Short and Long-Term Trainability in Older Adults: Training and Detraining Following Two Years of Multicomponent Cognitive-Physical Exercise Training

Despite the benefits of multicomponent physical–cognitive training programs (MCCogTPs), lower training intensities in the concurrent approach, and bigger heterogeneity with aging, suggest the need for long-term analyses, with special attention to training and detraining in older adults. The present study aims to examine these training/detraining effects in a two year MCCogTP, looking for specific dynamics in the trainability of their physical and cognitive capacities. The intervention was divided into four periods: T1, T2 (8 months of training each), and D1, D2 (3.5 months of detraining plus 0.5 of testing each). Twenty-five healthy seniors (70.82 ± 5.18 years) comprised the final sample and were assessed for cardiovascular fitness (6-minutes walking test), lower-limbs strength (30-seconds chair-stand test) and agility (8-feet timed up-and-go test). Inhibition (Stroop test) was considered for executive function. Physical and cognitive status improved significantly (p < 0.05) throughout the two years, with larger enhancements for physical function (mainly strength and agility). Strength and cardiovascular fitness were more sensitive to detraining, whilst agility proved to have larger training retentions. Inhibition followed an initial similar trend, but it was the only variable to improve along D2 (d = 0.52), and changes were not significant within periods. Notwithstanding aging, and the exercise cessation in D2, physical and cognitive status remained enhanced two years later compared to baseline, except for lower-limb strength. According to these results, basic physical capacities are very sensitive to training/detraining, deserving continuous attention (especially strength). Both reducing detraining periods and complementary resistance training should be considered. Additionally, physical enhancements following MCcogTPs may help cognition maintenance during detraining

Inspiratory Muscle Strength and Cardiorespiratory Fitness Association With Health-Related Quality of Life in Healthy Older Adults

The main purpose of this study was to explore similarities and differences in the association between two capabilities affecting the cardiorespiratory system (overall and multifactorial cardiorespiratory fitness and inspiratory muscle strength) and the health-related quality of life (HRQoL), in a group of active healthy seniors. Sixty-five individuals (age, 73.01 ± 5.27 years; 53 women) who participated regularly in a multicomponent training program completed the EuroQol 5D-5L questionnaire, the 6-min walking test (6MWT), and the maximum inspiratory pressure test (MIP). Non-parametric correlations (Spearman's rho) were conducted to analyze the association between HRQoL indices (EQindex and EQvas), MIP, and 6MWT, considering both, the whole sample and men and women separately. Furthermore, partial correlation was made by controlling age and sex. We found a moderate association between HRQoL and cardiorespiratory fitness (EQvas: r = 0.324, p = 0.009; EQindex: r = 0.312, p = 0.011). Considering sex, relationship EQvas-6MWT decrease to small (r = 0.275; p = 0.028) whereas EQindex-6MWT remained moderated (r = 0.425; p = 0.000). When we considered women and men separately, the association between HRQoL and 6MWT appeared only in women, while the observed strong trend (p = 0.051) toward a large and positive association between EQindex and MIP, mediated by the covariate age, appeared only in men. Conversely to the cardiorespiratory fitness, MIP is not a limiting factor of HRQoL in healthy active elderly. Moreover, MIP and HRQoL should be included in the assessment of exercise interventions because they provide different information about the cardiorespiratory system deterioration. Similarly, EQvas and EQindex confirm to be complementary in the assessment of HRQoL. Furthermore, like aging process is different for men and women, the association between MIP and cardiorespiratory fitness with HRQoL may behave differently, so keeping on research these associations could help to improve training programs for this population

Assessing Health-Related Quality of Life in Older Adults: EuroQol Five-Dimensional Questionnaire vs the Short Form Health Survey

This study analyses the association between EuroQol five-dimensional questionnaire indexes (utility index and visual analogue scale) and the physical and mental components of the Short Form Health Survey, considering the impact of some variables that may influence both questionnaires (i.e., age, BMI, physical fitness and cognitive function). Bivariate and partial correlation analysis between EuroQol five-dimensional questionnaire indexes and summary components of the Short Form Health Survey, including the mentioned covariates, were conducted in 58 older adults (71.03±4.32 years). The large to small correlations found between utility index and the physical component (0.647), as well as the utility index and the visual analogue scale (0.441), persisted by adjusting physical condition, cognitive function, BMI and age, while mental components showed no association at all. The utility index and physical component were confirmed to correlate with physical fitness, although moderately (0.294; 0.284). BMI was negatively associated, but only to the utility index (-0.322). These results reinforce the concurrent validity only for the utility index and physical components and highlight the importance of physical fitness in a comprehensive geriatric assessment. The indexes of the Short Form Health Survey seem to provide diverse information regarding those of the EuroQol five-dimensional questionnaire in terms of the HRQL construct

