologies hold promise for personalized frailty interventions, research in this area is limited. Future studies should focus on evaluating the effectiveness of Metaverse interventions and promoting collaboration between healthcare providers and technology developers to advance frailty management in older individuals.

Collaborative Care for Injured Older Adults

Older adults with recent injuries can have impaired long-term biopsychosocial function and may benefit from interventions adapted to their needs. To determine if a collaborative care intervention, Trauma Medical Home (TMH), improved the biopsychosocial function of older patients in the year after injury. This was a single-blinded, randomized clinical trial conducted at 4 level I trauma centers in Indianapolis, Indiana, and Madison, Wisconsin. Between October 2017 and October 2021, patients aged 50 years and older with an Injury Severity Score (ISS) of 9 or greater and without traumatic brain or spinal cord injury were enrolled. Exclusions were significant brain injury or a spinal cord injury with a persistent neurologic deficit at the time of enrollment, extensive burns, pregnancy, incarceration, neurodegenerative disease, visual or auditory impairment that would preclude study participation, a life expectancy of less than 1 year, significant alcohol or drug use history, and acute stroke during admission. Of 10 276 patients screened, 430 were randomized and 299 completed 12-month follow-up. Data were analyzed from March to July 2023. Intervention patients received 6 months of TMH delivered by a nurse care coordinator guided by an interdisciplinary team (trauma surgeon, pulmonary critical care and geriatrician physicians, nurses, and psychologist) in partnership with primary care. The care coordinator used standard protocols to monitor and treat biopsychosocial symptoms. Primary outcomes were Medical Outcome Study Short Form-36 (SF-36) score and Short Physical Performance Battery (SPPB) score at 12 months. Secondary outcomes were Patient Health Questionnaire-9 (PHQ-9) score, the Generalized Anxiety Disorder scale-7 (GAD-7) score, and health care utilization. A total of 429 participants (228 [53.1%] female; mean [SD] age, 69.3 [10.8] years; mean [SD] ISS, 12.3 [4.6]) completed baseline assessments and were randomized. Follow-up was 76% (n = 324) at 6 months and 70% (n = 299) at 12 months. There were no differences between the TMH and usual care groups at 12 months in SF-36 Physical Component Summary score (mean [SD], 40.42 [12.82] vs 39.18 [12.43]), SF-36 Mental Component Summary score (mean [SD], 53.92 [10.02] vs 53.21 [10.82]), or SPPB score (mean [SD], 8.00 [3.60] vs 8.28 [3.88]). Secondary outcomes were also no different. Planned subgroup analysis revealed patients with baseline symptoms of anxiety or depression (high GAD-7 and PHQ-9 scores) experienced improvement in the Mental Component Summary score when randomized to the TMH intervention. The TMH intervention did not significantly influence quality of life, depressive and anxiety symptoms, or physical function of older adults with injury at 12 months. Subgroup analysis showed positive impact in patients with a high burden of anxiety and depression symptoms at enrollment. Collaborative care interventions may improve long-term outcomes of select patients, but further research is needed. ClinicalTrials.gov Identifier: NCT03108820.

Hearing Impairment and Physical Activity and Physical Functioning in Older Adults: Baseline Results From the ACHIEVE Trial.

Hearing loss is associated with restricted physical activity (PA) and impaired physical functioning, yet the relationship between severity of hearing impairment (HI) and novel PA measures in older adults with untreated HI is not well understood. Analyses included 845 participants aged ≥70 years (mean = 76.6 years) with a better-hearing ear pure-tone average (PTA) ≥30 and <70 dB in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study who wore an ActiGraph accelerometer for 7 days. Physical functioning measures included grip strength and the Short Physical Performance Battery (SPPB). Linear regression models estimated the association by HI level (moderate or greater [PTA ≥ 40 dB] vs mild [PTA < 40 dB]) and continuous hearing with total daily activity counts, active minutes/day, activity fragmentation, grip strength, and gait speed. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of poor performance on the SPPB (≤6) and its subtests (≤2). Mixed-effects models estimated differences by HI level in activity by time of day. Participants with moderate or greater HI had poorer physical functioning, particularly balance (OR = 2.17, 95% CI = 1.29-3.67), versus those with mild impairment. There was no association of HI level with activity quantities or fragmentation. For diurnal patterns of activity, participants with moderate or greater HI had fewer activity counts in the afternoon (12:00 pm -05:59 pm). Older adults with worse hearing had shifted diurnal patterns and poorer balance performance. Exercise programs should be tailored to older adults with different levels of HI to maintain PA and physical functioning, particularly balance control.

