Predictive equations to estimate peak aerobic capacity and peak heart rate in persons with Down syndrome

Author(s):  
Goncalo V. Mendonca ◽  
Inês Santos ◽  
Bo Fernhall ◽  
Tracy Baynard

Estimations based on the available equations for predicting oxygen uptake (VO2) from treadmill speed of locomotion are not appropriate for individuals with Down syndrome (DS). We aimed at developing prediction models for peak absolute oxygen uptake (VO2peak) and peak heart rate (HRpeak) based on retrospective data from a healthy population with and without Down syndrome (DS). A cross-sectional analysis of VO2peak and HRpeak was conducted in 196 and 187 persons with and without DS, respectively, aged from 16-45 years. Non-exercise data alone versus combined with HRpeak were used to develop equations predictive of absolute VO2peak. Prediction equations for HRpeak were also developed. Two additional samples of participants (30 with, 29 without DS) enabled model cross-validation. Relative VO2peak and HRpeak were lowest for persons with DS across all ages (~ 40% and 20 bpm, respectively). For persons with DS, VO2peak predictions provided no differences compared with actual values. Predicted HRpeak was similar to actual values in both groups of participants. Large limits of agreement were obtained for VO2peak (DS: 735, non-DS: 558.2 mL.min-1) and HRpeak (DS: 24.8, non-DS: 16.6 bpm). Persons with DS exhibit low levels of VO2peak and HRpeak in all age groups included in this study. It is possible to estimate absolute VO2peak in persons with DS using non-exercise variables. HRpeak can be accurately estimated in groups of people with and without DS. Yet, because of large limits of agreement, caution is advised if using these equations for individual estimations of VO2peak or HRpeak in either population.

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Haitham Ahmed ◽  
Di Zhao ◽  
Eliseo Guallar ◽  
Michael J Blaha ◽  
Clinton A Brawner ◽  
...  

Background: The declines in peak heart rate (HR) and fitness level with age are related; however, whether this association differs based on gender is not well appreciated. In a large cross-sectional cohort of women and men referred for a clinically indicated exercise treadmill test (ETT), we set out to determine whether the decrease in peak HR by age varied by gender (and fitness) in the Henry Ford Exercise Testing (FIT) project. Methods: We analyzed data on 38,196 apparently-healthy patients aged 18-96 [mean age 51 ± 12 yrs, 25% black, 48% women] who completed an ETT. Those with history of coronary heart disease, congestive heart failure, diabetes on medications, atrial fibrillation or flutter, or taking AV nodal blocking medications were excluded. Being “fit” was defined as achieving ≥ the median MET level for each sex/age-decile group. Peak HR vs age was plotted, and regression lines were used to determine the intercept and slope for each group. Results: Men had higher peak HR than women but with a greater decline over time; the respective intercepts and slopes for peak HR estimates were 202.9 and 0.90 for men and 197.3 and 0.80 for women, (p-interaction = 0.023). Fit people also started out with higher peak HR but approached unfit people at higher age groups; respective intercept and slope by fitness status were 203.0 and 0.87 for fit and 194.7 and 0.83 for unfit (p-interaction <0.001). Separate regression lines were generated for categories of fit men/unfit men, fit women/unfit women ( Figure ). Fit and unfit men had similar declines in peak HR with increasing age (slope=0.92); whereas fit women (slope=0.81) had a slightly greater decline in peak HR with increasing age than unfit women (slope=0.73). However, peak absolute HR for fit people still remains higher than for unfit people even into elderly ages. Conclusion: In this cross-sectional cohort of patients referred for a clinical ETT, we found that the age-related decline in peak HR is influenced by both gender and fitness status.


Author(s):  
Giselle Sarganas ◽  
Anja Schienkiewitz ◽  
Jonas D. Finger ◽  
Hannelore K. Neuhauser

AbstractTo track blood pressure (BP) and resting heart rate (RHR) in children and adolescents is important due to its associations with cardiovascular outcomes in the adulthood. Therefore, the aim of this study was to examine BP and RHR over a decade among children and adolescents living in Germany using national examination data. Cross-sectional data from 3- to 17-year-old national survey participants (KiGGS 2003–06, n = 14,701; KiGGS 2014–17, n = 3509) including standardized oscillometric BP and RHR were used for age- and sex-standardized analysis. Measurement protocols were identical with the exception of the cuff selection rule, which was accounted for in the analyses. Different BP and RHR trends were observed according to age-groups. In 3- to 6-year-olds adjusted mean SBP and DBP were significantly higher in 2014–2017 compared to 2003–2006 (+2.4 and +1.9 mm Hg, respectively), while RHR was statistically significantly lower by −3.8 bpm. No significant changes in BP or in RHR were observed in 7- to 10-year-olds over time. In 11- to 13-year-olds as well as in 14- to 17-year-olds lower BP has been observed (SBP −2.4 and −3.2 mm Hg, respectively, and DBP −1.8 and −1.7 mm Hg), while RHR was significantly higher (+2.7 and +3.7 bpm). BP trends did not parallel RHR trends. The downward BP trend in adolescents seemed to follow decreasing adult BP trends in middle and high-income countries. The increase in BP in younger children needs confirmation from other studies as well as further investigation. In school-aged children and adolescents, the increased RHR trend may indicate decreased physical fitness.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Andreea Rawlings ◽  
A. Richey Sharrett ◽  
David Knopman ◽  
Christina Parrinello ◽  
Priya Palta ◽  
...  

