A Comparison of Cardiopulmonary Exercise Testing and Field Walking Tests in Community-Dwelling Older Adults With Mild-to-Moderate Alzheimer’s Dementia

2020 ◽  
Vol 28 (6) ◽  
pp. 911-919
Author(s):  
Dereck L. Salisbury ◽  
Fang Yu
Keyword(s):  
Older Adults ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Alzheimer’S Dementia ◽  
Community Dwelling ◽  
Rating Of Perceived Exertion ◽  
Walking Distance ◽  
Walk Test ◽  
Alzheimer's Dementia ◽  
Cardiopulmonary Exercise

The purpose of this study was to investigate the relationships among peak exercise parameters on 6-min walk test, shuttle walk test, and laboratory-based cardiopulmonary exercise testing in persons with Alzheimer’s dementia. This study is a cross-sectional analysis of the baseline data of 90 participants (age 77.1 [6.6] years, 43% female) from the FIT-AD trial. Cardiopulmonary exercise testing produced significantly higher peak heart rate (118.6 [17.5] vs. 106 [22.8] vs. 106 [18.8] beats/min), rating of perceived exertion (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]), and systolic blood pressure (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared with the shuttle walk test and 6-min walk test, respectively. Peak walking distance on shuttle walk test (241.3 [127.3] m) and 6-min walk test (365.0 [107.9] m) significantly correlated with peak oxygen consumption (17.1 [4.3] ml·kg−1·min−1) on cardiopulmonary exercise testing (r = .449, p ≤ .001 and r = .435, p ≤ .001), respectively, which is considerably lower than what is seen in older adults and persons with cardiopulmonary diseases.

scholarly journals RELATIONSHIP OF CARDIOPULMONARY EXERCISE TESTING AND FIELD WALKING TESTS IN MILD-MODERATE ALZHEIMER’S DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S611-S611
Author(s):  
Dereck L Salisbury ◽  
Fang Yu
Keyword(s):  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Alzheimer’S Dementia ◽  
Community Dwelling ◽  
Rating Of Perceived Exertion ◽  
Walking Distance ◽  
Alzheimer's Dementia ◽  
Cardiopulmonary Exercise ◽  
Peak Vo2 ◽  
Walking Tests

Abstract The purpose of this study was to investigate relationships among peak exercise parameters on 6-minute walk (6MWT) and shuttle walk tests (SWT), and laboratory-based cardiopulmonary exercise testing (CPET). These relationships have been established in cardiopulmonary patient populations, but not in community-dwelling older adults with mild-moderate Alzheimer’s dementia (AD). This study is a cross-sectional analysis of the baseline data of 6MWT, SWT, and CPET from the FIT-AD Trial (n=88: 49 males [76.6 {7.0} years and MMSE 21.5{3.5}] and 39 females [77.3 {6.5} years and MMSE 22.1 {3.4}]). Peak values for each test included heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE). Peak oxygen assumption (VO2) was measured in the CPET. Peak walking distance (PWD) was measured for the 6MWT and SWT. CPET produced significantly higher peak HR (118.7 [17.5] vs. 106 [22.8] vs. 106 [18.8] bpm), RPE (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]) and SBP (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared to the SWT and 6MWT respectively. PWD on SWT (240.4 [128.1] m) and 6MWT (364.3 [108.5] m) significantly correlated with peak VO2 (17.0 [4.3]ml/kg/min) on CPET (r=.44 and r=.43) respectively. Correlations of peak VO2 and PWD on SWT in persons with AD are considerably lower than what is seen for persons with cardiopulmonary diseases. This lower correlation seen in our sample may be due to shorter PWD on walking tests. Future research should focus how mobility affects correlation of peak values on these tests.

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.

Neuropathologic Correlates of Human Cortical Proteins in Alzheimer Disease and Related Dementias

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013252
Author(s):  
Lei Yu ◽  
Patricia A Boyle ◽  
Aliza P Wingo ◽  
Jingyun Yang ◽  
Tianhao Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Lewy Bodies ◽  
Clinical Syndrome ◽  
Alzheimer’S Dementia ◽  
Community Dwelling ◽  
Integrative Approach ◽  
Amyloid Angiopathy ◽  
Alzheimer's Dementia ◽  
Age Related ◽  
Cortical Lewy Bodies

