Increasing poor physical (motor) function from around age 65 is associated with an increased risk of death, finds research published by The BMJ today.
14 aug 2021--Signs of increasing decline, such as difficulty getting up from a chair or getting dressed, emerge up to 10 years beforedeath, the findings show.
The researchers therefore suggest that early detection of changes in motor function "might offer opportunities for prevention and targeted interventions."
It is well known that motor function, also commonly known as physical function or physical capability, declines with age, but rates of decline differ widely from person to person. And while studies show that decline in cognitive (mental) skills can emerge up to 15 years before death, it's not clear whether the same is true for physical abilities.
To explore this further, researchers examined several measures of motor function for their associations with mortality over a 10 year period from around age 65.
Their findings are based on over 6,000 participants of the Whitehall II Study, which recruited participants aged 35-55 years in 1985-88 to look at the impact of social, behavioural, and biological factors on long term health.
Between 2007 and 2016, participants underwent motor function assessments on up to three occasions. These included measures of walking speed, chair rise time, and grip strength, along with self-reported measures of functioning and difficulties with activities of daily living, such as dressing, using the toilet, cooking and grocery shopping.
Deaths from any cause were then recorded until October 2019.
After taking account of other potentially influential factors, the researchers found that poorer motor function was associated with an increased mortality risk of 22% for walking speed, 15% for grip strength and 14% for timed chair rises, while difficulties with activities of daily living were associated with a 30% increased risk.
These associations became progressively stronger with later life assessments.
Further analysis showed different patterns of change between participants who died and those who survived.
For example, participants who died had poorer chair rise times than survivors up to 10 years before death, poorer self-reported functioning up to seven years before death, and more difficulties with activities of daily living up to four years before death.
These differences increased steadily in the period leading to death.
This is an observational study, so can't establish cause and the researchers point to some limitations, such as being unable to examine trajectories of motor function by cause of death or in specific minority groups, and not accounting for events such as falls or hospital admissions.
Nevertheless, they say this study "adds to the sparse literature on terminal decline in motor function and, to our knowledge, is the first to examine terminal and age related long term trajectories of multiple measures of motor function."
The ageing of populations worldwide makes understanding of the functional status of older adults and change in functioning with age important, they write.
These results suggest that strategies to reduce accelerated decline should start before old age, and that early detection of changes in motor function might offer opportunities for prevention and targeted interventions, they conclude.
This study adds to a rapidly growing evidence base providing novel insights on healthy ageing, say researchers in a linked editorial.
They point out that as the study participants continue to age and more data becomes available, this will help to inform the development of interventions to promote healthy ageing.
Although the authors suggest that "early detection of changes in motor function might offer opportunities for prevention and targeted interventions," what these interventions would be and what specifically they would be aiming to achieve is unclear, they note. "Despite the focus on death as an outcome in these analyses, our goal should always be to add life to years, not just years to life."
More information: Terminal decline in objective and self-reported measures of motor function before death: 10 year follow-up of Whitehall II cohort study, BMJ (2021). DOI: 10.1136/bmj.n1743
A federally funded study by Johns Hopkins Medicine researchers shows that wearable accelerometers—mechanical sensors worn like a watch, belt or bracelet to track movement—are a more reliable measure of physical activity and better than patient surveys and other methods used by physicians at assessing five-year risk of death in older adults.
03 nov 2019--The research also added to evidence that an accurate and objective accounting ofphysical activityoutperforms traditional predictors ofmortalitywithin five years, such as age, smoking, diabetes,alcohol use, or history of cancer or heart disease.
Based on these findings, the researchers say physicians could confidently use the devices' fitness profiles to help patients change unhealthy behaviors, increase physical activity and, potentially, extend healthy lifespans.
While their study is far from the first to report an association between physical activity and risk of death, the investigators say their findings, reported in the Oct. 15 issue of The Journal of Gerontology: Medical Sciences, is among the first to offer solid evidence that wearable activity trackers provide key predictors of mortality that outperform other measures.
"People can overestimate or underestimate on surveys how much and when they move, but wearable devices provide accurate data that cuts through the bias and guesswork," says Jacek Urbanek, Ph.D., assistant professor of medicine at the Johns Hopkins University School of Medicine and a member of the research team. "The technology is readily available and relatively inexpensive, so it seems feasible to be able to incorporate recommendations for its use into a physician's practice."
"We've been interested in studying physical activity and how accumulating it in spurts throughout the day could predict mortality because activity is a factor that can be changed, unlike age or genetics," says Ciprian Crainiceanu, Ph.D., professor of biostatistics at the Johns Hopkins Bloomberg School of Public Health, who is also a member of the research team.
For the new study, the researchers focused on the total amount of physical activity and times the participants were most active during the day.
First, using data from the National Health and Nutrition Examination Survey (NHANES) conducted by the U.S. Centers for Disease Control and Prevention (CDC), researchers looked at 33 predictors of five-year all-cause mortality, including 20 objective measures of physical activity, such as total activity, amount of time not moving or amount of time doing moderate to vigorous activity. In this way, they ranked physical activity and other factors, such as total cholesterol, smoking status, and having cancer or diabetes, to identify which ones best predict mortality within the following five years of the study population.
For their look at physical activity, the researchers used accelerometry data from nearly 3,000 adult Americans collected during the NHANES 2003-2004 and NHANES 2005-2006 surveys. Individual data came from responses to demographic, socioeconomic and health-related survey questions, along with information accessed from medical records and clinical laboratory test results. Participants were asked to wear an accelerometer device at the hip for seven consecutive days, removing it only when sleeping, showering or swimming.
The average age the study group was 65.9, and all participants were between 50 and 84 years old. While the gender proportion was nearly even—men made up 51%—a larger percentage of the men, 65%, died within five years of the study's follow up efforts.
