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Traditional methods for assessing lower body strength and balance, particularly in older individuals, lack objective and comprehensive analysis. The Up-Down Hop Test is widely used, yet leveraging mobile device sensors, specifically accelerometers and gyroscopes, can enhance the effectiveness of the Up-Down Hop Test by providing an objective evaluation of lower body strength, balance, and neuromuscular control. This study involved attaching mobile devices to participants during the Up-Down Hop Test. Data from the sensors were analyzed to assess patterns of body imbalance and fatigue, focusing on older participants. Integrating mobile sensor data offered insights into the participants' physical performance, revealing specific patterns of imbalance and fatigue. Although traditional assessment methods can observe these patterns, they lack measurability and auditability when evaluating the physical performance of older adults. The experimental results, obtained from analyzing data from mobile device sensors during the Up-Down Hop Test, revealed patterns of imbalance. These findings can be utilized in health monitoring and targeted intervention scenarios, specifically those aimed at enhancing physical performance and preventing injuries. [ABSTRACT FROM AUTHOR]

The Japanese Orthopaedic Association (JOA) introduced the concept of locomotive syndrome (LS), which indicates a decline in mobility function by musculoskeletal disorders with new 3-staged category. Additionally, sarcopenia indicates a decline in the quantity and/or quality of skeletal muscle. However, the relationship between low back pain (LBP) and LS or sarcopenia in older people has not been sufficiently understood. This study aimed to investigate the association between them through a cross-sectional locomotorium survey. A total of 302 participants were drawn from the aquatic exercise participants in a rural area of Japan. The body mass index, body fat percentage, skeletal muscle mass index (SMI), spinal inclination angle (SIA), grip strength, timed up-and-go test (TUG), and maximum stride of the participants were measured. LBP and LBP-related quality of life (QOL) were evaluated using the Oswestry Disability Index (ODI), visual analogue scale (VAS) of LBP, and the Short-Form 8 (SF-8). Associations between the investigating parameters and sarcopenia or LS were analyzed. There were no significant differences in the findings except grip strength between the non-sarcopenia and sarcopenia groups. However, the LS group showed significantly larger SIA, higher ODI, higher VAS of LBP, lower physical component score (PCS) of the SF-8, longer time in TUG, and lower value in maximum stride than the non-LS group. In addition, the ODI and PCS of the SF-8 significantly deteriorated as the LS stage progressed, and the GLFS-25 score was significantly correlated with ODI (r = 0.706, p < 0.001) and PCS (r = −0.643, p < 0.001) scores. LBP, LBP-related QOL, and physical performance were found to be significantly associated with LS, not sarcopenia, with LBP-related QOL and physical function being closely correlated with 3-stage categories of LS. Thus, these results suggested that LBP is a key factor for LS prevalence. [ABSTRACT FROM AUTHOR]

China is on the brink of transitioning into an aged society, resulting in a growing demand for an age-friendly street-built environment. However, previous research has paid limited attention to the differentiated walking needs of older adults. To address this gap, this study investigated the relationship between street-built environments and the subjective perception of older adults with different physical capabilities, focusing on safety, comfort, and interest. The older adults were classified into three types based on their physical mobility abilities. The TrueSkill algorithm was used to develop an online image selection website to obtain perception scores for sampled pictures from these three types of older adults. Image segmentation and deep learning were combined to extract indices of street view factors, and machine learning was used to train a scoring prediction model for all streetscape pictures of the area. The study found differences in the subjective perception among all three types of older adults, namely independent elderly (A), mediated-assisted elderly (B), and dependent elderly (C). Type A older adults might be attracted to factors related to the interest of walking despite their negative impact on safety and comfort; Type B older adults were more concerned about street conditions for safety and comfort. Type C older adults were prone to the convenience of barrier-free access and visibility. This study contributes to the study of walkability by providing a research framework for the subjective walking perceptions of older adults with different physical capabilities. Additionally, the visualized walkability map can serve as a reference for architects and urban designers, further strengthening the development of age-friendly communities with the aid of human-centric computational analysis, evaluation, and design. • Refines walkability research for older adults by categorizing and studying them based on walking abilities, showing differences by physical conditions. • Explores the relationship between subjective perceptions and the objective built environment, focusing on long-established communities. • Uncovers implicit needs and tendencies using picture selection and the TrueSkill rating method. • Uses pedestrian-perspective street view images instead of the commonly used vehicular-perspective images for research. [ABSTRACT FROM AUTHOR]

