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Background: The physical function of elderly individuals reflects whether they have had a history of regular physical activity over the long term. Such indicators have been found to have a certain connection with cognitive function these years. However, there is limited research that associates it with mechanisms such as cerebral Aβ deposition. We aim to investigate this relationship and unveil the underlying mechanisms. Method: Physical function and cognition data of 4189 participants were obtained from the Chinese preclinical Alzheimer's disease study. Participants were divided into six groups according to disease severity. Among them, 1048 participants underwent the positron emission tomography‐computed tomography (PET‐CT) and plasma biomarker test. Grip strength and gait were combined into a score indicating physical function. Multiple linear regression models and logistic regression models were mainly used to conduct the analysis. Results: There was a significant positive correlation between physical function and cognitive function (R = 0.48, p < 0.001), independent of sex, age, apolipoprotein E‐ε4 genotype, and disease stages (p < 0.001). Physical function was effective in distinguishing individuals with cognitive impairment from those without (AUC = 0.835). Physical function was negatively associated with brain Aβ deposition (p = 0.008) and brain Aβ had an intermediary effect (p < 0.01) on the association between physical function and cognition in women. This association was mainly evident in the lateral parietal, lateral temporal, posterior cingulate, frontal, occipital, and precuneus regions. Physical function was negatively associated with plasma neurofilament light‐chain (Nfl) level (p < 0.001). Conclusions: Physical function is strongly associated with cognitive function in the Chinese elderly, and brain Aβ deposition partly mediates the linkage in women. Plasma Nfl can be used as a potential target for exercise intervention in cognitive function. Improving physical function will contribute to the alleviation of cognition decline. [ABSTRACT FROM AUTHOR]

Background: Ageing, sex and polypharmacy affect physical function. Objectives: This mouse study investigates how ageing, sex and polypharmacy interact and affect grip strength, balance beam and wire hang, correlating and comparing the different test results between and within subgroups. Methods: Young (2.5 months) and old (21.5 months) C57BL/6 J male and female mice (n = 10–6/group) were assessed for physical function at baseline on grip strength, balance beam and wire hang with three trials of 60 s (WH60s) and one trial of 300 s (WH300s). Mice were randomised to control or diet containing a high Drug Burden Index (DBI, total anticholinergic and sedative drug exposure) polypharmacy regimen (metoprolol, simvastatin, citalopram, oxycodone and oxybutynin at therapeutic oral doses). Following 6–8 weeks of treatment, mice were reassessed. Results: High DBI polypharmacy and control mice both showed age group differences on all tests (p < 0.05). Only control mice showed sex differences, with females outperforming males on the WH60s and balance beam for old mice, WH300s for young mice (p < 0.05). Polypharmacy reduced grip strength in all subgroups (p < 0.05) and only in old females reduced wire hang time and cumulative behaviour and balance beam time and %walked (p < 0.05). Physical function assessments were all correlated with each other, with differences between subgroups (p < 0.05), and mice within subgroups showed interindividual variability in performance. Conclusion: Age, sex and polypharmacy have variable effects on different tests, and behavioural measures are useful adjuvants to assessing performance. There was considerable within‐group variability in change in measures over time. These findings can inform design and sample size of future studies. [ABSTRACT FROM AUTHOR]

Background: The efficacy of creatine replacement through supplementation for the optimization of physical function in the population at risk of functional disability is unclear. Methods: We conducted a systematic literature search of MEDLINE, EMBASE, the Cochrane Library, and CINAHL from inception to November 2022. Studies included were randomized controlled trials (RCTs) comparing creatine supplementation with placebos in older adults and adults with chronic disease. The primary outcome was physical function measured by the sit‐to‐stand test after pooling data using random‐effects modeling. We also performed a Bayesian meta‐analysis to describe the treatment effect in probability terms. Secondary outcomes included other measures of physical function, muscle function, and body composition. The risk of bias was assessed using the Cochrane risk‐of‐bias tool. Results: We identified 33 RCTs, comprising 1076 participants. From six trials reporting the primary outcome, the pooled standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]: 0.01–1.00; I2 = 62%; P = 0.04); using weakly informative priors, the posterior probability that creatine supplementation improves physical function was 66.7%. Upper‐body muscle strength (SMD: 0.25; 95% CI: 0.06–0.44; I2 = 0%; P = 0.01), handgrip strength (SMD 0.23; 95% CI: 0.01–0.45; I2 = 0%; P = 0.04), and lean tissue mass (MD 1.08 kg; 95% CI: 0.77–1.38; I2 = 26%; P < 0.01) improved with creatine supplementation. The quality of evidence for all outcomes was low or very low because of a high risk of bias. Conclusion: Creatine supplementation improves sit‐to‐stand performance, muscle function, and lean tissue mass. It is crucial to conduct high‐quality prospective RCTs to confirm these hypotheses (PROSPERO number, CRD42023354929). [ABSTRACT FROM AUTHOR]

