Prospective associations of plasma growth differentiation factor 15 with physical performance and cognitive functions in older adults

Background Growth differentiation factor 15 (GDF15) has been associated with several age-related disorders, but its associations with functional abilities in community-dwelling older adults are not well studied. Methods The study was a secondary analysis on 1096 community-dwelling older adults (aged 69 to 94 years) recruited from the Multidomain Alzheimer’s Preventive Trial. Plasma GDF15 was measured one year after participants’ enrolment. Annual data of physical performance (grip strength and short physical performance battery [SPPB]) and global cognitive functions (mini-mental state examination [MMSE] and a composite cognitive score) were measured for four years. Adjusted mixed-effects linear models were performed for cross-sectional and longitudinal association analyses. Results A higher GDF15 was cross-sectionally associated with a weaker grip strength (β = -1.1E-03, 95%CI [-2.0E-03, -1.5E-04]), a lower SPPB score (β = -3.1E-04, 95%CI [-5.4E-04, -9.0E-05]) and worse cognitive functions (β = -2.4E-04, 95%CI [-3.3E-04, -1.6E-04] for composite cognitive score; β = -4.0E-04, 95%CI [-6.4E-04, -1.6E-04] for MMSE). Participants with higher GDF15 demonstrated greater longitudinal declines in SPPB (β = -1.0E-04, 95%CI [-1.7E-04, -2.0E-05]) and composite cognitive score (β = -2.0E-05, 95%CI [-4.0E-05, -3.6E-06]). The optimal initial GDF15 cutoff values for identifying participants with minimal clinically significant decline after one year were 2189 pg/mL for SPPB (AUC: 0.580) and 2330 pg/mL for composite cognitive score (AUC: 0.587). Conclusions Plasma GDF15 is cross-sectionally and longitudinally associated with lower-limb physical performance and global cognitive function in older adults. Circulating GDF15 alone has limited capacity of discriminating older adults who will develop clinically significant functional declines.

Specific Physical Ability Prediction in Youth Basketball Players According to Playing Position

This study investigated the hierarchical structure of physical characteristics in elite young (i.e., U17-U19) basketball players according to playing positions. In addition, their predictive value of physical characteristics was determined for the evaluation of players’ physical preparedness. Sixty elite male basketball players performed 13 standardized specific field tests in order to assess the explosive power of lower limbs, speed, and change-of-direction speed. They were divided into three groups according to playing positions (guard [n = 28], forward [n = 22], center [n = 10]). The basic characteristics of the tested sample were: age = 17.36 ± 1.04 years, body height = 192.80 ± 4.49 cm, body mass = 79.83 ± 6.94 kg, and basketball experience = 9.38 ± 2.10 years for guards; age = 18.00 ± 1.00 years, body height = 201.48 ± 3.14 cm, body mass = 90.93 ± 9.85 kg, and basketball experience = 9.93 ± 2.28 years for forwards; and age = 17.60 ± 1.43 years; body height = 207.20 ± 3.29 cm, body mass = 104.00 ± 9.64 kg, and basketball experience = 9.20 ± 1.62 years for centers. For all playing positions factor analysis extracted three factors, which cumulatively explained 76.87, 88.12 and 87.63% of variance, respectively. The assessed performance measures were defined as significant (p < 0.001), with regression models of physical performance index (PPINDEX). PPINDEX of guards = −6.860 + (0.932 × t-test) − (1.656 × Acceleration 15 m) − (0.020 × Countermovement jump); PPINDEX of forwards = −3.436 − (0.046 × Countermovement jump with arm swing) − (1.295 × Acceleration 15 m) + (0.582 × Control of dribbling); PPINDEX of centers = −4.126 + (0.604 × Control of dribbling) − (1.315 × Acceleration 15 m) − (0.037 × Sargent jump). A model for the evaluation of physical performance of young basketball players has been defined. In addition, this model could be used as a reference model for selection procedures, as well as to monitor the efficacy of applied training programmes within the short, medium and long-term periodization.