After studying each individual variable associated with mortality—including education, sedentary time, and ethnicity—the researchers concluded that the total measure of physical activity accumulated during each day was the strongest predictor of five-year mortality, followed by age and moderate-to-vigorous activity. When comparing the data of a person who died within five years and a person who survived, researchers said they were able to correctly rank the mortality risk using accelerometers 30% more accurately than using information about smoking status and 40% better than using information about whether a person suffered a stroke or had cancer.
With a focus on fragmented activity, researchers also collected data for two-hour spans throughout the day in order to look at patterns in physical activities. Their analysis showed that physical activity—or lack thereof—between noon and 2 p.m. was the highest predictor of mortality risk, outperforming more commonly considered risk factors such as diabetes, cancer and alcohol consumption.
The researchers caution that their study wasn't designed to establish cause and effect, however, they did note that their data suggests that being more sedentary during the day is linked with higher mortality.
"The most surprising finding was that a simple summary of measures of activity derived from a hip-worn accelerometer over a week outperformed well-established mortality risk factors such as age, cancer, diabetes and smoking," says Ekaterina Smirnova, M.S., Ph.D., assistant professor of biostatistics at Virginia Commonwealth University and the lead author on the paper.
"While this study affirmed a link between physical activity and short-term mortality risk in an older population, the data don't guarantee that one's risk of mortality is going to be lower with more physical activity," noted Andrew Leroux, a Ph.D. candidate at Johns Hopkins and co-author of the study report. "However, our findings do indicate that an accurate measure of physical activity is a more reliable way for doctors and patients to assess physical activity and intervene to increase it as a potential way to improve health."
The researchers hope to use their data to help design clinical trials that could confirm the potential for physical activity to increase lifespan. One caveat to the study is that researchers aren't able to distinguish sedentary behavior from sleep or if someone has removed the device.
More information: Ekaterina Smirnova et al, The Predictive Performance of Objective Measures of Physical Activity Derived From Accelerometry Data for 5-Year All-Cause Mortality in Older Adults: National Health and Nutritional Examination Survey 2003–2006, The Journals of Gerontology: Series A (2019). DOI: 10.1093/gerona/glz193
Sunday, October 13, 2019
Six minutes of walking can increase motivation to perform physical activity
Just six minutes of walking can increase a person's motivation to perform physical activity and improve feelings of energy, fatigue, depression, and confusion, according to research conducted by Clarkson University Associate Professor in Physical Therapy, Ali Boolani.
13 oct 2019--Boolani recently completed a study where he measured the mood of patients over the age of 65 before and after taking a six minute walk, and found that patients saw decreasedmental fatigueand improved physicalenergyafter their walk.
Patients were asked to participate in a three-day study. On the first day, Boolani and his team measured their moods, had them walk around, and measured their moods again. On days two and three, the patients were given cognitive tasks that were meant to make them feel worse, after which their mood was measured. Then, it was time for a walk.
We had them walk for six minutes around a track, and we had them walk at a pace that they felt comfortable with," Boolani said. "Even on the days they did cognitive tasks they started feeling better, and they even got up above baseline, which was really cool."
Levels of anxiety in patients were also found to decrease, according to Boolani.
"Feelings of anxiety definitely improved, this is along the lines of most of the studies that have been done that show that physical activity improves feelings of anxiety," he said.
On top of an increase in physical energy and a decrease in mental fatigue, Boolani measured patients' motivation levels.
"Turns out, after six minutes of physical activity, they were more motivated to perform physical tasks," He said. "In a real setting if you're having a tough day, you don't feel like working out, maybe six minutes of just walking can make you more motivated to be more physically active."
According to Boolani, similar studies have been conducted in the past, but six minutes is the shortest amount of time anyone has tested the impact of walking.
He also said the pace at which patients walked had an impact on their energy and fatigue levels.
"The faster they walked, the more their feelings of energy increased and their feelings of fatigue decreased," Boolani said.
Provided by Clarkson University
Thursday, February 15, 2018
Everyday activities associated with more gray matter in brains of older adults
Rush University College of Nursing researcher Shannon Halloway, PhD and patient. Higher levels of lifestyle physical activity - such as house cleaning, walking a dog and gardening, as well as exercise - are associated with more gray matter in the brains of older adults, according to a study by researchers at Rush University Medical Center. The Journal of Gerontology: Psychological Sciences will publish the study's findings on Feb. 14.
15 feb 2018--The gray matter in the brain includes regions responsible for controlling muscle movement, experiencing the senses, thinking and feeling, memory and speech and more. The volume of gray matter is a measure of brain health, but the amount of gray matter in the brain often begins to decrease in late adulthood, even before symptoms of cognitive dysfunction appear.
"More gray matter is associated with better cognitive function, while decreases in gray matter are associated with Alzheimer's disease and other related dementias," said Shannon Halloway, PhD, the lead author of the Journal of Gerontology paper and the Kellogg/Golden Lamp Society Postdoctoral Fellow in the Rush University College of Nursing. "A healthy lifestyle, such as participating in lifestyle physical activity, is beneficial for brain health, and may help lessen gray matter atrophy (decreases)."
Study used accelerometer to measure activity of 262 older adults
The study measured the levels of lifestyle physical activity by 262 older adults in Rush's Memory and Aging Project, an ongoing epidemiological cohort study. Participants are recruited from retirement communities and subsidized housing facilities in and around Chicago to participate in annual clinical evaluations and magnetic resonance imaging (MRI) scans, and to donate their brains and other parts of their bodies for research after their deaths.
Participants in the lifestyle study wore a non-invasive device called an accelerometer continuously for seven to ten days. The goal was to accurately measure the frequency, duration and intensity of a participant's activities over that time.
Lifestyle physical activity is "more realistic for older adults" than a structured exercise program that might require them to go to a gym, according to Halloway.
"Accessibility becomes an issue as one ages," Halloway said. "Transportation can be a problem. Gym settings can be intimidating for any individual, but especially so for older adults."
