scholarly journals Longitudinal Association Between Perceived Fatigability and Brain Volumes in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 209-209
Author(s):  
Fangyu Liu ◽  
Yang An ◽  
Amal Wanigatunga ◽  
Alden Gross ◽  
Eleanor Simonsick ◽  
...  
Keyword(s):  
Older Adults ◽  
Gray Matter ◽  
Brain Atrophy ◽  
Perceived Exertion ◽  
Community Dwelling ◽  
Rating Of Perceived Exertion ◽  
Intracranial Volume ◽  
Brain Volumes ◽  
Potential Marker ◽  
Longitudinal Association

Abstract Perceived fatigability is linked to declining physical and cognitive performance, yet whether fatigability reflects early subclinical change in brain structure is unknown. Using mixed effects models, we assessed the longitudinal association of 3T MRI-derived brain volumes with perceived fatigability after a 5-min treadmill walk (0.67 m/s, 0% grade) using the Borg Rating of Perceived Exertion scale (range 6-20) in 802 BLSA participants (age 68.2+/-12.4 years, 45% men 66% White). In models adjusted for intracranial volume, demographics, chronic conditions, and CESD score, declining gray matter volumes in the frontal (β=-0.01) and temporal (β=-0.02) lobes, as well as the hippocampus (β=-0.25), precuneus (β=-0.10) and thalamus (β=-0.19) were associated with higher fatigability. Larger ventricular volumes were also associated with higher fatigability (β=0.02). Brain atrophy, particularly in gray matter and the hippocampal region, is longitudinally associated with increased fatigability in cognitively normal older adults, making it a potential marker of brain atrophy.

scholarly journals The Longitudinal Association of Walking Efficiency With Brain Volumes in Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 783-783
Author(s):  
Jennifer Schrack ◽  
Fangyu Liu ◽  
Amal Wanigatunga ◽  
Yang An ◽  
Christos Davatzikos ◽  
...  
Keyword(s):  
Region Of Interest ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Intracranial Volume ◽  
Brain Volumes ◽  
Age Related ◽  
Lower Baseline ◽  
Longitudinal Association ◽  
Mri Scans ◽  
Walking Efficiency

Abstract Walking efficiency (WE) predicts mobility decline and is linked with higher fatigability. Fatigability is associated with cognitive decline and reduced brain volumes (BV), but the link between WE and BV is undefined. We examined associations between WE and BV in 860 participants of the BLSA (mean age 66.4(14.4) years, 54.5% women). WE was assessed during 2.5-minutes of usual-paced walking using indirect calorimetry and standardized per meter (ml/kg/m). BV measures were derived using MRI scans and an automated multi-atlas region-of-interest approach. In linear mixed models adjusted for demographics, education, BMI, intracranial volume, and cognitive status, lower baseline WE was associated with lower total, white, and gray matter, primarily in the frontal and temporal lobes (all p<0.05). Longitudinally, declining WE was associated with increasing ventricular and decreasing hippocampal volumes over follow-up (all p<0.01). Findings suggest rising age-related inefficiencies may reflect underlying brain atrophy and serve as a novel indicator for future interventions.

Association of Sleep, Neuropsychological Performance, and Gray Matter Volume With Glymphatic Function in Community-Dwelling Older Adults

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013215
Author(s):  
Tiing Yee Siow ◽  
Cheng Hong Toh ◽  
Jung-Lung Hsu ◽  
Geng-Hao Liu ◽  
Shwu-Hua Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Gray Matter ◽  
Gray Matter Volume ◽  
Community Dwelling ◽  
Intracranial Volume ◽  
Waste Products ◽  
Glymphatic System ◽  
Matter Volume ◽  
Gray Matter Volumes ◽  
Community Dwelling Older Adults

