Creating and Keeping Exercise Gains Into Your 70s, 80s and 90s

Abstract Background: Gerofit, an exercise program for older Veterans, is undergoing national dissemination (17 sites in 6 years). Four sites have accrued 4-year functional outcomes (gait speed, 8-foot-up-and-go, 30-second chair stand, and six-minute walk). Methods: Functional assessments were administered quarterly in first year and annually thereafter. Individuals with baseline and at least two follow up measures were included for analysis (n=587). Means were gathered across each timepoint. Results: Mean values for functional assessments from baseline to 4 year were as follows: gait speed m/s- 1.04, 1.12, 1.13, 1.13, 1.09, 1.07, 1.13; 8 ft-up-and-go seconds- 7.6, 6.82, 6.69, 6.69, 7.29, 7.29, 7.51; 30 second chair stands 11.88, 14.06, 14.72, 14.89, 14.69, 14.71, 14.96; and six-minute-walk yards- 499, 532, 541, 544, 531, 530, 556. All follow up measures were significantly improved over baseline (P<.01) and superior to normative age-related decline. Implications: Results indicate that exercise promotes compression of morbidity and improved functional health.

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Characterisation of macular neovascularisation in geographic atrophy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-318820 ◽

2021 ◽

pp. bjophthalmol-2021-318820

Author(s):

Riccardo Sacconi ◽

Maria Brambati ◽

Alexandra Miere ◽

Eliana Costanzo ◽

Vittorio Capuano ◽

...

Keyword(s):

Fundus Autofluorescence ◽

Geographic Atrophy ◽

Age Related Macular Degeneration ◽

First Year ◽

Age Related ◽

Treatment Naïve ◽

Type 3 ◽

Endothelial Growth Factor

AimTo characterise macular neovascularisation (MNV) developing in eyes affected by geographic atrophy (GA).MethodsIn this multicentric longitudinal study involving three retina referral centres, patients previously affected by GA who developed an active MNV were included. Patients were investigated using structural optical coherence tomography (OCT), fundus autofluorescence, OCT-angiography and dye angiographies. Patients were treated with ProReNata antivascular endothelial growth factor (VEGF) injections and were revaluated after treatment.ResultsAmong 512 patients previously diagnosed with GA, 40 eyes of 40 patients (mean age 80.8±7.9 years, mean GA area 8.73±7.39 mm2) presented with treatment-naïve exudative MNV (accounting for an estimated prevalence of 7.81%; 5.49 to 10.13, 95% CIs) and thus were included in the analysis. 67.5% of MNVs were classified as type 2 MNV, 25% as type 1, 2.5% as type 3 and 5% as mixed phenotype. In 92.5% of cases, active MNV in GA showed subretinal hyperreflective material with or without evidence of subretinal/intraretinal hyporeflective exudation. During a mean follow-up of 28±25 months, patients were treated with 6.6±6.3 anti-VEGF injections, with 2.9±1.4 injections in the first year of treatment. No patient developed GA enlargement in the area of MNV.ConclusionsMNVs in GA showed different features and therapeutic response in comparison to previously reported features of MNV in age-related macular degeneration (AMD) without GA. For these reasons, the combined phenotype (ie, GA with neovascular AMD) should be considered as a distinct entity in the research and clinical setting.

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Effects of a Fixed Dietary Intake on Changes in Red Blood Cell Delta-Aminolevulinate Dehydratase Activity and Hemolysis in Female Rhythmic Gymnasts: A Two-Year Follow-Up Study ▀

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.16.6.597 ◽

2006 ◽

Vol 16 (6) ◽

pp. 597-610 ◽

Cited By ~ 7

Author(s):

Sakuko Ishizaki ◽

Takako Koshimizu ◽

Kae Yanagisawa ◽

Yoshiko Akiyama ◽

Yuko Mekada ◽

...

Keyword(s):

Blood Cell ◽

Dietary Intake ◽

Red Blood Cell ◽

Dietary Intervention ◽

Deficiency Anemia ◽

First Year ◽

Dietary Intakes ◽

Mean Values ◽

Rhythmic Gymnasts

This study was to assess the effect of a fixed dietary intake on biomarkers of red blood cell (RBC) biosynthesis and degradation. Over a two-year period, eight collegiate rhythmic gymnasts participated in this study. During the first year, they ate self-selected diets. During the second year, a fixed dietary intake involving consumption of common Japanese foods containing 15 mg iron and 1500 kcal energy was maintained for 4 wk at the beginning of the program. Fixed dietary intakes resulted in significantly increased intakes of protein, minerals and vitamins, and significantly decreased fat intake, but total energy and carbohydrate intakes were unchanged. Mean values of RBC, Hb, Ht, or TIBC were not affected by the intervention. A fixed dietary intervention appeared to enhance RBC turnover by increasing the capacity for erythrocyte biosynthesis and degradation, although the prevalence of iron-deficiency anemia remained unchanged.