Accelerometers provide more precise measures of activity
The use of accelerometers was only one of the ways in which this analysis differed from some other investigations of the health of older people. Most research that explores the effects of exercise relies on questionnaires, which ask participants to "self-report" their levels of activity, Halloway said. She added that questionnaires tend to ask in a fairly non-specific fashion about types and intensity of exercise.
The real problem with questionnaires, though, is that "sometimes, we get really inaccurate reports of activity," Halloway acknowledged. "People commonly over-estimate, and on the flip side, some underestimate the lifestyle activity they're getting from things they don't consider exercise, like household chores, for example."
As to the accelerometer, she says, "it's not as commonly used (in studies of exercise) as we would like," even though accelerometers provide more precise results than self-reporting.
Study provided insights into activity levels of people past 80
Another departure in Halloway's study from some other investigations was the opportunity she had to assess the effects of exercise on individuals older than 80. In fact, the mean age in this study was 81 years, compared with 70 years for other studies Halloway used as a reference.
"One great strength of the Rush Alzheimer's Disease Center is its amazing ability to follow up with participants, and its high retention rates of participants," Halloway says. As a result, the Memory and Aging Project captures a number of participants in that older age group.
However, no one was included in Halloway's analysis who had a diagnosis or symptoms of dementia, or even mild cognitive impairment; a history of brain surgery; or brain abnormalities such as tumors, as seen on MRIs.
The study compared gray matter volumes as seen in participants' MRIs with readings from the accelerometers and other data, which all were obtained during the same year. Halloway's analysis found the association between participants' actual physical activity and gray matter volumes remained after further controlling for age, gender, education levels, body mass index and symptoms of depression, all of which are associated with lower levels of gray matter in the brain.
"Our daily lifestyle physical activities are supportive of brain health, and adults of all ages should continue to try and increase lifestyle physical activity to gain these benefits," Halloway said. "Moving forward, our goal is to develop and test behavioral interventions that focus on lifestyle physical activity for older adults at increased risk for cognitive decline due to cardiovascular disease."
Provided by Rush University Medical Center
Tuesday, November 07, 2017
More physical activity, higher intensity may significantly reduce risk of death in older women in the short term
More physical activity and at higher intensities could lead to a big drop in the risk of death in older women from any cause, according to new research in the American Heart Association's journal Circulation.
07 nov 2017--Researchers found the volume of light intensity physical activity or sedentary behavior was not associated with death rate. However, light intensity activity may be beneficial for other health outcomes not studied in this research.
Previous studies, which used self-reports, showed that active people have about 20 percent to 30 percent lower death rates compared to their least active counterparts.
This research, conducted from 2011 to 2015, is among the first to investigate physical activity, measured using a wearable device called a triaxial accelerometer, and a clinical outcome. The device is capable of measuring activity along three planes: up and down, front to back and side to side. These capabilities increase sensitivity to detect physical activity and allow for more precise measurements.
"We used devices to better measure not only higher intensity physical activities, but also lower intensity activities and sedentary behavior, which has become of great interest in the last few years," said I-Min Lee, M.B.B.S., Sc.D., the study's first author and professor of medicine and epidemiology at Harvard University's medical and public health schools in Boston, Massachusetts.
More than 17,700 women (average age 72) who were asked to wear the device for seven days, when awake, returned their devices. Data were analyzed from 16,741 compliant participants (i.e., their devices showed it was worn for at least 10 hours a day, on at least four days). During an average follow-up of approximately two-and-a-half years, 207 women died.
Researchers found:
More moderate to vigorous intensity physical activity (such as brisk walking) was associated with roughly a 60 percent to 70 percent lower risk of death at the end of the study among the most active women, compared to the least active.
More light intensity activity (such as housework and slow walking - e.g., window shopping in a mall), or more sedentary behavior was not independently associated with death risk at the study's end. Researchers stressed this finding does not mean light activity isn't beneficial for other health outcomes not studied here.
Researchers chose this study population to begin addressing knowledge gaps, said Lee who is also an associate epidemiologist at Brigham and Women's Hospital in Boston. "Younger people in their 20s and 30s generally can participate in vigorous intensity activities, such as running or playing basketball. But for older people, vigorous intensity activity may be impossible, and moderate intensity activity may not even be achievable. So, we were interested in studying potential health benefits associated with light intensity activities that most older people can do."
The study's participants, selected from the Women's Health Study, were relatively healthy, and mostly white women, therefore the findings may have limited generalizability to other groups of people.
The findings support 2008 federal guidelines and American Heart Association that suggest at least 150 minutes a week of moderate intensity or 75 minutes a week of vigorous-intensity aerobic physical activity (or a combination of the two) and muscle-strengthening exercises two or more days a week.
"We hope to continue this study in the future to examine other health outcomes, and particularly to investigate the details of how much and what kinds of activity are healthful. What is irrefutable is the fact that physical activity is good for your health," Lee said.
This figure shows the amount of time each group spent physically active over a 24 hour period. The healthy control group engages in the largest amount of activity, with the institutionalized dementia group engaging in significantly less. It has been recognised for over 60 years that regular physical activity provides health benefits. Our bodies are designed to be stimulated by physical exertion. Fitness is associated with lower all-cause mortality, along with improved sleep, quality of life, social life and reduced stress. On the other hand, physical inactivity predicts obesity, diabetes, cardiovascular disease, mental health issues, reduced quality of life and overall mortality. The evidence is clear: we need to get moving.
18 jun 2016--In addition to health outcomes, cognition and physical activity are intrinsically linked. This is increasingly true within the senior population. More physically active older adults show less cognitive decline than those who are not active. Older adults participating in physical activity programs often demonstrate improvements in their cognitive abilities – particularly with attention and executive function. In frailer older adults with many health problems, physical activity interventions facilitate better cognition, physical capacity and quality of life. Regular physical activity has also been associated with reduced risk of cognitive decline and development of dementia. Many hypotheses have been postulated regarding the role of physical activity in staving off cognitive impairment. It may protect cardiovascular changes in the brain by maintaining cerebral blood flow, facilitate the growth of new neurons or relieve stress and therefore improve cognitive function.
