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Purpose: Force production is crucial in football, and it is the main limitation of people with cerebral palsy (CP). This study aimed to describe the changes in sprint force–velocity (Fv) profile after a period of 25 weeks of regular training in international football players with CP. Methods: The sprint Fv profile and other physical performance variables (ie, linear sprint, vertical jump, change of direction, and intermittent endurance) of 14 international players from the Spanish national team were assessed during 2 consecutive training camps. Pretesting and posttesting sessions were carried out 1 week before and after the 25-week intervention period. The intervention consisted of 2 strength sessions per week added to the usual football training. Results: The repeated-measures analysis of variance showed changes in players' physical performance (linear sprint: F = 18.05, P <.01; change of direction: F = 16.71, P <.01; and endurance: F = 31.45, P <.01) and in some variables of the sprint Fv profile (maximal horizontal force, maximal power, slope, maximal ratio of force, and decrease of ratio of force; F = 14.28–37.81; P <.01), whereas players' maximal velocity (theoretical and actual) did not change (F = 0.13 and 0.01; P =.72 and.98, respectively). Conclusions: This study showed that the implementation of 2 strength-training sessions per week, for 25 weeks, is effective to improve CP football players' physical performance. The main finding of this study is the improvement of force application in the acceleration phase (sprint Fv profile), which is the main attribute in many physical performance tests and is the main limitation of the CP population. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, clinical diagnosis, and treatment lines in cancer patients, with the goal of improving understanding and management of this debilitating symptom to enhance patient care and quality of life. Methods: This study employed an observational, cross-sectional, and descriptive approach to investigate patients with oncological disease at the University Hospital of Salamanca between March 2021 and April 2024. A convenience sample was selected, including patients over 18 years old with a pathological diagnosis of cancer, experiencing any degree of dyspnea, and who consented to participate by signing the informed consent. Exclusion criteria included lack of consent and clinical conditions that prevented an interview. The studied variables encompass sociodemographic (age, gender, diagnosis, tumor stage, number of treatment lines) and clinical aspects (daily activities, degree of dyspnea, functional capacity, physical performance), evaluated using the Barthel Index, the mMRC Dyspnea Scale, the ECOG Scale, and the Short Physical Performance Battery (SPPB). Data were collected through semistructured interviews and medical records, and analyzed using specialized software. This research has ethical approval CEiM Code 2023 12 1472, Reference 2024/01. Results: The mean age was 66.82 years. Lung cancer was predominant (60.2%), with most patients in stage 3 (65.7%) and receiving three treatment lines (68.7%). Higher age, advanced disease stage, and more treatment lines correlated with lower Barthel and SPPB scores, and higher ECOG and mMRC scores, indicating worse functionality, physical performance, and greater dyspnea. No significant correlations were found between gender or pathological diagnosis and the studied variables. Conclusions: Advanced age, higher disease stage, and more treatment lines are associated with decreased functionality, poorer physical performance, and increased dyspnea in cancer patients. Gender and specific cancer diagnosis do not significantly affect these relationships. Addressing dyspnea is crucial to improving the quality of life and physical performance in this population. Future studies should explore additional factors like treatment types and nutritional status. [ABSTRACT FROM AUTHOR]

Purpose: The authors investigated the association between risk of tendinopathies and genetic markers in professional team sports. Methods: The authors studied 363 (mean [SD]; 25 [6] y, 89% male) elite players (soccer, futsal, basketball, handball, and roller hockey) from a top-level European team (FC Barcelona, Spain). Of 363, 55% (cases) had experienced 1+ episodes of tendinopathy during 2008–2018 and 45% (controls) remained injury free. The authors first examined the association between single-nucleotide polymorphisms (SNPs) and tendinopathy risk in a hypothesis-free case-control genome-wide association study (495,837 SNPs) with additional target analysis of 58 SNPs that are potential candidates to influence tendinopathy risk based on the literature. Thereafter, the authors augmented the SNP set by performing synthetic variant imputation (1,419,369 SNPs) and then used machine learning-based multivariate modeling (support vector machine and random forest) to build a reliable predictive model. Results: Suggestive association (P < 10−5) was found for rs11154027 (gap junction alpha 1), rs4362400 (vesicle amine transport 1-like), and rs10263021 (contactin-associated protein-like 2). Carriage of 1+ variant alleles for rs11154027 (odds ratio = 2.11; 95% confidence interval, 1.07–4.19, P = 1.01 × 10−6) or rs4362400 (odds ratio = 1.98; 95% confidence interval, 1.05–3.73, P = 9.6 × 10−6) was associated with a higher risk of tendinopathy, whereas an opposite effect was found for rs10263021 (odds ratio = 0.42; 95% confidence interval, 0.20–0.91], P = 4.5 × 10−6). In the modeling approach, one of the most robust SNPs was rs10477683 in the fibrillin 2 gene encoding fibrillin 2, a component of connective tissue microfibrils involved in elastic fiber assembly. Conclusions: The authors have identified previously undescribed genetic predictors of tendinopathy in elite team sports athletes, notably rs11154027, rs4362400, and rs10263021. [ABSTRACT FROM AUTHOR]

