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JARLIFE Vol 10, 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

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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