Cognitive Function Improvements Mediate Exercise Intervention Effects on Physical Performance in Acutely Hospitalized Older Adults

Author(s):  
Mikel L. Sáez de Asteasu ◽  
Nicolás Martínez-Velilla ◽  
Fabricio Zambom-Ferraresi ◽  
Robinson Ramírez-Vélez ◽  
Antonio García-Hermoso ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marina Petrella ◽  
Ivan Aprahamian ◽  
Ronei Luciano Mamoni ◽  
Carla Fernanda de Vasconcellos Romanini ◽  
Natália Almeida Lima ◽  
...  

Abstract Background To investigate whether an exercise intervention using the VIVIFRAIL© protocol has benefits for inflammatory and functional parameters in different frailty status. Methods/design This is a randomized clinical trial in an outpatient geriatrics clinic including older adults ≥60 years. For each frailty state (frail, pre-frail and robust), forty-four volunteers will be randomly allocated to the control group (n = 22) and the intervention group (n = 22) for 12 weeks. In the control group, participants will have meetings of health education while those in the intervention group will be part of a multicomponent exercise program (VIVIFRAIL©) performed five times a week (two times supervised and 3 times of home-based exercises). The primary outcome is a change in the inflammatory profile (a reduction in inflammatory interleukins [IL-6, TNF- α, IL1beta, IL-17, IL-22, CXCL-8, and IL-27] or an increase in anti-inflammatory mediators [IL-10, IL1RA, IL-4]). Secondary outcomes are change in physical performance using the Short Physical Performance Battery, handgrip strength, fatigue, gait speed, dual-task gait speed, depressive symptoms, FRAIL-BR and SARC-F scores, and quality of life at the 12-week period of intervention and after 3 months of follow-up. Discussion We expect a reduction in inflammatory interleukins or an increase in anti-inflammatory mediators in those who performed the VIVIFRAIL© protocol. The results of the study will imply in a better knowledge about the effect of a low-cost intervention that could be easily replicated in outpatient care for the prevention and treatment of frailty, especially regarding the inflammatory and anti-inflammatory pathways involved in its pathophysiology. Trial registration Brazilian Registry of Clinical Trials (RBR-9n5jbw; 01/24/2020). Registred January 2020. http://www.ensaiosclinicos.gov.br/rg/RBR-9n5jbw/.


2010 ◽  
Vol 59 (3) ◽  
pp. 313-322 ◽  
Author(s):  
JI-YEONG YOON ◽  
TOMOHIRO OKURA ◽  
KENJI TSUNODA ◽  
TAISHI TSUJI ◽  
YOSHIE KOHDA ◽  
...  

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 932 ◽  
Author(s):  
Carliene van Dronkelaar ◽  
Michael Tieland ◽  
Jesse Aarden ◽  
Lucienne Reichardt ◽  
Rosanne van Seben ◽  
...  

Decreased appetite is one of the main risk factors of malnutrition. Little is known on how appetite changes during hospitalization and after discharge and how it relates with sarcopenia-related outcomes. We analyzed data of the Hospital-ADL study, a multicenter prospective cohort study that followed 400 acutely hospitalized older adults (≥70 year). Appetite (SNAQ), handgrip strength (Jamar), muscle mass (BIA), mobility (DEMMI), and physical performance (SPPB) were assessed within 48 h of admission, at discharge, and at one and three months post-discharge. The course of decreased appetite was analysed by Generalised Estimating Equations. Linear Mixed Model was used to analyse the associations between decreased appetite and the sarcopenia-related outcomes. Decreased appetite was reported by 51% at hospital admission, 34% at discharge, 28% one month post-discharge, and 17% three months post-discharge. Overall, decreased appetite was associated with lower muscle strength (β = −1.089, p = 0.001), lower mobility skills (β = −3.893, p < 0.001), and lower physical performance (β = −0.706, p < 0.001) but not with muscle mass (β = −0.023, p = 0.920). In conclusion, decreased appetite was highly prevalent among acute hospitalized older adults and remained prevalent, although less, after discharge. Decreased appetite was significantly associated with negative sarcopenia-related outcomes, which underlines the need for assessment and monitoring of decreased appetite during and post hospitalization.


