Associations between sedentary time, physical activity and bone health among older people using compositional data analysis

Introduction : Aging is associated with a progressive decrease in bone mass (BM), and being physical active is one of the main strategies to combat this continuous loss. Nonetheless, because daily time is limited, time spent on each movement behavior is co-dependent. The aim of this study was to determine the relationship between BM and movement behaviors in elderly people using compositional data analysis. Methods : We analyzed 871 older people [395 men (76.9 +/- 5.3y) and 476 women (76.7 +/- 4.7y)]. Time spent in sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA), was assessed using accelerometry. BM was determined by bone densitometry (DXA). The sample was divided according to sex and bone health indicators. Results : The combined effect of all movement behaviors (PA and SB) was significantly associated with whole body, leg and femoral region BM in the whole sample (p<0.05), with leg and pelvic BM (p<0.05) in men and, with whole body, arm and leg BM (p<0.05) in women. In men, arm and pelvic BM were negatively associated with SB and whole body, pelvic and leg BM were positively associated with MVPA (p<0.05). In women, whole body and leg BM were positively associated with SB. Arm and whole body BM were positively associated and leg BM was negatively associated with LPA and arm BM was negatively associated with MVPA (p<0.05). Women without bone fractures spent less time in SB and more in LPA and MVPA than the subgroup with bone fractures. Conclusion : We identified that the positive effect of MVPA relative to the other behaviors on bone mass is the strongest overall effect in men. Furthermore, women might decrease bone fracture risk through PA increase and SB reduction, despite the fact that no clear benefits of PA for bone mass were found

Scoping Review of Neuroimaging Studies Investigating Frailty and Frailty Components

Background: Neuroimaging techniques are a cornerstone for diagnosing and investigating cognitive decline and dementia in the elderly. In frailty research, the physical as opposed to the cognitive domain of the aging process, neuroimaging studies are less common. Here we systematically review the use of neuroimaging techniques in frailty research.Methods: We searched PUBMED for any publication reporting the association between neuroimaging markers and frailty, following Fried's original definition, as well as its determining phenotypes: gait speed, grip strength, fatigue and recent weight loss in the non-diseased population older than 65 years.Results: The search returned a total of 979 abstracts which were independently screened by 3 reviewers. In total, 17 studies met the inclusion criteria. Of these, 12 studies evaluated gait speed, 2 grip strength, and 3 frailty (2 Fried Frailty, 1 Frailty Index). An association between increased burden of white matter lesions, lower fractional anisotropy, and higher diffusivity has been associated consistently to frailty and worse performance in the different frailty components.Conclusions: White matter lesions were significantly associated to frailty and frailty components thus highlighting the potential utility of neuroimaging in unraveling the underlying mechanisms of this state. However, considering small sample size and design effects, it is not possible to completely rule out reverse causality between frailty and neuroimaging findings. More studies are needed to clarify this important clinical question

The impact of movement behaviors on bone health in elderly with adequate nutritional status: compositional data analysis depending on the frailty status

The aim of this study was to determine the relationship between bone mass (BM) and physical activity (PA) and sedentary behavior (SB) according to frailty status and sex using compositional data analysis. We analyzed 871 older people with an adequate nutritional status. Fried criteria were used to classify by frailty status. Time spent in SB, light intensity PA (LPA) and moderate-to-vigorous intensity PA (MVPA) was assessed from accelerometry for 7 days. BM was determined by dual-energy X-ray absorptiometry (DXA). The combined effect of PA and SB was significantly associated with BM in robust men and women (p ≤ 0.05). In relation to the other behaviors, SB was negatively associated with BM in robust men while BM was positively associated with SB and negatively with LPA and MVPA in robust women. Moreover, LPA also was positively associated with arm BM (p ≤ 0.01). Finally, in pre-frail women, BM was positively associated with MVPA. In our sample, to decrease SB could be a good strategy to improve BM in robust men. In contrast, in pre-frail women, MVPA may be an important factor to consider regarding bone health

Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis

Objective To assess the effectiveness of acute geriatric units compared with conventional care units in adults aged 65 or more admitted to hospital for acute medical disorders

Diabetes and Risk of Frailty and Its Potential Mechanisms: A Prospective Cohort Study of Older Adults

