Search

Background: Examining the interrelationships between symptoms of depression and sociodemographic and behavioral correlates is challengeful using traditional regression analysis. Objective: to identify the sociodemographic, movement behaviors, and sleep correlates that contribute the most to symptoms of depression in Brazilian older females, using a network analysis approach. Methods: This cross-sectional study analyzed 1019 older females from Brazil. Data (sociodemographic, height (meters), weight (kilograms), symptoms of depression, physical activity, sleep) were self-reported via phone calls. The relationships between symptoms of depression and their correlates were assessed using the Network Analysis (qgraph package of the Rstudio) for entire sample and age groups (60-69; 70-79 and 80+ years old). Results: 60-69 and 70-79 groups have more weekly home exits, with aging “single, widowed or divorced” was progressively higher, and “married or stable union” and Overweight/obesity were progressively fewer (p < 0.05). 60-69 have more education years and fewest medicaments use. Sleep compliance (for the entire sample), body mass index (for the 60-69), compliance with moderate to vigorous physical activity (for the 70-79), and educational level (for 80+) were the variables with the highest expected influence values (p < 0.05) on symptoms of depression (1.370; 1.388; 1.129; and 1.354, respectively). Conclusion: Symptoms of depression vary throughout the aging process and thus determine that intervention strategies encompass these specific factors according to each age group. Poor sleep behavior has a strong positive association with symptoms of depression. This result highlights that health professionals must be aware of the importance of sleep to mitigate the worsening of depression among older Brazilian females.

A solidão é uma percepção de insatisfação que parece resultar da carência de relacionamentos significativos, sendo múltiplos os seus potenciais fatores causais. A atual evidência não é robusta no que diz respeito à associação da solidão com a atividade física (AF) e aptidão física (ApF) em adultos 50+. O objetivo deste estudo transversal é caracterizar a AF e ApF de acordo com a solidão. Os 62 indivíduos portugueses (64,68 ± 6,85 anos; 68% mulheres) foram avaliados para solidão (Escala de Solidão de 16 itens da Universidade da Califórnia em Los Angeles - UCLA-16) e classificados como Isolamento Social ou Afinidades, i.e., presença de relações socias significativas. A AF foi estimada por questionário (Questionário Internacional de AF - Versão Curta - IPAQ-SV) e a ApF medida pela bateria Senior Fitness Test (força de membros superiores e inferiores, flexibilidade de membros superiores e membros inferiores, aptidão cardiorrespiratória e agilidade e equilíbrio dinâmico. Foram utilizadas estatísticas descritivas. A comparação entre grupos foi realizada através de testes paramétricos (teste-t, ANCOVA ajustada ao sexo e qui quadrado) e não paramétricos (Mann-Whitney). A prevalência de isolamento social foi de 53%. O grupo Afinidades apresentou mais AF moderada a vigorosa comparativamente ao grupo Isolamento Social (11,43 [0,00 – 17,14] vs (0,00 [0,00 – 12,86], respetivamente; p = 0,041). Após ajuste para o sexo, as diferenças deixaram de ser significativas. Os grupos de solidão não foram diferentes relativamente à ApF. A AF parece contribuir para um melhor perfil mental de adultos e idosos, contudo, os resultados devem ser confirmados em estudos com amostras maiores.

