Cardiorespiratory fitness, obesity, and functional limitation in older adults

One hundred forty-six abdominally obese adults age 60-80 yr were studied to investigate the interaction between cardiorespiratory fitness (CRF) and obesity on functional limitation. Obesity was determined by fat mass (FM), CRF was determined by a maximal treadmill test, and functional limitation was based on 4 different tasks that are predictive of subsequent disability. Both FM (r = -.34, p ≤ .01) and CRF (r = .54, p ≤ .01) were independently associated with functional limitation in bivariate analysis.After further control for sex, age, and the interaction term (CRF × FM), FM was no longer independently associated with functional limitation (p = .10). Analyses were also based on sex-specific tertiles of FM and CRF. The referent group demonstrated significantly lower functional limitation than the low-CRF/low-FM and the low-CRF/high-FM groups (both p ≤ .05). These results highlight the value of recommending exercise for abdominally obese adults.     

Enhancing strength and postocclusive calf blood flow in older people with training with blood-flow restriction

The response of calf-muscle strength, resting blood flow, and postocclusive blood flow (PObf) were investigated after 4 wk of low-load resistance training (LLRT) with and without blood-flow restriction in a matched-leg design. Ten untrained older individuals age 62-73 yr performed unilateral plantar-flexion LLRT at 25% 1-repetition maximum (1RM). One limb was trained with normal blood flow and the other had blood flow restricted using a pressure cuff above the knee. 1RM, isometric maximal voluntary contraction, and isokinetic strength at 0.52 rad/s increased (p < .05) more after LLRT with blood-flow restriction than with normal blood flow. Peak PObf increased (p < .05) after LLRT with blood-flow restriction, compared with no change after LLRT with normal blood flow. These results suggest that 4 wk of LLRT with blood-flow restriction may be beneficial to older individuals to improve strength and blood-flow parameters.     

The relationship between heart rate as an indicator of work hardness and results of dynamometry

Heart rate is associated with work hardness and increase linearly with its increasing. In the average of energy consumption, heart rate measurement is simple but non-accurate method for calculation of work hardness. Our purpose in this research was to evaluate the relationship between heart rate and dynamometry results with hypothesis of work hardness effectiveness on the human power. This study was conducted on 102 porcelain workers. Participants were selected randomly. The research tools include stethoscope, the dynamometer. Heart rate, and pinch, grip, and back-leg-chest force were measured and relationships between variables were analyzed with Pearson correlation test and independent T-test using Spss 16 software. The average heart rate of participants were 4.11 ± 1.79 with minimum 60 and maximum 120. The average force of pinch, grip, and back-leg-chest were 8.9 ± 3.20, 4.2 ± 4.5 and 9.36 ± 6.55, respectively. Work hardness for 3.86% of workers were light, 7.12% were moderate and 1% were heavy. Pinch, grip, and back-leg-chest force relation with heart rate were not significant (r=0.01, p=0.85), (r=-0.03, p=0.74), and (r=0.05, p= 0.59), respectively. There was no correlation between heart rate and work hardness. So we can't use the dynamometry results to determine of work hardness.     

Leg-extension strength and chair-rise performance in elderly women with Parkinson's disease

The lower extremity performance in elderly female patients with mild to moderate Parkinson's disease (PD; n = 12) and controls (n = 16) was compared. Isometric dynamometry and force-plate measurements were used. PD patients had lower (p < .05) bilateral (BL) maximal isometric leg-extension force (MF), BL isometric MF relative to body mass, and maximal rate of isometric force development than control participants. BL strength deficit was greater (p < .05) in PD patients than in controls. A significantly longer chair-rise time and lower maximal rate of vertical-ground-reaction-force development while rising from a chair was found in PD patients than in controls. These findings suggest that elderly women with PD have lowered voluntary isometric force-generation capacity of the leg-extensor muscles. Reduced BL leg-extension strength might contribute to the difficulty of individuals with PD to rise from a chair.     

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.     

The effect of 6 months training on leg power, balance, and functional mobility of independently living adults over 70 years old

Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996). Many studies use participants from care homes rather than community dwellers. We investigated changes in leg power, balance, and functional mobility in community-dwelling sedentary men and women over 70 years of age (n = 6 for training group [TR]; n = 10 for control group [CN]). Progressive training took place over 24 weeks using seated and nonseated exercise. For TR, leg power increased 40%, from 108 +/- 40 to 141 +/- 53 W (p < .01); dynamic balance increased 48%, from 22.3 +/- 7.9 to 33.1 +/- 6.1 cm (p < .01; functional reach); and functional mobility increased 12%, from 7.46 +/- 1.32 to 6.54 +/- 1.41 s (p < .05; timed walk). CN showed no significant change. In conclusion, a community-based exercise program led to large improvements in leg-extensor power, dynamic balance, and functional mobility.     

