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  • CT Papers related to ageing

    Intelligence in Childhood and Atherosclerosis of the Carotid and Peripheral Arteries in Later Life: The Lothian Birth Cohort 1936

    http://journals.plos.org/plosone/art...l.pone.0125280

    Abstract

    Objective

    There is some evidence that people who score higher on tests of intelligence in childhood have lower carotid intima-media thickness and higher ankle brachial index in middle age. These findings need replicating in other, older populations. We investigated the prospective relationship between intelligence in childhood and atherosclerosis in the carotid and peripheral arteries at age 73 years.

    Methods

    Participants were 713 members of the Lothian Birth Cohort 1936 whose intelligence was assessed at age 11 years. At age 73 years, carotid intima-media thickness and degree of stenosis were measured using ultrasound imaging; ankle-brachial index was measured using Doppler ultrasound.

    Results

    There were no significant associations between intelligence at age 11 and measures of atherosclerosis at age 73. In age- and sex-adjusted analyses, for a standard deviation higher score in intelligence, intima-media thickness (x 10) was lower by 0.07 (-0.20, 0.06) mm and ankle brachial index (x 10) was lower by 0.09 (-0.24, 0.07); odds ratios for having carotid stenosis >25% or peripheral arterial disease were 0.98 (0.82, 1.16) and 1.05 (0.81, 1.36) respectively.

    Conclusion

    In this study of people aged 73 years, higher childhood intelligence was not associated with reduced risk of atherosclerosis in the carotid or peripheral arteries.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

  • #2
    Physical Activity in Non-Frail and Frail Older Adults

    http://journals.plos.org/plosone/art...l.pone.0123168

    Abstract

    Introduction

    Physical activity (PA) is important for healthy ageing. Better insight into objectively measured PA levels in older adults is needed, since most previous studies employed self-report measures for PA assessment, which are associated with overestimation of PA.

    Aim

    This study aimed to provide insight in objectively measured indoor and outdoor PA of older adults, and in PA differences by frailty levels.

    Methods

    Data were collected among non-frail (N = 74) and frail (N = 10) subjects, aged 65 to 89 years. PA, measured for seven days with accelerometers and GPS-devices, was categorized into three levels of intensity (sedentary, light, and moderate-to-vigorous PA).

    Results

    Older adults spent most time in sedentary and light PA. Subjects spent 84.7%, 15.1% and 0.2% per day in sedentary, light and moderate-to-vigorous PA respectively. On average, older adults spent 9.8 (SD 23.7) minutes per week in moderate-to-vigorous activity, and 747.0 (SD 389.6) minutes per week in light activity. None of the subjects met the WHO recommendations of 150 weekly minutes of moderate-to-vigorous PA. Age-, sex- and health status-adjusted results revealed no differences in PA between non-frail and frail older adults. Subjects spent significantly more sedentary time at home, than not at home. Non-frail subjects spent significantly more time not at home during moderate-to-vigorous activities, than at home.

    Conclusions

    Objective assessment of PA in older adults revealed that most PA was of light intensity, and time spent in moderate-to-vigorous PA was very low. None of the older adults met the World Health Organization recommendations for PA. These levels of MVPA are much lower than generally reported based on self-reported PA. Future studies should employ objective methods, and age specific thresholds for healthy PA levels in older adults are needed. These results emphasize the need for effective strategies for healthy PA levels for the growing proportion of older adults.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • #3
      Negative Perceptions of Aging and Decline in Walking Speed: A Self-Fulfilling Prophecy

      http://journals.plos.org/plosone/art...l.pone.0123260

      Abstract

      Introduction

      Walking speed is a meaningful marker of physical function in the aging population. While it is a primarily physical measure, experimental studies have shown that merely priming older adults with negative stereotypes about aging results in immediate declines in objective walking speed. What is not clear is whether this is a temporary experimental effect or whether negative aging stereotypes have detrimental effects on long term objective health. We sought to explore the association between baseline negative perceptions of aging in the general population and objective walking speed 2 years later.

