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Cuando una pelota incide sobre una mesa actúa una fuerza de fricción entre las superficies de ambos cuerpos. Esto provoca que tras el choque la pelota gire alrededor de su eje (lo que comúnmente se denomina “efecto”), lo cual tiene importantes consecuencias para un juego (¡con trampa!) que nos hará pasar un buen rato. Al mismo tiempo que un entretenimiento, esta actividad puede servir para discutir cómo actúa la fuerza de fricción y las leyes de conservación que intervienen en los choques elásticos.

En este trabajo se discute una experiencia clásica de la física recreativa,que consiste en dejar caer una taza (o cualquier otro objeto delicado,para que sea más efectiva la demostración)desde cierta altura.Siguiendo los pasos que detallaremos a continuación,la taza se detendrá unos centímetros antes de llegar al suelo,saliendoindemne de una caída que presagiaba un desastre.

Background: Our aim was to analyze the effects of a multicomponent exercise program (MEP) on frailty and physical performance in older adults with HIV (OAWH) since exercise can reverse frailty in the older population overall, but there is no data for OAWH., Methods: A prospective longitudinal study with intervention and control group was designed. Sedentary adults 50 or over with and without HIV were included. The intervention was a 12-week home-based MEP. Dependent variables were frailty (frailty phenotype), physical performance (Senior Fitness Test), muscle mass (ASMI) by bioimpedance. Pre- and postintervention measurements were analyzed using McNemar's test for categorical variables and the Wilcoxon signed-rank test for quantitative variables., Results: 40 OAWH and 20 OA without HIV. The median age was 56.5 years. 23.3% were women. The prevalence of frailty was 6.6% with no frail HIV-negative participants. Three of the four frail HIV-participants transitioned two (50%) from frail to prefrail and one (25%) to robust after the MEP. In participants with an adherence ≥50%, physical performance was significantly improved [basal vs. 12 week]: upper extremity strength [13 (13-15) vs. 16 (15-19), p = 0.0001], lower extremity strength [13 (11-16) vs. 15 (13-16), p = 0.004], aerobic endurance [62 (55-71) vs. 66 (58-80), p = 0.005]. Participants with low adherence experienced a significant worsening in ASMI [8.35 (7.44-9.26) vs. 7.09 (6.08-8.62), p = 0.03]., Conclusion: A 12-week MEP enhances frailty by increasing robustness in OAWH, and improves physical performance, and preserves muscle mass in older adults with good adherence to the MEP independently of HIV status., Competing Interests: FB reports research grant from MSD, non-financial support from Nestlé, and personal fees from ViiV Healthcare, Gilead, AMGEN, UCB, Grünenthal, Abbott, Vegenat, and Nestlé. MS-C reports research grant from Gilead, educational grants from MSD, Gilead, and ViiV Healthcare, and personal fees and non-financial support from Gilead. PR reports grants and personal fees from Gilead and personal fees from ViiV Healthcare and Abbvie. BV-B reports grants from Nutricia, and personal fees from Abbott nutrition, and Fresenius Kabi. EM reports conference attendance support from Gilead and ViiV Healthcare. JM-S reports personal fees from ViiV Healthcare, Janssen, Gilead, and MSD, non-financial support from ViiV Healthcare, Jannsen, and Gilead, and research grants from Gilead. FD has received research grants or honoraria for lectures or for participation in advisory boards from Gilead, ViiV-Healthcare, and unrestricted grants from ViiV Healthcare and Gilead. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Brañas, Díaz-Álvarez, Fernández-Luna, Vásquez-Brolen, García-Molina, Moreno, Ryan, Martínez-Sanz, Luna, Martínez, Dronda and Sánchez-Conde.)