The effect of testosterone therapy on lower urinary tract symptoms/bladder and sexual functions in men with symptomatic late-onset hypogonadism

Objective.?To prospectively investigate the effect of testosterone therapy on lower urinary tract symptoms (LUTS)/bladder and sexual functions in men with symptomatic late-onset hypogonadism (SLOH).

Methods.?The study included 25 men (age range 38 to 73 years) presented with sexual dysfunction, having SLOH, at a single university hospital. All men received testosterone replacement therapy with transdermal testosterone 50–100 mg gel per day for one year. Urodynamic studies with pressure-flow analysis, measurement of prostate volume, prostate specific antigen (PSA) and free PSA level, International Prostate Symptom Score (IPSS), Aging Male Symptom (AMS) scale and International Index of Erectile Function (IIEF-5) score were recorded in all men before and after one year of the treatment.

Results.?The mean AMS score significantly decreased from 40.4 ± 7.3 to 28.8 ± 5.31 (p = 0.001), and mean IIEF-5 score significantly increased from 8.84 ± 3.76 to 14.36 ± 3.62 (p = 0.001). The mean maximal bladder capacity and compliance significantly increased (p = 0.007 and p = 0.032, respectively), and mean detrusor pressure at Qmax significantly decreased from pre-treatment to post-treatment (p = 0.017).

Conclusion.?This study suggests that in addition to improvement in sexual functions, testosterone therapy may also improve LUTS/bladder functions by increasing bladder capacity and compliance and decreasing detrusor pressure at maximal flow in men with SLOH.     

The ethnic context of Mexican American fertility

Researchers analyzed 1980 data on 9954 ever married Mexican American 20-44 year old women living in metropolitan statistical areas (MSA) in the US with at least 50 Mexican Americans to test a multilevel model of Mexican American fertility. The model included percent Mexican American and measures of ethnic cultural integration and constraints in labor market opportunities. The index of ethnic cultural context consisted of percent of Mexican Americans in the MSA who were born in Mexico, immigrated to the US since 1970, and did not speak English well or not at all. Overall it did not have any effect on recent births (at least 1 birth in past 3 years). Yet it did increase the probability of other births among =or30 year old women who already had at least 4 children (p.05). Nevertheless only 13.4% of =or30 year old women with at least 4 children had another child in the last 3 years, thus the effect on overall Mexican American fertility was minimal. Limited economic opportunities had a significant positive effect on fertility for 30 year old women (p.05) as indicated by the unemployment ratio (unemployment rate of Mexican American females/unemployment rate of White females). The greatest effect of limited economic opportunities was that they induced these women to have a 3rd child. Further percent Mexican American also influenced recent births for 30 year old women even after the researchers included the direct measures of cultural and economic context in their analyses (p.05). Like the measure of economic context, the pattern of significance of percent Mexican American held true across age and parity. Thus economic limitations were more likely to explain the effect of group size on fertility than were cultural patterns.     

The reliability and validity of the physical activity survey in long-term care

The purpose of this study was to develop and test a measure of physical activity for residents in long-term-care facilities, the Physical Activity Survey in Long-Term Care (PAS-LTC). Sixty-six activities are included in the PAS-LTC: routine physical activity, personal-care activities, structured exercise, recreational activities, caretaking activities, and repetitive activities. The study included 13 residents in a long-term-care facility, most of whom were women (62%), with an average age of 84 years (+/- 6.0) and an average Mini Mental State Examination score of 6 (+/- 6.9). There was evidence of interrater reliability of the PAS-LTC with intraclass correlations of .83-.94. There was some evidence of validity of the measure with statistically significant correlations between PAS-LTC recorded during the evening and night shifts and the number of counts of activity per the ActiGraph (r = .60 and r = .57, respectively, p < .05) and the calories estimated (r = .58 and r = .60, respectively, p < .05). The PAS-LTC completed during the day shift and total activity based on the PAS-LTC showed nonsignificant correlations of .40 or greater with the ActiGraph activity counts and calories.     