Introduction: Among older adults with diabetes, cognitive dysfunction is of particular concern as it has implications for treatment adherence and diabetes self-management. The prevalence of cognitive dysfunction has not been well characterized in this population. Methods: We conducted a cross-sectional analysis of 5509 participants (1815 with diabetes) from visit 5 (2011-2013) of the ARIC Study. Diabetes was defined based on self-reported physician diagnosis, diabetes medication use, or HbA1c ≥ 6.5%. Cognitive function was measured using 8 neuropsychological tests, which were grouped into three cognitive domains representing memory, executive function, and language. Participants were categorized as having cognitive dysfunction if test scores were more than 1.5 standard deviations below age-, race-, and education-adjusted scores derived from a cognitively healthy population. We calculated crude prevalence estimates and used Poisson regression to estimate adjusted prevalence ratios (PRs), comparing cognitive dysfunction in persons with and without diabetes. We adjusted for demographic and clinical characteristics. Results: The mean age of participants was 75 years, 59% were female, 79% were white, and 33% had diabetes. In each domain, the prevalence of cognitive dysfunction among persons with diabetes ranged from 14% to 27%. Persons with diabetes were more likely than persons without diabetes to have dysfunction in multiple domains (PR = 1.29, 95% CI: 1.12, 1.49). Prevalence of cognitive dysfunction was significantly higher in persons with versus without diabetes for memory (PR=1.13, 95% CI: 1.02, 1.25), language (PR=1.24, 95% CI: 1.09, 1.45), and executive function (PR=1.10, 95% CI: 1.00, 1.22)(Figure). PRs were similar in crude models. Conclusions: The prevalence of cognitive dysfunction among older adults with diabetes is high. These results have implications for how physicians educate patients in appropriate self-management practices and for the prevention of diabetes-related complications.


2017 ◽  
Vol 35 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Jacinta A Lucke ◽  
Jelle de Gelder ◽  
Fleur Clarijs ◽  
Christian Heringhaus ◽  
Anton J M de Craen ◽  
...  

ObjectiveThe aim of this study was to develop models that predict hospital admission to ED of patients younger and older than 70 and compare their performance.MethodsPrediction models were derived in a retrospective observational study of all patients≥18 years old visiting the ED of a university hospital during the first 6 months of 2012. Patients were stratified into two age groups (<70 years old and ≥70 years old). Multivariable logistic regression analysis was used to identify predictors of hospital admission among factors available immediately after patient arrival to the ED. Validation of the prediction models was performed on patients presenting to the ED during the second half of the year 2012.Results10 807 patients were included in the derivation and 10 480 in the validation cohorts. The strongest independent predictors of hospital admission among the 8728 patients <70 years old were age, sex, triage category, mode of arrival, performance of blood tests, chief complaint, ED revisit, type of specialist, phlebotomised blood sample and all vital signs. The area under the curve (AUC) of the validation cohort for those <70 years old was 0.86 (95% CI 0.85 to 0.87). Among the 2079 patients ≥70 years, the same factors were predictive, except for gender, type of specialist and heart rate; the AUC was 0.77 (95% CI 0.75 to 0.79). The prediction models could identify a group of 10% of patients with the highest risk in whom hospital admission was predicted at ED triage, with a positive predictive value (PPV) of 71% (95% CI 68% to 74%) in younger patients and PPV of 87% (95% CI 81% to 92%) in older patients.ConclusionDemographic and clinical factors readily available early in the ED visit can be useful in identifying patients who are likely to be admitted to the hospital. While the model for the younger patients had a higher AUC, the model for older patients had a higher PPV in identifying the patients at highest risk for admission. Of note, heart rate was not a useful predictor in the older patients.


2014 ◽  
Vol 30 (1) ◽  
pp. 11-15
Author(s):  
Qazi Farzana Akhter ◽  
Qazi Shamima Akhter ◽  
Farhana Rahman ◽  
Sybyla Ferdousi ◽  
Susmita Sinha

Heart rate variability (HRV) has been considered as an indicator of autonomic nerve function status. We aimed to find out the reference values of heart rate variability by power spectral analysis in our healthy population of different age. This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from the period of July 2012 to June 2013. For this, 180 subjects were selected with the age ranging from 15-60 years. All the study subjects were divided into 3 different groups according to age (Group A: 15-30 years; Group B: 31-45 years; Group C: 46-60 years). Each group contained 60 subjects of which 30 were male and 30 were female. The subjects were selected from different areas of Dhaka city by personal contacts. Analysis of HRV parameters were done in Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. For statistical analysis, one way ANOVA, unpaired Students t-test and Pearson’s correlation coefficient test were performed by using SPSS (version-17) as applicable. LF nu, LF power and LF/HF were significantly (p<0.001) higher in group C in comparison to those of group A and B. Again Total power, HF power, HF nu (p<0.001) were significantly higher in group A and B in comparison to that of group C. This study concludes that cardiac parasympathetic activity was decreased and sympathetic activity was increased with aging.DOI: http://dx.doi.org/10.3329/bjpp.v30i1.20788 Bangladesh J Physiol Pharmacol 2014; 30(1):11-15


