scholarly journals DOES PHYSICAL FUNCTION RESPONSE TO INTENTIONAL WEIGHT LOSS IN OLDER ADULTS VARY BY RACE-ETHNICITY?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S680-S680
Author(s):  
Daniel P Beavers ◽  
Rebecca Neiberg ◽  
Kristen Beavers ◽  
Dalane Kitzman ◽  
Barbara M Nicklas ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
African Americans ◽  
Physical Function ◽  
Gait Speed ◽  
Intentional Weight Loss ◽  
High Loss ◽  
Individual Level ◽  
Beneficial Effects ◽  
Race Ethnicity

Abstract The purpose of this study is to explore whether the effect of weight loss on physical function in older adults varies by race/ethnicity. Individual level data from 1369 older, (67.7±5.4 years), obese (BMI: 33.9±4.4 kg/m2), adults (30% male, 21% African American) who participated in eight randomized controlled trials of weight loss were pooled. Studies were 5-6 months in duration and collected baseline demographic and pre/post gait speed (n=1296), short physical performance battery (SPPB; n=866), and grip strength (n=401) data. Treatment effects were generated by weight loss assignment [weight loss (WL; n=764) versus non-weight loss (NWL; n=605)], as well as categorical amount of weight change (high loss: >-7%, moderate loss: -7 to -3%, and weight gain/stability: <-3%). Analyses were adjusted for age, sex/gender, study, education, baseline BMI, and baseline value of the outcome measure of interest. Race/ethnicity stratified results were presented if the interaction term was p≤0.10. A race/ethnicity*weight loss assignment interaction was observed for gait speed (p=0.07), with African Americans experiencing greater weight loss-associated improvement (WL: 0.07±0.01 m/s versus NWL: 0.02±0.01 m/s; p=0.03) compared to Whites (WL: 0.08±0.01 m/s versus NWL: 0.07±0.01 m/s). A race/ethnicity*weight loss amount interaction was also observed for gait speed (p<0.01), with greater weight loss associated with greater improvement in both African Americans and Whites; although, gains were most apparent in African Americans experiencing high loss (0.12±0.02 m/s) compared to gain/stability (0.01±0.01 m/s). The beneficial effects of weight loss on gait speed appear greater in African Americans and are augmented with greater weight loss.

scholarly journals DOES PHYSICAL FUNCTION RESPONSE TO INTENTIONAL WEIGHT LOSS IN OLDER ADULTS VARY BY SEX-GENDER?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S686-S687
Author(s):  
Kristen Beavers ◽  
Rebecca Neiberg ◽  
Daniel P Beavers ◽  
Eliza Dewey ◽  
Dalane Kitzman ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Weight Gain ◽  
Physical Function ◽  
Grip Strength ◽  
Intentional Weight Loss ◽  
High Loss ◽  
Individual Level ◽  
Level Data ◽  
Baseline Bmi

Abstract The purpose of this study is to explore whether the effect of intentional weight loss on physical function in older adults varies by sex/gender. Individual level data from 1369 older, (67.7±5.4 years), obese (BMI: 33.9±4.4 kg/m2), adults (30% male, 21% African American) who participated in eight randomized controlled trials of weight loss were pooled. All studies were 5-6 months in duration and collected baseline demographic and pre/post gait speed (n=1296), short physical performance battery (SPPB; n=866), and grip strength (n=401) data. Treatment effects were generated by weight loss assignment [weight loss (WL; n=764) versus non-weight loss (NWL; n=605)], as well as categorical amount of weight change (high loss: >-7%, moderate loss: -7 to -3%, and weight gain/stability: <-3%). Analyses were adjusted for age, race/ethnicity, study, education, baseline BMI, and baseline value of the outcome measure of interest. Sex/gender stratified results were presented if the interaction term was p≤0.10. A sex/gender*weight loss assignment interaction was observed for SPPB (p=0.07), with women experiencing greater weight loss-associated improvement in SPPB score (WL: 0.42±0.08 versus NWL: 0.10±0.09; p=0.02) compared to men (WL: 0.30±0.11 versus NWL: 0.30±0.13). A sex/gender*weight loss amount interaction was observed for grip strength (p=0.05), with no difference observed across categories in women; however, greatest grip strength improvement was seen in men experiencing moderate weight loss compared to high loss and weight gain/stability categories. Weight loss-associated improvement in SPPB score is greater in women than men; grip strength gains in men are greatest among those achieving moderate weight loss.

