Employment status and insulin resistance in the elderly population

“Mood, lifestyle and cardiovascular risk factors among older caregivers of patients with Alzheimer’s disease dementia: a case–control study”: a letter in response

Retraction Note to: Effect of whole-body vibration exercise on lumbar bone mineral density, bone turnover, and chronic back pain in post-menopausal osteoporotic women treated with alendronate The Editor-in-Chief has retracted this article [1] because an investigation by Keio University has concluded that there are inaccuracies in the data reported.

A simple method to categorize gait speed of older persons based on visual inspection of stepping Abstract The aim of this study was to develop a simple visualized approach to classify persons into meaningful gait speed categories. Footprints of 310 instrumented gait analyses of 190 geriatric persons (mean age 79.1 years, 74 women) were used in a retrospective analysis to classify persons´ footprints into a left/right step overlapping, an intermediate or a long stepping pattern. The association between gait speed and step length was r = 0.91. More than 75% of the measurements classified as overlapping stepping pattern had a gait speed of below 0.5 m/s. All participants of the long stepping pattern group had a gait speed of faster than 1 m/s. The positive predictive values for classifying gait speed correctly were 71–100%. The proposed screening tool can be used in outpatient settings or home visits and is likely to be applicable if instrumented gait speed assessment is not available.

Comparing absolute handgrip strength and handgrip strength normalized to body weight in aging adults

Does the identification of seniors at risk (ISAR) score effectively select geriatric patients on emergency admission? Abstract The number of older patients admitted to emergency departments (ED) increases continuously. The Identification of Seniors at Risk (ISAR) score is currently recommended to screen patients in German ED, but its appropriateness is being criticized. ISAR scores and clinical characteristics from 98 emergency admissions (EA), 80 from acute geriatrics (AG) and 89 from a geriatric rehabilitation (GR) unit were compared retrospectively. No significant differences were found between groups, being the ISAR score positive in 87.7% of EA, 94.9% of AG and 94.4% of GR cases. None of positively identified geriatric patients in the EA was transferred to the geriatric ward of competence. EA patients showed significantly higher number of functional impairments (p = 0.001) and higher BI score (p < 0.0001) compared to AG and GR groups. A higher ISAR score threshold and additional functional information might be needed to better select patients in need of prompt treatment by a geriatric team.

The effects of same-session combined exercise training on cardiorespiratory and functional fitness in older adults: a systematic review and meta-analysis Abstract Endurance and strength training are effective strategies for counteracting age-associated reductions in physical performance in older adults, with a combination of both exercise modes recommended to maximise potential fitness benefits. This meta-analysis sought to quantify the effects of same-session combined endurance and strength training on fitness in adults aged over 50 years. Five electronic databases were searched with studies required to include one of the following outcome measures: VO2peak, 6-min walk test (6MWT), 8-ft timed up-and-go (TUG), and 30-s chair stand. Separate random-effects meta-analyses compared combined training with (1) no-exercise control, (2) endurance training, and (3) strength training with probabilistic magnitude-based inferences subsequently applied. Twenty-seven studies involving 1346 subjects with a mean age of 68.8 years (range 54–85 years) were included in the analysis. The meta-analysed effect on VO2peak was a moderately beneficial effect for the combined training compared to no-exercise controls (3.6 mL kg−1 min−1; ± 95% confidence limits 0.8 mL kg−1 min−1) with additional increases for studies with greater proportions of female participants and shorter training interventions. Combined training also had small-to-moderately beneficial effects on VO2peak when compared to endurance training (0.8 mL kg−1 min−1; ± 1.0 mL kg−1 min−1), 30-s chair stand when compared with strength training (1.1 repetitions; ± 0.5 repetitions) and on TUG (0.8 s; ± 0.7 s), 30-s chair stand (2.8 repetitions; ± 1.7 repetitions), and 6MWT (31.5 m; ± 22.4 m) when compared to no-exercise controls. All other comparisons were unclear. Same-session combined training can induce clinically relevant fitness improvements in older adults.