Background and Objectives:The glymphatic system, which is robustly enabled during some stages of sleep, is a fluid-transport pathway that clears cerebral waste products. Most contemporary knowledge regarding glymphatic system is inferred from rodent experiments and human research is limited. The objective of the research is to explore the associations between human glymphatic function, sleep, neuropsychological performances, and cerebral gray matter volumes.Methods:This cross-sectional study included individuals 60 years or older who had participated in the Integrating Systemic Data of Geriatric Medicine to Explore the Solution for Health Aging study between September 2019 and October 2020. Community-dwelling older adults were enrolled at 2 different sites. Participants with dementia, major depressive disorders, and other major organ system abnormalities were excluded. Sleep profile was accessed using questionnaires and polysomnography. Administered neuropsychological test batteries included Everyday Cognition (ECog) and the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NB). Gray matter volumes were estimated based on magnetic resonance imaging (MRI). Diffusion tensor imaging-analysis along the perivascular space (DTI-ALPS) index was used as the MRI marker of glymphatic function.Results:A total of 84 participants (mean [SD] age, 73.3 [7.1] years, 47 [56.0%] women) were analyzed. Multivariate linear regression model determined that age (unstandardized β, -0.0025 [SE, 0.0001]; P = 0.02), N2 sleep duration (unstandardized β, 0.0002 [SE, 0.0001]; P = 0.04), and the apnea-hypopnea index (unstandardized β, -0.0011 [SE, 0.0005]; P = 0.03) were independently associated with DTI-ALPS. Higher DTI-ALPS was associated with better ECog language scores (unstandardized β, -0.59 [SE, 0.28]; P = 0.04) and better CERAD-NB word-list-learning delayed recall subtest scores (unstandardized β, 6.17 [SE, 2.31]; P = 0.009) after co-varying for age and education. Higher DTI-ALPS was also associated with higher gray matter volume (unstandardized β, 107.00 [SE, 43.65]; P = 0.02) after controlling for age, gender, and total intracranial volume.Discussion:Significant associations were identified between glymphatic function and sleep stressing the importance of sleep for brain health. This study also revealed associations between DTI-ALPS, neuropsychological performances, and cerebral gray matter volumes suggesting the potential of DTI-ALPS as a biomarker for cognitive disorders.

scholarly journals Associations of Actigraphic Sleep Parameters With Fatigability in Older Adults

2020 ◽  
Vol 75 (9) ◽  
pp. e95-e102 ◽  
Author(s):  
Alfonso J Alfini ◽  
Jennifer A Schrack ◽  
Jacek K Urbanek ◽  
Amal A Wanigatunga ◽  
Sarah K Wanigatunga ◽  
...  
Keyword(s):  
Older Adults ◽  
Perceived Exertion ◽  
Sleep Onset ◽  
Later Life ◽  
Sleep Time ◽  
Community Dwelling ◽  
Rating Of Perceived Exertion ◽  
Poor Sleep ◽  
Wrist Actigraphy ◽  
Sleep Parameters

Abstract Background Poor sleep may increase the likelihood of fatigue, and both are common in later life. However, prior studies of the sleep–fatigue relationship used subjective measures or were conducted in clinical populations; thus, the nature of this association in healthier community-dwelling older adults remains unclear. We studied the association of actigraphic sleep parameters with perceived fatigability—fatigue in response to a standardized task—and with conventional fatigue symptoms of low energy or tiredness. Methods We studied 382 cognitively normal participants in the Baltimore Longitudinal Study of Aging (aged 73.1 ± 10.3 years, 53.1% women) who completed 6.7 ± 0.9 days of wrist actigraphy and a perceived fatigability assessment, including rating of perceived exertion (RPE) after a 5-minute treadmill walk or the Pittsburgh Fatigability Scale (PFS). Participants also reported non-standardized symptoms of fatigue. Results After adjustment for age, sex, race, height, weight, comorbidity index, and depressive symptoms, shorter total sleep time (TST; <6.3 hours vs intermediate TST ≥6.3 to 7.2 hours) was associated with high RPE fatigability (odds ratio [OR] = 2.56, 95% confidence interval [CI] = 1.29, 5.06, p = .007), high PFS physical (OR = 1.88, 95% CI = 1.04, 3.38, p = .035), and high mental fatigability (OR = 2.15, 95% CI = 1.02, 4.50, p = .044), whereas longer TST was also associated with high mental fatigability (OR = 2.19, 95% CI = 1.02, 4.71, p = .043). Additionally, longer wake bout length was associated with high RPE fatigability (OR = 1.53, 95% CI = 1.14, 2.07, p = .005), and greater wake after sleep onset was associated with high mental fatigability (OR = 1.14, 95% CI = 1.01, 1.28, p = .036). Conclusion Among well-functioning older adults, abnormal sleep duration and sleep fragmentation are associated with greater perceived fatigability.