But what does physical activity look like in the cognitively impaired population – specifically within dementia? A recent study in PLOS ONE aimed to quantify and characterize physical activity in dementia patients objectively. While previous studies report that dementia patients are less physically active than older adults without cognitive impairment, the majority of these findings come from self-reported measures. These are often not as reliable or accurate as they are subjective, and may be impacted by memory recall problems. Van Alphen and colleagues chose to use the Actiwatch, a wrist-worn accelerometer, to collect objective data on the frequency, duration and intensity of daily physical activity in dementia patients. One hundred and twenty dementia patients were included in the study, recruited from 13 nursing homes and four day-care centers, along with 26 older adult controls. All participants were required to wear the Actiwatch for at least six days, 24 hours a day.
The researchers were interested in the differences in physical activity levels between community-dwelling dementia patients and institutionalized patients. To this end, daily physical activity levels were significantly different between institutionalized patients and community-dwelling patients and controls, with institutionalized patients engaging in physical activity 23.5% less than community-dwelling patients and 40% less than controls. This is important to note as infrastructures and activities could be implemented in care homes to encourage physical activity.
This figure demonstrates the amount of time the different groups spend sedentary compared to other levels of physical intensity. The first bars (0-99) represent sedentary time, while the rest of the bars show a gradual climb in activity intensity. Additionally, institutionalized patients spent 72% of their day in a sedentary state; 9.3% more than community-dwelling patients and 19% more than controls. These results remain significant after controlling for age, cognitive abilities and use of walking aids. While there were no significant differences in amount of physical activity between Alzheimer's disease patients and non-Alzheimer's disease patients (encompassing dementia with Lewy bodies, Parkinson's disease with dementia, vascular dementia and frontotemporal dementia), Alzheimer's disease patients did spend significantly less time (6.9%) in a sedentary state. Van Alphen and colleagues concluded that both institutionalized and community-dwelling dementia patients remained sedentary for the majority of the day and performed lower intensity activities than that of controls.
But why is it important to know about physical activity levels in dementia? The dangers of physical inactivity were highlighted earlier; for dementia patients, the ability to carry out everyday activities may be compromised, along with reduced quality of life and further cognitive decline. Studies have demonstrated that encouraging active participation in functional tasks – such as dressing and washing – and attending dance or exercise classes – can improve physical capacity and reduce fall risk in moderate-to-severe dementia. Bi-weekly exercise programs are associated with slower rates of cognitive and functional decline in dementia. Individuals with mild cognitive impairment – a pre-dementia stage – undergoing an aerobic fitness intervention demonstrate significant improvements in cognition, particularly executive function. Encouraging physical activity in this population holds a range of benefits – from improved mood, function, cognition and fitness to reduced stress and improved quality of life for their caregiver.
There is still much work to be done. Studies need to recruit larger samples of patients with non-Alzheimer's disease dementias to assess the differences across dementia subtypes. Type of activity should be examined; most accelerometers can provide data about frequency and duration of movement but fail to automatically specify what activities are being undertaken. Individual differences in activity type may predict different health outcomes. As Van Alphen and colleagues reported, dementia groups are more likely to engage in low-intensity activities such as walking or household chores. These activities are beneficial for cardiorespiratory capacity and body composition, and exercise interventions could be tailored to suit this preference. The effects of vigorous – such as sprinting or spinning – and low-intensity activities should also be compared. This is an area ripe for investigation and may be beneficial for the development of physical interventions.
Increasing physical activity levels is a global challenge and one that is continuously being addressed. The World Health Organization (WHO) recommends 30 minutes of moderate-to- vigorous exercise a day, which can be achieved by walking, gym classes and activities, sports or physical hobbies such as gardening. Governments develop policies, guidelines and initiatives to encourage people to participate in physical exercises, such as Let's Move. National campaigns – such as This Girl Can – promote a sense of unity in keeping active. Free exercise programs – such as Shape Up New York – allow people to engage in a range of fitness classes, from aerobics to Zumba. These all endorse the message to get up, get going and get active! Still 20% of individuals older than 15 years do not meet these physical activity guidelines. Therefore, I believe our approach to the promotion and facilitation of physical activity needs to change. Most people associate the prescription of getting active with problems like obesity and heart disease. More education on how active individuals incur health benefits beyond physical health is also needed.
Exercise is often portrayed as inaccessible without expensive gym facilities and a grueling experience for those who do take part – think of all those films depicting the embarrassment of being picked last in gym class. Facilities allowing engagement in moderate-intensity exercise – such as walking, cycling and running – should be built; fun and simple ways to get involved should be endorsed. Physical activity is an inexpensive, easily-accessible approach to improve health and overall well-being – and we should be taking full advantage of that.