Control and monitor the training load program and training responses in athletes is important to avoid negative consequences of high training loads, such as injuries, illness and performance decay. Specifically in American football teams, there is a large number of athletes to monitor and depending on the sports team, they may or may not have easy access to a certain type of instrument. A reference material about instruments already used to monitor training load and training responses in American football athletes is interesting. This could help coaches and researchers to choose better instruments to use in their clinical practice or to cover some gap in the literature, advancing the state of the art. In this sense, the objective of this scope review is to indicate which tools have already been used to monitor training response and training load, thus indicating the limitations and gaps that researchers can advance. This study is a scoping review of the literature to be performed based on the stages proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) for Scoping Reviews. The search for studies will be carried out in the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE [via: PubMed]), Web of Science, Excerpta Medica DataBase (EMBASE), Scopus, and SPORTDiscus. For Scopus and Embase we used the “title, abstract, keywords” filter. For the Web of Science we used the “topic” (title, abstract, author keywords, and Keywords Plus) filter. For SPORTDiscus we selected only "Academic Journals". The gray literature will be consulted using Google Scholar, Research Square, and MedRxiv. The search strategy will be developed from a combination of controlled descriptors and/or keywords related to the topic, without applying restrictions related to publication periods or language. The identified studies will be imported to EndNote Basic to remove the duplicates, and then imported into the Rayyan software. Studies without duplicates will then be evaluated and selected based on eligibility criteria by groups of two independent and blinded reviewers by reading the title and abstract of the studies (phase 1), followed by reading the full text of the selected studies in phase 1 (phase 2). Any disagreements in the process of study selection will be solved by a third reviewer. The lists of references cited by selected studies in phase 2 will be analyzed (hand search) to identify other eligible studies to be included in this review. The data of selected studies will be analyzed and collected by two independent and blinded reviewers, by filling out a characterization table in Microsoft Word software, which contains: characteristics of the study, characteristics of individuals, characteristics of instruments. At the end of this process, a cross-checking of all information retrieved from the studies will be carried out. The divergences will be resolved by a third reviewer.

Aim: The time spent in different physical activity (PA) intensities is associated with sarcopenia risk for community-dwelling older women. Introduction: To evaluate the role of sitting time and physical activity (PA) level as predictors of sarcopenia odds. Method: In a cross-sectional study, physically independent older women (n=67) performed the six-minute walk test to identify functional limitations (≤400m). Sedentary time (as sitting time) and PA (light, moderate and vigorous) were obtained with the International Physical Activity Questionnaire (IPAQ). Sarcopenia was diagnosed as recommended by the Society of Sarcopenia, Cachexia and Wasting Disorders (SCWD) [1]. Sarcopenia odds (low muscle mass and functional limitation) was predicted by binary logistic regression, considering the weekly sitting time and PA as independent variables. Results: Sarcopenia prevalence was 7.5% (n=5), with functional limitation present in 38.8% (n=26), and low muscle mass in 22.4% (n=15). The predictive model (p=0.014) involved moderate PA as the only significant predictor (OR=0.999; p=0.005; 95% CI: 0.998–1.000) of functional limitation. Moderate PA prevents sarcopenia odds. Each weekly hour of moderate PA decreased sarcopenia odds by 6%. Conclusion: Time spent in moderate PA can prevent sarcopenia.

Handgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness.A cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0-10.0% (reference group), 10.1-20.1%, 20.1-30.0% or30.0%. Slow gait speed was established as0.59 (men) and0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index "[(HGS asymmetry*HGS)/(BMI*Age)]*100" cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%).Compared to HGS reference group, those with HGS asymmetry of 10.1-20%, 20.1-30.0% and30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men).HGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity.

Background Social distancing during the COVID-19 pandemic may lead to adverse mental health consequences, such as depression, among older adults. This study aimed to investigate the predictors of lower depression scores in older adults living under lockdown. Methods 1,123 older Brazilian adults were cross-sectionally assessed for depression, physical activity (PA), pet ownership (dogs, cats, and birds), ability to make video calls, leaving home during lockdown, and not living alone. The statistical procedures included linear regression and analysis of covariance (ANCOVA). Results After adjusting for age, sex, and race, moderate to vigorous PA (β = −0.014, p < .001), it was found that PA (β = −0.905, p < .001) and dog ownership (β = −0.545, p = .004) were associated with lower depression. No association was observed between depression and other conditions. Conclusions With the likelihood of subsequent COVID-19 waves, remotely delivered PA programs might be a strategy to counteract the negative psychological effects of lockdown on older adults.

