Effects of a Rehabilitation Program on Perceived Environmental Barriers in Older Patients Recovering from Hip Fracture: A Randomized Controlled Trial
Objectives. To study effects of a one-year multicomponent intervention on perceived environmental barriers in hip fracture patients.Design. Randomized controlled trial of a 12-month home-based rehabilitation aiming to improve mobility and function (ISRCTN53680197); secondary analyses.Subjects. Community-dwelling hip fracture patients on average 70 days after trauma (n=81).Methods. Assessments at baseline, 3, 6, and 12 months later included perceived entrance-related barriers (e.g., indoor/outdoor stairs, lighting, floor surfaces, and storage for mobility devices) and perceived barriers in the outdoor environment (poor street condition, hilly terrain, long-distances, and lack of resting plac…
Long-term leisure time physical activity and properties of bone: A twin study
Effects of physical activity on bone properties, when controlled for genetic effects, are not fully understood. We aimed to study the association between long-term leisure time physical activity (LTPA) and bone properties using twin pairs known to be discordant for leisure time physical activity for at least 30 yr. Volumetric BMD and geometric properties were measured at the tibia shaft and distal end using pQCT in 16 middle-aged (50-74 yr) same-sex twin pairs (seven monozygotic [MZ] and nine dizygotic [DZ] pairs) selected from a population-based cohort. Paired differences between active and inactive co-twins were studied. Active members of MZ twin pairs had larger cortical bone cross-secti…
The role of physical activity in the link between menopausal status and mental well-being
OBJECTIVE To examine the relationship between menopausal status and mental well-being, and whether this relationship varies as a function of physical activity (PA). METHODS Based on a hormonal analysis and bleeding diary, women aged 47 to 55 were categorized as pre (n = 304), early peri (n = 198), late peri (n = 209), or postmenopausal (n = 387). Mental well-being was assessed using the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the Satisfaction with Life Scale. PA was self-reported and categorized as low, medium, and high. Associations between variables were analyzed using multivariate linear regression adjuste…
Genetic and Environmental Effects on Telomere Length and Lung Function: A Twin Study.
Background The purpose of the study was to estimate the heritability of leukocyte telomere length (LTL) and lung function and to examine whether LTL and lung function share genetic or environmental effects in common. Methods 386 monozygotic and dizygotic Finnish twin sisters (age 68.4±3.4 years) were included. Relative LTL was determined from peripheral blood DNA by qPCR. Lung function measures of FEV1, FVC, FEV1/FVC, and PEF were derived from spirometry. Genetic modeling was performed with MPlus statistical software. Results Univariate analysis revealed that in LTL, 62% (95% confidence interval 50-72) of the variance was explained by additive genetic and 38% (28-50) by unique environmental…
Physical activity after a hip fracture : effect of a multicomponent home-based rehabilitation program - a secondary analysis of a randomized controlled trial
Objectives To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture. Design Secondary analysis of a randomized, controlled, parallel-group trial. Setting Home-based rehabilitation; measurements in university laboratory. Participants Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital. Intervention A yearlong intervention included evaluation and …
Estrogen Regulates the Satellite Cell Compartment in Females
SUMMARY Skeletal muscle mass, strength, and regenerative capacity decline with age, with many measures showing a greater deterioration in females around the time estrogen levels decrease at menopause. Here, we show that estrogen deficiency severely compromises the maintenance of muscle stem cells (i.e., satellite cells) as well as impairs self-renewal and differentiation into muscle fibers. Mechanistically, by hormone replacement, use of a selective estrogen-receptor modulator (bazedoxifene), and conditional estrogen receptor knockout, we implicate 17β-estradiol and satellite cell expression of estrogen receptor α and show that estrogen signaling through this receptor is necessary to preven…
Individual and environmental factors underlying life space of older people – study protocol and design of a cohort study on life-space mobility in old age (LISPE)
Abstract Background A crucial issue for the sustainability of societies is how to maintain health and functioning in older people. With increasing age, losses in vision, hearing, balance, mobility and cognitive capacity render older people particularly exposed to environmental barriers. A central building block of human functioning is walking. Walking difficulties may start to develop in midlife and become increasingly prevalent with age. Life-space mobility reflects actual mobility performance by taking into account the balance between older adults internal physiologic capacity and the external challenges they encounter in daily life. The aim of the Life-Space Mobility in Old Age (LISPE) p…
Hormone replacement therapy enhances IGF-1 signaling in skeletal muscle by diminishing miR-182 and miR-223 expressions : a study on postmenopausal monozygotic twin pairs
MiRNAs are fine-tuning modifiers of skeletal muscle regulation, but knowledge of their hormonal control is lacking. We used a co-twin case-control study design, that is, monozygotic postmenopausal twin pairs discordant for estrogen-based hormone replacement therapy (HRT) to explore estrogen-dependent skeletal muscle regulation via miRNAs. MiRNA profiles were determined from vastus lateralis muscle of nine healthy 54-62-years-old monozygotic female twin pairs discordant for HRT (median 7 years). MCF-7 cells, human myoblast cultures and mouse muscle experiments were used to confirm estrogen's causal role on the expression of specific miRNAs, their target mRNAs and proteins and finally the act…
Effects of a 12‐month home‐based exercise program on functioning after hip fracture – Secondary analyses of an RCT
Background Long-term functional limitations are common after hip fractures. Exercise may alleviate these negative consequences but there is no consensus on an optimal training program. The objective was to study the effects of a 12-month home-based supervised, progressive exercise program on functioning, physical performance, and physical activity. Methods Secondary analysis of a randomized controlled trial targeting patients with surgical repair of a hip fracture, aged >= 60 years, Mini-Mental State Examination (MMSE) score of >= 12. The participants were randomized into Exercise (n = 61) or Usual care (n = 60). Assessments at baseline, 3, 6, and 12 months included Lawton's Instrumental Ac…
Muscle strength in male athletes aged 70-81 years and a population sample.
Muscle strength characteristics of different muscle groups were studied in active male strength-trained (ST, n = 14), speed-trained (SP, n = 16), and endurance-trained (EN, n = 67) athletes aged between 70 and 81 years. A population sample of similar age (n = 42) served as a control group. The isometric forces for hand grip, arm flexion, knee extension, trunk extension, and trunk flexion were higher for the athletes than the controls and higher for the ST than EN group. The SP athletes showed higher values in knee extension and trunk flexion than the EN group. When the isometric muscle forces were related to lean body mass, significant differences still existed between the athletes and cont…
Physical Activity After a Hip Fracture: Effect of a Multicomponent Home-Based Rehabilitation Program—A Secondary Analysis of a Randomized Controlled Trial
Objectives To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture. Design Secondary analysis of a randomized, controlled, parallel-group trial. Setting Home-based rehabilitation; measurements in university laboratory. Participants Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital. Intervention A yearlong intervention included evaluation and …
Knee extension strength and walking speed in relation to quadriceps muscle composition and training in elderly women.
Summary. Knee extension strength, walking speed, quadriceps muscle mass and composition of the muscle compartment were studied in 66 to 85-year-old female athletes and controls. Maximal voluntary knee extension force, force/body mass, extension torque, torque/body mass and walking speed were higher for the athletes than the controls. A muscle index indicating intramuscular fat and connective tissue measured using ultrasonography was lower for the athletes than the controls. There were no differences between the study groups in knee extension force related either to cross-sectional area (CSA) or lean tissue area (CSAL) of the quadriceps. Within the subgroups, there was no significant correla…
Muscle cross-sectional area and structural bone strength share genetic and environmental effects in older women
The purpose of this study was to estimate to what extent muscle cross-sectional area of the lower leg (mCSA) and tibial structural strength are influenced by common and trait-specific genetic and environmental factors. pQCT scans were obtained from both members of 102 monozygotic (MZ) and 113 dizygotic (DZ) 63- to 76-yr-old female twin pairs to estimate the mCSA of the lower leg, structural bending strength of the tibial shaft (BSIbend), and compressive strength of the distal tibia (BSIcomp). Quantitative genetic models were used to decompose the phenotypic variances into common and trait-specific additive genetic (A), shared environmental (C), and individual environmental (E) effects. The …
Effects of strength and endurance training on thigh and leg muscle mass and composition in elderly women
The effects of 18 wk of intensive strength and endurance training on knee extensor, knee flexor, and lower leg muscle mass and composition were studied in 76- to 78-yr-old women. Muscle cross-sectional area (CSA), lean tissue CSA, and relative proportion of fat were determined using computed tomography. The strength-trained women increased their total muscle lean tissue CSA of the thigh (1.5%; P = 0.035), quadriceps CSA (4.5%; P = 0.021), quadriceps lean tissue CSA (5.8%, P = 0.009), and mean Hounsfield unit of the lower leg muscles (11.2%; P = 0.035) compared with the changes that occurred in the control group during the experiment. The change in quadriceps lean tissue CSA because of the …
Handgrip Strength Cannot Be Assumed a Proxy for Overall Muscle Strength
OBJECTIVES: Dynapenia, low muscle strength, is predictive for negative health outcomes and is usually expressed as handgrip strength (HGS). Whether HGS can be a proxy for overall muscle strength and whether this depends on age and health status is controversial. This study assessed the agreement between HGS and knee extension strength (KES) in populations differing in age and health status.DESIGN: Data were retrieved from 5 cohorts.SETTING AND PARTICIPANTS: Community, geriatric outpatient clinics, and a hospital. Five cohorts (960 individuals, 49.8% male) encompassing healthy young and older individuals, geriatric outpatients, and older individuals post hip fracture were included.MEASURES: …
Shared Genetic and Environmental Effects on Strength and Power in Older Female Twins
Purpose: This study examined the relative contribution of genetic and environmental effects on maximal leg extensor power and also investigated whether leg extensor power and maximum voluntary isometric knee extensor strength share a genetic component. Methods: Muscle functions were measured as part of the Finnish Twin Study on Aging in 101 monozygotic (MZ) and 116 dizygotic (DZ) female twin pairs aged 63–76 yr. Leg extensor power was measured using the Nottingham Leg Extensor Power Rig and maximum voluntary isometric knee extensor strength using an adjustable dynamometer chair. The analyses were carried out using the maximum likelihood method in Mx-program on the raw data set. Results: A b…
Maintenance of aquatic training-induced benefits on mobility and lower-extremity muscles among persons with unilateral knee replacement.
Abstract Valtonen A, Poyhonen T, Sipila S, Heinonen A. Maintenance of aquatic training-induced benefits on mobility and lower-extremity muscles among persons with unilateral knee replacement. Objective To evaluate the maintenance of observed aquatic training-induced benefits at 12-month follow-up. Design Twelve-month follow-up of a randomized controlled study. Setting Research laboratory and hospital rehabilitation pool. Participants Population-based sample of 55 to 75-year-old women and men 4 to 18 months (on average 10mo) after unilateral knee replacement. Fifty people were willing to participate in the exercise trial and 42 people in the follow-up study. Intervention Twelve-month follow-…
Critical Factors in Opening Pharmaceutical Packages: a Usability Study among Healthcare Workers, Women with Rheumatoid Arthritis and Elderly Women
Effects of comprehensive geriatric intervention on physical performance among people aged 75 years and over.
Background and aims: We studied the effects of comprehensive geriatric assessment and multifactorial intervention on physical performance among older people. Methods: In a 3-year geriatric development project with an experimental design, 668 participants aged 75–98 were assigned to intervention (n=348) or control (n=320) groups. The intervention group received comprehensive geriatric assessment with an individually targeted intervention for 2 years. The outcome measures—performance in the Timed Up-and-Go (TUG), 10-meter walking and Berg Balance Scale tests 2 were gathered annually during the intervention and the 1-year follow-up after it. Results: With linear mixed models, over the 2-year i…
Menopause and adipose tissue: miR-19a-3p is sensitive to hormonal replacement
Tissue-specific effects of 17 beta-estradiol are delivered via both estrogen receptors and microRNAs (miRs). Menopause is known to affect the whole-body fat distribution in women. This investigation aimed at identifying menopause-and hormone replacement therapy (HRT)-associated miR profiles and miR targets in subcutaneous abdominal adipose tissue and serum from the same women. A discovery phase using array technology was performed in 13 women, including monozygotic twin pairs discordant for HRT and premenopausal young controls. Seven miRs, expressed in both adipose tissue and serum, were selected for validation phase in 34 women from a different cohort. An age/menopause-related increase of …
Birth cohort differences in cognitive performance in 75- and 80-year-olds: a comparison of two cohorts over 28 years.
Abstract Objective To evaluate cohort differences in cognitive performance in older men and women born and assessed 28 years apart. Methods Data in this study were drawn from two age-homogeneous cohorts measured in the same laboratory using the same standardized cognitive performance tests. Participants in the first cohort were born in 1910 and 1914 and assessed in 1989–1990 (Evergreen project, n = 500). Participants in the second cohort were born in 1938 or 1939 and 1942 or 1943 and assessed in 2017–2018 (Evergreen II, n = 726). Participants in both cohorts were assessed at age 75 and 80 years and were recruited from the population register. Cognitive performance was measured using the Dig…
Genetic effects in common on maximal walking speed and muscle performance in older women
The purpose was to examine whether maximal walking speed, maximal isometric knee extensor strength, and leg extensor power share genetic or environmental effects in common. The data was collected from 103 monozygotic and 114 dizygotic female twin pairs aged 63–76 years. Maximal walking speed over 10 m was measured in the laboratory corridor using photocells for timing. Isometric knee extensor strength and leg extensor power were measured using an adjustable dynamometer. The genetic models showed that strength, power, and walking speed had a genetic effect in common which accounted for 52% of the variance in strength, 36% in power, and 34% in walking speed. Strength and power had a non-share…
Catechol-O-Methyltransferase Gene Polymorphism Is Associated with Skeletal Muscle Properties in Older Women Alone and Together with Physical Activity
BackgroundMuscle strength declines on average by one percent annually from midlife on. In postmenopausal women this decrement coincides with a rapid decline in estrogen production. The genetics underlying the effects of estrogen on skeletal muscle remains unclear. In the present study, we examined whether polymorphisms within COMT and ESR1 are associated with muscle properties and assessed their interaction and their combined effects with physical activity.Methodology/principal findingsA cross-sectional data analysis was conducted with 434 63-76-year-old women from the population-based Finnish Twin Study on Aging. Body anthropometry, muscle cross-sectional area (mCSA), isometric hand grip a…
Physical activity compensates for increased mortality risk among older people with poor muscle strength
The aim of the study was to determine whether habitual physical activity can compensate for the increased mortality risk among older people with poor muscle strength. Mortality was followed up for 10 years after laboratory examination in 558 community dwelling 75- and 80-year-old men and women. Maximal isometric strength of five muscle groups was measured and tertile cut-off points were used to categorize participants. Participants, who reported moderate physical activity for at least 4 h a week, were categorized as physically active and the others as sedentary. High muscle strength and physical activity both protected from mortality, but their effect was not additive. Within each muscle st…
Hormone therapy is associated with better body composition and adipokine/glucose profiles
Objective: The aim of this study was to evaluate the possibility of preventing the metabolic health consequences of postmenopausal hypogonadism with the use of long-term hormone therapy (HT). Methods: We used a monozygotic co-twin control design including 10 twin pairs (aged 56-62 y) discordant for HT (duration of HT, 2-10 y). In addition, 14 premenopausal women (aged 29-35 y) who did not use HT were studied to evaluate the differences in metabolic health between the premenopausal and postmenopausal states. Body composition was determined, and waist-to-hip ratio was used as an estimate for fat distribution. Serum sex steroids, sex hormone-binding globulin, and serum lipid and glucose profil…
Supplemental_figure_2 – Supplemental material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial
Supplemental material, Supplemental_figure_2 for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial by Katri M Turunen, Laura Aaltonen-Määttä, Timo Törmäkangas, Timo Rantalainen, Erja Portegijs, Sirkka Keikkala, Marja-Liisa Kinnunen, Taija Finni, Sarianna Sipilä and Riku Nikander in Clinical Rehabilitation
Validity and Reliability of a Single Question for Leisure-Time Physical Activity Assessment in Middle-Aged Women.