Improving Physical Abilities And The Most Efficient Methods In Adults Over 40 Years Old

Only a small percentage of adults engage in regular physical activity, which means a decline in quality of life and a very poor result compared to Europe (Osiński, 2013). The purpose of this literature review is to find the most contemporary methods from the most ranked scientific works on the improvement of physical abilities and the most efficient methods in adults over 40 years old. Digital databases such as Scopus, Medline, JStore, Embase, Cochrane Central, PsycInfo, Schoolar, and SPORTDiscus were used in this literature review. Inclusion criteria are: individuals must be healthy and average age at least 40 years old. Many other studies such as (Skelton et al., 1994; Foldvari et al., 2000; Bean et al., 2007) report that physical functions are more related to muscle power than to muscle strength or mass. Strength training has many benefits on physical function in older adults compared to traditional strength training (Tschopp et al., 2011; Da Rosa., 2019). Harmonization or proper use of variables such as exercise selection, breaks, number of sets, number of repetitions, frequency affect the increase in the level of muscular fitness. Strength, muscular endurance, muscular strength and muscular hypertrophy are the characteristics that should be trained (Ratamess et al., 2009). While in an all-inclusive program resistance training improves the cardiovascular system (Fleck. 1988), limits the risk of coronary heart disease (Goldberg. 1989; Hurley &amp; Kokkinos, 1987), helps prevent osteoporosis (Layne &amp; Nelson. 1999), removes the risk of diabetes (Miller et al., 1984), promotes maintaining a healthy weight and losing excess weight (Evans. 1999), reduces the risk of cancer in the spine (Koffler et al., 1992), helps in psychological/mental well-being (Ewart. 1989) as well as improves dynamic stability and maintenance of functional capacity (Evans. 1999). In conclusion from the study of Balachandran et al. (2022) found that strength training leads to improvements in physical function more than traditional strength training. Keywords: fitness, aging, power, strength, exercises

Pulse pressure is associated with decline in physical function in older adults

ObjectivesThis study examined the associations between pulse pressure, hypertension, and the decline in physical function in a prospective framework. Study designThe Healthy Aging Longitudinal Study tracked a group of Taiwanese adults aged 55 or more over an average of 6.19 years to assess pulse pressure and decline in physical function, including in handgrip strength, gait speed, and 6-min walking distance, at baseline (2009–2013) and in the second phase of assessments (2013−2020). Main outcome measuresPulse pressure was calculated as the difference between systolic and diastolic blood pressure values. Weakness, slowness, and low endurance were defined as decreases of ≥0.23 m/s (one standard deviation) in gait speed, ≥5.08 kg in handgrip strength, and ≥ 57.73 m in a 6-min walk, as determined from baseline to the second phase of assessment. Linear and logistic regressions were employed to evaluate the associations between pulse pressure, hypertension, and decline in physical function. ResultsBaseline pulse pressure was associated with future handgrip strength (beta = −0.017, p = 0.0362), gait speed (beta = −0.001, p < 0.0001), and 6-min walking distance (beta = −0.470, p < 0001). In multivariable models, only handgrip strength (beta = −0.016, p = 0.0135) and walking speed (beta = −0.001, p = 0.0042) remained significantly associated with future pulse pressure. Older adults with high systolic blood pressure (≥140 mmHg) and elevated pulse pressure (≥60 mmHg) exhibited a significantly increased risk of weakness (odds ratio: 1.30, 95 % confidence interval: 1.08–1.58), slowness (1.29, 1.04–1.59), and diminished endurance (1.25, 1.04–1.50) compared with the reference group, who exhibited systolic blood pressure of <140 mmHg and pulse pressure of <60 mmHg. ConclusionsAmong older adults, pulse pressure is associated with a decline in physical function, especially in terms of strength and locomotion.

Household Environments and Functional Decline Among Middle-Aged and Older Adults in China: Variations by Gender, Age, and Residence.