Individual healthy aging indices, measurements and scores Abstract The positive gerontological approach to aging has resulted in successive terminologies to describe the process of aging, including successful aging, active aging, healthy aging, or healthy and active aging, amongst others. Each definition proposed by geriatricians, psychologists, sociologists or public health specialists has been based on specific aspects of aging that are most important to the authors’ discipline, explaining the current difficulty in determining which is the best set of criteria to determine “good aging”. Two successive analyses of the measurements used in longitudinal studies from 1989 to 2018 testify to this heterogeneity in the types of questions proposed to evaluate the quality of the individual aging process. To confront this complexity, new and integrated indices have successively been proposed to quantify and qualify the survival period of aging individuals. The present paper aims to describe and compare the value of the “healthy aging index”, the “modified healthy aging index”, the “healthy aging score” and the “selfie aging test”. Attempts to date to identify the best individual measurement of “aging well” have been interesting, and certainly show promise, but their limitations to specific populations call for more concerted effort from the scientific community to obtain worldwide validation. Another option would be to identify the best self-assessment questionnaire and include it in a mobile device, enabling longer term personal follow-up of aging functions. There is a clear lack of data of this type at present, and an urgent need to obtain such information, to enable early and targeted interventions.

The effect of ageing on shear wave elastography muscle stiffness in adults Abstract Background Skeletal muscle undergoes structural changes with ageing which may alter its biomechanical properties. Shear wave elastography (SWE) may detect these changes by measuring muscle stiffness. Aims To investigate muscle stiffness in healthy young, middle-aged and elderly cohorts using SWE and correlate it with muscle strength and mass. Methods Shear wave velocity (SWV) was measured in the quadriceps, hamstrings and biceps brachii of 26 young (range 20–35 years), 21 middle-aged (40–55) and 30 elderly (77–94) volunteers. The participants performed several muscle tests to evaluate their strength. The One-way ANOVA was used to test the muscle stiffness differences between the groups and the Pearson’s correlation coefficient to evaluate the relationship between SWV and muscle strength. Results The overall resting muscle SWV gradually decreased with age but was only significantly reduced in the elderly group (p < 0.001); with the exception of the vastus lateralis SWV where a significant difference was noted (p < 0.05) between young (1.77 m/s), middle-aged (1.64 m/s) and elderly (1.48 m/s). The elderly group had on average 16.5% lower muscle stiffness compared to the young. SWV significantly correlated with muscle mass (r = 0.316), walking time (r = − 0.560), number of chair stands (r = 0.522), handgrip strength (r = 0.436) and isokinetic knee strength (r = 0.640). Sex and BMI did not explain any significant variation in SWV. Conclusions Ageing was associated with a decline in skeletal muscle stiffness which positively correlates with muscle weakness. Further research is needed to evaluate the promising role of SWE as a biomarker for sarcopenia assessment and potential falls risk prediction in elderly individuals.

Consistency and test–retest reliability of stepping tests designed to measure self-perceived and actual physical stepping ability in older adults Abstract Background Older adults with an incorrect perception of their physical abilities may fall more often, suggesting a need for tests to quantify self-perceived and actual abilities. Aims To determine between-test consistency and test–retest reliability of three tests that measure self-perceived and actual stepping ability in older adults. Methods Older adults performed three stepping tests, covering high (bar test) and far steps (river and step tests). We studied between-test consistency in the perceived ability and actual ability of 269 participants at each task and in the difference between these two (degree of misjudgment). We also studied test–retest reliability in 21 participants. Results Perceived ability showed moderate consistency (r = 0.46–0.55, p < 0.001) and moderate-to-strong reliability [ICC(2,1) = 0.42–0.63, p < 0.03] for all tests. Actual ability showed strong consistency (r = 0.77, p < 0.001) and strong-to-excellent reliability [ICC(2,1) = 0.68–0.93, p < 0.001]. Degree of misjudgment was weakly consistent between two stepping far tests (r = 0.32, p < 0.001), but not consistent between stepping far and high tests (r = 0.05 and 0.06, p > 0.3). Test–retest reliability of the degree of misjudgment was poor-to-moderate [ICC(2,1) = 0.38 and 0.50, p < 0.05 on the two stepping far tests and ICC(2,1) = − 0.08, p = 0.63 on the stepping high test]. Conclusions Actual and perceived ability can be consistently and reliably measured across tests, whereas the degree of misjudgment is less reliable and consistent within individuals.