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A Mobile Health App for the Collection of Functional Outcomes After Inpatient Stroke Rehabilitation: Pilot Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/17219 ◽

2020 ◽

Vol 8 (5) ◽

pp. e17219

Author(s):

Li Li ◽

Jia Huang ◽

Jingsong Wu ◽

Cai Jiang ◽

Shanjia Chen ◽

...

Keyword(s):

Functional Status ◽

Functional Outcomes ◽

Home Visit ◽

Controlled Trial ◽

Completion Rates ◽

Validity And Reliability ◽

Randomized Controlled ◽

Group Completion ◽

Functional Assessments

Background Monitoring the functional status of poststroke patients after they transition home is significant for rehabilitation. Mobile health (mHealth) technologies may provide an opportunity to reach and follow patients post discharge. However, the feasibility and validity of functional assessments administered by mHealth technologies are unknown. Objective This study aimed to evaluate the feasibility, validity, and reliability of functional assessments administered through the videoconference function of a mobile phone–based app compared with administration through the telephone function in poststroke patients after rehabilitation hospitalization. Methods A randomized controlled trial was conducted in a rehabilitation hospital in Southeast China. Participants were randomly assigned to either a videoconference follow-up (n=60) or a telephone follow-up (n=60) group. We measured the functional status of participants in each group at 2-week and 3-month follow-up periods. Half the participants in each group were followed by face-to-face home visit assessments as the gold standard. Validity was assessed by comparing any score differences between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Reliability was assessed by computing agreements between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Feasibility was evaluated by the levels of completion, satisfaction, comfort, and confidence in the 2 groups. Results Scores obtained from the videoconference follow-up were similar to those of the home visit assessment. However, most scores collected from telephone administration were higher than those of the home visit assessment. The agreement between videoconference follow-up and home visit assessments was higher than that between telephone follow-up and home visit assessments at all follow-up periods. In the telephone follow-up group, completion rates were 95% and 82% at 2-week and 3-month follow-up points, respectively. In the videoconference follow-up group, completion rates were 95% and 80% at 2-week and 3-month follow-up points, respectively. There were no differences in the completion rates between the 2 groups at all follow-up periods (X21=1.6, P=.21 for 2-week follow-up; X21=1.9, P=.17 for 3-month follow-up). Patients in the videoconference follow-up group perceived higher confidence than those in the telephone follow-up group at both 2-week and 3-month follow-up periods (X23=6.7, P=.04 for 2-week follow-up; X23=8.0, P=.04 for 3-month follow-up). The videoconference follow-up group demonstrated higher satisfaction than the telephone follow-up group at 3-month follow-up (X23=13.9; P=.03). Conclusions The videoconference follow-up assessment of functional status demonstrates higher validity and reliability, as well as higher confidence and satisfaction perceived by patients, than the telephone assessment. The videoconference assessment provides an efficient means of assessing functional outcomes of patients after hospital discharge. This method provides a novel solution for clinical trials requiring longitudinal assessments. Trial Registration chictr.org.cn: ChiCTR1900027626; http://www.chictr.org.cn/edit.aspx?pid=44831&htm=4.

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A Mobile Health App for the Collection of Functional Outcomes After Inpatient Stroke Rehabilitation: Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.17219 ◽

2019 ◽

Author(s):

Li Li ◽

Jia Huang ◽

Jingsong Wu ◽

Cai Jiang ◽

Shanjia Chen ◽

...

Keyword(s):

