scholarly journals GAIT SLOWING AMONG FRAIL OLDER ADULTS: IS HIGHER DOPAMINERGIC SIGNALING PROTECTIVE?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S89-S89
Author(s):  
Caterina Rosano ◽  
Stephanie Studenski ◽  
Nicolaas Bohnen ◽  
Andrea Rosso
Keyword(s):  
Older Adults ◽  
Racial Differences ◽  
Gait Speed ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Linear Regression Models ◽  
Full Cohort ◽  
Frail Older Adults ◽  
Age Related

Abstract Strategies to reduce gait slowing in frail older adults are urgently needed. Higher dopaminergic (DA) signaling is emerging as a protecting factor against age-related gait slowing, in the absence of Parkinson’s Disease (PD). DA signaling is potentially modifiable, thereby offering promising novel strategies to reduce gait slowing. In 3,752 PD-free participants of the Cardiovascular Health Study (72.3 years, 81% white, 39% male), we measured gait speed (usual pace, 15 feet), frailty (Fried definition), and genetic polymorphism of Catechol-O-methyltransferase (COMT, rs4680), an enzyme regulating tonic brain DA levels. Multivariable linear regression models of COMT predicting gait speed were adjusted for age, gender, BMI, ankle-arm index, vision, and arthritis. Strength, education, medications, pulmonary, cardio- and cerebro-vascular diseases, diabetes, mood, and cognition were considered as additional covariates. We examined the full cohort and the subgroup with frailty (n=222), without and with race-stratification to address racial differences in allele frequencies. Average (SE) gait speed was 0.88 (0.003) and 0.58 (0.01) m/sec in the full cohort and the frail subgroup, respectively. COMT was linearly associated with gait speed; gait was faster for met/met (higher DA signaling) and slower for val/val (lower DA signaling) participants. In adjusted models, differences between these two groups were: 0.02 (0.01) m/sec in the full cohort (p=0.4); 0.07(0.02) m/sec in the frail subgroup (p=0.02); 0.10 (0.02) m/sec in white with frailty (p=0.01). COMT genotyping may help identify frail adults who are less vulnerable to gait impairments. Studies of frailty should examine whether higher DA signaling offers resilience against age-related gait slowing.

scholarly journals Exercise prescription to reverse frailty

2016 ◽  
Vol 41 (10) ◽  
pp. 1112-1116 ◽  
Author(s):  
Nick W. Bray ◽  
Rowan R. Smart ◽  
Jennifer M. Jakobi ◽  
Gareth R. Jones
Keyword(s):  
Older Adults ◽  
Perceived Exertion ◽  
Cardiovascular Health ◽  
Balance Training ◽  
Rating Of Perceived Exertion ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Geriatric Syndrome ◽  
Frailty Phenotype ◽  
Frail Older Adults

Frailty is a clinical geriatric syndrome caused by physiological deficits across multiple systems. These deficits make it challenging to sustain homeostasis required for the demands of everyday life. Exercise is likely the best therapy to reverse frailty status. Literature to date suggests that pre-frail older adults, those with 1–2 deficits on the Cardiovascular Health Study-Frailty Phenotype (CHS-frailty phenotype), should exercise 2–3 times a week, for 45–60 min. Aerobic, resistance, flexibility, and balance training components should be incorporated but resistance and balance activities should be emphasized. On the other hand, frail (CHS-frailty phenotype ≥ 3 physical deficits) older adults should exercise 3 times per week, for 30–45 min for each session with an emphasis on aerobic training. During aerobic, balance, and flexibility training, both frail and pre-frail older adults should work at an intensity equivalent to a rating of perceived exertion of 3–4 (“somewhat hard”) on the Borg CR10 scale. Resistance-training intensity should be based on a percentage of 1-repetition estimated maximum (1RM). Program onset should occur at 55% of 1RM (endurance) and progress to higher intensities of 80% of 1RM (strength) to maximize functional gains. Exercise is the medicine to reverse or mitigate frailty, preserve quality of life, and restore independent functioning in older adults at risk of frailty.

scholarly journals Catechol-O-Methyltransferase Genotype, Frailty, and Gait Speed: The Cardiovascular Health Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 757-757
Author(s):  
Shannon Mance ◽  
Andrea Rosso ◽  
Joshua Bis ◽  
Stephanie Studenski ◽  
Nico Bohnen ◽  
...  
Keyword(s):  
Gait Speed ◽  
Chronic Conditions ◽  
Regression Models ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Full Cohort ◽  
Cross Sectional ◽  
Multivariable Regression ◽  
Multivariable Regression Models

Abstract The association of COMT with gait speed varies across studies; frailty, a condition increasing vulnerability to stressors, may influence this association. Cross-sectional data was obtained in 3,744 participants (71 years, 82% white, 39% male) for gait speed, frailty (Fried definition), and COMT. Multivariable regression models of COMT predicting gait were adjusted for demographics, chronic conditions, and locomotor factors. Interactions of COMT by frailty and by race predicting gait speed were p=0.03 and p=0.02, respectively. Compared to Met/Met, the Val/Val group walked marginally more slowly in the full cohort (0.87 vs 0.89 m/sec, p=0.2); differences were significant for those with frailty (n=220, 0.55 vs 0.63m/sec, p=0.03), but not for those with moderate (n=1691, 0.81 vs 0.81m/sec, p=0.9), or no frailty (n=1833, 0.98 vs 0.97 m/sec, p=0.7). Associations were similar by race, but significant for whites only. Studies should assess the influence of dopaminergic signaling on gait slowing due to frailty.

scholarly journals Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

2021 ◽  
Vol 18 (6) ◽  
pp. 2931
Author(s):  
Ryo Komatsu ◽  
Koutatsu Nagai ◽  
Yoko Hasegawa ◽  
Kazuki Okuda ◽  
Yuto Okinaka ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Cross Sectional ◽  
Important Indicator ◽  
Community Dwelling Older Adults ◽  
Oral Frailty

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.

scholarly journals Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group.

Hypertension ◽  
1992 ◽  
Vol 19 (6_pt_1) ◽  
pp. 508-519 ◽  
Author(s):  
G H Rutan ◽  
B Hermanson ◽  
D E Bild ◽  
S J Kittner ◽  
F LaBaw ◽  
...  
Keyword(s):  
Older Adults ◽  
Orthostatic Hypotension ◽  
Research Group ◽  
Collaborative Research ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study
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