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Background Osteoarthritis (OA) is a chronic degenerative disease which can result in chronic pain, loss of joint function and consequently decline in quality of life. Research question A variety of instruments that measure the different dimensions of health status in patients with OA are available. However, despite the fact that WOMAC and other questionnaires and scales may provide additional understanding regarding the patient’s condition, some studies have reported discrepancies between patients’ perceptions and their actual ability to perform the task. The aim of the present study was investigate the physical capabilities with the function domain of WOMAC. Methods This study has a cross-sectional design including patients diagnosed with moderate to severe knee OA (i.e., grades II, III and IV) according to the Kellgren-Lawrence. These patients were submitted to the battery of functional tests recommended by the OARSI group (30-second chair stand test, 40 meters fast paced walking test, Stair climb test, timed “Up and Go”, and Six-minute walking test) and filled the WOMAC. Pearson’s correlation and multiple linear regression was applied. Results A total of 153 patients were included. A significant and weak correlation was observed between WOMAC and the 40-meter walking test, TUG, stair-climbing test, and the 6MWT. In addition, 30-second chair stand test demonstrated a significant and moderate correlation (r=-0.503). The multiple regression analysis results indicated that only 30-second chair stand test was a significant (p = 0.001) predictor of WOMAC. This result remains significant even after adjusting for age, BMI, total muscle mass, and number of knees affected Significance The 30-second chair stand test is associated with the WOMAC function domain. There is no correlation of this domain with any other functional tests, emphasizing the importance of including other tests for a global evaluation.

Background and purpose Although combining classical resistance (RT) and power training (PT) might be an efficient strategy to achieve optimal enhancements in body composition and physical function in older adults, the most effective approach to combine these different types of exercise training is still unknown. Periodization, an organizational model that refers to a succession of cycle that will vary in exercise intensity and/or volume to allow for the training stimulus to remain biologically challenging and effective, may represent an interesting approach. Among the different types of periodization, daily undulating periodization (DUP) has attracted considerable attention given its superiority in comparison to nonperiodized (NP) RT programs to elicit neuromuscular improvements in young adults. However, whether a DUP program combining PT and traditional RT can produce similar or greater improvements in body composition and physical function in older adults than a NP RT program has not yet been established. Therefore, the present study compared the effects of a DUP and NP programs on body composition and physical function in healthy community-dwelling older women. Methods Forty-two older women (60–79 years) were randomized into one of the three experimental groups: NP, DUP, and control group (CG). Body composition and physical function were assessed at baseline and after the intervention. The sessions of exercises were performed twice a week over 22 weeks. In NP, the two exercise sessions were based on three sets of 8–10 repetitions at a “difficult” intensity (i.e., 5–6) prescribed based on the Rating of Perceived Exertion (RPE) scale. In DUP, the first session was based on PT (three sets of 8–10 repetitions at a “moderate” intensity, i.e., 3, performed as fast as possible), while the second session was similar to the NP. Results There were no significant changes in body composition in any of the groups. Relative to baseline, participants assigned to NP showed significant improvements in countermovement jump (+55.7%), timed “Up and Go” (TUG) test (−43.2%, faster), walking speed (+12.0%), and one-leg-stand (+154.5%). In contrast, DUP only improved TUG performance (−53.2%, faster). Conclusion NP and DUP improved physical function in community-dwelling older women, with greater improvements in physical parameters only observed after NP.

Purpose To compare the effects of exergames versus conventional physical training on the cognitive skills of older adults. Materials and Methods Scientific studies published in PubMed, Web of Science, and Cochrane Library databases were searched. Individual studies were assessed using the Cochrane Risk-of-bias tool for randomized trials (RoB 2). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE Pro). The cognitive outcomes were Trail Making Test (TMT)-A, TMT-B, Stroop Word-Color test, Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). Results We identified 256 studies, in which 13 studies were included in the systematic review and 11 in the meta-analysis. The majority of the exergame interventions were based on the Xbox 360′s Kinect, followed by the Impact Dance Platform, Nintendo Wii, and the Bike Labyrinth. We observed heterogeneity in the conventional exercise group and in the duration of training, which ranged from 12 to 52 sessions. There was no statistically significant difference between groups in TMT-A (p=0.083), TMT-B (p=0.122), and Stroop (p=0.191). There were differences in favor of exergames in MMSE (raw mean difference=-1.58, 95% CI: -2.87 to -0.28, p Conclusions Despite statistical differences in MMSE and MoCA, these results should be interpreted with caution due to methodological heterogeneity. Some studies reported possible neurophysiological benefits induced by exergames, which should be explored in future investigations.