Background: The physical challenges faced by adolescents and young adults (AYA) after a cancer diagnosis may be different from those experienced by paediatric and older adult cancer patients. Patient‐reported outcome measures (PROMs) are valuable tools that can be useful in exploring the experiences of AYAs and identifying important issues, recurrent themes and areas to potentially improve quality of life. Objective: We compared patient‐reported physical function outcomes between AYAs diagnosed with cancer and non‐cancer controls. Method: This paper builds on a scoping review published in early 2023 and focuses on PROMs related to physical function. Results: This systematic review includes 16 studies that measured and reported on physical function PROMs in AYA cancer survivors compared with their cancer‐free peers. Of these studies, 14 found that physical function in AYA survivors was significantly worse. This paper also includes a meta‐analysis conducted on 5 studies using the EORTC‐QLQ‐C30 to measure physical function, which found that physical function score was an average of 7.03 (95% CI: −10.21, −3.86) points lower in the AYA cancer group, compared to their cancer free‐peers, a difference that is clinically meaningful. Conclusions: The results overwhelmingly demonstrate that AYAs post a cancer diagnosis have worse health‐related quality of life from a physical function perspective than their cancer‐free peers, providing a compelling argument for the need to address this issue. All but one of the studies were cross‐sectional, which highlights the need for further assessment of this group longitudinally throughout their cancer journey. [ABSTRACT FROM AUTHOR]

Age‐related alterations in physiology lead to declines in physical function that are associated with numerous adverse outcomes among older adults. Utilizing a hybrid design, we aimed to understand whether both long‐term and short‐term Tai Chi (TC) training are associated with age‐related decline in physical function in healthy older adults. We first conducted cross‐sectional comparisons among TC‐naïve older adults (n = 60, 64.2 ± 7.7 years), TC‐expert older adults (n = 27, 62.8 ± 7.6 years, 24.5 ± 12 years experience), and TC‐naïve younger adults (n = 15, 28.7 ± 3.2 years) to inform long‐term effects of TC training on physical function, including single leg stance time with eyes closed, grip strength, Timed Up and Go, maximum walking speed, functional reach, and vertical jump for lower‐extremity power. There were significant differences among the three groups on all the six tests. For most functional tests, TC‐experts performed better than age‐matched TC‐naïve controls and were statistically indistinguishable from young healthy adult controls. Long‐term TC training was associated with higher levels of physical function in older adults, suggesting a potential preventative healthy aging effect. In the randomized longitudinal trial, TC‐naïve subjects were randomized (n = 31 to Tai Chi group, n = 29 to usual care control group) to evaluate the short‐term effects of TC over 6 months on all outcomes. TC's short‐term impacts on physical function were small and not statistically significant. The impact of short‐term training in healthy adults is less clear. Both potential longer‐term preventive effects and shorter‐term restorative effects warrant further research with rigorous, adequately powered controlled clinical trials. [ABSTRACT FROM AUTHOR]