Background: Frailty resulting from the loss of muscle quality can potentially be delayed through early detection and physical exercise interventions. There is a demand for cost-effective tools for the objective evaluation of muscle quality, in both cross-sectional and longitudinal assessments. Literature suggests that quantitative analysis of ultrasound data captures morphometric, compositional, and microstructural muscle properties, while biological assays derived from blood samples are associated with functional information., Objective: This study aims to assess multiparametric combinations of ultrasound and blood-based biomarkers to offer a cross-sectional evaluation of the patient frailty phenotype and to track changes in muscle quality associated with supervised exercise programs., Methods: This prospective observational multicenter study will include patients aged 70 years and older who are capable of providing informed consent. We aim to recruit 100 patients from hospital environments and 100 from primary care facilities. Each patient will undergo at least two examinations (baseline and follow-up), totaling a minimum of 400 examinations. In hospital environments, 50 patients will be measured before/after a 16-week individualized and supervised exercise program, while another 50 patients will be followed up after the same period without intervention. Primary care patients will undergo a 1-year follow-up evaluation. The primary objective is to compare cross-sectional evaluations of physical performance, functional capacity, body composition, and derived scales of sarcopenia and frailty with biomarker combinations obtained from muscle ultrasound and blood-based assays. We will analyze ultrasound raw data obtained with a point-of-care device, along with a set of biomarkers previously associated with frailty, using quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Additionally, we will examine the sensitivity of these biomarkers to detect short-term muscle quality changes and functional improvement after a supervised exercise intervention compared with usual care., Results: At the time of manuscript submission, the enrollment of volunteers is ongoing. Recruitment started on March 1, 2022, and ends on June 30, 2024., Conclusions: The outlined study protocol will integrate portable technologies, using quantitative muscle ultrasound and blood biomarkers, to facilitate an objective cross-sectional assessment of muscle quality in both hospital and primary care settings. The primary objective is to generate data that can be used to explore associations between biomarker combinations and the cross-sectional clinical assessment of frailty and sarcopenia. Additionally, the study aims to investigate musculoskeletal changes following multicomponent physical exercise programs., Trial Registration: ClinicalTrials.gov NCT05294757; https://clinicaltrials.gov/ct2/show/NCT05294757., International Registered Report Identifier (irrid): DERR1-10.2196/50325., (©Naiara Virto, Xabier Río, Garazi Angulo-Garay, Rafael García Molina, Almudena Avendaño Céspedes, Elisa Belen Cortés Zamora, Elena Gómez Jiménez, Ruben Alcantud Córcoles, Leocadio Rodriguez Mañas, Alba Costa-Grille, Ander Matheu, Diego Marcos-Pérez, Uxue Lazcano, Itziar Vergara, Laura Arjona, Morelva Saeteros, Diego Lopez-de-Ipiña, Aitor Coca, Pedro Abizanda Soler, Sergio J Sanabria. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 23.02.2024.)