Continuous Compared to Accumulated Walking-Training on Physical Function and Health-Related Quality of Life in Sedentary Older Persons

The present study aimed to analyze the impact of overground walking interval training (WIT) in a group of sedentary older adults, comparing two different dose-distributions. In this quasi-experimental and longitudinal study, we recruited twenty-three sedentary older adults (71.00 ± 4.10 years) who were assigned to two groups of WIT. The continuous group (CWIT) trained for 60 min/session in the morning, while the accumulated group (AWIT) performed the same duration and intensity of exercise, but it was distributed twice a day (30 min in the morning and 30 more in the afternoon). After 15 weeks of an equal external-load training (3 days/week), Bonferroni post-hoc comparisons revealed significant (p < 0.050) and similar large improvements in both groups in cardiorespiratory fitness and lower limb strength; even larger gains in preferred walking speed and instrumental daily life activity, which was slightly superior for CWIT; and improvements in agility, which were moderate for CWIT and large for AWIT. However, none of the training protocols had an impact on the executive function in the individuals, and only the AWIT group improved health-related quality of life. Although both training protocols induced a general significant improvement in physical function in older adults, our results showed that the accumulative strategy should be recommended when health-related quality of life is the main target, and the continuous strategy should be recommended when weakness may be a threat in the short or medium term

Inspiratory muscle strength, handgrip strength and muscle mass in active elderly women

El objetivo del estudio fue analizar la relación entre la fuerza de la musculatura inspiratoria (MIP), la fuerza periférica medida como prensión manual (HG), y la masa muscular (MM), en mujeres mayores sanas y activas. Tras recoger 126 mediciones de usuarias del programa de entrenamiento multicomponente EFAM-UV© y comprobar la influencia de la edad sobre MM, HG y MIP, incluidos sus gráficos de dispersión y R2, se analizó la asociación entre estas variables, con y sin la covariable edad (Coeficientes Pearson o Spearman según corresponda). La esperada relación negativa entre edad y MM, y edad y HG, fue moderada, y se redujo para Edad vs. MIP (r=-0,178; R2 <2%). MIP, HG y MM no mostraron asociación. Envejecimiento y entrenamiento son procesos selectivos. Una MIP baja a pesar de la buena aptitud física justificaría estos resultados y confirmaría que, aun siendo activas, las mujeres mayores deben entrenar específicamente la musculatura inspiratoria.The aim of this study was to analyse the relationship between inspiratory muscle strength (MIP), peripheral strength assessed by means of the handgrip test (HG), and muscle mass (MM) in healthy active elderly women. 126 measurements from women undergoing the multicomponent training program EFAM-UV© were collected between October 2017 to June 2019. After testing the influence of age on MM, HG and MIP, including their Scatter plots and R2 , the relationship between these variables was analysed, with and without Age as a covariate. The expected negative association between age and MM, and age and HG, were moderated and were reduced when considering Age vs. MIP (r=- 0.178; R2 <2%). Moreover, there was no relationship between MIP, HG and MM. Aging and Exercise Training are both selective processes. Low MIP values despite a good physical fitness would justify these results, confirming that even being active, elderly women should train inspiratory muscles specifically

T test vs categorical analysis: evolution of agility in older adults following two years of training

