Premenopausal Bilateral Oophorectomy Effects on Clinical and Real-World Physical Function Measures

Abstract Women with premenopausal bilateral oophorectomy (PBO) are at increased risk for physical function (PF) declines. This study investigated the relationships of field-based physical activity measures with clinical PF and strength parameters in post-menopausal women with and without PBO. Women with (n=21; age=64±4 years; BMI=32±8 kg.m-2) and without (n=15; age=67±6 years; BMI=28±6 kg.m-2) PBO performed PF and strength tests (walking speed, distance walked, short physical performance battery (SPBB), leg and chest strength), and wore ankle accelerometers for 7 days (daily step count and loading index [the cumulative sum of each step’s skeletal loading]). Age, BMI, step count and loading index were entered into stepwise multiple regression to identify significant predictors of PF and strength parameters. Step count was a predictor of SPBB score in both groups. In women without PBO, step count was a predictor of walking speed; loading index was a predictor of leg strength; step count and loading index were predictors of distance; and step count and age were predictors of chest strength. For PBO women, loading index and BMI were predictors of walking speed and distance; BMI was a predictor of leg strength; and there were no predictors of chest strength. These data suggest while field-based physical activity was strongly and positively associated with clinical PF and strength measures for women without PBO, BMI was a dominant negative factor for PF in women with PBO. Future work will include a larger sample size and additional confounders to further elucidate underlying factors of reduced PF and mobility after PBO.

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Changes in the Dynamic Stability of Walking in Active Healthy Older Adults Independent of Changes in Walking Speed

Volume 2: Biomedical and Biotechnology Engineering ◽

10.1115/imece2008-67807 ◽

2008 ◽

Author(s):

Hyun Gu Kang ◽

Jonathan B. Dingwell

Keyword(s):

Older Adults ◽

Young Adults ◽

Dynamic Stability ◽

Walking Speed ◽

Age Groups ◽

Leg Strength ◽

Age Related ◽

Increased Risk ◽

Risk Of Falls ◽

Walking Speeds

Older adults commonly walk slower, which many believe helps improve their walking stability. However, they remain at increased risk of falls. We investigated how differences in age and walking speed independently affect dynamic stability during walking, and how age-related changes in leg strength and ROM affected this relationship. Eighteen active healthy older and 17 younger adults walked on a treadmill for 5 minutes each at each of 5 speeds (80–120% of preferred). Local divergence exponents and maximum Floquet multipliers (FM) were calculated to quantify each subject’s responses to small inherent perturbations during walking. These older adults exhibited the same preferred walking speeds as the younger subjects (p = 0.860). However, these older adults still exhibited greater local divergence exponents (p<0.0001) and higher maximum FM (p<0.007) than young adults at all walking speeds. These older adults remained more unstable (p<0.04) even after adjusting for declines in both strength and ROM. In both age groups, local divergence exponents decreased at slower speeds and increased at faster speeds (p<0.0001). Maximum FM showed similar changes with speed (p<0.02). The older adults in this study were healthy enough to walk at normal speeds. However, these adults were still more unstable than the young adults, independent of walking speed. This greater instability was not explained by loss of leg strength and ROM. Slower speeds led to decreased instability in both groups.

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Promoting Health and Physical Function Among Cancer Survivors: Potential for Prevention and Questions That Remain

Journal of Clinical Oncology ◽

10.1200/jco.2006.06.6175 ◽

2006 ◽

Vol 24 (32) ◽

pp. 5125-5131 ◽

Cited By ~ 167

Author(s):

Wendy Demark-Wahnefried ◽

Bernardine M. Pinto ◽

Ellen R. Gritz

Keyword(s):