Genome-Wide Analysis in Drosophila Reveals the Genetic Basis of Variation in Age-Specific Physical Performance and Response to ACE Inhibition

Despite impressive results in restoring physical performance in rodent models, treatment with renin–angiotensin system (RAS) inhibitors, such as Lisinopril, have highly mixed results in humans, likely, in part, due to genetic variation in human populations. To date, the genetic determinants of responses to drugs, such as RAS inhibitors, remain unknown. Given the complexity of the relationship between physical traits and genetic background, genomic studies which predict genotype- and age-specific responses to drug treatments in humans or vertebrate animals are difficult. Here, using 126 genetically distinct lines of Drosophila melanogaster, we tested the effects of Lisinopril on age-specific climbing speed and endurance. Our data show that functional response and sensitivity to Lisinopril treatment ranges from significant protection against physical decline to increased weakness depending on genotype and age. Furthermore, genome-wide analyses led to identification of evolutionarily conserved genes in the WNT signaling pathway as being significantly associated with variations in physical performance traits and sensitivity to Lisinopril treatment. Genetic knockdown of genes in the WNT signaling pathway, Axin, frizzled, nemo, and wingless, diminished or abolished the effects of Lisinopril treatment on climbing speed traits. Our results implicate these genes as contributors to the genotype- and age-specific effects of Lisinopril treatment and because they have orthologs in humans, they are potential therapeutic targets for improvement of resiliency. Our approach should be widely applicable for identifying genomic variants that predict age- and sex-dependent responses to any type of pharmaceutical treatment.

Changes in respiratory function and physical performance in middle-aged and old inpatients recovering from COVID-19 after a rehabilitation program

Степень изменений дыхательной функции и физической подготовленности у пациентов, выздоравливающих после COVID-19, представляет интерес для реабилитационных мер. 56 пациентов (67 % - женщины), средний возраст - 64±11 лет, перенесшие COVID-19, прошли курс комплексной реабилитации (16,9±3,8 дня). После курса реабилитации пациенты показали улучшение дыхательной функции: проба Штанге - на 19 % (p=0,006), проба Генчи - на 25 % (p=0,026), улучшение самочувствия по результатам КТ легких (p<0,001); повышение физической подготовленности: скорость привычной ходьбы - на 80 % (р=0,025); толерантности к физической нагрузке: пройденное расстояние до первых признаков утомления - на 227 % (р<0,001), ЧСС в покое - на 1 % (р=0,011). Темпы изменений дыхательной функции и физической подготовленности были значительными и превышали подобные изменения, приводимые в литературе для относительно здоровых пожилых людей, которые приступают к физическим занятиям. Однако абсолютные показатели функции дыхания и физической подготовленности после реабилитационной программы были ниже нормированных значений для данного возраста. Данные результаты могут быть полезны для клиницистов при составлении программы реабилитации пациентов, перенёсших COVID-19. Changes in respiratory and physical performance in geriatric inpatients recovering from COVID-19 are of interest for rehabilitation interventions. 56 inpatients (67 % women), average age 64±11 years recovering from COVID-19 underwent a comprehensive rehabilitation program (16,9±3,8 days). After the rehabilitation program, the patients showed an improvement in respiratory function: voluntary breath-holding after inhalation - by 19 % (p=0,006), breath-holding after exhalation - by 25 % (p=0,026), lungs computed tomography (p<0,001); physical performance: handgrip strength - by 14 % (p=0,083), preferred walking speed - by 80 % (p=0,025); exercise tolerance: distance walked until the first signs of fatigue - by 227 % (p<0,001), resting heart rate - by 1 % (p=0,011). The interaction of rehabilitation time and patient sex was statically nonsignificant across all variables of interest. The rates of changes in respiratory function and physical performance were significant and exceeded similar changes recorded in healthy old people who begin an exercise program. However, in absolute values, respiratory function and physical performance values after the rehabilitation were lower than reference values for this age group. These results can be valuable for clinicians when designing a rehabilitation program for geriatric patients recovering from COVID-19.

Urinary Incontinence and Its Association with Physical and Psycho-Cognitive Factors: A Cross-Sectional Study in Older People Living in Nursing Homes

Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in 5 Spanish NHs. UI (measured with Minimum Data Set 3.0.), sociodemographic and health-related variables were collected. Chi- square (or Fisher&rsquo;s) or Student&rsquo;s t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6&ndash;77.2) and was significantly associated with frailty (PR 1.84; 95%CI 0.96&ndash;3.53), faecal incontinence (FI) (PR 1.65; 95%CI 1.02&ndash;2.65), anxiety (PR 1.64; 95%CI 1.01&ndash;2.66), physical performance (PR 1.77; 95%CI 1.00&ndash;3.11) and cognitive state (PR 1.95; 95%CI 1.05&ndash;3.60). Statistically significant differences between incontinent-continent groups were found for activities of daily living (ADL) limitations, mobility, quality of life, sedentary behaviour (SB) and handgrip strength. It can be concluded that 2/3 of the residents experienced UI, and its significant associated factors were mainly physical (SB, frailty, physical performance, ADL limitations, mobility, FI and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety and quality of life).