scholarly journals Fat Mass Loss Predicts Gain in Physical Function With Intentional Weight Loss in Older Adults

2012 ◽  
Vol 68 (1) ◽  
pp. 80-86 ◽  
Author(s):  
K. M. Beavers ◽  
M. E. Miller ◽  
W. J. Rejeski ◽  
B. J. Nicklas ◽  
S. B. Kritchevsky
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Mass Loss ◽  
Physical Function ◽  
Fat Mass ◽  
Intentional Weight Loss ◽  
Fat Mass Loss

scholarly journals Divergent Benefits of a Diet Plus Exercise Obesity Intervention by Race (black/white): Preliminary Cognitive and Functional Outcomes in Obese Older Adults (P21-045-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Marshall Miller ◽  
Kathryn Porter Starr ◽  
Connie Bales
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Body Weight ◽  
Physical Function ◽  
Protein Intake ◽  
The United States ◽  
Functional Improvement ◽  
Physical And Mental Health ◽  
Intentional Weight Loss ◽  
Race Time

Abstract Objectives Obesity affects a growing number of older adults, contributing to poor physical and mental health outcomes; meanwhile, treatments to reduce obesity in older adults are complicated by a relatively limited treatment window and potential loss of lean mass. Furthermore, obesity's prevalence is unevenly distributed and highest among black and Hispanic older adults, thus contributing to ongoing health disparities. Recent research from our laboratory shows that higher protein intake (≥30 g/meal) enhances functional improvement during intentional weight loss but it is not yet known whether these effects are consistent across race. Methods In an ancillary pilot study, change in body weight, physical function (Short Physical Performance Battery), and cognitive function (Trail Making Test, TMT; Symbol Digit Modalities, SMD) was assessed among obese black and white older adults with mild to moderate functional impairment (n = 10) following 3 months of weight loss intervention at one of two protein intake levels (RDA 0.8 vs 1.2 g/kg/d and (≥30 g/meal) and moderate exercise. Results Significant weight loss (P = 0.009) and improvement in physical function (SPPB; P = 0.008) were observed at 3 months. While protein effects were not observed in this subset, trends toward race*time interactions showing greater weight loss among white participants (P = 0.062) and greater function improvement among black participants (P = 0.067) were observed. Additionally, cognitive assessment revealed a race*time interaction on TMT performance (TrailsB-A; P = 0.012), which correlated with changes in body weight and physical function. Conclusions These preliminary findings suggest that obesity reduction interventions benefited older adults across multiple health domains and underscore the need for further research to characterize potentially divergent benefits of intentional weight loss within these populations. Funding Sources This study was funded by the National Dairy Council and received additional support from the United States (U.S.) Department of Veterans Affairs Rehabilitation Research and Development Service Program and the National Institute of Aging.

scholarly journals HETEROGENEITY OF GAIT SPEED RESPONSE TO INTENTIONAL WEIGHT LOSS IN OLDER ADULTS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 694-694
Author(s):  
D.P. Beavers ◽  
K.M. Beavers ◽  
J.J. Newman ◽  
B.J. Nicklas ◽  
S. Mihalko ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Gait Speed ◽  
Intentional Weight Loss ◽  
Speed Response

scholarly journals Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
John A. Batsis ◽  
Curtis L. Petersen ◽  
Matthew M. Clark ◽  
Summer B. Cook ◽  
David Kotz ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Physical Function ◽  
Weight Management ◽  
Remote Monitoring ◽  
Rural Areas ◽  
Physical Therapist ◽  
Anthropometric Measures ◽  
Clinical Trial Registration ◽  
Data Feedback