The aim was to analyze the changes of physical performance and physiological responses during a high-intensity training task in wheelchair basketball (WB) players. Thirteen Spanish first divisionWBmale players participated in this study. A test battery (change of direction ability, sprints, and sled towing) was performed to study neuromuscular responses before (pre) and after (post) the small-sided games (SSG). Furthermore, tympanic temperature and blood lactate concentration were measured before and immediately after players finished the SSG. The SSG tasks consisted in four players against four, 4 bouts of 4 min with 2 min of recovery periods. There was a 1.10% decline in performance in both 5- and 20-m sprints (p < .01; effect size [ES] ≤ 0.14), 1.82% decline in 5-m sled towing (p < .05; ES = 0.18), and 2.68% decline in 20-m sled towing (p < .01; ES = 0.27) between pre- and post-SSG. As in physical performance results, significant differences were observed between pre and post in physiological markers, with increasing tympanic temperature (36.21 ± 0.60 °C to 36.97 ± 0.59 °C; p < .001; ES = 1.27) and blood lactate concentrations (1.95 ± 1.30 mmol/L to 5.84 ± 2.04 mmol/L; p < .001; ES = 2.99) after SSG. The SSG produced a decrease in sprint and sled towing performance after 16 min of intense exercise. Moreover, the decrease in physical performance was accompanied with an increase in physiological responses. These neuromuscular responses could be similar in the real game; thus, coaching staff could benefit from this information when changing bench players. [ABSTRACT FROM AUTHOR]

This study aims 1) to compare repeated change of direction ability (rCODA) and bench press (BP) between low (A category, ≤2.5) and high (B category, ≥3.0) sport classes and 2) to analyse the relationships between rCODA and BP performance in a sample of wheelchair basketball (WB) players. Seventeen world-class WB players volunteered participated in this study. All the players undertook two tests: the repeated (x12) Modified Agility T-test (rMAT) to measure the rCODA and the movement velocity in a BP test. No significant differences were observed between categories in the rMAT and BP. For the total sample, BP variables with a mean propulsive velocity of 1 m·s−1 (V1LOAD) largely correlated with all the full rMAT outcomes (r>-0.625; p< 0.05). Having a better BP could be favourable to perform repeated efforts and this seems particularly relevant in fatigue conditions, and especially for the B category players. [ABSTRACT FROM AUTHOR]

The aims of this study were to report the relative age effect in different competitive levels and field positions and to analyse the differences within and between different competitive levels and field positions. Data for 203 young soccer players (14.2 ± 1.1 years) included anthropometrics and physical performance (Countermovement jump [CMJ], 30-m sprint, T-test and Yo-Yo IR1). Their competitive level and their field position were registered. The percentage of relative older players (1stHY) was higher in the better competitive levels (L1: 80.6%, p <.001; L2: 68.2%, p <.001 and L3: 58.5%, p <.01), but it was similar between field positions (DF: 68.1%, p <.001; MF: 69.6%, p <.001 and FW: 67.2%, p <.001). Anthropometrical and physical performance differences were found between players of different competitive levels but not between relative older and younger players in each competitive level and field position. The relative age effect is higher in the better competitive levels. Anthropometrical and physical performance differences between players are not due to the relative age but to the level of competition. Relatively older players do not seem to be more likely to be selected for specific field positions. The causes of relative age effect need more research. [ABSTRACT FROM AUTHOR]

