Speed In Older Adults Research Articles

Mobility Rehab visual feedback system for gait rehabilitation in older adults

BackgroundGait and balance impairments are among the main causes of falls in older adults. The feasibility and effectiveness of adding sensor-based feedback to physical therapy (PT) in an outpatient PT setting is unknown. We evaluated the feasibility and effectiveness of PT intervention combined with a therapist-assisted visual feedback system, called Mobility Rehab, (PT + MR) in older adults.MethodsTwenty-eight older adults with and without neurological diseases were assigned either PT + MR (n = 22) or PT alone (n = 6). Both groups performed 8 sessions (individualized) of 45 min long (30 min for gait training and 15 min for endurance, strength, and balance exercises) in an outpatient clinic. Mobility Rehab uses unobtrusive, inertial sensors on both wrists and feet, and at the sternum level with real-time algorithms to provide real-time feedback on five gait metrics (step duration, stride length, elevation at mid-swing, arm swing range-of-motion [ROM], and trunk coronal ROM), which are displayed on a tablet. The primary outcome was the Activities-specific Balance Confidence scale (ABC). The secondary outcome was gait speed measured with wearable inertial sensors during 2 min of walking.ResultsThere were no between-group differences at baseline for any variable (P > 0.05). Neither PT + MR nor PT alone showed significant changes on the ABC scores. PT + MR, but not PT alone, showed significant improvements in gait speed and arm swing ROM. The system was evaluated as ‘easy to use’ by the PT.ConclusionsOur preliminary results show that PT + MR improves gait speed in older adults with and without neurological diseases in an outpatient clinic.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT03869879.

Evidence accumulation rate moderates the relationship between enriched environment exposure and age-related response speed declines.

Older adults exposed to enriched environments (EE) maintain relatively higher levels of cognitive function, even in the face of compromised markers of brain health. Response speed (RS) is often used as a simple proxy to measure the preservation of global cognitive function in older adults. However, it is unknown which specific selection, decision, and/or motor processes provide the most specific indices of neurocognitive health. Here, using a simple decision task with electroencephalography (EEG), we found that the efficiency with which an individual accumulates sensory evidence was a critical determinant of the extent to which RS was preserved in older adults (63% female, 37% male). Moreover, the mitigating influence of EE on age-related RS declines was most pronounced when evidence accumulation rates were shallowest. These results suggest that the phenomenon of cognitive reserve, whereby high EE individuals can better tolerate suboptimal brain health to facilitate the preservation of cognitive function, is not just applicable to neuroanatomical indicators of brain ageing, but can be observed in markers of neurophysiology. Our results suggest that EEG metrics of evidence accumulation may index neurocognitive vulnerability of the ageing brain.SIGNIFICANCE STATEMENT:Response speed in older adults is closely linked with trajectories of cognitive ageing. Here, by recording brain activity while individuals perform a simple computer task, we identify a neural metric which is a critical determinant of response speed. Older adults exposed to greater cognitive and social stimulation throughout a lifetime could maintain faster responding, even when this neural metric was impaired. This work suggests EEG is a useful technique for interrogating how a lifetime of stimulation benefits brain health in ageing.

Balance beam crossing times are slower after noise exposure in rats.