Physical Activity ◽

Smoking Cessation ◽

Cancer Survivors ◽

Physical Function ◽

Behavioral Change ◽

Exercise Interventions ◽

Increased Risk ◽

Health Related ◽

The Impact

Cancer survivors are at increased risk, not only for progressive and recurrent disease, but also other cancers, cardiovascular disease, diabetes, osteoporosis, and functional decline. Lifestyle interventions to improve dietary and physical activity behaviors, and smoking cessation, have the potential to improve the overall health and quality of life of this vulnerable population. Studies on overall health and physical function from 1966 and beyond regarding the impact of behavioral interventions that used randomized and controlled designs were identified through MEDLINE and PubMed searches. Published reports currently exist for 22 exercise interventions, 11 diet-related interventions (excluding those limited to dietary supplements or single nutrients), two diet and exercise interventions, and 10 behavioral-based smoking cessation interventions. Although many interventions have been successful in promoting behavioral change and have resulted in improvements in various health-related outcomes, more research is needed to determine the key components of interventions that are able to produce the greatest behavioral change and the most favorable health-related benefits. The oncology care provider can play a pivotal role in improving the long-term health of cancer survivors by (1) being aware of opportunities to encourage healthful behaviors (ie, smoking cessation, weight control, and increased physical activity); (2) vigilantly tracking long-term effects among cancer survivors and exploring whether they are amenable to intervention; (3) staying abreast of current health behavior guidelines for cancer survivors and existing resources for professional and patient education; and (4) supporting and contributing to efforts aimed at primary and tertiary prevention research.

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The Associations between Objectively Measured Physical Activity and Physical Function in Community-Dwelling Older Japanese Men and Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010369 ◽

2021 ◽

Vol 19 (1) ◽

pp. 369

Author(s):

Harukaze Yatsugi ◽

Tao Chen ◽

Si Chen ◽

Xin Liu ◽

Hiro Kishimoto

Keyword(s):

Physical Activity ◽

Physical Function ◽

Walking Speed ◽

Vigorous Physical Activity ◽

Community Dwelling ◽

Japanese Men ◽

Men And Women ◽

Standing Time ◽

Women Subjects ◽

Objectively Measured

Objective: The relationships between physical activity (PA) and physical function (PF) among older Japanese adults have been examined before, with some studies reporting that moderate-to-vigorous physical activity (MVPA) is positively associated with PF. However, it is unclear whether the observed associations differ between men and women. In this study, we investigated the associations of objectively measured MVPA, light physical activity (LPA), and sedentary time (ST) with different PF levels in older Japanese men and women. Subjects and Methods: A total of 810 community-dwelling subjects aged 65–75 years were investigated (52.1% women, 47.9% men). The PF variables included grip strength, one-leg standing, usual and maximum walking speeds, and chair-standing time. PA (MVPA, LPA, and ST) and the number of steps taken daily were assessed for seven consecutive days by a tri-axial accelerometer. We determined the sex-specific quartiles of MVPA, LPA, and ST and analyzed their associations with physical function in separate models for each exposure measure. Results: In the crude analysis, MVPA was significantly associated with all PF variables in the men, and with the usual walking speed, max. walking speed, and chair-standing time in the women. Neither LPA nor ST was significantly associated with any PF variables. After adjusting potential confounding factors, significant associations between MVPA and usual walking speed remained in the men and women. Conclusions: Only greater moderate-to-vigorous physical activity (MVPA) was significantly associated with higher levels of PF variables in both men and women. Thus, time spent in moderate-to-vigorous physical activity (MVPA) can help older adults maintain or improve their physical function.

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Abstract 14750: Characteristics Associated With Postpartum Physical Activity Levels Among Women With Hypertensive Disorders of Pregnancy

Circulation ◽

10.1161/circ.142.suppl_3.14750 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Jennifer Lewey ◽

Samantha Murphy ◽

Michal Elovitz ◽

Lisa Levine

Keyword(s):