This cross-sectional study was designed to develop normative functional fitness standards for the Portuguese older adults, to analyze age and gender patterns of decline, to compare the fitness level of Portuguese older adults with that of older adults in other countries, and to evaluate the fitness level of Portuguese older adults relative to recently published criterion fitness standards associated with maintaining physical independence. A sample of 4,712 independent-living older adults, age 65-103 yr, was evaluated using the Senior Fitness Test battery. Age-group normative fitness scores are reported for the 10th, 25th, 50th, 75th, and 90th percentiles. Results indicate that both women and men experience age-related losses in all components of functional fitness, with their rate of decline being greater than that observed in other populations, a trend which may cause Portuguese older adults to be at greater risk for loss of independence in later years. These newly established normative standards make it possible to assess individual fitness level and provide a basis for implementing population-wide health strategies to counteract early loss of independence. [ABSTRACT FROM AUTHOR]

We aimed (1) to report age-specific physical fitness levels in people with fibromyalgia of a representative sample from Andalusia; and (2) to compare the fitness levels of people with fibromyalgia with non-fibromyalgia controls. This cross-sectional study included 468 (21 men) patients with fibromyalgia and 360 (55 men) controls. The fibromyalgia sample was geographically representative from southern Spain. Physical fitness was assessed with the Senior Fitness Test battery plus the handgrip test. We applied the Generalized Additive Model for Location, Scale and Shape to calculate percentile curves for women and fitted mean curves using a linear regression for men. Our results show that people with fibromyalgia reached worse performance in all fitness tests than controls ( P < 0.001) in all age ranges ( P < 0.001). This study provides a comprehensive description of age-specific physical fitness levels among patients with fibromyalgia and controls in a large sample of patients with fibromyalgia from southern of Spain. Physical fitness levels of people with fibromyalgia from Andalusia are very low in comparison with age-matched healthy controls. This information could be useful to correctly interpret physical fitness assessments and helping health care providers to identify individuals at risk for losing physical independence. [ABSTRACT FROM AUTHOR]

The aims of this study are (a) to describe the evolution of neuromuscular performance over an 18 year period within a Spanish elite reserve team; (b) to check if there were any relation between the playing position and sprint and jump performances and (c) to look into the alleged impact of this factor on the top playing level attained by the soccer players. We considered the physical tests (5 m and 15 m sprint times and countermovement jump (CMJ) height) made by 235 players enrolled in the reserve team of the Club from 1994 to 2012 and the highest competitive-level they achieved: Spanish first (n = 39) and second divisions (n = 36) and semi-professional (n = 160). Furthermore, the players were classified according to their playing positions. The main findings were a very-likely/most-likely lower neuromuscular performance (ES = 0.48–0.68, small to moderate) in the last six-season term (2006–2012) than in the first term (1994–2000); possibly/very-likely lower performances in sprinting and CMJ (ES = 0.22–0.55, small) by central defenders (CDs) and midfielders than by other playing positions; very-likely better performances in sprinting and jumping by first and second divisions central defenders than by semi-professional central defenders (ES = 0.90–1.02, moderate). Sprint and jump performances are not a relevant physical parameter to promote to the top level of soccer in Spain except for one in six of the playing positions: CDs. [ABSTRACT FROM PUBLISHER]

The article discusses the influence of velocity-based resistance training (RT) with medium loads on the physical performance of soccer players from different age groups. Topics discussed include methods for examining strength performance, variables for testing neuromuscular performance and the practical applications in fitness coaching.

The article discusses research which investigated fluctuations in rating of local-muscular (sRPEmus) and central-respiratory (sRPEres) perceived exertion measured after the completion of each training and competitive session in professional soccer players. Researchers evaluated 21 players. They found that at the end of matches average sRPEmus was higher than sRPEres and concluded that RPEmus should be considered the main fatigue rating during a soccer match.

