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Background: Sarcopenia, the gradual and generalized loss of muscle mass and function with ageing, is one of the major health problems in older adults, given its high prevalence and substantial socioeconomic implications. Despite the extensive efforts to reach consensus on definition and diagnostic tests and cut-offs for sarcopenia, there is an urgent and unmet need for non-invasive, specific and sensitive biomarkers for the disease. Extracellular vesicles (EVs) are present in different biofluids including plasma, whose cargo reflects cellular physiology. This work analysed EV proteome in sarcopenia and robust patients in the search for differentially contained proteins that can be used to diagnose the disease., Methods: Plasma small EVs (sEVs) from a total of 29 robust controls (aged 73.4 ± 5.6 years; 11 men and 18 women) and 49 sarcopenic patients (aged 82.3 ± 5.4 years; 15 men and 34 women) aged 65 years and older were isolated and their cargo was analysed by proteomics. Proteins whose concentration in sEVs was different between sarcopenic and robust patients were further validated using ELISA. The concentration of these candidates was correlated to the EWGSOP2 sarcopenia tests for low muscle strength and low physical performance, and receiver operating characteristic (ROC) curve analyses were carried out to evaluate their diagnostic power, sensitivity and specificity., Results: Proteomic analysis identified 157 sEVs proteins in both sarcopenic and robust samples. Among them, 48 proteins had never been reported in the ExoCarta nor Vesiclepedia databases. Statistical analysis revealed eight proteins whose concentration was significantly different between groups: PF4 (log2 FC = 4.806), OIT3 (log2 FC = -1.161), MMRN1 (log2 FC = -1.982), MASP1 (log2 FC = -0.627), C1R (log2 FC = 1.830), SVEP1 (log2 FC = 1.295), VCAN (FC = 0.937) and SPTB (log2 FC = 1.243). Among them, platelet factor 4 (PF4) showed the lowest concentration while Complement C1r subcomponent (C1R) increased the most in sarcopenic patients, being these results confirmed by ELISA (P = 1.07E-09 and P = 0.001287, respectively). The concentrations of candidate proteins significantly correlated with EWGSOP2 tests currently used. ROC curve analysis showed an area under the curve of 0.8921 and 0.7476 for PF4 and C1R, respectively. Choosing the optimal for PF4, 80% sensitivity and 85.71% specificity was reached while the optimal cut-off value of C1R would allow sarcopenia diagnosis with 75% sensitivity and 66.67% specificity., Conclusions: Our results support the determination of EV PF4 and C1R as plasma diagnostic biomarkers in sarcopenia and open the door to investigate the role of the content of these vesicles in the pathogeny of the disease., (© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.)

Aims: The present study sought to analyze the effects of 6-month multicomponent training (MCT) combined with a 4-month detraining on metabolic syndrome (MetS) profile among older adults with decreased functional capacity., Methods: This quasi-experimental study included a total of 104 older adults (80.5 ± 6.0 years) and the sample was divided into a training (TRAIN, n = 55) or control group (CON). Harmonized definition was used to diagnose the MetS. Functional capacity, blood biochemical parameters, blood pressure, body composition and anthropometric measurements were assessed 3 times. Analysis of variance for repeated measures and Wilcoxon signed-rank test were used to check the differences within groups., Results: TRAIN decreased diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDLC) and total fat mass during training period, whereas CON did not show any significant changes. During detraining, TRAIN increased HDLC, systolic blood pressure (SBP), waist circumference (WC) and total fat mass; and decreased glucose and fat free mass, whereas CON increased the concentration of glucose and HDLC. From baseline to post-detraining assessment, CON increased the concentration of triglycerides and the WC, while TRAIN only increased the WC (all p < 0.05)., Conclusions: Exercise can be a key component in the treatment of the MetS, since MCT seems to be effective to decrease DBP and total fat mass. Nevertheless, 4-months of detraining could cause a drop of total fat mass, but no in DBP. To avoid reversibility of the benefits obtained, it could be beneficial to promote continuing exercise programs., Trial Registration: ClinicalTrial.gov identifier: NCT03831841., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Achieving a high quality of life in older adults can be difficult if they have limited physical function. The aims of this study were to evaluate the relationship between baseline values and variations in body composition, fitness, and nutritional status on health-related quality of life (HRQoL) and to describe the effects of a 6-month multicomponent training (MCT) programme and a 4-month detraining period on HRQoL. A total of 106 participants with limited physical function were included in this study (age: 80.8 ± 5.9 years; 74 females) and were divided into two groups: control (CON) and intervention (TRAIN). HRQoL was measured using the EQ-5D-3L questionnaire and a visual analogue scale (EQ-VAS). Information on body composition, physical fitness, Mediterranean diet adherence, and nutritional status were obtained. Healthier baseline values for body composition, fitness and nutritional status were associated with better HRQoL (explaining 23.7-55.4%). The TRAIN group showed increased HRQoL during this 6-month MCT, showing group-by-time interaction ( p < 0.05) and a deleterious effect of detraining. Changes in weight, arm strength, and aerobic capacity contributed to explaining 36% of the HRQoL changes obtained with MCT (all p < 0.05). This MCT improved HRQoL in older adults with limited physical function. However, HRQoL returned to baseline values after detraining. This study highlights the importance of performing ongoing programs in this population.

The aims of this study were (1) to analyse the effects of a 6-month multicomponent training (MCT) on the physical fitness of older adults with or at risk of frailty; (2) to study the consequences of a 4-month detraining period; (3) to analyse the influence of frailty status on the training and detraining adaptations. A total of 102 robust, frail and prefrail older adults (80.1 ± 6.1 y) were divided into an intervention (TRAIN) and control group (CON). The TRAIN performed a 6-month MCT, while the CON continued with their usual lifestyle. Fitness assessment was mainly based on the Senior Fitness Test. Four evaluations were carried out; at baseline, and at 3, 6 and 10 months from baseline. Linear mixed models were performed to analyse group by time interactions and to compare differences in changes within groups between different time points. After 6-month MCT, TRAIN showed greater improvements for all fitness variables (group effects p  < 0.05, except for flexibility) when compared to the CON. During the 4-month detraining period, TRAIN significantly decreased their balance, upper-limb flexibility and upper and lower-limb strength (all p  < 0.05). CON only decreased upper-limb flexibility. When accounting for frailty status in the TRAIN, the frail-prefrail showed lower adaptations to the training and were more affected by detraining than the robust. The presented MCT is a good strategy to improve fitness in this population, but its positive effects are limited in time. It is, therefore, critical to avoid detraining periods. Trial registration: ClinicalTrials.gov identifier: NCT03831841. Highlights Our 6-month MCT-program improves the physical fitness of robust, frail and prefrail older adultsA detraining period of four months partially deteriorates the physical fitness of robust, frail and prefrail older adults, so it is recommended to promote ongoing exercise programs or smaller break periodsIt seems that those older adults with a more advanced frailty status may not benefit from exercise to the same degree and will be more affected by detraining. Therefore, trainers may need to individualize training protocols to obtain the greatest exercise benefits.