Abstract Background Older adults with obesity residing in rural areas have reduced access to weight management programs. We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology. Methods A 6-month, non-randomized, non-blinded, single-arm study was conducted from October 2018 to May 2020 at a community-based aging center of adults aged ≥65 years with a body mass index (BMI) ≥30 kg/m2. Weekly dietitian visits focusing on behavior therapy and caloric restriction and twice-weekly physical therapist-led group strength, flexibility and balance training classes were delivered using video-conferencing to participants in their homes. Participants used a Fitbit Alta HR for remote monitoring with data feedback provided by the interventionists. An aerobic activity prescription was provided and monitored. Results Mean age was 72.9±3.9 years (82% female). Baseline anthropometric measures of weight, BMI, and waist circumference were 97.8±16.3 kg, 36.5±5.2 kg/m2, and 115.5±13.0 cm, respectively. A total of 142 participants were screened (n=27 ineligible), and 53 consented. There were nine dropouts (17%). Overall satisfaction with the trial (4.7+ 0.6, scale: 1 (low) to 5 (high)) and with Fitbit (4.2+ 0.9) were high. Fitbit was worn an average of 81.7±19.3% of intervention days. In completers, mean weight loss was 4.6±3.5 kg or 4.7±3.5% (p< 0.001). Physical function measures of 30-s sit-to-stand repetitions increased from 13.5±5.7 to 16.7±5.9 (p< 0.001), 6-min walk improved by 42.0±77.3 m (p=0.005) but no differences were observed in gait speed or grip strength. Subjective measures of late-life function improved (3.4±4.7 points, p< 0.001). Conclusions A technology-based obesity intervention is feasible and acceptable to older adults with obesity and may lead to weight loss and improved physical function. Clinical trial registration Registered on Clinicaltrials.gov #NCT03104205. Registered on April 7, 2017. First participant enrolled on October 1st, 2018.

Medical and Social Determinants of Brain Health and Dementia in a Multicultural Community Cohort of Older Adults

2021 ◽  
pp. 1-14
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Lun-Ching Chang
Keyword(s):  
Older Adults ◽  
Health Disparities ◽  
African Americans ◽  
Health Outcomes ◽  
Sex Education ◽  
Screening Program ◽  
Healthcare Services ◽  
Social Dimension ◽  
Medical Comorbidities ◽  
Race Ethnicity

Background: Socioeconomic status (SES), race, ethnicity, and medical comorbidities may contribute to Alzheimer’s disease and related disorders (ADRD) health disparities. Objective: Analyze effects of social and medical determinants on cognition in 374 multicultural older adults participating in a community-based dementia screening program. Methods: We used the Montreal Cognitive Assessment (MoCA) and AD8 as measures of cognition, and a 3-way race/ethnicity variable (White, African American, Hispanic) and SES (Hollingshead index) as predictors. Potential contributors to health disparities included: age, sex, education, total medical comorbidities, health self-ratings, and depression. We applied K-means cluster analyses to study medical and social dimension effects on cognitive outcomes. Results: African Americans and Hispanics had lower SES status and cognitive performance compared with similarly aged Whites. We defined three clusters based on age and SES. Cluster #1 and #3 differed by SES but not age, while cluster #2 was younger with midlevel. Cluster #1 experienced the worse health outcomes while cluster #3 had the best health outcomes. Within each cluster, White participants had higher SES and better health outcomes, African Americans had the worst physical performance, and Hispanics had the most depressive symptoms. In cross-cluster comparisons, higher SES led to better health outcomes for all participants. Conclusion: SES may contribute to disparities in access to healthcare services, while race and ethnicity may contribute to disparities in the quality and extent of services received. Our study highlights the need to critically address potential interactions between race, ethnicity, and SES which may better explain disparities in ADRD health outcomes.

scholarly journals Effect of Intentional Weight Loss on Mortality Biomarkers in Older Adults With Obesity

2018 ◽  
Vol 74 (8) ◽  
pp. 1303-1309 ◽  
Author(s):  
Lauren N Shaver ◽  
Daniel P Beavers ◽  
Jessica Kiel ◽  
Stephen B Kritchevsky ◽  
Kristen M Beavers
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Cystatin C ◽  
Healthy Aging ◽  
Fasting Blood Glucose ◽  
Observational Research ◽  
Digit Symbol Substitution Test ◽  
Intentional Weight Loss ◽  
Meta Analyses ◽  
Hai Score