Introduction: Intradialytic exercise is essential for improving physical function for older patients. This study aimed to examine the relationship between the effects of exercise therapy and aging. Methods: This multicenter cohort study included 1176 patients aged 40–89 years, who participated in an intradialytic exercise program, comprising stretching and resistance training, three times per week for 12 months. Isometric knee extension strength (IKES), 10‐m walking speed, Short Physical Performance Battery (SPPB), and Geriatric Nutritional Risk Index (GNRI) were measured at baseline and after 12 months. The patients were divided according to age as follows: 40–59, 60–69, 70–79, and 80–89 years. A linear mixed‐effects model examined the improvement within‐group and between‐control differences, as the 40–59 age group was the control group. Findings: The 40–59, 60–69, 70–79, and 80–89 age groups comprised 180, 317, 466, and 213 participants, respectively. Within‐group differences, all the age groups significantly improved IKES and SPPB. The 10‐m walking speed [0.02 (0.02) m/s] and GNRI [0.38 (0.33)] did not improved only in the 80–89 age group despite other age groups significantly improved. Between‐control differences, IKES of the 70–79 age group [−0.24 (−0.42 to −0.06) %] was significantly lower improvement than control. GNRI of all the older groups were significantly smaller improvement than control (p < 0.05). Discussion: The older group demonstrated difficulty in improving walking ability and nutritional status compared with the younger groups. Clinicians need to consider the difference in effectiveness due to age and prescribe intradialytic exercises accordingly. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the crucial roles of physical function (PF) and physical activity (PA) in axial spondyloarthritis (axSpA) patients, as well as their correlation with disease activity (DA), and to explore the influence of general characteristics among them. Methods: We enrolled axSpA patients from Xijing Hospital, spanning March 2022 to August 2022. Spearman rank correlation coefficients were used to assess correlations between PA (measured by the Global Physical Activity Questionnaire [GPAQ]), PF (measured by the Assessment of Spondyloarthritis international Society Health Index [ASAS‐HI], the Short Form 36‐Item Health Survey [SF‐36], and the Bath Ankylosing Spondylitis Functional Index [BASFI]), DA, and their influencing factors. A Mann–Whitney U‐test and Kruskal–Wallis H‐test were used to compare variables between different patients grouped by sex, human leukocyte antigen B27 (HLA‐B27), hip involvement, and intensity of PA and DA. Results: Three hundred fifty‐five axSpA patients were included. We observed a moderate to strong correlation between DA and PF in axSpA patients. PA was weakly correlated with DA or PF. DA varied significantly at different PA levels, and patients with low PA levels had poorer PF. Active patients had worse PF, less transport‐related PA, and a higher rate of hip involvement with a worse Harris Hip Score (HHS). Conclusions: We identified a close relationship between DA, PF, and PA in axSpA patients. Further, gender, HLA‐B27, and hip involvement affected the clinical manifestation of axSpA patients. These findings demonstrate that clinical remission of axSpA patients requires a comprehensive assessment rather than a single remission of DA. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the intricate relationship between physical function factors and each subcategory score of the Anterior Cruciate Ligament‐Return to Sport after Injury (ACL‐RSI) scale among patients following ACL reconstruction. Methods: Participants comprised 59 patients who had undergone primary ACL reconstruction using hamstring tendon. The ACL‐RSI was completed 6 months after reconstruction and five physical functions were measured in patients on the same day. Simple linear regression was performed multiple times to investigate the relationship between ACL‐RSI subcategory scores as a dependent variable and each independent variable (knee strength, leg anterior reach distance, single‐leg hop [SLH] distances, side bridge endurance, and subjective running ability). Multiple regression analysis was performed using a stepwise method, with factors showing a risk rate <0.05 in simple linear regression analyses as independent variables and the ACL‐RSI in each subcategory score as the dependent variable. Results: Multiple regression analysis showed that subjective running ability affected all subcategories (p ≤ 0.001), and that the limb symmetry index of medial SLH distance affected both the Emotions (p = 0.047) and Confidence (p = 0.009) subcategories. Higher subjective running ability and greater limb symmetry in the medial SLH were thus positively associated with each dimension of psychological readiness. Conclusions: This study highlights the differential impact of physical function factors on specific subcategories of the ACL‐RSI scale, providing clinicians with insights for designing targeted rehabilitation strategies. This original paper suggests the importance of analysing factors related to subcategory scores in addition to total ACL‐RSI score, and could contribute to the understanding of determinants for a successful return to sport following ACL reconstruction. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Background: People with HIV (PWH) are prone to mobility impairments and physical dysfunction, with the loss of skeletal muscle quantity and quality being a major contributor to the dysfunction. Assessment of skeletal muscle is an important component of care for this patient population for early intervention and treatment. The use of non‐invasive imaging techniques to evaluate skeletal muscle, such as dual X‐ray absorptiometry, computer tomography and magnetic resonance imaging, has increased in popularity in recent years. Purpose: This narrative review synthesizes the use of these techniques and summarizes the associations between outcomes from these imaging modalities and physical function in PWH. [ABSTRACT FROM AUTHOR]