Physical exercise effects and ageing on fitness may be influenced by nutritional status. This study investigates the effects of a 6-month multicomponent exercise training (MCT) on nutritional status and evaluates if this type of exercise could affect differently body composition and physical fitness depending on the nutritional status of older adults with decreased functional capacity. Ninety-three participants (80.4 ± 6.0 y) were divided into control ( n  = 45) and intervention ( n  = 48) groups. The intervention consisted of a 6-month multicomponent training. Comparisons between changes in body composition and fitness during the 6-months were performed between individuals at risk of malnutrition and those well-nourished, according to the Mini Nutritional Assessment. Model mixed-effect analyses were used to investigate differences after the 6 months of MCT between groups. Well-nourished participants compared with those at risk of malnutrition had higher: arm (13.4 ± 3.5 vs 14.3 ± 33.6 repetitions) and leg strength (9.0 ± 3.0 vs 11.1 ± 3.3 repetitions), maximum walking speed (31.6 ± 13.1 vs 23.7 ± 6.3s), agility (11.9 ± 5.8 vs 8.3 ± 2.1s), and aerobic capacity (31.6 ± 13.1 vs 23.7 ± 6.3 m), at baseline. After the training, those without risk of malnutrition in CON decreased their nutritional status (-1.7 + 0.7 points). Those well-nourished that performed the intervention decreased total fat mass (-1.0 ± 0.3 kg) and body fat percentage (-1.2 ± 0.4%). Both groups of training improved similarly in all tests, except for balance, in which the well-nourished showed improvements of 6.3 ± 1.9s. These results underline the usefulness of MCT in improving physical fitness regardless of nutritional status and preventing nutritional status detriment in well-nourished older adults, who are fitter and benefit more, in terms of body composition. Trial registration: ClinicalTrials.gov identifier: NCT03831841. Highlights Multicomponent exercise programme seems to be effective in delaying detriments in the nutritional status of well-nourished people.Well-nourished older people obtain more benefits in body composition from the multicomponent exercise than those at risk of malnutrition, decreasing adiposity.The positive effect of multicomponent exercise was observed in physical fitness independently of nutritional status.

This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (-0.7 ± 1.3), and FTS-5 (-5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (-1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.

Metabolic syndrome (MetS) is a cluster of medical conditions associated with several health disorders. MetS and frailty can be related to prolonged physical deconditioning. There is a need to know whether there is concordance between the different ways of diagnosing it and to know their prevalence in Spanish older adults. Thus, the aims of this study were to describe the prevalence of MetS; to analyse the concordance between different definitions to diagnose MetS; and to study the associations between MetS, frailty status, and physical activity (PA) in older adults with decreased functional capacity. This report is a cross-sectional study involving 110 Spanish older adults of ages ≥65 years with decreased functional capacity. Clinical criteria to diagnose MetS was defined by different expert groups. Anthropometric measurements, blood biochemical analysis, frailty status, functional capacity, and PA were assessed. The Kappa statistic was used to determine the agreement between the five MetS definitions used. Student's t -test and the Pearson chi-square test were used to examine differences between sex, frailty, and PA groups. The sex-adjusted prevalence of MetS assessed by the National Cholesterol Education Program-Third Adult Treatment Panel was 39.4% in men and 32.5% in women. The International Diabetes Federation and the Harmonized definitions had the best agreement (k = 1.000). The highest odds ratios (ORs) of cardiometabolic risk factors to develop MetS were elevated triglycerides (37.5) and reduced high-density lipoprotein cholesterol (27.3). Central obesity and hypertension prevalence were significantly higher in the non-active group (70.7% and 26.8%, respectively), compared to the active group (50.0% and 7.7%, respectively). Moreover, the active group (OR = 0.85, 95% CI = 0.35, 2.04) and active women group (OR = 0.77, 95% CI = 0.27, 2.20) appeared to show a lower risk of developing this syndrome. MetS is highly prevalent in this sample and changes according to the definition used. It seems that sex and frailty do not influence the development of MetS. However, PA appears to decrease central obesity, hypertension, and the risk of developing MetS.

Background: Increased physical activity (PA) is a very important factor in a healthy aging lifestyle. Psychosocial factors have also a main role in the initiation and maintenance of this behavior, but nowadays its implications for frailty elderly people are unknown, therefore, the aim of this study was to identify the psychosociological variables of behavior change that influence the practice of (PA) in frail and prefrail elderly., Methods: A total of 103 frail and pre-frail elderly people (72 females) participated in this cross-sectional study, on the framework of the EXERNET-Elder3.0 project. Age ranged from 68-94 years (mean = 80.4 ± 5.9 years). Individualized face-to-face interviews according to the constructs of the Transtheoretical Model of Change (TTM) [(decisional balance (DB) and self-efficacy (SE)], social support (SS) (family and friends) and outcome expectations (OE) were administered to all participants., Results: Significant differences were found in DB, perceived benefits (PBn), SE, family-related SS and OE as a function of stages of change (SoC) (p < 0.005), but no significant were found in perceived barriers (PBrr) (p = 0.259) and friends-related SS (p = 0.068). According to the Scheffé post-hoc test, those in advanced SoC (Action-Maintenance), scored higher than those in lower SoC (Precontemplation-Contemplation and Preparation)., Conclusion: The scores obtained from the study variables differed according to the SoC, supporting the external validity for the use of the TTM in frailty elderly. Further research is needed to determine the impact of PBrr and friends-related SS on this people, as well as to identify the validity of this model in the long-term in this population., (© 2022. The Author(s).)

Background: Physical fitness and body composition are important health indicators; nevertheless, their combined pattern interrelationships and their association with mortality are poorly investigated., Methods: This longitudinal study is part of the Spanish EXERNET-Elder project. Person-months of follow-up were calculated from the interview date, performed between June 2008 and November 2009, until the date of death or censoring on March 2018 (whichever came first). In order to be included, participants had to fulfill the following criteria: (a) be older than 65 years, (b) live independently at home, (c) not suffer dementia and/or cancer, and (d) have a body mass index above 18.5. Body fat and weight were assessed by a bioelectrical impedance analyzer. Fitness was measured with the Senior Fitness and the one-leg static balance tests. The Spanish Death Index was consulted for the death's identification. Cluster analysis was performed to identify Fat-Fit patterns and traditional cut-points and percentiles to create the Fat-Fit groups. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of death in clustered Fat-Fit patterns and in traditional Fat-Fit groups., Results: A total of 2299 older adults (76.8% of women) were included with a baseline mean age of 71.9 ± 5.2 years. A total of 196 deaths (8.7% of the sample) were identified during the 8 years of follow-up. Four clustered Fat-Fit patterns (Low fat-Fit, Medium fat-Fit, High fat-Unfit, and Low fat-Unfit) and 9 traditional Fat-Fit groups emerged. Using the Low fat-Fit pattern as the reference, significantly increased mortality was noted in High fat-Unfit (HR: 1.68, CI: 1.06-2.66) and Low fat-Unfit (HR: 2.01, CI: 1.28-3.16) groups. All the traditional Fit groups showed lower mortality risk when compared to the reference group (obese-unfit group)., Conclusion: Physical fitness is a determinant factor in terms of survival in community-dwelling older adults, independently of adiposity levels., (© The Author(s) 2021. 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.)