Older women's cardiovascular responses to deep-water running

The aim of the study was to examine submaximal and maximal physiological responses and perceived exertion during deep-water running with a vest compared with the responses during treadmill running in healthy elderly women. Eleven healthy women 70 +/- 2 years old participated. On two different occasions they performed a graded maximal exercise test on a treadmill on land and a graded maximal exercise test in water wearing a vest. At maximal work the oxygen uptake was 29% lower (p < .05), the heart rate was 8% lower (p < .05), and the ventilation was 16% lower (p < .05) during deep-water running than during treadmill running. During submaximal absolute work the heart rate was higher during deep-water running than during treadmill running for the elderly women. The participants had lower maximal oxygen uptake, heart rate, ventilation, respiratory-exchange ratio, and rate of perceived exertion during maximal deep-water running with a vest than during maximal treadmill running. These responses were, however, higher during submaximal deep-water running than during treadmill running.     

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.     

Bicycle ergometry in subacute-stroke survivors: feasibility, safety, and exercise performance

This study evaluated the feasibility, safety, and findings from a protocol for exercise-bicycle ergometry in subacute-stroke survivors. Of 117 eligible candidates, 14 could not perform the test and 3 discontinued because of cardiac safety criteria. In the 100 completed tests, peak heart rate was 116 +/- 19.1 beats/min; peak VO(2) was 11.4 +/- 3.7 ml x kg x min(-1), peak METs were 3.3 +/- 0.91, exercise duration was 5.1 +/- 2.84 min, and Borg score was 14 +/- 2.6. Among 71 tests, anaerobic threshold was achieved in 3.0 +/- 1.7 min with a VO(2) of 8.6 +/- 1.7 ml x kg x min(-1). After screening, this protocol is feasible and safe in subacute-stroke survivors with mild to moderate deficits. These stroke survivors have severely limited functional exercise capacity. Research and clinical practice in stroke rehabilitation should incorporate more comprehensive evaluation and treatment of endurance limitations.     

Validation of the OMNI-cycle scale of perceived exertion in the elderly

This study examined the concurrent and construct validity of the OMNI-Cycle Rating of Perceived Exertion (RPE) Scale, using elderly men and women. Seventy-six participants performed a load-incremented cycle-ergometer exercise test. Concurrent validity was determined by correlating OMNI-RPE responses with oxygen uptake, relative peak oxygen uptake, pulmonary ventilation, heart rate, respiratory rate, and respiratory-exchange ratio during a load-incremented cycle-ergometer protocol. Construct validity was established by correlating RPE derived from the OMNI-Cycle Scale with RPE from the Borg (6-20) Scale. Multilevel, mixed linear-regression models indicated that OMNI-RPE distributed as a significant (p < .05) positive linear function (r = .81-.92) for all physiological measures. OMNI-RPE was positively (p < .01) and linearly related to Borg-RPE in elderly men (r = .97) and women (r = .96). This study demonstrates both concurrent and construct validity of the OMNI-Cycle RPE Scale. These findings support the use of this scaling metric with elderly men and women to estimate RPE during cycle-ergometer exercise.     

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.     

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.     

Family life cycle and labour force behaviour of married women

A sociologist analyzed 1984 data on 18-49 year old Canadian women married to their 1st husband to examine the effect of certain variables on the probability that they work at 3 different stages of the family life cycle. The older the woman the less likely she would be working at each state. Age was most significant at stage 1 (married with no children) (p.05) and less significant at stage 3 (married with 1 or more children and expected no more) (p.1). Neither age nor marriage age determined wife's labor force participation at stage 2 (married with 1 or more children and expected more). Marriage age was positively related to labor force participation at stage 1 (p.1). At all stages, the more education a woman had the more likely she worked. This effect was significant at stage 3 (p.1). Place of birth had a significant negative effect on employment at stage 3 (p.05). Canadian-born women with children had a tendency not to work or not seek work (stages 2 and 3), but those with no children either worked or were seeking work. The age of the youngest child had no significant effect on labor force participation. The more children a woman in stage 3 had the more likely she did not work (p.1), but those in stage 2 were more likely to work even though the number of children did not strongly influence labor force participation. Husband's income had a small effect on labor force participation of wives at all stages, but it was significant at stages 1 and 3 (p.1). Husbands were more likely to have a favorable attitude toward employment of wives at stages 1 and 3, but it was only significant at stage 3 (p.05). Women at stage 2 preferred to combine work, often part time, and motherhood. This study suggests that labor force participation of mothers will most likely continue to grow.     

Acculturative Stress and Mental Health Among Korean Adolescents in the United States

This study investigated Korean-American adolescents' stress related to their acculturation experiences and mental health. A total of 260 Korean-American adolescents from immigrant families (ages 12–18 years) participated in the study. The U.S. born group had a higher level of acculturative stress than the Korea-born group (t = 2.222; df = 258; p < .05). Males reported a higher level of self-esteem than females (t = ?2.112; df = 257; p < .05). Acculturative stress was positively correlated with depression (r = .299; p < .01) and negatively related to self-esteem (r = ?.292; p < .01). Self-esteem was negatively related to depression (r = ?.536; p < .01).     

