The impact of body-mass index and steps per day on blood pressure and fasting glucose in older adults

The purpose of this study was to investigate the combined impact of obesity and physical activity (PA) on the health of older adults. Pedometer-determined steps/d, body-mass index (BMI), resting blood pressure, and fasting glucose (FG) were assessed in 137 older adults (69.0 +/- 8.9 yr). The active group (>4,227 steps/d) had lower systolic blood pressure (SBP; p = .001), diastolic blood pressure (DBP; p = .028), and FG (p < .001) than the inactive group (< or = 4,227 steps/d). The normal-BMI group (18.5-24.9 kg/m2) had lower SBP (p < .001) and DBP (p = .01) than the obese group (> or =30 kg/m2). There were no differences in SBP (p = .963) or DBP (p = 1.0) between active obese and inactive normal-BMI groups. The active obese group, however, had a more favorable FG than the inactive normal-BMI group (chi 2 = 18.9, df = 3, p = .001). Efforts to increase PA of older adults should receive the same priority as reducing obesity to improve BP and FG levels.     

Sex-dependent associations between daily physical activity and leg exercise blood pressure responses

The authors examined interindividual and sex-specific variation in systolic (SBP) and diastolic (DBP) blood pressure responses to graded leg-extension exercise in healthy older (60-78 yr) women (n = 21) and men (n = 19). Maximal oxygen uptake (VO2max), body composition, physical activity (accelerometry), and vascular function were measured to identify predictors of exercise BP. Neither VO2max nor activity counts were associated with the rise in SBP or DBP during exercise in men. The strongest predictors of these responses in men were age (SBP: r2 = .19, p = .05) and peak exercise leg vasodilation (DBP: r2 = -.21, p < .05). In women, the modest relationship observed between VO2max and exercise BP was abolished after adjusting for central adiposity and activity counts (best predictors, cumulative r2 = .53, p < .05, for both SBP and DBP). These results suggest that determinants of variation in submaximal exercise BP responses among older adults are sex specific, with daily physical activity influencing these responses in women but not men.     

Endurance exercise and leg strength in older women

Quadriceps strength and mass peak in the third decade of life, plateau, and then decline from the fifth decade on. To examine the influence of chronic endurance training and age on lean mass and leg strength, women runners (n = 62, age 43-69 years) and sedentary participants (n = 33, age 43-66 years) were divided into 40-, 50-, and 60-year age groups. Absolute isokinetic concentric torque did not differ between runners and sedentary women (97.9 +/- 19.5 and 104.6 +/- 22.7 N . m, respectively, p = .18) but was different between age groups independent of exercise status (107.6 +/- 18.4, 97.1 +/- 19.9, and 90.1 +/- 21.4 N . m, for 40s, 50s, and 60s, respectively, p < .05). Lean body mass also differed by age group (p < .05) but did not change differently among runners and sedentary women. These findings suggest that chronic endurance training might not influence the loss of muscle mass and muscle strength that occur with aging.     

The effects of life events and interpersonal loss on exercise adherence in older adults

Associations of life events and interpersonal loss with participation in home- and group-based exercise were studied in 97 older adults (64 % women, 70.2 +/- 4.1 years). Life events were assessed with a modified Social Readjustment Rating Scale at baseline and 6 and 12 months. Exercise logs and class-attendance records documented exercise participation. Participants experienced 3.62 +/- 3.56 unique life events over the course of the study, and 28 participants reported an interpersonal loss (5 men, 23 women). Number of life events was negatively associated with home-based exercise participation (p <.05); among women, this association approached significance (p =.06) for class-based exercise. Women who experienced an interpersonal loss had lower class-based participation than those who did not (p =.02), but home-based participation rates were unaffected. Life events, particularly interpersonal loss, appear to have a negative impact on exercise in women, and this effect appears greater for class-based than for home-based exercise.     

The impact of high-calorie-expenditure exercise on quality of life in older adults with coronary heart disease

The acceptability of a high-calorie-expenditure (HCE) exercise program in older coronary heart disease patients participating in a behavioral weight-control program was evaluated. Seventy-four overweight patients (median age 63 yr) were randomly assigned to a 5-mo intervention of HCE exercise (3,000-3,500 kcal/wk daily walking) or standard cardiac-rehabilitation (CR) exercise (700-800 kcal/wk). Both groups received counseling to achieve a dietary caloric deficit of 3,500 kcal/ wk. Assessments at baseline and 5 mo included self-reported measures of quality of life and psychosocial variables. The HCE group experienced significantly greater weight loss (8.2 ± 4 vs. 3.7 ± 5 kg, p < .001). Changes from baseline to 5 mo on scores of physical, emotional, and social functioning were greater for the HCE than CR group (p < .05). HCE exercise also resulted in greater positive change in exercise enjoyment (p = .05), which was mediated by weight change. Even high-risk older adults can be successful in an HCE exercise program and experience no adverse physical or emotional changes.     