• Study suggests exercise may help prevent traffic injuries. • Elderly people who do not exercise have a gap between their awareness and behavior when crossing the street. • A high percentage of elderly people are able to react in some way when they are about to have an injury. Introduction: In recent years, the percentage of elderly fatalities in traffic crashes in Japan has been increasing and has exceeded 50% since 2010. The fatality rate is high for the elderly due to the deterioration of physical functions. Method: The purpose of this study was to reduce the high fatality rate of elderly people at the time of the crash and to find out the effective exercise elements for maintaining physical functions, and to deter traffic crashes and reduce the fatality rate of the elderly people. Results: The effect of exercise on improving and maintaining physical fitness was remarkable, and even when encountering a near miss injuries or crashes, the percentage of the group that was able to respond in some way to a near miss or crashes was higher in the group that regularly exercised. The elderly who do not exercise tend to take longer to start crossing and tend to check both sides of the road less often while crossing. In addition, when they were about to encounter a car, they tended to continue walking, which tended to lead to dangerous crossing. Conclusion: As a result of the questionnaire survey, the possibility of preventing traffic crashes by participating in sports was confirmed. As a result of running experiments using a crossing simulator, it was found that elderly people who do not exercise have a gap between their usual awareness of crossing and their actual behavior. Practical implications: Through the discovering elements of exercise that are useful in reducing injuries will make it possible to provide accurate guidance and training to elderly people with reduced physical functions, and it is expected that pedestrians will be able to avoid traffic injuries with their own abilities. [ABSTRACT FROM AUTHOR]

In recent years the focus of healthcare and nutritional science in older adults has shifted from mortality towards physical performance and quality of life. The aim of this review was to summarize observational studies on physical performance in malnourished (MN) or at risk of malnutrition (RMN) older adults compared with well-nourished (WN) older adults. Eligible studies had to report on nutritional status and objectively measured physical performance in older adults (≥60 y). MN or RMN groups had to be compared with a WN group, measured with a validated nutrition screener. Ovid Medline and Web of Science were searched until 13 November, 2020. Study quality was scored using a modified Newcastle–Ottawa Scale (NOS). Results were analyzed by meta-analysis when possible, or narratively reviewed otherwise. Forty-five studies (16,911 participants in total) were included from studies in outpatient clinics (n = 6), nursing homes (n = 3), community-dwelling older adults (n = 20), hospitalized patients (n = 15), or a combination (n = 1). Studies used 11 different screeners of malnutrition, and 8 types of physical performance measures. Meta-analysis showed that compared with MN, WN groups had better hand grip strength (mean difference [MD] = 4.92 kg; 95% CI: 3.43, 6.41; P < 0.001; n = 23), faster gait speed (MD = 0.16 m/s; 95% CI: 0.05, 0.27; P = 0.0033; n = 7), performed faster on timed-up-and-go (MD = –5.94 s; 95% CI: –8.98, –2.89; P < 0.001; n = 8), and scored 1.2 more short physical performance battery points (95% CI: 1.32, 2.73; P < 0.001; n = 6). Results were less pronounced when compared with RMN. Narratively, all studies showed an association for knee extension strength, 6-min walking test, and multicomponent tests, except for the chair stand test. Study limitations include no studies scoring "good" on NOS, lack of confounder adjustment, and high heterogeneity. Overall, evidence from cross-sectional studies indicate an association between malnutrition and worse physical performance in older adults. This study is registered in PROSPERO as CRD42020192893. [ABSTRACT FROM AUTHOR]

Background: Protein intake greater than the currently recommended amount is suggested to improve physical functioning and well-being in older adults, yet it is likely to increase diet-associated greenhouse gas emissions (GHGEs) if environmental sustainability is not considered.Objectives: We aimed to identify dietary changes needed to increase protein intake while improving diet environmental sustainability in older adults.Methods: Starting from the habitual diet of 1,354 Dutch older adults (aged 56-101 y) from the Longitudinal Aging Study Amsterdam cohort, mathematical diet optimization was used to model high-protein diets with minimized departure from habitual intake in cumulative steps. First, a high-protein diet defined as that providing ≥1.2 g protein · kg body weight-1 · d-1 was developed isocalorically while maintaining or improving nutritional adequacy of the diet. Second, adherence to the Dutch food-based dietary guidelines (FBDG) was imposed. Third, a stepwise 10% GHGE reduction was applied.Results: Achieving a high-protein diet aligned with the FBDG without considering GHGEs required an increase in vegetables, legumes, nuts, whole grains, meat/dairy alternatives, dairy, and eggs and a reduction in total meat (for men only) and discretionary products, but it resulted in a 5% increase in GHGEs in men and 9% increase in women. When a stepwise GHGE reduction was additionally applied, increases in poultry and pork (mainly for women) and decreases in beef/lamb and processed meat were accrued, with total meat staying constant until a 50-60% GHGE reduction. Increases in whole grains, nuts, and meat/dairy alternatives and decreases in discretionary products were needed to lower GHGEs.Conclusions: A high-protein diet aligned with FBDG can be achieved in concert with reductions in GHGEs in Dutch older adults by consuming no more than the recommended 500 g meat per week while replacing beef and lamb and processed meat with poultry and pork and increasing intake of diverse plant-protein sources. [ABSTRACT FROM AUTHOR]

