scholarly journals Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review

2022 ◽  
Vol 11 (2) ◽  
pp. 328
Author(s):  
Nuria Marín-Jiménez ◽  
Carolina Cruz-León ◽  
Alejandro Perez-Bey ◽  
Julio Conde-Caveda ◽  
Alberto Grao-Cruces ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Predictive Validity ◽  
Systematic Reviews ◽  
Gait Speed ◽  
Meta Analysis ◽  
Motor Fitness ◽  
All Cause Mortality ◽  
Impaired Balance ◽  
Over 40 Years

Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.

Clinical and Ambulatory Gait Speed in Older Adults: Associations With Several Physical, Mental, and Cognitive Health Outcomes

2020 ◽  
Vol 100 (4) ◽  
pp. 718-727
Author(s):  
Miguel Á De la Cámara ◽  
Sara Higueras-Fresnillo ◽  
Kabir P Sadarangani ◽  
Irene Esteban-Cornejo ◽  
David Martinez-Gomez ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Predictive Validity ◽  
Gait Speed ◽  
Well Being ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Walk Test ◽  
Physical And Mental Health ◽  
Cognitive Health

Abstract Background Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes. Objective The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults. Design A cross-sectional design was used. Methods The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper- and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status). Results The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures. Limitations The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study. Conclusion The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs.

Associations Between Handgrip Strength and Disease-Specific Mortality Including Cancer, Cardiovascular, and Respiratory Diseases in Older Adults: A Meta-Analysis

2020 ◽  
Vol 28 (2) ◽  
pp. 320-331
Author(s):  
Junga Lee
Keyword(s):  
Older Adults ◽  
Older Women ◽  
Respiratory Diseases ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Adult Participants ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Several controversial studies linking handgrip strength and health have suggested that low handgrip strength in older adults may be related to health problems and have investigated whether there is a minimum handgrip strength level associated with reduced mortality. Thus, by meta-analysis, the authors identified an association between handgrip strength in older adults and disease-specific mortality and all-cause mortality. Thirty studies with a total of 194,767 older adult participants were included in this meta-analysis. Higher handgrip strength was associated with an 18% decrease in all-cause mortality. Lower handgrip strength was associated with increased all-cause mortality. The minimum handgrip strength in older women that did not increase all-cause mortality was 18.21 kg. Increased handgrip strength showed a decreased all-cause mortality, whereas decreased handgrip strength was associated with increased all-cause mortality. Strengthening the handgrip may help improve disease-specific mortality in older adults.

scholarly journals A reassessment of the relationship between depression and all-cause mortality in 3,604,005 participants from 293 studies

2017 ◽  
Author(s):  
Eiko I Fried ◽  
Beyon Miloyan
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Total Sample ◽  
Mental Condition ◽  
Analysis Methodology ◽  
All Cause Mortality ◽  
Model Adjustment ◽  
Relationship Of ◽  
The Relationship

The objective of this study is to explain inconsistencies in the relationship between depression and all-cause mortality by performing a reassessment of the included studies of previous systematic reviews. We assessed study-level methodological variables with a focus on sample size and follow-up period, measurement and classification of depression, and model adjustment. We included the constituent studies of fifteen systematic reviews on depression and mortality, yielding 488 articles after the removal of duplicates. 333 studies were extracted, 40 of which used data that overlapped with other included studies. We included 313 estimates from 293 articles in the meta-analysis with a total sample of 3,604,005 participants and over 417,901 deaths. We identified a pronounced publication bias favoring large, positive associations in imprecise studies. Several factors moderated the relationship between depression and mortality. Most importantly, the 16 estimates adjusting for at least one comorbid mental condition (Pooled Effect: 1.08; 95% CI: 0.98-1.18), and the fraction of 8 of those estimates also adjusting for health variables (e.g., smoking, alcohol use, or physical inactivity; Pooled Effect: 1.04; 95% CI: 0.87-1.21), reported considerably smaller associations than the 204 unadjusted estimates (Pooled Effect: 1.32; 95% CI: 1.28-1.36). The sizable relationship of depression and mortality reported in previous systematic reviews is largely based on low-quality studies; controlling for important covariates attenuates the association considerably. Higher quality studies are needed based on large community samples, extensive follow-up, adjustment for health behaviors and mental disorders, and time-to-event outcomes based on survival analysis methodology.

