Associations among Fall Risk Appraisal, Body Composition, and Physical Activity in Older Adults

Abstract One-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between perceived fall risk or levels of fear of falling (FOF) and physiological fall risk (balance performance). We aimed to examine the associations among FRA, body composition, and physical activity (PA) using Assistive Health Technology, including the Bioelectrical Impedance Analysis, BTrackS Balance System, and activity monitoring devices. We evaluated 124 older adults with a mean age of 74.81 (SD=7.31, range 60 to 96), 77% were female, and 72% had no history of falls. The multinomial logistic regression was used to analyze the data. FRA was classified into 4 quadrants, and we found 47% of rational FRA (low FOF and normal balance), 19% of incongruent FRA (low FOF despite poor balance), 18% of irrational FRA (high FOF despite normal balance), and 16% congruent FRA (high FOF and poor balance). We found these following variables are associated with FRA: accelerometer-based moderate to vigorous physical activity (MVPA: mins), self-reported PA score (strength & flexibility), had difficulty walking up 10 steps without resting (resistance), had difficulty walking several city blocks (ambulation), left-hand average handgrip strength, CDC fall risk score, Senior Technology Acceptance (STA) score and body composition including Body Fat Mass (BFM), Percent Body Fat (PBF), Body Mass Index (BMI), Whole Body Phase Angle, Skeletal Muscle Mass (SMM) and Skeletal Muscle Index (SMI). Our results support the efficacy of using Assistive Health Technology on screening individuals with maladaptive FRA with targeted interventions to reduce fall risk.

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Using Assistive Health Technology to Assess Fall Risk Appraisal, Body Composition, and Physical Activity

Innovation in Aging ◽

10.1093/geroni/igab046.100 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 28-28

Author(s):

Ladda Thiamwong ◽

Joon-Hyuk Park ◽

Renoa Choudhury ◽

Oscar Garcia ◽

Maxine Furtado ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Fall Risk ◽

Fear Of Falling ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Health Technology ◽

Cross Sectional ◽

Risk Appraisal

Abstract One-third of older adults have a discrepancy between perceived and physiological fall risks or maladaptive fall risk appraisal (FRA). Older adults who report high fear of falling and overestimate their physiological fall risk are less likely to participate in physical activity (PA). Limited data suggest the interrelation between fall risk appraisal, body composition, and objective measured PA. This cross-sectional study examines the feasibility of recruitment and acceptability of Assistive Health Technology (AHT), including the BTrackS Balance System (BBS), Bioelectrical Impedance Analysis (InBody s10), and ActiGraph GT9X Link wireless activity monitor. This study demonstrates the benefits of using AHT to study the associations among FRA, body composition, and PA in older adults. We hypothesize that rational FRA is associated with higher levels of PA and skeletal muscle mass and lower levels of percent of body fat and body mass index. Topics presentation included research protocol and preliminary results.

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Technology-based fall risk assessments for older adults in low-income settings: A cross-sectional study protocol (Preprint)

10.2196/preprints.27381 ◽

2021 ◽

Author(s):

Ladda Thiamwong ◽

Jeffrey R. Stout ◽

Joon-Hyuk Park ◽

Xin Yan

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Low Income ◽

Fall Risk ◽

Fear Of Falling ◽

Cross Sectional Study ◽

Balance Performance ◽

Cross Sectional ◽

Risk Appraisal

BACKGROUND One-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between a level of fear of falling (FOF) and physiological fall risk (balance performance). Older adults who overestimate their physiological fall risk and report high fear of falling are less likely to participate in physical activity. Limited data suggest the association between fear of falling, body composition, and physical activity intensity differs by fear severity. OBJECTIVE This study examines the associations among fall risk appraisal, body composition, and physical activity using Assistive Health Technology, including the BTrackS Balance System (BBS), Bioelectrical Impedance Analysis, and activity monitoring devices. This study also aims to examine the feasibility of recruitment and acceptability of technologies and procedures for use among older adults in low-income settings. METHODS This is a cross-sectional study. This study will be conducted at older adults’ homes/apartments in low-income settings in Central Florida, USA. Following consent, participants will be contacted, and our team will have two visits with them. The first visit includes questionnaires completion (e.g., socio-demographic, FOF) and the balance performance test using the BBS. Participants will be stratified by the FRA matrix. Also, they will perform the hand-grip strength and dynamic balance performance tests. Participants will then be asked to wear the ActiGraph GT9X Link wireless activity monitor on the non-dominant wrist for 7 consecutive days. The second visit includes body composition testing and a structured interview about the acceptability of technologies and procedures. RESULTS The ethical approval was obtained from the institutional review board, University of Central Florida (Protocol No. 2189; September 10, 2020). As of December 2020, the enrollment of participating is ongoing. CONCLUSIONS Accurate fall risk appraisal is essential in implementing physical activity programs, especially in low-income older adults. This study will provide data for developing technology-based fall risk assessments for improving participation in physical activity, thus enhancing healthy longevity among older adults in low-income settings.