This study examined the associations between household social, economic, and physical environments and the trajectory of functional limitations over time among middle-aged and older adults in China, and how this relationship differs by gender, age, and residence. Linear growth curve models were applied to a sample of 13,564 respondents aged 45 years and older from four waves of the China Health and Retirement Longitudinal Study (CHARLS 2011-2018). Living alone, particularly for rural, female, and older respondents, was associated with a faster functional decline when compared to living with a spouse and without children. Improved housing quality was associated with a slower functional decline. Living with young descendants and without adult children for urban residents and a lower expenditure per capita for younger respondents were associated with a faster functional decline. These findings suggest that policies aimed at enhancing living conditions have the potential to improve physical functioning of older adults.

Clinical studies with drugs and biologics aimed at slowing or reversing normal aging processes—emerging results and future perspectives

Five families of investigational products are in clinical investigation to slow or reverse normal aging processes [longevity candidates, mesenchymal stem cells, senolytics drugs, sirtuin activators, and nicotinamide adenine dinucleotide (NAD)+ precursors]. The longevity candidates, vitamin D and metformin, appear to significantly reduce all-cause mortality and prolong life expectancy. This should be confirmed by interventional studies. The mesenchymal stem cell family is the most advanced in clinical trial development [phase 2b randomized controlled trial (RCT)]. An allogeneic bone marrow stem cell preparation (Lomecel-B) reduced locomotor frailty in older people. The improvement in locomotion was modest. In the future, attempts could be made to improve potency through a precondition or genetic modification of naive bone marrow stem cells. Autologous adipose stem cell-assisted fat grafting increased graft survival, facial volume, and skin quality. The association of the senolytic drugs dasatinib and quercetin was well tolerated, with low brain penetration of dasatinib and undetectable levels of quercetin. The sirtuin-1 activator resveratrol (combined with physical exercise) improved physical function in older adults with physical limitations. The NAD+ precursor nicotinamide riboside improved physical exercise performance. In conclusion, Lomecel-B is the most advanced agent in clinical trial development for normal aging processes (phase 2b for locomotion frailty), followed by resveratrol and nicotinamide riboside.

Associations between regular physical exercise and physical, emotional, and cognitive health of older adults in China: an 8-year longitudinal study with propensity score matching.

The importance of healthy aging is growing in China as it has the largest number of older adults in the world and is one of the fastest-aging countries. This study aimed to examine the predictive value of regular physical exercise in relation to the physical, emotional, and cognitive health among samples of adults aged ≥60 years in China during an 8-year period. A total of 10,691 older adults were extracted from two waves of national data from the China Family Panel Studies in 2010 and 2018. To minimize the impact of selection bias on the findings, a longitudinal propensity score matching (LPSM) method was used to examine the relationships between regular physical exercise and emotional health (depression), between regular physical exercise and physical health (instrumental activities of daily living), and between regular physical exercise and cognitive health (cognitive ability) of older adults. After LPSM, 856 older adults were included in the study. In the regular physical exercise group, the average age of participants at baseline year was 65.67 years, with an average age of 65.90 years for 238 men and 65.45 years for 190 women, and in the non-physical exercise group, their average age at baseline year was 65.70 years, with an average age of 65.45 years for 253 men and 65.98 years for 175 women. LPSM indicated that regular physical exercise has been found to be effective in improving physical function and reducing depressive symptoms in old adults, even after controlling for background differences. However, the sensitivity analysis suggests that the positive association between regular physical exercise and cognitive function may not be sufficiently valid. The findings of this study indicate that engaging in long-term structured and repetitive physical exercise can have a significant positive effect on reducing depressive symptoms and improving the physical function of older adults. As a result, incorporating regular physical exercise into the lifestyle of older adults is recognized as an effective strategy for promoting healthy aging and reducing the strain on public health resources.