Functional Status ◽

Functional Outcomes ◽

Home Visit ◽

Controlled Trial ◽

Completion Rates ◽

Validity And Reliability ◽

Randomized Controlled ◽

Group Completion ◽

Functional Assessments

BACKGROUND Monitoring the functional status of poststroke patients after they transition home is significant for rehabilitation. Mobile health (mHealth) technologies may provide an opportunity to reach and follow patients post discharge. However, the feasibility and validity of functional assessments administered by mHealth technologies are unknown. OBJECTIVE This study aimed to evaluate the feasibility, validity, and reliability of functional assessments administered through the videoconference function of a mobile phone–based app compared with administration through the telephone function in poststroke patients after rehabilitation hospitalization. METHODS A randomized controlled trial was conducted in a rehabilitation hospital in Southeast China. Participants were randomly assigned to either a videoconference follow-up (n=60) or a telephone follow-up (n=60) group. We measured the functional status of participants in each group at 2-week and 3-month follow-up periods. Half the participants in each group were followed by face-to-face home visit assessments as the gold standard. Validity was assessed by comparing any score differences between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Reliability was assessed by computing agreements between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Feasibility was evaluated by the levels of completion, satisfaction, comfort, and confidence in the 2 groups. RESULTS Scores obtained from the videoconference follow-up were similar to those of the home visit assessment. However, most scores collected from telephone administration were higher than those of the home visit assessment. The agreement between videoconference follow-up and home visit assessments was higher than that between telephone follow-up and home visit assessments at all follow-up periods. In the telephone follow-up group, completion rates were 95% and 82% at 2-week and 3-month follow-up points, respectively. In the videoconference follow-up group, completion rates were 95% and 80% at 2-week and 3-month follow-up points, respectively. There were no differences in the completion rates between the 2 groups at all follow-up periods (X21=1.6, P=.21 for 2-week follow-up; X21=1.9, P=.17 for 3-month follow-up). Patients in the videoconference follow-up group perceived higher confidence than those in the telephone follow-up group at both 2-week and 3-month follow-up periods (X23=6.7, P=.04 for 2-week follow-up; X23=8.0, P=.04 for 3-month follow-up). The videoconference follow-up group demonstrated higher satisfaction than the telephone follow-up group at 3-month follow-up (X23=13.9; P=.03). CONCLUSIONS The videoconference follow-up assessment of functional status demonstrates higher validity and reliability, as well as higher confidence and satisfaction perceived by patients, than the telephone assessment. The videoconference assessment provides an efficient means of assessing functional outcomes of patients after hospital discharge. This method provides a novel solution for clinical trials requiring longitudinal assessments. CLINICALTRIAL chictr.org.cn: ChiCTR1900027626; http://www.chictr.org.cn/edit.aspx?pid=44831&htm=4.

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Association of 4 epigenetic clocks with measures of functional health, cognition, and all-cause mortality in The Irish Longitudinal Study on Ageing (TILDA)

10.1101/2020.04.27.063164 ◽

2020 ◽

Cited By ~ 3

Author(s):

Cathal McCrory ◽

Giovanni Fiorito ◽

Belinda Hernandez ◽

Silvia Polidoro ◽

Aisling M. O’Halloran ◽

...

Keyword(s):

Longitudinal Study ◽

Functional Health ◽

Interindividual Variation ◽

Predictive Utility ◽

Clinical Phenotypes ◽

Age Related ◽

Wide Range ◽

All Cause Mortality ◽

Health Cognition

ABSTRACTThe aging process is characterized by the presence of high interindividual variation between individuals of the same chronical age prompting a search for biomarkers that capture this heterogeneity. The present study examines the associations of four epigenetic clocks - Horvath, Hannum, PhenoAge, GrimAge - with a wide range of clinical phenotypes, and with all-cause mortality at up to 10-year follow-up in a sample of 490 participants in the Irish Longitudinal Study on Ageing. Results indicate that the GrimAge clock represents a step-improvement in the predictive utility of the epigenetic clocks for identifying age-related decline in an array of clinical phenotypes.

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P5982Transcatheter aortic valve replacement in elderly patients with severe symptomatic aortic stenosis

European Heart Journal ◽

10.1093/eurheartj/ehz746.0703 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

P J Antunez Muinos ◽

L Alvarez Rodrigez ◽

J Lopez Pais ◽

D Lopez Otero ◽

X Sanmartin Pena ◽

...

Keyword(s):

Elderly Patients ◽

Descriptive Analysis ◽

Cardiac Conduction ◽

First Year ◽

Safe Procedure ◽

Age Related ◽

Wide Range ◽

Risk Patients ◽

Valve Implantation

Abstract Introduction TAVR has proven to be a safe technique for high-risk patients. The objective of our work is to know the results of TAVR in patients older than 90 years; which are the riskiest and had more complications during the admission. Methods Observational retrospective analysis based on all a single-center registry of all consecutive TAVR (N=518) during the last 10 years (2008–2018). Patients older than 90 years old represent 5.8 of the procedures (N=30). We performed a descriptive analysis of the baseline characteristics of our patient cohort, and the development of events during follow-up. Results Our population, as reflected in TABLE 1, had a median age of 91,32 years old, and the majority were women (57.58%). The procedures were mostly elective, unless in 4 patients (12.12%) that were urgent. None valvuloplasty was done before TAVR in this cohort, neither Valve-in-valve. Stratification scores had a wide range, from 1.45 to 28.8% for EurSCORE II and from 4.19 to 17.19% for STS, with a median of 5.53 and 8.49% respectively. Mortality in the first 30 days and in the first year was 0.00%. Mortality after the first year was 71.40% due to non-cardiovascular events (median time of follow-up of 34.34 months). Finally, we would also like to remark that the incidence of heart failure during the first year was 14.29%, taking into account all the follow-up, the incidence was 37.04%. Despite these data, in our registry, the need for pacemaker after the valve implantation was higher than in younger populations (40.62%), probably due to the age-related fibrosis of the cardiac conduction system. Conclusions TAVR is a very safe procedure with very successful results in elderly patients, nevertheless, due to the frailty of this population, individualization is mandatory in order to optimize the resources. Acknowledgement/Funding None

