Usual Walk Research Articles

A Voice-Activated Device Exercise and Social Engagement Program for Older Adult-Care Partner Dyads: Pilot Clinical Trial and Focus Group Study Evaluating the Feasibility, Use, and Estimated Functional Impact of EngAGE.

Maintaining exercise is essential for healthy aging but difficult to sustain. EngAGE is a socially motivated exercise program delivered over a voice-activated device that targets older adult-care partner dyads. This 10-week pilot study aimed to assess EngAGE feasibility and use, obtain user experience feedback, and estimate potential impact on function. In total, 10 older adults aged ≥65 years were recruited from an independent living residence together with their self-identified care partners. EngAGE delivered National Institute on Aging Go4Life exercises to older adults daily, while care partners received progress reports and prompts to send encouraging messages that were read aloud by the device to the older adult. Older adults' use was tracked, and physical function was assessed at baseline and follow-up. Follow-up focus group data provided qualitative feedback. On average, participants completed 393.7 individual exercises over the 10-week intervention period or 39.4 exercises/wk (range 48-492, median 431, IQR 384-481, SD 112.4) without injury and used EngAGE on an average of 41 of 70 days or 4.1 d/wk (range 7-66, median 51, IQR 23-56, and SD 21.2 days). Mean grip strength increased nonsignificantly by 1.3 kg (preintervention mean 26.3 kg, SD 11.0; postintervention mean 27.6 kg, SD 11.6; P=.34), and 4 of 10 participants improved by a minimal clinically important difference (MCID) of 2.5 kg. Further, the time for 5-repeated chair stands significantly reduced by 2.3 seconds (preintervention mean 12, SD 3.6 s; postintervention mean 9.7, SD 2.7 s; P=.02), and 3 of 9 participants improved by an MCID of -2.3 seconds. Furthermore, 3-meter usual walk performance was brisk at baseline (mean 2.1, SD 0.4 s) and decreased by 0.1 seconds (postintervention 2, SD 0.4 s; P=.13), although 5 of 9 participants improved by a MCID of 0.05 m/s. Qualitative results showed perceived benefits, favored program features, and areas for improvement. We present a pilot study of a new voice-activated device application customized to older adult users that may serve as a guide to other technology development for older adults. Our pilot study served to further refine the application and to inform a larger trial testing EngAGE's impact on functional outcomes, a necessary step for developing evidence-based technology tools.

Prehabilitative versus rehabilitative exercise in prostate cancer patients undergoing prostatectomy

PurposeThe study compared the efficacy of commencing supervised exercise in men with prostate cancer before and after prostatectomy on objective and patient-reported outcomes, hospital length of stay, and urinary incontinence.MethodsForty-one men were randomised to a 6-week prehabilitation or rehabilitation exercise programme. Prehabilitation involved resistance and aerobic exercise thrice weekly pre-surgery, while rehabilitation comprised the same commencing 6-weeks post-surgery. Assessments included strength, function (chair rise, stair climb, 400-m, 6-m usual, fast, and backwards walk), body composition, fatigue and quality of life, undertaken at pre-surgery, early post-surgery and late post-surgery phase, with urinary incontinence (24-h pad test) assessed at 2, 6, and 12-weeks post-surgery. Intention-to-treat and sensitivity analyses were undertaken.ResultsOf thirty-eight men (48–73 years), 29 completed all assessments with most undergoing robotic-assisted laparoscopic prostatectomy (92.1%). In the pre-surgery phase, prehabilitation improved muscle strength (leg press: 17.2 kg; chest press: 2.9 kg; p ≤ 0.001), 400-m, chair rise, 6-m fast and backward walk tests (p ≤ 0.001–0.028). Strength and function declines in the early post-surgery phase were maintained late post-surgery. Rehabilitation showed declines of these outcomes after surgery with improvement late post-surgery (leg press: 14.6 kg, p < 0.001; chest press: 6.8 kg, p < 0.001; 400-m walk: -12.0 s, p = 0.005), resulting in no difference between groups at 12 weeks. There were no significant differences between groups for patient-reported outcomes, hospital length of stay or urinary incontinence.ConclusionPre-surgical exercise enhanced strength and function, protecting against post-surgery declines. Although exercise post-surgery is beneficial for recouping strength and function, where possible men undergoing prostatectomy are encouraged to exercise pre-surgery.Trial registrationACTRN12617001115325 registered 31 July 2017.