Introduction: Recent recommendations of core outcome sets for haemophilia highlight the need for including measures of performance‐based physical health and physical function sustainability. To date, there is no consensus on what outcomes might be of value to clinicians and patients. Aim: To identify instruments of performance‐based physical function to monitor musculoskeletal health in people with haemophilia that are practical in the clinical setting. Methods: Utilising components from the Activities and Participation Category of the WHO International Classification of Functioning (WHO‐ICF), a consensus‐based, decision analysis approach was used to: identify activities people with haemophilia have most difficulty performing; identify quantitative performance‐based measures of identified activities via a scoping review; and obtain views on acceptability of the tests utilising a DELPHI approach. Results: Eleven activities were identified: maintaining a standing position, walking long distances, walking up and down stairs, walking on different surfaces, running, hopping, jumping, squatting, kneeling, undertaking a complex lower limb task, undertaking a complex upper limb task. Following a 2‐round DELPHI survey of international physiotherapists, the 6‐min walk test, timed up and down stairs, 30‐s sit to stand, single leg stance, tandem stance, single hop for distance (children only) and timed up and go (adults only) reached consensus. Conclusion: This study is the first step in defining a core set of performance‐based instruments to monitor physical health and sustainability of physical function outcomes in people with haemophilia. Establishing the psychometric properties of the instruments and whether they are meaningful to people with haemophilia is essential. [ABSTRACT FROM AUTHOR]

Background: Several studies describe poorer motor developmental motor outcomes post‐liver transplant (LT) in younger children. Limited studies examine physical function in older children and adolescents pre‐ and post‐LT. Methods: Retrospective review of standard of care physical function outcome measures pre‐ and 1‐year post‐LT in children ≥6 years at LT. Measures include: 6‐minute walk test (6MWT), grip strength, Bruininks‐Oseretsky Test of Motor Proficiency‐2 (BOT‐2) components, Physical Activity Questionnaire (PAQ), and Paediatric Quality of Life Multidimensional Fatigue Scale. Association of medical variables with outcomes was explored. Results: The study cohort included 23 (8 male, median (interquartile range) age 11.67 (8.25, 13.92) years at LT) participants. Top two primary diagnoses included biliary atresia (30.4%) and fulminant hepatic failure (21.7%). At 1‐year post‐LT, over one‐third (36%) were overweight or obese. Compared with healthy norms, children had significantly lower pre‐LT PAQ scores (p =.002), pre‐ and post‐6MWT scores (p <.001) and post‐LT BOT‐2 strength and agility scores (p <.001). Pre‐LT, lower balance scores were associated with abdominal distention/ascites (p =.009) and splenomegaly (p =.017). Lower pre‐LT platelet count correlated with poorer balance (r =.532, p =.017) and lower strength and agility scores (r =.446, p =.043). Significant moderate inverse correlations were found between weight/body mass index z‐scores and BOT‐2 components. Post‐LT children continue to demonstrate decreased levels of motor proficiency and functional capacity but report less fatigue and increased physical activity. Conclusions: Older children and adolescents undergoing LT are at risk of decreased physical function, highlighting the need for pre‐ and post‐LT rehabilitation to optimize long term outcomes. [ABSTRACT FROM AUTHOR]