Background : Handgrip strength (HGS) is a well-established clinical biomarker that assesses functional capacity in older populations. In addition, HGS is a diagnostic tool that forecasts aging health conditions, such as sarcopenia. Aims : This paper provides HGS statistical tolerance regions and presents the need to establish HGS reference values according to patients' characteristics. Methods : For this purpose, we used a conditional tolerance algorithm for HGS, and we observed the tolerances regions in different age strata and sex of non-sarcopenic individuals from the National Health and Nutrition Examination Survey (NHANES, wave 2011-2012). Results and Discussion : Our results have critical implications for sarcopenia since conventional and available HGS cut-offs do not consider age range. Conclusions : This paper offers new perspectives on the evolution of traditional definitions of sarcopenia according to the principles of precision medicine.

Background Some behaviors can influence compliance to physical activity and exercise during aging. Nutritional status, health risk behaviors, and eating habits may be associated with recommended amounts of physical activity and exercise in healthy older adults. However, these associations are still not clear for older hypertensive adults, that require greater care from health professionals. We aimed to associate the nutritional status, health risk behaviors, and eating habits with recommended amounts of physical activity and exercise practice of older hypertensive adults. Methods 10,789 older hypertensive adults (70.9 ± 7.4 years) from VIGITEL survey were classified according to physical activity/exercise practice. Binary logistic regression was used to observe the odds ratio (OR) between nutritional status, risk behaviors (screen time, alcohol, and tobacco consumption), and eating habits (minimally/ultra-processed foods consumption score) with recommended amounts of physical activity/exercise. Results Highest nutritional status (ORPHYSICAL−ACTIVITY=-2.7%; OREXERCISE=-2.1%), screen time (ORPHYSICAL−ACTIVITY=-10.2%), alcohol consumption (ORPHYSICAL−ACTIVITY=-31.1%; OREXERCISE=-29.4%), tobacco (ORPHYSICAL−ACTIVITY=-38.4%; OREXERCISE=-53.2%) and ultra-processed foods consumption score (ORPHYSICAL−ACTIVITY=-10.1%; OREXERCISE=-11.2%) reduced the odds of being sufficiently active/practicing exercise (p PHYSICAL−ACTIVITY=13.2%; OREXERCISE=16.8%, respectively; p

O treinamento de força com restrição do fluxo sanguíneo (TFRFS) permite que pessoas vivendo com HIV/AIDS (PVHA) se exercitem em intensidades mais baixas do que o treinamento de força tradicional (TFT). Mas as respostas hemodinâmicas agudas e crônicas de PVHA seguindo um protocolo de TFRFS são desconhecidas. Assim, o objetivo deste estudo foi comparar as respostas hemodinâmicas agudas entre TFT ou TFRFS em PVHA. Neste ensaio clínico randomizado, 14 PVHA foram alocados em TFRFS (GTFRFS; n = 7) ou TRT (GTRT; n = 7). Ambos os protocolos de treinamento de força tiveram 36 sessões (12 semanas, três vezes por semana). A intensidade do protocolo foi de 30% (GTFRFS) e 80% (GTFT). A frequência cardíaca e a pressão arterial foram registradas de forma aguda (repouso e pós-exercícios 7ª, 22ª e 35ª sessões) e cronicamente (pré e pós programa). Modelos lineares gerais foram aplicados para determinar a interação grupo*tempo. Nas comparações entre os grupos as respostas hemodinâmicas não foram diferentes (p> 0,05), independente da sessão de avaliação. Conclui-se que TFRFS e TRT induziram respostas hemodinâmicas semelhantes em PVHA, sem riscos significativos de aumento do estresse cardiovascular. Portanto, o TFRFS apresenta uma alternativa segura ao treinamento de força para PVHA.