Relating depression, anxiety, stress and loneliness to 5-year decline in physical function and frailty

ObjectivesWhile depression has been associated with physical function decline and worsening frailty in older adults, the impact of other mental health symptoms on physical function and frailty is unknown. The study objective was to determine whether depression, perceived stress, loneliness, and anxiety symptoms affect 5-year physical function and frailty trajectories of older adults. MethodsThe National Social Life, Health, and Aging Project (NSHAP) is a nationally-representative study of adults born between 1920 and 1947. The analysis included data collected in 2010–11 and 2015–16. Mental health symptoms were quantified using NSHAP's measures of anxiety (range:0–21), perceived stress (0–8), depression (0–22), and loneliness (0–6); higher scores indicated worse symptoms. We regressed 2015–16 3 m usual walk time, five-repeated chair stand time or an adapted frailty phenotype scale (0–4) separately on each 2010–11 mental health scale, adjusting for baseline physical function or frailty, demographics, and comorbidities. ResultsIn separate models, every one-point increase on the depression or perceived stress scales was associated with, respectively, a 0.06 s slower (95 % CI: 0.03, 0.10) or 0.09 s slower (95 % CI: 0.01, 0.16) 5-year walk time. Every one-point increase on the depression or perceived stress scales was associated with a 0.15 s slower (95 % CI: 0.06, 0.23) or 0.16 s slower (95 % CI: 0.02, 0.29) 5-year chair stand time. Every one-point increase on the depression scale predicted 0.06 higher log odds of having a worse frailty score 5 years later. Only depression's association with 3 m walk time and chair stands remained significant in models including all four mental health scales. DiscussionOlder adults with more depression and to a lesser extent stress symptoms may experience faster physical function decline and worsening frailty. Future work exploring and addressing the mechanisms underlying these relationships are warranted.

Impact of balance on the energetic cost of walking and gait speed.

Examine the relationship between balance test performance and the energetic cost of walking (ECW) and gait speed. Cross-sectional and longitudinal analyses of data from the Baltimore Longitudinal Study of Aging. Men (48%) and women aged 60-96 years enrolled in the BLSA between 2007 and 2020 (n = 1132). Balance was assessed using narrow walk (NW) and progressive standing balance tests (SB). ECW measured during 2.5-min usual paced walk while participants wore a portable indirect calorimeter. Gait speed assessed over 6-m. Each test parameterized using validated methods. Statistical analysis to compare balance measures to ECW, and gait speed used generalized logistic regression models and adjustments for age, sex, race, height, weight, and comorbidities. Cross-sectionally, mean ECW was higher and gait speed slower in persons who failed the NW than those who passed (0.189 vs. 0.164 mL/kg/m, p < 0.0001 and 0.96 vs. 1.15 m/s, p < 0.0001, respectively). Mean ECW was increasingly higher and gait speed slower over three progressively challenging SB tests (0.207 vs. 0.171 vs. 0.164 mL/kg/m, p < 0.0001 and 0.95 vs. 1.05 vs. 1.15 m/s, p < 0.0001). Over an average 2.4 years, those who declined in SB and NW had a higher ECW and slower gait speed than persons who maintained performance (SB: 0.18 vs. 0.160 mL/kg/m, p = 0.0003, and 1.00 vs. 1.13 m/s, p = <0.001; NW: 0.175 vs. 0.160 mL/kg/m, p = 0.002, and 1.04 vs. 1.14 m/s, p = 0.001). Persons who improved had lower ECW and faster gait speed than those who failed at both visits (SB: 0.169 vs. 0.240 mL/kg/m, p = 0.0002, and 0.99 vs. 0.94 m/s, p = 0.67, NW: 0.163 vs. 0.195 mL/kg/m, p = 0.0005, and 1.10 vs. 0.92 m/s, p < 0.001). Instability contributes to higher ECW and slower gait speed which suggests that rehabilitation efforts to improve balance may help maintain function further into older adulthood and delay mobility limitation.

Electrocortical Dynamics of Usual Walking and the Planning to Step over Obstacles in Parkinson's Disease.