scholarly journals Association Between Brain Volumes and Patterns of Physical Activity in Community-Dwelling Older Adults

2020 ◽  
Author(s):  
Amal A Wanigatunga ◽  
Hang Wang ◽  
Yang An ◽  
Eleanor M Simonsick ◽  
Qu Tian ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
White Matter ◽  
Brain Structure ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Intracranial Volume ◽  
Accelerometer Data ◽  
Brain Volumes ◽  
Cognitively Normal

Abstract Background Larger brain volumes are often associated with more free-living physical activity (PA) in cognitively normal older adults. Yet, whether greater brain volumes are associated with more favorable (less fragmented) PA patterns, and whether this association is stronger than with total PA, remains unknown. Methods Brain magnetic resonance imaging and wrist-worn accelerometer data were collected in 301 participants (mean age = 77 [SD = 7] years, 59% women) enrolled in the Baltimore Longitudinal Study of Aging. Linear regression models were fit to examine whether brain volumes (cc) were cross-sectionally associated with: (a) total daily PA minutes and (b) activity fragmentation (mean number of PA bouts / total PA minutes × 100). Sensitivity analyses were conducted by adjusting for counterpart PA variables (eg, fragmentation covariate included in the PA minutes model). Results Greater white matter volumes in the parietal and temporal lobes were associated with higher daily PA minutes (2.6 [SE = 1.0] and 3.8 [0.9] min/day, respectively; p < .009 for both) after adjusting for demographics, behavioral factors, medical conditions, gait speed, apolipoprotein E e4 status, and intracranial volume. Greater temporal white matter volume was associated with lower fragmentation (−0.16% [0.05], p = .003). In sensitivity analyses, observed associations between brain volumes and daily PA minutes remained significant while associations with fragmentation no longer remained significant. Conclusions Our results suggest white matter brain structure in cognitively normal older adults is associated with the total amount of PA and, to a lesser extent, the PA accumulation patterns. More work is needed to elucidate the longitudinal relationship between brain structure and function and PA patterns with aging.

scholarly journals Hyposmia and Neuroimaging Signature in Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 530-530
Author(s):  
Cynthia Felix ◽  
Lana Chahine ◽  
Honglei Chen ◽  
Zichun Cao ◽  
Caterina Rosano
Keyword(s):  
Older Adults ◽  
Gray Matter ◽  
Orbitofrontal Cortex ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Community Dwelling ◽  
Intracranial Volume ◽  
Total Brain ◽  
Identification Test ◽  
Community Dwelling Older Adults

Abstract Olfaction declines with aging, and hyposmia, or impaired sense of smell, is associated with neurodegenerative disorders including Alzheimer’s Disease (AD) and Parkinson’s Disease (PD). Neuroimaging studies of hyposmia in AD/PD patients have often examined pathology-specific brain regions. Our knowledge of neural correlates in regions that mediate olfaction in community-dwelling older adults, is limited. We quantified mean diffusivity (MD) of the gray matter (GM) using diffusion tensor imaging in a community-dwelling sample of 308 older adults (mean age: 82.9 years, 58% women, 40% black). We focused on total brain and these regions involved in olfaction- olfactory bulb, amygdala, entorhinal cortex, orbitofrontal cortex, and hippocampus. Smell was tested with a scratch-and-sniff validated odor identification test, the Brief Smell Identification Test (BSIT). Hyposmia was defined as BSIT score of ≤8, assessed about 7 years prior to neuroimaging. In our sample, 23% had hyposmia, more in in men (30%) than in women (19%). Hyposmia was not significantly associated with cardiovascular risk factors such as hypertension; diseases such as stroke; age; race; cognitive or mobility functions (all p>0.1). In linear regression models adjusted for demographics and brain atrophy (total brain gray matter volume divided by intracranial volume), hyposmia was significantly associated with higher GM MD (lower microstructural integrity) of the left orbitofrontal cortex (standardized beta: 0.142, t=2.56, p=0.011). Understanding the neural substrates involved in hyposmia in aging is an important step towards advancing research on hyposmia in non-clinic-based, community-dwelling populations.