Purpose: To investigate the validity and test–retest reliability of a single seven-level scale physical activity assessment question (SR-PA L7) and its three-level categorization (SR-PA C3). Methods: The associations of SR-PA L7 and C3 with accelerometer-measured leisure-time physical activity (ACC-LTPA) and with the results of four different physical performance tests (6-min walk [n = 733], knee extension [n = 695], vertical jump [n = 731], and grip force [n = 780]) were investigated among women aged 47–55 years participating in the Estrogenic Regulation of Muscle Apoptosis study (n = 795). The reliability was studied using Spearman correlations with 4-month test–retest period (n = 152). R…
Effects of power training on muscle structure and neuromuscular performance
The present study examines changes in muscle structure and neuromuscular performance induced by 15 weeks of power training with explosive muscle actions. Twenty-three subjects, including 10 controls, volunteered for the study. Muscle biopsies were obtained from the gastrocnemius muscle before and after the training period, while maximal voluntary isometric contractions (MVC) and drop jump tests were performed once every fifth week. No statistically significant improvements in MVC of the knee extensor (KE) and plantarflexor muscles were observed during the training period. However, the maximal rate of force development (RFD) of KE increased from 18,836+/-4282 to 25,443+/-8897 N (P0.05) durin…
Effects of exhaustive stretch-shortening cycle exercise on muscle blood flow during exercise
Aim: The influence of exhaustive stretch-shortening cycle exercise (SSC) on skeletal muscle blood flow (BF) during exercise is currently unknown. Methods: Quadriceps femoris (QF) BF was measured in eight healthy men using positron emission tomography before and 3 days after exhaustive SSC exercise. The SSC protocol consisted of maximal and submaximal drop jumps with one leg. Needle biopsies of the vastus lateralis muscles were taken immediately and 2 days after SSC for muscle endothelial nitric oxide synthase (eNOS) and interleukin-1-beta (IL-1β) mRNA level determinations. Results: All subjects reported subjective muscle soreness after SSC (P < 0.001), which was well in line with a decre…
Thigh muscle function in stroke patients revealed by velocity-encoded cine phase-contrast magnetic resonance imaging.
Current methods of clinical assessment of muscle coordination and function after stroke do not provide information on deep muscles. The objective of this study was to examine how stroke affects both superficial and deep muscles' coordination and whether muscle function improves after rehabilitation. Muscle function, coordination, and activity of quadriceps femoris (QF) and hamstrings were evaluated in 10 stroke patients with mild hemiparesis and in 6 controls using velocity-encoded cine phase-contrast magnetic resonance imaging (VE-PC MRI), surface electromyography (sEMG), and maximal voluntary isometric contraction torque (MVC). At baseline, the peak muscle velocity of the rectus femoris (…
Associations Between Physical and Executive Functions Among Community-Dwelling Older Men and Women
Walking is a complex task requiring the interplay of neuromuscular, sensory, and cognitive functions. Owing to the age-related decline in cognitive and physical functions, walking may be compromised in older adults, for cognitive functions, especially poor performance in executive functions, is associated with slow walking speed. Hence, the aim of this study was to investigate the associations between different subdomains of executive functions and physical functions and whether the associations found differ between men and women. Multiple linear regression analysis was performed on data collected from 314 community-dwelling older adults who did not meet physical activity guidelines but had…
Do Associations Between Perceived Environmental and Individual Characteristics and Walking Limitations Depend on Lower Extremity Performance Level?
Objective: The aim of this study was to analyze whether the associations between perceived environmental and individual characteristics and perceived walking limitations in older people differ between those with intact and those with poorer lower extremity performance. Method: Persons aged 75 to 90 ( N = 834) participated in interviews and performance tests in their homes. Standard questionnaires were used to obtain walking difficulties; environmental barriers to and, facilitators of, mobility; and perceived individual hindrances to outdoor mobility. Lower extremity performance was tested using Short Physical Performance Battery (SPPB). Results: Among those with poorer lower extremity perf…
Effects of home-based physical exercise on days at home, healthcare utilization and functional independence among patients with hip fractures : a randomized controlled trial
Objective To evaluate the effects of a physical exercise program on days lived at home, the use and costs of healthcare and social services mortality and functional independence among patients with hip fractures. Design Randomized controlled trial with parallel two-group design, consisting of a 12-month intervention and 12-month registry follow-up. Setting Home-based intervention. Participants Patients with operated hip fracture, living at home, aged ≥60 years, randomized into physical-exercise (n=61) or usual-care (n=60) groups. Intervention Supervised physical exercise twice a week. Main Outcome Measures The primary outcome was the number of days lived at home over 24 months. Secondary ou…
Hormone Replacement Therapy Associated White Blood Cell DNA Methylation and Gene Expression are Associated With Within-Pair Differences of Body Adiposity and Bone Mass.
The loss of estrogen during menopause causes changes in the female body, with wide-ranging effects on health. Estrogen-containing hormone replacement therapy (HRT) leads to a relief of typical menopausal symptoms, benefits bone and muscle health, and is associated with tissue-specific gene expression profiles. As gene expression is controlled by epigenetic factors (including DNA methylation), many of which are environmentally sensitive, it is plausible that at least part of the HRT-associated gene expression is due to changes in DNA methylation profile. We investigated genome-wide DNA methylation and gene expression patterns of white blood cells (WBCs) and their associations with body compo…
Effects of a progressive aquatic resistance exercise program on the biochemical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial
Background Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods A minimum of 80 volunteers who meet the inclusion criteria will b…
Muscle inactivity is adversely associated with biomarkers in physically active adults.
PURPOSE While the lack of muscular activity is a proposed trigger for metabolic alterations, this association has not been directly measured. We examined the associations between EMG-derived muscle inactivity and activity patterns and cardiometabolic biomarkers in healthy, physically active adults. METHODS Data for this cross-sectional study were pooled from two studies (EMG24 and InPact), resulting in a sample of 150 individuals without known chronic diseases and with high-quality EMG data (female n = 85, male n = 65, age = 38.8 ± 10.6 yr, body mass index = 23.8 ± 3.1 kg·m⁻²). EMG was measured during one to three typical weekdays using EMG shorts, measuring quadriceps and hamstring muscle …
Muscle deficits persist after unilateral knee replacement and have implications for rehabilitation.
BackgroundKnee joint arthritis causes pain, decreased range of motion, and mobility limitation. Knee replacement reduces pain effectively. However, people with knee replacement have decreases in muscle strength (“force-generating capacity”) of the involved leg and difficulties with walking and other physical activities.Objective and DesignThe aim of this cross-sectional study was to determine the extent of deficits in knee extensor and flexor muscle torque and power (ability to perform work over time) and in the extensor muscle cross-sectional area (CSA) after knee joint replacement. In addition, the association of lower-leg muscle deficits with mobility limitations was investigated.Methods…
Effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults: randomized controlled trial
Purpose (1) To determine the effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults, and (2) to compare effects between different training frequencies. Methods Men and women aged 65–75 (N = 106) were randomized to four groups according to training frequency: training groups RT1 (n = 26), RT2 (n = 27), and RT3 (n = 28) and non-training control group (n = 25). All training groups attended supervised resistance training twice a week for 3 months. For the following 6 months, they continued training with different frequencies (1, 2 or 3 times per week). Psychological functioning was measured by quality of life (WHOQOL…
OGT and OGA expression in postmenopausal skeletal muscle associates with hormone replacement therapy and muscle cross-sectional area
Protein glycosylation via O-linked N-acetylglucosaminylation (O-GlcNAcylation) is an important post-translational regulatory mechanism mediated by O-GlcNAc transferase (OGT) and responsive to nutrients and stress. OGT attaches an O-GlcNAc moiety to proteins, while O-GlcNAcase (OGA) catalyzes O-GlcNAc removal. In skeletal muscle of experimental animals, prolonged increase in O-GlcNAcylation associates with age and muscle atrophy. Here we examined the effects of hormone replacement therapy (HRT) and power training (PT) on muscle OGT and OGA gene expression in postmenopausal women generally prone to age-related muscle weakness. In addition, the associations of OGT and OGA gene expressions with…
A tailored counseling and home-based rehabilitation program to increase physical activity and improve mobility among community-dwelling older people after hospitalization: protocol of a randomized controlled trial
Physical activity (PA) decreases during hospitalization. In particular, the amount of PA engaged in by older people who are hospitalized following musculoskeletal injury is likely to be limited for months after discharge home. Given the importance of an active lifestyle for their recovery and the prevention of future adverse outcomes, there is clearly a need for interventions to increase PA. This article describes the protocol of a randomized controlled trial set up to investigate the effects of a physical activity oriented home rehabilitation program (ProPA) on PA and the restoration of mobility in community-dwelling older people. Men and women aged 60 years or older hospitalized due to a …
ASYMMETRICAL LOWER EXTREMITY POWER DEFICIT AS A RISK FACTOR FOR INJURIOUS FALLS IN HEALTHY OLDER WOMEN
Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: a randomized controlled trial
Objective: To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain. Design: Three-year geriatric development project with randomized assignment to intervention and control group. Setting: Research centre, community and assisted living facilities. Participants: Seven hundred and eighty-one Finnish persons aged 75–98 years were assigned to an intervention ( n = 404) or control ( n = 377) group. Intervention: A comprehensive geriatric assessment with a multifactorial intervention lasting two ye…
Associations of physical activity in detailed intensity ranges with body composition and physical function : a cross-sectional study among sedentary older adults
Background Physical activity is crucial to maintain older adults’ health and functioning, but the health benefits of particular activity intensities remain unclear. The aim of this cross-sectional study was to peruse the distribution of physical activity, and to investigate the associations of particular physical activity intensities with body composition and physical function among older adults. Methods The sample comprised of 293 community-dwelling sedentary or at most moderately active older adults (42% men, mean age 74 ± 4 years). Physical activity was measured with a hip-worn tri-axial accelerometer over seven consecutive days, and investigated in detailed intensity range and in catego…
A twin study on the heritability of walking ability among older women
BACKGROUND This study examined the role of genetic and environmental factors explaining individual differences in women's walking ability in old age. METHODS A maximal walking speed test over 10 meters and a 6-minute walking endurance test were done under standard conditions among 92 monozygotic and 105 dizygotic pairs of twin sisters reared together, aged 63-75 years. RESULTS The mean maximum walking speed was 1.73 +/- 0.32 m/s and the mean distance covered in the 6-minute walking test was 525.6 +/- 77.3 m. Multivariate genetic modeling showed that a minor part of the variances in walking speed (16%, 95% confidence interval [CI]: 0%-54%) and endurance (20%, 95% CI: 0%-56%) were accounted f…
Muscle Inactivity and Activity Patterns after Sedentary-Time Targeted Randomized Controlled Trial
Purpose: Interventions targeting sedentary time are needed. We used detailed EMG recordings to study the short-term effectiveness of simple sedentary time-targeted tailored counseling on the total physical activity spectrum. Methods: This cluster randomized controlled trial was conducted between 2011 and 2013 (InPact, ISRCTN28668090), and short-term effectiveness of counseling is reported in the present study. A total of 133 office workers volunteered to participate, from which muscle activity data were analyzed from 48 (intervention, n = 24; control, n = 24). After a lecture, face-to-face tailored counseling was used to set contractually binding goals regarding breaking up sitting periods …
DIFFERENTIAL INFLUENCE OF PERIPHERAL AND SYSTEMIC SEX STEROIDS ON SKELETAL MUSCLE QUALITY IN PRE- AND POSTMENOPAUSAL WOMEN.
Aging is associated with gradual decline of skeletal muscle strength and mass often leading to diminished muscle quality. This phenomenon is known as sarcopenia and affects about 30% of the over 60-year-old population. Androgens act as anabolic agents regulating muscle mass and improving muscle performance. The role of female sex steroids as well as the ability of skeletal muscle tissue to locally produce sex steroids has been less extensively studied. We show that despite the extensive systemic deficit of sex steroid hormones in postmenopausal compared to premenopausal women, the hormone content of skeletal muscle does not follow the same trend. In contrast to the systemic levels, muscle t…
Assessment of maximal handgrip strength: how many attempts are needed?
© 2017 The Authors. Background: Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to obtain maximal HGS. Methods: Three cohorts (939 individuals) differing in age and health status were included. HGS was assessed three times and explored as continuous and dichotomous variable. Paired t-test, intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to test reproducibility of HGS. The number of individuals with misclassified dynapenia at attemp…
Association of interleukin-6 rs1800796 polymorphism with reduced cognitive performance in healthy older adults
© 2018 Elsevier B.V. With increasing life expectancy, age-associated cognitive impairment is an escalating problem worldwide. Inflammation is one of the features that characterises cognitive decline and can stimulate neurodegeneration. Interleukin 6 (IL-6) is a cytokine frequently associated with a pro-inflammatory phenotype and increased levels have been associated with the pathogenesis of dementia. The rs1800796 polymorphism in the promoter region of IL-6 gene was previously shown to influence IL-6 expression and therefore we hypothesised this gene polymorphism would be associated with IL-6 plasma levels and cognitive performance of older adults. The present study investigated the associa…
Coimpairments as Predictors of Severe Walking Disability in Older Women
OBJECTIVE: Severe disabilities are common among older people who have impairments in a range of physiologic systems. It is not known, however, whether the presence of multiple impairments, or coimpairments, is associated with increased risk of developing new disability. The aim of this study was to determine the combined effects of two impairments, decreased knee-extension strength and poor standing balance, on the risk of developing severe walking disability among older, moderately-to-severely disabled women who did not have severe walking disability at baseline. DESIGN: The Women's Health and Aging Study is a 3-year prospective study with 6 semi-annual follow-up data-collection rounds fol…
Changes in Postural Balance in Frail Elderly Women during a 4-Week Visual Feedback Training: A Randomized Controlled Trial
<i>Background:</i> Balance training programs have not shown consistent results among older adults, and it remains unclear how different training methods can be adapted to frail elderly people. <i>Objective: </i>The purpose of this study was to investigate the effects of a 4-week visual feedback-based balance training on the postural control of frail elderly women living in residential care homes. <i>Methods:</i> Elderly women of two residential care facilities were randomized to an exercise group (EG, n = 20) and to a control group (CG, n = 7). The EG participated in training sessions three times/week for 4 weeks. The exercises were carried out with a com…
The effects of a physical and cognitive training intervention vs. physical training alone on older adults' physical activity : A randomized controlled trial with extended follow-up during COVID-19
BackgroundExecutive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown.MethodsData from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70-85 years old community-dwel…
Quantitative ultrasonography of muscle: Detection of adaptations to training in elderly women
Abstract Objective: To develop quantitative ultrasonography in studying the adaptation of quadriceps muscle mass and composition to short-term physical training and rehabilitation in elderly women. Design: Randomized control trial. Setting: Measurements in a research laboratory and training in a fitness center and sports hall. Participants: Forty-two women, aged 76 to 78 years, with no indications against intensive physical exercise, randomly assigned to strength ( n = 16), endurance ( n = 15), and control ( n = 11) groups. Twelve subjects from the strength, 12 from the endurance, and 11 from the control group completed the study. Intervention: Supervised physical training 3 times a week fo…
Type of surgery is associated with pain and walking difficulties among older people with previous hip fracture
Aim The aim was to assess the level of lower body pain among people with previous femoral neck fracture, and whether the type of surgery was associated with pain and physical function a mean of 2 years after surgery. Methods The study included 115 community-dwelling older adults aged 60 years and older with previous femoral neck fracture, and 31 reference subjects without previous lower limb injuries. A total of 30 patients had internal fixation surgery, 70 had hemiarthroplasty and 15 had total hip replacement. All patients had surgery in the same hospital and received typical inpatient rehabilitation. From 1.6 months to 7.5 years after the fracture, the patients underwent examination inclu…
Cross-Sectional and Longitudinal Associations between Leisure Time Physical Activity, Mental Well-Being and Subjective Health in Middle Adulthood
Previous studies have shown that participation in leisure time physical activity is related to better mental well-being and subjective health. However, the associations between different types of leisure time physical activities and different dimensions of mental well-being have rarely been studied. In addition, longitudinal research, analyzing possible causal relations between these variables, is lacking. To investigate these research questions, data gathered at ages 42 and 50 (present N = 303) for the Finnish Jyväskylä Longitudinal Study of Personality and Social Development were used. Physical activity was assessed as frequency of participation at ages 42 and 50, and at age 50 also as fr…
A family based tailored counselling to increase non-exercise physical activity in adults with a sedentary job and physical activity in their young children: design and methods of a year-long randomized controlled trial
Abstract Background Epidemiological evidence suggests that decrease in sedentary behaviour is beneficial for health. This family based randomized controlled trial examines whether face-to-face delivered counselling is effective in reducing sedentary time and improving health in adults and increasing moderate-to-vigorous activities in children. Methods The families are randomized after balancing socioeconomic and environmental factors in the Jyväskylä region, Finland. Inclusion criteria are: healthy men and women with children 3-8 years old, and having an occupation where they self-reportedly sit more than 50% of their work time and children in all-day day-care in kindergarten or in the firs…
LEISURE TIME PHYSICAL ACTIVITY, LEISURE SATISFACTION AND SUBJECTIVE WELL-BEING: CAUSAL RELATIONSHIPS IN MIDLIFE
Participation in leisure time physical activity (LTPA) in midlife is linked to both current well-being and many future benefits in older age. However, longitudinal analyses of the causal links between LTPA and well-being are lacking. Therefore, the aim of this study was to investigate longitudinal associations between LTPA and subjective well-being in middle adulthood. In addition, the role of leisure satisfaction in these relationships were investigated. The data gathered at ages 42 and 50 for the Finnish Jyväskylä Longitudinal Study of Personality and Social Development were used (present N=303). LTPA was asked as frequency of participation and leisure satisfaction as general satisfaction…
Does telomere length predict decline in physical functioning in older twin sisters during an 11-year follow-up?