      Method

      4,803 participations were assessed over 2 waves of The Irish Longitudinal Study on Ageing (TILDA), a prospective, population representative study of adults aged 50+ in the Republic of Ireland. Wave 1 measures – which included the Aging Perceptions Questionnaire, walking speed and all covariates - were taken between 2009 and 2011. Wave 2 measures – which included a second measurement of walking speed and covariates - were collected 2 years later between March and December 2012. Walking speed was measured as the number of seconds to complete the Timed Up-And-Go (TUG) task. Participations with a history of stroke, Parkinson’s disease or an MMSE < 18 were excluded.

      Results

      After full adjustment for all covariates (age, gender, level of education, disability, chronic conditions, medications, global cognition and baseline TUG) negative perceptions of aging at baseline were associated with slower TUG speed 2 years later (B=.03, 95% CI = .01 to 05, p< .05).

      Conclusions

      Walking speed has previously been considered to be a consequence of physical decline but these results highlight the direct role of psychological state in predicting an objective aging outcome. Negative perceptions about aging are a potentially modifiable risk factor of some elements of physical decline in aging.
      Jo Bowyer
      Chartered Physiotherapist Registered Osteopath.
      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

      Comment


      • #4
        Association between Number of Teeth and Chronic Systemic Diseases: A Cohort Study Followed for 13 Years

        http://journals.plos.org/plosone/art...l.pone.0123879

        Abstract

        Background

        There is growing evidence of an association between oral health, specifically dental status, and chronic systemic diseases. However, varying measures of dental status across different populations and low study sample has made comparison of studies and conclusion of findings unclear. Our aim is to examine whether the number of teeth as a measure of dental status is associated with incident chronic diseases in a cohort setting.

        Methods

        We conducted a cohort study among 24,313 middle-aged Germans followed up for 13 years. Data on number of teeth as a measure of dental status were obtained through self-reports. Outcomes were clinically–verified incident non–fatal myocardial infarction, stroke, type 2 diabetes mellitus, and cancer. Hazard ratio (HR) and 95% confidence intervals (CI) were obtained from Cox regression models.

        Results

        Increasing number of teeth is inversely related to risk of myocardial infarction (HR: 0.97; 95% CI: 0.96, 0.99). The full multivariate model of teeth groups showed a strong linear trend for myocardial infarction, a less strong trend for stroke, and no relation with type 2 diabetes mellitus and cancer in a competing risk model. Participants with 18–23 teeth and those without teeth were at 76% (95%CI: 1.04, 3) and 2.93 times (95%CI: 1.61, 5.18) higher risk of myocardial infarction compared to those with nearly all teeth (28–32 teeth).

        Conclusions

        Number of teeth is specifically associated with myocardial infarction and not with other chronic disease indicating that dental status further strengthens the link between oral health and cardiovascular diseases.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • #5
          Frequency of sarcopenia and associated factors among hospitalized elderly patients

          http://www.biomedcentral.com/1471-2474/16/108

          Abstract
          Background
          Sarcopenia is an important public health problem that affects mainly elders, and has negative consequences, such as disability and even death. Due to the lack of studies evaluating sarcopenia in elderly persons hospitalized in Brazil, the aim of the present study was to describe the frequency of sarcopenia and associated factors among elders in a hospital in the city of Salvador - Brazil.

          Methods
          This cross-sectional study included 110 hospitalized elderly patients in a multi-specialty hospital in Salvador-BA, Brazil. Inclusion criteria: were elders aged ≥60 years between the first and fifth day of hospitalization; who were able to walk without external assistance; with medical permission to walk, and who did not take vasoactive and inotropic drugs. The diagnosis of sarcopenia was determined by combining the reduction in skeletal muscle mass with muscle weakness (women, <20 kg; men, <30 kg) and/or poor physical performance (gait speed ≤0.8 m/s). To obtain reduced skeletal muscle mass, the skeletal muscle mass index ≤6.37 kg/m2 for women and ≤8.90 kg/m2 for men was used. Cognitive function, Charlson index, admission profile (clinical and surgical), smoking, falls suffered in the last year and physical inactivity prior to admission were also evaluated. The frequency of sarcopenia was described in percentages with their respective confidence intervals and logistic regression was performed for multivariate analysis of factors associated with sarcopenia.