The vestibular system integrates signals related to vision, head position, gravity, motion, and body position to provide stability during motion through the environment. Disruption in any of these systems can reduce agility and lead to changes in ability to safely navigate one's environment. Causes of vestibular decline are diverse; however, excessive noise exposure can lead to otolith organ dysfunction. Specifically, 120 decibel (dB) sound pressure level (SPL) 1.5 kHz-centered 3-octave band noise (1.5 kHz 3OBN) causes peripheral vestibular dysfunction in rats, measured by vestibular short-latency evoked potential (VsEP) and reduced calretinin-immunolabeling of calyx-only afferent terminals in the striolar region of the saccule. The present study examined the functional impact of this noise exposure condition, examining changes in motor performance after noise exposure with a balance beam crossing task. Balance beam crossing time in rats was assessed for 19 weeks before and 5 weeks after noise exposure. Balance beam crossings were scored to assess proficiency in the task. When animals were proficient, they received a single exposure to 120 dB SPL 3-octave band noise. During the initial training phase slower crossing times and higher scores, including multiple failures were observed. This was followed by a period of significant improvement leading to proficiency, characterized by fast and stable crossing times and consistently low scores. After noise exposure, crossing times were significantly elevated from baseline for 4-weeks. A total of 5 weeks after noise exposure, crossing times improved, and though still trending higher than baseline, they were no longer significantly different from baseline. These findings show that the noise-induced peripheral vestibular changes we previously observed at cellular and electro-physiological levels also have an impact at a functional level. It has been previously shown that imbalance is associated with slower walking speed in older adults and aged rats. These findings in noise-exposed rats may have implications for people who experience noisy environments and for seniors with a history of noise exposure who also experience balance disorders and may be at increased fall risk.

Determinants of Dual-task Gait Speed in Older Adults with and without Parkinson's Disease.

Mobility difficulties for people with Parkinson's disease (PwPD) are more pronounced when they perform a simultaneous cognitive task while walking. Although it is known that neurodegeneration results in widespread motor and brain impairments, few studies have comprehensively examined possible physical and mental determinants of dual task walking in PwPD. In this cross-sectional study, we aimed to investigate if and how muscle strength (sit-to-stand 30-sec test), cognition (mini-mental state examination) and functionality (timed up and go test) affect walking performance (10-meter walking test) with and without arithmetic dual task from older adults with and without Parkinson's disease. Walking speed was reduced by 16% and 11% with arithmetic dual task for PwPD (from 1.07±0.28 to 0.91±0.29 m.s-1, p<0.001) and older adults (from 1.32±0.28 to 1.16±0.26 m.s-1, p=0.002) compared to essential walking. The cognitive state was similar among the groups, but it was only associated with the dual-task walking speed in PwPD. In PwPD, lower limb strength was the better predictor of speed, whereas mobility was more related to it in older adults. Therefore, future exercise interventions aiming to improve walking in PwPD should consider these findings to maximize their effectiveness.

Investigating the efficacy of a tactile feedback system to increase the gait speed of older adults

The objective of this study was to determine (1) if a novel haptic feedback system could increase the walking speed of older adults while it is being employed during overground walking and (2) whether the frequency at which this feedback was presented would have a differential impact on the ability of users to change walking speed while it was present. Given that peak thigh extension has been found to be a biomechanical surrogate for stride length, and consequently gait speed, vibrotactile haptic feedback was provided to the participants' thighs as a cue to increase peak thigh extension while the effect on gait speed was monitored. Ten healthy community-dwelling older adults (68.4 ± 4.1 years) participated. Participants' peak thigh extension, cadence, normalized stride length and velocity, along with their coefficients of variation (COV) were compared across baseline normal and fast walking (with no feedback) and three different frequency of feedback conditions. The findings indicated that, compared to self-selected normal and fast walking speeds, peak thigh extension was significantly increased when feedback was present and after it was withdrawn in a post-test. An increase in thigh extension led to an increase in stride length and, consequently, an increase in stride velocity compared to normal speed. There were no significant differences in the gait parameters as a function of feedback frequency during its application. In conclusion, while present, the haptic feedback system increased thigh extension and walking speed in older adults regardless of the feedback frequency and when the feedback was withdrawn, participants could maintain an increase in those parameters.

Left and Right Cortical Activity Arising from Preferred Walking Speed in Older Adults.

Cortical activity and walking speed are known to decline with age and can lead to an increased risk of falls in the elderly. Despite age being a known contributor to this decline, individuals age at different rates. This study aimed to analyse left and right cortical activity changes in elderly adults regarding their walking speed. Cortical activation and gait data were obtained from 50 healthy older individuals. Participants were then grouped into a cluster based on their preferred walking speed (slow or fast). Analyses on the differences of cortical activation and gait parameters between groups were carried out. Within-subject analyses on left and right-hemispheric activation were also performed. Results showed that individuals with a slower preferred walking speed required a higher increase in cortical activity. Individuals in the fast cluster presented greater changes in cortical activation in the right hemisphere. This work demonstrates that categorizing older adults by age is not necessarily the most relevant method, and that cortical activity can be a good indicator of performance with respect to walking speed (linked to fall risk and frailty in the elderly). Future work may wish to explore how physical activity training influences cortical activation over time in the elderly.

