Epidemiology of Perceived Physical Fatigability in Older Adults: The Long Life Family Study

Abstract Background Fatigability is a construct that measures whole-body tiredness anchored to activities of a fixed intensity and duration; little is known about its epidemiology and heritability. Methods Two generations of family members enriched for exceptional longevity and their spouses were enrolled (2006–2009) in the Long Life Family Study (LLFS). At Visit 2 (2014–2017, N = 2,355) perceived physical fatigability was measured using the 10-item self-administered Pittsburgh Fatigability Scale (PFS), along with demographic, medical, behavioral, physical, and cognitive risk factors. Results Residual genetic heritability of fatigability was 0.263 (p = 6.6 × 10–9) after adjustment for age, sex, and field center. PFS physical scores (mean ± SD) and higher physical fatigability prevalence (% PFS ≥ 15) were greater with each age strata: 60–69 (n = 1,009, 11.0 ± 7.6, 28%), 70–79 (n = 847, 12.5 ± 8.1, 37%), 80–89 (n = 253, 19.3 ± 9.9, 65.2%), and 90–108 (n = 266, 28.6 ± 9.8, 89.5%), p < .0001, adjusted for sex, field center, and family relatedness. Women had a higher prevalence of perceived physical fatigability compared to men, with the largest difference in the 80–89 age strata, 74.8% versus 53.5%, p < .0001. Those with greater body mass index, worse physical and cognitive function, and lower physical activity had significantly higher perceived physical fatigability. Conclusions Perceived physical fatigability is highly prevalent in older adults and strongly associated with age. The family design of LLFS allowed us to estimate the genetic heritability of perceived physical fatigability. Identifying risk factors associated with higher perceived physical fatigability can inform the development of targeted interventions for those most at risk, including older women, older adults with depression, and those who are less physically active.

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PREVALENCE AND HERITABILITY OF PERCEIVED MENTAL FATIGABILITY IN THE LONG LIFE FAMILY STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.865 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S233-S233

Author(s):

Alexa J Meinhardt ◽

Theresa Gmelin ◽

Allison L Kuipers ◽

Stacy L Andersen ◽

Stephanie Cosentino ◽

...

Keyword(s):

Older Adults ◽

Family Structure ◽

Family Study ◽

Female Self ◽

Field Center ◽

Genetic Heritability ◽

Long Life ◽

Study Participants

Abstract We examined the prevalence and heritability of perceived mental fatigability among older adults enrolled in the Long Life Family Study. Participants (N=2342; 55% female) self-administered the Pittsburgh Fatigability Scale (PFS; scores range 0-50; higher score=greater fatigability). Using the PFS mental subscale, we evaluated differences across age strata (adjusted for family structure and field center) and estimated genetic heritability using the variance covariance methods implemented in SOLAR to determine genetic heritability (adjusted for age, sex, and field center). PFS mental score (mean±SD) and prevalence of higher mental fatigability (PFS ≥13) was greater across age strata: 60-69 (N=996, 5.9± 6.5, 14.5%), 70-79 (N=830, 6.8 ±7.6, 18.7%), 80-89 (N=251, 11.7±10.8, 41.8%), and ≥90 (N=265, 20.2±13.6, 67.2%), p<0.0001. Only among those ≥90, females (21.7±13.5) had greater mental fatigability than males (18.0±13.5), p=0.03. Residual heritability of mental fatigability was 0.17, p<0.0001. Future analyses will evaluate correlates of mental fatigability to identify potential avenues for intervention.

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

Journal of Aging Research and Lifestyle ◽

10.14283/jarlife.2021.7 ◽

2021 ◽

pp. 1-6

Author(s):

F. Saucedo ◽

E.A. Chavez ◽

H.R. Vanderhoof ◽

J.D. Eggleston

Keyword(s):

Risk Factors ◽

Older Adults ◽

Training Program ◽

Fall Risk ◽

Whole Body Vibration ◽

Whole Body ◽

Body Vibration ◽

Fall Risk Factors ◽

Vibration Training ◽

Whole Body Vibration Training

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.

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Age and Sex Distributions of Age-Related Biomarker Values in Healthy Older Adults from the Long Life Family Study

Journal of the American Geriatrics Society ◽

10.1111/jgs.14522 ◽

2016 ◽

Vol 64 (11) ◽

pp. e189-e194 ◽

Cited By ~ 20

Author(s):

Paola Sebastiani ◽

Bharat Thyagarajan ◽

Fangui Sun ◽

Lawrence S. Honig ◽

Nicole Schupf ◽

...