Background: There is emerging evidence of the role of diabetes as a risk factor for frailty. However, the mechanisms of this association are uncertain. Methods: Prospective cohort study of 1750 non-institutionalized individuals aged ≥60 years recruited in 2008-2010. At baseline, information was obtained on health behaviors, morbidity, cardiometabolic biomarkers, and antidiabetic treatments. Individuals were considered diabetic if they reported a physician-diagnosis or had fasting serum glucose ≥126 mg/dl. Study participants were followed-up through 2012 to assess incident frailty, defined as at least three of the five Fried criteria. Results: At baseline, the cohort included 346 individuals with diabetes and 1404 without it. Over a mean 3.5-year follow-up, 115 cases of incident frailty were ascertained. After adjustment for age, sex and education, participants with diabetes showed an increased risk of frailty (odds ratio [OR]: 2.18; 95% confidence interval [CI]: 1.42-3.37). Additional adjustment for health behaviors and abdominal obesity yielded a 29.7% reduction in the OR (OR: 1.83; 95%CI: 1.16-2.90). Subsequent adjustment for morbidity produced an additional 8.4% reduction (OR: 1.76; 95%CI: 1.10-2.82), and for cardiometabolic biomarkers, a further 44% reduction (OR: 1.32; 95% 0.70-2.49). In particular, adjustment for HbA1c, lipoproteins and triglycerides accounted for the greatest reductions. Finally, additional adjustment for oral antidiabetic medication reduced the OR to 1.01 (95%CI: 0.46-2.20), while adjustment for nutritional therapy increased it to 1.64 (95%CI: 0.77-3.49). Conclusions: Diabetes mellitus is associated with higher risk of frailty; this association is partly explained by unhealthy behaviors and obesity and, to a greater extent, by poor glucose control and altered serum lipid profile among diabetic individuals. Conversely, diabetes nutritional therapy reduces the risk of frailtyBaseline data collection was funded by Sanofi-Aventis. Data collection during follow-up was funded by the Spanish Government FIS grants 09/1626 and 09/0104 (Instituto de Salud Carlos III). Funding specific for this analysis was obtained from the Spanish Government FIS grant 12/1166 (Instituto de Salud Carlos III) and the FP7-HEALTH-2012-Proposal No: 305483–2 (FRAILOMIC Initiative)

Поліваріантність ефектів біоактивної води Нафтуся на вегетативну реактивність, їх ендокринний і імунний супровід та можливість прогнозування

Выявлены разнонаправленные изменения (а также отсутствие оных) в результате питьевой монотерапии биоактивной водой Нафтуся вегетативной реактивности у женщин детородного возраста с хронической гинекологически-эндокринной патологией. Прослежены сопутствующие изменения ряда эндокринных и иммунных показателей. Доказана возможность надежного прогнозирования (точность - 92%) типа эффекта по 30 исходным показателям, отобранным методом дискриминантного анализа.Are revealed various changes (and also absence these) as a result of drinking monotherapy by bioactive water Naftussya of vegetative reactivity at the women of reproductive age with chronic ginecological and endocrine pathology. Are investigated accompanying changes of line of endocrine and immune parameters. The opportunity of reliable forecasting (accuracy - 92 %) such as effect on 30 initial parameters selected method of discriminant analysis is proved

Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging

Background: Physical activity (PA) is a recognized contributor to healthy aging. However, the majority of studies exploring its associations with adverse outcomes in cohorts of older adults use single-time PA estimates, which do not consider its dynamic nature. The aim of the present study is to explore the presence of different PA trajectories in the Toledo Study of Healthy Aging and their association with adverse outcomes. Our hypothesis is that prospectively maintaining or increasing PA is associated with a reduced risk of adverse outcomes. Methods: We used data from 1679 participants enrolled in the Toledo Study of Healthy Aging. Trajectories based on the Physical Activity Scale for the Elderly were identified using group-based trajectory modelling. Cox and logistic regression were used to investigate associations between PA trajectories and mortality and hospitalization, and incident and worsening disability, respectively. Mortality was ascertained by linkage to the Spanish National Death Index; disability was evaluated through the Katz Index; and hospitalization was defined as the first admission to Toledo Hospital. Models were adjusted by age, sex, smoking, Charlson Index, education, cognitive impairment, polypharmacy, and Katz Index at Wave 2. Results: We found four PA-decreasing and one PA-increasing trajectories: high PA-consistent (n = 566), moderate PA-mildly decreasing (n = 392), low PA-increasing (n = 237), moderate PA-consistent (n = 191), and low PA-decreasing (n = 293). Belonging to the high PA-consistent trajectory group was associated with reduced risks of mortality as compared with the low PA-decreasing group [hazard ratio (HR) 1.68; 95% confidence interval (CI) = 1.21–2.31] and hospitalization compared with the low PA-increasing and low PA-decreasing trajectory groups (HR 1.24; 95% CI = 1.004–1.54 and HR 1.25; 95% CI = 1.01–1.55, respectively) and with lower rates of incident [odds ratio (OR) 3.14; 95% CI = 1.59–6.19] and worsening disability (OR 2.16; 95% CI = 1.35–3.45) in relation to the low PA-decreasing trajectory group and at follow-up. Increasing PA during late life (low PA-increasing group) was associated with lower incident disability rates (OR 0.38; 95% CI = 0.19–0.82) compared with decreasing PA (low PA-decreasing group), despite similar baseline PA. Conclusions: Our results suggest that sustaining higher PA levels during aging might lead to healthy aging, characterized by a reduction in adverse outcomes. Our study supports the need for enhancing PA participation among older populations, with the goal of reducing personal and economic burden in a worldwide aging population.The present work was funded by grants from the Spanish Ministry of Economy, Industry and Competitiveness, cofinanced by the European Regional Development Funds (RD120001/0043) and the Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CB16/10/00464)