The neural correlates of locomotion impairments observed in people with Parkinson's disease (PD) are not fully understood. We investigated whether people with PD present distinct brain electrocortical activity during usual walking and the approach phase of obstacle avoidance when compared to healthy individuals. Fifteen people with PD and fourteen older adults walked overground in two conditions: usual walking and obstacle crossing. Scalp electroencephalography (EEG) was recorded using a mobile 64-channel EEG system. Independent components were clustered using a k-means clustering algorithm. Outcome measures included absolute power in several frequency bands and alpha/beta ratio. During the usual walk, people with PD presented a greater alpha/beta ratio in the left sensorimotor cortex than healthy individuals. While approaching obstacles, both groups reduced alpha and beta power in the premotor and right sensorimotor cortices (balance demand) and increased gamma power in the primary visual cortex (visual demand). Only people with PD reduced alpha power and alpha/beta ratio in the left sensorimotor cortex when approaching obstacles. These findings suggest that PD affects the cortical control of usual walking, leading to a greater proportion of low-frequency (alpha) neuronal firing in the sensorimotor cortex. Moreover, the planning for obstacle avoidance changes the electrocortical dynamics associated with increased balance and visual demands. People with PD rely on increased sensorimotor integration to modulate locomotion.

Quantifying the benefits of inefficient walking: Monty Python inspired laboratory based experimental study

ObjectiveTo compare the rate of energy expenditure of low efficiency walking with high efficiency walking.DesignLaboratory based experimental study.SettingUnited States.Participants13 healthy adults (six women, seven men) with no known gait disorder,...

PRELIMINARY SOMMA DATA: D3CR MUSCLE MASS AND STRENGTH AND WALKING SPEED IN OLDER MEN AND WOMEN

Abstract D3Cr muscle mass, grip strength, leg extension 1-rm max (Keiser), and walking speed (400m usual walk) were collected with standardized protocols. We calculated sex-stratified unadjusted Pearson correlation coefficients, and partial Pearson correlation coefficient adjusted for body size (height, weight). D3Cr muscle mass was positively correlated with grip strength (men: unadjusted r=0.28, p&amp;lt;.001; women: unadjusted r=0.16, p=0.02) and leg extension strength (men: unadjusted r=0.44, p&amp;lt;.001; women: unadjusted r=0.31, p&amp;lt;.001). D3Cr muscle mass was correlated with 400-m walk speed only after adjustment for body size among both men (partial r=0.29, p&amp;lt;.001) and women (partial r=0.16, p=0.02). Associations of total thigh muscle volume by MRI with strength and walking speed were of similar magnitude to the association between D3Cr muscle mass with strength and walking speed.

Evaluating the difference in walk patterns among normal-weight and overweight/obese individuals in real-world surfaces using statistical analysis and deep learning methods with inertial measurement unit data.

Unusual walk patterns may increase individuals' risks of falling. Anthropometric features of the human body, such as the body mass index (BMI), influences the walk patterns of individuals. In addition to the BMI, uneven walking surfaces may cause variations in the usual walk patterns of an individual that will potentially increase the individual's risk of falling. The objective of this study was to statistically evaluate the variations in the walk patterns of individuals belonging to two BMI groups across a wide range of walking surfaces and to investigate whether a deep learning method could classify the BMI-specific walk patterns with similar variations. Data collected by wearable inertial measurement unit (IMU) sensors attached to individuals with two different BMI were collected while walking on real-world surfaces. In addition to traditional statistical analysis tools, an advanced deep learning-based neural network was used to evaluate and classify the BMI-specific walk patterns. The walk patterns of overweight/obese individuals showed a greater correlation with the corresponding walking surfaces than the normal-weight population. The results were supported by the deep learning method, which was able to classify the walk patterns of overweight/obese (94.8 ± 4.5%) individuals more accurately than those of normal-weight (59.4 ± 23.7%) individuals. The results suggest that application of the deep learning method is more suitable for recognizing the walk patterns of overweight/obese population than those of normal-weight individuals. The findings from the study will potentially inform healthcare applications, including artificial intelligence-based fall assessment systems for minimizing the risk of fall-related incidents among overweight and obese individuals.

Association between the risk of malnutrition and functional capacity in patients with peripheral arterial disease: A cross-sectional study.