Background: Referees play a crucial role in soccer, although relevant key aspects of their physiological performance remain uncertain. Research question: To describe the physiological profile of national-level Spanish soccer referees. Type of study: Descriptive study. Methods: Twenty-two male referees (age: 26.0 ± 4.9 years; height: 1.76 ± 0.08m; body mass: 76.3 ± 13.1kg; body mass index: 24.4 ± 2.8kg·m-2) were the participants of the study. Referees were subjected to a medical examination to determine their basal cardiovascular, haematological, pulmonary function and echocardiographical profile. Complementarily, the referees carried out an incremental maximal treadmill test and two field tests: a repeated sprint (6 x 40 m/90s recovery) and a running test (fastest time to complete 2000m). Results: The left ventricular mass index averaged 122.3 ± 23.6g·m-1. Mean oxygen uptake (VO2max) averaged 48.7 ± 4.3ml·kg·min-2. Mean time during the repeated sprint test was 5.53 ± 0.21s, while mean time to complete the endurance test was 7 min 43s. Conclusion: The physiological profile of national-level Spanish soccer referees reveals moderate aerobic cardiac adaptations to training and match officiating. As match demands are relative to the standard of competition, the referees should increase their physiological parameters to be able to cope with the demands imposed by the players. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess effects of a short-term resistance program on strength in fit young women using weight machines/free weights or elastic tubing. 42 physically fit women (21.79 ± 0.7 years) were randomly assigned to the following groups: (i) the Thera-Band® Exercise Station Group (TBG); (ii) the weight machines/ free weights group (MFWG); or (iii) the control group (CG). Each experimental group performed the same periodised training program that lasted for 8 weeks, with 2-4 sessions per week and 3-4 sets of 8-15 submaximal reps. A load cell (Isocontrol; ATEmicro, Madrid, Spain) was used to test the evolution of the Maximum Isometric Voluntary Contraction (MIVC) in 3 different exercises: Vertical Rowing (VR), Squat (S) and Back Extension (BE). A mixed model MANOVA [group (CG, TBG, MFWG) x testing time (pre-test, post-test)] was applied to determine the effect of the different resistance training devices on strength. The only groups to improve their MIVC (p <0.005) were TBG and MFWG, respectively: VR 19.87% and 19.76%; S 14.07 and 28.88; BE 14.41% and 14.00%. These results indicate that resistance training using elastic tubing or weight machines/ free weights have equivalent improvements in isometric force in short-term programs applied in fit young women. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effect of match location, quality of opposition, and match status on distance covered at various speeds in elite soccer. Twenty-seven Spanish Premier League matches played by a professional soccer team were monitored in the 2005-2006 season using a multiple-camera match analysis system. The dependent variables were the distance covered by players at different intensities. Data were analysed using a linear regression analysis with three independent variables: match status (i.e. whether the team was winning, losing or drawing), match location (i.e. playing at home or away), and quality of the opponents (strong or weak). The top-class players performed less high-intensity activity (>19.1 km · h-1) when winning than when they losing, but more distance was covered by walking and jogging when winning. For each minute winning, the distance covered at submaximal or maximal intensities decreased by 1 m (P<0.05) compared with each minute losing. For each minute winning, the distance covered by walking and jogging increased by 2.1 m (P<0.05) compared with each minute losing. The home teams covered a greater distance than away teams during low-intensity activity (<14.1 km · h-1) (P<0.01). Finally, the better the quality of the opponent, the higher the distance covered by walking and jogging. Our findings emphasize the need for match analysts and coaches to consider the independent and interactive effects of match location, quality of opposition, and match status during assessment of the physical component of football performance. [ABSTRACT FROM AUTHOR]

Background: most of the research concerning the influence of genetics on endurance performance has been carried out by investigating target genes separately. However, endurance performance is a complex trait that can stem from the interaction of several genes. The objective of this study was to compare the frequencies of polymorphisms in target genes involving cardiorespiratory functioning in elite endurance athletes vs. non-athlete controls., Methods: genotypic frequencies were determined in 123 elite endurance athletes and in 122 non-athletes. Genotyping of ACE (rs4340), NOS3 (rs2070744 and rs1799983), ADRA2a (rs1800544 and rs553668), ADRB2 (rs1042713 and rs1042714), and BDKRB2 (rs5810761) was performed by polymerase chain reaction. The total genotype score (TGS: from 0 to 100 arbitrary units; a.u.) was calculated from the genotype score in each polymorphism., Results: the mean TGS in non-athletes (47.72 ± 11.29 a.u.) was similar to elite endurance athletes (46.54 ± 11.32 a.u., p = 0.415). The distribution of TGS frequencies were also similar in non-athletes and elite endurance athletes ( p = 0.333). There was no TGS cut-off point to discriminate being elite endurance athletes., Conclusions: the genetic profile in the selected genes was similar in elite endurance athletes and in controls, suggesting that the combination of these genes does not determine endurance performance.

