Does bimanual coordination training benefit inhibitory function in older adults?

IntroductionWhether complex movement training benefits inhibitory functions and transfers the effects to non-practiced motor and cognitive tasks is still unknown. The present experiment addressed this issue using a bimanual coordination paradigm. The main hypothesis was that bimanual coordination training allows for improving the involved cognitive (i.e., inhibition) mechanisms and then, transferring to non-practiced cognitive and motor tasks, that share common processes.Methods17 older participants (72.1 ± 4.0 years) underwent 2 training and 3 test sessions (pre, post, and retention one week after) over three weeks. Training included maintaining bimanual coordination anti-phase pattern (AP) at high frequency while inhibiting the in-phase pattern (IP). During the test sessions, participants performed two bimanual coordination tasks and two cognitive tasks involving inhibition mechanisms. Transfer benefits of training on reaction time (RT), and total switching time (TST) were measured. In the cognitive tasks (i.e., the Colour Word Stroop Task (CWST) and the Motor and Perceptual Inhibition Test (MAPIT)), transfer effects were measured on response times and error rates. Repeated one-way measures ANOVAs and mediation analyses were conducted.ResultsResults confirmed that training was effective on the trained task and delayed the spontaneous transition frequency. Moreover, it transferred the benefits to untrained bimanual coordination and cognitive tasks that also involve inhibition functions. Mediation analyses confirmed that the improvement of inhibitory functions mediated the transfer of training in both the motor and cognitive tasks.DiscussionThis study confirmed that bimanual coordination practice can transfer training benefits to non-practiced cognitive and motor tasks since presumably they all share the same cognitive processes

Association between Statin Use and Balance in Older Adults

ABSTRACT: Background: Several medications have been associated with an increased risk of balance deficits and greater likelihood to sustain a fall, representing a large health and economic issue. Statins are regularly prescribed to prevent strokes and heart attacks, but their impact on balance is unknown. The aim of this paper was to determine whether statin use is associated with poorer balance performances in older adults. Methods: All participants, one group taking statins (n = 34), and the other group not taking statins (n = 31), completed a balance assessment with their eyes closed and their eyes opened on a MatScan Pressure Sensing Mat. Center of Pressure (CoP) velocity, peak-to-peak distance, and standard deviation were collected in both anteroposterior (AP) and mediolateral (ML) directions. Multiple linear regression analyses were performed for each balance outcome, testing the statin use status as a predictor and controlling for appropriate factors including participants characteristics, lipid profile, and cardiovascular disease. Results: After controlling for confounding factors, statin use significantly predicted both CoP ML-Amplitude (beta = 0.638, p = 0.004) and ML-Velocity (beta = 0.653, p = 0.002) in the eyes-opened condition. Conclusions: The present study detected a negative association between statin use and balance control in the ML direction, suggesting that caution should be taken when prescribing statins in older adults, as this could decrease ML stability and ultimately increase fall and fracture risks

Myokines as mediators of exercise-induced cognitive changes in older adults: protocol for a comprehensive living systematic review and meta-analysis