The present study compared the effects of traditional resistance training (TRT) and combined power training (PT) and TRT (PTRT) on cognitive parameters and serum brain-derived neurotrophic factor (BDNF) levels in non-demented, well-functioning, community-dwelling older women. Forty-five older women were randomized into one of three experimental groups: TRT, PTRT, and control group (CG). Cognitive tests explored global cognitive function, short-term memory, and dual-task performance. Serum BDNF levels were assessed at baseline and after the intervention. Exercise sessions were performed twice a week over 22 weeks. In TRT, exercise sessions were based on three sets of 8&ndash, 10 repetitions at &ldquo, difficult&rdquo, intensity. In PTRT, the first session was based on PT (three sets of 8&minus, moderate&rdquo, intensity), while the second session was similar to the TRT. Our analyses indicated that overall cognitive function, short-term memory, and dual-task performance were similarly improved after TRT and PTRT. Serum BDNF concentrations were not altered by any training protocol. In conclusion, the two RT programs tested in the present trial improved global cognitive function, short-term memory and dual task performance in non-demented, well-functioning, community-dwelling older women. In addition, our findings suggest that mechanisms other than BDNF may be associated with such improvements.

CONTEXT AND OBJECTIVE: Sarcopenia is an emerging public health issue in Brazil. Because of its high prevalence and the lack of national data, the objective here was to identify cutoff points for appendicular skeletal muscle (ASM) and handgrip strength in relation to fear of falling among Brazilian older adults. DESIGN AND SETTING: Cross-sectional study; in the community. METHODS: Participants underwent morphological and functional evaluations; and were asked about previous falls and fear of falling. Different adjustments to ASM and handgrip strength were used. Slow walking speed was defined as < 0.8 m/s or 1.0 m/s. Gender and age groups were compared using t tests, analysis of variance (ANOVA), chi-square test or Fisher’s exact test. Receiver operating characteristic curves were used to identify cutoffs for ASM and handgrip strength in relation to fear of falling. RESULTS: 578 older adults participated in this study. Function levels decreased with increasing age, and body composition differed between the sexes. In relation to fear of falling, the cutoffs for ASM adjusted for body mass index (BMI) were < 0.85 for men and < 0.53 for women; the cutoffs for absolute handgrip strength and relative handgrip strength (adjusted for BMI) were 30.0 kgf and 21.7 kgf, and 1.07 and 0.66, for men and women, respectively. CONCLUSION: The values presented can be used as references in clinical practice and research. We recommend use of ASM adjusted for BMI and choosing between absolute and relative handgrip strength for men and women, according to study needs.

CONTEXT AND OBJECTIVE: In elderly people, measurement of several anthropometric parameters may present complications. Although neck circumference measurements seem to avoid these issues, the cutoffs and cardiovascular risk factors associated with this parameter among elderly people remain unknown. This study was developed to identify the cutoff values and cardiovascular risk factors associated with neck circumference measurements among elderly people. DESIGN AND SETTING: Cross-sectional study conducted in two community centers for elderly people. METHODS: 435 elderly adults (371 women and 64 men) were recruited. These volunteers underwent morphological evaluations (body mass index and waist, hip, and neck circumferences) and hemodynamic evaluations (blood pressure values and heart rate). Receiver operating characteristic curve analyses were used to determine the predictive validity of cutoff values for neck circumference, for identifying overweight/obesity. Multivariate analysis was used to identify cardiovascular risk factors associated with large neck circumference. RESULTS: Cutoff values for neck circumference (men = 40.5 cm and women = 35.7 cm), for detection of obese older adults according to body mass index, were identified. After a second analysis, large neck circumference was shown to be associated with elevated body mass index in men; and elevated body mass index, blood pressure values, prevalence of type 2 diabetes and hypertension in women. CONCLUSION: The data indicate that neck circumference can be used as a screening tool to identify overweight/obesity in older people. Moreover, large neck circumference values may be associated with cardiovascular risk factors. RESUMO CONTEXTO E OBJETIVO: Em idosos, diversas ferramentas antropométricas podem apresentar complicações durante a mensuração. Embora a circunferência do pescoço pareça evitar tais problemas, os pontos de corte e fatores de risco cardiovascular associados a essa ferramenta em idosos permanecem desconhecidos. Este estudo foi desenvolvido para identificar os valores de ponto de corte e fatores de risco cardiovascular associados à circunferência do pescoço em idosos. DESENHO E LOCAL: Estudo transversal, realizado em dois centros comunitários para idosos. MÉTODOS: 435 idosos (371 mulheres e 64 homens) foram recrutados. Os voluntários foram submetidos a avaliação morfológica (índice de massa corporal e cintura, quadril, e circunferência do pescoço) e hemodinâmica (valores da pressão arterial e frequência cardíaca). A análise pela curva receiver operating characteristic foi usada para determinar o valor preditivo dos valores de ponto de corte da circunferência do pescoço para identificação de sobrepeso/obesidade. Análise multivariada foi usada para identificar os fatores de risco cardiovascular associados com circunferência do pescoço larga. RESULTADOS: Os valores de corte para circunferência do pescoço (homens = 40,5 cm e mulheres = 35,7 cm) para detectar adultos idosos obesos, de acordo com o índice de massa corporal, foram identificados. Depois da segunda análise, circunferência do pescoço larga foi associada com elevado índice de massa corporal em homens e mulheres e elevados valores de pressão arterial, prevalência de diabetes mellitus tipo II e hipertensão em mulheres. CONCLUSÃO: Os dados indicam que a circunferência do pescoço pode ser utilizada como ferramenta de rastreio para identificar sobrepeso/obesidade em idosos. Ademais, altos valores de circunferência do pescoço podem estar associados com fatores de risco cardiovascular.