Relationship between quadriceps femoris echotexture biomarkers and muscle strength and physical function in older adults with heart failure with preserved ejection fraction

BackgroundMuscle wasting is pronounced in patients with heart failure with preserved ejection fraction (HFpEF). The quadriceps femoris echotexture biomarkers assessed by ultrasound (US) have not been studied in these patients. ObjectiveTo describe echotexture biomarkers assessed by the US and to assess their relationship with sex, age, body mass index (BMI), self-reported outcomes, muscle strength and physical function in older adults with HFpEF. MethodsA cross-sectional study was conducted. Patients 70 years and older with HFpEF were included. The sex, age, BMI, and self-reported outcomes were collected. The US assessed muscle and subcutaneous fat tissue contrast, correlation, energy, homogeneity, and entropy at rest and maximal voluntary isometrical contraction (MVIC). The six-minute walk test (6MWT), the short physical performance battery (SPPB), the timed up and go test (TUG), the usual pace gait speed test (UGS), and the fast pace gait speed test (FGS) were used to assess physical function. The five-repetitions sit-to-stand test (5-STS) was performed to assess muscle strength. Bivariant Pearson correlations and subsequent multivariate linear regression analyses were conducted. ResultsSeventy-two older adults with HFpEF [81.06 years, 29.13 BMI, and 55.60% females] were recruited. In women, relaxed and MVIC muscle energy and entropy explained 35.40% of the TUG variance; relaxed muscle entropy and MVIC muscle energy shared 24.00% of the UGS variance; relaxed and MVIC muscle entropy, MVIC muscle contrast and MVIC muscle energy explained 32.60% of the FGS variance, adjusted all the models by age and BMI. ConclusionsEchotexture biomarkers are related to women's muscle strength and physical function, especially muscle energy, contrast, and entropy. Echotexture biomarkers assessed by the US could facilitate the management of older adults with HFpEF, monitor its progression and assess the effectiveness of treatments on the musculoskeletal structure. Trial registrationNCT03909919. April 10, 2019. Retrospectively registered.

Effects of Combined Cognitive and Physical Exercise Program on Cognitive and Physical Functions in Older Adults with Mild Cognitive Impairment

Effects of Combined Cognitive and Physical Exercise Program on Cognitive and Physical Functions in Older Adults with Mild Cognitive Impairment

Frailty as a Key Predictor of Malnutrition among Older Adults with Swallowing Problems

Geriatric syndrome—frailty—has a more significant influence on the health of older, pre-frail and frail older adults who tend to have a poor nutritional status or develop severe malnutrition. Investigation of frailty and its association with malnutrition and swallowing problems is limited in older Thais. This cross-sectional study examined the association among frailty and other associated factors with malnutrition in older adults with swallowing problems. A purposive sampling method was employed to recruit 120 participants who met the specified inclusion criteria. Data were obtained from older adults who visited and received medical services at the rehabilitation department of a university hospital in Bangkok, Thailand, from July 2022 to February 2023. The instruments included the Demographic and Health Information Record Form, Mini Nutritional Assessment Short-Form - MNA® Elderly, Reported Edmonton Frail Scale-Thai Version, and Modified Barthel Activities of Daily Living Index. Data were analyzed using descriptive statistics and multiple logistic regression.The findings indicated that 82.5% of participants were frail, and approximately 30% and 80.0% presented with dependence and at-risk or malnutrition, respectively. Frailty, age, comorbidities, a history of aspiration, and activities of daily living could predict malnutrition, accounting for 71.7%. Significantly, frailty demonstrated a 4.47-fold increased risk of malnutrition, while dependence on activities of daily living had a 6.41-fold increased risk of malnutrition among this population. The findings of this study provide valuable insights for healthcare professionals, especially gerontological nurse practitioners, to raise awareness of the early detection of frailty, swallowing problems, and potential risks of malnutrition, together with promoting daily activity in older adults across settings. Implementing comprehensive management to improve swallowing and physical function in older adults at risk of frailty and malnutrition may enable gerontological nurse practitioners to strengthen professional care. By doing so, maintaining nutritional health among these populations can be achieved.

The application of virtual reality meditation and mind-body exercises among older adults.

Virtual reality (VR)-based mindfulness is a promising method to improve the health of older adults. Therefore, many attempts have been made to explore the application of VR-based mindfulness, such as VR meditation and mind-body exercises, in older adults. Generally, current studies indicate the heavy reliance on apparatus for implementing VR-based mindfulness interventions. In VR meditation, the crucial apparatus is VR headsets. In VR mind-body exercises, three essential components are required: motion capture sensors, main consoles, and display screens. In the aspect of health promotion, VR meditation is an effective method for improving mental health, pain, and quality of life in older adults. VR mind-body exercises contribute to increasing the mental health and physical function of older adults. Furthermore, VR mind-body exercises may be combined with other forms of exercise as a mixed method to promote the health of older adults. VR-based mindfulness interventions enhance the meditation and mind-body exercises experience for older adults while improving accessibility. However, their implementation still encounters a series of challenges, such as cost, technical anxiety, and apparatus-related issues. Additionally, we recommend future research to examine the optimal exercise dose for VR mind-body exercises to maximize their health benefits.