Background: Alterations in resting metabolic rate (RMR), the largest component of daily total energy expenditure, with aging have been shown in various studies. However, little is known about the associations between RMR and health outcomes in later life., Aims: To analyze whether RMR is associated with incident disability and mobility decline in a 10-year longitudinal study, as well as the moderating role of frailty in these associations., Methods: Data from 298 older adults aged 70 and over from the Frailty and Dependence in Albacete (FRADEA) study in Spain were used, including a baseline measurement in 2007-2009 and a follow-up measurement 10 years later. RMR was measured by indirect calorimetry. Outcomes were incident disability in basic activities of daily living (BADL, Barthel Index), incident disability in instrumental ADL (IADL, Lawton index), and mobility decline (Functional Ambulation Categories scores). Fried's frailty phenotype was used as an indicator of frailty. Logistic regression analyses were conducted., Results: Fully adjusted and stratified analyses revealed that only in the pre-frail/frail group, a higher RMR was associated with a lower risk of incident BADL disability (OR = 0.47, 95% CI = 0.23-0.96, p = 0.037), incident IADL disability (OR = 0.39, 95% CI = 0.18-0.84, p = 0.017), and mobility decline (OR = 0.30, 95% CI = 0.14-0.64, p = 0.002)., Conclusions: To our knowledge, this is the first study looking at the associations between RMR and functional health using a longitudinal research design. The results suggest that RMR could be used as an early identifier of a specific resilient group within the pre-frail and frail older population, with a lower risk of further health decline., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background/objetives: Multicomponent exercise programs have been demonstrated to prevent falls in older adults. However, the underlying responsible mechanisms are not clear. We aimed to analyze the association between changes in the limits of stability (LOS) as a relevant balance component, and falls occurrence during a multicomponent physical exercise program., Methods: Retrospective study, including ninety-one participants who had experienced a fall in the previous year, and were attended in a falls unit. All of them were included in a twice-a-week multicomponent exercise program during 16 weeks. Pre- and post-program measurements were collected for leg press, gait speed, the short physical performance battery (SPPB), and LOS (point of excursion [POE] and maximal excursion [MEX]) with posturography. Falls occurrence was assessed between the beginning and the completion of the exercise program (16 week)., Results: The mean age was 77.2 years, and 72 were female. Thirty-two participants fell at least once during the exercise period. The global baseline POE was 47.6 %, and the MEX was 64.7 %, and there were no differences between fallers and nonfallers. Nonfallers presented greater improvements in POE (6.3 % versus 1.3 %; p < .05) and MEX (9.2 % versus 3.0 %; p < .01) than fallers. The POE and MEX were independently associated with a reduced probability of having had a fall, OR: 0.95 (95 % CI: 0.91 to 0.99) and 0.94 (95 % CI: 0.90 to 0.99), respectively. Changes in SPPB results or leg press strength were not associated with decreased falls. Adjusted probability of fall occurrence decreased by 5 % and 6 % per 1 % improvement in absolute values in POE and MEX, respectively., Conclusions: Improvements in LOS after a multicomponent physical exercise program in older adults with previous falls may be associated with a decreased occurrence of falls., Competing Interests: Declaration of competing interest All authors declare that there are no conflicts of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objectives: To determine whether the interaction between frailty status and depression risk is associated with hospitalization density in older adults., Methods: Ongoing cohort study in 794 subjects aged over 70 years from Albacete (Spain). Data were collected on depression risk, frailty, hospitalizations, and covariates. Participants were categorized into six groups., Results: Adjusted hospitalization risk was higher for groups of prefrail/-non depression risk (HR 1.48; 95% confidence interval (CI) 1.16-1.89), prefrail/depression risk (HR 1.73; 95% CI 1.29-2.30), frail/non depression risk (HR 1.79; 95% CI 1.22-2.62), and frail/depression risk (HR 2.12; 95% CI 1.49-3.02), compared with robust/non depression risk group (p<0.01). Frail and prefrail groups presented increased hospitalization density in the first four follow-up years., Conclusions: Depression risk changes the yearly probabilities of hospitalization in prefrail and frail groups, increasing them in the first years. Depression risk should be monitored in prefrail and frail older adults as an independent risk factor for hospitalization., Competing Interests: Declarations of competing interest none, (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the psychological and functional sequelae of the COVID-19 pandemic among older adults living in long term care facilities (LTCFs)., Design: Cohort longitudinal study SETTING ANT PARTICIPANTS: A total of 215 residents ≥ 65 years without moderate-to-severe cognitive impairment, living in five LTCFs in Albacete (Spain)., Measurements: Baseline on-site data were collected between March - June 2020 and three-month follow-up between June to September 2020. Symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and sleep disturbances were measured as psychological variables. Disability in basic activities of daily living (BADL), ambulation and frailty were assessed as functional variables. Differences were analyzed in relation to level of comorbidity and test positivity for COVID-19., Results: At baseline, residents with COVID-19 presented worse functionality, higher frailty levels and malnutrition risk compared to non-COVID-19 residents. At three-month follow-up, higher rates of clinically significant depressive symptoms (57.7%), anxiety symptoms (29.3%), PTSD symptoms (19.1%) and sleep disturbances (93.0%) were found among residents regardless of COVID status. Thus, among 215 residents, 101 (47%) experienced a decline in BADL from baseline to the 3-month follow-up (median functional loss = 5 points in Barthel Index). In multivariate analyses, COVID-19 status did not explain either the functional or the ambulation loss. By contrast, residents with low comorbidity and COVID-19 presented higher PTSD symptoms (effect 2.58; 95% CI 0.93 to 4.23) and anxiety symptoms (effect 2.10; 95% CI 0.48 to 3.73) compared to the low comorbidity/non-COVID19 group., Conclusion: COVID-19 pandemic was associated, after three-months, with high psychological impact in older adults in LTCFs., specifically with higher post-traumatic stress and anxiety symptoms. Functional decline did not differ in relation to COVID-19 status but could be related to isolation strategies used for pandemic control., (Copyright © 2022. Published by Elsevier Inc.)

