scholarly journals RISK FACTORS FOR LOW GAIT SPEED: A NESTED CASE-CONTROL SECONDARY ANALYSIS OF THE MEXICAN HEALTH AND AGING STUDY

2015 ◽  
pp. 1-5
Author(s):  
M.U. PÉREZ-ZEPEDA ◽  
J.G. GONZÁLEZ-CHAVERO ◽  
R. SALINAS-MARTINEZ ◽  
L.M. GUTIÉRREZ-ROBLEDO
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Physical Performance ◽  
Gait Speed ◽  
Representative Sample ◽  
Performance Test ◽  
Subsequent Development ◽  
Case Control ◽  
Adverse Outcomes ◽  
Aging Study

Background: Physical performance tests play a major role in the geriatric assessment. In particular, gait speed has shown to be useful for predicting adverse outcomes. However, risk factors for slow gait speed (slowness) are not clearly described. Objectives: To determine risk factors associated with slowness in Mexican older adults. Design: A two-step process was adopted for exploring the antecedent risk factors of slow gait speed. First, the cut-off values for gait speed were determined in a representative sample of Mexican older adults. Then, antecedent risk factors of slow gait speed (defined using the identified cut-points) were explored in a nested cohort case-control study. Setting, participants: One representative sample of a cross-sectional survey for the first step and the Mexican Health and Aging Study (a cohort characterized by a 10-year follow-up). Measurements: A 4-meter usual gait speed test was conducted. Lowest gender and height-stratified groups were considered as defining slow gait speed. Sociodemographic characteristics, comorbidities, psychological and health-care related variables were explored to find those associated with the subsequent development of slow gait speed. Unadjusted and adjusted logistic regression models were performed. Results: In the final model, age, diabetes, hypertension, and history of fractures were associated with the development of slow gait speed. Conclusions: Early identification of subjects at risk of developing slow gait speed may halt the path to disability due to the robust association of this physical performance test with functional decline.

scholarly journals The Benefits of Physical Activity in Individuals with Cardiovascular Risk Factors: A Longitudinal Investigation Using fNIRS and Dual-Task Walking

2021 ◽  
Vol 10 (4) ◽  
pp. 579
Author(s):  
Deborah Talamonti ◽  
Thomas Vincent ◽  
Sarah Fraser ◽  
Anil Nigam ◽  
Frédéric Lesage ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cognitive Performance ◽  
Dual Task ◽  
Gait Speed ◽  
Regular Physical Activity ◽  
Cortical Response

Cardiovascular fitness is linked to better executive functions, preserved gait speed, and efficient cortical activity. Older adults with cardiovascular risk factors (CVRFs) typically show poor cognitive performance, low physical fitness, and altered brain functioning compared with healthy individuals. In the current study, the impact of regular physical activity on cognition, locomotion, and brain functions was explored in a cohort of older adults with low or high CVRFs. Cortical activation of the frontal areas was investigated using functional Near-Infrared Spectroscopy (fNIRS) at baseline, at 6 months and at 12 months. Evoked cortical response and behavioral performance were assessed using the dual-task walking paradigm, consisting of three conditions: single cognitive task (2-back task), single walking task (walking), and dual-task (2-back whilst walking). Results show greater task-related cortical response at baseline in individuals with high CVRFs compared to those with low CVRFs. Moreover, participants with high CVRFs benefitted the most from participating in regular physical activity, as their cortical response decreased at the 12-month follow-up and became comparable to that of participants with low CVRFs. These changes were observed in conjunction with improved cognitive performance and stable gait speed throughout the 12-month period in both groups. Our findings provide evidence that participation in regular physical activity may be especially beneficial in individuals with CVRFs by promoting brain and cognitive health, thus potentially contributing to prevention of cognitive decline. Future research may explore whether such effects are maintained in the long-term in order to design ad-hoc interventions in this specific population.