Keyword(s):

Older Adults ◽

Family Study ◽

Healthy Older Adults ◽

Age Related ◽

Long Life ◽

Age And Sex

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Predictors of Longitudinal Changes in Older Adults’ Physical Activity Engagement

Journal of Aging and Physical Activity ◽

10.1123/japa.18.2.141 ◽

2010 ◽

Vol 18 (2) ◽

pp. 141-157 ◽

Cited By ~ 14

Author(s):

Jiska Cohen-Mansfield ◽

Dov Shmotkin ◽

Shira Goldberg

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Older Adults ◽

Significant Risk ◽

Personal Characteristics ◽

Female Gender ◽

Cognitive Status ◽

Physically Active ◽

Activity Engagement ◽

The Face

The study aimed to investigate factors influencing older adults’ physical activity engagement over time. The authors analyzed 3 waves of data from a sample of Israelis age 75–94 (Wave 1n= 1,369, Wave 2n= 687, Wave 3n= 154). Findings indicated that physical activity engagement declined longitudinally. Logistic regressions showed that female gender, older age, and taking more medications were significant risk factors for stopping exercise at Wave 2 in those physically active at Wave 1. In addition, higher functional and cognitive status predicted initiating exercise at Wave 2 in those who did not exercise at Wave 1. By clarifying the influence of personal characteristics on physical activity engagement in the Israeli old-old, this study sets the stage for future investigation and intervention, stressing the importance of targeting at-risk populations, accommodating risk factors, and addressing both the initiation and the maintenance of exercise in the face of barriers.

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Self-Reported Modifiable Risk Factors of Cardiovascular Disease among Older Adults in Malaysia: A Cross-Sectional Study of Prevalence and Clustering

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157941 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7941

Author(s):

Ying Ying Chan ◽

Norhafizah Sahril ◽

Muhammad Solihin Rezali ◽

Lim Kuang Kuay ◽

Azli Baharudin ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Older Adults ◽

Logistic Regression ◽

Modifiable Risk Factors ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cross Sectional ◽

Targeted Interventions ◽

Multivariable Logistic Regression

The co-occurrence of multiple modifiable risk factors increases the risk of cardiovascular disease (CVD) morbidity or mortality. This study examines the prevalence and clustering of self-reported modifiable CVD risk factors among older adults in Malaysia. A total of 7117 adults aged ≥50 years participated in the National Health and Morbidity Survey (NHMS) 2018: Elderly Health, a community-based cross-sectional survey. Data were collected using a standardized structured questionnaire. Multivariable logistic regression was used to determine the factors associated with the clustering of self-reported modifiable CVD risk factors. The prevalence of self-reported diabetes, hypertension, hypercholesterolemia, overweight/obesity, and current smoking was 23.3%, 42.2%, 35.6%, 58.4%, and 17.5%, respectively. Overall, the prevalence of clustering of ≥1, ≥2, and ≥3 modifiable CVD risk factors was 83.3%, 75.4%, and 62.6%, respectively. Multivariable logistic regression analysis showed that men, 60–69 age group, urban dwellers, having no formal education, unemployed/retirees/homemakers, and being physically inactive were independently associated with self-reported modifiable CVD risk factors clustering. There are also ethnic differences in self-reported modifiable CVD risk factors clustering. Our findings underscore the necessity of targeted interventions and integrated strategies for early detection and treatment of modifiable CVD risk factors among older adults, considering age, sex, ethnicity, and socioeconomic status.

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Association Between APOE Alleles and Change of Neuropsychological Tests in the Long Life Family Study

Journal of Alzheimer s Disease ◽

10.3233/jad-201113 ◽

2021 ◽

Vol 79 (1) ◽

pp. 117-125

Author(s):

Mengtian Du ◽

Stacy L. Andersen ◽

Nicole Schupf ◽

Mary F. Feitosa ◽

Megan S. Barker ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Test Scores ◽

Healthy Aging ◽

Family Study ◽

Apoe Genotype ◽

Cognitive Test ◽

Cross Sectional ◽

Long Life ◽

E4 Allele

Background: The Long Life Family Study (LLFS) is a family based, prospective study of healthy aging and familial longevity. The study includes two assessments of cognitive function that were administered approximately 8 years apart. Objective: To test whether APOE genotype is associated with change of cognitive function in older adults. Methods: We used Bayesian hierarchical models to test the association between APOE alleles and change of cognitive function. Six longitudinally collected neuropsychological test scores were modelled as a function of age at enrollment, follow-up time, gender, education, field center, birth cohort indicator (≤1935, or >1935), and the number of copies of ɛ2 or ɛ4 alleles. Results: Out of 4,587 eligible participants, 2,064 were male (45.0%), and age at enrollment ranged from 25 to 110 years, with mean of 70.85 years (SD: 15.75). We detected a significant cross-sectional effect of the APOE ɛ4 allele on Logical Memory. Participants carrying at least one copy of the ɛ4 allele had lower scores in both immediate (–0.31 points, 95% CI: –0.57, –0.05) and delayed (–0.37 points, 95% CI: –0.64, –0.10) recall comparing to non-ɛ4 allele carriers. We did not detect any significant longitudinal effect of the ɛ4 allele. There was no cross-sectional or longitudinal effect of the ɛ2 allele. Conclusion: The APOE ɛ4 allele was identified as a risk factor for poorer episodic memory in older adults, while the APOE ɛ2 allele was not significantly associated with any of the cognitive test scores.

