184 research outputs found
Comprehensive Quantitative Spatiotemporal Gait Analysis Identifies Gait Characteristics for Early Dementia Subtyping in Community Dwelling Older Adults
Background: Recent studies associated gait patterns with cognitive impairment stages. The current study examined the relation between dementia type and spatiotemporal gait characteristics under different walking conditions in pre and mild neurocognitive disorder stage.Methods: Community-dwelling older adults (age 50+) with memory complaints consulting a memory clinic underwent, at baseline and during follow-up (every 4 months), a standard dementia assessment and a comprehensive spatiotemporal gait analysis [walking on an electronic walkway at usual pace (UP) with and without a counting-backwards (CW) or animal-reciting dual-task (AW), at fast (FP) and at slow (SP) pace]. At baseline the participants were categorized according to the Clinical Dementia Rating (CDR) scale. At the end of the study, the dementia diagnosis was used to stratify the categories in three outcome groups: developed âNo-dementia,â âAD+FTDâ (grouping Alzheimer's or Fronto-temporal dementia) or âVascD+LBDâ dementia (grouping Vascular dementia or Lewy body dementia). The gait characteristics were compared per category in paired groups. Sub-analyzing in the â„70-years-old participants evaluated the age effect.Results: Five hundred and thirty-six participants, age 50-to-95-years old were followed for 31-to-41 months. In the CDR 0, no differences were seen between eventual dementia and no-dementia individuals. In the CDR 0.5, CW dual task cost (DTC) step width was larger in the imminent âAD+FTDâ and AW (normalized) gait speed was slower in the future âVascD+LBDâ group compared to the no-dementia participants. Slower UP (normalized) gait speed differed the future âVascD+LBDâ from the âAD+FTDâ individuals. In the CDR 1: Wider steps in UP, SP and CW differed the âVascD+LBDâ from the âAD+FTDâ group. In the â„70-years old CDR 0 category, higher AW cycle time variability in the imminent âAD+FTDâ dementia group, wider UP step width and higher AW cycle time variability in the âVascD+LBDâ group differed them from the no-dementia group up to 3 years before dementia diagnosis. The distinctive gait characteristics between the no-dementia and the imminent dementia groups in CDR 0.5 and CDR 1 remained the same as in the overall group. However, no gait differences were found between âVascD+LBDâ and âAD+FTDâ groups in the pre-dementia stages.Conclusion: Distinctive spatiotemporal gait characteristics were associated with specific dementia types up to 3 years before diagnosis. The association is influenced by the cognitive stage and age
Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People
The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and GeriatricsâEuropean Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as âpresarcopenia', âsarcopenia' and âsevere sarcopenia'. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatmen
Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses
peer reviewedContext: Sarcopenia is a progressive and generalized skeletal muscle disorder associated
with an increased risk of adverse outcomes such as falls, disability, and
death. The Belgian Society of Gerontology and Geriatrics has developed evidencebased
guidelines for the prevention and treatment of sarcopenia. This umbrella review
presents the results of the Working Group on Nutritional Interventions.
Objective: The aim of this umbrella review was to provide an evidence-based overview
of nutritional interventions targeting sarcopenia or at least 1 of the 3 sarcopenia
criteria (ie, muscle mass, muscle strength, or physical performance) in persons
aged 65 years. Data sources: Following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines, the PubMed and Web of Science
databases were searched for systematic reviews and meta-analyses reporting the
effect of nutritional supplementation on sarcopenia or muscle mass, strength, or
physical performance. Data extraction: Two authors extracted data on the key
characteristics of the reviews, including participants, treatment, and outcomes.
Methodological quality of the reviews was assessed using the product A
Measurement Tool to Assess Systematic Reviews. Three authors synthesized the
extracted data and generated recommendations on the basis of an overall synthesis
of the effects of each intervention. Quality of evidence was rated with the
Grading of Recommendations Assessment, Development and Evaluation approach.
Data analysis: A total of 15 systematic reviews were included. The following
supplements were examined: proteins, essential amino acids, leucine, b-hydroxy-b-methylbutyrate, creatine, and multinutrient supplementation (with or
without physical exercise). Because of both the low amount and the low to moderate
quality of the reviews, the level of evidence supporting most recommendations
was low to moderate. Conclusions: Best evidence is available to recommend
leucine, because it has a significant effect on muscle mass in elderly people with
sarcopenia. Protein supplementation on top of resistance training is recommended
to increase muscle mass and strength, in particular for obese persons and for
>=24weeks. Effects on sarcopenia as a construct were not reported in the included
reviews
Nutrition for the ageing brain: towards evidence for an optimal diet
As people age they become increasingly susceptible to chronic and extremely debilitating brain diseases. The precise cause of the neuronal degeneration underlying these disorders, and indeed normal brain ageing remains however elusive. Considering the limits of existing preventive methods, there is a desire to develop effective and safe strategies. Growing preclinical and clinical research in healthy individuals or at the early stage of cognitive decline has demonstrated the beneficial impact of nutrition on cognitive functions. The present review is the most recent in a series produced by the Nutrition and Mental Performance Task Force under the auspice of the International Life Sciences Institute Europe (ILSI Europe). The latest scientific advances specific to how dietary nutrients and non-nutrient may affect cognitive ageing are presented. Furthermore, several key points related to mechanisms contributing to brain ageing, pathological conditions affecting brain function, and brain biomarkers are also discussed. Overall, findings are inconsistent and fragmented and more research is warranted to determine the underlying mechanisms and to establish dose-response relationships for optimal brain maintenance in different population subgroups. Such approaches are likely to provide the necessary evidence to develop research portfolios that will inform about new dietary recommendations on how to prevent cognitive decline
Sarcopenia: revised European consensus on definition and diagnosis
Correction: Volume: 48 Issue: 4 Article Number: UNSP 601 DOI: 10.1093/ageing/afz046Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.Peer reviewe
Nutrition for the ageing brain: towards evidence for an optimal diet
As people age they become increasingly susceptible to chronic and extremely debilitating brain diseases. The precise cause of the neuronal degeneration underlying these disorders, and indeed normal brain ageing remains however elusive. Considering the limits of existing preventive methods, there is a desire to develop effective and safe strategies. Growing preclinical and clinical research in healthy individuals or at the early stage of cognitive decline has demonstrated the beneficial impact of nutrition on cognitive functions. The present review is the most recent in a series produced by the Nutrition and Mental Performance Task Force under the auspice of the International Life Sciences Institute Europe (ILSI Europe). The latest scientific advances specific to how dietary nutrients and non-nutrient may affect cognitive ageing are presented. Furthermore, several key points related to mechanisms contributing to brain ageing, pathological conditions affecting brain function, and brain biomarkers are also discussed. Overall, findings are inconsistent and fragmented and more research is warranted to determine the underlying mechanisms and to establish dose-response relationships for optimal brain maintenance in different population subgroups. Such approaches are likely to provide the necessary evidence to develop research portfolios that will inform about new dietary recommendations on how to prevent cognitive decline
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