The objective of this study was to investigate changes in physical activity (PA) between January (before the COVID-19 epidemic) and April (during the COVID-19 epidemic) 2020 in community-dwelling ...older adults in Japan.
Cross-sectional online survey.
From April 23 to 27, 2020, an online survey was completed by 1,600 community-dwelling older adults in Japan.
We assessed the frailty status using the Kihon checklist, and other demographics and asked questions regarding PA at two time points: January and April 2020. We defined the total PA time (minutes) per week based on activity frequency and time.
The study participants' mean age, proportion of women, and prevalence of frailty were 74.0±5.6 years, 50% (n=800), and 24.3% (n=388), respectively. We found a significant decrease in total PA time in April 2020 (median interquartile range (IQR), 180 0 to 420) when compared to January 2020 (median IQR, 245 90 to 480) (P<0.001). We also performed a subgroup analysis according to the frailty category; total PA time significantly decreased in April 2020 when compared to January 2020 for all frailty categories (P<0.001).
In conclusion, due to the COVID-19 epidemic, the total PA time in April 2020 significantly decreased compared to that in January 2020 in older adults. This finding may lead to a higher incidence of disability in the near future in older people.
Objectives
The objective of this study was to investigate changes in physical activity (PA) between January (before the COVID-19 epidemic) and April (during the COVID-19 epidemic) 2020 in ...community-dwelling older adults in Japan.
Design
Cross-sectional online survey.
Setting and Subjects
From April 23 to 27, 2020, an online survey was completed by 1,600 community-dwelling older adults in Japan.
Methods
We assessed the frailty status using the Kihon checklist, and other demographics and asked questions regarding PA at two time points: January and April 2020. We defined the total PA time (minutes) per week based on activity frequency and time.
Results
The study participants’ mean age, proportion of women, and prevalence of frailty were 74.0±5.6 years, 50% (n=800), and 24.3% (n=388), respectively. We found a significant decrease in total PA time in April 2020 (median interquartile range (IQR), 180 0 to 420) when compared to January 2020 (median IQR, 245 90 to 480) (P<0.001). We also performed a subgroup analysis according to the frailty category; total PA time significantly decreased in April 2020 when compared to January 2020 for all frailty categories (P<0.001).
Conclusion
In conclusion, due to the COVID-19 epidemic, the total PA time in April 2020 significantly decreased compared to that in January 2020 in older adults. This finding may lead to a higher incidence of disability in the near future in older people.
Objectives
The objective of this study was to investigate the influence of the COVID-19 pandemic on physical activity (PA) and the incidence of frailty among initially non-frail older adults in ...Japan.
Design
A follow-up online survey.
Setting and Subjects
Among the 1,600 baseline online survey participants, 388 adults were already frail, and 275 older adults did not respond to the follow-up survey. Thus, the final number of participants in this study was 937 (follow-up rate: 77.3%).
Methods
We assessed the total PA time at four time points according to the COVID-19 waves in Japan: January 2020 (before the pandemic), April 2020 (during the first wave), August 2020 (during the second wave), and January 2021 (during the third wave). We then investigated the incidence of frailty during a one-year follow-up period (during the pandemic).
Results
The total PA time during the first, second, and third waves of the pandemic decreased from the pre-pandemic PA time by 33.3%, 28.3%, and 40.0%, respectively. In particular, the total PA time of older adults who were living alone and socially inactive decreased significantly: 42.9% (first wave), 50.0% (second wave), and 61.9% (third wave) less than before the pandemic, respectively. Additionally, they were at a significantly higher risk of incident frailty than those who were not living alone and were socially active (adjusted odds ratio: 2.04 95% confidence interval: 1.01–4.10).
Conclusion
Our findings suggest that older adults who live alone and are socially inactive are more likely to experience incident frailty/disability due to decreased PA during the pandemic. Understanding this mechanism may be crucial for maintaining the health status of older adults.
Objectives
The aim of this study was to examine whether older users of information and communicative technology (ICT) participate in active behaviors, such as voluntary exercise, to maintain health, ...even under community containment to suppress the coronavirus disease 2019 (COVID-19) pandemic.
Design
Cross-sectional study.
Setting
Community setting.
