Oxygen-Uptake (VO2) Kinetics and Functional Mobility Performance in Impaired Older Adults

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

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Sport Involvement Among Middle-Aged and Older Adults With Arthritis: Motivations and Constraints to Participation

Innovation in Aging ◽

10.1093/geroni/igaa057.1303 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 405-405

Author(s):

Megan Janke ◽

Julie Son ◽

Jill Naar ◽

Stephanie West ◽

Toni Liechty ◽

...

Keyword(s):

Older Adults ◽

Sport Participation ◽

The United States ◽

Functional Mobility ◽

Online Questionnaire ◽

Physically Active ◽

Social Wellbeing ◽

Constraint Negotiation ◽

Active Leisure ◽

Physically Active Leisure

Abstract Although participation in physical activity is recommended for adults with arthritis, research indicates individuals often stop participating in sports and physically active leisure due to the pain and symptoms associated with arthritis (Wilcox et al., 2006). Examining a group of older adults with arthritis, the present study examines motivations and constraints related to participating in sport and physically active leisure as well as how they negotiate constraints. Data (N=1203) were collected through an online questionnaire of adults aged 50 and older in the United States. This study includes individuals reporting a diagnosis of some form of arthritis (n=288; M age = 64.8, SD = 8.08). Approximately 32% self-reported participation in sport in the past 12 months. Descriptive statistics were conducted to explore motivations and constraints to sport involvement. Regressions were run to determine whether constraints and motivations explained adults’ functional mobility and social wellbeing. The most commonly identified motivation for participation was for health purposes (80.2%). Constraints to participation included not being in good enough shape (51.9%) and not having others their age with whom to participate (47.4%). The most commonly identified constraint negotiation was to budget money (51.4%); this is not surprising since sport participation was perceived as expensive (41.3%). Motivations (p<.01) and constraints (p<.001) significantly predicted functional mobility; constraints significantly predicted some aspects of social wellbeing (i.e., coherence, contribution, actualization; p<.05) while constraint negotiation predicted social acceptance (p<.05) and integration (p<.001). Discussion will include implications and strategies for agencies and professionals who work with adults who have arthritis.

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180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study

Open Heart ◽

10.1136/openhrt-2020-001442 ◽

2021 ◽

Vol 8 (1) ◽

pp. e001442

Author(s):

John A Dodson ◽

Alexandra M Hajduk ◽

Terrence E Murphy ◽

Mary Geda ◽

Harlan M Krumholz ◽

...

Keyword(s):

Myocardial Infarction ◽

Older Adults ◽

Acute Myocardial Infarction ◽

Risk Model ◽

Functional Mobility ◽

Derivation Cohort ◽

History Of ◽

Reported Health ◽

Self Reported Health Status ◽

Readmission Risk

ObjectiveTo develop a 180-day readmission risk model for older adults with acute myocardial infarction (AMI) that considered a broad range of clinical, demographic and age-related functional domains.MethodsWe used data from ComprehenSIVe Evaluation of Risk in Older Adults with AMI (SILVER-AMI), a prospective cohort study that enrolled participants aged ≥75 years with AMI from 94 US hospitals. Participants underwent an in-hospital assessment of functional impairments, including cognition, vision, hearing and mobility. Clinical variables previously shown to be associated with readmission risk were also evaluated. The outcome was 180-day readmission. From an initial list of 72 variables, we used backward selection and Bayesian model averaging to derive a risk model (N=2004) that was subsequently internally validated (N=1002).ResultsOf the 3006 SILVER-AMI participants discharged alive, mean age was 81.5 years, 44.4% were women and 10.5% were non-white. Within 180 days, 1222 participants (40.7%) were readmitted. The final risk model included 10 variables: history of chronic obstructive pulmonary disease, history of heart failure, initial heart rate, first diastolic blood pressure, ischaemic ECG changes, initial haemoglobin, ejection fraction, length of stay, self-reported health status and functional mobility. Model discrimination was moderate (0.68 derivation cohort, 0.65 validation cohort), with good calibration. The predicted readmission rate (derivation cohort) was 23.0% in the lowest quintile and 65.4% in the highest quintile.ConclusionsOver 40% of participants in our sample experienced hospital readmission within 180 days of AMI. Our final readmission risk model included a broad range of characteristics, including functional mobility and self-reported health status, neither of which have been previously considered in 180-day risk models.

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Perception Versus Reality: Subjective and Objective Neighborhood Characteristics and Cognitive Function in REGARDS

Innovation in Aging ◽

10.1093/geroni/igaa057.2470 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 703-703

Author(s):

Jessica Finlay ◽

Philippa Clarke ◽

Lisa Barnes

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Racial Differences ◽

Secondary Data ◽

Well Being ◽

Daily Basis ◽

Cognitive Status ◽

Functional Mobility ◽

Neighborhood Size ◽

Regards Study

Abstract Does the world shrink as we age? The neighborhood captures a spatial area someone inhabits and moves through on a daily basis. It reflects a balance between internal perceptions and abilities, and the external environment which may enable or restrict participation in everyday life. We frequently hear that older adults have shrinking neighborhoods given declining functional mobility. This is associated with declines in physical and cognitive functioning, depression, poorer quality of life, and mortality. Knowledge of the interplay between objective and subjective neighborhood measurement remains limited. This symposium will explore these linked yet distinct constructs based on secondary data analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a racially diverse sample of 30,000+ aging Americans. Finlay investigates how someone’s perceived neighborhood size (in number of blocks) varies by individual and geographic characteristics including age, cognitive function, self-rated health, and urban/rural context. Esposito’s analyses focus on neighborhood size in relation to race and residential segregation. Clarke compares subjective perceptions of neighborhood parks and safety from crime to objective indicators, and examines variations by health and cognitive status. Barnes will critically consider implications for how older adults interpret and engage with their surrounding environments. The symposium questions the validity of neighborhood-based metrics to reflect the perspectives and experiences of older residents, particularly those navigating cognitive decline. It informs policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the health and well-being of older adults aging in place.