Background: Leucocyte telomere length (LTL) is known to be associated with mortality, but its association with age-related decline in physical functioning and the development of disability is less clear. This study examined the associations between LTL and physical functioning, and investigated whether LTL predicts level of physical functioning over an 11- year follow-up. Methods: Older mono- (MZ) and dizygotic (DZ) twin sisters (n=386) participated in the study. Relative LTL was measured by qPCR at baseline. Physical functioning was measured by 6-min walking distance and level of physical activity (PA). Walking distance was measured at baseline and at 3-year follow-up. PA was assessed by q…
Muscular transcriptome in postmenopausal women with or without hormone replacement.
The loss of muscle mass and strength with aging is well characterized, but our knowledge of the molecular mechanisms underlying the development of sarcopenia remains incomplete. Although menopause is often accompanied with first signs of age-associated changes in muscle structure and function, the effects of hormone replacement therapy (HRT) or menopause-related decline in estrogen production in the muscles of postmenopausal women is not well understood. Furthermore the knowledge of the global transcriptional changes that take place in skeletal muscle in relation to estrogen status has thus far been completely lacking. We used a randomized double-blinded study design together with an explor…
Participant characteristics associated with the effects of a physical and cognitive training program on executive functions
Background: Physical and cognitive interventions have been shown to induce positive effects on older adults’ executive functioning. However, since participants with different background characteristics may respond differently to such interventions, we investigated whether training effects on executive functions were associated with sex, training compliance, and age. We also investigated if change in global cognition was associated with physical and cognitive training intervention-induced changes in executive functions. Methods: Exploratory data from a randomized controlled trial were analyzed. Participants were 70–85-year-old men and women who received a 12-month physical (PT) or physical a…
Telomere Length in Circulating Leukocytes is Associated with Lung Function and Disease
Several clinical studies suggest the involvement of premature ageing processes in chronic obstructive pulmonary disease (COPD). Using an epidemiological approach, we studied whether accelerated ageing indicated by telomere length, a marker of biological age, is associated with COPD and asthma, and whether intrinsic age-related processes contribute to the interindividual variability of lung function. Our meta-analysis of 14 studies included 934 COPD cases with 15 846 controls defined according to the Global Lungs Initiative (GLI) criteria (or 1189 COPD cases according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria), 2834 asthma cases with 28 195 controls, and s…
Effect of 12-month supervised, home-based physical exercise on functioning among persons with signs of frailty : Randomized Controlled Trial
Objectives To investigate the effects of a 12-month home-based exercise program on functioning and falls among persons with signs of frailty. Design A randomized controlled trial with a 1:1 allocation Setting Home-based Participants Home-dwelling persons aged ≥65 years meeting at least one frailty phenotype criteria (n=300). Intervention 12-month, individually tailored, progressive and physiotherapist-supervised, physical exercise twice a week (n=150) vs. usual care (n=149). Main outcome Measures Functional Independence Measure (FIM), Short Physical Performance Battery (SPPB), handgrip strength, instrumental activities of daily living (IADL), and self-reported falls and physical activity (o…
Effects of 32-year leisure time physical activity discordance in twin pairs on health (TWINACTIVE study): aims, design and results for physical fitness.
AbstractThe physically active lifestyle is associated with low future morbidity and mortality, but the causality between physical activity and health is not always clear. As some inherited biological characteristics and childhood experiences may cause selection bias in observational studies, we sought to take them into account by identifying 16 twin pairs (7 MZ, 9 DZ, mean age 60 years) discordant for leisure time physical activity habits for thirty years. We conducted detailed health-related examinations among these twin pairs. Our main aims were to study the effects of physical activity and genes on fitness and body composition, with special reference to body fat compartments, metabolic s…
Hormone replacement therapy improves contractile function and myonuclear organization of single muscle fibres from postmenopausal monozygotic female twin pairs
Ageing is associated with a decline in muscle mass and strength leading to increased physical dependency in old age. Postmenopausal women experience a greater decline than men of similar age in parallel with the decrease in female sex steroid hormone production. We recruited six monozygous female twin pairs (55-59 years old) where only one twin pair was on hormone replacement therapy (HRT use = 7.8 ± 4.3 years) to investigate the association of HRT with the cytoplasmic volume supported by individual myonuclei (myonuclear domain (MND) size,) together with specific force at the single fibre level. HRT use was associated with a significantly smaller (∼27%; P < 0.05) mean MND size in muscle fib…
Knee extensor and flexor muscle power explains stair ascension time in patients with unilateral late-stage knee osteoarthritis: a cross-sectional study.
To determine the extent of asymmetrical deficits in knee extensor and flexor muscles, and to examine whether asymmetrical muscle deficits are associated with mobility limitations in persons with late-stage knee osteoarthritis (OA).Cross-sectional.Research laboratory.A clinical sample (N=56; age range, 50-75y) of eligible persons with late-stage knee OA awaiting knee replacement.Not applicable.Knee extensor and flexor power and torque assessed isokinetically; thigh muscle cross-sectional area (CSA) assessed by computed tomography; mobility limitation assessed by walking speed and stair ascension time; and pain assessed with the Western Ontario and McMaster Universities Osteoarthritis Index q…
Is frailty associated with life-space mobility and perceived autonomy in participation outdoors? A longitudinal study
Background: essential aspects of independence in community mobility among older people concern the control over where, when and how to participate (perceived autonomy), and actual mobility (life-space mobility; frequency, distance and need of assistance). We studied relationships between frailty and life-space mobility and perceived autonomy in participation outdoors among community-dwelling 75–90 years old people. Methods: longitudinal analyses of the ‘Life-space mobility in old age’ cohort study (n = 753). Life-space mobility (Life-Space Assessment, range 0–120) and perceived autonomy in participation outdoors (Impact on Participation and Autonomy subscale ‘autonomy outdoors’, range 0–20)…
Muscle Cross-Sectional Area and Structural Bone Strength Share Genetic and Environmental Effects in Older Women
The purpose of this study was to estimate to what extent muscle cross-sectional area of the lower leg (mCSA) and tibial structural strength are influenced by common and trait-specific genetic and environmental factors. pQCT scans were obtained from both members of 102 monozygotic (MZ) and 113 dizygotic (DZ) 63- to 76-yr-old female twin pairs to estimate the mCSA of the lower leg, structural bending strength of the tibial shaft (BSIbend), and compressive strength of the distal tibia (BSIcomp). Quantitative genetic models were used to decompose the phenotypic variances into common and trait-specific additive genetic (A), shared environmental (C), and individual environmental (E) effects. The …
Physical Function and Properties of Quadriceps Femoris Muscle in Men With Knee Osteoarthritis
To examine the objective physical function of the lower extremities, to measure the properties of quadriceps femoris muscle (QFM), and to assess subjective disabilities in men with knee osteoarthritis (OA) and to compare the results with those obtained from age- and sex-matched control subjects.Cross-sectional study.Rehabilitation clinic in a university hospital.Male volunteers (n=54) (age range, 50-69y) with knee OA and randomly selected healthy, age- and sex-matched control subjects (n=53).Not applicable.Physical function evaluated with a test battery including the QFM composition measurement, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the RAND 36-Item…
Predicting the age at natural menopause in middle-aged women
Objective To predict the age at natural menopause (ANM). Methods Cox models with time-dependent covariates were utilized for ANM prediction using longitudinal data from 47 to 55-year-old women (n = 279) participating in the Estrogenic Regulation of Muscle Apoptosis study. The ANM was assessed retrospectively for 105 women using bleeding diaries. The predictors were chosen from the set of 32 covariates by using the lasso regression (model 1). Another easy-to-access model (model 2) was created by using a subset of 16 self-reported covariates. The predictive performance was quantified with c-indices and by studying the means and standard deviations of absolute errors (MAE ± SD) between the pre…
Physical Performance During the Menopausal Transition and the Role of Physical Activity
Abstract Background To examine longitudinal changes in physical performance during the menopausal transition and the role of physical activity (PA) in these changes. Methods Based on follicle-stimulating hormone levels and bleeding diaries, women (47–55 years) were classified as early (n = 89) and late perimenopausal (n = 143) and followed prospectively until postmenopausal status, with mean duration of 17.5 and 13.8 months, respectively. Physical performance was measured by handgrip force, knee extension torque, vertical jumping height, maximal walking speed, and 6-minute walking distance. Physical activity was self-reported and categorized as inactive, low, medium, and high. Longitudinal …
Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older.
Background. Balance is among the most important prerequisites for safe and independent mobility. Whether musculoskeletal pain is related to standing balance impairment has received limited attention. The aim of this study was to examine the association of musculoskeletal pain with the control of balance in older people. Methods. A total of 605 participants aged 75 years and older (mean age 80.4, 71 % women) were interviewed about presence and severity of musculoskeletal pain. Balance was measured by a force platform, and impaired balance was defined as a high sway velocity moment or inability to maintain semitandem standing. Results. Musculoskeletal pain was reported by 48% of the participa…
Global gene expression profiles in skeletal muscle of monozygotic female twins discordant for hormone replacement therapy
Aging is accompanied by inexorable loss of muscle tissue. One of the underlying causes for this is the massive change in the hormonal milieu of the body. The role of a female sex steroid – estrogen – in these processes is frequently neglected, although the rapid decline in its production coincides with a steep deterioration in muscle performance. We recruited 54- to 62-year-old monozygotic female twin pairs discordant for postmenopausal hormone replacement therapy (HRT, n = 11 pairs; HRT use 7.3 ± 3.7 years) from the Finnish Twin Cohort to investigate the association of long-term, estrogen-based HRT with skeletal muscle transcriptome. Pathway analysis of muscle transcript profiles revealed …
Musculoskeletal pain and use of analgesics in relation to mobility limitation among community-dwelling persons aged 75 years and older
Pain and factors related to it constitute serious health problems in the older population. This populationbased cross-sectional study aimed to investigate whether musculoskeletal pain is associated with mobility limitation and whether the relationship between pain and mobility limitation varies according to the use of analgesics among community-dwelling older people. A total of 622 community-dwelling participants aged 75 years and older (mean age 80.4, 74% women) were interviewed about presence and severity of musculoskeletal pain. Self-reported analgesic drug utilization was verified against medical records. Mobility limitation was assessed by the Timed Up & Go test (TUG) time of >13.5 s o…
The Older Finnish Twin Cohort : 45 Years of Follow-up
AbstractThe older Finnish Twin Cohort (FTC) was established in 1974. The baseline survey was in 1975, with two follow-up health surveys in 1981 and 1990. The fourth wave of assessments was done in three parts, with a questionnaire study of twins born during 1945–1957 in 2011–2012, while older twins were interviewed and screened for dementia in two time periods, between 1999 and 2007 for twins born before 1938 and between 2013 and 2017 for twins born in 1938–1944. The content of these wave 4 assessments is described and some initial results are described. In addition, we have invited twin-pairs, based on response to the cohortwide surveys, to participate in detailed in-person studies; these …
Walking recovery after a hip fracture: A prospective follow-up study among community-dwelling over 60-year old men and women
Purpose. Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture.Methods. A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery), and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes dur…
Body composition in 18 to 88-year-old adults - comparison of multifrequency bioimpedance and dual-energy X-ray absorptiometry
Objective -- This study compared bioimpedance analysis (BIA) in the assessment of body composition with dual-energy X-ray absorptiometry (DXA) in 18- to 88-year-old adults. Design and Methods -- Body composition of 882 adults was estimated by eight-polar BIA and DXA. In addition, estimates of lean mass, fat mass, and percentage of fat were investigated across a range of age and leisure time physical activity (LTPA) groups. Results -- Compared to DXA, larger lean masses (mean difference 2.9 and 1.6 kg) and smaller fat masses (3.1 and 2.6 kg) were estimated by BIA in both women and men, respectively. Differences between the methods' mean values were evident in all age and LTPA groups, except …
Knowledge of Nutrition and Physical Activity Guidelines is Not Associated with Physical Function in Dutch Older Adults Attending a Healthy Ageing Public Engagement Event
Keenan A Ramsey,1 Suey SY Yeung,1 Anna GM Rojer,1 Noémie Gensous,2 Evans A Asamane,3 Justin Avery Aunger,3 Dmitriy Bondarev,4 Andrea Cabbia,5 Paul Doody,3 Barbara Iadarola,6,7 Belina Rodrigues,8,9 Muhammad R Tahir,10 Victor Kallen,10 Paola Pazienza,6,7 Nadine Correia Santos,8,9 Sarianna Sipilä,4 Janice L Thompson,3 Carel GM Meskers,1,11 Marijke C Trappenburg,12,13 Anna C Whittaker,15 Andrea B Maier1,14,16,17 1Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit, Faculty of Behavioural and Human Movement Sciences, Amsterdam, the Netherlands; 2Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bolog…
Physical performance in relation to menopause status and physical activity
Objective: The aim of this study was to examine differences in physical performance (muscle power, muscle strength, aerobic capacity, and walking speed) across menopausal stages and potential of leisure physical activity (PA) to modify the impact of menopause on physical performance. Methods: In this cross-sectional study, women aged 47 to 55 were randomly selected from the Finnish National Registry and categorized as premenopausal (n ¼ 233), perimenopausal (n ¼ 381), or postmenopausal (n ¼ 299) based on serum concentrations of follicle-stimulating hormone and bleeding diary. Physical performance was measured by knee extension force, handgrip force, vertical jumping height, maximal walking …
Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons: Randomized Controlled Trial.
Objectives: Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study the effects of home-based physical exercise on the number of days spent at home among pre frail and frail persons, versus usual care. In addition, utilization and costs of health care and social services, cost-effectiveness, and health-related quality-of-life (HRQoL) were explored. Design: Randomized controlled trial, with year-long supervised exercise for 60 minutes twice a week versus usual care. Follow-up for 24 months after randomization. Setting and Participants: A sample of 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: >65 years, meeti…
Biomechanical and skeletal muscle determinants of maximum running speed with aging.
Purpose: Aging diminishes the ability to run fast, but the specific mechanisms responsible for this deterioration remain largely unknown. In the present study, we investigated the age-related decline in sprint running ability through a cross-sectional examination of biomechanical and skeletal muscle characteristics in 77 competitive male sprinters aged 17-82 yr. Methods: Ground reaction force (GRF) and kinematic stride cycle parameters were measured during the maximum-velocity phase using a 9.4-m-long force platform. Knee extensor (KE) and ankle plantar flexor (PF) structural characteristics were investigated using ultrasonography and muscle biopsies (vastus lateralis). Force production cha…
Effects of hormone replacement therapy and high-impact physical exercise on skeletal muscle in post-menopausal women: a randomized placebo-controlled study
An age-related decline in muscle performance is a known risk factor for falling, fracture and disability. In women, a clear deterioration is observed from early menopause. The effect of hormone replacement therapy (HRT) in preserving muscle performance is, however, unclear. This trial examined the effects of a 12-month HRT and high-impact physical exercise regimen on skeletal muscle in women in early menopause. A total of 80 women aged 50–57 years were assigned randomly to one of four groups: exercise (Ex), HRT, exercise+HRT (ExHRT) and control (Co). The exercise groups participated in a high-impact training programme. The administration of HRT (oestradiol/noretisterone acetate) or placebo …
Muscle strength and history of heavy manual work among elderly trained women and randomly chosen sample population.