Effects of an 8-week multimodal exercise program on strength, flexibility, and golf performance in 55- to 79-year-old men

Substantial research has indicated the beneficial effect of physical activity on physical fitness and activities of daily living in older adults, but none have investigated the effects on performance of recreational activities. This investigation studied the effect of an exercise program on fitness and golf-clubhead speed in older men. Thirty-one golfers (mean age 65.1 +/- 6.2 years) were randomly assigned to a treatment (n = 19) or control (n = 12) group. The treatment group completed an 8-week strength and flexibility program. Assessments included 10-RM muscle strength; selected range-of-motion (ROM) measurements; and golf-clubhead speed (CHS). ANCOVA revealed significant differences between groups (p <.005) for all strength measurements and several ROM measurements. CHS was significantly different (p <.05) between groups after the intervention. Mean CHS improved from 85.0 to 87.1 miles/hr (136.8 to 140.2 km/hr). These results indicate that a strength and flexibility program can improve golf performance in older adults.     

Incremental exercise tests in master athletes and untrained older adults

This study aimed to analyze the impact of step-duration protocols, 1-min vs. 3-min, on cardiorespiratory responses to exercise, whatever the aerobic-fitness level of sedentary (65.5 +/- 2.3 years, n = 8) or highly fit (63.1 +/- 3.2 years, n = 19) participants. Heart rate and VO2 at the first and second ventilatory thresholds (VT1 ,VT2) and maximal exercise were not significantly different between the two protocols. In master athletes, the 3-min protocol elicited significantly lower ventilation at VT2 and maximal exercise (p < .01). In the latter, breathlessness was also lower at maximal exercise (p < .05) than in sedentary participants. In trained or sedentary older adults, VT1, VT2, and were not influenced by stage duration. According to the lower breathlessness and ventilation, however, the 3-min step protocol could be more appropriate in master athletes. In untrained participants, because the cardiorespiratory responses were similar with the two incremental exercise tests, either of them could be used.     

The gallon-jug shelf-transfer test: an instrument to evaluate deteriorating function in older adults

This study examined the validity, reliability, and discriminatory capacity of the gallon-jug shelf-transfer (GJST) test. Six hundred fifty-three independent-living older adults (463 women age 72.9 +/- 7.0 years, 190 men age 74.3 +/- 6.7 years) participated. Participants moved five 1-gallon jugs (approximately 3.9 kg) from a knee-high to a shoulder-high shelf as quickly as possible. The GJST showed an exponential performance decline with age, and there were significant correlations between the GJST and common functional tests (p<.001). High within-day and between-days reliability was detected. The test also detected differences resulting from training status (p<.01) and training protocols (p<.05). The GJST is a valid, reliable, inexpensive, safe, and easily administered clinical test for identifying physically vulnerable elders who could benefit from interventions such as exercise to improve their physical capacities and maintain independence.     

Adaptive changes in gait of older and younger adults as responses to challenges to dynamic balance

The study proposed to identify balance strategies used by younger and older adults during gait under proprioceptive, visual, and simultaneous proprioceptive-visual challenges. Participants ambulated under 4 conditions: consistent, noncompliant surface; inconsistent, compliant surface (C); consistent, noncompliant surface with vision obscured (NCVO); and inconsistent, compliant surface with vision obscured (CVO). Balance adaptations were measured as changes in gait velocity, cadence, and gait-stability ratio (GSR). Participants were 5 younger (mean age = 27.2) and 5 older (mean age = 68) healthy adults. Significant age differences were found for GSR (p = .03) on all surfaces. Older adults adopted a more stable gait pattern than younger adults regardless of the challenge presented by surface. Significant condition differences were found for velocity (p < .001) and cadence (p = .001). All participants exhibited significantly decreased velocity and increased cadence on surfaces C and CVO. Gait speed and cadence did not significantly change in NCVO. Younger and older adults exhibited similar adaptive balance strategies, slowing and increasing steps/s, under proprioceptive and proprioceptive-visual challenges to dynamic balance.     