Leg skeletal muscle mass asymmetry is independently associated with gait speed in older adults requiring long-term care.

Decreased gait speed in older adults has been associated with incident disability, cognitive impairment, institutionalization, falls, deterioration in level of care, and mortality. Gait speed has been reported to be related to leg asymmetry. However, the relationship between gait speed and leg skeletal muscle mass asymmetry in older adults requiring long-term care has not been clarified. In this study, we examined the association between gait speed and leg skeletal muscle mass asymmetry and the cutoff values of leg skeletal muscle mass asymmetry that may affect gait speed. The asymmetry index of leg skeletal muscle mass was measured in 230 older adults under the Japanese long-term care insurance system using bioelectrical impedance analysis. This cross-sectional study used multiple regression analysis and receiver operating characteristic (ROC) curve analysis to determine the relationship between gait speed and the asymmetry index of leg skeletal muscle mass. Multiple regression analysis revealed that the asymmetry index of leg skeletal muscle mass (β = -0.19, P = 0.002, R2 = 0.261) was independently and significantly associated with gait speed. Furthermore, ROC analysis showed that the cutoff value of the asymmetry index of leg skeletal muscle mass that identified reduced gait speed (<1.0 m/s) was 3.02% (Area under the curve = 0.62, sensitivity 47.3%, specificity 81.0%, P = 0.014). The asymmetry index of leg skeletal muscle mass was associated with gait speed in older adults requiring long-term care. Future assessment and interventions directed towards symmetry of leg skeletal muscle mass may help to improve gait speed in older adults. Geriatr Gerontol Int 2023; 23: 371-375.

Higher Movement-Evoked Pain Is Associated With Slower Walking Speed In Older Adults Undergoing Skilled Nursing Facility Rehabilitation

Higher Movement-Evoked Pain Is Associated With Slower Walking Speed In Older Adults Undergoing Skilled Nursing Facility Rehabilitation

Effect of gait training using rhythmic auditory stimulation on gait speed in older adults admitted to convalescent rehabilitation wards: A study protocol for a pilot randomized controlled clinical trial

BackgroundDecreased walking speed in older patients admitted to convalescent rehabilitation wards (CRWs) is one of the factors that inhibit home discharge. Therefore, interventions to improve gait speed in older patients admitted to CRWs are important, and rhythmic auditory stimulation (RAS) may be an effective intervention strategy. However, the effect of RAS on gait speed in older patients admitted to CRWs is not well known. Therefore, this study protocol aims to determine the feasibility of the RAS-based gait practice for older patients admitted to the CRW. MethodsThe study is designed as a single-center, open-label, pilot, randomized, parallel-group study. Participants will be 30 patients aged ≥65 years admitted to the CRW and randomly assigned to the experimental group (RAS-based gait practice; n = 15) or the control group (normal gait practice; n = 15). In both groups, interventions will be conducted for 30 min per session, 5 times per week for 3 weeks. The primary outcome is the change in the 10-m walk test 3 weeks after the baseline assessment. Secondary outcome is the change in the score of the Medical Outcome Study 8-Item Short-Form Health Survey and the Japanese version of the modified Gait Efficacy Scale from baseline assessment to 3 weeks later. DiscussionThis exploratory RCT was developed using strict scientific standards and is based on defined protocols. Thus, this study will be used to assess the viability of a larger investigation into RAS-based gait practice. If our theory is accurate, this study could serve as a foundation for establishing RAS-based gait practice in CRWs as a common rehabilitation strategy. Trial registrationThis study was registered in the University Hospital Medical Information Network (UMIN) clinical trials registry in Japan (UMIN000049089).

