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01/2021 journal articles

A NON-CONTROLLED STUDY OF A MULTI-FACTORIAL EXERCISE AND NUTRITIONAL INTERVENTION TO IMPROVE FUNCTIONAL PERFORMANCE AND PREVENT FRAILTY PROGRESSION IN COMMUNITY-DWELLING PRE-FRAIL OLDER ADULTS

W.L. Low, R. Sultana, A.B. Huda Mukhlis, J.C.Y. Ho, A. Latib, E.L. Tay, S.M. Mah, H.N. Chan, Y.S. Ng, L. Tay

J Aging Res & Lifestyle 2021;10:1-7

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Background: Preventing frailty is important to avoid adverse health outcomes. Intervention studies have largely focused on frail elderly, although the intermediate pre-frail state may be more amenable to improvement. Objectives: This study aims to assess how physical performance may change among pre-frail elderly enrolled in a pragmatic non-controlled exercise and nutritional intervention programme. Methods: This is a non-controlled study involving a 4-month exercise and nutritional intervention for community dwelling pre-frail older adults. Pre-frailty was defined as the presence of 1 or 2 positive responses on the FRAIL questionnaire, or evidence of weak grip strength (<26kg for males; <18kg for females) or slow gait speed (<0.8m/s) amongst participants who were asymptomatic on FRAIL. Physical performance in flexibility, grip and lower limb strength, endurance, balance, and Short Physical Performance Battery were measured at 3 time-points: baseline, 3-month from recruitment (without intervention), and immediate post-intervention. Repeated measures mixed model analysis was performed to compare physical performance measures across the 3 time-points. Results: 94 pre-frail participants were eligible for intervention, of whom 59 (mean age = 70.9±7.2 years) were ready for the post-intervention review. 21 (35.6%) transitioned to robust phenotype while 32 (54.2%) remained as pre-frail. Significant improvement post-intervention was observed in lower limb strength and power, evident on reduction in time taken for 5 sit-to-stand repetitions (0.46±0.20s, p=0.03). There was no significant change to the other physical performance measures examined. Conclusion: We observed reversibility of pre-frailty, and the benefit of multi-component intervention in improving physical performance of pre-frail older adults. The findings in this non-controlled study will need to be corroborated with future controlled trials.

CITATION:
W.L. Low ; R. Sultana ; A.B. Huda Mukhlis ; J.C.Y. Ho ; A. Latib ; E.L. Tay ; S.M. Mah ; H.N. Chan ; Y.S. Ng ; L. Tay (2021): A Non-Controlled Study of a Multi-factorial Exercise and Nutritional Intervention to Improve Functional Performance and Prevent Frailty Progression in Community-Dwelling Pre-frail Older Adults. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.1

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BRAIN Α-TOCOPHEROL CONCENTRATION IS INVERSELY ASSOCIATED WITH NEUROFIBRILLARY TANGLE COUNTS IN BRAIN REGIONS AFFECTED IN EARLIER BRAAK STAGES: A CROSS-SECTIONAL FINDING IN THE OLDEST OLD

J. Tanprasertsuk, T.M. Scott, M.A.Johnson, L.W. Poon, P.T. Nelson, A. Davey, J.L. Woodard, R. Vishwanathan, A.K. Barbey, K. Barger, X.-D. Wang, E.J. Johnson