The association between a history of heavy work and muscle strength was studied among 51 physically active women aged 66–85 years trained in sports and 41 women aged 70–81 years selected randomly from the population register. Maximal isometric muscle strength of hand grip, arm flexion, leg extension and trunk flexion and extension were measured using specially constructed dynamometers. The capacity of the abdominal muscles was evaluated by means of a sit-up test. The study included an interview dealing with the subjects' histories of heavy manual employment. The mean histories of heavy work for the trained and untrained women were 24 and 36 years, respectively. The trained women showed sign…
Metabolic health, menopause, and physical activity : a 4-year follow-up study
Background In women, metabolic health deteriorates after menopause, and the role of physical activity (PA) in mitigating the change is not completely understood. This study investigates the changes in indicators of metabolic health around menopause and evaluates whether PA modulates these changes. Methods Longitudinal data of 298 women aged 48–55 years at baseline participating in the ERMA and EsmiRs studies was used. Mean follow-up time was 3.8 (SD 0.1) years. Studied indicators of metabolic health were total and android fat mass, waist circumference, waist-to-hip ratio (WHR), systolic (SBP) and diastolic (DBP) blood pressure, blood glucose, triglycerides, serum total cholesterol, and high…
Impaired geometric properties of tibia in older women with hip fracture history.
This study evaluated side-to-side differences in tibial mineral mass and geometry in women with previous hip fracture sustained on average 3.5 years earlier. Both tibial mineral mass and geometry were found to be reduced in the fractured leg. INTRODUCTION: The purpose of this study was to evaluate side-to-side differences in tibial mineral mass and geometry after hip fracture and to assess the determinants of such differences. METHODS: Thirty-eight 60- to 85-year-old women with a previous hip fracture and 22 same-aged control women without fractures participated in the study. Bone characteristics of the distal tibia and tibial shaft of both legs were assessed using pQCT in order to compare …
Effects of resistance training on lower-extremity impairments in older people with hip fracture
Abstract Portegijs E, Kallinen M, Rantanen T, Heinonen A, Sihvonen S, Alen M, Kiviranta I, Sipila S. Effects of resistance training on lower-extremity impairments in older people with hip fracture. Objective To study the effects of resistance training on muscle strength parameters, mobility, and balance. Design Randomized controlled trial. Setting Research laboratory and senior gym. Participants Population-based sample of eligible 60- to 85-year-old community-dwelling men and women 0.5 to 7.0 years after hip fracture. Forty-six people had no contraindications and were willing to participate in the exercise trial. Intervention Twelve-week intensive progressive strength-power training (n=24),…
Dysregulation of C-X-C motif ligand 10 during aging and association with cognitive performance
International audience; Chronic low-grade inflammation during aging (inflammaging) is associated with cognitive decline and neurodegeneration; however, the mechanisms underlying inflammaging are unclear. We studied a population (n = 361) of healthy young and old adults from the MyoAge cohort. Peripheral levels of C-X-C motif chemokine ligand 10 (CXCL10) was found to be higher in older adults, compared with young, and negatively associated with working memory performance. This coincided with an age-related reduction in blood DNA methylation at specific CpGs within the CXCL10 gene promoter. In vitro analysis supported the role of DNA methylation in regulating CXCL10 transcription. A polymorph…
Associations of physical performance and physical activity with mental well-being in middle-aged women
Abstract Background To investigate whether physical performance is independently of physical activity (PA) associated with positive and negative dimensions of mental well-being in middle-aged women. Methods Data were drawn from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study in which women 47 to 55 years were randomly selected from the Finnish National Registry. They (n = 909) participated in measurements of physical performance (handgrip force, knee extension force, vertical jumping height, maximal walking speed, and six-minute walking distance). Both mental well-being (the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule…
Interrelationships between Muscle Structure, Muscle Strength, and Running Economy
The present study was designed to investigate possible differences in running economy (RE) among elite middle-distance runners by examining muscle structure and maximal isometric force (MVC).Ten young male runners ran at six different running speeds. During the running bouts, respiratory gases, and blood lactate were measured. Muscle biopsies were obtained from the vastus lateralis muscle for analyzing fiber type distribution, muscle fiber area, myosin heavy chain (MHC) composition, activities of a number of metabolic enzymes (citrate synthase, lactate dehydrogenase, phosphofruktokinase, and 3-hydroxyacyl-CoA-dehydrogenase), and titin isoforms.Energy expenditure (EE) increased linearly up t…
Change in bone mass distribution induced by hormone replacement therapy and high-impact physical exercise in post-menopausal women.
The purpose of this intervention trial was to determine whether changes in bone mass distribution could be observed in postmenopausal women following hormone replacement therapy (HRT) and/or high-impact physical exercise. Eighty healthy women, aged 50-57 years, at5 years after the onset of menopause and with no previous use of HRT, were randomly assigned to one of four groups: HRT; exercise (Ex); HRT + Ex (ExHRT); and control (Co). HRT administration was conducted in a double-blind manner for 1 year using estradiol plus noretisterone acetate (Kliogest). The exercise groups participated in a 1 year progressive training program consisting of jumping and bounding activities. Subjects participa…
Beta-band MEG signal power changes in older adults after physical exercise program with and without additional cognitive training
Physical exercise has been considered to be an efficient mean of preserving cognitive function and it influences both the structural and functional characteristics of the brain. It has especially been shown to increase brain plasticity, the capacity to re-structure brain properties in response to interaction, such as cognitive practice. Studies have also examined the potential additive effect of cognitive training on the documented benefit of physical exercise, commonly, however, not at the neural level. We monitored, using magnetoencephalography (MEG), the brain processes associated with executive functions in older individuals who participated in a 12-month randomized controlled trial inc…
Personality traits and physical functioning : a cross-sectional multimethod facet-level analysis
Background This study aimed to investigate whether personality traits and their facets are associated with a multi-methods assessment of physical activity and walking performance and whether they explain the discrepancy between self-reported and accelerometer-assessed physical activity. Methods The participants were community-dwelling, 70–85-year-old men and women from Finland (n = 239) who were part of a clinical trial. Personality traits and their facets were measured using the 240-item NEO Personality Inventory-3. Physical activity was assessed using questions about frequency, intensity and duration of exercise (self-reported metabolic equivalent minutes (MET)) and by tri-axial accelerom…
Effects of comprehensive geriatric assessment-based individually targeted interventions on mobility of pre-frail and frail community-dwelling older people
Aim To assess the effects of comprehensive geriatric assessment (CGA)-based individually targeted interventions on the ability to walk 400 m in pre-frail or frail and non-frail community-dwelling older people. Methods A subgroups analysis of a population-based comparative study, the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) was carried out in the city of Kuopio, Finland, from 2004 to 2007. This study was based on data from 2005 to 2007. The present analysis included 605 community-dwelling older adults aged ≥76 years (mean age 80.9, 70% women), 314 in the intervention and 291 in the control group. Frailty status was assessed in 2005. Mobility was assessed b…
Leisure-time physical activity and high-risk fat: a longitudinal population-based twin study.
Exercise is thought to reduce high-risk body fat, but intervention studies are frequently limited by short follow-ups and observational studies by genetic selection. Therefore, we studied the effects of a physically inactive vs active lifestyle on high-risk (visceral, liver and intramuscular) fat in twin pairs discordant for leisure-time physical activity habits for over 30 years.A longitudinal population-based twin study.Sixteen middle-aged (50-74 years) same-sex twin pairs (seven monozygotic (MZ), nine dizygotic (DZ)) with long-term discordance for physical activity habits were comprehensively identified from the Finnish Twin Cohort (TWINACTIVE study). Discordance was initially defined in…
Body composition and muscle performance during menopause and hormone replacement therapy.
Menopausal transition is characterized by ovarian failure and its consequent decrease in female sex steroid production. Earlier studies suggest that an increase and redistribution of body fat during menopause predispose women to cardiovascular disease and metabolic syndrome. In addition, peri- and post-menopausal women seem to have less lean body mass (LBM) compared with pre-menopausal women. Accordingly, a changing ovarian hormonal status may accelerate the loss of muscle mass and result in decreased muscle performance and functional capacity. Hormone replacement therapy (HRT) has been used to treat menopausal symptoms and as a primary prevention therapy in chronic conditions. Inconsistent…
Additional file 1 of Blood and skeletal muscle ageing determined by epigenetic clocks and their associations with physical activity and functioning
Additional file 1: Within-pair correlations in age acceleration in blood and in muscle. Additional file 2: Associations between DNAmAge age acceleration estimates and body composition and physical activity in blood. Additional file 3: Sensitivity analyses related to twin pair discordance in body mass index.
Comparison of ultrasound and bone mineral density assessment of the calcaneus with different regions of interest in healthy early menopausal women.
This study investigated the effect of different sized regions of interest (ROIs) on quantitative ultrasound (QUS) variables of the calcaneus. The effect on QUS of using a fixed ROI as opposed to an ROI adjusted for foot length was also assessed. Eighty Caucasian women, aged 50-57 yr (mean 53 +/- 2) who were healthy and within 0. 5-5 yr of the onset of menopause participated in this study. Using the QUS-1(trade mark) Ultrasonometer (Metra Biosystems, Mountain View, CA), we assessed broadband ultrasound attenuation ([BUA] and UBI-4, dB/MHz), the average transit time through the heel ([TTH], mus) and a multiple-factor index (UBI-4T = UBI-4/TTH, dB/[MHz. mus]). The QUS measurement results were …
Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity
This study aimed to investigate the associations of competitive sport participation in adolescence and age at menarche (AAM) with body composition, femoral neck bone mineral density (BMD), physical performance, and physical activity (PA) in middle-aged women. 1098 women aged 47&ndash
Muscle ultrasonography and computed tomography in elderly trained and untrained women
Ultrasonography (US) and computed tomography (CT) were compared in studying the associations between long-term physical training and quadriceps muscle mass and structure in female athletes and controls, aged 66-85 years. Muscle cross-sectional area (CSA) measured using US correlated highly with that measured using CT, but the latter technique yielded 30% higher values on average. The echo intensity of the fasciae and bone measured by US correlated positively with the mean radiological density and negatively with the relative proportion of fat obtained from CT. Low intramuscular echo intensity was accompanied by high muscle density and low relative proportion of fat. The athletes had larger …
The effect of individualized, theory-based counselling intervention on active aging and quality of life among older people (the AGNES intervention study)
Abstract Background We define active aging as a striving for activities as per one’s goals, capacities and opportunities. Aim To test the 1-year counselling intervention effects on active aging. Methods In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation for active life (one face-to-face session, four phone calls and supportive written material, n = 101) and the control group written health information (n = 103). Participants were community-dwelling men and women aged 75 or 80 years with intermediate mobility function and without cognitive impairment. The primary outcome was active agi…
EFFECTS OF A HOME-BASED REHABILITATION PROGRAM ON HEALTH-RELATED QUALITY OF LIFE
Health-Related Quality of life (HRQoL) decreases after a hip fracture (HF) and may remain low for a long time. Knowledge is needed on effective rehabilitation strategies after HF. Purpose of this study was to investigate the effects of individualized home-based rehabilitation on HRQoL among community-dwelling older people after HF.
Associations of physical activity intensities, impact intensities and osteogenic index with proximal femur bone traits among sedentary older adults
Background Dynamic high-intensity physical activity is thought to be beneficial for older adults’ bone health. Traditional volume-based processing of accelerometer-measured physical activity data, quantified on a minute-per-minute basis, may average out sporadic high impact activity, whereas accelerometer data processing approaches based on identifying impacts can capture also these potentially beneficial short activity bursts. We investigated the associations between habitual physical activity and proximal femur bone traits among sedentary older adults utilizing three different numerical treatments of accelerometer-data to examine, if impact-based processing approaches are more suitable to…
Additional file 1 of Blood and skeletal muscle ageing determined by epigenetic clocks and their associations with physical activity and functioning
Additional file 1: Within-pair correlations in age acceleration in blood and in muscle. Additional file 2: Associations between DNAmAge age acceleration estimates and body composition and physical activity in blood. Additional file 3: Sensitivity analyses related to twin pair discordance in body mass index.
Triceps surae muscle-tendon properties in older endurance- and sprint-trained athletes
Previous studies have shown that aging is associated with alterations in muscle architecture and tendon properties (Morse CI, Thom JM, Birch KM, Narici MV. Acta Physiol Scand 183: 291–298, 2005; Narici MV, Maganaris CN, Reeves ND, Capodaglio P. J Appl Physiol 95: 2229–2234, 2003; Stenroth L, Peltonen J, Cronin NJ, Sipila S, Finni T. J Appl Physiol 113: 1537–1544, 2012). However, the possible influence of different types of regular exercise loading on muscle architecture and tendon properties in older adults is poorly understood. To address this, triceps surae muscle-tendon properties were examined in older male endurance (OE, n = 10, age = 74.0 ± 2.8 yr) and sprint runners (OS, n = 10, age…
Heritability of maximal isometric muscle strength in older female twins.
The purpose of the present study was to examine genetic and environmental effects on maximal isometric handgrip, knee extension, and ankle plantar flexion strength. In addition, we wanted to investigate whether the strength of these three muscle groups shares a genetic component or whether the genetic effect is specific for each muscle group. Muscle strength was measured as part of the Finnish Twin Study on Aging in 97 monozygotic (MZ) and 102 dizygotic (DZ) female twin pairs, aged 63-76 yr. The MZ and DZ individuals did not differ from each other in age, body height, weight, or self-related health. The age-adjusted pairwise (intraclass) correlations of the MZ and DZ twins were, respective…
Effects of combined hormone replacement therapy or its effective agents on the IGF-1 pathway in skeletal muscle.
Objectives To investigate the effects of combined hormone replacement therapy (HRT) and its effective agents on the IGF-1 signaling pathway. Design and methods To examine the effects of HRT on skeletal muscle in vivo, we utilized pre- and post-intervention samples from a randomized double blinded trial with 50–57-year-old women. The intervention included the year-long use of either HRT preparation (2 mg 17β-estradiol, E2; 1 mg norethisterone acetate, NETA, n = 10) or placebo (CO, n = 9). Microarray technology and quantitative PCR (qPCR) were used to study the expression of insulin-like growth factor I (IGF-1) and its splice variants as well as IGF-1 receptor, Akt1, mTOR, FOXO1, FOXO3, atrog…
Genetic and Environmental Effects on Telomere Length and Lung Function : A Twin Study
Background The purpose of the study was to estimate the heritability of leukocyte telomere length (LTL) and lung function and to examine whether LTL and lung function share genetic or environmental effects in common. Methods 386 monozygotic and dizygotic Finnish twin sisters (age 68.4±3.4 years) were included. Relative LTL was determined from peripheral blood DNA by qPCR. Lung function measures of FEV1, FVC, FEV1/FVC, and PEF were derived from spirometry. Genetic modeling was performed with MPlus statistical software. Results Univariate analysis revealed that in LTL, 62% (95% confidence interval 50–72) of the variance was explained by additive genetic and 38% (28–50) by unique environmental…
Hormone replacement therapy improves contractile function and myonuclear organization of single fibres from postmenopausal monozygotic female twin pairs.