Body mass index,waist/hip ratio and androgen—estrogen activity in younger versus older Polish men

This study was performed to evaluate the associations between estradiol, dehydroepiandrosterone sulfate (DHEAS), free and total testosterone levels, and anthropometric parameters of general adiposity (body mass index, BMI) and fat distribution (waist/hip ratio, WHR), separately in two subgroups of healthy Polish men: younger (aged 22–39 years, n = 95) and older (aged 40 years and over, n = 141) subjects. Sex steroid levels were assessed using radioimmunoassay (RIA). BMI was used as a measure of general adiposity. WHR was used to estimate distribution of adipose depots. The relationships between sex steroids, BMI, WHR and age were evaluated by use of non-parametric statistics (Spearman coefficients). Aging was related to a reduction of all hormone levels (correlation coefficients with age: free testosterone r = -0.52, p < 0.001; total testosterone r = -0.25, p < 0.001; estradiol r = -0.18, p < 0.001; DHEAS r = -0.45, p < 0.001) and an increase of BMI and WHR for BMI r = 0.23, p < 0.001; for WHR r = 0.47, p < 0.001). A one way analysis of co-variance (ANCOVA) was applied separately in the two subgroups of subjects to assess the relationships between hormonal and anthropometric variables. In men aged 22–39 years, the total (but not free) testosterone and DHEAS (when controlled for age) significantly differentiated BMI values. In subjects aged 40 years and over, no associations between sex steroids and BMI were revealed. In younger males DHEAS differentiated WHR values (even when controlled for age and BMI), whereas after the age of 40 years an increased WHR was accompanied by increases in both estradiol and DHEAS levels. The associations between the androgen—estrogen activity and the anthropometric parameters of adiposity vary in younger versus older healthy men.     

Effects of long-acting testosterone undecanoate on bone mineral density in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 36 months controlled study

We evaluated the effects of long-term testosterone replacement therapy (TRT) on the bone mineral density (BMD) in obese patients with metabolic syndrome (MS) and late-onset hypogonadism (LOH). Sixty men (mean age 57 ± 10) with low serum testosterone (T < 320 ng/dL) and MS regardless the presence of osteoporosis were enrolled. Forty men received intramuscular T-undecanoate (TU) four times/year for 36 months and 20 age-matched hypogonadal men with MS in whom T treatment was contraindicated were used as controls. Hormonal, biochemical markers, vertebral and femoral BMD by dual-energy x-ray absorptiometry were measured. At baseline, overall patients had mild osteopenia (lumbar BMD= 0.891 ± 0.097 g/cm(2); femoral BMD= 0.847 ± 0.117 g/cm(2)). TU induced a significant improvement of bone mass after 36 months (lumbar BMD=1.053 ± 0.145 g/cm(2); p < 0.002; femoral BMD=0.989 ± 0.109; p < 0.003 g/cm(2)) with a 5%/year increase and a significant reduction in hs-CRP without changes in body mass index. A direct relationship between serum T and BMD increments at the lumbar (r(2)?= 0.66, p < 0.0001) and femoral (r(2)?=0.52, p < 0.0001) sites was demonstrated. Study adherence was 50% without serious side effects. Long-term TRT in middle-aged men with LOH and MS determines a significant increase in both vertebral and femoral BMD related to increased serum T levels, probably independently from estradiol modifications.     

Comparison of the IPAQ-Short Form and accelerometry predictions of physical activity in older adults

Older adult physical activity (PA) levels obtained from the International Physical Activity Questionnaire-Short Form (IPAQ) and accelerometry (ACC) were compared. Mean difference scores between accumulated or bout ACC PA and the IPAQ were computed. Spearman rank-order correlations were used to assess relations between time spent in PA measured from ACC and self-reported form of the IPAQ, and percentage agreement across measures was used to classify meeting or not meeting PA recommendations. The IPAQ significantly underestimated sitting and overestimated time spent in almost all PA intensities. Group associations across measures revealed significant relations in walking, total PA, and sitting for the whole group (r = .29-.36, p < .05). Significant relationships between bout ACC and IPAQ walking (r = .28-.39, p < .05) were found. There was 40-46% agreement between measures for meeting PA recommendations. The IPAQ appears not to be a good indicator of individual older adult PA behavior but is better suited for larger population-based samples.