scholarly journals Walking cadence (steps/min) and intensity in 61–85-year-old adults: the CADENCE-Adults study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Catrine Tudor-Locke ◽  
Jose Mora-Gonzalez ◽  
Scott W. Ducharme ◽  
Elroy J. Aguiar ◽  
John M. Schuna ◽  
...  
Keyword(s):  
Older Adults ◽  
Perceived Exertion ◽  
Prediction Interval ◽  
Community Dwelling ◽  
Rating Of Perceived Exertion ◽  
Intensity Level ◽  
Physical Activity Intensity ◽  
Old Adults ◽  
Activity Intensity ◽  
Metabolic Equivalents

Abstract Background Heuristic (i.e., evidence-based, rounded) cadences of ≥100 and ≥ 130 steps/min have consistently corresponded with absolutely-defined moderate (3 metabolic equivalents [METs]) and vigorous (6 METs) physical activity intensity, respectively, in adults 21–60 years of age. There is no consensus regarding similar thresholds in older adults. Purpose To provide heuristic cadence thresholds for 3, 4, 5, and 6 METs in 61–85-year-old adults. Methods Ninety-eight community-dwelling ambulatory and ostensibly healthy older adults (age = 72.6 ± 6.9 years; 49% women) walked on a treadmill for a series of 5-min bouts (beginning at 0.5 mph with 0.5 mph increments) in this laboratory-based cross-sectional study until: 1) transitioning to running, 2) reaching ≥75% of their age-predicted maximum heart rate, or 3) reporting a Borg rating of perceived exertion > 13. Cadence was directly observed and hand-tallied. Intensity (oxygen uptake [VO2] mL/kg/min) was assessed with indirect calorimetry and converted to METs (1 MET = 3.5 mL/kg/min). Cadence thresholds were identified via segmented mixed effects model regression and using Receiver Operating Characteristic (ROC) curves. Final heuristic cadence thresholds represented an analytical compromise based on classification accuracy (sensitivity, specificity, positive and negative predictive value, and overall accuracy). Results Cadences of 103.1 (95% Prediction Interval: 70.0–114.2), 116.4 (105.3–127.4), 129.6 (118.6–140.7), and 142.9 steps/min (131.8–148.4) were identified for 3, 4, 5, and 6 METs, respectively, based on the segmented regression. Comparable values based on ROC analysis were 100.3 (95% Confidence Intervals: 95.7–103.1), 111.5 (106.1–112.9), 116.0 (112.4–120.2), and 128.6 steps/min (128.3–136.4). Heuristic cadence thresholds of 100, 110, and 120 were associated with 3, 4, and 5 METs. Data to inform a threshold for ≥6 METs was limited, as only 6/98 (6.0%) participants achieved this intensity. Conclusions Consistent with previous data collected from 21–40 and 41–60-year-old adults, heuristic cadence thresholds of 100, 110, and 120 steps/min were associated with 3, 4, and 5 METs, respectively, in 61–85-year-old adults. Most older adults tested did not achieve the intensity of ≥6 METs; therefore, our data do not support establishing thresholds corresponding with this intensity level. Trial registration Clinicaltrials.gov NCT02650258. Registered 24 December 2015.

scholarly journals Perceived exertion and energy expenditure during physical activities in healthy young people and older adults