Ageing is associated with a decline in muscle mass and strength leading to increased physical dependency in old age. Postmenopausal women experience a greater decline than men of similar age in parallel with the decrease in female sex steroid hormone production. We recruited six monozygous female twin pairs (55–59 years old) where only one twin pair was on hormone replacement therapy (HRT use = 7.8 ± 4.3 years) to investigate the association of HRT with the cytoplasmic volume supported by individual myonuclei (myonuclear domain (MND) size,) together with specific force at the single fibre level. HRT use was associated with a significantly smaller (∼27%; P < 0.05) mean MND size in muscle fib…
Effects of combined strength and sprint training on regulation of muscle contraction at the whole-muscle and single-fibre levels in elite master sprinters
The aims of this study were to investigate the mechanisms underlying (1) the ageing-related motor handicap at the whole muscle, cellular, contractile protein and myonuclear levels; and (2) ageing-related differences in muscle adaptability.In vivo muscles function was studied in the knee extensors. Decreases were observed in isokinetic and isometric torque outputs in old age in the sedentary men and women and elite master sprinters. A 20-week long specific sprint and resistance training successfully improved the maximal isometric force and rate of force development in a subgroup of master sprinters.In vitro measurements were performed in muscle biopsies from the vastus lateralis muscle. Immu…
Bidirectional associations between cognitive functions and walking performance among middle-aged women
Objective: This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and walking are associated in middle-aged women, and (3) cognitive functions assessed in perimenopause are associated with walking after reaching the postmenopause or vice versa. Methods: In total, 342 women, categorized as early (n = 158) or late perimenopausal (n = 184), were included in the study and followed up until postmenopausal. Psychomotor speed, executive functions related to set-shifting and updating, working memory, and visual memory were assessed. Walking was assessed with walking speed, walking distance, and…
The Physical Activity and Nutritional INfluences in Ageing (PANINI) Toolkit: a standardized approach towards physical activity and nutritional assessment of older adults
Assessing multiple domains of health in older adults requires multidimensional and large datasets. Consensus on definitions, measurement protocols and outcome measures is a prerequisite. The Physical Activity and Nutritional INfluences In Ageing (PANINI) Toolkit aims to provide a standardized toolkit of best-practice measures for assessing health domains of older adults with an emphasis on nutrition and physical activity. The toolkit was drafted by consensus of multidisciplinary and pan-European experts on ageing to standardize research initiatives in diverse populations within the PANINI consortium. Domains within the PANINI Toolkit include socio-demographics, general health, nutrition, ph…
Associations between muscle strength, spirometric pulmonary function and mobility in healthy older adults
Background: Pathological obstruction in lungs leads to severe decreases in muscle strength and mobility in patients suffering from chronic obstructive pulmonary disease. The purpose of this study was to investigate the interdependency between muscle strength, spirometric pulmonary functions and mobility outcomes in healthy older men and women, where skeletal muscle and pulmonary function decline without interference of overt disease. Methods: 135 69 to 81‐yr‐old participants were recruited into the cross‐sectional study, which was performed as a part of European study MyoAge. Full, partial and no mediation models were constructed to assess the interdependency between muscle strength (handgr…
The effects of muscle strength and power training on mobility among older hip fracture patients
The incidence of hip fractures is growing in all Western societies. The mobility of hip fracture patients does not return to the pre-fracture level even 2 years after fracture. One reason for mobility limitation may be the persistent muscle weakness on the fractured leg. The purpose of this randomized controlled study was to examine whether 12-week muscle strength and power training twice a week has an effect on mobility in 60–85-year-old hip fracture patients. Forty-three persons were randomly assigned to an intervention (n=23) and a control (n=20) group. The intervention comprised 12-week supervised intensive progressive strength–power training twice per week. All the measurers were blind…
Older persons with signs of frailty in a home-based physical exercise intervention : baseline characteristics of an RCT
Background Increasing the level of physical activity among persons with signs of frailty improves physical functioning. There is a lack of long-term supervised physical exercise intervention studies including a validated definition of frailty. Aims To present baseline characteristics of persons with signs of frailty participating in a randomized long-term home-based physical exercise trial (HIPFRA), and to study associations between the severity of frailty, functional independence and health-related quality-of-life (HRQoL). Methods Three hundred persons, ≥ 65 years old and with signs of frailty (assessed by Fried´s phenotype criteria) were recruited from South Karelia, Finland and randomize…
Serum albumin and muscle measures in a cohort of healthy young and old participants
Consensus on clinically valid diagnostic criteria for sarcopenia requires a systematical assessment of the association of its candidate measures of muscle mass, muscle strength, and physical performance on one side and muscle-related clinical parameters on the other side. In this study, we systematically assessed associations between serum albumin as a muscle-related parameter and muscle measures in 172 healthy young (aged 18–30 years) and 271 old participants (aged 69–81 year) from the European MYOAGE study. Muscle measures included relative muscle mass, i.e., total- and appendicular lean mass (ALM) percentage, absolute muscle mass, i.e., ALM/height2 and total lean mass in kilograms, handg…
Lowered vision as a risk factor for injurious accidents in older people
Poor vision in older people is often related to increased fall risk. However, the association of the severity between visual deficit and risk for all kind of injurious accidents has not been widely studied. The aim of this study was to examine whether visual loss is associated with higher incidence of injurious accidents and whether walking speed or physical activity play a mediating role in the association.416 persons aged 75 and 80 years at baseline underwent visual acuity measurements. Visual acuity (VA)0.3 in the better eye, with spectacle correction when necessary, was defined as visual impairment, VAor=0.3 butor=0.5 as lowered vision, and VA0.5 as normal VA. Hospital records of accide…
Effects of 12-month home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with a recent hip fracture - protocol of a randomized controlled trial (HIPFRA study)
Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture. This is a non-blinded, parallel group, randomized controlled trial performed in South Karelia Social and Health Care District, Finland (popu…
Aging and serum exomiR content in women-effects of estrogenic hormone replacement therapy.
AbstractExosomes participate in intercellular messaging by transporting bioactive lipid-, protein- and RNA-molecules and -complexes. The contents of the exosomes reflect the physiological status of an individual making exosomes promising targets for biomarker analyses. In the present study we extracted exosome microRNAs (exomiRs) from serum samples of premenopausal women (n = 8) and monozygotic postmenopausal twins (n = 10 female pairs), discordant for the use of estrogenic hormone replacement therapy (HRT), in order to see whether the age or/and the use of HRT associates with exomiR content. A total of 241 exomiRs were detected by next generation sequencing, 10 showing age, 14 HRT and 10 a…
Physical activity at age of 20-64 years and mobility and muscle strength in old age: a community-based study.
Background. Physical activity in midlife has been related to lower mortality and better health in old age. The present study evaluated whether physical activity at age of 20–64 years was associated with mobility and muscle strength in old age. Methods. A random sample of 1,000 persons was extracted from all the ≥75-year-old people living in Kuopio, Finland, and 679 community-dwelling participants were included in the present analyses. Data on health status, ability to walk outside or 400 m, and physical activity level were obtained through structured interviews. Participants’ walking speed, grip strength, and knee extension strength were measured by physiotherapists. Relationship between ph…
Fall incidence in frail older women after individualized visual feedback-based balance training.
<i>Background:</i> The knowledge concerning balance training actually lowering fall rates among frail older persons is limited. <i>Objective:</i> The aim of this study was to examine the effects of a 4-week individualized visual feedback-based balance training on the fall incidence during 1-year follow-up among frail older women living in residential care. <i>Methods:</i> Twenty-seven older women from 2 residential care homes were randomized into exercise (n = 20) and control (n = 7) groups. Balance measurements were carried out before and after a 4-week training period and falls were monitored by monthly diaries for 1 year. An interview about fear of fal…
Promoting mobility after hip fracture (ProMo): study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people
Abstract Background To cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture. Methods/Design Population-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women) participat…
Body Weight, Physical Activity, and Risk of Cancer in Lynch Syndrome
Simple Summary Lifestyle modifies cancer risk in the general public. How lifestyle modifies cancer risk in individuals carrying the inherited pathogenic gene variants in DNA mismatch repair genes (Lynch syndrome) remains understudied. We conducted a retrospective study with cancer register data to investigate associations between body weight, physical activity, and cancer risk among Finnish Lynch syndrome carriers (n = 465, 54% women). The results of our study indicated that longitudinal weight gain increases cancer risk, whereas being highly physically active during adulthood could decrease cancer risk in men. Further, women were observed to be less prone to lifestyle-related risk factors …
Female reproductive factors are associated with objectively measured physical activity in middle-aged women
Physical activity improves health and may delay the onset of several chronic diseases. For women in particular, the rate of these diseases accelerates at middle age; therefore it is important to identify the determinants of health-enhancing physical activity during midlife in this population. In this study, we focused on determinants that are unique to the female sex, such as childbearing and menopause. The main objective was to characterize the level of physical activity and differences between active and inactive middle-aged Finnish women. In addition, we examined the association of physical activity with female reproductive factors at midlife. The study population consisted of 647 women …
Estrogen Regulates the Satellite Cell Compartment in Females
SUMMARYSkeletal muscle mass, strength, and regenerative capacity decline with age, with many measures showing greater deterioration in females about the time estrogen levels decrease at menopause. Here we show that maintenance of muscle stem cells, satellite cells, as well as self-renewal and differentiation into muscle fibers, are severely compromised by estrogen deficiency. Mechanistically, by hormone replacement, use of a selective estrogen-receptor modulator (bazedoxifene), and conditional estrogen receptor knockout, we implicate 17β-estradiol and satellite cell expression of estrogen receptorα(ERα) and show that estrogen signaling through this receptor is necessary to prevent apoptosis…
Effects of Physical and Cognitive Training on Gait Speed and Cognition in Older Adults : A Randomized Controlled Trial
Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12‐month physical and cognitive training (PTCT) on gait speed, dual‐task cost in gait speed, and executive functions (EFs) compared to physical training (PT) (ISRCTN52388040). Community‐dwelling older adults, who did not meet physical activity recommendations, were recruited (n=314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2‐3 times weekly) and moderate aerobic activity 150 minutes/week in bouts of >10 minutes. PTCT included …
Effects of aerobic and strength training on aerobic capacity, muscle strength, and gene expression of lymphomonocytes in patients with stable CAD
This study examined the effectiveness, suitability, and safety of a mixed interval-type aerobic and strength training program (MIAST) on physical fitness in patients with stable coronary artery disease (CAD) without history of myocardial infarction (MI). Twenty-three patients with stable CAD were randomly assigned to a MIAST (n = 12; mean age 58.6 years) or control (n = 11; 63.3 years) group. The MIAST group participated in the progressive training program twice a week for 21 weeks. Peak oxygen uptake (VO2peak), workload, and exercise time were measured as were maximal muscle strength, serum lipids, glucose concentration, and the cross-sectional area (CSA) of knee extensors. The safety and …
Comment on "Effects of Elastic Resistance Band Exercise on Postural Balance, Estrogen, Bone Metabolism Index, and Muscle Strength of Perimenopausal Period Women".
Effects of intensive strength-power training on sense of coherence among 60-85-year-old people with hip fracture: A randomized controlled trial
Background and aims: Older people with disabilities are at increased risk of psychological health decline. There are no earlier studies on the effects of resistance training on sense of coherence (SOC) among older people with a history of hip fracture. The aim of this study is to test the effects of intensive 12-week strength-power training on SOC among older adults after hip fracture. Methods: A clinical sample of 60-85-year-old community-dwelling men and women was studied, 0.5. to 7.0 years after hip fracture. Forty-six had no contraindications for participation and were randomized into training (n=24) and control groups (n=22). The training group participated in a 12-week, individually t…
Intramuscular sex steroid hormones are associated with skeletal muscle strength and power in women with different hormonal status
International audience; Estrogen (E2)-responsive peripheral tissues, such as skeletal muscle, may suffer from hormone deficiency after menopause potentially contributing to the aging of muscle. However, recently E2 was shown to be synthesized by muscle and its systemic and intramuscular hormone levels are unequal. The objective of the study was to examine the association between intramuscular steroid hormones and muscle characteristics in premenopausal women (n = 8) and in postmenopausal monozygotic twin sister pairs (n = 16 co-twins from eight pairs) discordant for the use of E2-based hormone replacement. Isometric skeletal muscle strength was assessed by measuring knee extension strength.…
Effects of Home-Based Physical Exercise on Days at Home, Health Care Utilization, and Functional Independence Among Patients With Hip Fractures: A Randomized Controlled Trial.
Abstract Objective To evaluate the effects of a physical exercise program on days lived at home, the use and costs of health care and social services, mortality, and functional independence among patients with hip fractures. Design Randomized controlled trial with a parallel 2-group design consisting of a 12-month intervention and 12-month registry follow-up. Setting Home-based intervention. Participants Patients aged ≥60 years (N=121) with operated hip fracture and who were living at home were randomized into physical exercise (n=61) and usual care (n=60) groups. Interventions Supervised physical exercise twice a week. Main Outcome Measures The primary outcome was the number of days lived …
Effects of a progressive aquatic resistance exercise program on the biomechanical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial
Background. Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods. A minimum of 80 volunteers who meet the inclusion criteria will…
Effects of preoperative group-based aquatic training on health related quality of life in persons with late stage knee osteoarthritis
drainage is better than resistance training alone as far as improvement in lymphedema is concerned. Implications: Lymphedema has a substantial effect on the upper limb functioning, independence as well as quality of life post mastectomy. Manual lymphatic drainage can help these patients to achieve functional independence and thereby increase their life quality in a simple, cost effective and efficient way.
Leg extension power deficit and mobility limitation in women recovering from hip fracture.
OBJECTIVE: After hip fracture, muscle strength and power remain persistently poor, especially in the fractured leg. This study explores whether asymmetrical leg extension power (LEP) deficit affects mobility in women after proximal femoral fracture (PFF). DESIGN: In this observational study, LEP of both legs, 10- and 50-foot walking speed, and stair-climbing speed were measured in 43 women, aged 73-96, at 1 and 13 wks after surgical repair of PFF. Asymmetrical LEP deficit was calculated as (fractured/(sum both legs)) x 100%. RESULTS: Between weeks 1 and 13 after PFF surgery, LEP increased in the fractured and nonfractured legs by 100% and 30%, respectively. Asymmetrical deficit was reduced …
Aging, muscle fiber type, and contractile function in sprint-trained athletes
Biopsy samples were taken from the vastus lateralis of 18- to 84-yr-old male sprinters ( n = 91). Fiber-type distribution, cross-sectional area, and myosin heavy chain (MHC) isoform content were identified using ATPase histochemistry and SDS-PAGE. Specific tension and maximum shortening velocity ( Vo) were determined in 144 single skinned fibers from younger (18–33 yr, n = 8) and older (53–77 yr, n = 9) runners. Force-time characteristics of the knee extensors were determined by using isometric contraction. The cross-sectional area of type I fibers was unchanged with age, whereas that of type II fibers was reduced ( P < 0.001). With age there was an increased MHC I ( P < 0.01) and re…
Effects of preoperative aquatic resistance training on knee pain, mobility limitation and muscle impairments in people with late-stage knee osteoarthritis
Combination of hormone replacement therapy and high physical activity is associated with differences in Achilles tendon size in monozygotic female twin pairs.
Estrogen concentration has been suggested to play a role in tendon abnormalities and injury. In physically active postmenopausal women, hormone replacement therapy (HRT) has been suggested to decrease tendon diameter. We hypothesized that HRT use and physical activity are associated with Achilles tendon size and tissue structure. The study applied cotwin analysis of fourteen 54- to 62-yr-old identical female twin pairs with current discordance for HRT use for an average of 7 yr. Achilles tendon thickness and cross-sectional areas were determined by ultrasonography, and tendon structural organization was analyzed from the images using linear discriminant analysis (LDA). Maximal voluntary and…
S285 EFFECT OF COMPREHENSIVE GERIATRIC ASSESSMENT AND INDIVIDUALIZED INTERVENTION ON MOBILITY AMONG OLDER PERSONS WITH AND WITHOUT PAIN
Balance confidence and functional balance are associated with physical disability after hip fracture.
