The Effects of Arthritis Foundation’s “Walk With Ease” Program on Cognitive Function

Physical activity (PA) is believed to improve cognitive function, particularly executive function, in older adults. However, few interventions in community settings have been performed to improve executive function through PA. The purpose of this study was to determine the effects of a community-based walking program on executive function in older adults (60+ years). Older adults from senior centers throughout Lexington County, SC were recruited for participation in this intervention. Exclusion criteria included currently exercising \u3e30 minutes and exercising ≥2x/week or scoring ≤25 on the Mini-Mental State Exam. The intervention consisted of an evidenced-based community walking program, the Arthritis Foundation ’ s “ Walk With Ease”, which met two times a week for 9 weeks. Participants were tested at baseline and follow-up on the following measures: executive function (Stroop Color-Word, Trail Making Test A and B, Semantic Fluency, and Phonetic Fluency), physical performance (Timed Up-and-Go, Gait Speed, Chair Stand), depressive symptoms, disease management self-efficacy, and PA levels. Participants also reported demographics and subjective health status. Paired t-tests and repeated measures ANOVA were conducted for all outcomes of interest, along with effect sizes. Participants (N=56) were predominantly female (80.4%) and overweight (BMI= 29.81 ± 5.92). No significant improvements for any cognitive function measure or physical performance measure were found following the intervention. Repeated measures ANOVA revealed a significant improvement following the intervention for both PA (B=17.79 ± 5.42 MET hours/week, p\u3c0.01) and disease management self-efficacy (B=5.77 ± 2.53, p=0.03). The results of this community-based single group pretest-posttest study does not provide enough evidence that the WWE is associated with improvements in cognitive function or improvements in physical performance. This study indicates that WWE increases PA levels and disease management self-efficacy of older adults. Larger studies of longer duration may be needed to reveal impacts on cognitive function

Equating accelerometer estimates among youth : the Rosetta Stone 2

Different accelerometer cutpoints used by different researchers often yields vastly different estimates of moderate-to-vigorous intensity physical activity (MVPA). This is recognized as cutpoint non-equivalence (CNE), which reduces the ability to accurately compare youth MVPA across studies. The objective of this research is to develop a cutpoint conversion system that standardizes minutes of MVPA for six different sets of published cutpoint

The Integrin Receptor in Biologically Relevant Bilayers: Insights from Molecular Dynamics Simulations

Integrins are heterodimeric (αβ) cell surface receptors that are potential therapeutic targets for a number of diseases. Despite the existence of structural data for all parts of integrins, the structure of the complete integrin receptor is still not available. We have used available structural data to construct a model of the complete integrin receptor in complex with talin F2–F3 domain. It has been shown that the interactions of integrins with their lipid environment are crucial for their function but details of the integrin/lipid interactions remain elusive. In this study an integrin/talin complex was inserted in biologically relevant bilayers that resemble the cell plasma membrane containing zwitterionic and charged phospholipids, cholesterol and sphingolipids to study the dynamics of the integrin receptor and its effect on bilayer structure and dynamics. The results of this study demonstrate the dynamic nature of the integrin receptor and suggest that the presence of the integrin receptor alters the lipid organization between the two leaflets of the bilayer. In particular, our results suggest elevated density of cholesterol and of phosphatidylserine lipids around the integrin/talin complex and a slowing down of lipids in an annulus of ~30 Å around the protein due to interactions between the lipids and the integrin/talin F2–F3 complex. This may in part regulate the interactions of integrins with other related proteins or integrin clustering thus facilitating signal transduction across cell membranes

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)

An automatic estimation of the rest-interval for MotionWatch8© using uniaxial movement and lux data