J Aging Res & Lifestyle 2021;10:8-16

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Objectives: Higher vitamin E status has been associated with lower risk of Alzheimer’s disease (AD). However, evidence of the association of vitamin E concentration in neural tissue with AD pathologies is limited. Design: The cross-sectional relationship between the human brain concentrations of α- and γ-tocopherol and the severity of AD pathologies – neurofibrillary tangle (NFT) and neuritic plaque (NP) – was investigated. Setting & Participants: Brains from 43 centenarians (≥ 98 years at death) enrolled in the Phase III of the Georgia Centenarian Study were collected at autopsy. Measurements: Brain α- and γ-tocopherol concentrations (previously reported) were averaged from frontal, temporal, and occipital cortices. NP and NFT counts (previously reported) were assessed in frontal, temporal, parietal, entorhinal cortices, amygdala, hippocampus, and subiculum. NFT topological progression was assessed using Braak staging. Multiple linear regression was performed to assess the relationship between tocopherol concentrations and NP or NFT counts, with and without adjustment for covariates. Results: Brain α-tocopherol concentrations were inversely associated with NFT but not NP counts in amygdala (β = -2.67, 95% CI [-4.57, -0.79]), entorhinal cortex (β = -2.01, 95% CI [-3.72, -0.30]), hippocampus (β = -2.23, 95% CI [-3.82, -0.64]), and subiculum (β = -2.52, 95% CI [-4.42, -0.62]) where NFT present earlier in its topological progression, but not in neocortices. Subjects with Braak III-IV had lower α-tocopherol (median = 69,622 pmol/g, IQR = 54,389-72,155 pmol/g) than those with Braak I-II (median = 72,108 pmol/g, IQR = 64,056-82,430 pmol/g), but the difference was of borderline significance (p = 0.063). γ-Tocopherol concentrations were not associated with either NFT or NP counts in any brain regions assessed. Conclusions: Higher brain α-tocopherol level is specifically associated with lower NFT counts in brain structures affected in earlier Braak stages. Our findings emphasize the possible importance of α-tocopherol intervention timing in tauopathy progression and warrant future clinical trials.

CITATION:
J. Tanprasertsuk ; T.M. Scott ; M.A.Johnson ; L.W. Poon ; P.T. Nelson ; A. Davey ; J.L. Woodard ; R. Vishwanathan ; A.K. Barbey ; K. Barger ; X.-D. Wang ; E.J. Johnson (2021): Brain α-tocopherol concentration is inversely associated with neurofibrillary tangle counts in brain regions affected in earlier Braak stages: A cross-sectional finding in the oldest old. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.2

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MULTICOMPONENT INTERVENTIONS AGAINST FRAILTY

D. Azzolino, M. Cesari

J Aging Res & Lifestyle 2021;10:17-18

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CITATION:
D. Azzolino ; M. Cesari ; (2021): Multicomponent interventions against frailty. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.3

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URBAN-RURAL DIFFERENCES IN THE PREVALENCE OF MUSCLE WEAKNESS AND SLOW GAIT SPEED: A CROSS-SECTIONAL ANALYSIS FROM THE NHANES (2001-2002 AND 2011-2014)

J.J. Aziz, K.F. Reid, J.A. Batsis, R.A. Fielding

J Aging Res & Lifestyle 2021;10:19-25

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Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

CITATION:
J.J. Aziz ; K.F. Reid ; J.A. Batsis ; R.A. Fielding (2021): Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014). The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.4

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A CROSS-SECTIONAL ANALYSIS OF APOE GENE POLYMORPHISM AND THE RISK OF COGNITIVE IMPAIRMENTS IN THE ALZHEIMER’S DISEASE NEUROIMAGING INITIATIVE STUDY

G. Wang, D.E. Vance, W. Li

J Aging Res & Lifestyle 2021;10:26-31

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Background: It is inconclusive on how apolipoprotein epsilon (APOE) gene polymorphism is associated with the risk of having mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Objectives: To investigate how APOE genotype is associated with the risk of MCI or AD using the data collected from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) participants. Methods: A cross-sectional design was used to analyze the baseline data collected from the 1,720 ADNI participants. APOE gene polymorphism was analyzed on how they are related to the risk of cognitive impairments of either MCI or AD using a percent yield (PY) method. Then cognitive functions were compared among six different APOE genotypes using a two-way ANCOVA by controlling possible confounding factors. Results: The prevalence of six APOE genotypes in 1,720 participants is as following: e2/e2 (0.3%), e2/e3 (7.4%), e3/e3 (45.4%), e2/e4 (2%), e3/e4 (35%) and e4/e4 (9.9%). The e2/e2 and e4/e4 genotypes were associated with the lowest and the highest risk respectively for cognitive impairments of either MCI or AD. Further, a worse cognitive diagnosis was associated with an increasing number of APOE e4 allele in a dose dependent manner. Participants with genotype e3/e3 had a better memory measure than those with the genotype of e3/e4. Conclusions: APOE gene polymorphism is associated with different level of risks for cognitive impairments. The heterozygous genotype e3/e4 is associated with a worse memory function compared to the genotype of e3/e3. Further investigations are needed to intervene the cognitive deteriorations in those with at risk APOE genotypes.