Abstract Background Observational research has identified several mortality biomarkers; however, their responsiveness to change is unknown. We tested whether the Healthy Aging Index (HAI) and other mortality biomarkers were responsive to intentional weight loss (WL), which is associated with lower mortality risk in recent meta-analyses. Methods Older adults (70.3 ± 3.7 years) with obesity were randomized into a 6-month WL (n = 47) or weight stability (WS: ±5% baseline weight; n = 48) program. Baseline and 6-month HAI score (0–10) was calculated from component sum (each 0–2: systolic blood pressure, forced vital capacity [FVC], creatinine, fasting blood glucose [FBG], Montreal Cognitive Assessment), and gait speed, grip strength, Digit Symbol Substitution Test, FEV1, Interleukin-6, C-Reactive Protein, and Cystatin-C were assessed at baseline and 6 months. Results Mean baseline HAI was 3.2 ± 1.6. By 6 months, WL participants lost 8.87 (95% CI: −10.40, −7.34) kg, whereas WS participants remained weight stable. WL group reduced HAI score (WL: −0.75 [95% CI: −1.11, −0.39] vs WS: −0.22 [95% CI: −0.60, 0.15]; p = .04), and components changing the most were FBG (WL: −3.89 [95% CI: −7.78, 0.00] mg/dL vs WS: 1.45 [95% CI: −2.61, 5.50] mg/dL; p = .047) and FVC (WL: 0.11 [95% CI: −0.01, 0.23] L vs WS: −0.05 [95% CI: −0.17, 0.08] L; p = .06). Among other biomarkers, only Cystatin-C significantly changed (WL: −2.53 [95% CI: −4.38, −0.68] ng/mL vs WS: 0.07 [95% CI: −1.85, 1.98] ng/mL; p = .04). Combining treatment groups, 1 kg WL was associated with a 0.07 (95% CI: 0.03, 0.12) HAI reduction (p &lt; .01). Conclusion Intentional WL via caloric restriction reduced HAI score by 0.53 points, largely attributable to metabolic and pulmonary improvements.

scholarly journals 132 Physical Function Comparison of Acutely Unwell COVID-Negative Older Adults Pre-Pandemic and Through-Pandemic; “Covid-Protected”

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
S Ritchie ◽  
C Snape ◽  
N Triteos ◽  
R Vamadevan ◽  
L Olesk ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Physical Function ◽  
Gait Speed ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ethical Review ◽  
Short Period ◽  
Elderly Mobility

Abstract Introduction The risk of severe morbidity after COVID-19 infection is high in older adults (Lithander et al, 2020). Subsequent responsive UK Government guidance for older adults included self-isolation during the pandemic. It is therefore hypothesised that during the pandemic older adults are inadvertently deconditioned due to iatrogenic factors such as inactivity, social isolation, hospital-avoidance and malnutrition, and present with reduced resilience to illness and lower levels of function. The OPU continued to admit COVID-negative, or recently termed “COVID-protected”, patients throughout the pandemic. Data captured prior to, and during the COVID-19 pandemic has been compared to explore the implications on older adults, and elicit whether they are protected from the consequences of the pandemic? Method Demographic and physical function data (average 6 m gait-speed, Elderly Mobility Scale) were captured pre- and through-pandemic for all patients admitted to a COVID-negative OPU ward over a one month period. Ethical review was provided through local Trust governance process. Results Pre-pandemic 2019 (n = 67, mean(±SD) age 82.7(±8.2) years, 61%, hospital length-of-stay (LOS) 7.9(±7.3) days, hospital mortality-rate 7.2%) and through-pandemic 2020 (n = 73, 83.1(±8.3) years, 59%♀, LOS 9.0(±9.1) days, hospital mortality-rate 7.5%) data were captured during July 2019 and May 2020 respectively. There were no between-group differences in age [t(−.313) = 138, p = 0.755], gender [X2, 1 df, p = 0.782], LOS [t(0.78) = 134, p = 0.44], or hospital mortality-rate [X2 1 df, p = 0.96]. Through-pandemic patients had a significantly slower 6 m gait-speed (0.11(±0.05) m.s-1) than pre-pandemic (0.16(±0.24) m.s-1); [t(2.74) = 93, p = 0.007] and lower median (IQR) Elderly Mobility Scale (4(6 IQR) vs 9 (12 IQR) [u = 866, p = 0.015]). Conclusion Our data indicates this relatively short period of self-isolation might have significant implications on the physical function of older adults. The likely mechanism is iatrogenic deconditioning. Critical Public Health and policy responses are required to mitigate these unforeseen risks by deploying prehabilitative counter-measures and accurately targeted hospital and community rehabilitation.