The risk of malnutrition is an important predictor of functional capacity in the elderly population. However, whether malnutrition is associated with functional capacity in patients with peripheral artery disease (PAD) is poorly known. To analyse the association between the risk of malnutrition and functional capacity in patients with PAD. This cross-sectional study included 135 patients with PAD of both genders, ≥50 years old, with symptomatic PAD (Rutherford stage I to III) in one or both limbs and with ankle-brachial index ≤0.90. The risk of malnutrition was assessed by the short form of the Mini Nutritional Assessment-Short Form and patients were classified as having normal nutritional status (n = 92) and at risk of malnutrition (n = 43). Functional capacity was objectively assessed using the six-minute walking test (6MWT, absolute maximal distance and relativized and expressed as a percentage of health subjects), short-physical performance battery (SPPB, balance, gait speed and the sit and stand test) and the handgrip test, and subjectively, using the Walking Impairment Questionnaire and Walking Estimated-Limitation Calculated by History. The association between the risk of malnutrition and functional capacity was analysed using bivariate and multivariate logistic regression adjustments for gender, age, ankle-brachial index, body mass index, use of statins, coronary arterial disease and stroke. For all statistical analyses, significance was accepted at p<0.05. Thirty-two per cent of our patients were classified with a risk of malnutrition. The risk of malnutrition was associated with the absolute 6MWT total distance (OR = 0.994, P = 0.031) relative 6MWT total distance (OR = 0.971, P = 0.038), lowest SPPB total score (OR = 0.682, P = 0.011), sit and stand (OR = 1.173, P = 0.003) and usual 4-meter walk test (OR = 1.757, P = 0.034). In patients with PAD, the risk of malnutrition was associated with objective measurements of functional capacity.

Empirical Analysis of the Hugh Gray 'Nessie' Photograph

The first photograph said to be of the Loch Ness Monster was taken on 12th November 1933 around noon by a local man by the name of Hugh Gray. I say "Loch Ness Monster" because I believe the photograph to be genuine and part of the evidence portfolio. The picture that generally circulates is shown below. The Scottish Daily Record took his picture and Mr. Gray gave the following account to them having been interviewed by Hugh Mackenzie (the future Provost of Inverness), Peter Munro representing Hugh Gray's employers at the British Aluminium Company and a Daily Record staff member:&#x0D; Four Sundays ago, after church I went for my usual walk near where the river enters the Loch. The Loch was like a mill pond and the sun shining brightly. An object of considerable dimensions rose out of the water not very far from where I was. I immediately got my camera ready and snapped the object which was two or three feet above the surface of the water. I did not see any head, for what I took to be the front parts were under the water, but there was considerable movement from what seemed to be the tail, the part furthest from me. The object only appeared for a few minutes then sank out of sight.&#x0D; A contemporary picture of Hugh Gray was printed later which I don't think flatters him much but is shown below to show you the man behind the monster.&#x0D; The tenor of the account suggests some throwing up of spray and water as the presumed tail beat about the waters and hence caused some blurriness around that region of the picture. Mackenzie described Gray as a man highly respected by his fellow workmen, employers and locals. Likewise, the Daily Record had the negative examined by four experts who deemed it as untampered. It caused a stir, was panned by zoologists and faded along with general Nessie-lore as the World entered war six years later. Twenty-two years on, Nessie author, Constance Whyte, visited Hugh Gray in May 1955 who was sticking to his story and still had vivid memories of that day plus he also recounted five other times he claimed to have seen the monster over those decades. Renowned monster hunter, Tim Dinsdale, also recounts how he visited Gray in April 1960 and described him as "a most courteous individual" as he took him to the spot of the sighting[4]. He spoke with "complete conviction" about that day as well as maintaining an accuracy of his account. He also added some detail of his other sightings which partly consisted of rapidly moving bow waves with no visible cause. What remains of the photograph today is uncertain.

