Improving balance control and self-reported lower extremity function in community-dwelling older adults: a randomized control trial

ObjectiveTo evaluate the relationship of white matter hyperintensities (WMH) with decline in lower extremity function (LEF) over approximately 3 years in dementia-free older adults with memory complaints.MethodsWe obtained brain MRI data from 458 community-dwelling adults, aged 70 years or over, at baseline, and from 358 adults over an average follow-up of 963 days. We evaluated LEF using the Short Physical Performance Battery (SPPB). We related baseline WMH volumes and progression to SPPB scores over time, using mixed-effect linear regressions. For the secondary analyses, we categorized baseline WMH volume into quartiles, and dichotomized the WMH progression to compare fast and slow progression.ResultsBaseline WMH volume (β = −0.017, 95% confidence interval [CI] −0.025 to −0.009), as well as WMH progression (β = −0.002, 95% CI −0.003 to −0.001), significantly associated with a decline in SPPB performance in adjusted analyses. Compared with the lowest quartile of baseline WMH volume, the highest quartile associated with a decline in SPPB performance (β = −0.301, 95% CI −0.558 to −0.044). Fast progression also associated with a decline in SPPB performance. We found clinically meaningful differences in the SPPB, with higher scores in participants with slow progression of WMH, at both 24 and 36 months.ConclusionsBaseline level and WMH progression associated with longitudinal decline in SPPB performance among older adults. We detected clinically meaningful differences in SPPB performance on comparing fast with slow progression of WMH, suggesting that speed of WMH progression is an important determinant of LEF during aging.

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Plasma Ceramides and Risk of Impaired Lower-Extremity Function in Older Adults: A Nested Case–Control Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa188 ◽

2020 ◽

Author(s):

Francisco Félix Caballero ◽

Ellen A Struijk ◽

Antonio Buño ◽

Fernando Rodríguez-Artalejo ◽

Esther Lopez-Garcia

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Lower Extremity ◽

Body Mass ◽

Case Control Study ◽

Case Control ◽

Community Dwelling ◽

Lower Extremity Function ◽

Extremity Function ◽

Control Study

Abstract Background Higher levels of ceramides have been linked to several chronic diseases; also there is emerging cross-sectional evidence that ceramides are associated with lower physical functioning. This research assessed for the first time the prospective relationship between ceramide species and impaired lower-extremity function (ILEF) in older adults. Methods Case–control study with 43 cases of ILEF and 86 age- and sex-matched controls, which was nested in the Seniors-ENRICA cohort of community-dwelling older adults. Incident ILEF from 2015 to 2017 was ascertained with the Short Physical Performance Battery. In 2015, 27 ceramide species were measured in plasma by liquid chromatography-tandem mass spectrometry. Conditional logistic regression models were used to assess the longitudinal relationship between ceramides concentration and incidence of ILEF. Results After adjusting for education level, body mass index, alcohol and total energy intake, physical activity, and presence of chronic conditions, some ceramide species were related to 2-year incidence of ILEF. Specifically, the odds ratios of ILEF per 1-SD increase in ceramide concentration were: 1.66 [95% CI = (1.03, 2.68)] for ceramide C14:0, 1.61 (1.00, 2.59) for ceramide C16:0, and 1.64 (1.03, 2.60) for ceramide C16:1 (n-7). In the case of ceramides C16:0 and C16:1 (n-7), a stronger relationship was found in those with a higher body mass index; systolic blood pressure could also mediate the relationship between ceramide C16:1 (n-7) and ILEF (p for interaction = .03). Conclusions Higher plasma levels of ceramides C14:0, C16:0, and C16:1 (n-7) are associated with higher risk of ILEF, and might serve as risk markers for functional decline in older adults.

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The Relationship Between Cognitive Decline and Sedentary Time

Innovation in Aging ◽

10.1093/geroni/igaa057.618 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 191-191

Author(s):

Lorraine Phillips ◽

Mary Bowen

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cognitive Function ◽

Lower Extremity ◽

Sedentary Time ◽

Community Dwelling ◽

Physical Activity Intensity ◽

Lower Extremity Function ◽

Activity Intensity ◽

Extremity Function

Abstract Early identification of functional decline in older adults with mild cognitive impairment (MCI) provides the opportunity to initiate behavioral interventions to slow decline. More frequent breaks in sedentary time has been associated with greater lower extremity function. This longitudinal study examined the effect of 6-month change in cognitive function on monthly sedentary time, controlling for lower extremity function, among community-dwelling older adults with MCI. Twenty adults with Montreal Cognitive Assessment Score (MoCA) between 19-25, who were age ≥ 60 years old, and ambulatory, wore an actigraph for 6 months and participated in monthly in-person assessments. Measures included MoCA change (baseline to month 6), Short Physical Performance Battery (SPPB; baseline, months 3 and 6); sedentary time and physical activity intensity; and falls (monthly). The sample was 70% female, 60% non-Hispanic white, with a mean age of 77 years. Sixteen participants provided complete data for mixed-model analysis. Over 6 months, 11 falls occurred among 7 participants. The mean MoCA score declined from 22.7 to 21.9 while SPPB remained stable. Overall time spent in sedentary behavior was high (71%) and physical activity intensity was low (light and moderate combined= 26.1%). Results of multi-level analysis with sedentary time as a continuous Level-1 variable and MoCA change scores, SPPB scores, and age in Level-2 showed that negative change in MoCA (β=-0.11; p≤0.05) was associated with increased sedentary time. Given sedentary time increases as cognitive function declines, older adults with MCI could benefit from interventions designed to interrupt sedentary time as well as increase physical activity.