scholarly journals The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Gordana Dermody ◽  
Lisa Whitehead ◽  
Graham Wilson ◽  
Courtney Glass
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Virtual Reality ◽  
Pain Management ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Psychosocial Health ◽  
Community Dwelling ◽  
Residential Aged Care ◽  
Community Dwelling Older Adults

BACKGROUND Virtual reality (VR) delivered through immersive headsets creates an opportunity to deliver interventions to improve physical, mental, and psychosocial health outcomes. VR app studies with older adults have primarily focused on rehabilitation and physical function including gait, balance, fall prevention, pain management, and cognition. Several systematic reviews have previously been conducted, but much of the extant literature is focused on rehabilitation or other institutional settings, and little is known about the effectiveness of VR apps using immersive headsets to target health outcomes among community-dwelling older adults. OBJECTIVE The objective of this review was to evaluate the effectiveness of VR apps delivered using commercially available immersive headsets to improve physical, mental, or psychosocial health outcomes in community-dwelling older adults. METHODS Peer-reviewed publications that included community-dwelling older adults aged ≥60 years residing in residential aged care settings and nursing homes were included. This systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness evidence. The title of this review was registered with JBI, and the systematic review protocol was registered with the International Prospective Register of Systematic Reviews. RESULTS In total, 7 studies that specifically included community-dwelling older adults were included in this review. VR apps using a head-mounted display led to improvements in a number of health outcomes, including pain management, posture, cognitive functioning specifically related to Alzheimer disease, and a decreased risk of falls. A total of 6 studies reported a statistically significant difference post VR intervention, and 1 study reported an improvement in cognitive function to reduce navigational errors. Only one study reported on the usability and acceptability of the interventions delivered through VR. While one study used a distraction mechanism for pain management, none of the studies used gaming technology to promote enjoyment. CONCLUSIONS Interventions to improve health outcomes through VR have demonstrated potential; however, the ability to synthesize findings by primary outcome for the older adult population is not possible. A number of factors, especially related to frailty, usability, and acceptability, also need to be explored before more substantial recommendations on the effectiveness of VR interventions for older adults can be made. CLINICALTRIAL PROSPERO CRD42019143504; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143504

scholarly journals Dietary Carbohydrate and Diverse Health Outcomes: Umbrella Review of 30 Systematic Reviews and Meta-Analyses of 281 Observational Studies

2021 ◽  
Vol 8 ◽  
Author(s):  
Ya-Shu Liu ◽  
Qi-Jun Wu ◽  
Jia-Le Lv ◽  
Yu-Ting Jiang ◽  
Hui Sun ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Carbohydrate Intake ◽  
Dietary Carbohydrate ◽  
Umbrella Review ◽  
Suggestive Evidence ◽  
All Cause Mortality ◽  
Meta Analyses

Background and Aims: The associations between dietary carbohydrate and diverse health outcomes remain controversial and confusing. To summarize the existing evidence of the association between dietary carbohydrate intake and diverse health outcomes and to evaluate the credibility of these sources of evidence. We performed this umbrella review of evidence from meta-analyses of observational studies.Methods: PubMed, Embase, Web of Science databases, and manual screening of references up to July 2020 were searched. Systematic reviews with meta-analyses of observational studies in humans investigating the association between dietary carbohydrate intake and multiple health outcomes were identified. We assessed the evidence levels by using summary effect sizes, 95% prediction intervals, between-study heterogeneity, evidence of small-study effects, and evidence of excess significance bias for each meta-analysis.Results: We included 43 meta-analyses of observational research studies with 23 health outcomes, including cancer (n = 26), mortality (n = 4), metabolic diseases (n = 4), digestive system outcomes (n = 3), and other outcomes [coronary heart disease (n = 2), stroke (n = 1), Parkinson's disease (n = 1), and bone fracture (n = 2)]. This umbrella review summarized 281 individual studies with 13,164,365 participants. Highly suggestive evidence of an association between dietary carbohydrate intake and metabolic syndrome was observed with adjusted summary odds ratio of 1.25 [95% confidence interval (CI) 1.15–1.37]. The suggestive evidences were observed in associations of carbohydrate consumption with esophageal adenocarcinoma (0.57, 95% CI = 0.42–0.78) and all-cause mortality (adjusted summary hazard ratio 1.19, 95% CI = 1.09–1.30).Conclusions: Despite the fact that numerous systematic reviews and meta-analyses have explored the relationship between carbohydrate intake and diverse health outcomes, there is no convincing evidence of a clear role of carbohydrate intake. However, there is highly suggestive evidence suggested carbohydrate intake is associated with high risk of metabolic syndrome, suggestive evidence found its association with increased risk of all-cause mortality and decreased risk of esophageal adenocarcinoma.Systematic Review Registration: CRD42020197424.