Swarm Crawler Robots Using Lévy Flight for Targets Exploration in Large Environments

This study tackles the task of swarm robotics, where robots explore the environment to detect targets. When a robot detects a target, the robot must be connected with a base station via intermediate relay robots for wireless communication. Our previous results confirmed that Lévy flight outperformed the usual random walk for exploration strategy in an indoor environment. This paper investigated the search performance of swarm crawler robots with Lévy flight on target detection problems in large environments through a series of real robots’ experiments. The results suggest that the swarm crawler robots with Lévy flight succeeded in the target’s discovery in the indoor environment with a 100% success rate, and were able to find several targets in a given time in the outdoor environment. Thus, we confirmed that target exploration in a large environment would be possible by crawler robots with Lévy flight and significant variances in the detection rate among the positions to detect the outdoor environment’s target.

Challenging the Vestibular System Affects Gait Speed and Cognitive Workload in Chronic Mild Traumatic Brain Injury and Healthy Adults.

People with persistent symptoms after mild traumatic brain injury (mTBI) report imbalance during walking with head movements. The purpose of this study was (1) to compare usual walk gait speed to walking with head turns (HT) between people with mTBI and controls, (2) to compare the cognitive workload from usual walk to HT walk between groups, and (3) to examine if gaze stability deficits and mTBI symptoms influence gait speed. Twenty-three individuals (mean age 55.7 ± 9.3 years) with persistent symptoms after mTBI (between 3 months to 2 years post-injury) were compared with 23 age and sex-matched controls. Participants walked a 12-inch wide, 60-foot walkway when looking ahead and when walking with HT to identify letters and their colors. Gait speed during usual walk and HT walk were calculated. Pupillary responses during both walks were converted to the Index of Cognitive Activity (ICA) as a measure of cognitive workload. Gaze stability was examined by the dynamic visual acuity (DVA) test in the yaw plane. The post-concussion symptom scale (PCSS) was used to collect symptom severity. Within group analysis showed that gait speed was lower during HT walk compared to usual walk in the people with mTBI (p < 0.001) as well as in controls (p < 0.001). ICA was higher with HT compared to usual walk in the mTBI group in the right eye (p = 0.01) and left eye (p = 0.001), and in controls in the right eye (p = 0.01) and left eye (p = 0.01). Participants in the mTBI group had slower usual (p < 0.001), and HT gait speed (p < 0.001) compared to controls. No differences were noted in ICA in the right or left eye during usual walk and HT walk between groups (p > 0.05). DVA loss in the yaw plane to the right and left was not different between groups (p > 0.05) and were not correlated with gait speed. PCSS scores were correlated with usual walk (r = −0.50, p < 0.001) and HT gait speed (r = −0.44, p = 0.002). Slower gait speed, poorer stability, and higher cognitive workload during walking with head turns may reduce community participation in people with mTBI and persistent symptoms.

Challenging the Vestibular System Results in Slower Gait Speed in People With Persistent Symptoms After Mild Traumatic Brain Injury

<h3>Research Objectives</h3> People with persistent symptoms after mild traumatic brain injury (mTBI) often complain of imbalance when walking with head turns, an activity that challenges the vestibular system. The purpose of this study was 1) to compare gait speed during usual walk and during walking with head turns (HT) between people with mTBI and controls, 2) and to compare the cognitive workload during usual walk and during HT walk between people with mTBI and controls. <h3>Participants</h3> Twenty-three individuals (mean age 55.7 ± 9.3 years) with persistent symptoms after mTBI, who were between 3 months to 2 years post-injury and 23 age and sex-matched controls. <h3>Interventions</h3> Gait speed was recorded while walking a 12-inch wide, 60-foot walkway, during walking when looking ahead and when walking with HT to identify letters and their colors that were placed every 5 feet on the wall. <h3>Main Outcome Measures</h3> Gait speed during usual walk, HT walk, and the dual-task cost for gait speed were calculated. The number of steps outside the path during both walks and number of missed letters were collected. Pupillary responses during both walks were collected by the TOBII® eye tracker and the Index of Cognitive Activity (ICA) was calculated using EyeWorks™ software. The Post-Concussion Symptom Scale (PCSS) was used to collect symptom severity. <h3>Results</h3> Participants in the mTBI group had slower usual gait speed (p<0.001), and slower HT gait speed (p<0.001) compared to controls, however, the dual task cost for gait speed was not different between groups (p=0.88). More people with mTBI took steps off the path during usual walk and during HT walking compared to control subjects. No differences were noted between groups in ICA in the right or left eye for usual walk or HT walk, or the DTC for ICA. Within group analysis showed that gait speed was lower during HT walk compared to usual walk in the people with mTBI (p<0.001) as well as in controls (p<0.001). Average ICA was higher with HT compared to usual walk in the mTBI group in the right eye (p=0.01) and left eye (p=0.001), and in controls in the right eye (p=0.01) and left eye (p=0.01). <h3>Conclusions</h3> People with persistent symptoms after mTBI have slower usual gait speed which is further reduced when they must move their head to scan for objects. The cognitive workload increased with a dual task compared to a single task, however, the dual-task cost for gait speed and cognitive workload were similar between groups, showing that both groups responded in a similar manner to dual tasking. <h3>Clinical Relevance</h3> Walking with head turns to identify objects in our surroundings, at home, in the grocery store are part of daily life. Increased time required, poorer stability, and higher mental effort required to walk with head turns may reduce community participation in people with mTBI and persistent symptoms.