Background and Objectives:Alzheimer’s dementia is a complex clinical syndrome that can be defined broadly as an amnestic multidomain dementia. We previously reported human cortical proteins that are implicated in Alzheimer’s dementia. To understand the pathologic correlates of these proteins for underlying disease mechanisms, we investigated cortical protein associations with common age-related neuropathologies.Methods:Participants were community-dwelling older adults from two cohort studies of aging and dementia. All underwent detailed annual clinical evaluations, and brain autopsies were performed after death. We refer Alzheimer’s disease (AD) to pathologically defined disease, and refer Alzheimer’s dementia to the clinical syndrome. Indices for AD, cortical Lewy bodies, limbic predominant age-related TDP-43 encephalopathy neuropathologic changes (LATE-NC), hippocampal sclerosis, macroscopic infarcts, microinfarcts, cerebral amyloid angiopathy, atherosclerosis and arteriolosclerosis were quantified during uniform structured neuropathologic evaluations. High-throughput protein abundances from frozen dorsolateral prefrontal cortex were quantified using mass spectrometry based tandem mass tag proteomics analysis. Eleven human cortical proteins implicated in Alzheimer’s dementia, including ACE, CHSP1, CATH, DOC2A, ICA1L, LACTB, PKHA1, RTF2, SNX32, STX4, and STX6, were previously identified using an integrative approach. Logistic regression analysis examined the association of protein expression with each of the neuropathologic indices.Results:A total of 391 older adults were included. We did not observe associations of these protein targets with pathologic diagnosis of AD. By contrast, multiple proteins were associated with non-AD neurodegenerative and cerebrovascular conditions. In particular, higher CHSP1 expression was associated with cortical Lewy bodies and macroscopic infarcts, and higher CATH expression was associated with LATE-NC and arteriolosclerosis. Further, while higher STX6 expression increased the risk of Alzheimer’s dementia, the protein was not associated with any of the neuropathologic indices investigated.Discussion:Cortical proteins implicated in Alzheimer’s dementia do not necessarily work through AD pathogenesis; rather, non-AD neurodegenerative and vascular diseases, as well as other pathways are at play. Further, some proteins are pleiotrophic and associated with both neurodegenerative and cerebrovascular pathologies.

Comparison of the 6-minute walk test with established parameters for assessment of cardiopulmonary capacity in adults with complex congenital cardiac disease

2005 ◽  
Vol 15 (4) ◽  
pp. 385-390 ◽  
Author(s):  
Andreas Niedeggen ◽  
Erik Skobel ◽  
Philipp Haager ◽  
Wolfgang Lepper ◽  
Eberhard Mühler ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Exercise Testing ◽  
Cardiac Disease ◽  
Cardiopulmonary Exercise Testing ◽  
Walk Test ◽  
Cardiopulmonary Exercise ◽  
Congenital Cardiac Disease ◽  
6 Minute Walk Test ◽  
Minute Walk

Background:Objective assessment of the cardiopulmonary capacity in patients with complex congenital cardiac disease often remains difficult in clinical practice. The cardiopulmonary exercise test and determination of the levels of brain natriuretic peptide in the plasma are established tests, but expensive. The 6-minute walk test is also validated, but has not often been used in patients with heart failure due to congenital heart disease, nor compared with other tests. We sought to compare its value with the results of cardiopulmonary exercise testing and measuring the levels of brain natriuretic peptide in the plasma.Methods:We carried out a standardized 6-minute walk test in 31 patients with complex congenital cardiac disease on the same day that they underwent cardiopulmonary exercise testing and determination of levels of brain natriuretic peptide in the plasma. Of the patients, 7 had functionally univentricular hearts, 9 had transposition, 9 had tetralogy of Fallot, 3 had common arterial trunk, and 3 had pulmonary atresia with intact interventricular septum. Uptakes of oxygen at peak exercise, and at the anaerobic threshold, were determined using cardiopulmonary exercise testing, and classified as suggested by Weber. The 6-minute walk test was performed according to a standard protocol.Results:There was a significant correlation between brain natriuretic peptide, oxygen uptakes at peak exercise and 6-minute walk. The correlation between the 6-minute walk test and oxygen uptakes at the anaerobic threshold, however, was not significant.Conclusions:The 6-minute walk test can be performed easily, is inexpensive, widely available, and correlates well with measurements of brain natriuretic peptide and cardiopulmonary exercise testing, even in patients with corrected or palliated congenital cardiac malformations. A cut-off value of 450 metres in the 6-minute walk test allows a semi-quantitative classification in analogy to the classification suggested by Weber for cardiopulmonary exercise testing, and to a level of brain natriuretic peptide in the plasma of less or more than 100 picograms per millilitre.

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