Physical Activity ◽

Patient Characteristics ◽

Step Count ◽

Postpartum Women ◽

Daily Step ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Increased Risk ◽

Daily Step Count ◽

Participant Characteristics

Background: Hypertensive disorders of pregnancy (HDP), such as preeclampsia, are associated with increased risk of CV disease. Postpartum interventions may mitigate this risk but have not been well studied in women with HDP. STEP UP Mom is a randomized clinical trial to increase physical activity (PA) in postpartum women with HDP using remote monitoring and social incentives (NCT04119232). We analyzed patient characteristics associated with daily step count prior to study randomization to understand factors associated with postpartum PA. Methods: Between October 2019 and May 2020, 168 women were enrolled. Participant characteristics were collected from surveys and chart abstraction. We used univariate and multivariable linear regression to identify characteristics associated with step count, as measured by wearable devices. We also compared women with low step count (defined as ≤ 4800 steps/day, the lowest step count quartile) vs. > 4800 steps per day using chi-square test. This analysis includes 137 participants with complete baseline data available at end of enrollment. Results: Mean daily baseline step count was 7444 (SD 3453). The associations between participant characteristics and baseline daily step count are presented in the Table. In multivariable regression, characteristics associated with higher baseline step count were self-reported health as good or better (2789 steps, p<0.001), tobacco use (2622 steps, p=0.03) high school education or less (1676 steps, p=0.019) and weeks since delivery (293 steps per week, p=0.011). Participants with low baseline step count (≤ 4800 steps/day) were more likely to enroll after the COVID-19 pandemic (34% vs. 18%, p=0.04) and be married (71% vs. 49%, p=0.029) compared to those with normal/high step count. Conclusion: Multiple patient characteristics impact postpartum PA levels, which may be helpful in planning lifestyle interventions in high-risk postpartum women.

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Associations of Activity Monitor Output and an Estimate of Aerobic Fitness With Pulse Wave Velocities: The Nakanojo Study

Journal of Physical Activity and Health ◽

10.1123/jpah.2012-0374 ◽

2015 ◽

Vol 12 (1) ◽

pp. 139-144 ◽

Cited By ~ 5

Author(s):

Makoto Ayabe ◽

Sungjin Park ◽

Roy J. Shephard ◽

Yukitoshi Aoyagi

Keyword(s):

Physical Activity ◽

Arterial Stiffness ◽

Aerobic Fitness ◽

Walking Speed ◽

Pulse Wave ◽

Activity Monitor ◽

Step Count ◽

Daily Step ◽

Metabolic Equivalents ◽

Daily Step Count

Background:We examined the relative contributions of habitual physical activity and aerobic fitness to the prevention of arteriosclerosis.Methods:Elderly individuals (97 men and 109 women, aged > 65 y) each wore a uniaxial activity monitor continuously for 1 year, with activity data summarized as an average daily step count and duration of activity > 3 metabolic equivalents (METs). Aerobic fitness was assessed by a standardized 5-m walking test measure of maximal walking speed. Central arterial stiffness was determined using an automatic waveform analyzer measure of cardio-femoral pulse wave velocity (cfPWV).Results:The cfPWV was negatively associated with daily step count, duration of activity > 3 METs, and maximal walking speed (P < .05). Multiple stepwise regression analysis revealed that the step count, duration of activity > 3 METs, and maximal walking speed were all significant predictors of cfPWV, accounting for 11%, 7%, and 4% of total variance, respectively.Conclusions:In contrast to findings from studies using potentially fallible questionnaires, our data suggest that a measure of health (arterial stiffness) is more closely related to objective measures of physical activity than to an estimate of aerobic fitness.

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Body Composition, Muscle Capacity, and Physical Function in Older Adults: An Integrated Conceptual Model

Journal of Aging and Physical Activity ◽

10.1123/japa.2013-0009 ◽

2014 ◽

Vol 22 (3) ◽

pp. 441-452 ◽

Cited By ~ 47

Author(s):

Anne O. Brady ◽

Chad R. Straight ◽

Ellen M. Evans

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Physical Function ◽

Conceptual Model ◽

Physical Disability ◽

Aging Process ◽

Skeletal Muscle Mass ◽

Increased Risk ◽

Risk For Disability

The aging process leads to adverse changes in body composition (increases in fat mass and decreases in skeletal muscle mass), declines in physical function (PF), and ultimately increased risk for disability and loss of independence. Specific components of body composition or muscle capacity (strength and power) may be useful in predicting PF; however, findings have been mixed regarding the most salient predictor of PF. The development of a conceptual model potentially aids in understanding the interrelated factors contributing to PF with the factors of interest being physical activity, body composition, and muscle capacity. This article also highlights sex differences in these domains. Finally, factors known to affect PF, such as sleep, depression, fatigue, and self-efficacy, are discussed. Development of a comprehensive conceptual model is needed to better characterize the most salient factors contributing to PF and to subsequently inform the development of interventions to reduce physical disability in older adults.