A sarcopenia é uma doença caracterizada pela redução da força e da massa muscular. A prevalência desta condição tem uma tendência de aumento entre a população idosa, com maior incidência em países subdesenvolvidos. Os instrumentos recomendados por consensos e consórcios internacionais para medir os componentes que identificam a sarcopenia envolvem alto custo e nem sempre estão muito disponíveis na prática clínica. Este capítulo tem por objetivo apresentar alternativas viáveis para identificar sarcopenia na atividade cotidiana dos profissionais da saúde. Para tal, foi realizada uma revisão narrativa da literatura. Foram identificados modelos antropométricos preditivos da força de preensão manual e da massa muscular apendicular, mensuradas por dinamometria manual e absorciometria radiológica de dupla energia (DXA), respectivamente. Esses instrumentos são recomendados internacionalmente como os mais indicados na literatura, para identificar sarcopenia. Além dessas medidas, o consenso europeu sobre sarcopenia também recomenda o teste de sentar e levantar da cadeira (força muscular) e perímetro da panturrilha (estimativa da massa muscular) como alternativas possíveis. Neste capítulo, são apresentados quadros e tabelas com os parâmetros de referência (pontos de corte) de cada uma dessas medidas para identificar a baixa força e massa muscular. Em conclusão, existem métodos que fazem uso de medições antropométricas e testes simples, com referenciais específicos na identificação de baixa força e massa muscular. O profissional da saúde tem condições de monitorar o risco de sarcopenia nos idosos mediante recursos simples e rotineiros de sua prática clínica. Como resultado, aumentam as chances de sucesso nas estratégias de intervenção preventivas da sarcopenia no idoso ou seu agravamento.

Resumo Fundamento A aptidão física é um importante determinante da qualidade de vida (QV) em pacientes com insuficiência cardíaca com fração de ejeção preservada (ICFEP). No entanto, ainda não se sabe como os diferentes componentes da aptidão física se relacionam com as dimensões específicas da QV em pacientes com ICFEP. Objetivo Avaliar a associação entre diferentes componentes da aptidão física e dimensões da QV em pacientes com ICFEP, e examinar quais componentes da aptidão física foram independentemente associados à QV. Métodos Os pacientes com ICFEP foram avaliados quanto à aptidão física [equilíbrio dinâmico e mobilidade (“teste 8-feet Up-and-go ”), força da parte superior do corpo (Teste de força de preensão manual), aptidão cardiorrespiratória (ACR) (teste de caminhada de 6 minutos) e composição corporal (índice de massa corporal)] e para QV ( Minnesota Living With Heart Failure Questionnaire ). Uma correlação parcial foi utilizada para verificar a associação entre os componentes da aptidão física e as dimensões da QV. A análise das dimensões dos preditores independentes de QV foi realizada através da análise de regressão linear multivariada stepwise . A significância estatística foi estabelecida em p

BackgroundThe role of food type consumption on nutritional status (NS) transition from overweight (OW) to obesity (OB), represents a higher risk in the development of chronic diseases, morbidity, premature mortality, and health services burden compared to normal weight to OW. In this sense, minimally and ultra-processed foods can impact on NS transition. However, the influence of quantity consumption has not yet been investigated. We aimed to investigate the magnitude of the impact of ultra-processed food and minimally processed food consumption in the change of NS from OW to OB.MethodsWe included 15.024 participants (9.618 OW [body mass index 25.0-29.9kg/m2], 5.406 OB [body mass index ≥30kg/m2]) with age ranging from 18 to 59 years-old from the 2019 baseline survey of the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey (VIGITEL). Minimally processed and ultra-processed food daily consumption and other confounding variables (age, sex, scholarity, physical activity, hypertension, and diabetes) were measured. Binary logistic regression analyzes the magnitude of the impact of ultra-processed food and minimally processed food consumption in the change of OW to OB. The odds ratio (OR) of transition (OW to OB) was calculated.ResultsIn general, minimally processed food (1st=1[food/day]; 2nd=6[food/day]; 3rd=7[food/day]; 4th=8[food/day]) presented higher quartile values compared to ultra-processed food (1st=1[food/day]; 2nd=1[food/day]; 3rd=2[food/day]; 4th=4[food/day]). For each minimally processed food consumed, there was a -5.9% chance of NS transition to OB. In this sense, the higher quartile (4th) of minimally processed food consumption represents less chance of the NS transition to OB (OR: -47.2%; pth quartile) shows higher chance of the NS transition to OB (OR: +14.8%; pConclusionThe consumption of ultra-processed and minimally processed foods presented a magnitude to change the NS (from OW to OB), even when controlled by sociodemographic factors, physical activity, hypertension, and diabetes. Therefore, our findings can help to guide the population about the magnitude of the effects that the consumption of different types of foods can modify their health.