Entendiendo que entrenar no siempre significa alcanzar la independencia funcional para un adulto mayor (AM), ni desentrenar perderla, se crearon 4 categorías para valorar el efecto a largo plazo de un programa multicomponente físico-cognitivo sobre el nivel de independencia en sus usuarios. Se evaluaron 25 AM sanos (69.74±5.36 años) a lo largo de dos años, considerando 2 periodos de Entrenamiento (E1, E2; 8 meses cada uno) y Desentrenamiento (D1, D2; 3 meses + 1 de evaluación). Se analizó la agilidad (Time Up&Go Test) por su relación con la marcha y la prevención de caídas. Los cambios de categoría entre periodos se analizaron mediante el test exacto de Fisher, seguido de un ANOVA de medidas repetidas para comparar el análisis tras ambos enfoques. Aunque la agilidad mostró una mejora significativa al entrenar, mayor en E1 que en E2, el porcentaje de participantes independientes funcionalmente fue mayor en E2. En términos de desentrenamiento, la comparación por pares mostró pérdidas superiores durante D2, aunque esto no impidió que más de la mitad de los participantes alcanzaran la independencia funcional en este segundo periodo. Ambos análisis son complementarios y clarifican el beneficio del programa a largo plazo en la agilidad de la población adulta.Exercise training does not ensure functional independence among elders, neither detraining means to lose it, so 4 categories where designed in order to analyse the long-term effects of a multicomponent physical-cognitive training program over their users’ functional independence. A total of 25 healthy elders (69.74±5.36 years old) were assessed during two years, including 2 periods of training (T1, T2; 8 months each one) and detraining (D1, D2; 3 months + 1 of testing). Agility (Time Up&Go Test) was analysed because of its relationship with gait and fall-prevention. The exact Fisher’s test was considered to analzse between-period category changes, followed by a Repeated Measures ANOVA, to compare the results in both approaches. Although agility showed significant improvements following training, larger in T1 compared to T2, the percentage of independent participants was higher in T2. In terms of detraining, paired comparison showed larger losses during D2. However, more than half of participants reached the physical independence during this second period. Both analyses are complementary and clarify the long-term benefits of this training program for the agility of the elderly population

Comprehensive cross-platform comparison of methods for non-invasive EGFR mutation testing : results of the RING observational trial.

Abstract Several platforms for noninvasive EGFR testing are currently used in the clinical setting with sensitivities ranging from 30% to 100%. Prospective studies evaluating agreement and sources for discordant results remain lacking. Herein, seven methodologies including two next-generation sequencing (NGS)-based methods, three high-sensitivity PCR-based platforms, and two FDA-approved methods were compared using 72 plasma samples, from EGFR-mutant non-small-cell lung cancer (NSCLC) patients progressing on a first-line tyrosine kinase inhibitor (TKI). NGS platforms as well as high-sensitivity PCR-based methodologies showed excellent agreement for EGFR-sensitizing mutations (K = 0.80-0.89) and substantial agreement for T790M testing (K = 0.77 and 0.68, respectively). Mutant allele frequencies (MAFs) obtained by different quantitative methods showed an excellent reproducibility (intraclass correlation coefficients 0.86-0.98). Among other technical factors, discordant calls mostly occurred at mutant allele frequencies (MAFs) ≤ 0.5%. Agreement significantly improved when discarding samples with MAF ≤ 0.5%. EGFR mutations were detected at significantly lower MAFs in patients with brain metastases, suggesting that these patients risk for a false-positive result. Our results support the use of liquid biopsies for noninvasive EGFR testing and highlight the need to systematically report MAFs. Keywords: NGS; circulating free DNA; epidermal growth factor receptor; non-small-cell lung cancer; osimertinib; tyrosine kinase inhibitor

Balance Changes in Trained and Untrained Elderly Undergoing a Five-Months Multicomponent Training Program

Balance is a main focus of elderly activity programs which can be assessed by functional tests or stabilometry platforms. Our study aims to compare balance-changes in trained (TRA) and untrained (UNT) elderly following a 5-month Multi-Component Training Program (MCTP), twice a week, one hour per day. 10 TRA (>2-years) and 9 UNT (first year) performed the Romberg´s test (Open-Eyes 30 seconds/Closed-Eyes 30 seconds ratio) on a stabilometry platform (BT4, Hur Labs). COP displacement (Trace Length: TL) and sway area (C90) were registered twice PRE (1&2), POST (3&4) and 3 months later (Detraining: 5&6) the EFAM-UV© program, a Cognitive MCTP based on gait training and Dual-Task neuromuscular proposals in enriched environments. Regarding Open-Eyes, Bonferroni post-hoc comparisons showed significant group-differences in TL for 1, 2, 5 & 6 sample conditions, and a slight trend toward significance in C90 1&5. TL also showed significant group-differences in Closed-Eyes 1, 5 & 6, while C90 only in 5 & 6 Closed-Eyes. Balance indicators TL and C90 show a different way regarding the training status. A 5-month MCTP reduces differences, but detraining quickly affects UNT. Although effective, short multicomponent interventions could lead to early worsening, so the ratio training-detraining might be considered in untrained elderly population