Abstract Background This cross-sectional study investigated the associations between balance confidence, functional balance, and physical disability among older people after hip fracture. Material and methods The study utilizes baseline data of two randomized controlled trials (ISRCTN34271567 and ISRCTN53680197). The participants were 159 community-dwelling over 60-year-old people. Health, fracture status, the date and type of surgery, and contraindications for participation were assessed in a clinical examination. Balance confidence was assessed by the Activities-specific Balance Confidence Scale (ABC) and functional balance by the Berg Balance Scale. Physical disability was assessed by a …
Birth Size and Childhood Growth as Determinants of Physical Functioning in Older Age: The Helsinki Birth Cohort Study
The study reports on the associations of infant and childhood anthropometric measurements, early growth, and the combined effect of birth weight and childhood body mass index with older age physical functioning among 1,999 individuals born in 1934–1944 and belonging to the Helsinki Birth Cohort Study. Physical functioning was assessed by the Short Form 36 scale. Anthropometric data from infancy and childhood were retrieved from medical records. The risk of lower Short Form 36 physical functioning at the mean age of 61.6 years was increased for those with birth weight less than 2.5 kg compared with those weighing 3.0–3.5 kg at birth (odds ratio (OR) = 2.73, 95% confidence interval (CI): 1.57…
Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women
The separate effects of 18 weeks of intensive strength and endurance training on isometric knee extension (KE) and flexion (KF) strength and walking speed were studied in 76- to 78- year-old women. Maximal voluntary isometric force for both KE and KF was measured in a sitting position on a custom-made dynamometer chair at a knee angle of 60 degrees from full extension. Maximal walking speed was measured over a distance of 10 m. The endurance-trained women increased KE torque and KE torque/body mass after the first 9 weeks of training when compared with the controls. when comparing the baseline, 9 week and 18 week measurements within the groups separately, both the endurance- and strength-tr…
Body Fat and Mobility Are Explained by Common Genetic and Environmental Influences in Older Women
In older adults, mobility limitations often coexist with overweight or obesity, suggesting that similar factors may underlie both traits. This study examined the extent to which genetic and environmental influences explain the association between adiposity and mobility in older women. Body fat percentage (bioimpedance test), walking speed over 10 m, and distance walked in a 6-min test were evaluated in 92 monozygotic (MZ) and 104 dizygotic (DZ) pairs of twin sisters reared together, aged 63-76 years. Genetic and environmental influences on each trait were estimated using age-adjusted multivariate genetic modeling. The analyses showed that the means (and s.d.) for body fat percentage, walkin…
Plantarflexor Muscle-Tendon Properties are Associated With Mobility in Healthy Older Adults
BACKGROUND: Muscle mass, strength, and power are known determinants of mobility in older adults but there is limited knowledge on the influence of muscle architecture or tendon properties on mobility. The purpose of this study was to examine the relationship between mobility and plantarflexor muscle-tendon properties in healthy older adults.METHODS: A total of 52 subjects (age 70-81 years) were measured for 6-minute walk test (6MWT), timed "up and go"-test (TUG), isometric plantarflexion strength, Achilles tendon stiffness, triceps surae muscle architecture, lower extremity lean mass, isometric leg extension strength, and leg extension power. Partial correlations and multivariate regression…
Long-term Leisure-time Physical Activity and Serum Metabolome
Background— Long-term physical inactivity seems to cause many health problems. We studied whether persistent physical activity compared with inactivity has a global effect on serum metabolome toward reduced cardiometabolic disease risk. Methods and Results— Sixteen same-sex twin pairs (mean age, 60 years) were selected from a cohort of twin pairs on the basis of their >30-year discordance for physical activity. Persistently (≥5 years) active and inactive groups in 3 population-based cohorts (mean ages, 31–52 years) were also studied (1037 age- and sex-matched pairs). Serum metabolome was quantified by nuclear magnetic resonance spectroscopy. We used permutation analysis to estimate the …
Physical activity compensates for increased mortality risk among oder people with poor muscle strength
The aim of the study was to determine whether habitual physical activity can compensate for the increased mortality risk among older people with poor muscle strength. Mortality was followed up for 10 years after laboratory examination in 558 community dwelling 75- and 80-year-old men and women. Maximal isometric strength of five muscle groups was measured and tertile cut-off points were used to categorize participants. Participants, who reported moderate physical activity for at least 4 h a week, were categorized as physically active and the others as sedentary. High muscle strength and physical activity both protected from mortality, but their effect was not additive. Within each muscle st…
Accelerometer-measured and self-reported physical activity in relation to extraversion and neuroticism: a cross-sectional analysis of two studies
Background Personality reflects relatively stable and pervasive tendencies in feeling, thinking and behaving. While previous studies have found higher extraversion and lower neuroticism to be linked to higher self-reported physical activity levels, larger studies using accelerometer-measured physical activity are lacking. This study investigated the cross-sectional associations of extraversion and neuroticism with both accelerometer-measured and self-reported physical activity and the role of these personality traits in possible discrepancies between these two measures of physical activity among Finnish adults. Methods Two community-dwelling samples were used in this study: a) 47–55-yr-old …
Global gene expression profiles in skeletal muscle of monozygotic female twins discordant for hormone replacement therapy
Summary Aging is accompanied by inexorable loss of muscle tissue. One of the underlying causes for this is the massive change in the hormonal milieu of the body. The role of a female sex steroid – estrogen – in these processes is frequently neglected, although the rapid decline in its production coincides with a steep deterioration in muscle performance. We recruited 54- to 62-year-old monozygotic female twin pairs discordant for postmenopausal hormone replacement therapy (HRT, n = 11 pairs; HRT use 7.3 ± 3.7 years) from the Finnish Twin Cohort to investigate the association of long-term, estrogen-based HRT with skeletal muscle transcriptome. Pathway analysis of muscle transcript profiles r…
Early adulthood and current physical activity and their association with symptoms of pelvic floor disorders in middle-aged women : an observational study with retrospective physical activity assessment
Objective To investigate associations of early and middle adulthood physical activity (PA) with symptoms of pelvic floor disorders (PFD), i.e., stress urinary incontinence (SUI), urge urinary incontinence (UUI), fecal incontinence (FI), constipation or defecation difficulties (CDD), and feeling of pelvic organ prolapse (POP) among middle-aged women. Design A cross-sectional, observational study with retrospective PA assessment. Setting University Research Laboratory. Sample A random population sample of 1098 47-to-55-year-old Finnish women. Methods Early adulthood PA, current PA, and demographical and gynaecological variables were assessed using self-report questionnaires. Logistic regressi…
Power training and postmenopausal hormone therapy affect transcriptional control of specific co-regulated gene clusters in skeletal muscle
At the moment, there is no clear molecular explanation for the steeper decline in muscle performance after menopause or the mechanisms of counteractive treatments. The goal of this genome-wide study was to identify the genes and gene clusters through which power training (PT) comprising jumping activities or estrogen containing hormone replacement therapy (HRT) may affect skeletal muscle properties after menopause. We used musculus vastus lateralis samples from early stage postmenopausal (50–57 years old) women participating in a yearlong randomized double-blind placebo-controlled trial with PT and HRT interventions. Using microarray platform with over 24,000 probes, we identified 665 diffe…
Slower Walking Speed in Older Men Improves Triceps Surae Force Generation Ability
Purpose \ud Older adults walk slower than young adults, but it is not known why. Previous research suggests that ankle plantarflexors may have a crucial role in the reduction of walking speed. The purpose of this study was to investigate age-related differences in triceps surae muscle–tendon function during walking to further investigate the role of plantarflexors in the age-related reduction of walking speed.\ud \ud Methods \ud Medial gastrocnemius and soleus muscle fascicle lengths were measured using ultrasound imaging during walking from 13 young (25 ± 4 yr) men at preferred walking speed and from 13 older (73 ± 5 yr) men at preferred speed and at the young men’s preferred speed. Muscle…
Menopause modulates the circulating metabolome: evidence from a prospective cohort study
Abstract Aims We studied the changes in the circulating metabolome and their relation to the menopausal hormonal shift in 17β-oestradiol and follicle-stimulating hormone levels among women transitioning from perimenopause to early postmenopause. Methods and results We analysed longitudinal data from 218 Finnish women, 35 of whom started menopausal hormone therapy during the study. The menopausal transition was monitored with menstrual diaries and serum hormone measurements. The median follow-up was 14 months (interquartile range: 8–20). Serum metabolites were quantified with targeted nuclear magnetic resonance metabolomics. The model results were adjusted for age, follow-up duration, educat…
supplement_material – Supplemental material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial
Supplemental material, supplement_material for Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial by Katri M Turunen, Laura Aaltonen-Määttä, Timo Törmäkangas, Timo Rantalainen, Erja Portegijs, Sirkka Keikkala, Marja-Liisa Kinnunen, Taija Finni, Sarianna Sipilä and Riku Nikander in Clinical Rehabilitation
The role of personality traits in leisure time physical activity during COVID-19 pandemic
The COVID-19 pandemic has affected everyday life, including physical activity behavior. This study examined the role of the five factor model of personality traits on leisure time physical activity during the pandemic in a sample (n=168) of 61 year-old Finnish men and women, participating in a larger longitudinal study, between April 2020 and April 2021. Frequency of participation and changes in leisure time physical activity were self-reported. Personality traits and facets were assessed with the 181-item NEO-PI. Openness was the only factor positively associated with leisure time physical activity frequency. Participants scoring higher in extraversion (particularly the activity-facet) and…
Motivational characteristics and resistance training in older adults: A randomized controlled trial and 1-year follow-up
The aim of this study was to investigate the effects of a 9‐month supervised resistance training intervention on motivational and volitional characteristics related to exercise, and whether the absolute level and/or intervention‐induced change in these characteristics predict self‐directed continuation of resistance training 1 year after the intervention. Community dwelling older adults aged 65‐75, who did not fulfill physical activity recommendations, were randomized into resistance training intervention groups: training once‐ (n = 26), twice‐ (n = 27), three‐times‐a‐week (n = 28) or non‐training control group (n = 25). Training groups participated in supervised resistance training for 9 m…
Ultrasound imaging of the quadriceps muscle in elderly athletes and untrained men.
Ultrasound (US) technique was applied to measure the thickness, cross-sectional area (CSA), and internal structure of the quadriceps muscle in 70- to 80-year-old endurance and power athletes and untrained men. Isometric knee extension strength was higher in the power athletes than in the other groups. The mean values for thickness and CSA did not differ between the athletes and the untrained men. The intensity of the intramuscular echo was, however, lower and the echo reflected from the connective tissue septa and bone was higher in the athletes than in the untrained men. Both the CSA and internal structure of the muscle group correlated significantly with muscle strength and number of trai…
Maximal voluntary isokinetic knee flexion torque is associated with femoral shaft bone strength indices in knee replacement patients.
It is currently unknown whether knee replacement-associated bone loss is modified by rehabilitation programs. Thus, a sample of 45 (18 men and 25 women) persons with unilateral knee replacement were recruited; age 66 years (sd 6), height 169 cm (sd 8), body mass 83 kg (sd 15), time since operation 10 months (sd 4) to explore the associations between maximal torque/power in knee extension/flexion and femoral mid-shaft bone traits (Cortical cross-sectional area (CoA, mm(2)), cortical volumetric bone mineral density (CoD, mg/mm(3)) and bone bending strength index (SSI, mm(3))). Bone traits were calculated from a single computed tomography slice from the femoral mid-shaft. Pain in the operated …
Efficacy of progressive aquatic resistance training for tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis : a randomised controlled trial
Objective: To study the efficacy of aquatic resistance training on biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA). Design: Eighty seven volunteer postmenopausal women, aged 60-68 years, with mild knee OA (Kellgren-Lawrence grades I/II and knee pain) were recruited and randomly assigned to an intervention (n = 43) and control (n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessions over 16 weeks while the control group maintained usual level of physical activity. The biochemical composition of the medial and lateral tibiofemoral cartilage was estimated using single-slice transverse …
Genetics of maximal walking speed and skeletal muscle characteristics in older women.
AbstractThe aim of this study was to examine whether maximal walking speed, maximal isometric muscle strength, leg extensor power and lower leg muscle cross-sectional area (CSA) shared a genetic effect in common. In addition, we wanted to identify the chromosomal areas linked to maximal walking speed and these muscle characteristics and also investigate whether maximal walking speed and these three skeletal muscle characteristics are regulated by the same chromosomal areas. We studied 217 monozygotic (MZ) and dizygotic (DZ) female twin pairs aged 66 to 75 years in the Finnish Twin Study on Aging study. The DZ pairs (94) were genotyped for 397 microsatellite markers in 22 autosomes and X-chr…
Identification of Older People at Risk of ADL Disability Using the Life-Space Assessment : A Longitudinal Cohort Study
Abstract Objectives Life-space mobility, assessed with the Life-Space Assessment (LSA), reflects an individual's mobility in terms of the spatial area, frequency, and need for assistance. The aims were to study associations between life-space mobility and disability status in activities of daily living (ADL), and to define cutoff scores for baseline LSA and LSA change over time identifying individuals who developed ADL inability during 2 years of follow-up. Robustness of the cutoff scores was tested accounting for potential confounders. Design Longitudinal analyses of the “Life-space mobility in old age” cohort study. Setting Home-based interviews at baseline and phone interviews 2 years la…
Menopausal symptoms and cardiometabolic risk factors in middle-aged women : A cross-sectional and longitudinal study with 4-year follow-up
Objective To study associations of menopausal symptoms with cardiometabolic risk factors. Study design A cross-sectional and longitudinal study of a representative population sample of 1393 women aged 47–55 years with a sub-sample of 298 followed for four years. The numbers of vasomotor, psychological, somatic or pain, and urogenital menopausal symptoms were ascertained at baseline through self-report. Their associations with cardiometabolic risk factors were studied using linear regression and linear mixed-effect models. Models were adjusted for age, menopausal status, body mass index, the use of hormonal preparations, education, smoking, and alcohol consumption. Main outcome measures Card…
Longitudinal changes in genetic and environmental influences on older women's walking ability
This study examined the stability and change over time in genetic and environmental influences on walking ability among older women. Maximal walking speed over 10 m and 6-min walking endurance test were measured under standard conditions at baseline and 3 years later. At both times, 63 monozygotic (MZ) and 67 dizygotic (DZ) twin pairs were measured for walking speed and 58 MZ and 56 DZ pairs for walking endurance. Participants were twin sisters reared together and aged 63-75 years at baseline. Genetic and environmental influences were examined using longitudinal genetic modelling. The results showed that walking speed was preserved from baseline to follow-up. Genetic influences on walking s…
Effects of an individually targeted multicomponent counseling and home-based rehabilitation program on physical activity and mobility in community-dwelling older people after discharge from hospital: a randomized controlled trial.
Objectives: The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital. Design: Randomized controlled trial. Setting: Home and community. Participants: Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention ( n = 59) or a control (standard care, n = 58) group. Intervention: The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive hom…
The effect of hormone replacement therapy and/or exercise on skeletal muscle attenuation in postmenopausal women: a yearlong intervention
Hormone replacement therapy (HRT) has been reported to exert a positive effect on preserving muscle strength following the menopause, however, the mechanism of action remains unclear. We examined whether the mechanism involved preservation of muscle composition as determined by skeletal muscle attenuation. Eighty women aged 50-57 years were randomly assigned to either: HRT, exercise (Ex), HRT + exercise (ExHRT), and control (Co) for 1 year. The study was double-blinded with subjects receiving oestradiol and norethisterone acetate (Kliogest) or placebo. Exercise included progressive high-impact training for the lower limbs. Skeletal muscle attenuation in Hounsfield units (HU) was determined …
Estrogenic regulation of skeletal muscle proteome : a study of premenopausal women and postmenopausal MZ cotwins discordant for hormonal therapy
Female middle age is characterized by a decline in skeletal muscle mass and performance, predisposing women to sarcopenia, functional limitations, and metabolic dysfunction as they age. Menopausal loss of ovarian function leading to low circulating level of 17b-estradiol has been suggested as a contributing factor to aging-related muscle deterioration. However, the underlying molecular mechanisms remain largely unknown and thus far androgens have been considered as a major anabolic hormone for skeletal muscle. We utilized muscle samples from 24 pre- and postmenopausal women to establish proteome-wide profiles, associated with the difference in age (30–34 years old vs. 54– 62 years old), men…
Influence of long-term postmenopausal hormone-replacement therapy on estimated structural bone strength: A study in discordant monozygotic twins
Although postmenopausal hormone-replacement therapy (HRT) is known to prevent fractures, knowledge on the influence of long-term HRT on bone strength and its determinants other than areal bone mineral density is scarce. This study used a genetically controlled design with 24 monozygotic female twin pairs aged 54 to 72 years in which one cotwin was using HRT (mean duration 8 years) and the other had never used HRT. Estimated bone strength, cross-sectional area, volumetric bone mineral density, bone mineral mass, and cross-sectional density and mass distributions were assessed in the tibial shaft, distal tibia, and distal radius with peripheral computed tomography (pQCT). In the tibial shaft,…
Accelerometer-assessed sedentary work, leisure time and cardio-metabolic biomarkers during one year : Effectiveness of a cluster randomized controlled trial in parents with a sedentary occupation and young children
BackgroundIt is unknown whether reducing sedentary time at work and during leisure time is possible and effective during one year.MethodsOffice workers with young children were recruited for this one-year cluster-randomized controlled trial through kindergartens and primary schools from 7 clusters in the city of Jyväskylä, Finland. After a lecture, face-to-face tailored counseling was used to set contractually binding goals regarding reducing and breaking up sitting periods and increasing light intensity physical activity during work and leisure time. Primary outcomes of total, work and leisure sedentary time (ResultsParticipants from intervention (N = 71) and control (N = 62) regions were …
Circulating miR-21, miR-146a and Fas ligand respond to postmenopausal estrogen-based hormone replacement therapy--a study with monozygotic twin pairs.