Prevalence, Risk Factors, and Short-Term Outcomes of Full-Term Low Birth Weight Infants Born at a Tertiary Academic Center: A Prospective Case–Control Study

2021 ◽  
Author(s):  
Heidi K. Al-Wassia ◽  
Shahd K. Baarimah ◽  
Asmaa H. Mohammedsaleh ◽  
Manal O. Alsulami ◽  
Ragad S. Abbas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Case Control Study ◽  
Case Control ◽  
Adverse Outcomes ◽  
Chromosomal Anomalies ◽  
Short Term ◽  
Term Infants ◽  
Control Study

Objective Low birth weight (LBW) infants (<2,500 g) continued to be a global health problem because of the associated short- and long-term adverse outcomes. The study aimed to determine the prevalence, risk factors, and short-term outcomes of term LBW infants Study Design A prospective and case–control study. All infants born consecutively from September 1, 2018 to August 31, 2019 were included. Cases, term LBW infants, were 1:1 matched to controls, appropriate for gestational age (AGA) term infants. Major congenital or chromosomal anomalies and multiple pregnancies were excluded. Results The prevalence of term LBW in the studied period was 4.8%. Mothers of term LBW infants had significantly lower body mass index (p = 0.05), gained less weight (p = 0.01), had a history of previous LBW (p = 0.01), and lower monthly income (p = 0.04) compared with mothers of term AGA infants even after adjustment for confounders. A nonsignificant higher number of term LBW infants needed NICU admission, while their need for phototherapy was deemed significant. Conclusion We identified nutritional and socioeconomic maternal factors that are significantly associated with LBW infants and should be targeted during antenatal visits to improve neonatal outcomes. Key Points

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

scholarly journals Smartphone-Based Prediction Model for Postoperative Cardiac Surgery Outcomes Using Preoperative Gait and Posture Measures

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1704
Author(s):  
Rahul Soangra ◽  
Thurmon Lockhart
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Cardiac Surgery ◽  
Regression Model ◽  
Mobile Phone ◽  
Gait Speed ◽  
Adverse Outcomes ◽  
Postoperative Outcomes ◽  
Mortality And Morbidity ◽  
Prediction Of Mortality

Gait speed assessment increases the predictive value of mortality and morbidity following older adults’ cardiac surgery. The purpose of this study was to improve clinical assessment and prediction of mortality and morbidity among older patients undergoing cardiac surgery through the identification of the relationships between preoperative gait and postural stability characteristics utilizing a noninvasive-wearable mobile phone device and postoperative cardiac surgical outcomes. This research was a prospective study of ambulatory patients aged over 70 years undergoing non-emergent cardiac surgery. Sixteen older adults with cardiovascular disease (Age 76.1 ± 3.6 years) scheduled for cardiac surgery within the next 24 h were recruited for this study. As per the Society of Thoracic Surgeons (STS) recommendation guidelines, eight of the cardiovascular disease (CVD) patients were classified as frail (prone to adverse outcomes with gait speed ≤ 0.833 m/s) and the remaining eight patients as non-frail (gait speed > 0.833 m/s). Treating physicians and patients were blinded to gait and posture assessment results not to influence the decision to proceed with surgery or postoperative management. Follow-ups regarding patient outcomes were continued until patients were discharged or transferred from the hospital, at which time data regarding outcomes were extracted from the records. In the preoperative setting, patients performed the 5-m walk and stand still for 30 s in the clinic while wearing a mobile phone with a customized app “Lockhart Monitor” available at iOS App Store. Systematic evaluations of different gait and posture measures identified a subset of smartphone measures most sensitive to differences in two groups (frail versus non-frail) with adverse postoperative outcomes (morbidity/mortality). A regression model based on these smartphone measures tested positive on five CVD patients. Thus, clinical settings can readily utilize mobile technology, and the proposed regression model can predict adverse postoperative outcomes such as morbidity or mortality events.

scholarly journals The effect of a multicomponent exercise protocol (VIVIFRAIL©) on inflammatory profile and physical performance of older adults with different frailty status: study protocol for a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marina Petrella ◽  
Ivan Aprahamian ◽  
Ronei Luciano Mamoni ◽  
Carla Fernanda de Vasconcellos Romanini ◽  
Natália Almeida Lima ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Inflammatory Mediators ◽  
Gait Speed ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Frailty Status ◽  
Anti Inflammatory ◽  
Inflammatory Profile

