Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking: An exploration of policy incoherence

Along with cognitive decline, dementia is characterised by changes in emotional control, social behaviour and physical performance.1 Individuals living with dementia often require assistance with their activities of daily living as dementia progresses.2 Requirements for higher levels of care result in more individuals with dementia living in residential aged care facilities (RACFs); up to 52% of all individuals living in RACFs have a diagnosis of dementia

Reflex changes associated with anticipatory postural adjustments preceding voluntary arm movements in standing humans

Dynamic changes in human stability, such as those induced by upper body movements, are preceded by anticipatory postural adjustments (APAs) in the rest of the body. We measured the excitability of the stretch reflex of the triceps-surae muscle group during APAs associated with unilateral right arm raises in standing humans. Our results demonstrate that reflex excitability and underlying muscle activity are linked during the APA period, but that they differ in their relative timing. This supports the idea that reflexes are controlled independently of muscle activation

Neuromuscular and Perceptual Responses to Sub-Maximal Eccentric Cycling

ObjectiveEccentric (ECC) cycle-ergometers have recently become commercially-available, offering a novel method for rehabilitation training. Many studies have reported that ECC cycling enables the development of higher levels of muscular force at lower cardiorespiratory and metabolic loads, leading to greater force enhancements after a training period. However, fewer studies have focused on the specific perceptual and neuromuscular changes. As the two latter aspects are of major interest in clinical settings, this review aimed to present an overview of the current literature centered on the neuromuscular and perceptual responses to submaximal ECC cycling in comparison to concentric (CON) cycling.DesignNarrative review of the literature.ResultsAt a given mechanical workload, muscle activation is lower in ECC than in CON while the characteristics of the musculo-articular system (i.e., muscle-tendon unit, fascicle, and tendinous tissue length) are quite similar. At a given heart rate or oxygen consumption, ECC cycling training results in greater muscular hypertrophy and strength gains than CON cycling. On the contrary, CON cycling training seems to enhance more markers of muscle aerobic metabolism than ECC cycling performed at the same heart rate intensity. Data concerning perceptual responses, and neuromuscular mechanisms leading to a lower muscle activation (i.e., neural commands from cortex to muscular system) at a given mechanical workload are scarce.ConclusionEven though ECC cycling appears to be a very useful tool for rehabilitation purposes the perceptual and neural commands from cortex to muscular system during exercise need to be further studied

Commentaries on viewpoint : physiology and fast marathons

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Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

It\u27s never too late to become an Ironman - The example of an 85-year-old triathlete

This study aimed to analyse the performance of Hiromu Inada (HI), an 85-year-old triathlete, who became the oldest athlete in the world to complete the famous Hawaii Ironman triathlon consisting of a 3.8km swim, 180-km cycle and 42-km run. HI swam in 1 h 51 min, cycled in 8 h 02 min, ran in 6 h 28 min and took 31 min for his transitions, for a total time of 16 h 53 min. Compared to the winner\u27s speed, HI was 55, 47 and 58% slower in swimming, cycling and running, respectively. For the same age-group category (i.e. 85-89 years), the agerelated decline in performances of HI are more pronounced compared to the age-related decline in performance of shorter duration endurance single discipline such as 1500-m swimming, 1-h track cycling or marathon running. To our knowledge, the performance of HI represents the first written observation of a master athlete older than 85 years old who officially finished an ultra-endurance event. The HI case is a clear example that humans can retain remarkable functionality until the end of their life span⋯ if they train for it

Effects of physical activity on health and well-being of individuals living with a dementia in residential accommodation: a systematic review

Poster presented at 47th AAG National Conference, Adelaide, 26-28 November 2014

Measuring the effects of physical activity on individuals living with a dementia in residential accommodation: a systematic review of RCTs

Abstract of presentation from the Dementia Collaborative Research Centres\u27 (DCRC) 2014 National Dementia Research Forum, Sydney, 19 September 2014

Gender differences in wheelchair marathon performances - Oita Wheelchair Marathon from 1983 to 2011

Background: The purpose of the study was (1) to examine the changes in participation and performance of males and females at the Oita International Wheelchair Marathon in Oita, Japan, between 1983 and 2011, and (2) to analyze the gender difference in the age of peak wheelchair marathon performance. Methods: Age and time performance data for all wheelchair athletes completing the Oita International Wheelchair Marathon from 1983 to 2011 were analyzed. Results: Mean annual number of finishers was 123 ± 43 for males and 6 ± 3 for females (5.0% ± 2.0% of all finishers), respectively. Mean age of overall finishers was significantly (P = 0.026) greater for males (41.3 ± 1.8 years) compared to females (32.7 ± 1.4 years). In contrast, there was no difference in the mean age of the top three overall finishers between males (35.8 ± 3.2 years) and females (31.6 ± 1.5 years). The race time of the top three overall finishers was significantly lower (P \u3c 0.01) for males (1:34 ± 0:11 hours:minutes) compared to females (1:59 ± 0:20 hours:minutes), but it was not significantly different between male (2:06 ± 0:12 hours:minutes) and female (2:12 ± 0:18 hours:minutes) overall finishers. The mean gender difference in time was 26.1% ± 9.7% for the top three overall finishers. Conclusion: Further studies are required to investigate the reasons for the low participation of females in wheelchair marathons and why the gender difference in marathon performance is much greater for disabled athletes than for able-bodied athletes