Biological aging is associated with physiological deteriorations and its’ remodeling, which are partly due to changes in the hormonal profile. MicroRNAs are known to post-transcriptionally regulate various cellular processes associated with cell senescence; differentiation, replication and apoptosis. Measured from the serum, microRNAs have the potential to serve as noninvasive markers for diagnostics/prognostics and therapeutic targets. We analysed the association of estrogen-based hormone replacement therapy (HRT) with selected microRNAs and inflammation markers from the serum, leukocytes and muscle tissue biopsy samples obtained from 54-62 year-old postmenopausal monozygotic twins (n=11 p…
Effects of a Home-Based Physical Rehabilitation Program on Physical Disability After Hip Fracture: A Randomized Controlled Trial
Abstract Objective Fewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture. Design Randomized, controlled, parallel-group trial. Setting Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital. Participants Population-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups. Intervention The year-long intervent…
Influence of long-term postmenopausal hormone replacement therapy on estimated structural bone strength: A study in discordant monozygotic twins.
Although postmenopausal hormone-replacement therapy (HRT) is known to prevent fractures, knowledge on the influence of long-term HRT on bone strength and its determinants other than areal bone mineral density is scarce. This study used a genetically controlled design with 24 monozygotic female twin pairs aged 54 to 72 years in which one cotwin was using HRT (mean duration 8 years) and the other had never used HRT. Estimated bone strength, cross-sectional area, volumetric bone mineral density, bone mineral mass, and cross-sectional density and mass distributions were assessed in the tibial shaft, distal tibia, and distal radius with peripheral computed tomography (pQCT). In the tibial shaft,…
Menopausal Status and Physical Activity Are Independently Associated With Cardiovascular Risk Factors of Healthy Middle-Aged Women: Cross-Sectional and Longitudinal Evidence
Cardiovascular disease (CVD) is the primary cause of mortality in women in developed countries. CVD risk rises with age, yet for women there is a rapid increase in CVD risk that occurs after the onset of menopause. This observation suggests the presence of factors in the middle-aged women that accelerate the progression of CVD independent of chronological aging. Leisure time physical activity (LTPA) is a well-established protective factor against CVD. However, its role in attenuating atherogenic lipid profile changes and CVD risk in post-menopausal women has not been well-established. The present study is part of the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, a population-based…
Effect of 12-Month Supervised, Home-Based Physical Exercise on Functioning Among Persons With Signs of Frailty: A Randomized Controlled Trial
To investigate the effects of a 12-month home-based exercise program on functioning and falls among persons with signs of frailty.A randomized controlled trial with a 1:1 allocation.Home-based.Home-dwelling persons aged 65 years or older meeting at least 1 frailty phenotype criteria (N=300). The mean age of the participants was 82.2±6.3 years, 75% were women, 61% met 1-2 frailty criteria, and 39% met ≥3 criteria.A 12-month, individually tailored, progressive, and physiotherapist-supervised physical exercise twice a week (n=150) vs usual care (n=149).FIM, Short Physical Performance Battery (SPPB), handgrip strength, instrumental activities of daily living (IADL), and self-reported falls and …
Effects of progressive resistance training on physical disability among older community-dwelling people with history of hip fracture
Background and aims: Hip fracture is a common trauma in older people, and often leads to decreased muscle strength and increased physical disability. This randomized controlled trial examined whether three months of progressive resistance training (PRT) can reduce physical disability among older people with a history of hip fracture. Methods: A population-based sample of 60-85-year-old community-dwelling persons, with hip fractures sustained on average three years earlier, were enrolled in the study. Of 78 people participating in laboratory assessments, those without contraindications for participation in resistance training were randomly assigned to a training group (TG, n=22) or a control…
Physical inactivity and pain in older men and women with hip fracture history
Hip fracture patients often suffer from pain for several months after surgery. This may lead to physical inactivity and subsequent mobility limitation and disability. The purpose of this study was to investigate the association between severe musculoskeletal pain and the level of physical activity in older people with a history of hip fracture. Data were collected from 60- to 85-year-old (n = 78) community-dwelling people, 0.7–7.5 years after hip fracture. Physical activity was assessed with the Yale Physical Activity Survey (YPAS). According to the YPAS summary index distribution, the participants were divided into the physically inactive and physically active groups. Musculoskeletal pain …
Age-related differences in Achilles tendon properties and triceps surae muscle architecture in vivo
This study examined the concurrent age-related differences in muscle and tendon structure and properties. Achilles tendon morphology and mechanical properties and triceps surae muscle architecture were measured from 100 subjects [33 young (24 ± 2 yr) and 67 old (75 ± 3 yr)]. Motion analysis-assisted ultrasonography was used to determine tendon stiffness, Young's modulus, and hysteresis during isometric ramp contractions. Ultrasonography was used to measure muscle architectural features and size and tendon cross-sectional area. Older participants had 17% lower ( P < 0.01) Achilles tendon stiffness and 32% lower ( P < 0.001) Young's modulus than young participants. Tendon cross-section…
Balance Confidence Was Associated With Mobility and Balance Performance in Older People With Fall-Related Hip Fracture: A Cross-Sectional Study
Abstract Portegijs E, Edgren J, Salpakoski A, Kallinen M, Rantanen T, Alen M, Kiviranta I, Sihvonen S, Sipila S. Balance confidence was associated with mobility and balance performance in older people with fall-related hip fracture: a cross-sectional study. Objective To study the relationship between balance confidence, a concept closely related to fear of falling, mobility and balance performance, and perceived mobility limitation in older people after a fall-related hip fracture. Design Cross-sectional analyses of pretrial data of 2 randomized controlled trials of physical rehabilitation. Setting University research center. Participants Community-dwelling people aged over 60 years, 6 week…
Motor speed and lower extremity strength as predictors of fall-related bone fractures in elderly individuals.
Background and aims: The purpose of this prospective population-based study was to examine the combined effects of motor speed and knee extension strength on risk of fall-related bone fractures in elderly individuals over a 10-year period. Methods: Participants were 307 men and women aged 75 or 80 years at baseline, who visited the research laboratory at the University of Jyvaskyla, Finland. Multi-choice motor speed tests and maximal isometric knee extension strength tests were carried out at baseline. Information on fractures was collected from hospital and health center records. The presence of impairment was defined as a score in the lowest tertile of sex- and age-stratified distribution…
Note: Critical Factors in Opening Pharmaceutical Packages: a Usability Study among Healthcare Workers, Women with Rheumatoid Arthritis and Elderly Women
This cross-sectional study compared the usability of pharmaceutical packages to determine the critical factors involved in packages with different opening mechanisms. Four packaging types (a bottle with a screw cap, a box with a pill plate, disposable plastic droppers with a container and a jar with a hinge cap) were evaluated by 45 women (nurses, older women and women with rheumatoid arthritis). Usability was evaluated for subjective measures related to the ease of opening and for objective measures related to the time needed to open the packaging, electrical muscular activity (electromyography, EMG) and ranges of motion of the upper extremities. Of the arthritic women, 13% were unable to …
Physical Activity and Nutrition INfluences In ageing (PANINI): consortium mission statement
First paragraph: Current demographic trends indicate that by the year 2020, almost one in five of the European population will be aged 65 years or over. Although life expectancy is increasing by 2 years per decade, the period of life spent in good health is not keeping pace and most Europeans spend their last decade in poor health. Consequently, there is an urgent need to understand how lifestyle factors can influence age-related changes from gene to society level and how they may be integrated into a net effect of healthy ageing. It is also crucial to develop and validate interventions and health policies to ensure that more of our older adults have a healthy and active later life. This is…
Ikääntyvien kuntoutujien fyysinen aktiivisuus ja paikallaanolo laitoskuntoutusjakson aikana
Fyysinen aktiivisuus on tärkeää sairauksista, vammoista tai heikentyneestä elämänhallinnasta kuntoutuessa ja ylläpidettäessä saavutettuja kuntoutumistuloksia. Tämän tutkimuksen tarkoituksena oli kuvata ikääntyvien kuntoutujien fyysistä aktiivisuutta ja paikallaanoloa kuntoutuslaitoksessa. Tutkimus toteutettiin työkykyä ylläpitävän ja parantavan valmennuksen ja sydänkuntoutuksen kursseilla. Tutkimukseen osallistui 19 keskimäärin 57-vuotiasta miestä ja naista, joiden fyysistä aktiivisuutta ja paikallaanolo aikaa mitattiin kiihtyvyysanturilla viiden kuntoutuspäivän aikana. Tulokset osoittivat, että kuntoutujat olivat liikkumatta suurimman osan hereillä oloajasta. Toisaalta kuntoutujille kerty…
Effects of a multicomponent home-based physical rehabilitation program on mobility recovery after hip fracture: a randomized controlled trial.
To investigate whether a home-based rehabilitation program for community-dwelling older people with recent hip fracture is more effective than standard care in improving mobility recovery and reducing disability.Randomized, controlled, parallel-group trial.Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital.Clinical population of community-dwelling men and women (aged 60+) recovering from hip fracture. Participants were randomly assigned into control (n = 41) or intervention (n = 40) groups on average 42 ± 23 days after discharge home.A yearlong multicomponent home-based rehabilitation aimed at promoting mobility recovery and physical functi…
Genetic influences on adult body mass index followed over 29 years and their effects on late-life mobility: a study of twin sisters.
Background: The rise in body mass index (BMI) during adulthood increases the risk for metabolic disorders, functional limitations and disability in old age. This twin study examined prospectively whether genetic and environmental influences on women’s BMI also account for mobility 29 years later. Methods: The sample consisted of 103 monozygotic and 114 dizygotic pairs of twin sisters reared together. Body mass index was initially evaluated in 1975, when the women were aged 42.6±3.4 years, and was followed-up in 1981, 1990, 2001 and 2004. Mobility was evaluated using the standardised 6-minute walking test in 2001, when the women were aged 68.6±3.2 years, and followed-up 3 years later. An inv…
Muscle performance, sex hormones and training in peri-menopausal and post-menopausal women
Age-related deterioration in muscle performance is one of the major reasons for decreased functional capacity and disability in older people. In women, impaired muscle performance has already been observed during peri-menopause in concert with rapid and dramatic decrease in ovarian hormone production. This observation suggests that female sex steroids may have an important role among other agents in regulating muscle performance in middle-aged and older women. Previous experimental studies have shown that hormone replacement therapy (HRT) and intensive physical training have positive effects on muscle force and explosive power in healthy post-menopausal women. Hormone replacement therapy in…
Associations of neuroticism with falls in older adults : do psychological factors mediate the association?
OBJECTIVES Neuroticism predicts falls in older people. In addition, concern about falling and depressive symptoms are associated with fall risk. This study examined whether concern about falling and depressive symptoms mediate the association between neuroticism and falls. METHOD Cross-sectional data on 314 community-dwelling people aged 70–85 years were utilized. Neuroticism was assessed with a short modified form of the Eysenck Personality Inventory. Indoor and outdoor falls during the past year were self-reported. Concern about falling was assessed with the Falls Efficacy Scale-International and depressive symptoms with the Geriatric Depression Scale-15. Path modeling was used to examine…
Leg extension power asymmetry and mobility limitation in healthy older women
Objective To investigate the association of asymmetry in leg extension power (LEP) with walking and standing balance. Design Cross-sectional analysis. Setting Research laboratory. Participants Healthy female twins (N=419), ages 63 to 75 years. Interventions Not applicable. Main Outcome Measures The LEP difference between the stronger and the weaker leg, measured with the Nottingham power rig, was calculated. Ten-meter maximal walking velocity was assessed in a laboratory corridor on a wide (170cm) and narrow (35cm) track, and the ability to maintain tandem stance for 20 seconds was recorded. Results The mean LEP difference ± standard deviation between the legs was 15%±9% (P<.001). Those wit…
Muscle function in monozygotic female twin pairs discordant for hormone replacement therapy
Introduction: Postmenopausal monozygotic twin pairs discordant for hormone replacement therapy (HRT) provide an advantageous study design controlling for genetic background for elucidating the relationships between aging, sex hormone levels, muscle strength, contractile capacity, and fatigability. Methods: Thirteen postmenopausal monozygotic twin pairs discordant for HRT were measured for maximal voluntary torque (MVC) and twitch characteristics using electrical stimulation before and after intermittent dynamic plantarflexor exercise until exhaustion. Results: Peak twitch torque was 32% higher in HRT users than in their non-HRT, genetically identical sisters (P = 0.002), but MVC did not dif…
Effects of power training on mechanical efficiency in jumping.
The present study investigates the effects of power training on mechanical efficiency (ME) in jumping. Twenty-three subjects, including ten controls, volunteered for the study. The experimental group trained twice a week for 15 weeks performing various jumping exercises such as drop jumps, hurdle jumps, hopping and bouncing. In the maximal jumping test, the take-off velocity increased from 2.56 (0.24) m.s(-1) to 2.77 (0.18) m.s(-1) ( P<0.05). In the submaximal jumping of 50% of the maximum, energy expenditure decreased from 660 (110) to 502 (68) J.kg(-1).min(-1) ( P<0.001) while, simultaneously, ME increased from 37.2 (8.4)% to 47.4 (8.2)% ( P<0.001). Some muscle enzyme activities of the ga…
Poor vision accompanied with other sensory impairments as a predictor of falls in older women
Objectives:we studied visual acuity (VA) and co-existing hearing impairment and poor standing balance as predictors of falls. Design: prospective study with 1-year follow-up. Setting: research laboratory and residential environment. Participants: 428 women aged 63‐76 years from the Finnish Twin Study on Aging. Measurements: participants were followed up for incidence of falls over 1 year. VA, hearing ability and standing balance were assessed at the baseline. The incidence rate ratios (IRR) for falls were computed using the negative binomial regression model. Results: during the follow-up, 47% of participants experienced a fall. After adjusting for age and interdependence of twin sisters, p…
Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement.