Abstract Background To investigate whether an exercise intervention using the VIVIFRAIL© protocol has benefits for inflammatory and functional parameters in different frailty status. Methods/design This is a randomized clinical trial in an outpatient geriatrics clinic including older adults ≥60 years. For each frailty state (frail, pre-frail and robust), forty-four volunteers will be randomly allocated to the control group (n = 22) and the intervention group (n = 22) for 12 weeks. In the control group, participants will have meetings of health education while those in the intervention group will be part of a multicomponent exercise program (VIVIFRAIL©) performed five times a week (two times supervised and 3 times of home-based exercises). The primary outcome is a change in the inflammatory profile (a reduction in inflammatory interleukins [IL-6, TNF- α, IL1beta, IL-17, IL-22, CXCL-8, and IL-27] or an increase in anti-inflammatory mediators [IL-10, IL1RA, IL-4]). Secondary outcomes are change in physical performance using the Short Physical Performance Battery, handgrip strength, fatigue, gait speed, dual-task gait speed, depressive symptoms, FRAIL-BR and SARC-F scores, and quality of life at the 12-week period of intervention and after 3 months of follow-up. Discussion We expect a reduction in inflammatory interleukins or an increase in anti-inflammatory mediators in those who performed the VIVIFRAIL© protocol. The results of the study will imply in a better knowledge about the effect of a low-cost intervention that could be easily replicated in outpatient care for the prevention and treatment of frailty, especially regarding the inflammatory and anti-inflammatory pathways involved in its pathophysiology. Trial registration Brazilian Registry of Clinical Trials (RBR-9n5jbw; 01/24/2020). Registred January 2020. http://www.ensaiosclinicos.gov.br/rg/RBR-9n5jbw/.

GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Daily Living ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Performance Tests ◽  
One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study

2018 ◽  
Vol 57 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ferhat Arslan ◽  
Hulya Caskurlu ◽  
Sema Sarı ◽  
Hayriye Cankar Dal ◽  
Sema Turan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Absolute Risk ◽  
Subsequent Development ◽  
Bloodstream Infections ◽  
Case Control ◽  
Prior Exposure ◽  
Control Study

Abstract Candida bloodstream infections are associated with high mortality among critically ill patients in intensive care units (ICUs). Studies that explore the risk factors for candidemia may support better patient care in intensive care units. We conducted a retrospective, multicenter case-control study to investigate the risk factors for noncatheter-related Candida bloodstream infections (CBSI) in adult ICUs. Participants selected controls randomly on a 1:1 basis among all noncase patients stayed during the same period in ICUs. Data on 139 cases and 140 controls were deemed eligible. Among the controls, 69 patients died. The stratified Fine-Gray model was used to estimate the subdistribution Hazard ratios. The subdistribution hazards and 95% confidence intervals for final covariates were as follows: prior exposure to antimycotic agents, 2.21 (1.56–3.14); prior exposure to N-acetylcysteine, 0.11 (0.03–0.34) and prior surgical intervention, 1.26 (0.76–2.11). Of the patients, those exposed to antimycotic drugs, 87.1% (54/62) had breakthrough candidemia. Serious renal, hepatic, or hematologic side effects were comparable between patients those exposed and not-exposed to systemic antimycotic drugs. Untargeted administration of antimycotic drugs did not improve survival among candidemic patients (not-exposed, 63.6% [49/77]; exposed % 66.1 [41/62]; P = .899). This study documented that exposure to an antifungal agent is associated with increased the risk of subsequent development of CBSIs among nonneutropenic adult patients admitted to the ICU. Only two centers regularly prescribed N-acetylcysteine. Due to the limited number of subjects, we interpreted the positive effect of N-acetylcysteine on the absolute risk of CBSIs with caution.