Diurnal pattern of breaks in sedentary time and the physical function of older adults

BackgroundThe association of breaks in sedentary time with outcomes of physical function can vary according to the time of day. We examined the association of the diurnal pattern of breaks in sedentary time with physical function outcomes in older adults.MethodsA cross-sectional analysis was conducted among 115 older adults (≥60 years). The overall and time-specific breaks (morning: 06:00–12:00; afternoon: 12:00–18:00; evening: 18:00–24:00) in sedentary time were assessed using a triaxial accelerometer (Actigraph GT3X+). A break in sedentary time was defined as at least 1 min where the accelerometer registered ≥100 cpm following a sedentary period. Five physical function outcomes were assessed: handgrip strength (dynamometer), balance ability (single leg stance), gait speed (11-m walking), basic functional mobility (time up and go), and lower-limb strength (five times sit-to-stand). Generalized linear models were used to examine the associations of the overall and time-specific breaks in sedentary time with the physical function outcomes.ResultsParticipants showed an average of 69.4 breaks in sedentary time during the day. Less frequent breaks in the evening (19.3) were found than that in the morning (24.3) and the afternoon (25.3) (p < 0.05). Breaks in sedentary time during the day were associated with less time on gait speed in older adults (exp (β) = 0.92, 95% confidence interval [CI] 0.86–0.98; p < 0.01). Time-specific analysis showed that breaks in sedentary time were associated with less time on gait speed (exp (β) = 0.94, 95% CI 0.91–0.97; p < 0.01), basic functional mobility (exp (β) = 0.93, 95% CI 0.89–0.97; p < 0.01), and lower-limb strength (exp (β) = 0.92, 95% CI 0.87–0.97; p < 0.01) in the evening only.ConclusionA break in sedentary time, particularly during the evening, was associated with better lower extremity strength in older adults. Further strategies to interrupt sedentary time with frequent breaks, with an emphasis on evening hours, can be helpful to maintain and improve physical function in older adults.

Abstract P305: Peripheral Neuropathy is Associated With Slow Gait Speed in Older Adults in the Atherosclerosis Risk in Communities Study

Introduction: Peripheral neuropathy (PN) (decreased sensation in the foot) is associated with falls and mortality. Small studies have found an association between slow gait speed and PN, primarily in adults with diabetes, but evidence is limited in adults without diabetes. Hypothesis: We hypothesized that PN is associated with slow gait speed in older adults. Methods: We performed a non-concurrent cross-sectional analysis of 360 participants in the Atherosclerosis Risk in Communities (ARIC) Study who completed standardized monofilament testing for PN at visit 6 (2016-2017) and Zeno Walkway mat-sensor gait testing at visit 8 (2019-2020). Gait speed was assessed categorically (normal (≥1.0m/s) or slow (&lt;1.0m/s)) and continuously. Logistic and linear regression were used to examine the association between PN and slow gait speed overall and stratified by diabetes status after adjusting for traditional risk factors. Results: The prevalence of PN was 32.2% (34% in adults with diabetes and 30% in adults without diabetes). Slow gait speed was observed in 53% of patients with PN compared to 40% of patients without PN (p=0.022). In adjusted models, PN was significantly associated with slow (categorical) and slower (continuous) gait speed in the overall sample, and these associations were particularly robust among adults without diabetes ( Table ). Conclusions: PN was associated with slow gait speed in a community-dwelling cohort of older adults. The specific association of PN and slow gait speed in persons without diabetes is novel. Despite a relatively small sample size, the difference between PN and non-PN participants’ continuous gait speeds exceeded the accepted threshold for clinically meaningful differences (generally &gt;0.05m/s). A better understanding of additional PN-specific gait changes may help elucidate mechanisms underlying the association of PN with slow gait, falls, and mortality.