2009 ◽  
Vol 21 (6) ◽  
pp. 445-452 ◽  
Author(s):  
Steve Fisher ◽  
Kenneth J. Ottenbacher ◽  
James S. Goodwin ◽  
James E. Graham ◽  
Glenn V. Ostir

2012 ◽  
Vol 34 (11) ◽  
pp. 2972-2985 ◽  
Author(s):  
Michelle W. Voss ◽  
Susie Heo ◽  
Ruchika S. Prakash ◽  
Kirk I. Erickson ◽  
Heloisa Alves ◽  
...  

Author(s):  
Marina Arkkukangas ◽  
Karin Strömqvist Bååthe ◽  
Julia Hamilton ◽  
Anna Ekholm ◽  
Michail Tonkonogi

Studien undersöker genomförbarheten av ett nytt judoinspirerat träningsprogram för äldre personer, Judo4Balance. Vi utvärderade genomförbarheten inför en fullskalig studie genom att följa studieprocess, resurshantering och vetenskapliga aspekter. Ytterligare utfallsmått var fysisk funktion, tilltro till egen förmåga att utföra aktiviteter utan att falla samt falltekniker. Interventionen bedömdes vara genomförbar, med vissa ändringar i träningsprogrammets längd. Vi kunde se signifikanta förbättringar av fysisk funktion och falltekniker. När det gäller tilltro till egen förmåga att utföra aktiviteter utan att falla fann vi ingen motsvarande skillnad. Judo4Balance är ett genomförbart och effektivt träningsprogram för äldre personer. Studien bidrar till ett säkert och noggrant planerat protokoll för en större studie. Resultaten tyder på att interventionen kan vara effektiv för att förebygga fallolyckor och minska risken för skador vid ett eventuellt fall.   Pilot study of the feasibility of Judo4Balance – a fall preventive exercise programme targeting older adults living in their own homes The aim of this study was to assess the feasibility of Judo4Balance, a novel judo-inspired exercise intervention for community-dwelling older adults. The feasibility of carrying out a full-scale study was evaluated by the following: the study process, resource management and scientific aspects. The outcome measures evaluated were physical performance, fall related self-efficacy and fall techniques (backwards and forwards) among the older adults. The intervention was judged to be feasible in the different settings, with some changes regarding duration of the intervention. Significant improvements were seen in physical performance and fall techniques, but not for fall related self-efficacy. Judo4Balance is a feasible intervention for active older adults. This study will provide a safe and thoroughly planned protocol for the planned study and provides indication of appropriate setting depending on the target group. The results suggest that the intervention could be efficent in preventing fall accidents, or lower the risk of injury in case of a fall.


Author(s):  
Caterina Trevisan ◽  
Enrico Ripamonti ◽  
Giulia Grande ◽  
Federico Triolo ◽  
Stina Ek ◽  
...  

Abstract Background The impact of falls on cognitive function is unclear. We explored whether injurious falls are associated with cognitive decline in older adults, and evaluated the role of changes in psychological and physical health as mediators of such association. Methods This prospective study involved 2,267 community-dwelling participants in the Swedish National study on Aging and Care in Kungsholmen (≥60 years). Data on injurious falls (i.e., falls requiring medical attention) during each 3-year time interval of follow-up were obtained from national registers. Assessment of cognitive function (Mini-Mental State Examination[MMSE]), depressive mood (Montgomery-Åsberg Depression Rating Scale), and physical performance (walking speed) were carried out every 3 or 6 years over a 12-year follow-up. The association between falls and cognition was estimated through linear mixed effects models, and the mediating role of changes in depressive mood and physical performance was tested using mediation analysis. Results After adjusting for potential confounders, individuals who experienced injurious falls had a greater annual decline in MMSE in the subsequent time interval (β=-1.49, 95%CI:-1.84;-1.13), than those who did not. The association increased with the occurrence of ≥2 falls (β=-2.13, 95%CI:-2.70;-1.56). Worsening of walking speed and depressive mood explained around 26% and 8%, respectively, of the association between falls and cognitive decline. Conclusions Injurious falls are associated with greater cognitive decline, and this association is partly mediated by worsening of physical performance and, in a lesser extent, of depressive mood. These findings suggest that physical deficits and low mood are potential therapeutic targets for mitigating the association between falls and cognitive decline.


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