Folia Medica ◽  
2021 ◽  
Vol 63 (4) ◽  
pp. 502-510
Author(s):  
Oyéné Kossi ◽  
Justine Lacroix ◽  
Maxence Compagnat ◽  
Jean Christophe Daviet ◽  
Stéphane Mandigout
Keyword(s):  
Older Adults ◽  
Young People ◽  
Energy Expenditure ◽  
Perceived Exertion ◽  
Cross Sectional Study ◽  
Rating Of Perceived Exertion ◽  
Treadmill Running ◽  
Single Session ◽  
Cross Sectional ◽  
Healthy Young People

Aim: To test the validity of Borg’s 6–20 rating of perceived exertion scale in assessing the exertion intensity over a multi-activity session in young and older adults.Materials and methods: This cross-sectional study included 56 healthy participants. All participants underwent a single session of activities including working on a computer, treadmill walking, biking, and treadmill running. Results: Results showed a non-significant correlation between the overall perceived exertion and energy expenditure in young people (Rho=−0.05, p=0.75) and in older adults (Rho=−0.05, p=0.78) for the whole session. However, results showed that older adults perceived significantly higher exertion compared to young people while working on a computer, walking and running, whereas they presented lower energy expenditure while resting and working on a computer. Conclusions: Combining the perceived exertion method with other commonly used methods to estimate exercise intensity would be recommended for older adults.

scholarly journals Leisure Activity Variety and Brain Volume Among Community-Dwelling Older Adults: Analysis of the Neuron to Environmental Impact Across Generations Study Data

2021 ◽  
Vol 13 ◽  
Author(s):  
Ai Iizuka ◽  
Hiroshi Murayama ◽  
Masaki Machida ◽  
Shiho Amagasa ◽  
Shigeru Inoue ◽  
...  
Keyword(s):  
Older Adults ◽  
Environmental Impact ◽  
Gray Matter ◽  
Brain Volume ◽  
Linear Regression Analysis ◽  
Leisure Activity ◽  
Community Dwelling ◽  
Wide Range ◽  
Gray Matter Volumes ◽  
Community Dwelling Older Adults

Background: Recent findings indicate that leisure activity (LA) delays cognitive decline and reduces the risk of dementia. However, the association between LA and brain volume remains unclear. This study aimed to examine the association between LA variety and brain volume with a focus on the hippocampus and gray matter.Methods: Data were obtained from the baseline survey of the Neuron to Environmental Impact across Generations study, which had targeted community-dwelling older adults living in Niigata, Japan. We divided LAs into 10 categories, and counted the number of categories of activities in which the participants engaged. We classified them as follows: 0 (i.e., no activity), 1, 2, or ≥ 3 types. Brain volume was assessed through magnetic resonance imaging, and hippocampal and gray matter volumes were ascertained.Results: The sample size was 482. Multiple linear regression analysis showed that hippocampal and gray matter volumes were significantly greater among participants with ≥ 3 types of LAs than among their no-activity counterparts. Hippocampal volume was significantly greater among those who engaged in one type of LA than among those who engaged in no such activity. Sex-stratified analysis revealed that hippocampal volumes were significantly greater among males who engaged in ≥ 3 types of LAs and one type of LA. However, no such association was found among females.Conclusion: The present findings suggest that engaging in a wide range of LAs is related to hippocampal and gray matter volumes. Furthermore, there was a sex difference in the association between LA variety and brain volume.