Background: Selenium (Se) is a trace element with a narrow safety margin., Objectives: To evaluate the cross-sectional and longitudinal dose-response association between Se exposure and measures of impaired physical function and disability in older adults., Design: NHANES 2011-2014 cross-sectional (US, n = 1733, age ≥60 years) and Seniors-ENRICA-2 2017-2019 cross-sectional and longitudinal (Spain, n = 2548 and 1741, respectively, age ≥65 years) data were analyzed. Whole blood and serum Se levels were measured using inductively coupled plasma-mass spectrometry. Lower-extremity performance was assessed with the Short Physical Performance Battery, and muscle weakness with a dynamometer. Incident mobility and agility limitations, and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including physical activity. Results across studies were pooled using random-effects meta-analysis., Results: Meta-analyzed odds ratios (95% confidence interval) per log2 increase in whole blood Se were 0.54 (0.32; 0.76) for weakness, 0.59 (0.34; 0.83) for impaired lower-extremity performance, 0.48 (0.31; 0.68) for mobility limitations, 0.71 (0.45; 0.97) for agility limitations, and 0.34 (0.12; 0.56) for disability in at least one IADL. Analyses for serum Se in NHANES showed similar results. Findings suggest the inverse association with grip strength is progressive below 140 μg/L (p-value for non-linear trend in the Seniors-ENRICA-2 study = 0.13), and above 140 μg/L (p-value for non-linear trend in NHANES = 0.11). In the Seniors-ENRICA-2 cohort, with a 2.2 year follow-up period, a doubling in baseline Se levels were associated with a lower incidence of weakness [odds ratio (95% confidence interval): 0.45 (0.22; 0.91)], impaired lower-extremity performance [0.63 (0.32; 1.23)], mobility [0.43 (0.21; 0.91)] and agility [0.38 (0.18; 0.78)] limitations., Discussion: In US and Spanish older adults, Se concentrations were inversely associated with physical function limitations. Further studies are needed to elucidate underlying mechanisms., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

The aim of this study was to analyze the influence of the match half and the playing position on physical requirements in the Spanish Professional Futsal League players during official games. The external load from distance, speed, acceleration and deceleration variables were obtained from fourteen elite futsal players during 10 official matches of the 2019-2020 season using a Local Positioning System with ultra-wideband technology installed on the futsal pitch. The results revealed similar results from physical requirements between first and second half ( p > 0.05). Wingers demonstrated greater high-speed running distance (+4.04 m·min -1 ; CI95%: 0.35 to 7.72; ES: 0.87) than pivots ( p > 0.05). There were a high number of accelerations (7.42-9.41 n ·min -1 ) and decelerations (7.37-9.12 n ·min -1 ) per minute in all player positions. The principal finding of the current manuscript did not evidence differences in the physical performance of players between the first and second half. The physical requirements varied among pivots and wingers regarding high-intensity actions. These outcomes add new contributions to the understanding of futsal physical demands.