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AB0641 MANAGING ANKYLOSING SPONDYLITIS (AS) WITH SHORT TERM BIOSIMILAR ADALIMUMAB REGIMEN IN A RESOURCE STRAPPED SETTING: A PROTOCOL DRIVEN COMMUNITY CLINIC ORIENTED STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3459 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1615.1-1615

Author(s):

A. Chopra ◽

N. Khadke ◽

M. Saluja ◽

T. Kianifard ◽

A. Venugopalan

Keyword(s):

Stress Reduction ◽

Symptomatic Relief ◽

Real Life ◽

Substantial Improvement ◽

First Year ◽

Short Term ◽

Mean Values ◽

One Year

Background:We were handicapped by the exorbitant cost of innovator anti-Tumour Necrosis Factor (TNF) drugs. Despite limited use, we sometimes observed long-term benefits following short term induction like use. Emboldened by advent of biosimilars, we carried out an investigational study.Objectives:To evaluate the effectiveness of a short regimen of biosimilar (Bs) Adalimumab in ASMethods:50 consenting patients (86% B27+) naïve for biologics and negative for latent TB screen were enrolled into an observational design study of one year; Baseline mean values for age, duration, ASDAS and CRP was 31 years, 98.8 months, 4.6 and 64 mg per dl respectively. During the first year, patients were begun with 40 mg Bs Adalimumab (Bs-ADL) (Exemptia™), injected fortnight, for 12-16 weeks. No patient received DMARD or steroid in the first year of study. Patients continued standard of care follow up program in the clinic. The ASAS (Assessment Spondyloarthritis International Society) improvement indices were used. Standard intention-to-treat analysis was performed; significant p <0.05.Results:Optimum ASAS 40 improvement was observed at week 12 (68%); substantial improvement lasted till week 36. At one year, the ASAS 40 was 38%; ASAS partial remission 22% patients. Pro-inflammatory cytokines (IL-6, TNF α and IL-17) showed conspicuous reduction; maximum drop in IL-6 at week 24 (See Figure). 11 patients withdrew in the first year. 30 patients completed two years and 22 patients completed 3 year follow up. Over time, there was substantial loss in the ASAS 20 and 40 responses but patients seemed satisfied with the on-going symptomatic relief and improved function. Admittedly, patients showed more adherences to advice on physical exercise and stress reduction. Flares were more frequent after 1 year requiring short term round the clock NSAID; only 5 patients could afford to repeat a short term Bs-ADL regimen and one patient underwent hip arthroplasty. None received steroids and 5 patients were begun on Sulfasalazine in the second year and monitored. We could not evaluate structural modification (AS). Selected outcomes over 2 and 3 years from the current study will be compared to matched control (derived from the clinic database). None developed TB or any serious drug related toxicity. 2 patients developed recurrent uveitis.Conclusion:This real life documented experience unravelled impressive long term benefits following a kick start short term induction regimen of Biosimilar Adalimumab in AS. Though contrary to standard practice, this seemed a practical solution in our setting. We speculate a psychological and motivational boost rather than a prolonged real time biological effect (Bs-ADL) for this phenomenon. Our study has important socioeconomic bearing and merits validation.Acknowledgement:This was essentially a non-commercial investigator-initiated study. Zydus Cedilla India provided a generous research grant with free of cost Bs_ADL to several patients and a large concession in the cost to the rest.Disclosure of Interests:Arvind Chopra Grant/research support from: Zydus Pharamceutical Ltd India, Nagnath Khadke: None declared, Manjit Saluja: None declared, Toktam Kianifard: None declared, Anuradha Venugopalan: None declared

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Long-term outcomes after pollicization: a mean 11-year follow-up study

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193419876475 ◽

2019 ◽

Vol 45 (2) ◽

pp. 173-180

Author(s):