Understanding individual variability in response to physical activity is key to developing more effective and personalised interventions for healthy ageing. Here, we aimed to unpack individual differences by using longitudinal data from a randomised‐controlled trial of a 12‐month muscle strengthening intervention in older adults. Physical function of the lower extremities was collected from 247 participants (66.3 ± 2.5 years) at four time‐points. At baseline and at year 4, participants underwent 3 T MRI brain scans. K‐means longitudinal clustering was used to identify patterns of change in chair stand performance over 4 years, and voxel‐based morphometry was applied to map structural grey matter volume at baseline and year 4. Results identified three groups showing trajectories of poor (33.6%), mid (40.1%), and high (26.3%) performance. Baseline physical function, sex, and depressive symptoms significantly differed between trajectory groups. High performers showed greater grey matter volume in the motor cerebellum compared to the poor performers. After accounting for baseline chair stand performance, participants were re‐assigned to one of four trajectory‐based groups: moderate improvers (38.9%), maintainers (38.5%), improvers (13%), and decliners (9.7%). Clusters of significant grey matter differences were observed between improvers and decliners in the right supplementary motor area. Trajectory‐based group assignments were unrelated to the intervention arms of the study. In conclusion, patterns of change in chair stand performance were associated with greater grey matter volumes in cerebellar and cortical motor regions. Our findings emphasise that how you start matters, as baseline chair stand performance was associated with cerebellar volume 4 years later. [ABSTRACT FROM AUTHOR]

Background: This study aims to examine the association between mobility limitations and emotional dysfunction among older Ghanaians and evaluate the buffering effect of physical activity (PA) and social ties in this association. Methods: The analysis included 1201 adults aged ≥50 from the 2016‐17 Aging, Health, Psychological Well‐being, and Health‐seeking Behavior study. The Medical Outcomes Study Short Form‐36 (MOS SF‐36) assessed mobility limitations and emotional dysfunction. We measured PA using the International Physical Activity Questionnaire Short Form (IPAQ‐SF). Hierarchical OLS regressions were performed to evaluate the hypothesized direct and interactive relationships. Results: The mean age of the sample was 66.2 (SD = 11.9), and 63.3% were women. After full adjustment for potential confounders, OLS regressions found that mobility limitations increased the risk of emotional dysfunction (β = 0.113, p = 0.004). Moreover, social ties (β = −0.157, p < 0.001) and PA (β = −0.096, p < 0.001) were independently and negatively associated with emotional dysfunction. We finally found a significant effect modification of the association of mobility limitations with emotional dysfunction by PA (β = −0.040, p < 0.002) and social ties (β = −0.013, p = 0.013). Conclusions: Mobility‐enhancing strategies such as engagement in positive behavioral choices, focusing on regular PA, and maintaining resourceful interpersonal social networks can mitigate the impact of mobility limitations on emotional dysfunction in later life. Key points: This study included a large, representative older sample with and without mobility limitations in an innovative setting of the sub‐Saharan African context.Mobility limitations were significantly and independently associated with the risk of emotional dysfunction (β = 0.113, p < 0.005).The physically active and socially connected older persons experienced lower mobility‐induced emotional dysfunction than their physically inactive and socially isolated counterparts. [ABSTRACT FROM AUTHOR]

Summary: Weight‐lowering pharmacotherapies provide an option for weight management; however, their effects on physical activity, function, and cardiorespiratory fitness are not fully understood. We conducted a systematic review and meta‐analysis of randomized controlled trials to investigate the effect of licensed weight loss pharmacotherapies on physical activity, physical function, and cardiorespiratory fitness in individuals with obesity. Fourteen trials met our prespecified inclusion criteria: Five investigated liraglutide, four semaglutide, three naltrexone/bupropion, and two phentermine/topiramate. All 14 trials included a self‐reported measure of physical function, with the pooled findings suggesting an improvement favoring the pharmacotherapy intervention groups (SMD: 0.27; 95% CI: 0.22 to 0.32) and effects generally consistent across different therapies. Results were also consistent when stratified by the two most commonly used measures: The Short‐Form 36‐Item Questionnaire (SF‐36) (0.24; 0.17 to 0.32) and the Impact of Weight on Quality Of Life‐Lite (IWQOL‐Lite) (0.29; 0.23 to 0.35). Meta‐regression confirmed a significant association between pharmacotherapy induced weight loss and improved physical function for IWQOL‐Lite (p = 0.003). None of the studies reported a physical activity outcome, and only one study reported objectively measured cardiorespiratory fitness. Improvements in self‐reported physical function were observed with weight loss therapy, but the effect on physical activity or objectively measured physical function and fitness could not be determined. [ABSTRACT FROM AUTHOR]