Relationship Between the Face Scale for Rating of Perceived Exertion and Physiological Parameters in Older Adults and Patients with Atrial Fibrillation

2020 ◽  
Author(s):  
Satoshi Nashimoto ◽  
Shinichiro Morishita ◽  
Kazuki Hotta ◽  
Susumu Iida ◽  
Atsuhiro Tsubaki
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Exercise Test ◽  
Perceived Exertion ◽  
Cardiopulmonary Exercise Testing ◽  
Physiological Parameters ◽  
Rating Of Perceived Exertion ◽  
Cardiopulmonary Exercise ◽  
Face Scale ◽  
The Face

Abstract Background: The Borg scale is used to determine exercise intensity in rehabilitation but can be difficult for older adults to understand. By contrast, face scale that are used to evaluate pain are much easier to understand thanks to the inclusion of illustrations. On the other hand, the prevalence of atrial fibrillation (AF) increases with age. We aimed to investigate the correlation between face scale for rating of perceived exertion (RPE) and various physiological parameters during cardiopulmonary exercise testing in older adults and AF patients. We also investigated the relationship between Face Scale and anaerobic threshold (AT).Methods: Patients were asked to perform a ramp cardiopulmonary exercise test with an incremental increase in work rate (WR) of 10 watts/min, using a stationary bicycle until maximum fatigue. We recorded participant responses using a face scale for RPE compared with WR, heart rate (HR), oxygen uptake (VO₂), and minute ventilation (VE) every minute during the exercise test. We determined the AT by the V-slope method.Results: We enrolled 90 sinus rhythm (SR) patients (74 men 16 women) and 22 AF patients. For SR men, SR women and AF, there were significant positive correlations between the face scale RPE and HR, VO₂, WR, and VE. There was no statistically significant differences difference in correlation coefficient between age and SR or AF. The cutoff value for AT of the Face Scale was “4” and it showed high sensitivity and specificity.Conclusions: These results suggest that the face scale can be used to determine the intensity of physical exercise equivalent to AT unaffected by age, gender, SR or AF.

Abstract P411: Longitudinal Association Between Frailty and Arterial Stiffness in Community-dwelling Older Adults: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Alvin G Thomas ◽  
Anna Kucharska-Newton ◽  
Jingkai Wei ◽  
Priya Palta ◽  
Sheila Burgard ◽  
...  
Keyword(s):  
Older Adults ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Arterial Stiffening ◽  
Atherosclerosis Risk In Communities ◽  
Loss To Follow Up ◽  
Frailty Status ◽  
Longitudinal Association ◽  
Aortic Stiffening

Introduction: Frailty is predictive of cardiovascular disease and is suggested to co-occur with arterial stiffening, the hallmark of vascular aging. However, the temporal relationship is uncertain. Using the ARIC study, we examine the association of baseline frailty with cross-sectional and 5-year change in carotid-femoral pulse wave velocity (cfPWV) in older adults. Methods: Participants at visit 5 (2011-2013) were classified as frail (≥3 criteria), prefrail (1-2 criteria), or robust using the Fried frailty phenotype criteria (unintentional weight loss, exhaustion, grip strength, slow walking speed, and low physical activity). We measured cfPWV at visits 5 and 6/7 (2016-2019). We used linear regression with inverse-probability of attrition weights to estimate the association between frailty and 5-year change in cfPWV while accounting for loss-to-follow-up among survivors. Models were adjusted for age, sex, race-center, mean arterial pressure, height, heart rate, smoking, and time between visits. Results: Of 5,096 participants at visit 5 (58% female, 21% black, mean age 75 [SD 5.1] years), 296 (6%) were frail and 2403 (47%) prefrail. In adjusted analyses at visit 5, frail participants had 30 cm/s (95% CI: -9, 69; p=0.1) higher cfPWV and prefrail participants had 12 cm/s (95% CI: -5, 30; p=0.2) higher cfPWV than those classified as robust (Table 1). In longitudinal analyses adjusted for attrition, we observed a 3 cm/s (95% CI: -11, 19; p=0.6) and 6 cm/s (95% CI: 0, 12; p=0.05) greater annualized increase in cfPWV over ~5 years among frail and prefrail participants, respectively, relative to the rate of arterial stiffening among robust participants (26 cm/s per year). Conclusions: Compared to robust older adults, greater aortic stiffness was observed among frail community-dwelling adults. Changes in aortic stiffening over the course of 5 years were not materially influenced by frailty status at baseline. Frail older adults may present with greater arterial aging and its associated hemodynamic effects on target organs.

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