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Skeletal muscle TLR4 and TACE are associated with body fat percentage in older adults

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2015-0567 ◽

2016 ◽

Vol 41 (4) ◽

pp. 446-451 ◽

Cited By ~ 6

Author(s):

Kyle L. Timmerman ◽

Ian D. Connors ◽

Michael A. Deal ◽

Rachael E. Mott

Keyword(s):

Physical Activity ◽

Older Adults ◽

Skeletal Muscle ◽

Chronic Disease ◽

Body Fat ◽

Disease Risk ◽

Fasting Blood Glucose ◽

Activity Level ◽

Percent Body Fat ◽

Chronic Disease Risk

Elevated skeletal muscle expression of toll-like receptor 4 (TLR4) has been linked to increased inflammation in clinical populations. TNFα converting enzyme (TACE), which cleaves membrane-bound TNFα (mTNFα) to its soluble (sTNFα) and more bioactive form, has been linked to chronic disease. In contrast, higher physical activity level is associated with decreased chronic disease risk and inflammation. The purpose of the present study was to examine the relationship between physical activity and skeletal muscle TLR4, TACE, and TNFα in older adults. In 26 older adults (age = 68 ± 4 years, body mass index = 26 ± 3 kg·m−2), self-reported physical activity (kcal·week−1), estimated maximal oxygen consumption, and body composition (air plethysmography) were measured. TLR4, TACE, mTNFα, and sTNFα were measured in skeletal muscle biopsies (vastus lateralis) using western blot analyses. Pearson product-moment correlations were run between variables. Significance was set at p < 0.05. Skeletal muscle TACE was directly associated with sTNFα (r = 0.53, p < 0.01). Linear regression modeling showed that mTNFα and TACE expression were predictive of sTNFα expression. No correlations were observed between physical activity and TLR4, TACE, or sTNFα. Percent body fat was directly associated with skeletal muscle TLR4 (r = 0.52, p < 0.01) and TACE (r = 0.50, p < 0.01), whereas fasting blood glucose was directly associated with TACE and sTNFα. In conclusion, we found that percent body fat was directly associated with TLR4 and TACE expression in skeletal muscle of older adults. These findings suggest that elevated skeletal muscle expression of TLR4 and TACE may contribute to the augmented inflammation and chronic disease risk observed with increased adiposity.

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Vitamin D and Physical Activity Status: Associations With Five-Year Changes in Body Composition and Muscle Function in Community-Dwelling Older Adults

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-3519 ◽

2015 ◽

Vol 100 (2) ◽

pp. 670-678 ◽

Cited By ~ 25

Author(s):

David Scott ◽

Peter R. Ebeling ◽

Kerrie M. Sanders ◽

Dawn Aitken ◽

Tania Winzenberg ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Vitamin D ◽