This systematic review was conducted to examine the cost-effectiveness of exercise interventions in community-dwelling older adults. A systematic search for articles published in English or Spanish was carried out in PubMed, Web of Science and Cochrane Library that covered the period from the respective start date of each database to October 2021. Methodological quality was assessed with the Physiotherapy Evidence Database scale and quality of economic evaluation with the Quality of Health Economic Studies and Consolidated Health Economic Evaluation Reporting Standards. A total of 12 out of 15 studies on exercise programmes for older adults reported cost-effective results. The most cost-effective training appears to be a multicomponent training programme, including aerobic exercise, muscle-strengthening of lower extremities, and balance and stretching training. The training methodology should be of progressive moderate or vigorous intensity performed at least twice per week with each session lasting 60 min for ≥6 months. The exercise programme should be delivered as a group-based intervention, doing extra exercise at home to increase the cost-effectiveness. These findings suggest that exercise interventions in non-institutionalized older people are a cost-effective tool. Sex, age, cognitive status, frailty, frequency and training duration could modify the cost-effectiveness of exercise interventions. Systematic review registration. PROSPERO CRD42021231530 (date of registration: 20/02/2021)., (Copyright © 2022. Published by Elsevier Inc.)

Background: Regucalcin, or senescence marker protein-30 (SMP30), is a Ca 2+ -binding protein with multiple functions reported in the literature. Physical exercise has been shown to improve aging markers; nevertheless, SMP30 in humans has not been extensively researched. Older adults experience a decline in functional capacity and body composition. The purpose of this study was to examine the effects of a multicomponent training (MCT) program on SMP30 and its regulation of walking ability and body composition in functionally limited, frail, and pre-frail older adults., Methods: A total of 34 older adults (aged 80.3 ± 6.1 years) were divided into an intervention group (IG = 20) and control group (CG = 14). The IG performed a supervised MCT (strength, endurance, balance, coordination, and flexibility) program for 6 months, 3 days per week, whereas the CG continued their normal lives without any specific physical training. SMP30 was analyzed in plasma after 3 and 6 months of MCT, while some physical fitness variables (Timed Up and Go (TUG) and 6-min walk test (6MWT)) and body composition (fat mass and lean mass) were measured at baseline, as well as after 3 months and 6 months of MCT., Results: No significant changes were observed in SPM30 between the IG (877.5 a.u. to 940.5 a.u., respectively) and CG (790.4 a.u. to 763.8 a.u., respectively). Moreover, no SMP30 differences were found between groups after 3 and 6 months of MCT. The IG improved significantly in the 6MWT after 3 months (472.2 ± 84.2 m) compared to baseline (411.2 ± 75.2 m). The IG also significantly enhanced their TUG performance after 3 months (7.6 ± 1.6 s) and 6 months (7.3 ± 1.8 s) of training compared to baseline (9.3 ± 3.2 s) (all, p < 0.001). There were no significant differences in body composition between the IG and CG through the 6 months of MCT., Conclusions: The present study suggests that MCT did not change SMP30 levels from 3 to 6 months, where there were changes in neither walking ability nor body composition; however, MCT was effective in improving 6MWT and TUG performance from baseline to 3 months.

Objectives: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the 'fat but powerful' (F+P) (or 'fat but fit') paradox in older adults., Methods: A total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated., Results: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively)., Conclusion: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Physical fitness levels and the amount of accumulated adipose tissue (fatness) relate to current and future individuals' heath status. Nevertheless, the interrelationships of their combined patterns with polypharmacy and the types of medications consumed have not been sufficiently investigated., Methods: This cross-sectional study was carried out in six Spanish regions between 2008 and 2009 with a sample of older community-dwelling adults (≥65 years old) without dementia or cancer. Fitness was measured with one-leg balance and senior fitness tests, as well as by measuring weight and fat mass with a bioelectrical impedance analyzer. Polypharmacy was defined as the use of five or more medications. An analysis of variance was performed for comparisons between the physical fitness and fatness patterns and the medication consumed., Results: A total of 1709 elders were included in the study (72.1 ± 5.2 years). The two unfit patterns were those with the highest drug consumption. The High-Fat-Unfit pattern was the one that had the most significant consumption and had the highest percentage of polymedicated subjects. The Low-Fat-Fit pattern had a significantly lower percentage of people that did not consume any medications. The highest percentages of drug consumption in 7 of the 10 groups that were included were concentrated in the two unfit patterns., Conclusions: This study highlights the importance of fitness in older adults, as it is at least as important as the avoidance of accumulation of excess fat with respect to the consumption of a smaller number of medicines.

Frailty is a reversible condition, which is strongly related to physical function and nutritional status. Different scales are used to screened older adults and their risk of being frail, however, Short Physical Performance Battery (SPPB) may be more adequate than others to measure physical function in exercise interventions and has been less studied. Thus, the main aims of our study were: (1) to describe differences in nutritional intakes by SPPB groups (robust, pre-frail and frail); (2) to study the relationship between being at risk of malnourishment and frailty; and (3) to describe differences in nutrient intake between those at risk of malnourishment and those without risk in the no-frail individuals. One hundred one participants (80.4 ± 6.0 year old) were included in this cross-sectional study. A validated semi-quantitative food frequency questionnaire was used to determine food intake and Mini Nutritional Assessment to determine malnutrition. Results revealed differences for the intake of carbohydrates, n -3 fatty acids (n3), and saturated fatty acids for frail, pre-frail, and robust individuals and differences in vitamin D intake between frail and robust (all p < 0.05). Those at risk of malnutrition were approximately 8 times more likely to be frail than those with no risk. Significant differences in nutrient intake were found between those at risk of malnourishment and those without risk, specifically in: protein, PUFA n -3, retinol, ascorbic acid, niacin equivalents, folic acid, magnesium, and potassium, respectively. Moreover, differences in alcohol were also observed showing higher intake for those at risk of malnourishment (all p < 0.05). In conclusion, nutrients related to muscle metabolism showed to have different intakes across SPPB physical function groups. The intake of these specific nutrients related with risk of malnourishment need to be promoted in order to prevent frailty.

With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all p < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.