Abstract P238: Gait Characteristics in Older Adults Using the Protokinetics Zeno Walkway: The Atherosclerosis Risk in Communities Study

Introduction: Slowed gait speed in older adults is associated higher vascular disease burden, greater risk of dementia, and falls. Gait mat measurement technology captures speed as well as additional gait parameters, with potential importance for better risk prediction and identification in older adults, but normative data are needed. We assessed correlations between mat-measured gait speed and gait parameters to identify potential targets for future gait research. We hypothesized that gait parameters would not correlate with overall mat-measured gait speed as strongly as overall gait speed correlates within repeat trials of mat or stopwatch-measured trials. Methods: Participants (n = 402, mean age: 81 years, 54% women, 19% Black race) from the Atherosclerosis Risk in Communities Study completed two consecutive usual pace walks on Zeno Walkway™ gait mats at visit 8. Two-hundred thirty-six participants additionally completed two 4-meter usual pace walks timed by stopwatch. We assessed validity using the difference between the faster of two trials each for mat- and stopwatch-measured gait speed using Bland-Altman plots, and Pearson’s correlations, and examined reliability with consecutive trials within measurement type. We reported mean, standard deviation, range, and correlation of 37 gait parameters with gait speed, as well as intra-person variability (coefficient of variation) and parameter asymmetry between footfalls. Results: Participants had an average gait speed of 0.92 m/sec (SD 0.19 m/sec) measured by mat and 0.99 m/sec (SD 0.21 m/sec) by stopwatch. Mat-measured gait speed was strongly correlated with stopwatch measured speed (Pearson’s Correlation 0.85). Mat-measured walks were on average 0.08 m/sec faster than paired stopwatch-measured walks (standard deviation of difference 0.11 m/sec, p&lt;0.001), regardless of gait speed. Consecutive mat walks had higher Pearson’s and R-squared correlations (0.95 and 0.90) than consecutive stopwatch walks (0.89 and 0.83). Of 37 gait parameters tested, 9 were positively correlated (Pearson’s correlations 0.64 to 0.76) and 7 were negatively correlated (Pearson’s correlations -0.64 to -0.42) with gait speed. Parameter variability in single stance center of pressure distance and gait speed was moderately negatively correlated (Pearson’s correlation -0.50). Correlations between gait speed and gait parameter asymmetry were low (&lt;|0.33|). Conclusions: Gait mat technology shows high reliability and high correlation with stop-watch measurement in older adults in the ARIC population. Additional gait parameters were largely not strongly correlated with gait speed, including step-to-step measures of variability and asymmetry, suggesting avenues for future research to evaluate gait differences more granularly as more sensitive indicators of health risk in older adults.

Rationale and design of an ancillary study evaluating the effects of the cocoa flavanol and/or multivitamin interventions on falls and physical performance outcomes in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS)

BackgroundFalls and decreased physical function increase markedly with age and result in injury, hospitalization, and premature death. Emerging studies show potential benefits of supplemental cocoa extract on physical performance, including grip strength and walking speed in older adults. However, there are no large, long-term randomized controlled trials of effects of supplemental cocoa extract on falls, muscle performance, and/or fall-related injuries. MethodsThe COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a double-blind, placebo-controlled, 2 × 2 factorial trial investigating effects of supplementation with cocoa extract (500 mg/d, including 80 mg (−)-epicatechin) and/or a multivitamin on prevention of cardiovascular disease and cancer in 21,442 women (≥65 years) and men (≥60 years). COSMOS: Effects on Falls and Physical Performance is an ancillary study to COSMOS that will clarify effects of cocoa extract and/or multivitamin supplementation on falls, physical performance, and incident fracture outcomes in older adults. Injurious fall(s) resulting in healthcare utilization and recurrent falls were regularly assessed by follow-up questionnaires in the overall cohort. Incident fractures were also assessed by annual questionnaires. Circumstances surrounding falls and any fall-related injuries will be confirmed by medical record review. Effects of the interventions on 2-year changes in physical performance measures (grip strength, walking speed, and the Short Physical Performance Battery) will be tested in a clinic sub-cohort (n = 603). ConclusionResults from this ancillary study will determine whether supplemental cocoa extract slows age-related declines in physical performance and decrease injurious and recurrent falls and fall-related injuries and fractures that are major public health problems in older adults.

