Summary
This 3-year longitudinal study among older adults showed that declining muscle mass, strength, power, and physical performance are independent contributing factors to increased fear of ...falling, while declines of muscle mass and physical performance contribute to deterioration of quality of life. Our findings reinforce the importance of preserving muscle health with advancing age.
Introduction
The age-associated loss of skeletal muscle quantity and function are critical determinants of independent physical functioning in later life. Longitudinal studies investigating how decrements in muscle components of sarcopenia impact fear of falling (FoF) and quality of life (QoL) in older adults are lacking.
Methods
Twenty-six healthy older subjects (age, 74.1 ± 3.7; Short Physical Performance Battery (SPPB) score ≥10) and 22 mobility-limited older subjects (age, 77.2 ± 4.4; SPPB score ≤9) underwent evaluations of lower extremity muscle size and composition by computed tomography, strength and power, and physical performance at baseline and after 3-year follow-up. The Falls Efficacy Scale (FES) and Short Form-36 questionnaire (SF-36) were also administered at both timepoints to assess FoF and QoL, respectively.
Results
At 3-year follow-up, muscle cross-sectional area (CSA) (
p
< 0.013) and power decreased (
p
< 0.001), while intermuscular fat infiltration increased (
p
< 0.001). These decrements were accompanied with a longer time to complete 400 m by 22 ± 46 s (
p
< 0.002). Using linear mixed-effects regression models, declines of muscle CSA, strength and power, and SPPB score were associated with increased FES score (
p
< 0.05 for each model). Reduced physical component summary score of SF-36 over follow-up was independently associated with decreased SPPB score (
p
< 0.020), muscle CSA (
p
< 0.046), and increased 400 m walk time (
p
< 0.003).
Conclusions
In older adults with and without mobility limitations, declining muscle mass, strength, power, and physical performance contribute independently to increase FoF, while declines of muscle mass and physical performance contribute to deterioration of QoL. These findings provide further rationale for developing interventions to improve aging muscle health.
Many inverse and parameter estimation problems can be written as PDE-constrained optimization problems. The goal is to infer the parameters, typically coefficients of the PDE, from partial ...measurements of the solutions of the PDE for several right-hand sides. Such PDE-constrained problems can be solved by finding a stationary point of the Lagrangian, which entails simultaneously updating the parameters and the (adjoint) state variables. For large-scale problems, such an all-at-once approach is not feasible as it requires storing all the state variables. In this case one usually resorts to a reduced approach where the constraints are explicitly eliminated (at each iteration) by solving the PDEs. These two approaches, and variations thereof, are the main workhorses for solving PDE-constrained optimization problems arising from inverse problems. In this paper, we present an alternative method that aims to combine the advantages of both approaches. Our method is based on a quadratic penalty formulation of the constrained optimization problem. By eliminating the state variable, we develop an efficient algorithm that has roughly the same computational complexity as the conventional reduced approach while exploiting a larger search space. Numerical results show that this method indeed reduces some of the nonlinearity of the problem and is less sensitive to the initial iterate.
Orofacial functions are frequently affected by stroke, but little is known on the nature and extent of the impairment of mastication, which is investigated in this observational study. Thirty-one ...stroke patients, aged 69.0 ± 12.7 yrs, presenting with a hemi-syndrome with facial palsy, were recruited. Chewing efficiency, maximum bite and restraining lip forces were tested. Stroke severity (National Institutes of Health Stroke Scale) and dental state were recorded. The control group was similar in age, gender, and dental state (n = 24). The chewing efficiency was significantly lower in the stroke group (p ≤ 0.0001) and was related to both the dental state and the lip forces measured with small and medium-sized labial plates. The maximum bite force proved to be not significantly different between sides or groups (n.s.), whereas lip force was significantly lower in the stroke group (p ≤ 0.05). Chewing efficiency is severely affected by stroke; thus, rehabilitation protocols should aim to restore the strength and co-ordination of the orofacial muscles.
BACKGROUND: The interpretation of the increase in stride-to-stride variability of stride time (STV) regarding the evolution of cognitive deficits across the dementia spectrum is matter of debate. ...OBJECTIVE: The aim of this study was to compare STV at usual and fast-pace walking speeds of MCI patients with that of cognitively healthy individuals (CHI) and Alzheimer’s disease (AD) patients with mild dementia, while considering the effects of potential confounders. METHODS: STV while walking at usual and fast-pace walking speeds was recorded with the GAITRite® system from 116 older adults (mean age 75.6±6.5 years; 55.2% female) divided into 3 groups according to their cognitive status (44 CHI, 39 MCI patients and 33 AD patients with mild dementia). RESULTS: The full adjusted multiple linear regression models showed that high STV was associated with slow gait speed at usual-pace walking speed (P=0.002) and with the MCI status at fast-pace walking speed (P=0.015). CONCLUSIONS: High STV at fast-pace walking speed was a specific gait disturbance of MCI patients in the sample of studied participants, and thus could be used in the future as a specific biomarker of MCI patients.