scholarly journals Do highly physically active workers die early? A systematic review with meta-analysis of data from 193 696 participants

2018 ◽  
Vol 52 (20) ◽  
pp. 1320-1326 ◽  
Author(s):  
Pieter Coenen ◽  
Maaike A Huysmans ◽  
Andreas Holtermann ◽  
Niklas Krause ◽  
Willem van Mechelen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Health Outcomes ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Meta Analysis ◽  
Occupational Physical Activity ◽  
Low Level ◽  
All Cause Mortality ◽  
High Level

ObjectiveRecent evidence suggests the existence of a physical activity paradox, with beneficial health outcomes associated with leisure time physical activity, but detrimental health outcomes for those engaging in high level occupational physical activity. This is the first quantitative systematic review of evidence regarding the association between occupational physical activity and all-cause mortality.DesignSystematic review with meta-analysis.Data sourceA literature search was performed in electronic databases PubMed, Embase, CINAHL, PsycINFO and Cochrane.Eligibility criteria for selecting studiesWe screened for peer reviewed articles from prospective studies assessing the association of occupational physical activity with all-cause mortality. A meta-analysis assessed the association of high (compared with low) level occupational physical activity with all-cause mortality, estimating pooled hazard ratios (HR) (with 95% CI).Results2490 unique articles were screened and 33 (from 26 studies) were included. Data from 17 studies (with 193 696 participants) were used in a meta-analysis, showing that men with high level occupational physical activity had an 18% increased risk of early mortality compared with those engaging in low level occupational physical activity (HR 1.18, 95% CI 1.05 to 1.34). No such association was observed among women, for whom instead a tendency for an inverse association was found (HR 0.90, 95% CI 0.80 to 1.01).ConclusionsThe results of this review indicate detrimental health consequences associated with high level occupational physical activity in men, even when adjusting for relevant factors (such as leisure time physical activity). These findings suggest that research and physical activity guidelines may differentiate between occupational and leisure time physical activity.

scholarly journals Digital Predictors of Morbidity, Hospitalization, and Mortality Among Older Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Sofia Daniolou ◽  
Andreas Rapp ◽  
Celina Haase ◽  
Alfred Ruppert ◽  
Marlene Wittwer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Outcomes ◽  
Digital Health ◽  
Meta Analysis ◽  
Design Development ◽  
Clinical Implementation ◽  
Care Needs ◽  
Health Technologies ◽  
Improve Health

The widespread adoption of digital health technologies such as smartphone-based mobile applications, wearable activity trackers and Internet of Things systems has rapidly enabled new opportunities for predictive health monitoring. Leveraging digital health tools to track parameters relevant to human health is particularly important for the older segments of the population as old age is associated with multimorbidity and higher care needs. In order to assess the potential of these digital health technologies to improve health outcomes, it is paramount to investigate which digitally measurable parameters can effectively improve health outcomes among the elderly population. Currently, there is a lack of systematic evidence on this topic due to the inherent heterogeneity of the digital health domain and the lack of clinical validation of both novel prototypes and marketed devices. For this reason, the aim of the current study is to synthesize and systematically analyse which digitally measurable data may be effectively collected through digital health devices to improve health outcomes for older people. Using a modified PICO process and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, we provide the results of a systematic review and subsequent meta-analysis of digitally measurable predictors of morbidity, hospitalization, and mortality among older adults aged 65 or older. These findings can inform both technology developers and clinicians involved in the design, development and clinical implementation of digital health technologies for elderly citizens.