Background: Cancer supportive care interventions often have limited generalizability, goal misalignment, and high costs. We developed and piloted a health coaching intervention, UNC HealthScore, in patients undergoing cancer treatment (ClinicalTrials.gov identifier NCT04923997). We present feasibility, acceptability, and preliminary outcome data. Methods: HealthScore is a six‐month, theory‐based, multicomponent intervention delivered through participant‐driven coaching sessions. For the pilot study, participants were provided a Fitbit, responded to weekly symptom and physical function digital surveys, and met with a health coach weekly to develop and monitor goals. Coaching notes were discussed in weekly interdisciplinary team meetings and provided back to the treating oncology team. Symptom alerts were monitored and triaged through a study resource nurse to relevant supportive care services. Feasibility was determined based on intervention enrollment and completion. Acceptability was based on satisfaction with coaching and Fitbit‐wearing and was informed by semistructured exit interviews. Outcomes evaluated for signs of improvement included several PROMIS (Patient‐Reported Outcomes Measurement Information System) measures, including the primary intervention target, physical function. Results: From May 2020 to March 2022, 50 participants completed the single‐arm pilot. Feasibility was high: 66% enrolled and 71% completed the full intervention. Participants reported an average of 4.8 and 4.7 (out of 5) on the acceptability of coaching calls and using the Fitbit, respectively. Physical function scores rose 3.1 points (SE = 1.1) from baseline to 3 months, and 4.3 (SE = 1.0) from baseline to 6 months, above established minimal clinically important difference (MCID). Improvements above MCID were also evident in anxiety and depression, and smaller improvements were demonstrated for emotional support, social isolation, cognitive function, symptom burden, and self‐efficacy. Discussion: HealthScore shows feasibility, acceptability, and promising preliminary outcomes. Randomized studies are underway to determine the efficacy of preserving physical function in patients with advanced cancer. [ABSTRACT FROM AUTHOR]

Introduction: Peripheral artery disease (PAD) is commonly observed in patients undergoing hemodialysis. PAD impairs the vasculature and leads to pathophysiologic changes in the skeletal muscles, causing physical function impairment and physical inactivity in general. However, it is unclear whether PAD adversely affects physical function and physical activity in patients on hemodialysis. Methods: We performed a cross‐sectional study with a retrospective review of the data to determine whether PAD is associated with impaired physical function and physical activity in patients undergoing hemodialysis. The study population comprised 310 patients and 88 healthy subjects. PAD was diagnosed based on an ankle‐brachial index of <1.00 in patients on hemodialysis. Measurements of physical function included maximum walking speed, muscle strength in the lower extremities, and balance while standing. Findings: Of the 310 patients, 84 (27.1%) had PAD. When patients undergoing hemodialysis were divided into those without PAD and those with PAD, both groups had poorer physical function and physical activity than the healthy control subjects. After adjustments for potential confounders, it was found that patients on hemodialysis with PAD had slower walking speed, poorer standing balance, and less physical activity than those without PAD. However, there was no significant difference in lower extremity muscle strength between the two groups. Discussion: PAD diagnosed based on an ankle‐brachial index of <1.00 was independently associated with impaired physical function and reduced physical activity in patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

The biological mechanisms underlying decline in physical function with age remain unclear. We examined the plasma proteomic profile associated with longitudinal changes in physical function measured by gait speed and grip strength in community‐dwelling adults. We applied an aptamer‐based platform to assay 1154 plasma proteins on 2854 participants (60% women, aged 76 years) in the Cardiovascular Health Study (CHS) in 1992–1993 and 1130 participants (55% women, aged 54 years) in the Framingham Offspring Study (FOS) in 1991–1995. Gait speed and grip strength were measured annually for 7 years in CHS and at cycles 7 (1998–2001) and 8 (2005–2008) in FOS. The associations of individual protein levels (log‐transformed and standardized) with longitudinal changes in gait speed and grip strength in two populations were examined separately by linear mixed‐effects models. Meta‐analyses were implemented using random‐effects models and corrected for multiple testing. We found that plasma levels of 14 and 18 proteins were associated with changes in gait speed and grip strength, respectively (corrected p < 0.05). The proteins most strongly associated with gait speed decline were GDF‐15 (Meta‐analytic p = 1.58 × 10−15), pleiotrophin (1.23 × 10−9), and TIMP‐1 (5.97 × 10−8). For grip strength decline, the strongest associations were for carbonic anhydrase III (1.09 × 10−7), CDON (2.38 × 10−7), and SMOC1 (7.47 × 10−7). Several statistically significant proteins are involved in the inflammatory responses or antagonism of activin by follistatin pathway. These novel proteomic biomarkers and pathways should be further explored as future mechanisms and targets for age‐related functional decline. [ABSTRACT FROM AUTHOR]