Background: Theres is uncertain evidence regarding the prevalence, measurement tools, outcomes, and efficacy of the interventions on frailty in hospitalized older adults. For this reason, we present the results of a systematic review about Frailty and Hospital, following the PRISMA methodology., Methods: We found 2,050 articles published in PubMed. After an initial assessment of titles and abstracts, complete comprehensive text lecture, and meta-analysis review, we finally included in the systematic review 246 originals., Results: The main result of the systematic review is that from the 246 articles, 179 described frailty prevalence in hospital older adults, with a pooled prevalence of 41.4% (95% CI 38.4% to 44.4%; range 4.7% to 92.5%). The most frequent type of studies were those observational prospectives 166 (67.5%), being the rest observtcional retrospectives or cross-sectional 64 (26.2%) or randomized clinical trials 15 (6.1%). The most frequent healthcare levels where the studies took place were the Hospital/Hospitalization in 125 (50.8%), Geriatric Department in 41 (16.7%), Surgical Units in 23 (9.3%), Cardiology Department in 18 (7.3%), Emergency Department in 15 (6.1%), and other in 24 (9.8%). The most frequent used measurement tolos were the Clinical Frailty Scale in 69 works (28%), the frailty phenotype in 41 (15.9%), the Frailty Index in 39 (15.9%) and the FRAIL scale in 27 (11.0%). In several papers, more than one instrument was used, and in many of them, scales and cut-off points were arbitrarely determined, producing a great results heterogeneity., Conclusions: The prevalence of frailty in hospitalized older adults is very high. It is necessary to improve frailty measure homogenity and to realize randomized clinical trials in this population.

Using AI, we identified baricitinib as having antiviral and anticytokine efficacy. We now show a 71% (95% CI 0.15 to 0.58) mortality benefit in 83 patients with moderate-severe SARS-CoV-2 pneumonia with few drug-induced adverse events, including a large elderly cohort (median age, 81 years). An additional 48 cases with mild-moderate pneumonia recovered uneventfully. Using organotypic 3D cultures of primary human liver cells, we demonstrate that interferon-α2 increases ACE2 expression and SARS-CoV-2 infectivity in parenchymal cells by greater than fivefold. RNA-seq reveals gene response signatures associated with platelet activation, fully inhibited by baricitinib. Using viral load quantifications and superresolution microscopy, we found that baricitinib exerts activity rapidly through the inhibition of host proteins (numb-associated kinases), uniquely among antivirals. This reveals mechanistic actions of a Janus kinase-1/2 inhibitor targeting viral entry, replication, and the cytokine storm and is associated with beneficial outcomes including in severely ill elderly patients, data that incentivize further randomized controlled trials., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)

Background/objectives: To assess whether gait plasticity and gait reserve, valid measures of gait adaptation to environmental stressors, are associated with frailty., Design: Cross-sectional sub-analysis of the FISTAC study (Identification of the Physical Attributes of the Fear of Falling Syndrome)., Setting: Community-dwelling women from the Falls Unit of a Geriatrics Department., Participants: One hundred and twenty-nine women with an age ≥ 70 years old and presence of at least one previous fall in the last year., Measures: Age, comorbidity, nutritional status, cognitive status, depression, medications, disability, fear of falling, physical function, hand grip strength, 1RM leg-press strength, maximum and mean leg-press power were determined. Frailty was assessed using the frailty phenotype criteria. Gait plasticity parameters were measured by walking at normal pace, fast pace, and slow pace, and mean (left and right) stride velocity and stride variability (SD) for the three walks were determined independently and for the sum of the three walks. Gait reserve was calculated as the difference in stride velocity from normal to fast pace. ROC curves were constructed to determine the best association between gait plasticity parameters and frailty., Results: The mean age of the participants was 79 years (SD 8.0). The median of normal, fast, slow and three-walks pace stride velocity were 68.9 cm/s (interquartile range [IQR 33.8]), 96.1 cm/s (IQR 38.3), 51.6 cm/s (IQR 19.8), and 72.7 cm/s (IQR 20.7) respectively. The median of normal, fast, slow and three-walks pace stride variability were 4.5 cm/s (IQR 3.3), 5.4 cm/s (IQR 3.8), 3.6 cm/s (IQR 2.3) and 15.9 cm/s (IQR 16.5) respectively. The median of gait reserve was 23 cm/s (IQR 46). Gait reserve and fast pace stride velocity were associated not only with frailty, but also with a lower age, disability, depression, physical function, muscle strength and power, and fear of falling, more than gait velocity. Areas under the curve (95% CI) for gait parameters with stronger association with frailty were fast pace stride velocity 0.801 (0.723-0.880), three-walk mean stride velocity 0.761 (0.678-0.845), three-walks stride variability 0.724 (0.635-0.81) and gait reserve 0.727 (0.635-0.818)., Conclusions: Lower gait reserve and lower gait plasticity have a stronger association with frailty than gait speed in older women. Our results may support the use of these gait parameters to early identify frailty in community-dwelling older women., (Copyright © 2020. Published by Elsevier Inc.)