Background: The beneficial effect of nut consumption preventing cardio-metabolic diseases and cancer suggests that nuts might also protect from physical function impairment in older people since aging-related functional decline shares biological pathways with these chronic diseases. The objective was to examine the association between nut consumption and impairment of physical function in older adults., Methods: Prospective study with 3,289 individuals aged ≥60 years from the Seniors-ENRICA cohort. In 2008-2010 and 2012 nut consumption was measured with a validated diet history. Participants were followed-up until 2015 to ascertain incident impaired physical function, specifically impaired agility, mobility, grip strength, gait speed, and overall physical function. Statistical analyses were performed with Cox regression and adjusted for the main confounders, including a wide set of socioeconomic, lifestyle, dietary, and morbidity variables., Results: Overall, 65.7% of participants consumed any type of nuts. The mean intake among nut consumers was 15.1 g/d in men and 14.6 g/d in women. Median consumption of nuts was 11.5 g/d in both sexes. Men consuming ≥11.5 g/d of nuts had a lower risk of impaired agility and mobility than those who did not consume nuts; the hazard ratios (95% confidence interval (CI); p for linear trend) were 0.59 (0.39-0.90; p = .01) and 0.50 (0.29-0.90; p = .02), respectively. In women, compared with nonconsumers, the hazard ratio (95% CI; p for linear trend) of impaired overall physical function for nut intake ≥11.5 g/d was 0.65 (0.48-0.87; p = .004). No association was observed between nut consumption and low grip strength and slow gait speed., Conclusions: Nut consumption was associated with half the risk of impaired agility and mobility in men and with a lower risk of overall physical function impairment in women. The suggested protective effect of nut consumption on physical functioning merits further examination., (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background Elderly patients have been underrepresented in secondary cardiovascular prevention programmes. This study aimed to ascertain the effects of a secondary coronary disease prevention programme in these patients. Design Open randomised intervention study with parallel groups. Methods One hundred and twenty-seven patients aged ≥70 years with a recent acute coronary syndrome were randomised to a protocolised clinical intervention plus usual care (intervention group, n = 64) or to usual care alone (control group, n = 63). Patients were assessed at baseline and after 12 months. The main outcome was the percentage of patients with optimal risk factor control after 12 months of follow-up. Secondary outcomes included changes in Mediterranean diet adherence, quality of life and functionality. Mortality was evaluated three years after the end of the intervention. Results One hundred and six patients (83.4%) completed 12 months of follow-up (54 in the intervention group and 52 in the control group). At the end of intervention, 34.2% more patients in the intervention group had achieved optimal risk factor control with a number needed to treat of 3 (relative risk 2.18, 95% confidence interval 1.36 to 3.50). The intervention group improved adherence to the Mediterranean diet ( p = 0.013) and functionality assessed by the Short Physical Performance Battery ( p = 0.047). No differences between groups were found in quality of life (Short-Form 36 Health Survey) or mortality after three years (hazard ratio 1.19, 95% confidence interval 0.41 to 3.45). Conclusions A secondary coronary disease prevention programme in elderly patients with a recent acute coronary syndrome improved risk factor control, Mediterranean diet adherence and functionality.

Objectives: To evaluate the short-term effects of three different resistance training programs, conducted at low intensity, on physical performance, muscle cross-sectional area (CSA) and the capacity to perform daily tasks in older adults living in a geriatric nursing home., Design: Randomized controlled trial, with a 4-month intervention period., Setting: A geriatric nursing home in Valencia, Spain., Participants: Eighty-nine adults aged 75 to 96 who were independent in their daily activities., Intervention: After a baseline assessment, the participants were randomly assigned to the control group or one of the three intervention groups: volitional contraction (VC; n=22), neuromuscular electrical stimulation (NMES; n=22), or neuromuscular electrical stimulation superimposed onto voluntary contractions (NMES+; n=22). The intervention focused on knee extension exercises and its intensity was set at 40% of one-repetition maximum (1RM)., Measurements: The primary outcome measure was mobility. Secondary outcomes were rectus femoris CSA, balance, aerobic endurance, upper-body strength and the capacity to perform daily tasks. All data were collected at baseline and after the 4-month intervention period., Results: The two-way ANOVA analysis showed a significant group×time interaction effect for the mobility (P=.022), rectus femoris CSA (P=.001), and the capacity to perform daily tasks (P=.05). The within-group analysis found a more prominent effect in the NMES+ group. Significant improvements were seen in rectus femoris CSA and the capacity to perform daily tasks in all intervention groups. Mobility only improved in the NMES+ group (P=.026)., Conclusion: From a short-term perspective, NMES+ exercise training, performed at low intensity, can improve physical performance, muscle CSA, and the capacity to perform daily activities, and to partially mitigate age-related consequences in older adults., (Copyright © 2014 Elsevier Inc. All rights reserved.)