More information: Helena J. M. van Alphen et al. Older Adults with Dementia Are Sedentary for Most of the Day, PLOS ONE (2016). DOI: 10.1371/journal.pone.0152457
Helena J. M. van Alphen et al. Older Adults with Dementia Are Sedentary for Most of the Day, PLOS ONE (2016). DOI: 10.1371/journal.pone.0152457
Samuel C. Dumith et al. Worldwide prevalence of physical inactivity and its association with human development index in 76 countries, Preventive Medicine (2011). DOI: 10.1016/j.ypmed.2011.02.017
Laura D. Baker et al. Effects of Aerobic Exercise on Mild Cognitive Impairment, Archives of Neurology (2010). DOI: 10.1001/archneurol.2009.307
Nicola T. Lautenschlager et al. Physical Activity and Mild Cognitive Impairment and Alzheimer's Disease, Current Neurology and Neuroscience Reports (2010). DOI: 10.1007/s11910-010-0121-7
E. Galik et al. Optimizing Function and Physical Activity Among Nursing Home Residents With Dementia: Testing the Impact of Function-Focused Care, The Gerontologist (2013). DOI: 10.1093/geront/gnt108
Louis Bherer et al. A Review of the Effects of Physical Activity and Exercise on Cognitive and Brain Functions in Older Adults, Journal of Aging Research (2013). DOI: 10.1155/2013/657508
Study links physical activity to greater mental flexibility in older adults
Research reveals a new signal of brain health in older adults who regularly engage in moderate to vigorous physical activity Credit: Public domain/Julie McMahon28 aug 2015--One day soon, doctors may determine how physically active you are simply by imaging your brain. Physically fit people tend to have larger brain volumes and more intact white matter than their less-fit peers. Now a new study reveals that older adults who regularly engage in moderate to vigorous physical activity have more variable brain activity at rest than those who don't. This variability is associated with better cognitive performance, researchers say.
The new findings are reported in the journal PLOS ONE.
"We looked at 100 adults between the ages of 60 and 80, and we used accelerometers to objectively measure their physical activityover a week," said University of Illinois postdoctoral researcher Agnieszka Burzynska, who led the study with Beckman Institute for Advanced Science and Technology director Art Kramer.
The researchers also used functional MRI to observe how blood oxygen levels changed in the brain over time, reflecting each participant's brain activity at rest. And they evaluated the microscopic integrity of each person's white-matter fibers, which carry nerve impulses and interconnect the brain.
"We found that spontaneous brain activity showed more moment-to-moment fluctuations in the more-active adults," said Burzynska, who now is a professor at Colorado State University. "In a previous study, we showed that in some of the same regions of the brain, those people who have higher brain variability also performed better on complex cognitive tasks, especially on intelligence tasks and memory."
The researchers also found that, on average, older adults who were more active had better white-matter structure than their less-active peers.
"Our study, when viewed in the context of previous studies that have examined behavioral variability in cognitive tasks, suggests that more-fit older adults are more flexible, both cognitively and in terms of brain function, than their less-fit peers," Kramer said.
Beckman Institute postdoctoral researcher Agnieszka Burzynska and her colleagues found that older adults who are more active appear to have more mental flexibility than their less-active peers. Burzynska is now a professor at Colorado State University. Credit: L. Brian StaufferThe new research highlights yet another way to assess brain health in aging, Burzynska said.
"We want to know how the brain relates to the body, and how physical health influences mental and brain health in aging," she said. "Here, instead of a structural measure, we are taking a functional measure of brain health. And we are finding that tracking changes in blood-oxygenation levels over time is useful for predicting cognitive functioning and physical health in aging." More information: "Physical activity is linked to greater moment-to-moment variability in spontaneous brain activity in older adults" PLOS ONE, journals.plos.org/plosone/article?id=10.1371/journal.pone.0134819
Provided by University of Illinois at Urbana-Champaign
Sunday, May 17, 2015
30 minutes of physical activity six days a week linked to 40 percent lower risk of death in elderly men
Credit: George Hodan/public domain
Thirty minutes of physical activity—irrespective of its intensity—6 days a week is linked to a 40% lower risk of death from any cause among elderly men, finds research published online in the British Journal of Sports Medicine.
17 may 2015--Boosting physical activity levels in this age group seems to be as good for health as giving up smoking, the findings suggest.
The researchers base their findings on people taking part in the Oslo Study, which invited almost 26,000 men born between 1923 and 1932 for a health check in 1972-3 (Oslo I).
Some 15,000 agreed. Their height, weight, cholesterol and blood pressure were all assessed, and they were asked whether they smoked.
They were also asked to respond to a validated survey (Gothenburg questionnaire) on their weekly leisure time physical activity levels.
These were categorised as sedentary (watching TV/reading); light (walking or cycling, including to and from work for at least 4 hours a week); moderate (formal exercise, sporting activities, heavy gardening for at least 4 hours a week); and vigorous (hard training or competitive sports several times a week).
Some 6000 of the surviving men repeated the process in 2000 (Oslo II) and were monitored for almost 12 years to see if physical activity level over time was associated with a lowered risk of death from cardiovascular disease, or any cause, and if its impact were equivalent to quitting smoking.
During the monitoring period, 2154 out of the 5738 men who had gone through both health checks died.
The analysis indicated that less than an hour a week of light physical activity was not associated with any meaningful reduction in risk of death from any cause. But more than an hour was linked to a 32% to 56% lower risk.
Less than an hour of vigorous physical activity, on the other hand, was linked to a reduction in risk of between 23% and 37% for cardiovascular disease and death from any cause.
The more time spent doing vigorous exercise the lower the risk seemed to be, falling by between 36% and 49%.
And men who regularly engaged in moderate to vigorous physical activity during their leisure time lived five years longer, on average, than those who were classified as sedentary.
Factoring in that the risk of death from heart disease/stroke rises with age, made only a slight difference to the results.
Overall, these showed that 30 minutes of physical activity—of light or vigorous intensity—6 days a week was associated with a 40% lower risk of death from any cause.
The impact would seem to be as good for health as quitting smoking among this age group, suggest the researchers.
This is an observational study so no definitive conclusions can be drawn about cause and effect, and the researchers point out that only the healthiest participants in the first wave of the study took part in the second wave, which may have lowered overall absolute risk.
But the differences in risk of death between those who were inactive and active were striking, even at the age of 73, they suggest.
More effort should go into encouraging elderly men to become more physically active, with doctors emphasising the wide range of ill health that could be warded off as a result, conclude the researchers.