BackgroundThe world’s population is aging, but life expectancy has risen more than healthy life expectancy (HALE). With respect to brain and cognition, the prevalence of neurodegenerative disorders increases with age, affecting health and quality of life, and imposing significant healthcare costs. Although the effects of physical exercise on cognition in advanced age have been widely explored, in-depth fundamental knowledge of the underlying mechanisms of the exercise-induced cognitive improvements is lacking. Recent research suggests that myokines, factors released into the blood circulation by contracting skeletal muscle, may play a role in mediating the beneficial effect of exercise on cognition. Our goal in this ongoing (living) review is to continuously map the rapidly accumulating knowledge on pathways between acute or chronic exercise-induced myokines and cognitive domains enhanced by exercise.MethodRandomized controlled studies will be systematically collected at baseline and every 6 months for at least 5 years. Literature search will be performed online in PubMed, EMBASE, PsycINFO, Web of Science, SportDiscus, LILACS, IBECS, CINAHL, SCOPUS, ICTRP, and ClinicalTrials.gov. Risk of bias will be assessed using the Revised Cochrane Risk of Bias tool (ROB 2). A random effects meta-analysis with mediation analysis using meta-analytic structural equation modeling (MASEM) will be performed. The primary research question is to what extent exercise-induced myokines serve as mediators of cognitive function. Secondarily, the pooled effect size of specific exercise characteristics (e.g., mode of exercise) or specific older adults’ populations (e.g., cognitively impaired) on the relationship between exercise, myokines, and cognition will be assessed. The review protocol was registered in PROSPERO (CRD42023416996).DiscussionUnderstanding the triad relationship between exercise, myokines and cognition will expand the knowledge on multiple integrated network systems communicating between skeletal muscles and other organs such as the brain, thus mediating the beneficial effects of exercise on health and performance. It may also have practical implications, e.g., if a certain myokine is found to be a mediator between exercise and cognition, the optimal exercise characteristics for inducing this myokine can be prescribed. The living review is expected to improve our state of knowledge and refine exercise regimes for enhancing cognitive functioning in diverse older adults’ populations.RegistrationSystematic review and meta-analysis protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on the 24th of April 2023 (registration number CRD42023416996)

Prévention de la chute chez la personne âgée : de la détection du risque à la réhabilitation par électrostimulation

The objective of this work was to improve the prevention of falls in seniors by (i) improving the detection of people at risk, (ii) providing new tools for assessing postural control and (iii) studying the effects of rehabilitation program by electrostimulation on the markers of the risk of falling. In order to meet these three objectives, three parts were developed:The aim of Part I was to provide tools for better detection of persons at risk of falls or fractures through the identification of factors responsible for a decline in postural control. We have been able to establish through three studies that (i) elderly patients who take five or more drugs per day are at higher risk of cognitive and mobility impairments, (ii) subjects who undergo fractures have a stabilization deficit after obstacle crossing and (iii) fractured fallers reduce their walking speed less during dual-task walking.In Part II we evaluated for the first time the braking of the center of mass, a parameter correlated with the quality of the postural control, with a kinematic analysis technique. It has been demonstrated that the technic usually used, the force-plate analysis, presents greater variability and leads to an underestimation of the braking index in comparison with this new method of analysis.In Part III we tested the effectiveness of a training program by electrostimulation of the ankle plantar and dorsiflexors on the parameters related to the fall or its severity. This training increased the strenght, and probably the contraction speed of the ankle muscles. Although the rehabilitation of other muscles seems necessary to improve gait,the training program has rehabilitated dynamic balance.L’objectif de ce travail était d’améliorer la prévention de la chute des séniors en améliorant la détection des personnes à risque et les outils d’évaluation du contrôle postural ainsi qu’en utilisant un programme de réhabilitation par électrostimulation. Afin de répondre à ces trois objectifs, trois parties ont été développées :Le but de la partie I était d’apporter des outils permettant une meilleure détection des personnes à risque à travers l’identification de facteurs responsables d’un déclin du contrôle postural. Nous avons pu établir lors de trois études que (i) les personnes consommant cinq médicaments et plus par jour présentent un risque accru des troubles de la cognition et de la mobilité, (ii) les chuteurs fracturés ont un déficit de stabilisation après le passage d’obstacle et (iii) les chuteurs fracturés réduisent moins leur vitesse de marche lors de la double tâche. Dans la partie II nous avons évalué pour la première fois le freinage du centre de masse, paramètre corrélé à la qualité du contrôle postural, avec une technique d’analyse cinématique. Il a été mis en évidence que l’analyse sur plateforme de force, habituellement utilisée, présente une plus grande variabilité et conduit à une sous-estimation de l’indice de freinage, en comparaison à cette nouvelle méthode d’analyse. Dans la partie III nous avons testé l’efficacité d’un programme d’électrostimulation des muscles mobilisateurs de la cheville sur les facteurs de risque de chute. Cet entrainement a permis d’augmenter la force des muscles et bien que la réhabilitation d’autres muscles semble nécessaire afin d’améliorer la marche, le programme a réhabilité efficacement les performances d'équilibr