The association between low serum 25-hydroxyvitamin D 25(OH)D concentration and cognitive decline has been investigated by only a few studies, with mixed results. The objective of this ...cross-sectional population-based study was to examine the association between serum 25(OH)D deficiency and cognitive impairment while taking confounders into account.
The subjects, 752 women aged > or =75 years from the Epidémiologie de l'Ostéoporose (EPIDOS) cohort, were divided into 2 groups according to serum 25(OH)D concentrations (either deficient, <10 ng/mL, or nondeficient, > or =10 ng/mL). Cognitive impairment was defined as a Pfeiffer Short Portable Mental State Questionnaire (SPMSQ) score <8. Age, body mass index, number of chronic diseases, hypertension, depression, use of psychoactive drugs, education level, regular physical activity, and serum intact parathyroid hormone and calcium were used as potential confounders.
Compared with women with serum 25(OH)D concentrations > or =10 ng/mL (n = 623), the women with 25(OH)D deficiency (n = 129) had a lower mean SPMSQ score (p < 0.001) and more often had an SPMSQ score <8 (p = 0.006). There was no significant linear association between serum 25(OH)D concentration and SPMSQ score (beta = -0.003, 95% confidence interval -0.012 to 0.006, p = 0.512). However, serum 25(OH)D deficiency was associated with cognitive impairment (crude odds ratio OR = 2.08 with p = 0.007; adjusted OR = 1.99 with p = 0.017 for full model; and adjusted OR = 2.03 with p = 0.012 for stepwise backward model).
25-Hydroxyvitamin D deficiency was associated with cognitive impairment in this cohort of community-dwelling older women.
Purpose
Investigation of self-reported of low back pain (LBP) over the last month and associated health-related quality of life (HRQoL) in a sample of a community-dwelling population aged ≥65.
...Methods
Cross-sectional study including older adults selected randomly from population records. Data were collected within a sample stratified by age and sex. Physical and psychological healths were investigated using a standardized definition of LBP and the EuroQoL-5D for HRQoL. Analyses were first conducted on the entire sample (
N
= 3042) and subsequently considering the subsample who reported LBP and a paired sample drawn from the pool of LBP-free respondents.
Results
889 (29 %) respondents reported LBP within the past month, present ‘most days’ or ‘every day’ in 52 % and limiting activities in the same proportion. Average pain score was 4.6 (SD 2.2; 0–10 scale). Age was associated with pain frequency and duration, with younger groups more often reporting pain ‘some days’ and ‘dating back <3 months’. Results of regression analyses showed that individuals suffering from LBP had significantly more problems than LBP non-sufferers on all EQ-5D subscales, except self-care: pain/discomfort (OR 5.33; 95 % CI 4.19–6.79), mobility (OR 2.66; 95 % CI 2.04–3.46), usual activities (OR 1.92; 95 % CI 1.42–2.60), anxiety/depression (OR 1.59; 95 % CI 1.23–2.04) and self-care (OR 1.29; 95 % CI 0.84–1.98).
Conclusion
LBP appears to be a more permanent condition in the older groups. LBP may be a part of the definition of a subgroup of elderly at risk of becoming frail in relation with higher levels of functional limitations, psychological difficulties and social restrictions, hence globally impaired HRQoL.
Serum vitamin D concentrations are associated with global cognitive function among older adults. The benefits of vitamin D intake to treat or prevent cognitive impairment remain unknown. The ...objective of this cross-sectional study was to determine whether weekly dietary intake of vitamin D could be associated with global cognitive performance among older adults.
A total of 5,596 community-dwelling women (mean age 80.5 ± 0.1 years) free of vitamin D drug supplements from the Epidémiologie de l'Ostéoporose (EPIDOS) study were divided into 2 groups according to baseline weekly vitamin D dietary intake (either inadequate <35 μg/wk or recommended ≥35μg/wk). Weekly vitamin D dietary intakes were estimated from a self-administered food frequency questionnaire. Cognitive impairment was defined as a Pfeiffer Short Portable Mental State Questionnaire (SPMSQ) score <8. Age, body mass index, sun exposure at midday, season, disability, number of chronic diseases, hypertension, depression, use of psychoactive drugs, and education level were considered as potential confounders.
Compared to women with recommended weekly vitamin D dietary intakes (n = 4,802; mean age 80.4 ± 3.8 years), women with inadequate intakes (n = 794; mean age 81.0 ± 3.8 years) had a lower mean SPMSQ score (p < 0.001) and more often had an SPMSQ score <8 (p = 0.002). We found an association between weekly vitamin D dietary intake and SPMSQ score (β = 0.002, p < 0.001). Inadequate weekly vitamin D dietary intakes were also associated with cognitive impairment (unadjusted odds ratio = 1.42 with p = 0.002; full adjusted odds ratio = 1.30 with p = 0.024).
Weekly dietary intake of vitamin D was associated with cognitive performance in older women.
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