Body Composition ◽

Body Fat ◽

Muscle Function ◽

Community Dwelling ◽

Accelerometer Data ◽

High Vitamin ◽

Community Dwelling Older Adults

Abstract Context: High vitamin D and physical activity (PA) levels are independently associated with improved body composition and muscle function in older adults. Objective: The objective of this study was to investigate the interaction of 25-hydroxyvitamin D (25OHD) and PA status in maintenance of body composition and muscle function in older adults. Design and Setting: This was a 5-year prospective population-based study of Australian community-dwelling older adults. Participants: Participants in the study included 615 community-dwelling volunteers aged 50 years old or older [61.4 ± 6.9 (mean ± SD) y; 48% female] randomly selected from electoral rolls and categorized according to baseline serum 25OHD (≥ or <50 nmol/L) and PA (≥ or <10 000 pedometer determined steps/d) levels as follows: high 25OHD and high PA (VitD+PA+); high 25OHD and low PA (VitD+PA−); low 25OHD and high PA (VitD-PA+); and low 25OHD and low PA (VitD-PA−). A subset of 518 participants completed accelerometer assessments during follow-up. Main Outcome Measures: Changes in dual-energy X-ray absorptiometry-assessed body composition and lower-limb muscle function were measured. Results: VitD+PA+ had significantly smaller increases in body fat over 5 years compared with other groups (all P < .05). Higher baseline pedometer-determined PA resulted in declines in total body fat (β = −.23 kg per 100 steps/d, P = .001) over 5 years for participants with high 25OHD but not those with low 25OHD (P > .05). Among participants with accelerometer data, these associations were generally mediated by higher levels of moderate/vigorous PA. Conclusions: High vitamin D status appears to enhance PA-related declines in body fat during aging, but the mechanism may be greater amounts of outdoor moderate/vigorous PA rather than a direct effect of 25OHD.

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Body composition, skeletal muscle and body fat mass in the body trunk and extremities in male obese children without habitual physical activity

Japan Journal of Human Growth and Development Research ◽

10.5332/hatsuhatsu.2013.12 ◽

2013 ◽

Vol 2013 (59) ◽

pp. 12-19

Author(s):

Kazuo Oguri ◽

Toshiki Tachi ◽

Toshio Matsuoka

Keyword(s):

Physical Activity ◽

Skeletal Muscle ◽

Body Composition ◽

Body Fat ◽

Fat Mass ◽

The Body ◽

Habitual Physical Activity ◽

Body Fat Mass ◽

Obese Children

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Skeletal muscle TLR4 expression is associated with body composition, but not physical activity level in older adults (LB74)

The FASEB Journal ◽

10.1096/fasebj.28.1_supplement.lb74 ◽

2014 ◽

Vol 28 (S1) ◽

Author(s):

Ian Connors ◽

Rachael Mott ◽

Rudra Trivedi ◽

Larissa Combs ◽

Chase Heilbronn ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Skeletal Muscle ◽

Body Composition ◽

Physical Activity Level ◽

Activity Level ◽

Tlr4 Expression

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Targeting body composition in an older population: do changes in movement behaviours matter? Longitudinal analyses in the PREDIMED-Plus trial

BMC Medicine ◽

10.1186/s12916-020-01847-9 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Aina M. Galmes-Panades ◽

◽

Jadwiga Konieczna ◽

Veronica Varela-Mato ◽

Itziar Abete ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Metabolic Syndrome ◽

Body Composition ◽

Body Fat ◽

Controlled Trial ◽

Vigorous Physical Activity ◽

Activity Levels ◽

Longitudinal Assessment ◽

Tv Viewing

Abstract Background The optimal distribution between physical activity (PA) levels and sedentary behaviour (SB) for the greatest benefits for body composition among older adults with overweight/obesity and chronic health conditions remains unclear. We aimed to determine the prospective association between changes in PA and in SB with concurrent changes in body composition and to examine whether reallocating inactive time into different physical activity levels was associated with 12-month change to body composition in older adults. Methods Longitudinal assessment nested in the PREDIMED-Plus trial. A subsample (n = 1564) of men and women (age 55–75 years) with overweight/obesity and metabolic syndrome from both arms of the PREDIMED-Plus trial was included in the present analysis. Participants were followed up at 6 and 12 months. Physical activity and SB were assessed using validated questionnaires. Out of 1564 participants, 388 wore an accelerometer to objectively measure inactive time and PA over a 7-day period. At each time point, participants’ body composition was measured using dual-energy X-ray absorptiometry (DXA). Standard covariate-adjusted and isotemporal substitution modelling were applied to linear mixed-effects models. Results Increasing 30 min of total PA and moderate-to-vigorous physical activity (MVPA) was associated with significant reductions in body fat (β − 0.07% and − 0.08%) and visceral adipose tissue (VAT) (− 13.9 g, and − 15.6 g) at 12 months (all p values < 0.001). Reallocating 30 min of inactive time to MVPA was associated with reductions in body fat and VAT and with an increase in muscle mass and muscle-to-fat mass ratio (all p values < 0.001). Conclusions At 12 months, increasing total PA and MVPA and reducing total SB and TV-viewing SB were associated with improved body composition in participants with overweight or obesity, and metabolic syndrome. This was also observed when substituting 30 min of inactive time with total PA, LPA and MVPA, with the greatest benefits observed with MVPA. Trial registration International Standard Randomized Controlled Trial (ISRCTN), 89898870. Retrospectively registered on 24 July 2014