          Results
          Among the 110 patients included, the frequency of sarcopenia was 21.8%, with 10.0% being of the severe type. There was a predominance of clinical profile (59.1%), such as heart disease (20.0%), pneumonia (13.6%) and skin infections (9.1%), with a Charlson index of 5.4 ± 1.8. The factors associated with sarcopenia were age (OR = 1.14; 95% CI = 1.06 to 1.23), clinical profile on admission (OR = 5.15; 95% CI = 1.16–22.9) and smoking (OR = 7.8; 95% CI = 1.53–39.9).

          Conclusions
          The frequency of sarcopenia in elderly hospitalized patients was high (1 in 5 elderly) and anthropometric equation can be a viable and inexpensive alternative to screening and programming intervention in this population.
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • #6
            Effects of Healthy Ageing on Activation Pattern within the Primary Motor Cortex during Movement and Motor Imagery: An fMRI Study

            http://journals.plos.org/plosone/art...l.pone.0088443

            Abstract

            The increase in older adults over the coming decades will be accompanied by a greater burden of chronic neurological diseases affecting the motor system. The motor system adapts to maintain motor performance with the primary motor cortex (BA4) emerging as a pivotal node within this neuroplastic process. Studies of ageing often consider BA4 a homogenous area but cytoarchitectonic studies have revealed two subdivisions, an anterior (BA4a) and posterior subdivision (BA4p). Here we focus upon the effects of ageing on the involvement of BA4a and BA4p during movement and motor imagery (MI). Thirty-one right-handed healthy volunteers were recruited and screened for their ability to perform imagery (5 subjects excluded). The sample was split into an older group (n = 13, mean age 56.4 SD 9.4) and a younger group (n = 13, mean age 27.4 SD 5.3). We used an fMRI block-design (auditory-paced [1 Hz] right hand finger-thumb opposition sequence [2,3,4,5, 2…]) with MI & rest and actual movement & rest. We explored the distribution-based clustering and weighted laterality index within BA4a and BA4p. The involvement of BA4p during MI (measured with distribution-based clustering) was significantly greater in the older group (p<0.05) than in the younger group. Hemispheric balance of BA4p decreased with age during MI (Spearman rho −0.371; p<0.05), whereas that of BA4a decreased with age during actual movement (Spearman rho = −0.458 p<0.01). Irrespective of age, we found BA4 is involved during motor imagery, strengthening the rationale for its potential use in older subjects. These findings suggest that the functions of the subdivisions of BA4 are differentially affected by ageing and have implications regarding how ageing affects the cognitive processes underlying motor functions.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • #7
              Does Lower Limb Exercise Worsen Renal Artery Hemodynamics in Patients with Abdominal Aortic Aneurysm?

              http://journals.plos.org/plosone/art...l.pone.0125121

              Abstract

              Renal artery stenosis (RAS) and renal complications emerge in some patients after endovascular aneurysm repair (EVAR) to treat abdominal aorta aneurysm (AAA). The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS), increased the oscillatory shear index (OSI) and increased the relative residence time (RRT). EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients.

              Conclusion

              This study investigated the relationship between lower limb exercise and the renal hemodynamic environment. The study concluded that lower limb exercise worsens the hemodynamic environment in the renal artery and has potential negative influences on the renal artery and kidney physiologies, especially after EVAR. This study could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR, and it also serves as warnings of possible problems for the AAA patients. Some of the present nursing care strategies for AAA patients, which encourage patients to have exercises, are suggested to be reconsidered and evaluated.
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • #8
                Characteristics of Randomized Controlled Trials Designed for Elderly: A Systematic Review

                http://journals.plos.org/plosone/art...l.pone.0126709

                Abstract

                Objectives

                To quantify the proportion of randomized controlled trials (RCTs) specifically designed for elderly, and to assess their characteristics, as compared to RCTs not specifically designed for elderly.