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Ratings of Perceived Exertion during Walking: Predicting Major Mobility Disability and Effect of Structured Physical Activity in Mobility-Limited Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glab036 ◽

2021 ◽

Author(s):

Erta Cenko ◽

Haiying Chen ◽

Thomas M Gill ◽

Nancy W Glynn ◽

Rebecca M Henderson ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Perceived Exertion ◽

Walking Speed ◽

Walk Test ◽

Mobility Impairment ◽

Ratings Of Perceived Exertion ◽

Mobility Disability ◽

Increased Risk ◽

Walking Recovery

Abstract Background This study evaluated the association between ratings of perceived exertion (RPE) of walking and major mobility disability (MMD), as well as their transitions in response to a physical activity (PA) compared to a health education (HE) program. Methods Older adults (n=1633) at risk for mobility impairment were randomized to structured PA or HE programs. During a 400m walk, participants rated exertion as “light” or “hard”. An MMD event was defined as the inability to walk 400m. MMD events and RPE values were assessed every 6-months for an average of 2.6 years. Results Participants rating their exertion as “hard” had a nearly 3-fold higher risk of MMD compared with those rating their exertion as “light” (HR: 2.61, 95%CI: 2.19-3.11). The association held after adjusting for disease conditions, depression, cognitive function and walking speed (HR: 2.24, 95%CI: 1.87-2.69). The PA group was 25% more likely to transition from “light” to “hard” RPE than the HE group (1.25, 1.05-1.49). Additionally, the PA group was 27% (0.73, 0.55 – 0.97) less likely to transition from a “hard” RPE to inability to walk 400m and was more likely to recover their ability to walk 400m by transitioning to a “hard” RPE (2.10, 1.39-3.17) than the HE group. Conclusions Older adults rating “hard” effort during a standardized walk test were at increased risk of subsequent MMD. A structured PA program enabled walking recovery, but was more likely to increase transition from "light" to "hard" effort, which may reflect greater capacity to perform the test.

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Effects of Combined Exercise on Frailty index, Carotid Artery Beta-Stiffness, and Distensibility in Pre-frail Older Adults Women

Exercise Science ◽

10.15857/ksep.2020.29.3.233 ◽

2020 ◽

Vol 29 (3) ◽

pp. 233-241

Author(s):

Yung-Jung Jang ◽

Tea-Kyu Kim ◽

Jin-Kee Park

Keyword(s):

Physical Activity ◽

Carotid Artery ◽

Physical Function ◽

Grip Strength ◽

Walking Speed ◽

Frailty Index ◽

Adult Women ◽

Combined Exercise ◽

Time Interaction ◽

Group Time

PURPOSE: We studied the effects of combined exercise (CE) on frailty index, physical function, carotid artery (CA) distensibility, and beta-stiffness in pre-frailty older women.METHODS: A total of 27 pre-frailty older women (aged 70.6±4.0 years), who were divided into a control group (n=13) and a supervised CE group (n=14). The 12-week CE program (resistance and aerobic exercise) consisted of sessions 50 minutes in length 3 days per week under the supervision of an exercise specialist. Frailty index, blood pressure, physical function, and CA function were assessed.RESULTS: Frailty status showed a significantly (p=.001) group×time interaction. Also, physical activity (p=.019), walking speed (p=.049), and right grip strength (p=.040) showed a significantly group×time interaction. In the CE group, physical activity, walking speed, and right grip strength were significantly (p=.001, p<.001, p<.001) increased, and frailty state was significantly (p<.001) decreased 12-week. Left CA distensibility (p=.032), and beta-stiffness (p=.033) showed a significantly group×time interaction. In the CE group, CA distensibility was significantly (p<.05) increased, and CA beta-stiffness was significantly (p<.01) decreased after 12-week.CONCLUSIONS: In pre-frail older adult women, CE effectively improves frailty index, CA stiffness, and distensibility.