Background: Poor sleep is linked with chronic conditions common in older adults, including diabetes, heart disease, and dementia. Valid and reliable field methods to objectively measure sleep are thus greatly needed to examine how poor sleep impacts older adults. Wrist-worn actigraphy (WWA) is a common objective measure of sleep that uses motion and illuminance data to estimate sleep. The rest-interval marks the time interval between when an individual attempts to sleep and the time they get out of bed to start their day. Traditionally, the rest-interval is scored manually by trained technicians, however algorithms currently exist which automatically score WWA data, saving time and providing consistency from user-to-user. However, these algorithms ignore illuminance data and only considered motion in their estimation of the rest-interval. This study therefore examines a novel algorithm that uses illuminance data to supplement the approximation of the rest-interval from motion data. Methods: We examined a total of 1086 days of data of 129 participants who wore the MotionWatch8© WWA for ≥14 nights of observation. Resultant sleep measures from three different parameter settings were compared to sleep measures derived following a standard scoring protocol and self-report times. Results: The algorithm showed the strongest correlation to the standard protocol (r = 0.92 for sleep duration). There were no significant differences in sleep duration, sleep efficiency and fragmentation index estimates compared to the standard scoring protocol. Conclusion: These results suggest that an automated rest-interval scoring method using both light exposure and acceleration data provides comparable accuracy to the standard scoring method.Medicine, Faculty ofOther UBCPhysical Therapy, Department ofReviewedFacult

International depiction of the cost of functional independence limitations among older adults living in the community : a systematic review and cost-of-impairment study

Background: Functional independence limitations restrict older adult self-sufficiency and can reduce quality of life. This systematic review and cost of impairment study examined the costs of functional independence limitations among community dwelling older adults to society, the health care system, and the person. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines this systematic review included community dwelling older adults aged 60 years and older with functional independence limitations. Databases (Cochrane Database of Systematic Reviews, EconLit, NHS EED, Embase, CINAHL, AgeLine, and MEDLINE) were searched between 1990 and June 2020. Two reviewers extracted information on study characteristics and cost outcomes including mean annual costs of functional independence limitations per person for each cost perspective (2020 US prices). Quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results: 85 studies were included. The mean annual total costs per person (2020 US prices) were: $27,380.74 (95$4075.53, $50,685.96]) for societal,$24,195.52 (95% CI: [$9679.77,$38,711.27]) for health care system, and $7455.49 (95$2271.45, $12,639.53]) for personal. Individuals with cognitive markers of functional independence limitations accounts for the largest mean costs per person across all perspectives. Variations across studies included: cost perspective, measures quantifying functional independence limitations, cost items reported, and time horizon. Conclusions: This study sheds light on the importance of targeting cognitive markers of functional independence limitations as they accounted for the greatest costs across all economic perspectives.Management, Faculty of (Okanagan)Medicine, Faculty ofOther UBCPhysical Therapy, Department ofReviewedFacultyResearcherPostdoctoralGraduat

How much will older adults exercise? A feasibility study of aerobic training combined with resistance training

Background: Both aerobic training (AT) and resistance training (RT) have multidimensional health benefits for older adults including increased life expectancy and decreased risk of chronic diseases. However, the volume (i.e., frequency*time) of AT combined with RT in which untrained older adults can feasibly and safely participate remains unclear. Thus, our primary objective was to investigate the feasibility and safety of a high-volume exercise program consisting of twice weekly AT combined with twice weekly RT (i.e., four times weekly exercise) on a group of untrained older adults. In addition, we investigated the effects of the program on physical function, aerobic capacity, muscular strength, and explored factors related to participant adherence. Methods: We recruited eight inactive older adults (65+ years) to participate in a 6-week, single-group pre-post exercise intervention, consisting of 2 days/week of AT plus 2 days/week of progressive RT for 6 weeks. We recorded program attendance and monitored for adverse events during the course of the program. Participants were tested at both baseline and follow-up on the following: (1) physical function (i.e., timed-up-and-go test (TUG) and short physical performance battery (SPPB)), (2) aerobic capacity (VO2max) using the modified Bruce protocol; and (3) muscular strength on the leg press and lat pull-down. Post intervention, we performed qualitative semi-structured interviews of all participants regarding their experiences in the exercise program. We used these responses to examine themes that may affect continued program adherence to a high-volume exercise program. Results: We recorded an average attendance rate of 83.3% with the lowest attendance for one session being five out of eight participants; no significant adverse events occurred. Significant improvements were observed for SPPB score (1.6; 95% CI: [0.3, 2.9]), VO2max (8.8 ml/kg/min; 95% CI: [2.8, 14.8]), and lat pull-down strength (11.8 lbs; 95% CI: [3.3, 20.2]). Qualitative results revealed two themes that promote older adults’ adherence: (1) convenience of the program and (2) the social benefits of exercise. Conclusions: Our findings suggest untrained older adults can be successful at completing twice weekly AT combined with twice weekly progressive RT; however, these exercise programs should be group-based in order to maintain high adherence.Education, Faculty ofMedicine, Faculty ofOther UBCKinesiology, School ofPhysical Therapy, Department ofReviewedFacult

Measuring physical activity in older adults: calibrating cut-points for the MotionWatch 8©.