                Design

                Review and synthesis of published literature.

                Measurements

                We searched PubMed for articles published in the year 2012. We included RCTs. Articles were excluded if not conducted with human subjects or if findings of secondary analyses were reported. A random sample of 10% was drawn and of this selection the following trial characteristics were extracted: sample size, disease category, age of sample, and age-related inclusion criteria. Clinical trials were defined to be specifically designed for elderly if a lower age cut-off of ≥ 55 years was used, or when participants had an average age of ≥ 70 years.

                Results

                The search strategy yielded 26,740 articles, from which a random sample was drawn, resulting in 2375 articles. After exclusion, data was extracted from 1369 publications. Of these 1369 RCTs, 96 (7%) were specifically designed for elderly. In comparison with trials not designed for older adults, trials designed for elderly contained a significantly larger median number of participants (125 vs. 80, p = 0.008) significantly more trials designed for elderly fell into the disease categories eye (6% vs. 2%, p = 0.005), musculoskeletal (13% vs. 7%, p = 0.023) and circulatory system (16% vs. 9%, p = 0.039). No significant difference was observed with regard to the other disease categories.

                Conclusion

                There is a low proportion of RCTs specifically designed for elderly. As older patients will increasingly form the majority in medical practice, there is an urgent need for stronger evidence for the formulation of treatment guidelines specifically for older adults.
                Some of us have been lamenting this for decades. The epidemiologists were warning us in the '70s that we would have a massive rise in the elderly population and that their physiological parameters change over the years. There has been a reluctant stirring of interest with the ticking of the clock, but very little passion.
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • #9
                  Respective and Combined Effects of Impairments in Sensorimotor Systems and Cognition on Gait Performance: A Population-Based Cross-Sectional Study

                  http://journals.plos.org/plosone/art...l.pone.0125102

                  Abstract

                  Background

                  Respective and combined effects of impairments in sensorimotor systems and cognition on gait performance have not been fully studied. This study aims to describe the respective effects of impairments in muscle strength, distance vision, lower-limb proprioception and cognition on the Timed Up & Go (TUG) scores (i.e., performed TUG [pTUG], imagined TUG [iTUG] and the time difference between these two tests [delta TUG]) in older community-dwellers; and to examine their combined effects on TUG scores.

                  Methods

                  Based on a cross-sectional design, 1792 community-dwellers (70.2±4.8 years; 53.6% female) were recruited. Gait performance was assessed using pTUG, iTUG and delta TUG. Participants were divided into healthy individuals and 15 subgroups of individuals according to the presence of impairment in one or more subsystems involved in gait control (i.e., muscle strength and/or distance vision and/or lower-limb proprioception and/or cognition [episodic memory and executive performance]). Impairment in muscle strength, distance vision and lower-limb proprioception was defined as being in the lowest tertile of performance. Impairment in cognition was defined as abnormal episodic memory and executive tests.

                  Results

                  A total of 191 (10.7%) exhibited impairment in muscle strength, 188 (10.5%) in distance vision, 302 (16.9%) in lower-limb proprioception, and 42 (2.3%) in cognition. Linear regressions showed that cognitive impairment as well as dual combinations of impairments were associated with increased pTUG (P<0.02). Impairment in lower-limb proprioception was associated with decreased iTUG (P=0.015). All combinations of impairments, except those including muscle strength and the combinations of the 4 subsystems, were associated with increased delta TUG (P<0.04).

                  Conclusion

                  Cognitive integrity is central for efficient gait control and stability, whereas lower-limb proprioception seems to be central for gait imagery.
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • #10
                    Interesting papers, Jo.

                    Do you know what would be considered an appropriate walking speed promoting cardiovascular benefit for folk over 70?
                    I average around 4-4.5 kph over 2-3 hour, mostly level ground in bushland.