Camilla Hellevuo ◽

Olli V. Leppänen ◽

Susanne Kapanen ◽

Simo K. Vilkki

Keyword(s):

Functional Outcomes ◽

Long Term Results ◽

Long Term Outcomes ◽

Level Of Evidence ◽

Patients Satisfaction ◽

Metacarpal Head ◽

Follow Up Study ◽

Age Related

This study evaluates the long-term results of pollicization for a congenitally absent or severely hypoplastic thumb. Twenty-nine patients with 34 pollicizations were divided to two groups: those with simple thumb hypoplasia (22 pollicizations) and those with radial longitudinal dysplasia (12 pollicizations). The patients were followed from 1.3 to 32 years, with a mean follow-up time of 11 years. The patients were examined clinically and radiologically, and they completed a questionnaire concerning satisfaction with appearance, function, and social interaction. The Percival score was also calculated. In both groups, grip and pinch strengths of the operated hands were inferior to the normative age-related values. Radiologically, flattening of the original metacarpal head was found in 20 out of the 34 operated hands. We found better patient satisfaction in the simple hypoplasia group than in the radial longitudinal dysplasia group. The functional outcomes and patients’ satisfaction did not correlate with the age of patients at operation. Level of evidence: IV

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PSYCHOLOGICAL FACTORS ASSOCIATED WITH AMBULATION PERFORMANCE AFTER HIP FRACTURE AMONG HOME-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1566 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S419-S419

Author(s):

Richard H Fortinsky

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Gait Speed ◽

Psychological Factors ◽

Walk Distance ◽

Balance Confidence ◽

Minute Walk Distance ◽

Minute Walk ◽

Walking Endurance

Abstract Many older adults fail to resume optimal community living after hip fracture due to sustained limitations in ambulation capacity, yet reasons remain poorly understood. Roles of psychological factors in affecting ambulation performance post-hip fracture remain particularly understudied; depression has been associated with poorer self-reported functional status, and little is known about self-perceived balance confidence, resilience, and optimism. This presentation reports associations between each psychological factor, measured at CAP baseline, and gait speed and walking endurance, measured at baseline and 16 weeks later. In the CAP cohort (N=210), baseline mean/sd 4-meter gait speed (gs), 50-foot walk gs, and 6-minute walk distance were: 0.60/0.19 meters per second (mps); 0.67/0.20 mps; and 186.9/55.4 meters, respectively. In multivariate models, balance confidence was positively associated with all baseline ambulation measures (p<0.001 in all models), and resilience was positively associated with all 16-week follow-up ambulation measures (p>0.05 in all models). Implications of results will be discussed.

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COVID-19 Transition: Does virtual exercise maintain physical function?

Innovation in Aging ◽

10.1093/geroni/igaa057.3440 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 939-939

Author(s):

Stephen Jennings ◽

Kenneth Manning ◽

Megan Pearson ◽

Catalin Mateas ◽

Katherine Hall ◽

...

Keyword(s):

Physical Function ◽

Exercise Program ◽

Step Test ◽

Limited Sample ◽

Face To Face ◽

Home Based ◽

Functional Assessments ◽

The Us ◽

Virtual Platform ◽

Minute Walk

Abstract Background: In March 2020, COVID-19 mandates to restrict face to face exercise and group based gatherings were enacted. These mandates were enforced within most states in the US. Gerofit, a facility-based exercise program for older Veterans in Durham, NC, transitioned to remote virtual exercise instruction to accommodate continuity of care. Objectives: To explore whether remote virtual exercise (RVE) can sustain physical function within individuals previously participating in onsite face to face exercise (OFF). Methods: Physical function assessments performed during OFF were compared with assessments conducted remotely over virtual platform. Assessments included the 30-second arm curl, the 30-second chair stand, time to complete five chair stands, and either 6-minute walk or 2-minute step test. All assessments for RVE were completed via a remote virtual platform. Only participants enrolled in both OFF and home based RVE with functional assessments within 6-months of pre and post COVID-19 transition were compared. Descriptive comparisons, opposed to statistical, were reported due to the limited sample size. Results: Fourteen OFF Gerofit participants were reassessed remotely within the first 6-months of transitioning to RVE (12 male, 2 female, mean age 73.1, mean body mass index 31.5). Functional assessments between OFF versus RVE were arm curls (21.0 vs 20.4 repetitions), chair stands (15.0 vs 17.5 repetitions), and time to 5 chair stands (9.0 vs 8.4 seconds). Cardiovascular function, reported in normalized percentiles (46.4%tile vs 58.9%tile) Conclusion: Among older Veterans engaged in regular structured exercise, physical function was preserved with transition to virtual exercise.

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