Heterogeneity of Frailty Trajectories and Associated Factors in the Lothian Birth Cohort 1936

INTRODUCTION: Recent research suggests that the experience of frailty progression may be heterogeneous, with latent subpopulations of older adults following distinct trajectories of frailty. We aimed to investigate this notion and determine whether certain factors are associated with the membership of these subpopulations. METHODS: Data from 5 data waves collected over 12 years in participants of the Lothian Birth Cohort 1936, aged 70 at baseline, were used to derive the frailty index (FI) (NW1 = 1,091, NW5 = 431). These were used in latent class mixed modelling to estimate subpopulations of frailty trajectories. RESULTS: A quadratic latent class mixed model found 3 distinct groupings, which followed a low (61%, n = 632), medium (36%, n = 368), or high (3%, n = 28) FI trajectory. Each grouping had different intercepts and slopes, with the high grouping following the steepest trajectory indicating a rapid increase in frailty. Findings showed that in general, those in the low grouping were younger, had higher education, higher age 11 cognitive ability, and were from a higher social class than those in the medium and high groupings. DISCUSSION/CONCLUSION: Our findings demonstrate heterogeneity in frailty trajectories over 12 years in individuals aged 70 years at baseline. Membership of higher frailty trajectory groupings was associated with lower social class, less education, and lower childhood cognitive ability, indicating the potential for future interventions to target individuals who are at the greatest risk of belonging to the high frailty trajectory. Future research is required to continue this line of inquiry by exploring other risk and protective factors, and importantly, to assess whether it is possible to realign an individual's membership to a less detrimental grouping of frailty trajectory

Identification of loci involved in childhood visual acuity and associations with cognitive skills and educational attainment

Funding: The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. JS is funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation, 418445085) and supported by the Wellcome Trust [Institutional Strategic Support fund, Grant number 204821/Z/16/Z]. SP is funded by the Royal Society (UF150663). Support to the genetic analysis was provided by the St Andrews Bioinformatics Unit funded by the Wellcome Trust [grant 105621/Z/14/Z].Visual acuity significantly contributes to quality of life. Deficits in childhood are associated with reading difficulties, which can have detrimental effects on education outcomes. In adults, it has been observed that vision defects such as myopia are associated with higher educational attainment (EA). Understanding genetic factors contributing to visual acuity could help to dissect its links with cognitive skills, neurodevelopmental conditions, and education. We examined associations between distance visual acuity, cognitive measures including school grades, and neurodevelopmental conditions in a longitudinal cohort of British children (ALSPAC, n = 6807, M age = 11.8). We performed a genome-wide association study (GWAS, n = 5571) on visual acuity and tested for genetic associations with relevant phenotypes using polygenic scores (PGS) and genetic correlation analyses. Visual acuity was associated with better cognitive performance and school grades, and reduced in individuals with reading difficulties compared to controls. GWAS revealed genetic associations at the NPLOC4 locus and highlighted other genes involved in sensory function. In line with positive genetic correlations between visual acuity and cognitive measures, EA PGS were positively associated with visual acuity, while there was a less robust negative association with myopia PGS. In conclusion, increased visual acuity is associated with a range of positive outcomes, including better school grades. Our results suggest an association between a higher EA PGS and slightly increased visual acuity in childhood. This could indicate gene-environment correlation, in which environmental exposures linked to higher EA might have detrimental effects on vision offsetting the initial positive effect.Publisher PDFPeer reviewe

Pliometria Aplicada à Reabilitação de Atletas

A pliometria é uma técnica conhecida para aumentar a potência muscular e melhorar o rendimento atlético, porém, só recentemente, sua importância na prevenção e na reabilitação de lesões está sendo discutida. Os exercícios pliométricos são definidos como aqueles que ativam o ciclo excêntricoconcêntrico do músculo esquelético, provocando sua potenciação mecânica, elástica e reflexa. Esse ciclo refere-se às atividades concêntricas precedidas por uma ação excêntrica, cujo propósito é aumentar a força explosiva do músculo pelo armazenamento de energia elástica na fase de pré-alongamento e sua reutilização durante a contração concêntrica, além da ativação do reflexo miotático. O objetivo deste trabalho de revisão bibliográfica é descrever as bases mecânicas, elásticas e neurofisiológicas da pliometria, assim como, a sua importância na reabilitação de atletas, haja vista que eles precisam retornar de forma precoce e segura ao esporte competitivo. Para isso, foram utilizados livros e artigos científicos nacionais e internacionais. Pôde-se observar, que esses exercícios são usados na fase final da reabilitação de vários tipos de lesões musculoesqueléticas, tanto dos membros inferiores, quanto dos superiores e também na prevenção de alguns tipos de lesões, pois, acredita-se que eles são capazes de desenvolver força explosiva, aumentar a resposta muscular e melhorar a coordenação neuromuscular. Conclui-se, que é fundamental para o fisioterapeuta do esporte conhecer o conceito e a aplicação clínica da pliometria na prevenção e no tratamento das lesões esportivas para poder elaborar um programa de tratamento seguro e eficiente