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Prolonged nightly fasting and lower-extremity functioning in community-dwelling older adults

British Journal Of Nutrition ◽

10.1017/s0007114520005218 ◽

2020 ◽

pp. 1-26

Author(s):

Daniela B. Estrada-deLeón ◽

Ellen A. Struijk ◽

Francisco Félix Caballero ◽

Mercedes Sotos Prieto ◽

Fernando Rodríguez-Artalejo ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Lower Extremity ◽

Large Population ◽

Community Dwelling ◽

Lower Extremity Function ◽

Fasting Period ◽

Balance Impairment ◽

Fasting Time ◽

Community Dwelling Older Adults

Abstract It is unknown if time-restricted feeding confers a protective effect on the physical function of older adults. The aim of this study was to assess prolonged nightly fasting in association with performance-based lower-extremity function (LEF) in a large population of community-dwelling older adults. A cross-sectional study was carried out among 1,226 individuals ≥64 years from the Seniors-ENRICA-II cohort. In 2016-2017, habitual diet was assessed through a validated diet history. Fasting time was classified into the following categories: ≤9, 10-11, and ≥12hours/day, the latter being considered prolonged nightly fasting. Performance-based LEF was assessed with the Short Physical Performance Battery (SPPB). After adjusting for potential confounders, a longer fasting period was associated with a higher likelihood of impaired LEF [odds ratio (OR) and 95% confidence intervals (CI) for the second and third categories: 2.27 (1.56-3.33) and 2.70 (1.80-4.04), respectively, considering the ≤9 hours/day fasting group as reference; p-trend <0.001]. When assessing each SPPB subtest separately, fasting time showed a significant association with balance impairment (OR for highest vs. lowest fasting time: 2.48; 95% CI: 1.51-4.08; p-trend =0.001) and difficulty to rise from a chair (OR for highest vs. lowest fasting time: 1.47; 95% CI: 1.05-2.06; p-trend =0.01). The risk associated with ≥12 h fasting among those with the lowest levels of physical activity was three times higher than among those with ≤9 hours fasting with the same low level of physical activity. Prolonged nightly fasting was associated with a higher likelihood of impaired LEF, balance impairment, and difficulty to rise from a chair in older adults, especially among those with low levels of physical activity.

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Time-restricted feeding and lower-extremity functioning in community-dwelling older adults

10.21203/rs.3.rs-23132/v1 ◽

2020 ◽

Author(s):

Daniela B. Estrada-DeLeón ◽

Ellen A Struijk ◽

Francisco Félix Caballero ◽

Mercedes Sotos Prieto ◽

Fernando Rodríguez-Artalejo ◽

...

Keyword(s):

Older Adults ◽

Lower Extremity ◽

Large Population ◽

Community Dwelling ◽

Intermittent Fasting ◽

Restricted Feeding ◽

Lower Extremity Function ◽

Balance Impairment ◽

Fasting Time ◽

Community Dwelling Older Adults

Abstract Background: Time-restricted feeding, a specific form of intermittent fasting, has been associated with several possible health benefits including improved body composition, blood lipid levels and extended lifespan. However, it is unknown if time-restricted feeding confers a protective effect on the physical function of older adults. The aim of this study was to assess time-restricted feeding in association with performance-based lower-extremity function (LEF) in a large population of community-dwelling older adults.Methods: Cross-sectional study among 1,226 individuals ≥64 years from the Seniors-ENRICA-II cohort. In 2016-2017, habitual diet was assessed through a validated diet history. Fasting time was classified into the following categories: ≤9, 10-11, and ≥12hours/day, the latter being considered time-restricted feeding. Performance-based LEF was assessed with the Short Physical Performance Battery (SPPB).Results: After adjusting for potential confounders, a longer fasting period was associated with a higher likelihood of impaired LEF [odds ratio (OR) and 95% confidence intervals (CI) for the second and third categories: 2.27 (1.56-3.33); and 2.70 (1.80-4.04), respectively, considering the ≤9 hours/day fasting group as the reference category; p-trend <0.001]. When assessing each SPPB subtest separately, fasting time showed a significant association with balance impairment (OR for highest vs. lowest fasting time: 2.48; 95% CI: 1.51-4.08; p-trend= 0.001) and difficulty to rise from a chair (OR for highest vs. lowest fasting time: 1.47; 95% CI: 1.05-2.06; p-trend= 0.01).Conclusions: Time-restricted feeding was associated with a higher likelihood of impaired LEF, balance impairment, and difficulty to rise from a chair in older adults. These results need to be confirmed in further longitudinal studies.Trial registration: ClinicalTrials.gov NCT03541135. Registered 30 May 2018, retrospectively registered.

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