A randomized, controlled trial of group exercise training for fall prevention and functional improvements during and after treatment for prostate cancer.

TPS193 Background: Many prostate cancer survivors are treated with androgen deprivation therapy (ADT), but these therapies may increase frailty, worsen physical functioning, and increase fall risk. While exercise may counter functional declines associated with ADT, no studies have tested whether and which type of exercise may reduce falls and frailty. The purpose of this trial is to compare the relative efficacy of strength training versus tai ji quan training against each other and to a stretching control group on falls, frailty and physical functioning in men expose to ADT for prostate cancer. Methods: Prostate cancer survivors treated with ADT (n = 360) will be recruited to participate in this single-blind, parallel group, randomized trial. To be eligible men must meet the following criteria: 1) histologically confirmed prostate cancer, 2) received at least 6 months of ADT within the past 10 years, 3) report &gt;1 fall in the past year OR have a score on one of two physical performance tests that is associated with increased fall risk (i.e. ≥ 12.0 seconds to complete the 3 meter timed up and go (TUG), or ≥ 10.0 seconds to complete 5 chair stands), 4) completed any other treatment at least 6 weeks prior to enrollment and not be on any concurrent prostate cancer therapy besides ADT, 5) not currently participating in moderate-vigorous intensity lower-body strength training or tai ji quan training ≥ 2 times/week for ≥ 30 minutes per session, 6) no cognitive difficulties that limit ability to answer survey questions or participate in exercise classes and performance tests, 7) no medical condition, disorder, or take medication that contraindicates participation in moderate intensity exercise, and 8) are able to communicate in English. Participants will be randomized to one of three supervised, group training programs: i) strength training, ii) tai ji quan training, or iii) stretching (control), that train 3x/week for 6 months. Outcomes are assessed at baseline, 3 (mid-intervention), 6 (immediately post-intervention) and 12 (follow-up) months. The primary outcome is falls assessed by monthly self-report. Secondary outcomes include the following: Frailty (low lean body mass (by bioelectrical impedance analysis), exhaustion (by SF-36 vitality scale), low activity (by CHAMPS physical activity survey), slowness (by 4m usual walk speed), and weakness (by chair stand time)); Objective and subjective measures of physical function will also be collected. Negative binomial regression models will be used to assess differences in falls between groups, while mixed-effects modeling will be used to compare the relative efficacy of training group on secondary outcomes. Registered November 18, 2018. Clinical trial information: NCT03741335.

Evaluation of a blood-based geroscience biomarker index in a randomized trial of caloric restriction and exercise in older adults with heart failure with preserved ejection fraction.

