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1. Dynapenia and Metabolic Health in Obese and Nonobese Adults Aged 70 Years and Older: The LIFE Study

Author

Mylène Aubertin-Leheudre, Stephen Anton, Daniel P. Beavers, Todd M. Manini, Roger Fielding, Ann Newman, Tim Church, Stephen B. Kritchevsky, David Conroy, Mary M. McDermott, Anda Botoseneanu, Michelle E. Hauser, Marco Pahor, Thomas Gill, Carlos Fragoso, Jack M. Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E. Miller, Mark A. Espeland, Walter T. Ambrosius, William Applegate, Robert P. Byington, Delilah Cook, Curt D. Furberg, Lea N. Harvin, Leora Henkin, Med John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L. Stowe, Michael P. Walkup, Don Hire, W. Jack Rejeski, Jeffrey A. Katula, Peter H. Brubaker, Shannon L. Mihalko, Janine M. Jennings, Evan C. Hadley, Sergei Romashkan, Kushang V. Patel, Denise Bonds, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S. Church, Steven N. Blair, Valerie H. Myers, Ron Monce, Nathan E. Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K. Millet, Catrine Tudor-Locke, Ben P. Butitta, Sheletta G. Donatto, Shannon H. Cocreham, Abby C. King, Cynthia M. Castro, William L. Haskell, Randall S. Stafford, Leslie A. Pruitt, Kathy Berra, Veronica Yank, Roger A. Fielding, Miriam E. Nelson, Sara C. Folta, Edward M. Phillips, Christine K. Liu, Erica C. McDavitt, Kieran F. Reid, Dylan R. Kirn, Evan P. Pasha, Won S. Kim, Vince E. Beard, Eleni X. Tsiroyannis, Cynthia Hau, Stephen D. Anton, Susan Nayfield, Thomas W. Buford, Michael Marsiske, Bhanuprasad D. Sandesara, Jeffrey D. Knaggs, Megan S. Lorow, William C. Marena, Irina Korytov, Holly L. Morris, Margo Fitch, Floris F. Singletary, Jackie Causer, Katie A. Radcliff, Anne B. Newman, Stephanie A. Studenski, Bret H. Goodpaster, Nancy W. Glynn, Oscar Lopez, Neelesh K. Nadkarni, Kathy Williams, Mark A. Newman, George Grove, Janet T. Bonk, Jennifer Rush, Piera Kost, Diane G. Ives, Anthony P. Marsh, Tina E. Brinkley, Jamehl S. Demons, Kaycee M. Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M. Gill, Robert S. Axtell, Susan S. Kashaf, Nathalie de Rekeneire, Joanne M. McGloin, Karen C. Wu, Denise M. Shepard, Barbara Fennelly, Lynne P. Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N. Halpin, Matthew J. Brennan, Julie A. Bugaj, Maria A. Zenoni, Bridget M. Mignosa, Jeff Williamson, Hugh C. Hendrie, Stephen R. Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Valerie K. Wilson, Carl J. Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L. Chupp, Gail M. Flynn, John L. Hankinson, Carlos A. Vaz Fragoso, Erik J. Groessl, and Robert M. Kaplan

Subjects
Male, medicine.medical_specialty, Waist, Blood lipids, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Lower risk, Article, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Muscle Strength, Obesity, General Nursing, Abdominal obesity, Aged, Aged, 80 and over, Metabolic Syndrome, business.industry, Health Policy, General Medicine, Odds ratio, medicine.disease, Endocrinology, Female, Waist Circumference, Geriatrics and Gerontology, Metabolic syndrome, medicine.symptom, business, Body mass index
Abstract

Objective The purpose of this study was to examine the relationship between dynapenia and metabolic risk factors in obese and nonobese older adults. Methods A total of 1453 men and women (age ≥70 years) from the Lifestyle Interventions and Independence for Elders (LIFE) Study were categorized as (1) nondynapenic/nonobese (NDYN-NO), (2) dynapenic/nonobese (DYN-NO), (3) nondynapenic/obese (NDYN-O), or (4) dynapenic/obese (DYN-O), based on muscle strength (Foundation for the National Institute of Health criteria) and body mass index. Dependent variables were blood lipids, fasting glucose, blood pressure, presence of at least 3 metabolic syndrome (MetS) criteria, and other chronic conditions. Results A significantly higher likelihood of having abdominal obesity criteria in NDYN-NO compared with DYN-NO groups (55.6 vs 45.1%, P ≤ .01) was observed. Waist circumference also was significantly higher in obese groups (DYN-O = 114.0 ± 12.9 and NDYN-O = 111.2 ± 13.1) than in nonobese (NDYN-NO = 93.1 ± 10.7 and DYN-NO = 92.2 ± 11.2, P ≤ .01); and higher in NDYN-O compared with DYN-O ( P = .008). Additionally, NDYN-O demonstrated higher diastolic blood pressure compared with DYN-O (70.9 ± 10.1 vs 67.7 ± 9.7, P ≤ .001). No significant differences were found across dynapenia and obesity status for all other metabolic components ( P > .05). The odds of having MetS or its individual components were similar in obese and nonobese, combined or not with dynapenia (nonsignificant odds ratio [95% confidence interval]). Conclusion Nonobese dynapenic older adults had fewer metabolic disease risk factors than nonobese and nondynapenic older adults. Moreover, among obese older adults, dynapenia was associated with lower risk of meeting MetS criteria for waist circumference and diastolic blood pressure. Additionally, the presence of dynapenia did not increase cardiometabolic disease risk in either obese or nonobese older adults.