Background/objectives: To analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain., Design: Epidemiological study., Setting: Six open LTCFs in Albacete (Spain)., Participants: 198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents., Measurements: Baseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed., Results: The pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals., Conclusion: The COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high., Competing Interests: The authors have declared that no competing interests exist.

(1) Background: Linking physical activity to the teaching of curricular contents provides numerous motivational and emotional benefits which improve academic performance and lead to the improvement and creation of healthy habits from an early age. (2) Method: The objective of the study is to analyze the effectiveness of a 5-week intervention program based on the use of a combined methodology of physical activity and gestures on motivation and vocabulary learning in English. The sample of children was aged from 4 to 7 years and was recruited from three children's centers in Tegucigalpa, Honduras. A quasi-experimentalstudy was carried out using a pretest-posttest design in a sample (n = 88). (3) Results: Statistically significant results were obtained in the learning of words through the combined methodology of gestures and motor activity, compared to the traditional methodology used in the control group. (4) Conclusions: The main conclusions are that motor and expressive activities at an early age can be an effective motivational resource that promotes an increase in children's physical activity time in the classroom. Further, it improves academic performance, producing a more effective learning of the vocabulary of a second language.

Background/objectives: Multicomponent exercise programs are the cornerstone in preventing gait and balance impairments and falls in older adults. However, the effects of these programs in usual clinical practice have been poorly analyzed., Design: 4-Month, twice-a-week multicomponent exercise program cohort study in real-life., Setting: Falls Unit, Complejo Hospitalario Universitario of Albacete, Spain., Participants: Sixty-seven participants who had experienced a fall in the previous year were included., Measurements: Pre- and post-intervention measurements were collected for leg press, gait speed, the Short Physical Performance Battery (SPPB), the Falls Efficiency Scale International, fat mass percentage, body mass index, the Geriatric Depression Scale by Yesavage (GDS), the Mini Mental State Examination, and the number of falls., Results: Fifty participants completed the program (adherence rate 75%, attendance 80%). Their mean age was 77.2 (SD 5.8) years; 39 were women. The participants reduced the mean number of frailty criteria from 2.1 to 1.3 (95%CI 0.4-1.1) and increased mean gait speed from 0.65 m/s to 0.82 m/s (95%CI 0.11-0.22), increasing their median SPPB scores from 8.5 to 10.0 points (p < 0.001), leg press strength from 62.5 kg to 80.0 kg (p < 0.001), and leg press power at 60% load from 76 W to 119 W (p < 0.001). There was also an improvement in GDS scores from 5.3 to 4.4 (95%CI 0.1-1.7). Body mass index did not change, but fat-free mass increased from 43.7 kg to 44.2 kg (95%CI 0.1-1.0), and fat mass percentage declined from 36.7% to 36.0% (95% CI 0.1-1.4). Seventeen patients (34%) had a fall during the six-month follow-up, and there was a reduction in the median number of falls from 3.0/year to 0.0/six months., Conclusions: A multicomponent Falls Unit-based exercise program as part of usual clinical practice in real life, improved physical function, reduced depressive symptoms, improved body composition and decreased the number of falls in older adults with previous falls., (Copyright © 2018 Elsevier Inc. All rights reserved.)