The multicomponent training (MCT) effect on bone health in frail and pre-frail elders, which is influenced by dietary intake, is still unknown. The objective of this non-randomized intervention trial was to assess the effects of a 6-month MCT on bone structure in frail and pre-frail elders, and to analyse the influence of dietary intake and serum vitamin D (25(OH)D) in these changes. Thirty MCT (TRAIN) and sixteen controls (CON), frail and pre-frail completed the information required for this study. Peripheral quantitative computed tomography measurements were taken at 4% and 38% of the tibia length and dietary intake was registered. The 25(OH)D values were obtained from blood samples. Analyses of covariance (ANCOVA) for repeated measures showed significant decreases for CON in total bone mineral content at 38% of tibia length. One factor ANOVAs showed smaller decreases in bone mineral density and cortical thickness percentage of change in TRAIN compared to CON. Linear regression analyses were performed to study the influence of nutrients and 25(OH)D on bone changes. Alcohol showed a negative influence on fracture index changes, while polyunsaturated fatty acid and vitamin A showed a positive association with some bone variables. The 25(OH)D only affected positively the cortical bone mineral density. In conclusion, our MCT seems to slow down some of the bone detriments associated with ageing in frail and pre-frail older adults, with alcohol showing a negative effect on the bone and apparent limited effect of nutrients and serum 25(OH)D on training related changes.

The aims of the present study were (1) to describe the changes in physical fitness during an 8 year follow-up in a large sample of Spanish adults aged 65 or over that are initially engaged in organized physical activity (OPA), (2) to compare fitness changes according to different age groups (65 to 69 vs. 70 to 74 vs. ≥75 years-old), (3) to evaluate the independent and combined effects of changes in OPA engagement and sitting time (ST) on physical fitness. A total of 642 (147 males) non-institutionalized over 65 years-old participants completed the EXERNET battery fitness tests and completed a validated questionnaire from which information regarding OPA and ST were collected. All participants completed evaluations in 2008-2009 and in 2016-2017. An impairment of fitness-related variables happens after 65 years of age in both males and females, with the older participants (≥75), showing the largest decreases. Males who continued performing OPA demonstrated lower decreases in balance, leg flexibility and agility when compared to those who stopped performing OPA during the follow-up. Females who continued performing OPA demonstrated lower decreases of all variables except for balance when compared to those who stopped performing OPA during the follow-up.

The gradual deterioration of physiological systems with ageing makes it difficult to maintain skeletal muscle mass (sarcopenia), at least partly due to the presence of 'anabolic resistance', resulting in muscle loss. Sarcopenia can be transiently but markedly accelerated through periods of muscle disuse‐induced (i.e., unloading) atrophy due to reduced physical activity, sickness, immobilisation or hospitalisation. Periods of disuse are detrimental to older adults' overall quality of life and substantially increase their risk of falls, physical and social dependence, and early mortality. Disuse events induce skeletal muscle atrophy through various mechanisms, including anabolic resistance, inflammation, disturbed proteostasis and mitochondrial dysfunction, all of which tip the scales in favour of a negative net protein balance and subsequent muscle loss. Concerningly, recovery from disuse atrophy is more difficult for older adults than their younger counterparts. Resistance training (RT) is a potent anabolic stimulus that can robustly stimulate muscle protein synthesis and mitigate muscle losses in older adults when implemented before, during and following unloading. RT may take the form of traditional weightlifting‐focused RT, bodyweight training and lower‐ and higher‐load RT. When combined with sufficient dietary protein, RT can accelerate older adults' recovery from a disuse event, mitigate frailty and improve mobility; however, few older adults regularly participate in RT. A feasible and practical approach to improving the accessibility and acceptability of RT is through the use of resistance bands. Moving forward, RT must be prescribed to older adults to mitigate the negative consequences of disuse atrophy. What is the topic of this review?Use of resistance exercise training to prevent or mitigate the disuse‐induced muscle atrophy in an ageing population.What advances does it highlight?The review highlights several potential mechanisms of disuse‐induced muscle atrophy and strategies before, during and following disuse to prevent, mitigate and recover lost muscle. [ABSTRACT FROM AUTHOR]

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Background: Metabolic syndrome (MetS) in older adults with hypertension, diabetes, and hyperlipidemia increases the risks of cardiovascular diseases by 2.5 times and type 2 diabetes by five times. This study aimed to explain the multilevel relationships between health service system factors and individual-level factors influencing the control of MetS among older adults with NCDs receiving health care services at the NCD Plus clinics of hospitals in 1 year. Methods: This cross-sectional analytical study employed a systematic sampling method to have two groups of samples from 4 regions of Thailand: (1) 600 older adults having at least one diagnosis of NCDs receiving services at NCD Plus clinics and (2) 12 nurses in charge of the NCD Plus clinics at the hospitals providing services to these patient samples. Data were analyzed using multilevel logistic regression analysis. Results: 24% of older adults with NCDs can control MetS within one year. The MetS escalation from the initial assessment to 1-year follow-up varied according to the level of the hospitals. The transition from MetS to non-MetS status was rare in older adults with NCDs. Among health service system factors, complete screening for MetS influenced 1-year MetS control (95% CI [1.06, 2.92]). Older adults who were female and who had polypharmacy had a 66% (95% CI [0.22, 0.53]) and a 54% (95% CI [0.29 − 0.71]) reduction chance in MetS control. Older adults, who were ≥ 80 years old, labor-employed, healthy dietary patterns, and medication adherence increased chances of controlling MetS by 2.38 times (95% CI [1.12, 5.05]), 2.14 times (95% CI [1.03, 4.42]), 1.61 times (95% CI [1.06–2.46]), and 3.18 times (95% CI [1.51, 6.70]), respectively. Conclusions: NCDs Plus clinics that provide complete screening for MetS significantly enhance their effectiveness in reducing the proportion of older adults with MetS. In addition, the service should pay attention to older adults who are female, are retired, and take multiple medications to achieve MetS control better. The insights gained from such an analysis could be instrumental in pinpointing the resources necessary to bolster the efficacy of NCD Plus clinics. [ABSTRACT FROM AUTHOR]