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Short-term Effects of Whole-Body Vibration on Functional Mobility and Flexibility in Healthy, Older Adults

Journal of Geriatric Physical Therapy ◽

10.1519/jpt.0b013e318295dacd ◽

2014 ◽

Vol 37 (2) ◽

pp. 58-64 ◽

Cited By ~ 8

Author(s):

Taishi Tsuji ◽

Naruki Kitano ◽

Kenji Tsunoda ◽

Erika Himori ◽

Tomohiro Okura ◽

...

Keyword(s):

Older Adults ◽

Whole Body Vibration ◽

Functional Mobility ◽

Whole Body ◽

Short Term ◽

Healthy Older Adults ◽

Body Vibration ◽

Short Term Effects

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Functional Mobility in a Divided Attention Task in Older Adults With Cognitive Impairment

Journal of Motor Behavior ◽

10.1080/00222895.2014.998331 ◽

2015 ◽

Vol 47 (5) ◽

pp. 378-385 ◽

Cited By ~ 25

Author(s):

Sheila de Melo Borges ◽

Márcia Radanovic ◽

Orestes Vicente Forlenza

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Divided Attention ◽

Functional Mobility ◽

Attention Task ◽

Divided Attention Task

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Walking performance, oxygen uptake kinetics and resting muscle pyruvate dehydrogenase complex activity in peripheral arterial disease

Clinical Science ◽

10.1042/cs20030244 ◽

2004 ◽

Vol 106 (3) ◽

pp. 241-249 ◽

Cited By ~ 29

Author(s):

Glenn A. BARKER ◽

Simon GREEN ◽

Anita A. GREEN ◽

Philip J. WALKER

Keyword(s):

Peripheral Arterial Disease ◽

Oxygen Uptake ◽

Pyruvate Dehydrogenase ◽

Pyruvate Dehydrogenase Complex ◽

Arterial Disease ◽

Peak Vo2 ◽

Vo2 Kinetics ◽

Peripheral Arterial ◽

Walking Time ◽

Dehydrogenase Complex

In the present study, we tested the hypothesis that walking intolerance in intermittent claudication (IC) is related to both slowed whole body oxygen uptake (VO2) kinetics and altered activity of the active fraction of the pyruvate dehydrogenase complex (PDCa) in skeletal muscle. Ten patients with IC and peripheral arterial disease [ankle/brachial index (ABI)=0.73±0.13] and eight healthy controls (ABI=1.17±0.13) completed three maximal walking tests. From these tests, averaged estimates of walking time, peak VO2 and the time constant of VO2 (τ) during submaximal walking were obtained. A muscle sample was taken from the gastrocnemius medialis muscle at rest and analysed for PDCa and several other biochemical variables. Walking time and peak VO2 were approx. 50% lower in patients with IC than controls, and τ was 2-fold higher (P<0.05). τ was significantly correlated with walking time (r=-0.72) and peak VO2 (r=-0.66) in patients with IC, but not in controls. PDCa was not significantly lower in patients with IC than controls; however, PDCa tended to be correlated with τ (r=-0.56, P=0.09) in patients with IC, but not in controls (r=-0.14). A similar correlation was observed between resting ABI and τ (r=-0.63, P=0.05) in patients with IC. These data suggest that the impaired VO2 kinetics contributes to walking intolerance in IC and that, within a group of patients with IC, differences in VO2 kinetics might be partly linked to differences in muscle carbohydrate oxidation.

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The Impact of Behavioral Intervention on Obesity Mediated Declines in Mobility Function: Implications for Longevity

Journal of Aging Research ◽

10.4061/2011/392510 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Joe Nocera ◽

Thomas W. Buford ◽

Todd M. Manini ◽

Kelly Naugle ◽

Christiaan Leeuwenburgh ◽

...

Keyword(s):

Older Adults ◽

Aging Process ◽

Strong Predictor ◽

Functional Limitations ◽

Mobility Performance ◽

Mobility Function ◽

Age Related ◽

Close Relationship ◽

Primary Focus ◽

The Impact

A primary focus of longevity research is to identify prognostic risk factors that can be mediated by early treatment efforts. To date, much of this work has focused on understanding the biological processes that may contribute to aging process and age-related disease conditions. Although such processes are undoubtedly important, no current biological intervention aimed at increasing health and lifespan exists. Interestingly, a close relationship between mobility performance and the aging process has been documented in older adults. For example, recent studies have identified functional status, as assessed by walking speed, as a strong predictor of major health outcomes, including mortality, in older adults. This paper aims to describe the relationship between the comorbidities related to decreased health and lifespan and mobility function in obese, older adults. Concurrently, lifestyle interventions, including diet and exercise, are described as a means to improve mobility function and thereby limit the functional limitations associated with increased mortality.

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