To investigate whether the Kihon Checklist (KCL) can predict frailty and disability.The studies analyzed for the present review were retrieved by searching electronic databases and other sources using the keywords "Kihon Checklist" and "Basic Checklist." The articles were restricted to those written in English and published in health sciences journals from the year 2006 until the end of April 2015. To be included in the full analysis, the study had to be primary research and use the KCL as a dependent or independent variable.A total of 62 articles were identified in the initial search, and after screening, 13 articles were included in this review. The KCL was found to be closely correlated with validated assessments of frailty phenotypes. The complete version of the KCL and specific domains have been used as research outcomes to verify frailty in cross-sectional and longitudinal studies. KCL domains were applied to evaluate different outcomes, such as depressive mood, functional disability and instrumental activities of daily living limitations.The KCL is a reliable tool for predicting general frailty and frailty aspects in older adults. The KCL was shown to be adequate for cross-cultural studies and to be suitable for addressing frailty demands among elderly in multiple cohorts. The KCL is a short questionnaire, which makes its administration by health promoters easy; thus, it has been used to evaluate the effectiveness of frailty interventions. We strongly recommend use of the KCL in community and clinical practice to assess frailty status. Geriatr Gerontol Int 2016; 16: 893-902.

To investigate the lifestyles, physical performance and quality of life (QOL) of frail and robust Brazilian community-dwelling older women, and to identify risk factors for frailty.Frailty was assessed using the Kihon Checklist. Lifestyles were assessed using a questionnaire. Physical performance was assessed by measuring walking speeds, performance on the one-leg stand test and the five-times chair stand test and handgrip strength. QOL was assessed using the Short Form-8 questionnaire. Participants were divided into frail and robust groups based on their total Kihon Checklist scores.A total of 109 participants (age 70.8 ± 6.87 years) were included in this study (robust n = 85, frail n = 24). Differences in living structures (P 0.001), financial satisfaction (P = 0.004) and the frequencies with which participants leave the house (P 0.001) were found between groups. The frail group had more fallers (P = 0.047), and lower engagement in physical activity (P = 0.044), lower body mass indices (P = 0.043) and poorer nutritional status (P = 0.002), whereas robust older people showed better physical performance (walking speed P 0.001, one-leg stand P = 0.021, handgrip strength P = 0.002) and higher QOL scores (general health P = 0.005, role-physical P = 0.013, bodily pain P = 0.002, vitality P = 0.001, social functioning P = 0.001, role-emotional P = 0.008). Multivariate regression analysis identified a slow usual walking speed and bodily pain as risk factors for frailty.Frail participants had higher indices for being housebound, and having financial dissatisfaction, a sedentary lifestyle, falls, and malnutrition. Furthermore, they showed poorer physical performance and QOL. An early, well-focused approach is crucial, especially for older adults who walk slowly and have bodily pain to preserve health and QOL. Geriatr Gerontol Int 2016; 16: 829-835.

To investigate frailty in Japanese, Brazilian Japanese descendants and Brazilian older women.The collected data included sociodemographic and health-related characteristics, and the frailty index Kihon Checklist. We analyzed the differences between the mean scores of Kihon Checklist domains (using ancova) and the percentage of frail women (using χ(2)-test). We carried out a binary logistic regression with Kihon Checklist domains.A total of 211 participants (Japanese n = 84, Brazilian Japanese descendants n = 55, Brazilian n = 72) participated in this research. The Brazilian participants had the highest total Kihon Checklist scores (more frail), whereas the Brazilian Japanese descendants had the lowest scores (P 0.001). Furthermore, the Brazilian group had more participants with oral dysfunction (P 0.001), seclusion (P 0.001), cognitive impairment (P 0.001) and depression (P 0.001). They were more likely to be frail (OR 5.97, 95% CI 2.69-13.3, P 0.001), to have oral dysfunction (OR 3.18, 95% CI 1.47-6.85, P = 0.003), seclusion (OR 9.15, 95% CI 3.53-23.7, P 0.001), cognitive impairment (OR 3.87, 95% CI 1.93-7.75, P 0.001) and depression (OR 6.63, 95% CI 2.74-16.0, P 0.001) than the Japanese group.The older Brazilian women were likely to be more frail than the participants in other groups. More than the environment itself, the lifestyle and sociodemographic conditions could affect the frailty of older Brazilian women.