Background: The number of frail older people is increasing worldwide, and all countries will be confronted with their growing needs for healthcare and social support. The aim of this umbrella review was to summarize the evidence on the factors associated with frailty in older people, using a socioecological approach. Methods: PubMed (MEDLINE), Scopus, Web of Science, ScienceDirect, Hinari (research4life), and the Trip database were systematically searched up to April 2023. Systematic reviews of observational studies that explored factors associated with frailty in older adults aged 60 years and over were considered for inclusion. No language, geographical or setting restrictions were applied. However, we excluded systematic reviews that investigated frailty factors in the context of specific diseases. The Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses and the ROBIS tool were used to assess the quality and risk of bias in the included studies. Results: Forty-four systematic reviews were included, covering 1,150 primary studies with approximately 2,687,911 participants overall. Several risk factors, protective factors and biomarkers were found to be associated with frailty, especially in community-dwelling older people, including 67 significant associations from meta-analyses. The certainty of the evidence was rated as moderate or reached moderate levels for seven factors relevant to older people. These factors include depression (OR 4.66, 95% CI 4.07 to 5.34), loneliness (OR 3.51, 95% CI 2.70 to 4.56), limitations in activities of daily living (OR 2.59, 95% CI 1.71 to 3.48), risk of malnutrition (OR 3.52, 95% CI 2.96 to 4.17), Dietary Inflammatory Index score (OR 1.24, 95% CI 1.16 to 1.33), maximal walking speed (Standardized Mean Difference (SMD) -0.97, 95% CI -1.25 to -0.68), and self-reported masticatory dysfunction (OR 1.83, 95% CI 1.55 to 2.18). Additionally, only greater adherence to a Mediterranean diet showed a high level of evidence (OR 0.44, 95% CI 0.31 to 0.64). Conclusions: This umbrella review will provide guidance for prevention strategies and clinical practice by promoting healthy lifestyles and addressing all modifiable risk factors associated with frailty. Future systematic reviews should consider heterogeneity and publication bias, as these were the main reasons for downgrading the level of evidence in our review. Registration: PROSPERO 2022, CRD42022328902. [ABSTRACT FROM AUTHOR]

This study aimed to achieve two primary objectives. Firstly, to compare physical fitness levels based on sex, age groups, and body composition. Secondly, to examine physical fitness of the older adults against criterion-referenced fitness standard values using a representative sample from the district of Leiria in Portugal, a region undergoing exponential population growth, including a rise in the elderly population. Data from cross-sectional assessments of the Portuguese older adult community living in the Municipality of Leiria from 2014 to 2022 were collected. This study comprised a sample of 664 community-dwelling older adults (female = 480; male = 184) aged between 60 and 90 years (M = 70.34; SD = 12.67). Participants had a body mass ranging from 45 kg to 122 kg (M = 71.48; SD = 12.34) and a height ranging from 1.30 m to 1.89 m (M = 1.59; SD = 0.08). The Senior Fitness Test battery was used to evaluate parameters of physical fitness, body mass index was calculated, and abdominal circumference was measured. Females displayed a tendency to greater physical fitness compared to males, specifically in terms of lower and upper body flexibility compared to older male adults (p < 0.05). In addition, sexagenarian and older adults with normal weight tended to display greater physical fitness compared to septuagenarian and octogenarian, and overweight adults and those with obesity (p < 0.05), respectively. Information concerning physical fitness is crucial for guiding policymakers and other stakeholders in Leiria for the promotion of healthy aging among the older adult community. Furthermore, this study has established the preliminary reference standards for physical fitness, serving as a tool to promote healthy aging among Portuguese older adults residing in Leiria. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the relationships between accelerometer-measured physical activity (PA) and sedentary behaviour (SB) with physical function (PF) among older Chinese women in the community. Methods: The present study comprised 1,113 community-dwelling older females, with an average age of 65 ± 2 years. We employed a linear regression analysis to investigate the relationship between patterns of PA and SB with PF. PA variables consisted of total PA time, bouted PA time (a continuous PA that lasts equal to or more than 10 min), and sporadic PA time (a continuous PA that lasts less than 10 min). SB variables included total SB time, 30-min bout of SB (a continuous SB that lasts equal to or more than 30 min), and 60-min bout of SB (a continuous SB that lasts equal to or more than 60 min). PF variables comprised handgrip strength (HGS), one-legged stance test with eyes closed (OLSTEC), usual walking speed (UWS), maximum walking speed (MWS) and chair-stand time (CT). To explore the joint effects of moderate-to-vigorous-intensity PA (MVPA) and SB on PF, we divided the duration of SB and MVPA participation in older women into different combinations: low MVPA & high SB, low MVPA & low SB, high MVPA & high SB, high MVPA & low SB. Results: The study revealed a significant association between 30-min bout of SB and CT, which remained after adjusting for total MVPA time (P = 0.021). Both total MVPA and bouted MVPA were found to be positively associated with better UWS, MWS, CT, and PF Z-score. When the combination of low MVPA & high SB was used as a reference, the regression coefficients for PF ascended by 1.32 (P < 0.001) in the high MVPA & high SB group and by 1.13 (P < 0.001) in the high MVPA & low SB group. Conclusions: A significant association was observed between poorer lower limb function and prolonged, uninterrupted SB in older women, rather than with the total SB time. Concurrently, the insufficient engagement in MVPA may also be a crucial factor contributing to poorer PF in older women. Engaging in longer durations and higher intensity of PA, such as bouts of MVPA lasting a minimum of 10 min or longer, may contribute to better PF. [ABSTRACT FROM AUTHOR]

With a growing aging population, the routine assessment of physical function may become a critical component of clinical practice. The purpose of this cross-sectional study is to compare two common assessments of muscular function: (1) isometric knee extension strength (KES) and (2) sit-to-stand (STS) muscle power tests, in predicting objective physical function (i.e., gait speed) in aging adults. 84 adults (56% female, mean (SD) age = 66.6 (9.4) years) had their relative KES, STS power, usual gait speed (UGS), and fast gait speed (FGS) assessed. Multiple linear regression examined the associations between KES, STS power, and gait outcomes. When entered in separate models, KES and STS power were both independently associated with UGS and FGS (Std. β = 0.35–0.44 and 0.42–0.55 for KES and STS power, respectively). When entered in the same model, STS power was associated with UGS and FGS (Std. β = 0.37 [95%CI: 0.15, 0.58] and 0.51 [95%CI: 0.31, 0.70], respectively), while KES was only associated with FGS (Std. β = 0.25 [95%CI: 0.02, 0.48]). STS power seems to be a valid indicator of function in aging adults. Its feasibility as a screening tool for "low" function in the primary care setting should be explored. [ABSTRACT FROM AUTHOR]