Fall prevention in the elderly : from detection to rehabilitation by electrical muscular stimulation

L’objectif de ce travail était d’améliorer la prévention de la chute des séniors en améliorant la détection des personnes à risque et les outils d’évaluation du contrôle postural ainsi qu’en utilisant un programme de réhabilitation par électrostimulation. Afin de répondre à ces trois objectifs, trois parties ont été développées :Le but de la partie I était d’apporter des outils permettant une meilleure détection des personnes à risque à travers l’identification de facteurs responsables d’un déclin du contrôle postural. Nous avons pu établir lors de trois études que (i) les personnes consommant cinq médicaments et plus par jour présentent un risque accru des troubles de la cognition et de la mobilité, (ii) les chuteurs fracturés ont un déficit de stabilisation après le passage d’obstacle et (iii) les chuteurs fracturés réduisent moins leur vitesse de marche lors de la double tâche. Dans la partie II nous avons évalué pour la première fois le freinage du centre de masse, paramètre corrélé à la qualité du contrôle postural, avec une technique d’analyse cinématique. Il a été mis en évidence que l’analyse sur plateforme de force, habituellement utilisée, présente une plus grande variabilité et conduit à une sous-estimation de l’indice de freinage, en comparaison à cette nouvelle méthode d’analyse. Dans la partie III nous avons testé l’efficacité d’un programme d’électrostimulation des muscles mobilisateurs de la cheville sur les facteurs de risque de chute. Cet entrainement a permis d’augmenter la force des muscles et bien que la réhabilitation d’autres muscles semble nécessaire afin d’améliorer la marche, le programme a réhabilité efficacement les performances d'équilibreThe objective of this work was to improve the prevention of falls in seniors by (i) improving the detection of people at risk, (ii) providing new tools for assessing postural control and (iii) studying the effects of rehabilitation program by electrostimulation on the markers of the risk of falling. In order to meet these three objectives, three parts were developed:The aim of Part I was to provide tools for better detection of persons at risk of falls or fractures through the identification of factors responsible for a decline in postural control. We have been able to establish through three studies that (i) elderly patients who take five or more drugs per day are at higher risk of cognitive and mobility impairments, (ii) subjects who undergo fractures have a stabilization deficit after obstacle crossing and (iii) fractured fallers reduce their walking speed less during dual-task walking.In Part II we evaluated for the first time the braking of the center of mass, a parameter correlated with the quality of the postural control, with a kinematic analysis technique. It has been demonstrated that the technic usually used, the force-plate analysis, presents greater variability and leads to an underestimation of the braking index in comparison with this new method of analysis.In Part III we tested the effectiveness of a training program by electrostimulation of the ankle plantar and dorsiflexors on the parameters related to the fall or its severity. This training increased the strenght, and probably the contraction speed of the ankle muscles. Although the rehabilitation of other muscles seems necessary to improve gait,the training program has rehabilitated dynamic balance

Does neuromuscular electrical stimulation training of the lower limb have functional effects on the elderly?: A systematic review

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Igf-1 levels mediate the relationship between muscular aging and cognitive aging

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Blood biomarkers mediate the association between age and gait speed

International audienceIntroduction: Age-related gait speed declines are associated with an increased risk of falls and a loss of autonomy in older adults. Understanding the biological pathways and identifying the biomarkers associated with this decline could allow better and earlier detection of older adults at risk of mobility decline. The objective was to determine whether the age-related decline in gait speed was mediated by biomarkers from blood and urine samples known to be associated with metabolic and hormonal factors, inflammation and immune function, renal function, lipid profile, bone and collagen markers, vitamins, antioxidants, and stress. Methods: Parcipants (n=1030) from the Midlife in the United States (MIDUS) study, aged between 34 and 84 years (55% women), were included in the mediation analyses with Age as a predictor, the average time of two 50-foot-walk trials as an outcome, and 54 biomarkers as mediators. Results: Blood inflammation markers (IL6 and IL8) were the strongest mediators of age-related gait speed declines (22% and 15% of the total effect, respectively), followed by metabolic markers (blood hemoglobin, IGF-1, blood fasting glucose, corresponding to 10%; 7%, 4% of the total effect, respectively). Conclusion: Declines in gait speed may be caused by changes in blood biomarkers, particularly inflammation and metabolic markers, emphasizing their crucial role in understanding mobility decline. These findings could help early detection and intervention