An Intergenerational Perspective on Grandparent Roles

Abstract

This study provides an intergenerational perspective on grandparent roles. Data was collected from young parents (N = 105) and middle-age and older adults (N = 105). Both groups identified multiple roles as important for grandparents to initiate with young grandchildren: these included being a playmate as well as a friend, teacher, and role model. Intergenerational differences were also found with middle-age and older adults more likely than young parents to rank religious guide (p < .001) and family historian (p < .05) as important roles to enact with young grandchildren. However, the young parents were more likely than the older participants to predict that grandparents would be remembered by their grandchildren as fun, having high values, being a role model, and financially supportive (p < .001). Recommendations for future intergenerational research are recommended.     

Rate of perceived exertion as a tool to monitor cycling exercise intensity in older adults

The purpose of this study was to determine the efficacy of rate of perceived exertion (RPE) to monitor exercise intensity in older adults. Middle-aged (46.9 +/- 7.0 years, n = 24) and older women (75.5 +/- 3.8 years, n = 29) performed a graded maximal exercise test on a cycle ergometer while RPE, oxygen uptake, heart rate, and blood lactate levels were measured. The Pearson's product moment correlation coefficient between RPE and oxygen uptake for each stage of the graded exercise test was calculated for each participant. The mean coefficient for the older group (r =.954) was similar to that of middle-aged group (r =.963). The autocorrelation coefficient was much lower (r =.411) in the older group than in the middle-aged group (r =.871). Variability in RPE through the graded exercise test was similar between the two groups. In conclusion, RPE was strongly associated with oxygen uptake in the older group. These results indicate that RPE is effective in monitoring exercise intensity in older adults.     

Social physique anxiety, obligation to exercise, and exercise choices among college students

OBJECTIVE: The authors examined relationships among social physique anxiety, obligation to exercise, and exercise choices. PARTICIPANTS AND METHODS: College students (N = 337; 200 women, 137 men) volunteered to complete 3 questionnaires: the Social Physique Anxiety Scale (SPAS), Obligatory Exercise Questionnaire (OEQ), and Physical Activity Specification Survey (PASS). RESULTS: On the SPAS, men (M score = 31.9 +/- 8.8) differed from women (M score = 37.3 +/- 8.3; p = .001). Men (M score = 43.0 +/- 9.9) and women (M score = 43.0 +/- 9.6) responded similarly (p = .94) on the OEQ. There was no interaction between sex and exercise level on the SPAS or OEQ. When separated by low, medium, and high SPAS scores, neither OEQ nor exercise scores differed. CONCLUSIONS: Obligation to exercise appears to be similar for both sexes. Women, however, appear to have higher levels of anxiety regarding how others evaluate their physique than do men. The combination of level of activity and sex do not appear to be associated with social physique anxiety or obligation to exercise.     

The influence of familiarization sessions on the stability of ramp and ballistic isometric torque in older adults

Ramp isometric contractions determine peak torque (PT) and neuromuscular activation (NA), and ballistic contractions can be used to evaluate rate of torque development (RTD) and electrical mechanical delay (EMD). The purposes of this study were to assess the number of sessions required to stabilize ramp and ballistic PT and to compare PT and NA between contractions in older adults. Thirty-five older men and women (age 63.7 ± 3.7 yr, body mass 64.3 ± 10.7 kg, height 159.2 ± 6.6 cm) performed 4 sessions of unilateral ramp and ballistic isometric knee extension, 48 hr apart. PT significantly increased (main time effect p < .05) from the first to the third session, with no further improvements thereafter. There was a trend toward higher PT in ballistic than in ramp contractions. No difference between contraction types on EMG values was observed. Therefore, the authors suggest that 3 familiarization sessions be performed to correctly assess PT. In addition, PT, NA, RTD, and EMD can be assessed with ballistic contraction in older adults.     

Biomechanics of the heel-raise exercise

The purpose of this investigation was to determine whether increases in internal (muscular) demand would be proportional to increases in the external demand during heel-raise exercise. Seven male (mean age 74.9 +/- 4.8 years) and 9 female (mean age 74.4 +/- 5.1 years) older adults performed both double-leg heel raises and single-leg heel raises under 3 loading conditions (no external resistance and +5% and +10% of each participant's body weight). Kinematic and kinetic dependent variables were calculated using standard inverse-dynamics techniques. The results suggest that although the single-heel raise led to increases in peak net joint moments, power, and mechanical-energy expenditure (MEE), it did so at the expense of range of motion and angular velocity. In addition, increasing the external resistance by 5% of participants' body weight did not elicit significant changes in either the power or the MEE of the ankle joint. These effects should be considered when prescribing these exercises to older adults.     