scholarly journals Brain Magnetic Susceptibility is Associated With Slower Gait in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 878-878
Author(s):  
Victoria Poole ◽  
Robert Dawe ◽  
Sue Luergans ◽  
David Bennett ◽  
Aron Buchman ◽  
...  
Keyword(s):  
Older Adults ◽  
Magnetic Susceptibility ◽  
Health Outcomes ◽  
Gait Speed ◽  
Right Hemisphere ◽  
Community Dwelling ◽  
Gaussian Kernel ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Community Dwelling Older Adults

Abstract Age-related slowing of gait is exceedingly common and a robust predictor of various adverse health outcomes in older age. Prior neuroimaging studies have documented diverse non-specific structural brain abnormalities which are related to slow gait; however, the extent to which quantitative susceptibility mapping (QSM), which measures regional magnetic susceptibility in the brain, associates with gait speed remains unexplored. In the current study, 415 non-demented community-dwelling older adults (91 males; 81+/- 7 years) underwent an MRI (Siemens 3T TIM Trio) and in-home motor assessment. Gait speed was measured and averaged across 2 timed 8-ft walks. MR-acquired QSM data were pre-processed, registered to ICBM template, and spatially smoothed with a 5mm FWHM Gaussian kernel. When these maps entered group-level GLMs, voxel-wise associations with gait speed were of interest, after adjusting for demographics. We observed very strong negative associations between gait speed and magnetic susceptibility, such that those with slower gait had higher susceptibility in bilateral inferior frontal, superior temporal, and angular gyri (corrected p<.0005). Robust associations were also observed in the middle frontal, precentral, and postcentral gyri of the right hemisphere. These novel findings suggest that reduced myelination or increased iron accumulation in these brain regions may contribute to impaired gait. Future work will need to determine to what extent these cross-sectional QSM metrics are independent predictors of incident adverse health outcomes when controlling for other common brain imaging abnormalities observed in older adults.

Physical function and all-cause mortality in older adults diagnosed with cancer: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Yasmin Ezzatvar ◽  
Robinson Ramírez-Vélez ◽  
Mikel L Sáez de Asteasu ◽  
Nicolás Martínez-Velilla ◽  
Fabricio Zambom-Ferraresi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Physical Function ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Timed Up And Go ◽  
Hazard Ratios ◽  
Inverse Variance ◽  
All Cause Mortality ◽  
Prospective Association

Abstract Background Physical function is an independent predictor of numerous chronic diseases, but its association with all-cause mortality in older adults diagnosed with cancer has received little attention. Objective The aim of this study was to conduct a systematic review and meta-analysis on the prospective association between physical function and all-cause mortality in older adults diagnosed with cancer. Methods Two authors systematically searched MEDLINE, EMBASE, and SportsDiscus databases. Prospective studies reporting associations of baseline physical function with all-cause mortality in patients aged 60 years or older diagnosed with any type of cancer were included. Hazard Ratios (HR) with associated 95% confidence intervals (CI) were extracted from studies for all-cause mortality and pooled HRs were then calculated using the random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman adjustment. Results Data from 25 studies with 8,109 adults diagnosed with cancer aged ≥60 years were included in the study. Higher levels of physical function (short physical performance battery, HR=0.44 95% CI, 0.29–0.67; I 2=16.0%; timed up and go, HR=0.40 95% CI, 0.31–0.53; I 2=61.9%; gait speed, HR=0.41 95% CI, 0.17–0.96; I 2=73.3%; handgrip strength: HR=0.61 95% CI, 0.43–0.85, I 2=85.6%; and overall, HR=0.45 95% CI, 0.35–0.57; I 2=88.6%) were associated with a lower risk of all-cause mortality compared to lower levels of functionality. Neither age at baseline nor length of follow-up had a significant effect on the HR estimates for lower all-cause mortality risk. Conclusion Physical function may exert an independent protective effect on all-cause mortality in older adults diagnosed with cancer.

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