Published
2017
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2. Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study

Author

Shannon K. Cochrane, Shyh‐Huei Chen, Jodi D. Fitzgerald, John A. Dodson, Roger A. Fielding, Abby C. King, Mary M. McDermott, Todd M. Manini, Anthony P. Marsh, Anne B. Newman, Marco Pahor, Catrine Tudor‐Locke, Walter T. Ambrosius, Thomas W. Buford, Mark A. Espeland, William Applegate, Daniel P. Beavers, Robert P. Byington, Delilah Cook, Curt D. Furberg, Lea N. Harvin, Leora Henkin, John Hepler, Fang‐Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L. Stowe, Michael P. Walkup, Don Hire, W. Jack Rejeski, Jeffrey A. Katula, Peter H. Brubaker, Shannon L. Mihalko, Janine M. Jennings, June J. Pierce, Sergei Romashkan, Kushang V. Patel, Denise Bonds, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Steven N. Blair, Valerie H. Myers, Ron Monce, Nathan E. Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K. Millet, Ben P. Butitta, Sheletta G. Donatto, Shannon H. Cocreham, Cynthia M. Castro, William L. Haskell, Randall S. Stafford, Leslie A. Pruitt, Kathy Berra, Veronica Yank, Stephen D. Anton, Susan Nayfield, Michael Marsiske, Bhanuprasad D. Sandesara, Jeffrey D. Knaggs, Megan S. Lorow, William C. Marena, Irina Korytov, Holly L. Morris, Margo Fitch, Floris F. Singletary, Jackie Causer, Katie A. Radcliff, Stephanie A. Studenski, Bret H. Goodpaster, Nancy W. Glynn, Oscar Lopez, Neelesh K. Nadkarni, Kathy Williams, Mark A. Newman, George Grove, Janet T. Bonk, Jennifer Rush, Piera Kost, Diane G. Ives, Tina E. Brinkley, Jamehl S. Demons, Kaycee M. Sink, Kimberly Kennedy, Rachel Shertzer‐Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Robert S. Axtell, Susan S. Kashaf, Nathalie de Rekeneire, Joanne M. McGloin, Karen C. Wu, Denise M. Shepard, Barbara Fennelly, Lynne P. Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N. Halpin, Matthew J. Brennan, Julie A. Bugaj, Maria A. Zenoni, Bridget M. Mignosa, Hugh C. Hendrie, Stephen R. Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Valerie K. Wilson, Eileen Handberg, Gail M. Flynn, Thomas M. Gill, John L. Hankinson, Carlos A. Vaz Fragoso, and Robert M. Kaplan

Subjects
Gerontology, Male, Aging, Health Knowledge, Attitudes, Practice, Time Factors, Epidemiology, physical activity, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Cardiovascular Disease, Clinical Studies, Medicine, 030212 general & internal medicine, media_common, Original Research, Aged, 80 and over, Incidence, cardiovascular, Age Factors, Prognosis, Exercise Therapy, Cardiovascular Diseases, Female, Cardiology and Cardiovascular Medicine, media_common.quotation_subject, Physical activity, Fitness Trackers, 03 medical and health sciences, Patient Education as Topic, Predictive Value of Tests, Lifestyle intervention, accelerometry, Humans, Mobility Limitation, Association (psychology), Exercise, Geriatric Assessment, Aged, business.industry, Exercise therapy, Actigraphy, Protective Factors, Independence, United States, business, Risk Reduction Behavior
Abstract

Background Data are sparse regarding the value of physical activity ( PA ) surveillance among older adults—particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. Methods and Results Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home‐based activity data were collected by hip‐worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [ SD ] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84–0.96; P =0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65–0.89 [ P =0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow‐up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85–0.96 [ P =0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63–0.90 [ P =0.002]) were significantly associated with lower cardiovascular event rates. Conclusions Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01072500.