Leptin as a marker of body fat and hyperinsulinemia in college students

Little is known about obesity and insulin resistance in college students. Leptin is a hormone secreted by fat cells and has been shown to strongly correlate with both obesity and insulin resistance in children and adults. We investigated associations of leptin with insulin secretion and action in 119 normal-weight students aged 18-24 years. Leptin was strongly correlated with total fat mass (r = .67, p <.001), percentage body fat (r= .81, p < .001), and to a lesser degree Body Mass Index, or BMI, (r = .23, p < .02). Leptin was associated with fasting insulin (beta+/-SE = 0.30+/-0.06, p < .001) and insulin resistance (beta+/-SE = 0.41+/-0.20, p < .001) independent of total fat, gender, and age, suggesting other mechanisms of leptin and insulin regulation besides obesity. Leptin resistance is present even among young and normal-weight college students. Leptin, even more so than BMI, is an important marker of adiposity and hyperinsulinemia in normal-weight college students and may potentially be used to predict type 2 diabetes.     

Older adults' exercise behavior: roles of selected constructs of social-cognitive theory

Exercise is consistently related to physical and psychological health benefits in older adults. Bandura's social-cognitive theory (SCT) is one theoretical perspective on understanding and predicting exercise behavior. Thus, the authors examined whether three SCT variables-self-efficacy, self-regulation, and outcome-expectancy value-predicted older adults' (N = 98) exercise behavior. Bivariate analyses revealed that regular exercise was associated with being male, White, and married; having higher income, education, and self-efficacy; using self-regulation skills; and having favorable outcome-expectancy values (p < .05). In a simultaneous multivariate model, however, self-regulation (p = .0097) was the only variable independently associated with regular exercise. Thus, exercise interventions targeting older adults should include components aimed at increasing the use of self-regulation strategies.     

The effects of high- and moderate-resistance training on muscle function in the elderly

The purpose of this study was to investigate the effects of a 12-week resistance-training program on muscle strength and mass in older adults. Thirty-three inactive participants (60-74 years old) were assigned to 1 of 3 groups: high-resistance training (HT), moderate-resistance training (MT), and control. After the training period, both HT and MT significantly increased 1-RM body strength, the peak torque of knee extensors and flexors, and the midthigh cross-sectional area of the total muscle. In addition, both HT and MT significantly decreased the abdominal circumference. HT was more effective in increasing 1-RM strength, muscle mass, and peak knee-flexor torque than was MT. These data suggest that muscle strength and mass can be improved in the elderly with both high- and moderate-intensity resistance training, but high-resistance training can lead to greater strength gains and hypertrophy than can moderate-resistance training.     

The effect of habitual exercise on respiratory- muscle function in older adults

Older adults' participation in habitual exercise might be affected by alterations to respiratory mechanics such as decreased respiratory-muscle strength. This reduction can cause a decrease in efficiency of the ventilatory pump, potentially compromising exercise participation. This research examined the role of habitual exercise in respiratory-muscle function and the associated implications for exercise performance. Seventy-two healthy older adults (36 men, 64.9 +/- 8.6 years, 177.2 +/- 8.4 cm, 82.5+/- 11.9 kg; 36 women, 64.9 +/- 9.5 years, 161.7+/- 6.4 cm, 61.6 +/- 9.2 kg) undertook respiratory-function and walking-performance tests. Active men and women achieved higher scores than their inactive counterparts for all tests except spirometry, where no differences were evident. The results indicate that a significant amount of the elevated fitness level might be accounted for by increased endurance capacity of the inspiratory muscles. Inactive older individuals might be at risk for inadequate respiratory-muscle strength, so interventions should be considered.     

Community exercise program for older adults recovering from hip fracture: a pilot study

Community-based rehabilitative exercise programs might be an effective means to improve functional outcomes for hip-fracture patients. The purpose of this study was to evaluate the effectiveness of a community exercise program (CEP) for older adults recovering from hip fracture. Twenty-five older adults (mean age 80.0 +/- 6.0 years; 24 women; 71 +/- 23 days post-hip fracture) participated in this pilot study (17 exercise, 8 control). The CEP involved functional stepping and lower extremity-strengthening exercises. Control participants received only standard outpatient therapy. Measures of functional mobility, balance confidence, falls efficacy, lower extremity strength, and daily physical activity were evaluated at baseline and at 16 weeks. Improvements for self-reported physical activity, mobility, balance, and knee-extensor strength were observed for the CEP group. This study demonstrated that a CEP is beneficial for community-dwelling older adults post-hip fracture.