Intermediate endpoints are needed to evaluate the effect of interventions targeting the biology of aging in clinical trials. A working group identified five blood-based biomarkers that may serve such a purpose as an integrated index. We evaluated the responsiveness of the panel to caloric restriction or aerobic exercise in the context of a randomized clinical trial conducted in patients with heart failure with preserved ejection fraction (HFpEF) with obese phenotype who were predominantly female. Obese HFpEF is highly prevalent in women, and is a geriatric syndrome whose disease pathology is driven by non-cardiac factors and shared drivers of aging. We measured serum Interleukin-6, TNF-α-receptor-I, growth differentiating factor-15, cystatin C, and N-terminal pro-b-type natriuretic peptide at baseline and after 20weeks in older participants with stable obese HFpEF participating in a randomized, controlled, 2 × 2 factorial trial of caloric restriction and/or aerobic exercise. We calculated a composite biomarker index, summing baseline quintile scores for each biomarker, and analyzed the effect of the interventions on the index and individual biomarkers and their associations with changes in physical performance. This post hoc analysis included 88 randomized participants (71 women [81%]). The mean ± SD age was 66.6 ± 5.3years, and body mass index (BMI) was 39.3 ± 6.3kg/m2. Using mixed models, mean values of the biomarker index improved over 20weeks with caloric restriction (- 0.82 [Formula: see text] 0.58 points, p = 0.05), but not with exercise (- 0.28 [Formula: see text] 0.59 points, p = [Formula: see text]), with no evidence of an interaction effect of CR [Formula: see text] EX [Formula: see text] time (p = 0.80) with adjustment for age, gender, and BMI. At baseline, the biomarker index was inversely correlated with 6-min walk distance, scores on the short physical performance battery, treadmill test peak workload and exercise time to exhaustion (all [Formula: see text] s = between - 0.21 and - 0.24). A reduction in the biomarker index was also associated with increased 4-m usual walk speed ([Formula: see text] s = - 0.31). Among older patients with chronic obese HFpEF, caloric restriction improved a biomarker index designed to reflect biological aging. Moreover, the index was associated with physical performance and exercise tolerance.

Large deviations for the right-most position of a last progeny modified branching random walk

In this work, we consider a modification of the usual Branching Random Walk (BRW), where we give certain independent and identically distributed (i.i.d.) displacements to all the particles at the $n$-th generation, which may be different from the driving increment distribution. This model was first introduced by Bandyopadhyay and Ghosh (2021) and they termed it as Last Progeny Modified Branching Random Walk (LPM-BRW). Under very minimal assumptions, we derive the large deviation principle (LDP) for the right-most position of a particle in generation $n$. As a byproduct, we also complete the LDP for the classical model, which complements the earlier work by Gantert and H\"{o}felsauer (2018).

2015-2016 Normative Data for the 3-m Usual Walk, Five Repeated Chair Stands, and Static Balance Components of the SPPB Among U.S. Older Adults Across Two Nationally Representative Data Sets: NSHAP and NHATS.

Our primary objective was to examine the distribution of 3-m usual walk, five repeated chair stands, and three static balance stance performances among age and gender subgroups of adults at least 65 years in two national data sets. We secondarily determined whether demographic-function associations varied across data sets, birth cohorts, or models incorporating data from those "unable to do" tasks. Two nationally representative data sets were used to generate survey weight-adjusted performance distributions: the 2015-2016 National Social Life Health and Aging Project and the 2016 National Health and Aging Trends Study. We then regressed walk and chair stand performance on age, gender, and race/ethnicity, examining differences across data sets, birth cohorts (1920-1947, 1948-1965), and before/after incorporating the "unable to do" performers. Findings confirmed the gradual decline in function with age and allowed estimation of "relative" performance within age/gender subgroups. Data set distribution differences were noted, possibly due to recruitment, eligibility, and protocol variations. Demographic associations were similar across data sets but generally weaker among the 1948-1965 cohort and in models including the sizable "unable to do" group. We present the largest, most current Short Physical Performance Battery reference data in U.S. adults aged 65 or older. Findings support standardization of administration protocols in research and clinical care and differentiating absolute from relative performance.

The First Evaluation of a Geroscience Biomarker Index (TAME-BI) in a Trial of Caloric Restriction and Exercise

We leveraged the WF OAIC biorepository to measure a consensus-derived panel of blood-based biomarkers of aging and constructed a geroscience-guided biomarker index (TAME-BI), testing it for the first time in a clinical trial. We measured IL-6, TNF-α-receptor-I, growth differentiating factor-15, cystatin C, and N-terminal pro-B-type natriuretic peptide in a 20-week randomized trial of caloric restriction (CR), aerobic exercise (EX), CR+EX, or attention-control in 88 patients (67±5years) with heart failure with preserved ejection fraction (HFpEF). We calculated TAME-BI (analyte levels ranked, binned by quintile, and summed) and found a time×treatment interaction for improved TAME-BI with intervention (p≤0.05) and detected associations between change in TAME-BI and change in six-minute walk distance (r= -0.24), usual walk speed (r= -0.23), and left ventricular relative wall thickness (r= 0.31). In sum, CR+EX intervention improved TAME-BI and changes in TAME-BI were associated with changes in key functional measures in older HFpEF patients.