Muscle power training with emphasis on high‐velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail or have an ongoing acute or chronic disease, condition or illness; (3) study participants over the age of 18; (4) publication in English language; (5) included physical function as the primary or secondary outcome measures. Two independent reviewers assessed articles for inclusion and graded the methodological quality using Cochrane Risk‐of‐Bias tool for RCTs. Fourteen RCTs met the inclusion criteria. In seven studies, muscle power training was more effective at improving physical function compared to control activities with a mean fixed effect size (ES) of 0.41 (p = 0.006; 95% CI 0.12 to 0.71). Power training and conventional resistance training had similar effectiveness in eight studies with a mean fixed ES of 0.10 (p = 0.061; 95% CI –0.01 to 0.40). Muscle power training is just as efficacious for improving physical function in individuals diagnosed with frailty and chronic disease when compared to traditional resistance training. The advantages of power training with reduced work per session may support power training as a preferential exercise modality for clinical populations. The findings should be interpreted with caution since generalizability is questioned due to the heterogeneity of patient populations enrolled and participants were relatively mobile at baseline. [ABSTRACT FROM AUTHOR]

We aimed to investigate the factors associated with dropout from a physical function assessment program among participants receiving outpatient hemodialysis (HD). The participants were divided into continuation and dropout groups and followed up for 3 years after the initial physical function assessment. Multivariate logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the dropout group to determine the factors associated with dropout from the physical function assessment program. The continuation and dropout groups included 43 and 58 participants, respectively. The continuation group had a significantly higher self‐efficacy (SE) and age than the dropout group (p = 0.001, p = 0.047). Multivariate logistic regression analysis indicated that only SE (OR: 1.202, 95% CI: 1.082–1.334) remained a significant predictor after adjustment (p < 0.05). There is a need to evaluate SE to prevent dropout from physical functioning assessment programs. [ABSTRACT FROM AUTHOR]

Introduction: Dual-task (DT) exercise can act as a substitute, which can help improve both physical and cognitive functions. Thus, this study investigated the effects of a game-like cognitive DT exercise called "Synapsology" (SYNAP) among the oldest residents of a nursing home. Methods: Participants (aged 85-97 years) were assigned to the intervention group (n = 12) and the control group (n = 12). The intervention group underwent 60-minute sessions, twice a week for 24 weeks. Results: A comparison of the Mini-Mental State Examination scores and six physical function tests, before and after the intervention, shows that the SYNAP had a positive impact on the cognitive and physical functions among the intervention group. Discussion: These findings suggest that SYNAP may help maintain or improve cognitive and physical functions among older adults compared to no interventions. Therefore, SYNAP would act as a beneficial tool amidst a "superaging" society like Japan. [ABSTRACT FROM AUTHOR]