Background & Objective: As the prevalence of type 2 diabetes is growing worldwide, the need to use insulin and the resulting costs are progressively increasing. Exercise can be an effective way to reduce the insulin dose and its cost. This study investigates the effects of 12 weeks combined exercises on cost, dosage of insulin, and glycemic indices in type 2 diabetic patients. Materials & Methods: Sixty-eight patients, aged 40 to 60 years, with type 2 diabetes and acceptable conditions to perform targeted exercises, were recruited in a randomized clinical trial. All of them had been on treatment with a combination of short-acting and long-acting insulins. Participants were randomly divided into control and case groups with matched gender and age (17 women and 17 men). In addition to the standard exercise recommendations given to both groups, the case group also received the supervised aerobic and resistance exercises three sessions a week for 12 weeks reaching the defined maximum heart rate percentage. The dose of short- and long-acting insulins used during the study was recorded and the resulting cost change along with FBS, 2hpp and HbA1clevel alterations were calculated. Results: The cost and dosage of long-acting and short-acting insulins in the trained group were significantly reduced by 50% and 39.67%, respectively, compared to the control group (p=0.00). The values of HbA1c (21.5%), 2hpp-BS (24.68%), and FBS (13.89%) also decreased in the trained group (p=0.00), while all the mentioned values increased in the control group. Conclusion: The effect of 12 weeks combined exercises was remarkable on reducing the dose of injectable insulins, better glycemic control of patients, and reducing the cost of treatment. Providing the necessary arrangements for supervised exercise in diabetic patients can be economical and beneficial. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: It is unknown how thyroid hormones, TSH, and other elements of the metabolic syndrome are related to one another. It is possible to investigate and evaluate thyroid function in older adults with and without metabolic syndrome to draw attention to it and look for any connections between thyroid function and the elements of the metabolic syndrome. Aim: To detect the association of thyroid Hormones, TSH and components of metabolic syndrome and to evaluate the relationship between thyroid Hormones, TSH and HOMA-IR. Methods: This case-control study included 64 elderly subjects with and without metabolic syndrome recruited from outpatient of Zagazig University hospital, from July 2023 to January 2024. We divided the patients into group (I): 32 elderly healthy individuals without metabolic syndrome matched age and sex served as control group and group (II): 32 elderly patients with metabolic syndrome matched age and sex served as case group. Thyroid functions tests were measured. Results: There was a highly statistically significant increase in TSH in group II compared with group I (p≤0.001). There was statistically significant increase in FT3 in group II compared with group I (p≤0.05). There was statistically significant decrease in FT4 in group II compared with group I (p≤0.05) (Table 3). There was highly statistically significant increase in HOMA-IR in group II compared with group I (p≤0.001). Old age OR 1.79 (CI:1.07-3), smoking OR 1.88 (CI:1.36-2.99), obesity OR 1.07 (CI:1.07-1.26), DM OR 2.8 (CI:1.41- 5.57), HTN OR 1.14 (CI:1.03-1.25) & dyslipidemia OR 1.86 (CI:1.11- 3.12) were significant risk factors for metabolic syndrome (p≤0.05). Conclusion: In conclusion, there is a strong association between thyroid dysfunction and each of metabolic syndrome, and HOMA-IR. Patients with hypothyroidism and subclinical hypothyroidism had an increased risk of metabolic syndrome. [ABSTRACT FROM AUTHOR]

Metabolic syndrome increases the risk of developing diabetes and cardiovascular disease. The regular practice of physical activity is a crucial factor for healthy aging and for controlling and preventing chronic diseases. To assess the effects of regular physical activity on the biochemical and inflammatory profiles, as well as the quality of life of older adults diagnosed with metabolic syndrome. Participants (aged 55–70 years; living in the Balearic Islands, Spain) were divided into two groups (n = 50 each) according to the degree of physical activity measured by metabolic equivalents of task (METs). Anthropometric parameters, blood pressure, biochemical and hematological parameters, and inflammatory biomarkers were measured. Beck Depression Inventory and adherence to the Mediterranean diet questionnaires, as well as the Dietary Inflammatory Index, chair test, health-related quality of life (HRQoL), and Rapid Assessment of Physical Activity, were also determined. The characterization of the patients was similar in both groups, showing a homogeneous sample. The group with the highest METs experienced a decrease in depression and an increase in the intensity of physical activity. Adherence to the Mediterranean diet and HRQoL physical dimensions increased in participants with the highest METs, also showing a decrease in glycemia and glycosylated hemoglobin values. Inflammatory biomarkers, including tumor necrosis factor alpha, interleukin-6, interleukin-1β, and osteoprotegerin, decreased in patients practicing more physical activity. High levels of physical activity are related to a healthier lifestyle, characterized by high adherence to the Mediterranean diet, decreased depressive behavior, oxidative stress, and inflammatory status in older people with metabolic syndrome. [ABSTRACT FROM AUTHOR]

Background: Recent exercise intervention studies have shown promising results in improving quality of life (QoL) and physical function (PF) in diverse chronic disease and advanced cancer patients. However, the effects of structured exercise in palliative care patients, having different therapeutic needs, lower life expectancies and PFs remain unknown. This study primarily aimed to assess the feasibility of an exercise intervention with follow-up by analysing recruitment numbers, screening procedures, acceptability, preferences, and safety of the exercise intervention as well as retention in follow-up. Our secondary aims related to changes in QoL and PF. Methods: This study comprised of a one-arm design without a control group. Over 6 months, every in-hospital palliative care unit (PCU) patient was screened for eligibility. Eligible patients were asked to participate in a 2-week exercise intervention consisting of resistance training and/or endurance training with moderate or high intensity based on personal preferences and a 4-week follow-up. Before and after the exercise intervention, QoL and PF were assessed and a qualitative interview after the intervention addressed expectations and experiences of the exercise intervention. For follow-up, patients were provided with information on independent training and after 1 and 4 weeks a QoL assessment and qualitative interview were conducted. Results: Of 124 patients screened, 10 completed the intervention with an adherence rate of (80 ± 25%), of which 6 patients completed follow-up. Endurance training was the most performed training type and only a few minor adverse events occurred in certain or likely connection to the exercise intervention. While physical QoL and PF measured by arm curl strength and time up and go performance improved, mental QoL and the other PF tests remained unchanged. Conclusion: Despite the challenges that were faced in our screening and testing process, that are specific to the palliative patient population with their unique therapeutic requirements and varying mental-/ physical capabilities, we discovered the 2-week exercise intervention to be feasible, safe, and well tolerated by palliative care patients. Moreover, it seems that short-term improvements in QoL and PF are possible. Further full scale studies are required to confirm our findings. Trial registration: The study was retrospectively registered on 25.01.2022 in the German Clinical Trials Register (DRKS00027861) [ABSTRACT FROM AUTHOR]

Lower-limb muscle power should be closely monitored to prevent age-related functional ability declines. Stair-climbing (SC) power is a functionally relevant measurement of lower-limb muscle power. Body-fixed sensors can measure power production throughout the different steps of a flight of stairs to assess different aspects of performance. This study investigated: 1) power production throughout a full flight of stairs; 2) if staircases with less or more steps can provide similar information; and 3) test-retest reliability of SC power. 116 community-dwelling older adults (57 women) ascended three staircases as fast as possible: 12, 6 and 3 steps. Mean vertical power production per step was collected and analyzed using a commercial body-fixed sensor and software. Three phases were found in SC power production: 1) an acceleration phase, i.e., the power produced in step 1 (P1); 2) a phase where the highest performance (Pmax) is reached and; 3) a fatiguing phase with power loss (Ploss; only measurable on 12-step staircase). Mean power (Pmean) over the different steps was also evaluated. P1 did not differ between staircases (all p>0.05), whereas Pmax and Pmean were higher with increasing number of steps (p = 0.073 –p<0.001). P1, Pmax and Pmean were strongly correlated between staircases (r = 0.71–0.95, p<0.05). and showed good to excellent reliability (ICC = 0.66–0.95, p<0.05). Ploss showed poor reliability. To conclude, measurements of SC power production (P1, Pmax and Pmean) with a single sensor on the lower back are reliable across different staircases. A small, transportable, 3-step staircase can be used for measuring power production in clinical practices with no access to regular staircases. However, absolute values are dependent on the number of steps, indicating that measurements to track performance changes over time should always be done using an identical stair model. [ABSTRACT FROM AUTHOR]