To examine whether arterial stiffness, measured by the cardio-ankle vascular index (CAVI), is associated with skeletal muscle mass index (SMI) in Japanese community-dwelling older adults.Data were collected from 175 participants through questionnaires and specific tests; the data included demographic, lifestyle and health characteristics, body mass index (BMI), and body composition features determined by the bioelectrical impedance analysis, ankle-brachial index, the Mini-Nutritional Assessment, handgrip strength (GS), walking speed and shuttle walking tests (SW), and arterial stiffness determined by the CAVI. Absolute SMI was dichotomized according to the first quintile, which determined low (n = 35) and normal (n = 140) SMI.Participants with low SMI were older (P = 0.01), had more polypharmacy (P = 0.01), a lower BMI (P0.001), and fat mass index (P = 0.02), and had a greater risk of malnutrition (P0.001) than the normal group. Additionally, they showed poorer physical performance (GS and SW, P = 0.007 and 0.01, respectively) than the normal group. Furthermore, CAVI was associated with SMI even after adjustments (OR 1.82, 95% CI 1.14-2.90, P = 0.01).Our data showed that arterial stiffness is associated with low SMI in community-dwelling older adults, even when adjusting by multiple factors, showing a close interaction of vascular aging and muscle mass decline.

Poor sleep can affect physical and mental health, and consequently people's quality of life (QOL); however, only a few studies have addressed the potential associations of physical and mental health with quality of sleep (QOS) in Japan. The present study aimed to investigate the association of QOS with sociodemographic and lifestyle characteristics, cognitive status, nutrition, depression, seclusion, and QOL in Japanese community-dwelling older adults.Data were collected through self-administered questionnaires and other specific tests in 145 (age 73 years [range 70-77 years]) participants. The χ(2) -test or Fisher's exact test were used to compare categorical variables stratified by QOS, and the Mann-Whitney U-test was used for continuous variables. Furthermore, logistic regression analyses were carried out to verify the associations with QOS.The poor QOS group had more males (P0.05), a shorter self-reported sleep duration (P0.001), higher body mass index (P0.05) and higher risk of depression (P0.05), whereas the good QOS group showed higher scores in the QOL summary and domains of physical component (P0.01), general health (P0.001), bodily pain (P0.001) and vitality (P0.001). In the logistic regression model, cognitive status (OR 0.13, 95% CI 0.03-0.55), bodily pain (OR 0.91, 95% CI 0.84-1.00) and vitality (OR 0.82, 95% CI 0.73-0.92) were associated with QOS.The present study provides evidence that QOS is linked to cognitive status, bodily pain and vitality in Japanese older adults. We maintain that screening a person's sleep characteristics in a community setting might be relevant to identify those older adults at risk of a poor QOL and frailty in the early phase, triggering further health analyses.

To translate the Japanese Kihon Checklist (frailty index) into the Portuguese language, and to validate the use of the checklist for the assessment of the elderly Brazilian population.A semantic analysis was carried out, along with pretesting of bilingual participants. The checklist was validated against the Edmonton Frail Scale.A total of 188 Brazilian older adults (mean age 69.5 ± 7.47 years) participated in the present study. In the semantic analysis, six elderly participants reported no difficulty with responding to the Portuguese version of the Kihon Checklist. During pretesting with 21 bilingual participants, we found a strong correlation between the total scores of the original version of the Kihon Checklist in Japanese and the translated version in Portuguese (r = 0.764, P0.001). According to the validation process, which involved 161 participants, there was a significant correlation between the total scores of the Kihon Checklist and the Edmonton Frail Scale (r = 0.535, P0.001), and between each domain of the checklist with the total score of Edmonton Frail Scale (lifestyle τ = 0.429, P0.001; physical strength τ = 0.367, P0.001; nutrition τ = 0.211, P = 0.002; eating τ = 0.213, P = 0.001; socialization τ = 0.269, P0.001; memory τ = 0.285, P0.001; and mood τ = 0.359, P0.001). Furthermore, the Portuguese version of the Kihon Checklist showed satisfactory internal consistency (Cronbach's α coefficient: 0.787).The Portuguese language version of the Kihon Checklist presented good internal consistency and validity. Therefore, we encourage its application in the elderly Brazilian population with an aim of monitoring their frailty to prevent or delay the functional dependence and any other adverse health outcomes. [Correction added on 14 January 2013, after first online publication: the phrase 'loss of' has been deleted from the preceding statement.]