Bridging the Gap between Research and the Community: Implementing Physical and Cognitive Interventions to Improve Spontaneous Walking Speed in Older Adults.

The application of interventions to enhance mobility in ecological settings remain understudied. This study was developed to evaluate the feasibility of training methods in a community centre and to evaluate their impact on mobility outcomes. Fifty-four participants were randomized to one of three 12-week training programs (three times/week): aerobic (AE), gross motor abilities (GMA) or cognitive (COG). Feasibility was evaluated by calculating adherence, feedback from participants and long-term participation. The impact of these interventions on mobility was assessed by comparing pre- and post-program on Timed-up-and-go (TUG) and spontaneous walking speed (SWS) performances. Results showed relatively high rates of adherence (85.1%) and long-term participation (66.7%), along with favorable feedbacks. SWS significantly improved in COG (0.10 ± 0.11 m.s-1; p = 0.004) and AE (0.06 ± 0.11 m.s-1; p = 0.017) groups, and TUG performance was maintained in all groups. Results of this feasibility study demonstrated successful implementation of physical and cognitive training programs, encouraging the development of real-world applications.

LIPIDOMIC ANALYSIS OF GAIT SPEED IN THE LONG LIFE FAMILY STUDY

Abstract Gait speed is a predictor of overall health and mortality in older adults. Metabolomics may provide insights into biological mechanisms underlying gait speed. Herein, we examined the association between 193 lipid metabolites with gait speed in 1,717 adults (52.1% women) aged 82.0 ± 14.5. Lipidomic analysis was performed using liquid chromatography-mass spectrometry. Gait speed was measured over 4-meters and slowness was defined as &amp;lt;0.8m/s. Logistic regression, adjusted for age, sex, field center, height, fasting-duration and familial-relatedness, were used to examine the association between log-transformed metabolites with slowness. A false discovery rate (FDR) of p&amp;lt;0.05 was employed to account for multiple comparisons. Gait speed was 0.83 ± 0.32 and 53.4% had slowness. Three lipid metabolites were significantly associated with lower odds of slowness: an acylcarnitine, sphingomyelin and a ceramide non-hydroxy fatty acid-sphingosine. Our results potentially link lipids involved with mitochondrial beta-oxidation and nerve signal transduction to gait speed in older adults.

Is handgrip strength a useful tool to detect slow walking speed in older Indian adults: A cross-sectional study among geriatric outpatients in a tertiary care hospital in South India.

To determine whether handgrip strength can be used as a proxy for detecting slow walking speed in older adults. Measuring walking speed in older adults can be challenging as cognitive and functional decline may have a significant impact on test performance. Hundred subjects aged >/= 60 were recruited. Slow walking speed was defined as walking speed <1.0 m/s. Handgrip strength was measured using handheld dynamometer. Multiple linear regression analysis was used to determine the relationship between the two. The mean age of the study participants was 67.8±6.2 years. There were 63 males and 37 females. The mean handgrip strength of the participants was 23±5.9 kgs. Older subjects had slow gait speed (r=-0.40, p<0.001) while patients with higher BMI (r=0.36, p<0.001), handgrip strength (r=0.72, p<0.001) and appendicular lean mass (r=0.53, p<0.001) had normal gait speed. On multiple linear regression analysis, only handgrip strength (OR 0.71; 95% CI 0.58-0.87, p=0.001) and nutritional status (OR 8.60; 95% CI 1.98 - 37.40, p=0.004) were found to have a significant association with walking speed. Our study shows that handgrip strength assessment can be used as a surrogate indicator for detecting slow walking speed. Large population studies are warranted to examine its validity.