Home-based physical therapies are effective if the prescribed exercises are correctly executed and patients adhere to these routines. This is specially important for older adults who can easily forget the guidelines from therapists. Inertial Measurement Units (IMUs) are commonly used for tracking exercise execution giving information of patients' motion data. In this work, we propose the use of Machine Learning techniques to recognize which exercise is being carried out and to assess if the recognized exercise is properly executed by using data from four IMUs placed on the person limbs. To the best of our knowledge, both tasks have never been addressed together as a unique complex task before. However, their combination is needed for the complete characterization of the performance of physical therapies. We evaluate the performance of six machine learning classifiers in three contexts: recognition and evaluation in a single classifier, recognition of correct exercises, excluding the wrongly performed exercises, and a two-stage approach that first recognizes the exercise and then evaluates it. We apply our proposal to a set of 8 exercises of the upper-and lower-limbs designed for maintaining elderly people health status. To do so, the motion of 30 volunteers were monitored with 4 IMUs. We obtain accuracies of 88. 4 % and the 91. 4 % in the two initial scenarios. In the third one, the recognition provides an accuracy of 96. 2 %, whereas the exercise evaluation varies between 93. 6 % and 100. 0 %. This work proves the feasibility of IMUs for a complete monitoring of physical therapies in which we can get information of which exercise is being performed and its quality, as a basis for designing virtual coaches. [Display omitted] • This work covers the complex task of simultaneous exercise recognition and evaluation. • The exercises are characterized using data from four IMUs on the limbs. • Support Vector Machine provides the best metrics compare with other ML algorithms. • Motion recognition is less demanding than its evaluation due to the posture influence. • The inertial data used are publicly available. [ABSTRACT FROM AUTHOR]

Cadmium (Cd) is a toxic metal found in tobacco, air and food. Recent cross-sectional studies have suggested that Cd negatively impacts physical performance, but the prospective association is uncertain. We used data from 2548 older adults from the Seniors-ENRICA II cohort in Madrid, Spain. Whole blood Cd levels were measured at baseline using inductively coupled plasma-mass spectrometry. At baseline (2017) and follow-up (2019), overall physical function was evaluated using the physical component summary (PCS) of the SF 12-Item Health questionnaire, lower-extremity performance with the Short Physical Performance Battery (SPPB), muscle weakness with a hand dynamometer, and frailty with a Deficit Accumulation index. Mobility limitations and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including tobacco smoke, number of cigarettes smoked per day and time since cessation in former smokers. In cross-sectional analyses, odds ratios (95% confidence interval) per two-fold increase in blood Cd were 1.16 (1.03; 1.31) for low PCS scores, 1.08 (0.97; 1.20) for impaired lower-extremity performance, 1.10 (0.98; 1.23) for low grip strength, 1.11 (1.02; 1.20) for mobility limitations, 1.16 (1.02; 1.31) for frailty, and 1.26 (1.08; 1.47) for IADL disability. In longitudinal analyses, corresponding hazard ratios were 1.25 (1.03; 1.51) for low PCS scores, 1.14 (1.03; 1.27) for impaired lower-extremity performance, 1.02 (0.92; 1.13) for low grip strength, 1.03 (0.91; 1.16) for mobility limitations, and 1.16 (1.00; 1.35) for frailty. All the associations where consistent when current smokers were excluded from the analyses. Our results support the role of Cd as a risk factor for physical function impairments in older adults. [Display omitted] • Functional decline in older adults is a major challenge to health care systems. • Most of the few previous reports on Cd and functional decline are cross-sectional. • We prospectively studied this association in older adults with low cadmium exposure. • B–Cd levels were related to higher risk of limitations in several functional domains. • Further efforts should be made to protect the elderly against Cd exposure. [ABSTRACT FROM AUTHOR]