2006 ◽  
Vol 31 (5) ◽  
pp. 541-548 ◽  
Author(s):  
Adrian W. Midgley ◽  
Lars R. McNaughton ◽  
Sean Carroll

This study investigated the utility of a verification phase for increasing confidence that a “true” maximal oxygen uptake had been elicited in 16 male distance runners (mean age (±SD), 38.7  (± 7.5 y)) during an incremental treadmill running test continued to volitional exhaustion. After the incremental test subjects performed a 10 min recovery walk and a verification phase performed to volitional exhaustion at a running speed 0.5 km·h–1 higher than that attained during the last completed stage of the incremental phase. Verification criteria were a verification phase peak oxygen uptake ≤ 2% higher than the incremental phase value and peak heart rate values within 2 beats·min–1 of each other. Of the 32 tests, 26 satisfied the oxygen uptake verification criterion and 23 satisfied the heart rate verification criterion. Peak heart rate was lower (p = 0.001) during the verification phase than during the incremental phase, suggesting that the verification protocol was inadequate in eliciting maximal values in some runners. This was further supported by the fact that 7 tests exhibited peak oxygen uptake values over 100 mL·min–1 (≥ 3%) lower than the peak values attained in the incremental phase. Further research is required to improve the verification procedure before its utility can be confirmed.


1965 ◽  
Vol 20 (3) ◽  
pp. 432-436 ◽  
Author(s):  
K. Lange Andersen ◽  
Lars Hermansen

Maximal oxygen uptake and related respiratory and circulatory functions were measured in sedentary and well-trained middle-aged men. Maximal oxygen uptakes averaged 2.63 liter/min in sedentary men and 3.36 liter/min in well-trained men, the latter value being essentially the same as found in young untrained students. The heart rate/ oxygen uptake relationship was found to be the same for sedentary-living men, regardless of age, but maximal heart rate was lower in older men. The maximal heart rate is probably the same in well-trained as in sedentary middle-aged men, this in contrast to what has been observed in younger age groups, where training reduces maximal heart rate. The exercise-induced hyperventilation takes place at an oxygen uptake corresponding to 70–80% of the capacity, this being the same in trained and untrained, and essentially the same as found in young adult subjects. maximal O2 uptake Submitted on March 23, 1964


1995 ◽  
Vol 81 (2) ◽  
pp. 371-379
Author(s):  
Daniel E. Boone

WAIS–R aging patterns were examined for a group of 200 psychiatric inpatients. Inpatients were grouped into six age categories: less than 24, 24–28, 29–32, 33–38, 39–43, and greater than 43 years. Verbal and Performance sums of scaled score, subtest scaled score, and raw score total, and individual item score means were examined for each age category. The classical aging pattern was observed wherein more crystallized cognitive abilities remained stable over age groups of the life span while more fluid abilities dropped sharply with their increasing ages. Results supported the decline in fluid cognitive abilities hypothesis for WAIS–R aging patterns advocated by Horn in 1985 and Kaufman in 1990.


2014 ◽  
Vol 2 (3) ◽  
pp. 335 ◽  
Author(s):  
Margret Olafia Tomasdottir ◽  
Linn Getz ◽  
Johann A Sigurdsson ◽  
Halfdan Petursson ◽  
Anna Luise Kirkengen ◽  
...  

Rationale and aims: Accumulating evidence shows that diseases tend to cluster in diseased individuals, so-called multimorbidity. The aim of this study was to analyze multimorbidity patterns, empirically and theoretically, to better understand the phenomenon. Population and methods: The Norwegian population-based Nord-Trøndelag Health Study HUNT 3 (2006-8), with 47,959 individuals aged 20-79 years. A total of 21 relevant, longstanding diseases/malfunctions were eligible for counting in each participant. Multimorbidity was defined as two or more chronic conditions.Results: Multimorbidity was found in 18% of individuals aged 20 years. The prevalence increased with age in both sexes. The overall age-standardized prevalence was 42% (39% for men, 46% for women). ‘Musculoskeletal disorders’ was the disease-group most frequently associated with multimorbidity. Three conditions, strategically selected to represent different diagnostic domains according to biomedical tradition; gastro-esophageal reflux, thyroid disease and dental problems, were all associated with both mental and somatic comorbid conditions. Conclusions and implications: Multimorbidity appears to be prevalent in both genders and across age-groups, even in the affluent and relatively equitable Norwegian society. The disease clusters typically transcend biomedicine’s traditional demarcations between mental and somatic diseases and between diagnostic categories within each of these domains. A new theoretical approach to disease development and recovery is warranted, in order to adequately tackle ‘the challenge of multimorbidity’, both empirically and clinically. We think the concept allostatic load can be systematically developed to “capture” the interrelatedness of biography and biology and to address the fundamental significance of “that, which gains” versus “that, which drains” any given human being.


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