Given the world’s aging population, the staggering economic impact of dementia, the lack of effective treatments, and the fact a cure for dementia is likely many years away – there is an urgent need to develop interventions to prevent or at least delay dementia’s progression. Thus, lifestyle approaches to promote healthy aging are an important line of scientific inquiry. Good sleep quality and physical activity (PA) are pillars of healthy aging, and as such, are an increasing focus for intervention studies aimed at promoting health and cognitive function in older adults. However, PA and sleep quality are difficult constructs to evaluate empirically. Wrist-worn actigraphy (WWA) is currently accepted as a valid objective measure of sleep quality. The MotionWatch 8© (MW8) is the latest WWA, replacing the discontinued Actiwatch 4 and Actiwatch 7. In the current study, concurrent measurement of WWA and indirect calorimetry was performed during 10 different activities of daily living for 23 healthy older adults (aged 57-80 years) to determine cut-points for sedentary and moderate-vigorous PA – using receiver operating characteristic curves – with the cut-point for light activity being the boundaries between sedentary and moderate-vigorous PA. In addition, simultaneous multi-unit reliability was determined for the MW8 using inter-class correlations. The current study is the first to validate MW8 activity count cut-points – for sedentary, light, and moderate to vigorous PA – specifically for use with healthy older adults. These cut-points provide important context for better interpretation of MW8 activity counts, and a greater understanding of what these counts mean in terms of PA. Hence, our results validate another level of analysis for researchers using the MW8 in studies aiming to examine PA and sleep quality concurrently in older adults

Refining sleep measurement using the Motionwatch8©: how many days of monitoring do we need to get reliable estimates of sleep quality for older adults with mild cognitive impairment?

Background: Poor sleep is common among older adults with mild cognitive impairment (MCI)—a transition stage between healthy cognition and dementia. Objective, reliable, and low-burden field methods to measure older adult sleep are also currently needed. The MotionWatch8© (MW8) wrist-worn actigraph provides estimates of sleep with 14 days of observation; however, there may be underlying differences in the reliability of sleep estimates based on MCI status. We therefore investigated the number of MW8 monitoring days required to estimate sleep in older adults with MCI and without. Methods: Older adults (55+ years; N = 151) wore the MW8 for ≥14 days. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of < 26/30) and participants without MCI (≥ 26/30). We calculated intra-class reliability coefficients for one, seven, and 14 days of wear-time, and performed Spearman-Brown predictions to determine the number of monitoring days needed for an ICC = 0.80. Results: Older adults with MCI were older (p < 0.01), more likely to be male (p = 0.03), and had shorter sleep duration (p < 0.01). Spearman-Brown analyses indicated that the number of monitoring days needed for an ICC = 0.80 in older adults with probable MCI was 7 days for sleep duration, 4 days for fragmentation, and 4 days for efficiency; adults without MCI required 4 days for duration, 6 days for fragmentation, and 3 days for efficiency. Conclusions: Our results indicate that while the reliability of MW8 estimates of sleep differs based on cognitive status, 7 days of MW8 monitoring provides reliable estimates of sleep for adults with MCI and those without.Medicine, Faculty ofOther UBCPhysical Therapy, Department ofReviewedFacult

Extremes of weight gain and weight loss with detailed assessments of energy balance: illustrative case studies and clinical recommendations

Extreme weight changes, or changes in weight greater than 10 kg within a 2-year period, can be caused by numerous factors that are much different than typical weight fluctuations. This paper uses two interesting cases of extreme weight change (a female who experienced extreme weight gain and a male who experienced extreme weight loss) from participants in the Energy Balance Study to illustrate the physiological and psychosocial variables associated with the weight change over a 15-month period, including rigorous assessments of energy intake, physical activity (PA) and energy expenditure, and body composition. In addition, we provide a brief review of the literature regarding the relationship between energy balance (EB) and weight change, as well as insight into proper weight management strategies. The case studies presented here are then placed in the context of the literature regarding EB and weight change. This report further supports previous research on the importance of regular doses of PA for weight maintenance, and that even higher volumes of PA are necessary for weight loss. Practitioners should emphasize the importance of PA to their patients and take steps to monitor their patients’ involvement in PA