More information: Increases in physical activity is as important as smoking cessation for reduction in total mortality in elderly men: 12 years of follow up of the Oslo II study, British Journal of Sports Medicine, DOI: 10.1136/bjsports-2014-094522
Provided by British Medical Journal
Friday, March 13, 2015
Exercise may help keep seniors moving longer despite old age brain decline
Credit: Peter Griffin/public domain
13 mar 2015--Older people who are physically active may be protecting themselves from the effects of small areas of brain damage that can affect their movement abilities, according to a new study published in the March 11, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology.
Many older people have small areas of damage in their brains seen on magnetic resonance imaging (MRI) as white matter hyperintensities. Higher levels of this damage have been linked to more problems with movement, such as difficulty walking. But this new study found that people who were the most physically active did not have a drop-off in their movement abilities, even when they had high levels of brain damage.
"These results underscore the importance of efforts to encourage a more active lifestyle in older people to prevent movement problems, which is a major public health challenge," said study author Debra A. Fleischman, PhD, of Rush University Medical Center in Chicago. "Physical activity may create a 'reserve' that protects motor abilities against the effects of age-related brain damage."
The study involved 167 people with an average age of 80. The participants wore movement monitors on their wrists for up to 11 days to measure both exercise and non-exercise activity. They also took 11 tests of their movement abilities. MRI scans were used to determine the volume of white matter hyperintensities in the brain.
Compared to those at the 50th percent in activity level measured using the movement monitors, those in the top 10 percent had activity equal to walking at 2.5 mph for an additional 1.5 hours each day.
For the people in the top 10 percent, having greater amounts of brain damage did not change their scores on the movement tests. But for those at the 50th percent activity level, having greater amounts of brain damage was associated with significantly lower scores on the movement tests. For all the participants, the average score on the movement tests was 1.04. For people at the 50th percent activity level, scores ranged from 1.16 for those with the lowest amount of brain damage to 0.9 for those with the highest amount of brain damage. The detrimental effect was even stronger for those with the lowest levels of physical activity.
The results remained the same after researchers adjusted for other factors that could affect the relationship, such as body mass index (BMI), depression and vascular disease.
Fleischman noted that the study does not determine whether physical activity causes people to preserve their movement abilities; it only shows the association.
Provided by American Academy of Neurology
Monday, January 12, 2015
Physical activity intervention for the elderly
Aerobic, strength, balance, and flexibility training can improve overall physical function—even among people who already have lost muscle mass due simply to aging—a condition called “sarcopenia.” Credit: Stephen Ausmus
12 jan 2015--Bone loss is not the only nemesis of the elderly. As the percentage of people aged 85 and older grows, the stakes are high for healthy individuals living independently who do not maintain their muscle mass and strength. Age-related muscle loss—which excludes disease-related muscle loss—is called "sarcopenia." This condition can lead to costly surgeries and hospital stays due to fractures after falls that occurred from weak muscles, says physiologist Roger Fielding.
In 2012 alone, 2.4 million nonfatal falls among older adults were treated in emergency departments, according to the Centers for Disease Control and Prevention's (CDC) National Center for Injury Prevention and Control. In addition, death rates from falls among older people have risen sharply during the past decade, CDC reports.
Fielding is with the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston, Massachusetts. He is director of the center's Nutrition, Exercise, Physiology, and Sarcopenia Laboratory. The HNRCA is funded in part by the USDA Agricultural Research Service.
HNRCA and international scientists have now arrived at a consensus on sarcopenia's clinical definition. The team developed simple tests to help local healthcare practitioners make diagnoses and treatment plans. The tests include assessing whether a person can walk 13 feet in 4 seconds or less.
"The gait speed cut point we found is 1 meter—or 3.25 feet—per second," says Fielding. "Below that, the risk of mortality and institutionalization increases dramatically." Fielding wants clinicians to think of these tests as an important vital sign for elders, similar in importance to blood pressure readings.
By age 80, an estimated 40 percent of the muscle mass that was present at age 20 is lost, HNRCA researchers say. But a subpopulation of older adults has muscle loss that is even greater than that of others in their age group. This extrememuscle loss has been associated with physical performance limitations and disability.
A study headed by HNRCA's geriatrician Christine Liu and coauthored by Fielding and others looked at data collected on a group of 177 elders aged 70 to 89 years who were functionally limited and at risk of becoming disabled due to lack of mobility. The data was collected during the "Lifestyle Interventions and Independence for Elders" study. The volunteers' body composition, including lean muscle and body fat, was measured both before and after the intervention.
One group of volunteers participated in a physical activity intervention that included aerobic, strength, balance, and flexibility training. The results demonstrated that elders with sarcopenia are capable of improving their overall physical function, including balance, walking, and strength, in response to physical activity.
"Sarcopenia should not deter clinicians from encouraging physical activity in older clients," says Liu. "Even with relatively little muscle mass, these individuals benefited from preventive exercise."
Provided by Agricultural Research Service
Tuesday, November 26, 2013
Regular physical activity in later life boosts likelihood of 'healthy aging' up to sevenfold
It's never too late to get physically active, with even those starting relatively late in life reaping significant health benefits, finds research published online in the British Journal of Sports Medicine.
26nov 2013--Four years of sustained regular physical activity boosted the likelihood of healthy ageing sevenfold compared with consistent inactivity, the findings show.
The researchers tracked the health of almost 3500 people, whose average age was 64, for more than eight years. All were participants in the English Longitudinal Study of Ageing, which involves a nationally representative sample of the household population of England, born on or before 29 February 1952.
The researchers wanted to quantify the impact of physical activity on the risk of developing long term conditions, depression, and dementia, and on the likelihood of "healthy ageing."
This is usually taken to mean not only an absence of major disease and disability, but also good mental health, the preservation of cognitive abilities, and the ability to maintain social connections/activities.
There's a growing body of evidence to suggest that regular physical activity is essential for the maintenance of good health, while across the developed world, inactivity is ranked alongside smoking, excess drinking, and obesity as a leading cause of reduced life expectancy.
Participants described the frequency and intensity of regular physical activity they did in 2002-3, and then every subsequent two years until 2010-11.