Published
2017

3. Study design of ASPirin in Reducing Events in the Elderly (ASPREE): A randomized, controlled trial

Author

E. Volpi, S. Katzman, A. A. Anwarrulah, B. Lewis, C. Womack, P. Wilson, Erica M. Wood, E. Hadley, J. Keller, M. Kidd, K. Dodd, Sharyn M. Fitzgerald, B. Ference, W. B. Applegate, Shawna D. Nesbitt, Walter P. Abhayaratna, S. V. Romashkan, M. Lang, V. A. Atlanta, Gerard Gill, J. Powell, T. Obisesan, Latha Palaniappan, M. Malik, A. Le, R. Swerdlow, C. Eaton, David Ames, J. Burns, H. Anderson, Elsdon Storey, Jessica E. Lockery, C. I. Johnston, Mark Nelson, J. Hannah, R. Head, Geoffrey A. Donnan, P. Bolin, T. Johnson, Andrew Tonkin, A. Newman, Christopher M. Reid, R. C. Shah, G. Pressman, A. Thomas, S. Satterfield, J. Weissfeld, Kevin A. Peterson, B. Radziszewska, J. Williamson, D. Gilbertson, John J McNeil, J. Flack, Jamehl S. Demons, K. Margolis, Nigel Stocks, Priscilla Pemu, J. Allard, James M. Shikany, Barbara Workman, L. Beilin, M. Singh, S. Anton, V. Figueredo, Peter Gibbs, P. Lichtenberg, Marco Pahor, M. Ernst, M. Ahmad, C. Jackson, Rory Wolfe, Sara E. Espinoza, M. Mikhail, F. MacRae, H. Krum, L. Cobiac, Lee A Birnbaum, J. Wiggins, V. Myers, W. Applegate, Nathan E. Britt, S. Krstevska, A. B. Newman, M. Oberoi, G. Russell, A. Gupta, D. Kruger, Robyn L. Woods, T. Church, R. E. Trevaks, B. Kirpach, Anne M Murray, R. Shah, Ron Monce, H. Tindle, M. Jelnik, L. M. Rodriguez, J. Aloia, B. Ott, L. Nyquist, R. Grimm, K. C. Johnson, C. Lawson, R. Allman, and P. Jose

Subjects
Male, medicine.medical_specialty, Activities of daily living, Physical disability, Risk Assessment, Article, law.invention, Double-Blind Method, Randomized controlled trial, law, Neoplasms, Internal medicine, Activities of Daily Living, medicine, Clinical endpoint, Humans, Dementia, Cognitive Dysfunction, Disabled Persons, Pharmacology (medical), Mortality, Depression (differential diagnoses), Aged, Aspirin, Depression, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Australia, General Medicine, medicine.disease, United States, Clinical trial, Cardiovascular Diseases, Physical therapy, Female, Tablets, Enteric-Coated, Gastrointestinal Hemorrhage, business, medicine.drug
Abstract

Cost-effective strategies to maintain healthy active lifestyle in aging populations are required to address the global burden of age-related diseases. ASPREE will examine whether the potential primary prevention benefits of low dose aspirin outweigh the risks in older healthy individuals. Our primary hypothesis is that daily oral 100. mg enteric-coated aspirin will extend a composite primary endpoint termed 'disability-free life' including onset of dementia, total mortality, or persistent disability in at least one of the Katz Activities of Daily Living in 19,000 healthy participants aged 65. years and above ('US minorities') and 70. years and above (non-'US minorities'). ASPREE is a double-blind, randomized, placebo-controlled trial of oral 100. mg enteric-coated acetyl salicylic acid (ASA) or matching placebo being conducted in Australian and US community settings on individuals free of dementia, disability and cardiovascular disease (CVD) events. Secondary endpoints are all-cause and cause specific mortality, fatal and non-fatal cardiovascular events, fatal and non-fatal cancer (excluding non-melanoma skin cancer), dementia, mild cognitive impairment, depression, physical disability, and clinically significant bleeding. To 20 September 2013 14,383 participants have been recruited. Recruitment and study completion are anticipated in July 2014 and December 2018 respectively. In contrast to other aspirin trials that have largely focused on cardiovascular endpoints, ASPREE has a unique composite primary endpoint to better capture the overall risk and benefit of aspirin to extend healthy independent lifespan in older adults in the US and Australia.