                    Comment


                    • #11
                      I have had a look for data relating to over 70s and couldn't find anything useful Nari, perhaps Ken would have contacts who have access to good evidence.
                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • #12
                        Thanks Jo.
                        I have not found anything specific for that age group, only for those decades younger!

                        Comment


                        • #13
                          Steadiness of Spinal Regions during Single-Leg Standing in Older Adults with and without Chronic Low Back Pain

                          http://journals.plos.org/plosone/art...l.pone.0128318

                          Abstract

                          The aims of this study were to compare the steadiness index of spinal regions during single-leg standing in older adults with and without chronic low back pain (LBP) and to correlate measurements of steadiness index with the performance of clinical balance tests. Thirteen community-dwelling older adults (aged 55 years or above) with chronic LBP and 13 age- and gender-matched asymptomatic volunteers participated in this study. Data collection was conducted in a university research laboratory. Measurements were steadiness index of spinal regions (trunk, thoracic spine, lumbar spine, and pelvis) during single-leg standing including relative holding time (RHT) and relative standstill time (RST), and clinical balance tests (timed up and go test and 5-repetition sit to stand test). The LBP group had a statistically significantly smaller RHT than the control group, regardless of one leg stance on the painful or non-painful sides. The RSTs on the painful side leg in the LBP group were not statistically significantly different from the average RSTs of both legs in the control group; however, the RSTs on the non-painful side leg in the LBP group were statistically significantly smaller than those in the control group for the trunk, thoracic spine, and lumbar spine. No statistically significant intra-group differences were found in the RHTs and RSTs between the painful and non-painful side legs in the LBP group. Measurements of clinical balance tests also showed insignificant weak to moderate correlations with steadiness index. In conclusion, older adults with chronic LBP demonstrated decreased spinal steadiness not only in the symptomatic lumbar spine but also in the other spinal regions within the kinetic chain of the spine. When treating older adults with chronic LBP, clinicians may also need to examine their balance performance and spinal steadiness during balance challenging tests.
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • #14
                            Recent Paper

                            Hi Jo and Nari,
                            Recent paper that discusses average walking speed though only measured over a short distance. Overall a very interesting article.
                            Musculoskeletal pain and physical functioning in the oldest old.
                            http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933514/
                            Abstract
                            Background: Little is known about the impact of pain on physical functioning among the oldest-old subjects. In this study, we first examined the associations between the number of painful sites and measures of physical functioning reflecting different stages of the disablement process (physical impairment, functional limitation and disability) among nonagenarians (more than ninety years old persons). Second, we described the effect of painful sites on disability during a 2-year follow-up period.
                            Methods: This study is based on baseline (n = 1177) and 2-year follow-up (n = 709) data of the nationwide Danish 1905 cohort study. Musculoskeletal pain was assessed as reported pain in back, hips or knees when moving or resting. Physical performance measures included maximum grip strength and habitual walking speed. Disability in performing activities of daily living was defined as the need for assistive device or personal help in transferring, dressing, washing, using toilet and/or walking indoors.
                            Results: At baseline, the number of painful sites was significantly associated with measured grip strength and walking speed as well as self-reported disability in a stepwise manner; the more sites with pain, the poorer the physical functioning. The follow-up analyses showed corresponding but slightly weaker stepwise associations between baseline pain and disability level at follow-up, and indicated that although on the whole, single or multi-site pain did not predict the onset of disability multi-site pain increased the risk of developing severe disability.
                            Conclusions: The findings of this study suggest that musculoskeletal pain in nonagenarians is highly prevalent and is associated with poor physical performance and disability.
                            Last edited by Thinking_Chiro; 01-06-2015, 01:11 AM.
                            "In god I trust! Everyone elde must bring data!"

                            Comment


                            • #15
                              Another recent related article!

                              Physical, lifestyle, psychological, and social determinants of pain intensity, pain disability, and the number of pain locations in depressed older adults.

                              http://www.ncbi.nlm.nih.gov/pubmed/25072890
                              "In god I trust! Everyone elde must bring data!"

                              Comment

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