Background: Chronic low‐grade inflammation has been suggested as one of the key elements in the development of sarcopenia, but in contrast to disease‐related loss of muscle mass, the role of chronic low‐grade inflammation in age‐related (primary) sarcopenia is still not clear. The aim of this study was to investigate low‐grade inflammation in relation to age and the potential association between inflammatory biomarkers and body composition, muscle strength and physical performance in a healthy Danish cohort. Methods: There were 1160 generally healthy men and women (range: 22–93 years) included. Appendicular lean mass (ALM) and visceral fat normalized to height (kg/m2) was assessed by dual‐energy X‐ray absorptiometry (iDXA, GE Lunar). Muscle strength and physical performance were evaluated by handgrip strength (HGS), 30 s sit‐to‐stand performance, and maximal gait speed (GS). Systemic levels of TNF‐α, IL‐6, IL‐1β, IL‐4, IL‐13, and IFN‐γ were measured using multiplex bead‐based immunoassays (Bio‐Rad). hsCRP was assessed using latex particle‐enhanced immunoturbidimetric assays (Roche Diagnostics). Results: With age, ALM/h2, HGS, sit‐to‐stand performance and GS decreased, whereas visceral fat/h2 increased in both men and women (P < 0.05). Systemic levels of hsCRP, TNF‐α, IL‐4, and IFN‐γ increased with age in men and women (P < 0.05), while IL‐1β increased in women only (P < 0.01). Higher levels of hsCRP were associated with lower ALM/h2 in elderly (≥65 years) men and women (P < 0.001). Higher levels of hsCRP were associated with lower handgrip strength in elderly women (P < 0.05) whereas higher levels of hsCRP was not associated with lower HGS in elderly men (P = 0.056). Higher levels of hsCRP were associated with lower GS (P < 0.05), whereas IFN‐γ was positively associated with GS in elderly women (P < 0.05), but not elderly men. Visceral fat index was positively associated with hsCRP in elderly men and women (P < 0.001). Compared with elderly with normal HGS, elderly men and women with low HGS displayed higher levels of TNF‐α and hsCRP (P < 0.05). Conclusions: With age, systemic levels of hsCRP, TNF‐α, IL‐4, and IFN‐γ increased, with hsCRP and TNF‐α being especially elevated in more physically frail elderly supporting the association between low‐grade systemic inflammation and poor physical function. In contrast, only high levels of hsCRP were weakly associated with low muscle mass and positively associated with visceral fat and low physical function, suggesting that chronic low‐grade inflammation is not the main driver of age‐related loss of muscle mass as previously suggested. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a known risk factor for poor outcomes across many chronic diseases. The impact on outcomes of both pre‐existing sarcopenia and acute muscle wasting (AMW) in acute critical illness caused by sepsis remain unclear. Methods: We conducted a prospective longitudinal cohort study of critically ill patients with intra‐abdominal sepsis utilizing abdominal computed tomography at sepsis onset to determine baseline skeletal muscle index (SMI). Biomarkers of inflammation and catabolism were measured through 28 days while hospitalized. We performed follow‐up evaluations of strength and physical function at 3, 6, and 12 months, with interval CT analyses at 3 and 12 months to evaluate changes in muscle mass. Measured clinical outcomes included development of chronic critical illness (≥14 days in intensive care with persistent organ dysfunction), long‐term functional status, and 1 year mortality. Results: Among 47 sepsis patients enrolled (mean age 53 ± 14 years), half (n = 23; 49%) were sarcopenic at baseline. Overall, sepsis patients exhibited acute and persistent muscle wasting with an average 8% decrease in SMI from baseline at 3 months (P = 0.0008). Sarcopenic (SAR) and non‐sarcopenic (NSAR) groups were similar in regards to age and comorbidity burden. SAR patients had greater acute physiologic derangement (APACHE II, 18 vs. 12.5), higher incidence of multiple organ failure (57% vs. 17%), longer hospital (21 vs. 12 days) and intensive care unit length of stays (13 vs. 4 days), and higher inpatient mortality (17% vs. 0%; all P < 0.05). Pre‐existing SAR was a strong independent predictor of early death or developing chronic critical illness (odds ratio 11.87, 95% confidence interval CI 1.88–74.9; P = 0.009, area under the curve 0.880) and was associated with significantly higher risk of 1‐year mortality (34.9% vs. 4.2%, p = 0.007). Lower baseline SMI was also predictive of poor functional status at 12 months (OR 0.89, 95% confidence interval 0.80–0.99; p = 0.039, area under the curve 0.867). Additionally, SAR patients had AMW with persistent muscle mass loss at 3 months that was associated with decreased health‐related quality of life and SF‐36 physical function domains (P < 0.05). Persistent AMW at 3 months was not predictive of mortality or poor functional status, with return to near‐baseline muscle mass among sepsis survivors by 6 months. Conclusions: Critically ill patients have an acute and persistent loss of muscle mass after intra‐abdominal sepsis, which is associated with decreased health‐related quality of life and physical function at 3 months. However, pre‐existing sarcopenia, rather than persistent acute muscle mass loss at 3 months after sepsis, is independently associated with poor long‐term functional status and increased 1 year mortality. [ABSTRACT FROM AUTHOR]