Published
2013
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4. Predictors of Change in Physical Function in Older Adults in Response to Long-Term, Structured Physical Activity: The LIFE Study

Author

Andrew S. Layne, Fang-Chi Hsu, Steven N. Blair, Shyh-Huei Chen, Jennifer Dungan, Roger A. Fielding, Nancy W. Glynn, Alexandra M. Hajduk, Abby C. King, Todd M. Manini, Anthony P. Marsh, Marco Pahor, Christine A. Pellegrini, Thomas W. Buford, Jack M. Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E. Miller, Mark A. Espeland, Walter T. Ambrosius, William Applegate, Daniel P. Beavers, Robert P. Byington, Delilah Cook, Curt D. Furberg, Lea N. Harvin, Leora Henkin, John Hepler, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L. Stowe, Michael P. Walkup, Don Hire, W. Jack Rejeski, Jeffrey A. Katula, Peter H. Brubaker, Shannon L. Mihalko, Janine M. Jennings, Evan C. Hadley, Sergei Romashkan, Kushang V. Patel, Denise Bonds, Mary M. McDermott, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S. Church, Valerie H. Myers, Ron Monce, Nathan E. Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K. Millet, Catrine Tudor-Locke, Ben P. Butitta, Sheletta G. Donatto, Shannon H. Cocreham, Cynthia M. Castro, William L. Haskell, Randall S. Stafford, Leslie A. Pruitt, Kathy Berra, Veronica Yank, Miriam E. Nelson, Sara C. Folta, Edward M. Phillips, Christine K. Liu, Erica C. McDavitt, Kieran F. Reid, Won S. Kim, Vince E. Beard, Stephen D. Anton, Susan Nayfield, Michael Marsiske, Bhanuprasad D. Sandesara, Jeffrey D. Knaggs, Megan S. Lorow, William C. Marena, Irina Korytov, Holly L. Morris, Margo Fitch, Floris F. Singletary, Jackie Causer, Katie A. Radcliff, Anne B. Newman, Stephanie A. Studenski, Bret H. Goodpaster, Oscar Lopez, Neelesh K. Nadkarni, Kathy Williams, Mark A. Newman, George Grove, Janet T. Bonk, Jennifer Rush, Piera Kost, Diane G. Ives, Stephen B. Kritchevsky, Tina E. Brinkley, Jamehl S. Demons, Kaycee M. Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M. Gill, Robert S. Axtell, Susan S. Kashaf, Nathalie de Rekeneire, Joanne M. McGloin, Karen C. Wu, Denise M. Shepard, Barbara Fennelly, Lynne P. Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N. Halpin, Matthew J. Brennan, Julie A. Bugaj, Maria A. Zenoni, Bridget M. Mignosa, Jeff Williamson, Hugh C. Hendrie, Stephen R. Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Carl J. Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L. Chupp, Gail M. Flynn, John L. Hankinson, Carlos A. Vaz Fragoso, Erik J. Groessl, and Robert M. Kaplan

Subjects
Gerontology, Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Psychological intervention, Physical activity, Physical Therapy, Sports Therapy and Rehabilitation, Blood Pressure, Article, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Accelerometry, medicine, Humans, 030212 general & internal medicine, Mobility Limitation, Exercise, Health Education, Aged, Aged, 80 and over, Rehabilitation, Hazard ratio, Age Factors, Resistance Training, Odds ratio, Confidence interval, Walking Speed, Lower Extremity, Physical therapy, Patient Compliance, Health education, Female, Sedentary Behavior, Psychology, Body mass index, 030217 neurology & neurosurgery, Physical Conditioning, Human
Abstract

To evaluate the extent of variability in functional responses in participants in the Lifestyle Interventions and Independence for Elders (LIFE) study and to identify the relative contributions of intervention adherence, physical activity, and demographic and health characteristics to this variability.Secondary analysis.Multicenter institutions.A volunteer sample (N=1635) of sedentary men and women aged 70 to 89 years who were able to walk 400m but had physical limitations, defined as a Short Physical Performance Battery (SPPB) score of ≤9.Moderate-intensity physical activity (n=818) consisting of aerobic, resistance, and flexibility exercises performed both center-based (2times/wk) and home-based (3-4times/wk) sessions or health education program (n=817) consisting of weekly to monthly workshops covering relevant health information.Physical function (gait speed over 400m) and lower extremity function (SPPB score) assessed at baseline and 6, 12, and 24 months.Greater baseline physical function (gait speed, SPPB score) was negatively associated with change in gait speed (regression coefficient β=-.185; P.001) and change in SPPB score (β=-.365; P.001), whereas higher number of steps per day measured by accelerometry was positively associated with change in gait speed (β=.035; P.001) and change in SPPB score (β=.525; P.001). Other baseline factors associated with positive change in gait speed and/or SPPB score include younger age (P.001), lower body mass index (P.001), and higher self-reported physical activity (P=.002).Several demographic and physical activity-related factors were associated with the extent of change in functional outcomes in participants in the LIFE study. These factors should be considered when designing interventions for improving physical function in older adults with limited mobility.

Published
2016

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