Impedance-derived phase angle is associated with muscle mass, strength, quality of life, and clinical outcomes in maintenance hemodialysis patients

Introduction We aimed to evaluate the association between the phase angle and muscle mass, muscle strength, physical performance tests, quality-of-life scales, mood scales, or patient and hospitalization-free survival rates in hemodialysis (HD) patients. Methods We included 83 HD patients. The patients were divided into tertiles based on phase angle value. The phase angle was measured using a bioimpedance analysis machine. Thigh muscle area per height squared (TMA/Ht2), handgrip strength (HGS), nutritional indicators, physical performance, quality-of-life, depression or anxiety status, and the presence of hospitalization or death regardless of cause were evaluated. Results In our study, no significant differences were observed in the serum albumin level and body mass index according to tertiles of phase angle. The phase angle tertiles were associated with TMA/Ht2 and HGS. The phase angle was also associated with physical performance measurements and depression or anxiety status. Subgroup analyses according to sex, age, and diabetes mellitus showed similar trends to those of the total cohort. Furthermore, the hospitalization-free survival rate and patient survival rate were favorable in patients with high values for the phase angle. Conclusion The present study demonstrated that the phase angle is associated with muscle mass, strength, physical performance, quality-of-life scale, and hospitalization-free survival in maintenance HD patients.

Depression and Anxiety Are Associated with Physical Performance in Patients Undergoing Cardiac Rehabilitation: A Retrospective Observational Study

Background: Cardiac rehabilitation (CR) combined with stress management training has been shown to be associated with fewer clinical events than CR alone. However, there have been no reports on the associations of CR with the psychological condition and detailed physical activities evaluated on the same day. Method: One hundred outpatients who participated in a CR program were graded on the hospital anxiety and depression scale (HADS). We divided them into a high HADS group (n = 32) and a normal HADS group (n = 68) and investigated by whole patients, ischemic heart disease (IHD) patients, and heart failure patients. Results: Overall, the patient age was 70.5 ± 9.6 years, the percentage of males was 73.0%, and the body mass index was 23.4 (21.7–26.0) kg/m2. In the high HADS group, overall functional mobility was poor and the distance in a two-minute walking test was short. Especially in IHD patients, the high HADS group showed high fat mass in body composition and low exercise tolerance and ventilator equivalents in cardiopulmonary exercise test. Conclusions: Depression and anxiety involved poor physical performance in CR outpatients and particularly involved low exercise tolerance in IHD patients. To evaluate accurate physical performance, it is necessary to investigate psychological condition.

Differential Effects of One Meal per Day in the Evening on Metabolic Health and Physical Performance in Lean Individuals

Background: Generally, food intake occurs in a three-meal per 24 h fashion with in-between meal snacking. As such, most humans spend more than ∼ 12–16 h per day in the postprandial state. It may be reasoned from an evolutionary point of view, that the human body is physiologically habituated to less frequent meals. Metabolic flexibility (i.e., reciprocal changes in carbohydrate and fatty acid oxidation) is a characteristic of metabolic health and is reduced by semi-continuous feeding. The effects of time-restricted feeding (TRF) on metabolic parameters and physical performance in humans are equivocal.Methods: To investigate the effect of TRF on metabolism and physical performance in free-living healthy lean individuals, we compared the effects of eucaloric feeding provided by a single meal (22/2) vs. three meals per day in a randomized crossover study. We included 13 participants of which 11 (5 males/6 females) completed the study: age 31.0 ± 1.7 years, BMI 24.0 ± 0.6 kg/m2 and fat mass (%) 24.0 ± 0.6 (mean ± SEM). Participants consumed all the calories needed for a stable weight in either three meals (breakfast, lunch and dinner) or one meal per day between 17:00 and 19:00 for 11 days per study period.Results: Eucaloric meal reduction to a single meal per day lowered total body mass (3 meals/day –0.5 ± 0.3 vs. 1 meal/day –1.4 ± 0.3 kg, p = 0.03), fat mass (3 meals/day –0.1 ± 0.2 vs. 1 meal/day –0.7 ± 0.2, p = 0.049) and increased exercise fatty acid oxidation (p &lt; 0.001) without impairment of aerobic capacity or strength (p &gt; 0.05). Furthermore, we found lower plasma glucose concentrations during the second half of the day during the one meal per day intervention (p &lt; 0.05).Conclusion: A single meal per day in the evening lowers body weight and adapts metabolic flexibility during exercise via increased fat oxidation whereas physical performance was not affected.