Participants
Independent community-dwelling older residents aged ≥75 years.
Measurements
The municipality sent the Kihon Checklist (KCL) and Simplified Nutritional Appetite Questionnaire (SNAQ) with several questions on lifestyle and health conditions under social restriction.
Results
Among 3199 responders (72.1%), we analyzed the data of 2304 residents who provided complete answers to the KCL and SNAQ and on ICT use, voluntary exercise, polypharmacy, and families. The mean age was 79.7 years (51.3% male). The percentages of frailty assessed by the KCL, voluntary exercise, and low SNAQ scores (≤14) were 16.0%, 61.4%, and 43.8% in 808 ICT users and 30.3%, 47.2%, and 54.1% in 1496 ICT non-users, respectively (p<0.001). ICT use was significantly associated with voluntary exercise even during social restriction, independent of age, sex, polypharmacy, low SNAQ scores, and frailty status (odds ratio, 1.503; 95% confidential interval, 1.246–1.813).
Conclusion
Older ICT users are more active to maintain health even during social restriction, independent of frailty status.
Aim
Phase angle (PhA) can be determined through bioelectrical impedance analysis and is a unique variable for skeletal muscle. The objective of this study was to evaluate the relationship between PhA ...and muscle mass/quality in older adults. In addition, we attempted to determine the cutoff value of PhA for poor muscle function.
Methods
Community-dwelling Japanese older men (n=285, 81.1±7.1 years) and women (n=724, 80.4±6.8 years) participated in this study and were classified into four groups based on the Asian Working Group for Sarcopenia (normal, presarcopenia, dynapenia, and sarcopenia). We measured PhA using bioelectrical impedance analysis, muscle quantity and quality indicators using ultrasonography, muscle strength, and physical performance and compared them in four groups. We also tried to determine the cutoff value of PhA for poor muscle function.
Results
We found a significant difference in PhA among the four groups in men (P<0.05), and the dynapenia (3.61±0.75°) and sarcopenia groups (3.40±0.74°) showed significantly lower values than the normal group (4.50±0.86°) (P<0.05), but not the presarcopenia group (4.12±0.85°). In women, a significant difference was also observed among the four groups (P<0.05), and the dynapenia (3.41±0.65°) and sarcopenia groups (3.31±0.66°) showed significantly lower measures than the normal group (4.14±0.71°) (P<0.05), but not the presarcopenia group (4.07±0.51°). The receiver-operating characteristic curve analysis indicated the best cutoff value of PhA (men: 4.05°, women: 3.55°) to discriminate sarcopenia and dynapenia from normal and presarcopenia.
Conclusion
These findings suggest that PhA is a useful indicator for muscle function.
to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by ...the European Working Group on Sarcopenia in Older People (EWGSOP).
PubMed and Dialog databases were searched (January 2000-October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected.
prevalence of sarcopenia was, with regional and age-related variations, 1-29% in community-dwelling populations, 14-33% in long-term care populations and 10% in the only acute hospital-care population examined. Moderate quality evidence suggests that exercise interventions improve muscle strength and physical performance. The results of nutrition interventions are equivocal due to the low number of studies and heterogeneous study design. Essential amino acid (EAA) supplements, including ∼2.5 g of leucine, and β-hydroxy β-methylbutyric acid (HMB) supplements, show some effects in improving muscle mass and function parameters. Protein supplements have not shown consistent benefits on muscle mass and function.
prevalence of sarcopenia is substantial in most geriatric settings. Well-designed, standardised studies evaluating exercise or nutrition interventions are needed before treatment guidelines can be developed. Physicians should screen for sarcopenia in both community and geriatric settings, with diagnosis based on muscle mass and function. Supervised resistance exercise is recommended for individuals with sarcopenia. EAA (with leucine) and HMB may improve muscle outcomes.
Objectives
The present study examined whether the combination of self-reported mobility decline (SR-MD) and cognitive decline (SR-CD) was associated with mortality and new long-term care insurance ...(LTCI) service certifications based on sex and age.
Design
A prospective cohort study.
Setting and Participants
We analyzed cohort data from a sample of older adult residents in Kami Town, Japan. The response rate was 94.3%, and we followed 5,094 older adults for 3 years. Full analyses were conducted on 5,076 participants.