136 ASSOCIATIONS OF FRAILTY WITH CONSECUTIVE GAIT SPEED TRAILS MEASURED BOTH WITH AND WITHOUT ADDITIONAL STRESSORS

Abstract Background Frailty is associated with gait speed and is defined as increased vulnerability to stressors. While usual gait speed is often measured, gait speed under additional stressors such as simultaneously reciting alternate letters of the alphabet (cognitive dual task) or walking at maximum pace are also measured. Consecutive trials may introduce an additional temporal stressor and we hypothesise that frailty may be associated with a greater reduction in walking speed across trials. Methods Data from community-dwelling adults aged 50+ years at Wave 3 of The Irish Longitudinal Study on Ageing were utilized. Using a 32-item frailty index (FI) we derived non-frail, pre-frail and frail groups. Gait speeds were measured using a 4.88 m walkway (GAITRite, CIR Systems, NY, USA). We examined differences in gait speed between two consecutive walks in three conditions (usual pace, cognitive dual task, and maximum pace) for the entire cohort, and by frailty group. Related-samples Wilcoxon signed rank tests were employed, with statistical significance set at P &amp;lt; 0.05. Results For the entire cohort, walk 2 speed for usual and cognitive conditions was higher by 1.0 cm/s (N = 4,097) and 1.1 cm/s (N = 3,927) respectively, and lower by 1.9 cm/s for maximum (N = 3,926). Stratified by FI, all groups walked more quickly in normal (1.0, 1.1, 1.2, respectively) and cognitive (1.3, 0.8, 0.5), and more slowly in maximum (−2.2, −1.6, −1.0). Conclusion In our analyses, higher frailty seemed to be associated with a higher increase for the usual walk, a smaller increase for the cognitive walk, and a smaller decrease in maximum speed. The clinical significance of the differences was very small. However, our results support that in research and clinical practice, frailty by FI should not be expected to lead to a different pattern of gait speed change across consecutive trials.

Protocol for GET FIT Prostate: a randomized, controlled trial of group exercise training for fall prevention and functional improvements during and after treatment for prostate cancer

BackgroundMany prostate cancer survivors are treated with androgen deprivation therapy (ADT), but these therapies may increase frailty, worsen physical functioning, and increase fall risk. While exercise may counter functional declines associated with ADT, no studies have tested whether and which type of exercise may reduce falls and frailty. The purpose of this trial is to compare the relative efficacy of strength training versus tai ji quan training against each other and to a stretching control group on falls, frailty, and physical functioning in men expose to ADT for prostate cancer.MethodsProstate cancer survivors treated with ADT (N = 360) who have fallen in the past year or are at risk of a fall based on validated risk factors will be recruited to participate in this single-blind, parallel group, randomized trial. Participants will be randomized to one of three supervised, group training programs: (i) strength training, (ii) tai ji quan training, or (iii) stretching (control), that train 3×/week for 6 months. Outcomes are assessed at baseline, 3 (mid-intervention), 6 (immediately post-intervention), and 12 (follow-up) months. The primary outcome is falls assessed by monthly self-report. Secondary outcomes include the following: frailty (low lean body mass (by bioelectrical impedance analysis), exhaustion (by SF-36 vitality scale), low activity (by CHAMPS physical activity survey), slowness (by 4 m usual walk speed), and weakness (by chair stand time)); objective and subjective measures of physical function will also be collected. Negative binomial regression models will be used to assess differences in falls between groups, while mixed effects modeling will be used to compare the relative efficacy of training group on secondary outcomes.DiscussionExercise represents a non-pharmacologic approach to mitigate the problem of falls experienced among men treated with ADT. By engaging in appropriate exercise, men may be able to avoid or delay falls, frailty, and disability associated with their cancer treatment. Findings of the trial are expected to inform clinical practice about how exercise could be prescribed as part of cancer care for prostate cancer survivors prescribed ADT.Trial registrationClinicalTrials.gov NCT03741335. Registered on November 18, 2018.