Aims: Physical activity (PA) is an important target for improving clinical outcomes in heart failure (HF) patients. Nonetheless, assessing the daily PA profile in this population is a challenging task, traditionally performed using self‐report questionnaires such as the International PA Questionnaire Short Form (IPAQ‐SF). This study aimed to evaluate the concurrent validity of the IPAQ‐SF and accelerometer‐assessed PA using six published cut‐points in patients with HF and reduced or mildly reduced ejection fraction. Methods and results: The concordance between the IPAQ‐SF and a hip‐worn accelerometer regarding daily time spent performing moderate to vigorous PA in bouts of at least 10 min was assessed in 53 participants for seven consecutive days using six different cut‐points (Barnett, Dibben, Mark, Sanders, Troiano, and Vaha‐Ypya). Spearman's correlation and Bland–Altman plots were used to evaluate concurrent validity between methods. Regressions were used to study the association between patient variables, wear protocol (waking hour or 24 h), and absolute bias. The kappa index was used to evaluate the concordance between IPAQ‐SF and accelerometry for classifying patients as active or non‐active. All analyses were re‐run using non‐bouted metrics to investigate the effect of bouted versus non‐bouted analysis. The IPAQ‐SF and accelerometry showed low to negligible correlation (ρ = 0.12 to 0.37), depending on the cut‐point used. The regression analysis showed that the absolute bias was higher in participants following the waking‐hour protocol at all cut‐points except Dibben's (P ≤ 0.007). The concordance between the two methods to classify patients as active and non‐active was low when using Mark (κ = 0.23) and Barnett (κ = 0.34) cut‐points and poor for the remaining cut‐points (κ = 0.03 to 0.18). The results of the sensitivity analysis showed negligible to low correlation using non‐bouted metrics (ρ = 0.27 to 0.33). Conclusions: Moderate to vigorous PA measures using IPAQ‐SF and accelerometers are not equivalent, and we do not encourage researchers to use IPAQ‐SF alone when assessing PA in HF patients. Moreover, applying personalized collection and processing criteria is important when assessing PA in HF patients. We recommend following the 24 h protocol and selecting cut‐points calibrated in patients with cardiovascular diseases. Finally, it is necessary to develop a new tailored questionnaire that considers walking intensity and is adjusted to the current World Health Organisation recommendations, which use non‐bouted metrics. [ABSTRACT FROM AUTHOR]

This study is focused on the fact that in the context of increasing global aging and cancer diagnoses, additional challenges arise in clinical care. Adequate functionality and body composition are key to coping with antineoplastic treatment, which can lead to better treatment tolerance, survival, and quality of life. This is a cross-sectional comparative study focused on the assessment and comparison of body composition and functionality between cancer patients and a reference population, with the aim of establishing meaningful baseline values. Techniques such as manual dynamometry, the Five-Times Sit-to-Stand test, and bioimpedance were used to collect data from 374 oncologic patients and 1244 reference individuals. The results reveal significant disparities in functionality and body composition among participants, and provide age group-specific adjusted baseline values for those diagnosed with cancer. These findings may have crucial clinical implications for applying particular cut-off points designed for this population group, which makes the assessment process faster and more accurate, enhances the capacity of medical personnel to act quickly, and improves the management of frailty in cancer patients. [ABSTRACT FROM AUTHOR]

Background: Resuming a physical exercise program after a period of cessation is common in older women. Monitoring the responses during this detraining (DT) and retraining (RT) may allow us to analyze how the body reacts to an increase and a reduction in physical inactivity. Therefore, we conducted a follow-up training, DT, and RT in prehypertensive older women to analyze the response to these periods. Methods: Twenty-three prehypertensive older women (EG; 68.3 ± 2.8 years; 1.61 ± 0.44 m) performed 36 weeks of the multicomponent training program (MTP) followed by twelve weeks of DT plus eight weeks of RT. Fifteen prehypertensive older women (CG; 66.3 ± 3.2 years; 1.59 ± 0.37 m) maintained their normal routine. Functional capacity (FC), lipid, and hemodynamic profile were assessed before, during 24 and 36 weeks of the MTP, after 4 and 12 weeks of DT, and after 8 weeks of RT. Results: After 24 weeks of the MTP, only SBP did not improve. Four weeks of DT did not affect lower body strength (30-CS), TC, or GL. Eight weeks of RT improved BP (SBP: −2.52%; ES: 0.36; p < 0.00; DBP: −1.45%; ES: 0.44; p < 0.02), handgrip strength (3.77%; ES: 0.51; p < 0.00), and 30-CS (3.17%; ES: 0.38; p < 0.04) compared with 36 weeks of the MTP. Conclusions: Eight weeks of RT allowed patients to recover the benefits lost with detraining, which after only four weeks affected them negatively, and the systematic practice of exercise contributed to greater regulation of BP since 24 weeks of the MTP proved not to be enough to promote positive effects of SBP. [ABSTRACT FROM AUTHOR]