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Accelerometer-based measures of sedentary behavior and cardio-metabolic risk in active older adults

Clinical & Investigative Medicine ◽

10.25011/cim.v37i2.21093 ◽

2014 ◽

Vol 37 (2) ◽

pp. 108 ◽

Cited By ~ 15

Author(s):

Jocelyn M Chase ◽

Christine K Lockhart ◽

Maureen C Ashe ◽

Kenneth M Madden

Keyword(s):

Risk Factors ◽

Older Adults ◽

Sedentary Behavior ◽

Sedentary Time ◽

Density Lipoprotein ◽

Activity Level ◽

Metabolic Risk Factors ◽

Metabolic Effects ◽

Metabolic Risk ◽

Physically Active

Purpose: Sedentary behavior has been proposed as an independent cardio-metabolic risk factor even in adults who are physically active through recreational activity. Because little is known about the metabolic effects of sedentariness in seniors, the relationship between sedentary behavior and cardio-metabolic risk was examined in physically active older adults. Methods: Fifty-four community dwelling men and women > 65 years of age (mean 71.5 years) were enrolled in this cross-sectional observational study. Subjects were in good health and free of known diabetes. Activity levels (sedentary, light, moderate to vigorous activity time per day) were recorded with accelerometers worn continuously for 7 days. Cardio-metabolic risk factors measured consisted of the American Heart Association diagnostic criteria for metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein, systolic blood pressure and fasting glucose) as well as low-density lipoprotein (LDL). The relationships between activity measures and cardio-metabolic risk factors were examined. Significant variables were then entered into a stepwise multivariate regression model. Results: All but one subject achieved exercise levels recommended by the American College of Sports Medicine. The average proportion of time spent at a sedentary activity level each day was 72.7%. From the regression analysis, the only significant association found between cardio-metabolic risk outcomes and activity predictors was between LDL and sedentary time, with LDL detrimentally associated with average sedentary time per day (Standardized Beta Correlation Coefficient 0.302, p < 0.05). Conclusion: Sedentary behavior is associated with an adverse metabolic effect on LDL in seniors, even those who meet guideline recommendations for an active “fit” adult.

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Prevalence and severity of perceived mental fatigability in older adults: The Long Life Family Study

Journal of the American Geriatrics Society ◽

10.1111/jgs.17075 ◽

2021 ◽

Author(s):

Rebecca W. Cohen ◽

Alexa J. Meinhardt ◽

Theresa Gmelin ◽

Yujia (Susanna) Qiao ◽

Kyle D. Moored ◽

...

Keyword(s):

Older Adults ◽

Family Study ◽

Long Life

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Post-operative delirium in older patients following cancer related and other high-risk surgeries.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24024 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24024-e24024

Author(s):

Rawad Elias ◽

Ilene Staff ◽

Stephen Thompson ◽

Christine Waszynski ◽

Jennifer Zanchi ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Logistic Regression ◽

High Risk ◽

Tertiary Care ◽

Confusion Assessment Method ◽

Assessment Method ◽

Chi Square ◽

Targeted Interventions ◽

Increased Risk

e24024 Background: Older adults are at increased risk for postoperative delirium (POD). This risk might be higher in patients with cancer as underlying malignancy and its complications predispose individuals to develop delirium. Therefore, it is important to evaluate the onset of delirium in this patient population especially as POD is associated with increased risk of rehospitalization, decline in cognitive function, morbidity and mortality. Methods: We performed a retrospective review of patients aged ≥ 70 years admitted January 2017 through July 2019 to a tertiary care referral center for a high-risk surgery, defined as associated with a mortality risk greater than 1%. Cancer related surgeries (CRS) were identified through cross matching with Cancer Registry. Patients who had delirium assessment in the postoperative setting using the Confusion Assessment Method (CAM) were included. Chi-square tests of proportion, Wilcoxon Ranked Sum and multivariate logistic regression analyses were conducted. Results: A total of 2340 patients were included in this analysis, 315 of whom had (CRS). Overall, the age (median, IQR) of patients at surgery was 76 years (72-80) and the length of stay (LOS) was 7 (4-11) days. Patients receiving CRS were younger (75, 72-79) than those with non-CRS (76, 72-81) (p = 0.022); had a shorter post-operative LOS (4, 2-7 vs. 5, 3-8; p > 0.001), and were less likely to develop POD (7.6% vs. 16.1%; p < 0.001). Among patients receiving CSR, those who developed POD were older (78 vs. 74; p = 0.008) and had longer post-operative LOS (14.0 vs. 4.0; p < 0.001). Those having experienced radiotherapy (RT) for cancer within the year before the surgery, were more likely to develop POD (40.0% vs. 6.6% p. < 0.001). Chemotherapy in the year prior to surgery did not increase the risk of POD (6.1% vs. 7.8%; p = 0.721). Among those having non-CRS, a cancer diagnosis did not affect POD. A logistic regression predicting POD indicated that the lower likelihood of POD following CRS was independent of age or gender (OR = 0.40; p < .001); RT within one year prior was independent predictor of higher POD (OR = 5.48; p = 0.003). Our data presentation will include further analysis of POD risk factors. Conclusions: Although older adults receiving CRS were significantly less likely to develop delirium than patients with other high-risk surgeries, it is still important to evaluate POD in this population due to its impact of patients’ outcomes. Further understanding of POD risk factors, such as preoperative RT, would allow the development of targeted interventions that might lessen the risk.

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