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Mobility and Muscle Strength Trajectories: The Effect of Mediterranean Diet, Physical Activity, and Social Support

Innovation in Aging ◽

10.1093/geroni/igab046.274 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 71-72

Author(s):

Marguerita Saadeh ◽

Federica Prinelli ◽

Davide Vetrano ◽

Weili Xu ◽

Anna-Karin Welmer ◽

...

Keyword(s):

Physical Activity ◽

Social Support ◽

Muscle Strength ◽

Physical Function ◽

Mediterranean Diet ◽

Walking Speed ◽

National Study ◽

Chair Stand ◽

Modifiable Factors ◽

High Social Support

Abstract Decline in physical function varies substantially across older individuals due to several biological and extrinsic factors. We aimed to determine the effect of modifiable factors -such as dietary patterns, physical activity and social support- and their interaction with mobility and muscle strength decline after age 60. We analyzed data from 1686 individuals aged 60+ from the population-based Swedish National study on Aging and Care in Kungsholmen. The Mediterranean Diet Score was calculated based on a validated food frequency questionnaire. Physical activity was categorized based on current recommendations, and social support was measured according to participants' perceived material and psychological support. Participants’ physical function was assessed over 12 years through changes in walking speed (m/s) and chair stand time (s). Linear mixed models adjusted for socio-demographic and clinical factors were used. Subjects with high adherence to Mediterranean diet were <78 years (82.3%), women (56.1%), married (61.1%), with university education (52.8%), high levels of social support (39.3%) and health-enhancing physical activity (51.5%). One-point (over nine) increase in the MDS was associated with a slower annual worsening in walking speed (β*time=0.001; p=0.024) and chair stand time (β*time=-0.014; p=0.008). The protective effect of Mediterranean diet was highest among subjects reporting high social support (β*time=-0.065, p=0.026 for chair stands) and high physical activity (β*time=0.010, p=0.001 for walking speed), beyond the effect of each exposure individually. A higher adherence to Mediterranean diet, especially in combination with recommended levels of physical activity and high social support, contribute to delay the decline in physical function observed with aging.

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Mobility and muscle strength trajectories in old age: the beneficial effect of Mediterranean diet in combination with physical activity and social support

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01192-x ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Marguerita Saadeh ◽

Federica Prinelli ◽

Davide L. Vetrano ◽

Weili Xu ◽

Anna-Karin Welmer ◽

...

Keyword(s):

Physical Activity ◽

Social Support ◽

Muscle Strength ◽

Physical Function ◽

Mediterranean Diet ◽

Walking Speed ◽

National Study ◽

Chair Stand ◽

Modifiable Factors ◽

High Social Support

Abstract Introduction Decline in physical function varies substantially across older individuals due to several extrinsic modifiable factors such as dietary patterns, physical activity and social support. We aimed to determine the association of these factors and their interaction with mobility and muscle strength decline. Methods We analyzed data from 1686 functionally healthy individuals aged 60 + from the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K). The Mediterranean Diet Score (MDS) was calculated based on a validated food frequency questionnaire. Self-reported physical activity was categorized based on current recommendations, and social support was measured according to participants’ perceived material and psychological support from relatives and friends. Participants’ physical function was assessed over 12 years through changes in walking speed (m/s) and chair stand time (s). Linear mixed models adjusted for socio-demographic and clinical factors were used. In order to explore the combined effect of the different exposures, two indicator variables were created by cross-classifying individuals' levels of Mediterranean diet adherence and social support or physical activity. Results Participants with a high adherence to Mediterranean diet were primarily < 78 years (82.3%), women (56.1%), married (61.1%), with university education (52.8%), high levels of social support (39.3%) and health-enhancing levels of physical activity (51.5%). A one-point increase in MDS (score range 0–9) was associated with less annual deterioration in walking speed (β*time[year] = 0.001; p = 0.024) and chair-stand time (β*time[year] = -0.014; p = 0.008). The potential protective effect of Mediterranean diet was highest among participants reporting high social support (β*time[year] = -0.065, p = 0.026 for chair stands) and high physical activity (β*time[year] = 0.010, p = 0.001 for walking speed), beyond the effect of each exposure individually. Conclusion A higher adherence to Mediterranean diet, especially in combination with recommended levels of physical activity and high social support, may contribute to delay the decline in physical function observed with aging.

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