Activité physique à domicile pour les seniors : revue de la question et proposition d’une pratique optimisée

International audiencePhysiological and functional alterations caused by aging can lead to a loss of autonomy for daily living activities. In order to prevent these deleterious effects, it is recommended to practice physical activity regularly. Because exercise is not always accessible to older adults, this review reports the state of the art in home-based training research. It appeared that without supervision, physical training effects are lower or even non-existent compared to traditional exercise. It is also associated with high drop-out rates Semi-supervised home-based training could lead to higher health benefits but these benefits remain lower than supervised exercises. Remote contribution by a professional through a videoconferencing system could be an interesting solution that would lower the price and allow better accessibility to exercise training in the aging population. In the second part of this article, we present an optimized solution answering the problems identified in this review. The implementation of this innovating system is promising because of the high adherence, compliance and a level of satisfaction of the participants.Les altérations physiologiques et fonctionnelles liées au vieillissement peuvent avoir un impact sur l’autonomie des personnes dans les activités de la vie quotidienne. Afin de prévenir et de limiter ces effets délétères, il est recommandé d’avoir une activité physique adaptée régulière. Cependant, l’accès à un entraînement efficace n’est pas toujours possible pour les seniors. Dans une première partie, nous examinons donc l’état des connaissances scientifiques sur les différentes modalités d’entraînement au domicile d’un public âgé. En l’absence de supervision, il apparaît que les bénéfices associés à la pratique sont moindres et que l’adhésion au programme est réduite. Dans le cadre d’entraînements à domicile semi-supervisés, il semble que les bénéfices sur la santé soient encore une fois faibles. Lors d’entraînements à domicile avec supervision à distance, l’adhésion et les effets sur la santé semblent cette fois plus importants. Ainsi, afin de répondre aux problématiques relevées par cette revue, dans la seconde partie de ce travail nous présentons un projet novateur d’accompagnement à distance par un professionnel au moyen d’un système de visioconférence collectif. La mise en place de ce projet est prometteuse puisque les résultats préliminaires montrent des taux d’adhésion, d’observance et un niveau de satisfaction très élevés

Circadian rhythm of postural control, sleepiness and verticality perception in older adults

International audienceAbstract Introduction with ageing, the risk of falling increases. It has been reported that fall frequency may depend on the time of the day, suggesting a possible circadian rhythm of postural control. The objective was to test whether postural control in older adults followed a circadian rhythm. Then, in order to examine the possible functions involved in circadian variations in balance performances, circadian rhythm of sleepiness and vertical perception were also tested. Methods eight participants (70.7 ± 4.7 years) were included. Baseline circadian rhythm profile was assessed through continuous core temperature measurement. Static and dynamic balance, subjective sleepiness and fatigue, and verticality perception were measured at 2:00, 6:00, 10:00, 14:00, 18:00 and 22:00, on separate weeks in a random order. Results temperature followed a circadian rhythm, with lowest temperature occurring at 03:50. Circadian rhythm was detected for the centre of pressure displacement length and velocity, in dynamic condition eyes closed, with lowest performances occurring at 18:33 and 16:59, respectively. Subjective sleepiness and fatigue also followed circadian rhythm with lowest sleepiness occurring at 15:46 and 15:50, for the Karolinska Sleeping Scale and the Visual Analogic Scale of fatigue, respectively. Finally, the vertical perception was not significantly following a circadian rhythm. Conclusion older adults present a circadian rhythm of balance, in particular in more challenging conditions, and the lowest performances occurred in the late afternoon These circadian rhythms could explain some of the falls happening at this time in community-dwelling older adults