Short-Term Ingestion of Essential Amino Acid Based Nutritional Supplements or Whey Protein Improves the Physical Function of Older Adults Independently of Gut Microbiome.

Dietary proteins and essential amino acids (EAAs) are the major nutritional supplements that support the growth and activity of gut microbes contributing to the wellbeing of their host. This study hypothesizes that daily supplementation of the diet with either EAAs or whey protein for 12 weeks would improve the gut microbiome of older adults. The stool samples are processed and subjected to Illumina-based 16S ribosomal ribonucleic acid (rRNA)gene amplicon sequencing. In both groups, the most abundant families are found in order of relative abundance included: Bacteroidaceae, Lachnospiraceae, Ruminococcaceae, Prevotellaceae, Rikenellaceae, Enterobacteriaceae, Oscillospiraceae, Tannerellaceae, and Akkermansiaceae, which indicate that these subjects are able to maintain a same healthy microbial diversity in their guts. A significant finding is a reduction of proinflammatory cytokine, interleukin-18 (IL-18) in the EAAs group. It also uses the standard 6-min walking test (6MWT) as a measure of cardiopulmonary fitness. At the end of the study, the subjects in the EAAs group perform significantly better in the 6MWT as compared to the whey group. It seems plausible that the improved physical performance and reduced proinflammatory cytokine, IL-18 seen in the EAAs group, are independent of changes in gut microbiota.

Cardiovascular risk burden and disability: findings from the International Mobility in Aging Study (IMIAS).

The association of cardiovascular risk burden with disability is unclear. We examined the association between trajectories of the Framingham general cardiovascular disease risk score (FGCRS) with the trajectories of limitations of physical function in older adults. A total of 1219 participants with no disabilities from the International Mobility in Aging Study (IMIAS) study who had up to three repeated measures of FGCRS between 2012-2016 and without a history of stroke or coronary heart disease at baseline and follow-up were included. FGCRS at baseline was assessed and categorized into tertiles. Physical function was evaluated with the Short Physical Performance Battery (SPPB). The data were analyzed using linear mixed-effects models. At baseline, FGCRS ranged between 3-94 (mean score: 24 ± 15.8), participants were 32 (2.6%), 502 (41.2%) and 685 (56.2%) in lowest, middle, and highest tertiles, respectively. In the trajectories of limitations of physical function, the lowest FGCRS had no differences, while the middle and highest had a decrease in physical performance between 2012-2014 (P = 0.0001). Age, being female, living in Andes Mountains, having middle and highest FGCRS, higher alcohol consumption, being obese, lack of exercise and cognitive impairment increase the probability of disability (P < 0.05). Alternatively, living in more developed regions and having a higher educational level reduced the probability of disability during the follow-up time (P < 0.05). Higher cardiovascular risk burden is associated with decreased physical performance, especially in gait. Results suggest SPPB may provide a measure of cardiovascular health in older adults.

Fear of Falling in Older Adults Living in a Community-Dwelling Facility: Prevalence and Its Impact on Activity Behavior and Physical Function.

This study examined the prevalence and the impact of fear of falling (FOF) on physical activity (PA), sedentary behavior (PA), and physical function in older adults living in a continuing care retirement community (CCRC). Ninety-three older adults were included and self-reported assessed on PA and SB. Further, participants' physical function was assessed using a collection of measures of valid objective tests. Independent t test was used to compare the dependent variables between FOF groups, and analysis of covariance (ANCOVA) was used to control for assistive device usage. FOF was prevalent in 47.3% of the sample and PA and SB did not differ between FOF groups (p > .05). ANCOVA revealed that performance on several physical function tests remained significantly better (p < .05) for the no FOF group compared to the yes group. Our findings demonstrated similar levels of PA and SB between FOF groups, but worse physical function for older adults reporting FOF.