CITATION:
G. Wang ; D.E. Vance ; W. Li (2021): A Cross-Sectional Analysis of APOE Gene Polymorphism and the Risk of Cognitive Impairments in the Alzheimer’s Disease Neuroimaging Initiative Study. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.5

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NUTRITIONAL ASSESSMENT IN PATIENTS WITH EARLY-ONSET AUTOSOMAL DOMINANT ALZHEIMER’S DISEASE DUE TO PSEN1- E280A GENETIC VARIANT: A CROSS-SECTIONAL STUDY

M. Gómez-Vega, E. Garcia-Cifuentes, D. Aguillon, J.E. Velez, A. Jaramillo-Jimenez, D. Vasquez, C. Gómez-Henck, C. Andrés Tobon, G.C. Deossa Restrepo, F. Lopera

J Aging Res & Lifestyle 2021;10:32-38

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Background: Weight loss and malnutrition are frequent findings in late-onset and sporadic presentations of Alzheimer’s Disease (AD). However, less is known about nutritional status in Early-Onset Autosomal Dominant AD (EO-ADAD). Objective: To analyze the association between nutritional status and other clinical and sociodemographic characteristics in individuals with a genetic form of EO-ADAD. Design, settings, and participants: Cross-sectional study with 75 non-institutionalized participants from a cohort of Autosomal Dominant AD (13 with mild cognitive impairment and 61 with dementia, ages from 38 to 67 years) underwent a structured clinical assessment with emphasis on nutritional status. Measurements: Primary outcome was nutritional status and it was measured using the Mini Nutritional Assessment (MNA). Patients were categorized according to MNA total score, as undernourished (MNA ≤23.5) and well-nourished (MNA ≥ 24). Sociodemographic and clinical variables identified as potential predictors or confounders of nutritional status were also collected. Results: Undernourishment by MNA was present in 57.3% of the sample. Forty-two percent of participants had abnormal BMI values considered lower than 18.5 or higher than 24.9 kg/m2. Total BMI values were similar in well and undernourished patients (median 24.2 IQR 3.59 and median 23.9 IQR 4.42, respectively, p=0.476). When comparing well and undernourished groups, we found statistically significant differences for variables: severity of dementia (p=0.034), frailty (p=0.001), multimorbidity (p=0.035) and, polymedication (p=0.045). Neither adjusted logistic regression nor the Poisson regression showed that any clinical or sociodemographic variables explained undernourishment. Conclusions: Undernourishment was a frequent finding in our sample of EO-ADAD, especially in later stages of the disease. Patients with polymedication, multimorbidity, frailty and severe dementia show differences in their nutritional status with a tendency to be more frequently undernourished. Further studies with larger sample sizes are needed to establish this association.

CITATION:
M. Gómez-Vega ; E. Garcia-Cifuentes ; D. Aguillon ; J.E. Velez ; A. Jaramillo-Jimenez ; D. Vasquez ; C. Gómez-Henck ; C. Andrés Tobon ; G.C. Deossa Restrepo ; F. Lopera (2021): Nutritional assessment in patients with early-onset Autosomal Dominant Alzheimer’s Disease due to PSEN1- E280A genetic variant: a cross-sectional study. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.6

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EFFECTS OF CONTROLLED WHOLE-BODY VIBRATION TRAINING ON FUNCTIONAL PERFORMANCE AMONG HEALTHY OLDER ADULTS: A 6-WEEK PILOT STUDY