Their responses were categorised as: inactive (no moderate or vigorous activity on a weekly basis); moderately active (at least once a week); and vigorously active (at least once a week).
Any changes in frequency and intensity were noted at the two yearly monitoring sessions: always inactive; became inactive; became active; always active.
Serious ill health, such as heart disease/stroke, diabetes, emphysema, or Alzheimer's disease, was confirmed by medical records.
Cognitive abilities and mental health were assessed using a battery of validated tests, while disability was measured according to participants' responses to questions about the ease with which they were able to carry out routine activities of daily living, and an objective test of walking speed.
Nearly one in 10 of the sample became active and 70% remained active. The rest remained inactive or became inactive.
At the end of the monitoring period almost four out of 10 had developed a long term condition; almost one in five was depressed; a third had some level of disability; and one in five was cognitively impaired.
But one in five was defined as a healthy ager. And there was a direct link to the likelihood of healthy ageing and the amount of exercise taken.
Those who had regularly indulged in moderate or vigorous physical activity at least once a week were three to four times more likely to be healthy agers than those who had remained inactive, after taking account of other influential factors.
Those who became physically active also reaped benefits, compared with those who did nothing. They were more than three times as likely to be healthy agers.
And those who sustained regular physical activity over the entire period were seven times as likely to be healthy agers as those who had consistently remained inactive.
"This study supports public health initiatives designed to engage older adults in physical activity, even those who are of advanced age," conclude the authors.
More information: Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing, Online First, doi 10.1136/bjsports-2013-092993
Provided by British Medical Journal
Saturday, January 05, 2013
Why good resolutions about taking up a physical activity can be hard to keep
05 jan 2013--The collective appraisal conducted by Inserm in 2008 highlighted the many preventive health benefits of regular physical activity. Such activity is limited, however, by our lifestyle in today's industrial society. While varying degrees of physical inactivity may be partly explained by social causes, they are also rooted in biology.
"The inability to experience pleasure during physical activity, which is often quoted as one explanation why people partially or completely drop out of physical exercise programmes, is a clear sign that the biology of the nervous system is involved", explains Francis Chaouloff.
But how exactly? The neurobiological mechanisms underlying physical inactivity had yet to be identified.
The researchers used various lines of mutant mice for the CB1 receptor, together with pharmacological tools. They began by demonstrating that the CB1 receptor controlling running performance is located at the GABAergic nerve endings. They went on to show that the receptor is located in the ventral tegmental area of the brain (see diagram below), which is an area involved in motivational processes relating to reward, whether the reward is natural (food, sex) or associated with the consumption of psychoactive substances.
Based on the results of this study and earlier work, the Bordeaux team suggests the following neurobiological explanation: at the beginning and for the duration of physical exercise, the CB1 receptor is constantly simulated by the endocannabinoids, lipid molecules that naturally activate this receptor in response to pleasant stimuli (rewards) and unpleasant stimuli (stress). Endocannabinoid stimulation of the CB1 receptor during physical exercise inhibits the release of GABA, an inhibitory neurotransmitter that controls the activity of the dopamine neurons associated with the motivation and reward processes. This stimulation of the CB1 receptor "inhibits inhibition", in other words, it activates the dopaminergic neurons in the ventral tegmental area. The CB1 receptor must therefore be stimulated before the exercise can go on for longer and the body must receive the necessary motivation.
Conversely, without these CB1 receptors, the "GABAergic brake" continues to act on the dopaminergic neurons in the ventral tegmental area, leading to the reduced performance levels observed above.
It is already known that CB1 receptors play a regulatory role in the motivation to consume rewards, whether natural or not. What is original about this research is that it shows that physical exercise can be added to the array of natural rewards regulated by the endocannabinoid system. "If confirmed, this motivational hypothesis would imply that the role played by the CB1 receptor has more to do with 'staying power' in the exercise than with actual physical performance levels" explain the researchers.
This work reveals that the endocannabinoid system plays a major role in physical exercise performance through its impact on motivational processes. It thus opens up new avenues of research into the mediators of pleasure – and even addiction – associated with regular physical exercise. "After endorphins, we now need to consider endocannabinoids as another potential mediator of the positive effects that physical exercise has on our mood," the researchers conclude.
More information: "Ventral Tegmental Area Cannabinoid Type-1 Receptors Control Voluntary Exercise Performance" Biological Psychiatry, 12 December 2012
Provided by Institut National de la Sante et de la Recherche Medicale
Saturday, November 03, 2012
Regular physical activity reduces risk of dementia in older people
Regular physical activity may help older people reduce their chances of getting dementia.
03 nov 2012--In a new study published in the American Heart Association journal Stroke, older, non-disabled people who regularly engaged in physical activity reduced their risk of vascular-related dementia by 40 percent and cognitive impairment of any etiology by 60 percent.
The protective effect of regular physical activity remained regardless of age, education, changes in the brain's white matter and even previous history of stroke or diabetes, researchers said. The findings are based on a prospective multinational European study that included yearly comprehensive cognitive assessments for three years. The results are part of increasing evidence that regular physical activity promotes brain health, researchers said.
"We strongly suggest physical activity of moderate intensity at least 30 minutes three times a week to prevent cognitive impairment," said Ana Verdelho, M.D., lead author of the study and a neuroscience researcher at the University of Lisbon, Santa Maria Hospital in Portugal. "This is particularly important for people with vascular risk factors such as hypertension, stroke or diabetes."
The analysis included 639 people in their 60s and 70s; 55 percent were women and almost 64 percent said they were active at least 30 minutes a day three times a week. The activity included gym classes, walking and biking.
The American Heart Association recommends at least 150 minutes of moderate exercise every week or 75 minutes of vigorous exercise for optimal health.
Researchers performed magnetic resonance imaging (MRI) tests at the beginning and end of the study to gauge white matter changes in the brain, an indicator of possible cognitive decline.