Absolute muscle strength or adjusted by body mass index (BMI) are useful to identify sarcopenia. However, these values are not accurate for older adults with extreme body sizes because the nonlinear relationship between strength and body size. The purpose was to determine cut-off points for identify sarcopenia in older adults using allometric coefficients to normalise handgrip strength (HGS) and 30-sec chair stand test (30-s CST) by body size. Allometric exponents were proposed with log-linear models for body-size variables (body mass, height and BMI). The remotion of body-size effect on muscle strength with allometric normalisation was tested by partial correlation. Cut-off points for low muscle strength were established by ROC curve and Youden index considering functional limitation (six-minute walk test70%). Allometry removed influence of body size on the expression of HGS and 30-s CST and permits evaluate muscle strength regardless of body-size. RESUMO A força muscular absoluta ou ajustada pelo índice de massa corporal (IMC) é útil para identificar a sarcopenia. No entanto, esses valores não são precisos para idosos com tamanhos corporais extremos devido à relação não linear entre força e tamanho corporal. O objetivo foi determinar os pontos de corte para identificar a sarcopenia em idosos usando coeficientes alométricos para normalizar a força de preensão manual (FPM) e teste de sentar e levantar da cadeira em 30 segundos (30-s CST) por tamanho corporal. Os expoentes alométricos foram propostos com modelos log-lineares para variáveis de tamanho corporal (massa corporal, estatura e IMC). A remoção do efeito do tamanho corporal na força muscular com normalização alométrica foi testada por correlação parcial. Os pontos de corte para baixa força muscular foram estabelecidos pela curva ROC e índice de Youden considerando a limitação funcional (teste de caminhada de seis minutos70%). A alometria removeu a influência do tamanho corporal na expressão da FPM e 30-s CST e permite avaliar a força muscular independentemente do tamanho corporal.

OBJECTIVE: To test the cross-validation of anthropometric prediction equations for appendicular muscle mass (AMM) in older Brazilian women. METHODS: Sixty-seven older women (69.84 ± 5.95 years old) underwent anthropometric measurements. AMM (kg) reference values obtained by dual-energy X-ray absorptiometry (AMMDXA) were compared to 20 anthropometric equations for estimating AMM in older adults. A paired t-test (p > 0.05), standard error of estimate (SEE < 3.50 kg), and r2 > 0.70 confirmed the validity of the equations. The agreement between predictions and the reference was also verified (Bland-Altman analysis of agreement between methods). RESULTS: Four American equations and one Mexican equation were not statistically different from AMMDXA (p > 0.05) but did not present suitable r2 values for validation. The American equation from the National Health and Nutrition Examination Survey (NHANES), AMM (kg) = (-0.04 × age [years]) + (0.46 × calf circumference [cm]) + (0.32 × arm circumference [cm]) + (0.11 × thigh circumference [cm]) – (0.27 × body mass index [BMI, kg/m2]) + (0.07 × waist circumference [cm]) – 13 119 showed the best performance (r2 = 0.64; SEE = 3.24 kg), with minimal mean difference (0.26 kg), no heteroscedasticity for extreme values, and with high agreement with the Brazilian sample (-3.90 to 3.40 kg). CONCLUSION: When specific equations for a given population are not available, the use of generic equations of greater sample representativeness with scientifically and reliably analyzed data is allowed.