F. Saucedo, E.A. Chavez, H.R. Vanderhoof, J.D. Eggleston

J Aging Res & Lifestyle 2021;10:39-44

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Background: Falling is the second leading cause of injury-related death worldwide and is a leading cause of injury among older adults. Whole-body vibration has been used to improve fall risk factors in older adults. No study has assessed if vibration benefits can be retained over time. Objectives: The aims of this study were to examine if six-weeks of whole-body vibration could improve fall risk factors and to assess if benefits associated with the training program could be sustained two months following the final training session. Design and Setting: Repeated measures randomized controlled design. Participants: Twenty-four independent living older adults were recruited and were randomly assigned to the WBV or control group. Intervention: Participants performed three sessions of whole-body vibration training per week with a vibration frequency of 20Hz or with only an audio recording of the vibration noise. An assessment of fall risk factors was performed prior to, immediately following, and two-months after the completion of the training program. Main Outcome Measures: Fall risk factors including functional capacity, mobility, strength, and walking speed were assessed pre-training, post-training, and two-months post-training. Results: Seventeen participants completed the study. No improvements (p<0.05) between groups were found in the measures of physical performance. Conclusions: Findings revealed that six weeks of whole-body vibration is not effective in improving fall risk factors or producing benefits post-training.

CITATION:
F. Saucedo ; E.A. Chavez ; H.R. Vanderhoof ; J.D. Eggleston ; (2021): EFFECTS OF CONTROLLED WHOLE-BODY VIBRATION TRAINING ON FUNCTIONAL PERFORMANCE AMONG HEALTHY OLDER ADULTS: A 6-WEEK PILOT STUDY. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.7

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USE OF AN OPEN-SOURCE SOFTWARE TO EXAMINE LOW SKELETAL MUSCLE MASS IN PENILE CANCER PATIENTS: A CROSS-SECTIONAL STUDY

C. Ibilibor, H. Wang, D. Kaushik, R. Rodriguez

J Aging Res & Lifestyle 2021;10:45-49

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Purpose: Low skeletal muscle mass determined radiographically has emerged as an important prognostic marker in penile cancer patients but may be unrecognized in obese patients with a high comorbid disease burden. Moreover, publicly available software for image segmentation are limited. Thus, we describe the prevalence of radiographically low skeletal muscle mass in an obese penile cancer cohort, using an open-source software and examine its association with comorbid disease burden. Methods: This is a cross-sectional study, utilizing retrospective data from patients diagnosed with penile squamous cell carcinoma between October 2009 and December 2019. Available digital files of perioperative computerized tomography were analyzed, using CoreSlicer, an open-source image segmentation software. The correlation between radiographically low skeletal muscle mass, defined as a skeletal muscle index (SMI) less than 55 cm2/m2 and a Charlson Comorbidity Index (CCI) greater than 4 was examined, using logistic and linear regression. Results: Forty two of 59 patients had available digital files. Median SMI and body mass index (BMI) were 54.6cm2/m2 and 30.2kg/m2 respectively for the entire cohort. Of included patients, 54% had radiographically low skeletal muscle mass and a median BMI of 28.9 kg/m2. Radiographically low skeletal muscle mass was associated with a CCI greater than 4 on univariable and multivariable logistic regression with odds ratios of 4.85 (p = 0.041) and 7.32 (p = 0.033), respectively. When CCI was treated as a continuous variable on linear regression, the association between radiographically low skeletal muscle mass and CCI was positive, but not statistically significant with an estimated effect of 1.29 (p = 0.1) and 1.27 (p = 0.152) on univariable and multivariable analysis, respectively. Conclusion: Our data demonstrate that low skeletal muscle mass can be readily assessed with CoreSlicer and is associated with a CCI greater than 4 in obese penile cancer patients.

CITATION:
C. Ibilibor ; H. Wang ; D. Kaushik ; R. Rodriguez (2021): Use of an Open-Source Software to Examine Low Skeletal Muscle Mass in Penile Cancer Patients: A Cross-Sectional Study. The Journal of Aging and Lifestyle (JARLife). http://dx.doi.org/10.14283/jarlife.2021.8

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