Measures
A total of four groups were determined through self-reported responses on the Kihon Checklist for SR-MD (a score of 3 or more on 5 items) and SR-CD (a score of 1 or more on 3 items): non-SR-cognitive frailty, non-SR-MD & SR-CD, SR-MD & non-SR-CD, and SR-cognitive frailty.
Results
Main outcomes included mortality (n = 262) or new certifications for LTCI services (n = 708) during the 3-year period. Excluding overlapping, this included 845 older adults (16.6%). Among men, prevalence of non-SR-cognitive frailty, non-SR-MD & SR-CD, SR-MD & non-SR-CD, and SR-cognitive frailty (SR-MD & SR-CD) was 48.2%, 26.4%, 11.5%, and 13.8%, respectively. Respective rates for women were 45.7%, 15.5%, 23.1%, and 15.7%. Multivariate analyses revealed that for men, SR-MD & non-SR-CD significantly affected adverse health outcomes, leading to earlier negative outcomes relative to the non-SR-MD & SR-CD group. For women, non-SR-MD & SR-CD and SR-MD & non-SR-CD had similar slopes.
Conclusions
The impact of SR-MD or SR-CD on adverse health outcomes differed as a function of age and sex. Thus, we need to consider preventive approaches according to these specific target group features.
We investigated whether the association between sarcopenia and fall risk (FR) differs according to the muscle mass adjustment method in 357 outpatients who were not disabled in the activities of ...daily living or indicated for orthopedic surgery. Sarcopenia was diagnosed by the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, using adjusting methods of muscle mass by height squared (ht
2
), body mass index (BMI), or any of these (i.e., ht
2
-adjusted Sarc”, “BMI-adjusted Sarc”, or “ht
2
and/or BMI-adjusted Sarc, respectively). FR was defined by FR index ≥10. There were 111, 105, and 157 participants with ht
2
-adjusted, BMI-adjusted, and ht
2
and/or BMI-adjusted Sarc, respectively. After multivariable adjustment, ht
2
and/or BMI-adjusted Sarc was the most closely associated with FR odds ratio and 95% confidence interval: 2.94, 1.75–4.93. Our data suggest that the sarcopenia definition using low ASM/ht
2
and/or ASM/BMI muscle mass might better predict adverse outcomes in older patients.
The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by ...patterns of living - experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e., a sedentary lifestyle). Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiorespiratory fitness, resulting in an impaired capacity to perform daily activities and maintain independent functioning. However, in the presence of adequate exercise/PA these changes in muscular and aerobic capacity with age are substantially attenuated. Additionally, both structured exercise and overall PA play important roles as preventive strategies for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits. Notably, exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, PA level, energy) and cognition, thus optimising functional capacity during ageing. In these pathological conditions exercise is used as a therapeutic agent and follows the precepts of identifying the cause of a disease and then using an agent in an evidence-based dose to eliminate or moderate the disease. Prescription of PA/structured exercise should therefore be based on the intended outcome (e.g., primary prevention, improvement in fitness or functional status or disease treatment), and individualised, adjusted and controlled like any other medical treatment. In addition, in line with other therapeutic agents, exercise shows a dose-response effect and can be individualised using different modalities, volumes and/or intensities as appropriate to the health state or medical condition. Importantly, exercise therapy is often directed at several physiological systems simultaneously, rather than targeted to a single outcome as is generally the case with pharmacological approaches to disease management. There are diseases for which exercise is an alternative to pharmacological treatment (such as depression), thus contributing to the goal of deprescribing of potentially inappropriate medications (PIMS). There are other conditions where no effective drug therapy is currently available (such as sarcopenia or dementia), where it may serve a primary role in prevention and treatment. Therefore, this consensus statement provides an evidence-based rationale for using exercise and PA for health promotion and disease prevention and treatment in older adults. Exercise prescription is discussed in terms of the specific modalities and doses that have been studied in randomised controlled trials for their effectiveness in attenuating physiological changes of ageing, disease prevention, and/or improvement of older adults with chronic disease and disability. Recommendations are proposed to bridge gaps in the current literature and to optimise the use of exercise/PA both as a preventative medicine and as a therapeutic agent.
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