IMPLEMENTATION OF A COMMUNITY WALKING PROGRAM (WALK ON!) FOR FUNCTIONALLY-LIMITED OLDER ADULTS

2020 ◽  
pp. 1-7
Author(s):  
B.J. Nicklas ◽  
E.A. Chmelo ◽  
J. Sheedy ◽  
J.B. Moore
Keyword(s):  
Older Adults ◽  
Focus Group ◽  
Physical Function ◽  
Gait Speed ◽  
Assistive Device ◽  
Walking Ability ◽  
Mobility Limitations ◽  
Long Distance ◽  
Walking Program ◽  
Usual Gait Speed

Background: Walking interventions improve physical function, reduce fall risk, and prevent mobility disability—even in those with compromised walking ability. However, most prior studies have been conducted in controlled research settings, with no dissemination of an evidence-based walking program for older adults who have mobility limitations and/or are socially isolated. Objectives: This study reports data on the feasibility and acceptability of a community-based walking program (Walk On!) for older adults who are functionally limited, and assesses changes in physical function among attendees. The program sessions focused on long-distance walking, and took place for one-hour, for two days/week, and for 12 weeks at a time. Design: Pilot implementation study. Setting: Local church in Winston-Salem, NC. Participants: 49 program participants; Measurements: Physical function battery and satisfaction survey data, as well as formative evaluation data from six attendees of a focus group, are reported. Results: The majority of the participants were >75 years (71%), female (65%), and presented with low levels of physical function (usual gait speed=0.79±0.16; 30.6% used an assistive device). Satisfaction with the program was high (100% would recommend it to others) and focus group results were overwhelmingly positive. Mean attendance to scheduled sessions was 77%±21%, and 63% of participants attended at least 75% of scheduled sessions (n=8 attended 100%). On average, participants improved their 6-min walk distance by 8.9%, their SPPB score by 15.4%, their timed-up-go time by 9.0%, and their usual gait speed by 11.4%. Conclusion: The results of the initial evaluation of Walk On! show high feasibility and acceptability of the program, as well as efficacy for improving physical function. Further research is needed to evaluate a delivery method for wider implementation of the program and to definitively test its effectiveness for improving function and other health benefits.

scholarly journals Changes in Cardiometabolic Risk Among Obese Older Adults After a 12-Month Exercise and Diet Intervention

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1612-1612
Author(s):  
Anna Bragg ◽  
Kristi Crowe-White ◽  
Amy Ellis ◽  
Julie Locher ◽  
Jamy Ard ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Cardiometabolic Risk ◽  
Weight Maintenance ◽  
Exercise Group ◽  
Group Differences ◽  
Intentional Weight Loss ◽  
Time Interaction ◽  
Weight Loss Group ◽  
Syndrome Classification

Abstract Objectives Obesity imposes risk to cardiometabolic health; however, intentional weight loss in obese older adults remains controversial. Using data from the CROSSROADS Study (clinicaltrials.gov #NCT00955903), this ancillary study investigated effects of exercise with and without intentional weight loss on changes in cardiometabolic risk assessed by four risk-scoring tools. Methods Participants (n = 134, 39% male, 23% African American, 70.2 ± 4.7 y) were randomized to exercise (n = 48), exercise + nutrient-dense weight maintenance diet (n = 44), or exercise + nutrient-dense caloric restriction of 500 kcals/day (n = 42). The following risk scores were calculated using baseline and 12-month data: Framingham risk assessment, Cardiometabolic Disease Staging (CMDS), metabolic syndrome classification by the International Diabetes Federation (IDF), and metabolic syndrome classification by the National Cholesterol Education Program's Adult Treatment Panel (ATP III). Generalized Estimating Equations were employed to determine differences between groups with ethnicity, sex, and age as covariates. Results Group-time interaction was not significant in application of IDF or ATPIII. Group-time interaction was significant for Framingham and CMDS (P = 0.005 and 0.041, respectively). Upon post-hoc analysis, significant within-group improvements in Framingham scores were observed for exercise + weight maintenance (P &lt; 0.001, r = −1.682) and exercise + weight loss (P = 0.020, r = −0.881). In analysis of between-group differences in Framingham scores, a significant decrease was observed in the exercise + weight maintenance group (P = 0.001, r = −1.723) compared to the exercise group. For CMDS, the exercise + weight loss group had significant within-group improvements (P = 0.023, r = - 0.102). For between-group differences in CMDS, the exercise + weight loss group showed significant risk score reduction (P = 0.012, r = −0.142) compared to the exercise group. Conclusions Risk assessment by Framingham and CMDS showed greater sensitivity to change in cardiometabolic risk factors. Results suggest obese older adults can lower cardiometabolic risk by engaging in exercise + weight maintenance or exercise + weight loss by moderate caloric restriction. Funding Sources R01AG033094 NIA, K07AG043588 NIA, P30DK056336 NIDDK.

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