Aim: To learn the functional fitness levels in older adults with diabetes combined with sarcopenia and/or frailty. Design: A cross‐sectional investigation study. Methods: A total of 205 participants with type 2 diabetes were recruited from September 2019 to August 2020. All patients underwent diagnostic screening for sarcopenia and frailty, and were divided into combined group (the patients who had sarcopenia and/or frailty) and non‐combined group (the patient who had no sarcopenia and/or frailty). The diagnostic criteria for sarcopenia applied was proposed by the Asian Working Group on Sarcopenia in 2019 and frailty status was assessed using FRAIL Scale. Functional fitness was measured using the Senior Fitness Test and compared between combined and non‐combined groups. Biochemical data of blood routine, glycolipid, and hepatorenal function tests were acquired from medical records. Logistic regression analysis was applied to explore the factors associated with the sarcopenia and/or frailty in the older adults with diabetes. Results: Compared with non‐combined group, the participants in combined group exhibited shorter 6‐min walk distance, fewer repetitions of arm curls and chair stands, smaller back scratch and chair sit‐and‐reach values, and longer time in the 8‐ft up‐and‐go test. The patients in the combined group had significantly lower level of red blood cell, haemoglobin, haematocrit, and higher level of platelet and blood urea nitrogen. Apart from calf circumference, physical activity, and insulin injection treatment, 6‐min walk distance was the factor associated with diabetes combined with sarcopenia and/or frailty. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The multicomponent training program (MTP) is a physical exercise strategy used to combat the sedentary lifestyle in older women (OW). However, periods of interruption in training are common in this population. The aim of our study was to analyze the 8-week MTP effects followed by two, four, and eight weeks of interruption on the lipid profile (LP) and functional capacity (FC) of OW. Methods: Twenty-one OW (experimental group [EG], 67.6 ± 3.1 years; 1.55 ± 0.35 m) were subjected to an 8-week MTP followed by a detraining period, and 14 OW (control group [CG], 69.4 ± 4.7 years; 1.61 ± 0.26 m) maintained their daily routine. FC (i.e., 30-s chair stand [30-CS], 8-foot up and go [8-FUG], 6-min walk [6-MWT], handgrip strength [HGS], and heart-rate peak during 6-WMT [HRPeak]), total cholesterol (TC) and triglycerides (TG) were assessed before and after MTP and two, four, and eight weeks after MTP. Results: 8-week MTP resulted in higher FC and decreased LP values in EG (p < 0.05); two and four weeks of detraining did not promote changes. After eight weeks of detraining TC (ES: 2.74; p = 0.00), TG (ES: 1.93; p = 0.00), HGS (ES: 0.49, p = 0.00), HRPeak (ES: 1.01, p = 0.00), 6-MWT (ES: 0.54, p = 0.04), and 8-FUG (ES: 1.20, p = 0.01) declined significantly. Conclusions: Periods of more than four weeks of detraining should be avoided to promote a good quality of life and health in OW. If older people interrupt training for a period longer than four weeks, physical-education professionals must outline specific training strategies to maintain the adaptations acquired with MTP. Future studies should establish these criteria based on ideal training volume, intensity, and frequency. [ABSTRACT FROM AUTHOR]

Background and Aims: The worldwide aging population is expanding, with more individuals living into their 80s. Physiological functions decline gradually with age, compounded by sedentary lifestyles. Incorporating physical activity into daily routine is crucial for maintaining independence. This study aimed to assess a periodized high-intensity aerobic training program (PEZO-BT) in octogenarians, focusing on submaximal ergospirometry effects. Methods: A total of 48 non-frail octogenarian subjects (12 females, 36 males) were randomized into control and intervention groups. All subjects underwent submaximal cardiopulmonary exercise testing with gas analysis at baseline, stopping after the respiratory compensation point (RCP). Our intervention group completed a 14-week PEZO-BT aerobic training program. The outcomes were oxygen consumption at first ventilatory threshold (VO2AT), ventilatory efficiency slope (VE/VCO2), oxygen uptake efficiency slope (OUES), cardiorespiratory optimal point (COP), oxygen pulse change (ΔVO2/HR) from anaerobic threshold (AT) to respiratory compensation point (RCP), and power output at anaerobic threshold (POAT). Results: Mixed ANOVA examined time and treatment effects. If significance emerged, post hoc t-tests were used to compare significances between groups. The homogeneity of variance was assessed using Levene's test. Chi-square tests compared ergospirometry criteria and ventilatory performance within groups. The mean differences at post intervention were significant in VO2AT (p < 0.001), VE/VCO2 (p < 0.001), ΔVO2/HR (p < 0.05), and POAT (p < 0.001), while OUES and COP were not significant (p > 0.05). However, clinical effects were observed in the entire intervention group. Conclusions: Training improved exercise capacity and workload. Overall, this periodic aerobic and high-intensity interval training (HIIT) program yielded significant improvements in cardiorespiratory fitness (CRF) in previously untrained octogenarians with and without comorbidities. The findings suggest implications for promoting long-term healthy aging. [ABSTRACT FROM AUTHOR]

Significant costs and utilisation of healthcare resources are associated with hospitalisations for non-specific low back pain despite clinical guidelines recommending community-based care. The aim of this systematic review was to investigate the predictors of hospitalisation for low back pain. A protocol was registered with PROSPERO international prospective register of systematic reviews (#CRD42021281827) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Database search of Ovid Medline, Emcare, Embase, PsycINFO, Cochrane Library, PEDro and OTSeeker was conducted. Studies were included if they examined a predictor of hospitalisation for non-specific low back pain with or without referred leg pain. Data was extracted and descriptively synthesised. Risk of bias of included studies was assessed using the Critical Appraisal Skills Programme Checklists. There were 23 studies published over 29 articles which identified 52 predictor variables of hospitalisation for low back pain. The risk of hospitalisation was grouped into themes: personal, health and lifestyle, psychology, socioeconomic, occupational, clinical, and health systems and processes. There was moderate level evidence that arrival to an emergency department via ambulance with low back pain, and older age increase the risk of hospitalisations for low back pain. There was low level evidence that high pain intensity, past history of low back pain, opioid use, and occupation type increase the risk of hospitalisation for low back pain. Further research into psychological and social factors is warranted given the paucity of available studies. Hospital avoidance strategies, improved patient screening and resource utilisation in emergency departments are considerations for practice. [ABSTRACT FROM AUTHOR]

Background and aim: Management of falling and its consequences is a major challenge of elderly nursing care. An effective educational strategy is essential to prevent falling among elderly people. The aim of this study was to evaluate the effects of simulated video education (SVE) about falling on falling rate and fear of falling (FOF) among hospitalized elderly people. Methods: This randomized controlled clinical trial was conducted from May 2021 to February 2022. Participants were 132 elderly people conveniently selected from a leading hospital in Qom, Iran, and randomly allocated to an intervention and a control group through block randomization. Data collection instruments were a demographic and clinical questionnaire, a researcher-made falling rate questionnaire, and the Falls Efficacy Scale-International. Participants in the intervention group individually watched three simulated videos (fifteen minutes in total) and had access to the videos for frequent watching. Their FOF was assessed on the first day of hospitalization, hospital discharge, and one and three months after hospital discharge. The data were analyzed at a significance level of less than 0.05 using the SPSS software (v. 16.0). Results: Groups did not significantly differ from each other respecting baseline demographic and clinical characteristics (P > 0.05). After the intervention, falling rate in the intervention group was 46% less than the control group (incidence rate ratio = 0.5454, 95% CI = 0.307–0.968; P = 0.039). Moreover, the posttest mean score of FOF in the intervention group was significantly less than the control group (P < 0.001). Conclusion: SVE is effective in significantly reducing falling rate and FOF. Context-based SVE is recommended to reduce falling rate and FOF among hospitalized elderly people. Clinical trial registration: The effects of simulated video education about falling on falling rate and fear of falling among hospitalized elderly people. Clinical trial registration: this research was registered (17/09/2021) in the https://www.irct.ir with registration number: IRCT20210910052427N1). [ABSTRACT FROM AUTHOR]