Peripheral inflammation and cognition in older adults with and without cognitive impairment

AbstractBackgroundUnderstanding how different inflammatory markers relate to cognition is important for the development of therapeutic targets in Alzheimer’s disease (AD). However, many studies have relied on a single, broad measure of inflammation or a select handful of markers that have been identified in the AD literature. We examined a large set of plasma inflammatory markers that were statistically grouped via principal component analysis (PCA). Associations between inflammation component scores and cognition were examined.MethodParticipants included 41 cognitively normal (CN) and 64 cognitively impaired (CI; 47 mild cognitive impairment and 17 AD) older adults from the Center for Neurodegeneration and Translational Neuroscience. Composite scores for memory, executive functioning, processing speed, and language were created by averaging age‐adjusted z scores for two tests per domain. Plasma levels of inflammatory cytokines were measured using the Luminex platform and Biorad 48‐plex cytokine assay. Five markers with null values were excluded, and the remaining markers were included in a PCA. Relationships between the inflammation component scores and cognition were examined using linear regression models with inflammatory marker as the predictor and each cognitive composite separately as the dependent variable, with adjustment for education, sex, and clinical diagnosis (CN vs CI).ResultThe PCA produced a 7‐component solution that accounted for 75% of the variance. In the final models, Components 2 (β = 0.260, p = 0.020) and 4 (β = 0.235, p = 0.036) were positively associated with memory, Components 2 (β = 0.231, p = 0.052), 4 (β = 0.260, p = 0.031), and 6 (β = 0.280, p = 0.016) were positively associated with executive functioning, and Components 2 (β = 0.221, p = 0.032) and 4 (β = 0.283, p = 0.007) were positively associated with processing speed. Inflammatory components were not significantly related to language.ConclusionHigher levels of peripheral inflammatory cytokines were associated with better memory, executive functioning, and processing speed in older adults, even when accounting for clinical diagnosis. Acute elevations of certain inflammatory markers may be associated with a protective role in cognitive aging. Longitudinal research examining stability of cytokine levels and association with cognition in AD trajectories is needed.

The effects of walking training with poles on walking ability: A systematic review and meta-analysis of randomized controlled trials.

The purpose of this study was to consolidate the level of evidence for the effects of walking training with poles (pole walking; PW) on walking ability using a systematic review and meta-analysis. TYPE: Systematic review and meta-analysis. Databases including PubMed, Cochrane Library, Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature databases, and Igaku Chuo Zasshi were searched on June 20, 2021. Data from randomized controlled trials (RCTs) comparing the effects of PW with walking without poles and/or other exercise interventions in disease-specific and aging populations were collected. Data on walking speed, functional mobility, and walking endurance were collected for the meta-analyses. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated from postintervention means and standard deviations. The PEDro scale was used for assessing the risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the quality of evidence. This study included 13 RCTs comprising 750 participants; of these, six RCTs were included in the meta-analysis. The results showed that moderate-quality evidence supports the positive effects of PW on walking speed in patients with Parkinson disease (walking speed: SMD=0.42, 95% CI=0.04-0.80). In contrast, PW did not significantly improve functional mobility in patients with Parkinson disease and walking speed in older adults. There was moderate-quality evidence that PW improved walking speed in patients with Parkinson disease.

The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation Analysis.

Simple SummaryAging is associated with vulnerability in terms of a natural decline of most physiological systems, and, consequently, physical function (PF) performance (e.g., cardiorespiratory performance, muscle strength, flexibility, speed, balance) decreases. Adequate physical activity (PA) levels are essential to maintaining or increasing PF performance, directly influencing gait speed (GS). Having a fast GS increases the older adult’s capacity to perform daily tasks safely and remain autonomous at an advanced age. Our study aimed to explore the mediating role of PF in the relationship between PA and GS in a large sample of older adults from the north of Brazil. Regarding the PA-total level, the analysis showed that a fast GS was partially mediated by approximately 19% by a better PF performance. PF partially mediated the association between PA-sport and GS in approximately 9%, and PF partially mediated the association between PA-leisure and GS in 46%. We observed a significant and negative association between PA-housework and GS. Thus, PF partially mediated the association in about 9% of cases. Consequently, our study suggests that among older adults, PF plays a crucial role in mediating the association between PA and GS levels in the vulnerable aging population.Adequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project “Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas” (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.

Associations between Air Pollution and Gait Speed in Older Adults

Associations between Air Pollution and Gait Speed in Older Adults