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Youth and Young Adult Physical Activity and Body Composition of Young Adult Women: Findings from the Dietary Intervention Study in Children

Pediatric Exercise Science ◽

10.1123/pes.2014-0001 ◽

2015 ◽

Vol 27 (1) ◽

pp. 140-150

Author(s):

Melissa Hodge ◽

Mary Hovinga ◽

Kelley Gabriel ◽

Linda Snetselaar ◽

John Shepherd ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Young Adult ◽

Body Fat ◽

Intervention Study ◽

Dietary Intervention ◽

Whole Body ◽

Adult Women ◽

Young Adult Women ◽

Dietary Intervention Study

This study prospectively investigates associations between youth moderate-to-vigorous-intensity physical activity (MVPA) and body composition in young adult women using data from the Dietary Intervention Study in Children (DISC) and the DISC06 Follow-Up Study. MVPA was assessed by questionnaire on 5 occasions between the ages 8 and 18 years and at age 25-29 years in 215 DISC female participants. Using whole body dual-energy x-ray absorptiometry (DXA), overall adiposity and body fat distribution were assessed at age 25-29 years by percent body fat (%fat) and android-to-gynoid (A:G) fat ratio, respectively. Linear mixed effects models and generalized linear latent and mixed models were used to assess associations of youth MVPA with both outcomes. Young adult MVPA, adjusted for other young adult characteristics, was significantly inversely associated with young adult %fat (%fat decreased from 37.4% in the lowest MVPA quartile to 32.8% in the highest (p-trend = 0.02)). Adjusted for youth and young adult characteristics including young adult MVPA, youth MVPA also was significantly inversely associated with young adult %fat (β=-0.40 per 10 MET-hrs/wk, p = .02) . No significant associations between MVPA and A:G fat ratio were observed. Results suggest that youth and young adult MVPA are important independent predictors of adiposity in young women.

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Changes in physical activity, sedentary behaviour and body composition: longitudinal analysis in the PREDIMED-Plus trial

10.21203/rs.3.rs-44115/v1 ◽

2020 ◽

Author(s):

Aina M Galmes-Panades ◽

Jadwiga Konieczna ◽

Veronica Varela-Mato ◽

Itziar Abete ◽

Nancy Babio ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Metabolic Syndrome ◽

Body Composition ◽

Sedentary Behaviour ◽

Body Fat ◽

Controlled Trial ◽

Activity Levels ◽

Tv Viewing ◽

Prospective Association

Abstract Background:The optimal distribution between physical activity (PA) levels and sedentary behaviour (SB) for the greatest benefits for body composition among older adults with overweight/obesity and chronic health conditions remains unclear. We aimed to determine the prospective association between changes in PA and in SB with concurrent changes in body composition. To examine whether reallocating inactive time into different physical activity levels was associated with 12-month change to body composition in older adults.Methods: A subsample (n=1564) of men and women (age: 55-75 years) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus trial was included in the present analysis. Participant’s were followed-up at 6- and 12-months. Physical Activity and SB were assessed using validated questionnaires. Out of 1564 participants, 388 wore an accelerometer to objectively measure inactive time and PA over a 7-day period. At each time point, participants body composition was measured using dual-energy X-ray absorptiometry (DXA). Standard covariate-adjusted and isotemporal substitution modelling were applied to linear mixed-effects models.Results:Increasing 30 minute of total PA and MVPA were associated with significant reductions in body fat (β -0.07% and -0.08%) and VAT (-13.9g, and -15.6g) at 12-months (all p-values <0.001). Reallocating 30 minute of inactive time to MVPA was associated with reductions in body fat and VAT, and with an increase in muscle mass and muscle-to-fat mass ratio (all p-values <0.001).Conclusions:At 12 months, increasing total PA and MVPA and reducing total and TV-viewing SB were associated with improved body composition in participants with overweight or obesity, and metabolic syndrome. This was also observed when reallocating 30 minute of inactive time by total PA, LPA and MVPA, with the greatest benefits observed for MVPA.Trial registration: The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

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