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 +/- 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirao Preto, Sao Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19. Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) 001 88882.317622/2019-01 info:eu-repo/semantics/publishedVersion

Background: Although home confinement reduces the number of SARS-CoV-2 infections, it may negatively impact the psychological and physical health of older adults. Objective: The present study attempted to describe the quality of life (QoL) of older adults before and during the COVID-19 outbreak, focusing on evaluating QoL, physical activity, sitting time, and sleep quality during home confinement. Method: The present study was conducted in 1,063 older adults (91 % females) enrolled in a Brazilian social program. They were interviewed for QoL (EQ-5D), physical activity (international physical activity questionnaire-short), and sleep quality [Pittsburgh sleep quality index (PSQI)] after 11.6 ± 2.4 weeks of confinement. Logistic regression confirmed changes in QoL. Results: The QoL (86.5 ± 14.7) decreased significantly during confinement (66.0 ± 21.0; P < 0.001), whereas the PSQI global score was 6.8 ± 3.9 points. Older adults spent 18.7 ± 29.8 min/day in moderate to vigorous physical activity, whereas they spent 325.5 ± 144.4 min/day sitting. The PSQI global score [odds ratio (OR): 1.10], sitting time (OR: 1.001), and diseases (OR: 1.23) were significantly associated with low QoL (P < 0.05). Conclusion: Confinement has a deleterious effect on QoL, which is influenced by quality of sleep, sitting time, and disease. Awareness regarding the significance of sleep and physical exercise in older adults can mitigate the damage to their health during confinement.

Reduced levels of children’s physical activity (PA) and fundamental motor skills (FMS) along with increased sedentary behaviors have been observed in recent years. Yet, associations between these variables are not yet well established. This study aimed to observe the associations between FMS, PA and sedentary time in elementary school children. We evaluated 148 children (70 boys; Mage = 8.7, SD = 1.4 years old) from a private school using the Test of Gross Motor Development – Second Edition (TGMD-2) to measure FMS and examine locomotor, object control, and gross motor skills. We used accelerometry to measure PA performed on weekdays, weekends and total PA. We used descriptive statistics, partial correlations controlling for sex and age, and linear regression adjusted for sex and equivalent motor age to explain the relationships. Total moderate to vigorous PA (MVPA) (β: 0.153; p = .009) and weekend MVPA (β: 0.171; p = .003) were significantly associated with FMS, regardless of gender and equivalent motor age. Sedentary time was not significantly associated with FMS ( p = .065). Girls and boys who met PA recommendations (≥60 minutes/day of moderate to vigorous PA) had higher frequencies of high ratings on the TGMD-2 ( p

IntroductionWeakness is a natural age-related condition meaning the loss of muscle strength that impairs older adults’ mobility and quality of life. Because the relationship between muscle strength and body-size variables is non-linear, weakness is misclassified in older adults with extreme body size (e.g., light, short, heavy, or tall). This misclassification can be overcome using the allometric approach.ObjectivesTo propose cut-off points for older adults’ weakness for upper and lower limbs muscle strength normalized by body size with the ratio standard and allometric scaling.MethodsNinety-four community-dwelling older adults (69.1% women) were assessed for 49 body-size variables (anthropometry, body composition and body indexes), handgrip strength (HGS), one maximum repetition measurement for knee extensors (1RMknee extensors), isokinetic knee extension peak torque at 60°/s (knee extensionPT60°/s), and six-minute walk test (6MWT). Ratio standard (muscle strength/body size) and allometric scaling (muscle strength/body sizeb; when b is the allometric exponent) were applied for body-size variables that significantly were correlated with HGS, 1RMknee extensors and knee extensionPT60°/s. Cut-off points were computed based on ROC curve and Youden index. When there was mobility limitation (6MWTResultsAbsolute HGS, 1RMknee extensors and knee extensionPT60°/s cut-off points were not adequate because they were associated with body size (r>0.30). But it was corrected with muscle strength normalization according to body size-variables: HGS (n=1); 1RMknee extensors (n=24) and knee extensionPT60°/s (n=24). The best cut-off points, with the highest area under the curve (AUC), were found after normalization for men: HGS/forearm circumference (1.33 kg/cm, AUC=0.74), 1RMknee extensors/triceps skinfold (4.22 kg/mm, AUC=0.81), and knee extensionPT60°/s/body mass*height0.43 (13.0 Nm/kg*m0.43, AUC=0.94); and for women: HGS/forearm circumference (1.04 kg/cm, AUC=0.70), 1RMknee extensors/body mass (0.54 kg/kg, AUC=0.76); and knee extensionPT60°/s/body mass0.72 (3.14 Nm/kg0.72; AUC=0.82).ConclusionNormalization removes the effect of extreme body size on muscle strength and improves the accuracy to identify weakness at population level, reducing the risk of false-positive cases.HighlightsThis study proposed a new approach to identify muscle weakness in older adults based on upper and lower limbs muscle strength normalized by body size (ratio standard and allometry).The identification of functional limitation is more precise when procedures of muscle strength normalization is applied.