"Damage of the cerebral white matter is implicated in cognitive problems including depression, walking difficulties and urinary complaints," Verdelho said. "White matter changes are very common in older people and mainly associated with vascular risk factors like hypertension and stroke."
Throughout the study, researchers asked participants in phone interviews and clinical visits about depression, quality of life and performing everyday activities.
At the end of the follow-up, 90 patients had dementia, including 54 with vascular dementia in which impaired blood flow to the brain causes cognitive decline, and 34 patients met criteria for Alzheimer's disease. Another 147 patients developed cognitive impairment, but not dementia.
Provided by American Heart Association
Tuesday, August 14, 2012
Should doctors treat lack of exercise as a medical condition? Mayo expert says 'yes'
A sedentary lifestyle is a common cause of obesity, and excessive body weight and fat in turn are considered catalysts for diabetes, high blood pressure, joint damage and other serious health problems. But what if lack of exercise itself were treated as a medical condition? Mayo Clinic physiologist Michael Joyner, M.D., argues that it should be. His commentary is published this month in The Journal of Physiology.
14 aug 2012--Physical inactivity affects the health not only of many obese patients, but also people of normal weight, such as workers with desk jobs, patients immobilized for long periods after injuries or surgery, and women on extended bed rest during pregnancies, among others, Dr. Joyner says. Prolonged lack of exercise can cause the body to become deconditioned, with wide-ranging structural and metabolic changes: the heart rate may rise excessively during physical activity, bones and muscles atrophy, physical endurance wane, and blood volume decline.
When deconditioned people try to exercise, they may tire quickly and experience dizziness or other discomfort, then give up trying to exercise and find the problem gets worse rather than better.
"I would argue that physical inactivity is the root cause of many of the common problems that we have," Dr. Joyner says. "If we were to medicalize it, we could then develop a way, just like we've done for addiction, cigarettes and other things, to give people treatments, and lifelong treatments, that focus on behavioral modifications and physical activity. And then we can take public health measures, like we did for smoking, drunken driving and other things, to limit physical inactivity and promote physical activity."
Several chronic medical conditions are associated with poor capacity to exercise, including fibromyalgia, chronic fatigue syndrome and postural orthostatic tachycardia syndrome, better known as POTS, a syndrome marked by an excessive heart rate and flu-like symptoms when standing or a given level of exercise. Too often, medication rather than progressive exercise is prescribed, Dr. Joyner says.
Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center researchers found that three months of exercise training can reverse or improve many POTS symptoms, Dr. Joyner notes. That study offers hope for such patients and shows that physicians should consider prescribing carefully monitored exercise before medication, he says.
If physical inactivity were treated as a medical condition itself rather than simply a cause or byproduct of other medical conditions, physicians may become more aware of the value of prescribing supported exercise, and more formal rehabilitation programs that include cognitive and behavioral therapy would develop, Dr. Joyner says.
For those who have been sedentary and are trying to get into exercise, Dr. Joyner advises doing it slowly and progressively.
"You just don't jump right back into it and try to train for a marathon," he says. "Start off with achievable goals and do it in small bites."
There's no need to join a gym or get a personal trainer: build as much activity as possible into daily life. Even walking just 10 minutes three times a day can go a long way toward working up to the 150 minutes a week of moderate physical activity the typical adult needs, Dr. Joyner says.
Provided by Mayo Clinic
Monday, November 07, 2011
Physical activity reduces the effect of the 'obesity gene'
The genetic predisposition to obesity due to the 'fat mass and obesity associated' (FTO) gene can be substantially reduced by living a physically active lifestyle according to new research by a large international collaboration, led by Ruth Loos from the Medical Research Council Epidemiology Unit, in Cambridge, UK, and published in this week's PLoS Medicine. The researchers found that the effect of the FTO gene on obesity risk is nearly 30% weaker among physically active than in physically inactive adults.
07 nov 2011--This finding holds an important public health message relevant to health care professionals and the wider public as it challenges the widely-held view that obesity 'is in my genes' and not amenable to lifestyle changes. On the contrary, this study shows that even those genetically predisposed can reduce their risk of becoming obese by being physically active.
The authors performed a comprehensive literature search and invited all researchers who had reported on the FTO gene in the past to participate in their study. They used an extensive and innovative methodology to analyze data from over 218,000 adults, to show that, in general, carrying a copy of the FTO gene increases the risk of becoming obese. However, the effect of the FTO gene on obesity risk was 27% less pronounced in individuals who were physically active (1.22 fold) compared with those who were physically inactive (1.30 fold).
The authors say: "Our findings are highly relevant to public health. They emphasize that physical activity is an effective way of controlling body weight, particularly in individuals with a genetic predisposition towards obesity. Thus, they contrast with the determinist view held by many that genetic influences are unmodifiable." The researchers believe that these findings will bring them a step closer to more personalised healthcare by identifying people who will benefit most from a targeted treatment.
In an accompanying Perspective, J. Lennert Veerman from the School of Population Health at the University of Queensland in Australia says: "testing for genetic traits that are associated with obesity makes no difference in the advice to overweight persons: increased physical activity and a healthy diet are indicated regardless of the genes." Dr Veerman continues: "A focus on individual genetic traits is a mere distraction and reinforces the popular view of obesity as a problem that individuals have to deal with, rather than one that requires societal action."
More information: Kilpeläinen TO, Qi L, Brage S, Sharp SJ, Sonestedt E, et al. (2011) Physical Activity Attenuates the Influence of FTO Variants on Obesity Risk: A Meta-Analysis of 218,166 Adults and 19,268 Children. PLoS Med 8(11): e1001116. doi:10.1371/journal.pmed.1001116
Perspective: Veerman JL (2011) On the Futility of Screening for Genes That Make You Fat. PLoS Med 8(11): e1001114. doi:10.1371/journal.pmed.1001114