Abstract Valtonen A, Poyhonen T, Sipila S, Heinonen A. Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement. Objective To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area. Design Randomized controlled trial. Setting Research laboratory and hospital rehabilitation pool. Participants Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial. Interventions Twelve-week progressive aquatic resistance training (n=26) or no intervention (n=24). Main Out…
Methodological considerations for studies in sport and exercise science with women as participants: a working guide for standards of practice for research on women
AbstractUntil recently, there has been less demand for and interest in female-specific sport and exercise science data. As a result, the vast majority of high-quality sport and exercise science data have been derived from studies with men as participants, which reduces the application of these data due to the known physiological differences between the sexes, specifically with regard to reproductive endocrinology. Furthermore, a shortage of specialist knowledge on female physiology in the sport science community, coupled with a reluctance to effectively adapt experimental designs to incorporate female-specific considerations, such as the menstrual cycle, hormonal contraceptive use, pregnanc…
Validity of a single question to assess habitual physical activity of community-dwelling older people
The aim is to determine concurrent validity of a single self-report habitual physical activity (PA) question against accelerometer-based PA and mobility variables, and corresponding changes in self-reported PA and mobility. Cross-sectional and longitudinal data of the "Life-space mobility in old age" (LISPE) cohort and its substudy on PA were utilized. At baseline, 848 community-dwelling, 75- to 90-year-old people living independently in central Finland participated in home-based interviews. One and 2 years later, 816 and 761 of them were reassessed by phone, respectively. Tri-axial accelerometer data over 7 days were collected following the baseline assessments in a subsample of 174. Self-…
Personality Traits and Changes in Health Behaviors and Depressive Symptoms during the COVID-19 Pandemic: A Longitudinal Analysis from Pre-pandemic to Onset and End of the Initial Emergency Conditions in Finland
The COVID-19 pandemic and social distancing measures targeting the transmission of the virus impacted everyday life in 2020. This study investigated pre- to in-pandemic changes in health behaviors and depressive symptoms during the COVID-19 pandemic and the role of personality traits in these changes in Finland. Data from a larger population-based cohort study of 51–59-year-old Finnish women were used (n = 358). Self-reported questionnaires gathered information about depressive symptoms, eating behavior, physical activity, and alcohol consumption before the pandemic time, at the onset, and at the end of the COVID-19 emergency conditions. Information about personality traits (extraversion an…
Lower-Limb Pain, Disease, and Injury Burden as Determinants of Muscle Strength Deficit After Hip Fracture
Background: Hip fracture may result in an asymmetrical lower-limb strength deficit. The deficit may be related to the trauma, surgical treatment, pain, or disuse of the fractured limb. However, disease and injury burden or musculoskeletal pain in the other limb may reduce muscle strength on that side, reducing the asymmetrical deficit. The aim of our study was to explore the asymmetrical strength deficit and to determine the potential underlying factors in patients from six months to seven years after a hip fracture. Methods: The asymmetrical deficit was calculated ([fractured limb/sum of both lower limbs] x 100%) for isometric knee extension torque, rate of force development during isometr…
Physical activity and health
Advances in Physiotherapy is an international scientific journal on physiotherapy. Its Volume 9 is published in this year. This current number is a special issue on Physical Activity and Health for...
Muscle and bone mass in middle‐aged women : role of menopausal status and physical activity
Background. Women experience drastic hormonal changes during midlife due to the menopausal transition. Menopausal hormonal changes are known to lead to bone loss and potentially also to loss of lean mass. The loss of muscle and bone tissue coincide due to the functional relationship and interaction between these tissues. If and how physical activity counteracts deterioration in muscle and bone during the menopausal transition remains partly unresolved. This study investigated differences between premenopausal, early perimenopausal, late perimenopausal, and postmenopausal women in appendicular lean mass (ALM), appendicular lean mass index (ALMI), femoral neck bone mineral density (BMD) and T…
Sense of coherence: effect on adherence and response to resistance training in older people with hip fracture history.
Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5–7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), …
Effects of strength and endurance training on muscle fibrecharacteristics in elderly women
The effects of 18 weeks' intensive strength and endurance training on fibre characteristics of the vastus lateralis muscle were studied in 76- to 78-year-old women. Type I and type IIa fibres constituted over 90% of the cell population and were almost equally represented. No changes were observed in the proportions of the different fibre types. When comparing the baseline and the 18-week measurements within the groups, the strength group showed a mean increase of 34% (P = 0.028) in mean type I fibre area. The frequency histograms showed an increased proportion of larger type I fibres after strength training and a decreased proportion of smaller type IIa fibres after endurance training. In t…
Genetic and Environmental Influence on Structural Strength of Weight-Bearing and Non-Weight-Bearing Bone: A Twin Study
A bivariate genetic analysis among 217 older female twin pairs showed that, although the structural strength of tibia and radius are mainly regulated by same genetic and environmental factors, the tibia is more affected by environment. Introduction: The habitual loading environment of the bone may modulate the relative contribution of genetic and environmental factors to bone structure. The purpose of this study was to estimate the contribution of the common and site-specific genetic and environmental factors to interindividual variation in compressive structural strength of the weight-bearing tibia and non–weight-bearing radius. Materials and Methods: pQCT scans were obtained from both mem…
Differential influence of peripheral and systemic sex steroids on skeletal muscle quality in pre- and postmenopausal women
Aging is associated with gradual decline of skeletal muscle strength and mass often leading to diminished muscle quality. This phenomenon is known as sarcopenia and affects about 30% of the over 60-year-old population. Androgens act as anabolic agents regulating muscle mass and improving muscle performance. The role of female sex steroids as well as the ability of skeletal muscle tissue to locally produce sex steroids has been less extensively studied. We show that despite the extensive systemic deficit of sex steroid hormones in postmenopausal compared to premenopausal women, the hormone content of skeletal muscle does not follow the same trend. In contrast to the systemic levels, muscle t…
Postmenopausal hormone replacement therapy modifies skeletal muscle composition and function: a study with monozygotic twin pairs
We investigated whether long-term hormone replacement therapy (HRT) is associated with mobility and lower limb muscle performance and composition in postmenopausal women. Fifteen 54- to 62-yr-old monozygotic female twin pairs discordant for HRT were recruited from the Finnish Twin Cohort. Habitual (HWS) and maximal (MWS) walking speeds over 10 m, thigh muscle composition, lower body muscle power assessed as vertical jumping height, and maximal isometric hand grip and knee extension strengths were measured. Intrapair differences (IPD%) with 95% confidence intervals (CI) were calculated. The mean duration of HRT use was 6.9 ± 4.1 yr. MWS was on average 7% (0.9 to 13.1%, P = 0.019) and muscle…
Balance Confidence and Functional Balance in Relation to Falls in Older Persons with Hip Fracture History
PURPOSE: To investigate whether self-assessed balance confidence and functional balance are associated with falls in older persons with hip fracture history. METHODS: This study is a part of a larger study on functional capacity and exercise rehabilitation in hip fracture patients. Seventy-nine patients, operated at the local hospital for collum or trochanter fracture within one-half to 7 years, participated in the laboratory measurements. Balance confidence was assessed with Activities-specific Balance Confidence scale (ABC) and functional balance using the Berg Balance Scale (BBS). According to self-reported number of falls during the previous 6 months participants were classified as thos…
Effects of physical and cognitive training on gait speed and cognition in older adults: A randomized controlled trial
Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12-month physical and cognitive training (PTCT) on gait speed, dual-task cost in gait speed, and executive functions (EFs) compared with physical training (PT) (ISRCTN52388040). Community-dwelling older adults, who did not meet physical activity recommendations, were recruited (n = 314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2-3 times weekly), and moderate aerobic activity 150 min/week in bouts of >10 min. PTCT included the…
Recovery of Lower Extremity Performance After Hip Fracture Depends on Prefracture and Postdischarge Mobility : A Subgroup Analysis of a Randomized Rehabilitation Trial
Total and regional body adiposity increases during menopause : evidence from a follow‐up study
For women, menopausal transition is a time of significant hormonal changes, which may contribute to altered body composition and regional adipose tissue accumulation. Excess adiposity, and especially adipose tissue accumulation in the central body region, increases women's risk of cardiovascular and metabolic conditions and affects physical functioning. We investigated the associations between menopausal progression and total and regional body adiposity measured with dual-energy X-ray absorptiometry and computed tomography in two longitudinal cohort studies of women aged 47–55 (n = 230 and 148, mean follow-up times 1.3 ± 0.7 and 3.9 ± 0.2 years, mean baseline BMI 25.5 kg/m2). We also examin…
Design and protocol of Estrogenic Regulation of Muscle Apoptosis (ERMA) study with 47 to 55-year-old women's cohort : novel results show menopause-related differences in blood count
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Perimenopausal women show modulation of excitatory and inhibitory neuromuscular mechanisms.
Background Menopausal transition exposes women to an early decline in muscle force and motor function. Changes in muscle quality and function, especially in lower limbs, are crucial, as they expose individuals to increased risk of falls. To elucidate some of the related neuromuscular mechanisms, we investigated cortical inhibition and peripheral muscle twitch force potentiation in women during the early and late stages of perimenopause. Methods Participants were 63 women aged 48–55 years categorized as early (EP, n = 25) or late (LP, n = 38) perimenopausal according to serum follicle-stimulating hormone (FSH) levels and menstrual diaries. EP women had an irregular menstrual cycle and FSH 2…
Leukocyte and Skeletal Muscle Telomere Length and Body Composition in Monozygotic Twin Pairs Discordant for Long-term Hormone Replacement Therapy
Estrogen-based hormone replacement therapy (HRT) may be associated with deceleration of cellular aging. We investigated whether long-term HRT has effects on leukocyte (LTL) or mean and minimum skeletal muscle telomere length (SMTL) in a design that controls for genotype and childhood environment. Associations between telomeres, body composition, and physical performance were also examined. Eleven monozygotic twin pairs (age 57.6 ± 1.8 years) discordant for HRT were studied. Mean duration of HRT use was 7.3 ± 3.7 years in the user sister, while their co-twins had never used HRT. LTL was measured by qPCR and SMTLs by southern blot. Body and muscle composition were estimated by bioimpedance an…
Design and protocol of Estrogenic Regulation of Muscle Apoptosis (ERMA) study with 47 to 55-year-old women's cohort : novel results show menopause-related differences in blood count
Objective: The multidisciplinary Estrogenic Regulation of Muscle Apoptosis (ERMA) study was designed to reveal how hormonal differences over the menopausal stages affect the physiological and psychological functioning of middle-aged women. This paper describes the protocol and nonrespondent analysis of ERMA and novel findings on menopausal differences in blood count variables and their association with female sex hormones. Methods: Women aged 47 to 55 years were assigned to pre, early peri, late peri, and postmenopausal groups based on follicle-stimulating hormone (FSH) and bleeding diary. Multivariate linear regression models were constructed to estimate the association of 17b-estradiol (E…
Long-term home-based physiotherapy for persons with signs of frailty–RCT (NCT02305433)
Introduction/Background Frailty is a multidimensional condition, which can lead to disability. To postpone long-term care, one alternative is home-based physiotherapy. We study the effects of a 12-month home-based physiotherapy program on functional capacity, and applying successive 12-month register follow-up, on the use and costs of social and health care services, and on the duration of living at home during 24 months (the primary outcome). Here we report about feasibility of the intervention and baseline characteristics. Material and method Three hundred home-dwelling persons (>65 y) with signs of frailty were recruited by September, 2016. Frailty was screened by Morley's FRAIL question…
Endogenous Hormones, Muscle Strength, and Risk of Fall-Related Fractures in Older Women
Background. Among older people, fracture-causing fall often leads to health deterioration. The role of endogenous hormone status and muscle strength on fall-related fracture risk is unclear. This study investigates if, after adjustment for bone density, endogenous hormones and muscle strength would predict fall-related limb fracture incidence in older community-dwelling women followed-up over 10 years. Methods. As a part of a prospective population-based study, 187 75-year-old women were investigated. Serum estradiol, testosterone, sex hormone binding globulin, and dehydroepiandrosterone sulfate concentrations were analyzed, and isometric muscle strength and bone mineral density were assess…
Effects of Physical and Cognitive Training on Falls and Concern About Falling in Older Adults : Results From a Randomized Controlled Trial
Abstract Background The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Methods This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70–85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cogniti…
Counselling for physical activity, life-space mobility and falls prevention in old age (COSMOS): protocol of a randomised controlled trial.
IntroductionThe most promising way to promote active life years in old age is to promote regular participation in physical activity (PA). Maintaining lower extremity muscle function with good balance has been associated with fewer falls and the need of help from others. This article describes the design and intervention of a randomised controlled trial (RCT) investigating the effectiveness of a health and PA counselling programme on life-space mobility and falls rates in community-dwelling older adults at the Health Kiosk and/or Service Centre.Methods and analysisCommunity-dwelling men and women (n=450) aged 65 years and over with early phase mobility limitation will be recruited to a 24-mo…
Physical function and lean body mass as predictors of bone loss after hip fracture: a prospective follow-up study
Abstract Background: Predictors of bone deterioration after hip fracture have not been well characterized. The aim of this study was to examine the associations of physical function and lean body mass (LBM) with loss of bone density and strength in older people recovering from a hip fracture. Methods: A total of 81 over 60-year-old, community-dwelling men and women operated for a hip fracture participated in this 1-year prospective follow-up study. Distal tibia total volumetric bone mineral density (vBMDTOT, mg/cm³) and compressive strength index (BSI, g²/cm⁴) and mid-tibia cortical vBMD (vBMDCO, mg/cm³) and bending strength index (SSI, mm³) were assessed in both legs by peripheral quantita…
Differences in muscle and adipose tissue gene expression and cardio-metabolic risk factors in the members of physical activity discordant twin pairs
High physical activity/aerobic fitness predicts low morbidity and mortality. Our aim was to identify the most up-regulated gene sets related to long-term physical activity vs. inactivity in skeletal muscle and adipose tissues and to obtain further information about their link with cardio-metabolic risk factors. We studied ten same-sex twin pairs (age range 50-74 years) who had been discordant for leisure-time physical activity for 30 years. The examinations included biopsies from m. vastus lateralis and abdominal subcutaneous adipose tissue. RNA was analyzed with the genome-wide Illumina Human WG-6 v3.0 Expression BeadChip. For pathway analysis we used Gene Set Enrichment Analysis utilizing…
Role of Menopausal Transition and Physical Activity in Loss of Lean and Muscle Mass : A Follow-Up Study in Middle-Aged Finnish Women
In midlife, women experience hormonal changes due to menopausal transition. A decrease especially in estradiol has been hypothesized to cause loss of muscle mass. This study investigated the effect of menopausal transition on changes in lean and muscle mass, from the total body to the muscle fiber level, among 47–55-year-old women. Data were used from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, where 234 women were followed from perimenopause to early postmenopause. Hormone levels (estradiol and follicle stimulating hormone), total and regional body composition (dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) scans), physical activity level (self-reported…
The prevalence of malnutrition according to the new ESPEN definition in four diverse populations
© 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.Background & aims: Consensus on the definition of malnutrition has not yet been reached. Recently, The European Society for Clinical Nutrition and Metabolism (ESPEN) proposed a consensus definition of malnutrition. The aim of the present study was to describe the prevalence of malnutrition according to the ESPEN definition in four diverse populations. Methods: In total, 349 acutely ill middle-aged patients, 135 geriatric outpatients, 306 healthy old individuals and 179 healthy young individuals were included in the study. Subjects were screened for risk of malnutrition using the SNAQ. The ESPEN definition of maln…
Blood and skeletal muscle ageing determined by epigenetic clocks and their associations with physical activity and functioning
AbstractThe aim of this study was to investigate the correspondence of different biological ageing estimates (i.e. epigenetic age) in blood and muscle tissue and their associations with physical activity (PA), physical function and body composition. Two independent cohorts (N = 139 and N = 47) were included, whose age span covered adulthood (23–69 years). Whole blood and m. vastus lateralis samples were collected, and DNA methylation was analysed. Four different DNA methylation age (DNAmAge) estimates were calculated using genome-wide methylation data and publicly available online tools. A novel muscle-specific methylation age was estimated using the R-package ‘MEAT’. PA was measured with q…
Hormone replacement therapy enhances IGF-1 signaling in skeletal muscle by diminishing miR-182 and miR-233 expressions: A study on postmenopausal monozygotic twin pairs
MiRNAs are fine-tuning modifiers of skeletal muscle regulation, but knowledge of their hormonal control is lacking. We used a co-twin case–control study design, that is, monozygotic postmenopausal twin pairs discordant for estrogen-based hormone replacement therapy (HRT) to explore estrogen-dependent skeletal muscle regulation via miRNAs. MiRNA profiles were determined from vastus lateralis muscle of nine healthy 54–62- years-old monozygotic female twin pairs discordant for HRT (median 7 years). MCF-7 cells, human myoblast cultures and mouse muscle experiments were used to confirm estrogen’s causal role on the expression of specific miRNAs, their target mRNAs and proteins and finally the ac…
Effects of a Home‐Based Physical Rehabilitation Program on Tibial Bone Structure, Density, and Strength After Hip Fracture: A Secondary Analysis of a Randomized Controlled Trial
Abstract Weight‐bearing physical activity may decrease or prevent bone deterioration after hip fracture. This study investigated the effects of a home‐based physical rehabilitation program on tibial bone traits in older hip fracture patients. A population‐based clinical sample of men and women operated for hip fracture (mean age 80 years, 78% women) was randomly assigned into an intervention (n = 40) and a standard care control group (n = 41) on average 10 weeks postfracture. The intervention group participated in a 12‐month home‐based rehabilitation intervention, including evaluation and modification of environmental hazards, guidance for safe walking, nonpharmacological pain management, m…