The therapeutic potential of exercise training in the mobilization of endothelial progenitor cells (EPCs) into the peripheral blood in patients with cardiovascular disease is not yet clear. A systematic review and meta-analysis was performed in order to assess the effectiveness of exercise training in increasing the number of circulating EPCs in patients with cardiovascular disease. A literature search was conducted across the PubMed, Scopus, Web of Science and EBSCO databases, including the reference lists of relevant papers. The quality of randomized clinical trials was evaluated using the PEDro scale. The primary outcome data were circulating EPC levels. Six studies (236 participants) – three on heart failure (n=111), one on peripheral arterial disease (n=40) and two on coronary artery disease (n=85) – were included. There was an increase in EPC levels in the exercise training groups (effect size [ES]=0.57; 95% CI: 0.01-1.12), with considerable heterogeneity (I2=75.6%; p

Background Dementia is a leading cause of death and disability that was declared as one of the greatest health and social care challenges of the twenty-first century. Regular physical activity and exercise have been proposed as a non-pharmacological strategy in disease prevention and management. Multicomponent Training (MT) combines aerobic, strength, balance and postural exercises and might be an effective training to improve both functional capacity and cognitive function in individuals with dementia (IwD). Nevertheless, data on the effects of MT in IwD are still limited and the extent to which IwD can retain improvements after an exercise intervention still needs to be elucidated. The aim of “Body & Brain” study is to investigate the effects of a 6-month MT intervention and 3-month detraining on the physical and cognitive function of IwD. Additionally, we aim to explore the impact of this intervention on psychosocial factors and physiologic markers related to dementia. Methods This study is a quasi-experimental controlled trial using a parallel-group design. The study sample consists of community-dwelling individuals aged ≥60 years who are clinically diagnosed with dementia or major neurocognitive disorder. Participants will be either allocated into the intervention group or the control group. The intervention group will participate in MT biweekly exercise sessions, whereas the control group will receive monthly sessions regarding physical activity and health-related topics for 6 months. The main outcomes will be physical function as measured by the Short Physical Performance Battery (SPPB) and cognitive function evaluated using the Alzheimer Disease Assessment Scale – Cognitive (ADAS-Cog) at baseline, after 6-months and 3-months after the end of intervention. Secondary outcomes will be body composition, physical fitness, daily functionality, quality of life, neuropsychiatric symptoms and caregiver’s burden. Cardiovascular, inflammatory and neurotrophic blood-based biomarkers, and arterial stiffness will also be evaluated in subsamples. Discussion If our hypothesis is correct, this project will provide evidence regarding the efficacy of MT training in improving physical and cognitive function and give insights about its impact on novel molecular biomarkers related to dementia. This project may also contribute to provide guidelines on exercise prescription for IwD. Trial registration ClinicalTrials.gov – identifier number NCT04095962; retrospectively registered on 19 September 2019.