Abstract P335: Associations of Sleep Duration and Sleep Quality With Physical Performance in Older Adults --The Chicago Healthy Aging Study (CHAS)

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
ThanhHuyen T Vu ◽  
Kathryn J Reid ◽  
Martha L Daviglus ◽  
Daniel B Garside ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Sleep Duration ◽  
Physical Performance ◽  
Gait Speed ◽  
Healthy Aging ◽  
Handgrip Strength ◽  
Short Sleep Duration ◽  
Aging Study ◽  
Normal Sleep ◽  
And Performance

Background: Sleep duration (too short or too long) is associated with lower physical performance. However, the association of sleep duration and physical performance, taking into account the quality of sleep (e.g., sleep disturbance) in older populations, has not been thoroughly investigated. Methods: Using data from the Chicago Healthy Aging study conducted in 2007-10, we investigated a cross-sectional association of a combination of sleep duration and sleep disturbance with muscle strength (hand grip), and performance [4m gait speed and Short Physical Performance Battery (SPPB)]. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration [categorized as short (≤ 6 hours), normal (7-8 hours), and long (≥ 9 hours)] and sleep disturbance (defined as either cannot fall asleep within 30 minutes or waking up in the middle of the night or early morning three or more times per week). (See Table and Table Footnote for definitions of sleep duration and disturbance, and physical performance categories). Multivariable logistic regression analysis was used. Results: The study sample consists of 952 men and 350 women, ages 65-84 (mean age 71) in 2007-10; 9% were African American.12.6 % had SPPB score ≤ 8, 6.8 % had gait speed on 4 meter course < 0.8 m/s, and 23.4 % had low sex-BMI specific handgrip strength. As compared to the group with normal sleep duration (7-8 hours) without sleep disturbance, adjusted odds (95% confidence interval) of low gait speed <0.8 m/s in those with short sleep duration (≤ 6 hours) and sleep disturbance was much higher [2.00 (1.06-3.75)]. Similarly, the odds of low sex-BMI specific handgrip strength was about 2 times higher in those with long duration of sleep (≥ 9 hours), compared to those with normal sleep duration without sleep disturbance. No association was found for Short Physical Performance Battery (see Table). Conclusion: In older age, short sleep duration with poor quality as well as excessive sleep duration were associated with the greater likelihood of having low muscle strength and performance.

scholarly journals Childhood infectious diseases and old age cognitive functioning: a nationally representative sample of community-dwelling older adults

2020 ◽  
pp. 1-8
Author(s):  
A. Rotstein ◽  
S. Z. Levine
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Infectious Diseases ◽  
Cognitive Functioning ◽  
Old Age ◽  
Early Life ◽  
Representative Sample ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Nationally Representative

ABSTRACT Background: Cumulative evidence suggests that health-related risk factors during midlife and old-age are associated with cognitive impairment. However, studies are needed to clarify the association between early-life risk factors and impaired cognitive functioning to increment existing knowledge. Objective: To examine the association between childhood infectious diseases and late-life cognitive functioning in a nationally representative sample of older adults. Participants: Eligible respondents were 2994 community-dwelling individuals aged 65–85. Measurements: Cognitive functioning was assessed using the Mini-Mental State Examination (MMSE). Childhood infectious diseases (i.e. chicken pox, measles, and mumps) were self-reported. The study covariates were age, sex, highest educational level achieved, smoking status, body mass index, and depression. The primary statistical analysis examined the association between the number of childhood infectious diseases and total MMSE scores, accounting for all study covariates. Regression models of progressive complexity were examined for parsimony. The robustness of the primary results was tested in 17 sensitivity analyses. Results: The most parsimonious model was a linear adjusted model (Bayesian Information Criterion = 12646.09). Late-life cognitive functioning significantly improved as the number of childhood infectious diseases increased (β = 0.18; 95% CI = 0.11, 0.26; p < 0.001). This effect was not significantly attenuated in all sensitivity analyses. Conclusion: The current study results are consistent with prior ecological findings indicating that some childhood infectious diseases are associated with better cognitive functioning in old-age. This points to an early-life modifiable risk factor associated with older-life cognitive functioning. Our results may reflect selective mortality and/or beneficial effects via hormetic processes.

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