Absolute handgrip strength and adjusted by body mass index are useful to identify age-related conditions. However, these values are not accurate for older adults with extreme body size because of the nonlinear relationship between strength, height, and body mass. The purpose of this study was to determine cut-off points for age-related conditions of older adults using allometric coefficients to normalize grip strength by body size.Cross-sectional study.Data from 13,235 older adults of Study on Global Aging and Adult Health conducted in 6 low- and middle-income countries were analyzed.Country- and sex-specific allometric exponents for body-size variables (mass and height) were computed with log-linear models. Partial correlation verified whether allometric normalization removed the effect of body size on grip strength. Cut-off points were established (20th percentile) for low allometrically adjusted grip strength.Allometric exponents for normalization of grip strength were provided for body-size variables, ranging from 0.19 to 2.45. Allometric normalization removed the effect of body size on grip strength (r0.30). Overall, frequencies of low muscle strength were overestimated with international criteria (absolute grip strength) compared with the cut-off points proposed in this study.The proposed allometric exponents normalized grip strength according to body-size variables. These exponents improved the accuracy in identifying age-related conditions in older adults with extreme body size. The variability between strength reveals the need for developing specific cut-off points for low- and middle-income countries. New cut-off points of low normalized grip strength with automatized applicability were proposed for health care providers use in clinical practice.

The objective of this study was to observe the home-confinement effects on physical fitness, physical activity (PA), and body composition in active older adults, and to compare physical fitness and PA according to quality of life (QoL) during confinement. A total of 72 physically active older adults (61.1% females; 74.24 ± 5.57 years) were assessed pre- and postconfinement for aerobic capacity (6-min walk test), lower (30-s sit-to-stand), and upper (30-s arm-curl) body strength, PA (short-version of the International Physical Activity Questionnaire), and QoL (EQ-5D-visual analogue scale). The pre- and postconfinement comparisons show declines in upper (−2.24 ± 0.45 repetitions;p 2 = .276) and lower body strength (−2.65 ± 0.42 repetitions;p 2 = .378) in both genders, but not in aerobic capacity. Ninety percentage of older adults perceived a decline in PA. Older adults reporting high QoL increased 19.27 ± 97.04 m in the 6-min walk test, while the participants with low QoL reduced 28.32 ± 63.27 m (p = .018; η2 = .090). Previously active older adults did not have their aerobic capacity decrease significantly despite a decline in upper and lower body strength during an 11-week home confinement period.

Objective This study evaluated the effects of a short health education and counseling intervention program, in a primary healthcare setting, on daily physical activity (PA), arterial stiffness, and cardiac autonomic function in individuals with moderate-to-high risk of cardiovascular disease. Methods This was a parallel-group study with a 4-month-long intervention, plus 8 months of follow-up. 164 individuals with moderate-to-high cardiovascular risk were allocated to either an intervention (n = 87) or a control group (n = 77). The intervention consisted of 3 walking and face-to-face group sessions plus text messages. Primary outcome was daily PA (sedentary time, light and moderate-to-vigorous PA, all in min/day); secondary outcomes were arterial stiffness i.e., carotid-femoral pulse wave velocity (cfPWV, m/s)] and cardiac autonomic function [(i.e., standard deviation of all N-N intervals (SDNN, ms) and absolute high frequency (HF, ms2)]. Results There were not significant group*time interactions for sedentary time [−7.4 (7.6); p = 0.331)], light PA [4.4 (6.4); p = 0.491] or moderate-to-vigorous PA [0.1 (2.6); p = 0.938]. Considering secondary outcomes, there were not significant group*time interactions for cfPWV [0.09 (0.18); p = 0.592], Ln_SDNN [0.09 (0.06); p = 0.148], or Ln_HF [0.16 (0.14); p = 0.263]. Conclusion The program did not improve daily PA, arterial stiffness, or the autonomic cardiac function. Practice Implications Primary care staff should consider longer or other types of intervention to improve daily PA.