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Age-Related Changes in Motor Cortical Properties and Voluntary Activation of Skeletal Muscle
Brian C. Clark and Janet L. Taylor
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529329 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00001]
Motor Unit and Neuromuscular Junction Remodeling with Aging
Michael R. Deschenes
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529328 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00002]
Adaptations in Motor Unit Behavior in Elderly Adults
Minoru Shinohara
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529327 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00003]
Skeletal Muscle Protein Balance and Metabolism in the Elderly
Christopher S. Fry and Blake B. Rasmussen
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529326 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00004]
Age-Related Changes in Adult Muscle Morphology
Matthew C. Kostek and Matthew J. Delmonico
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529325 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00005]
Aging Changes in Satellite Cells and their Functions
Robert S. Hikida
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529324 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00006]
Cellular and Molecular Mechanisms of Apoptosis in Age-related MuscleAtrophy
Amie J. Dirks-Naylor and Shannon Lennon-Edwards
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529323 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00007]
The Endocrine System and Sarcopenia: Potential Therapeutic Benefits
Kevin L. McIntire and Andrew R. Hoffman
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529322 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00008]
Development of Physical Disability in Older Adults
Todd Manini
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529321 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00009]
Expression and Regulation of Excitation-Contraction Coupling Proteins in Aging Skeletal Muscle
Osvaldo Delbono
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529320 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00010]
The Impact of Old Age on Skeletal Muscle Energetics: Supply and Demand
David W. Russ and Ian R. Lanza
[Abstract] [FULL-TEXT INQUIRY] [PMID: 21529319 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00011]
The Effects of Age on Precision Pinch Force Control Across Five Days of Practice
Karen L. Francis, Priscilla G. MacRae, Waneen W. Spirduso and Tim Eakin
[Abstract] [Purchase Article] [PMID: 21762095 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00012]
Compensating, Controlling, Resigning and Accepting-Older Person’s Perception of Physical Decline
Anna Ekwall, Ingalill Rahm Hallberg and Jimmie Kristensson
[Abstract] [Purchase Article] [PMID: 21762094 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00013]
Effects of Tai Chi Exercise on Physical and Psychological Health of Older People
H. Blake and H. Hawley
[Abstract] [Purchase Article] [PMID: 21762093 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00014]
How Does the Treadmill Affect Gait in Parkinson’s Disease?
Olalla Bello and Miguel Fernandez-Del-Olmo
[Abstract] [Purchase Article] [PMID: 21762092 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00015]
Physical Activity and Urinary Incontinence in Older Adults: A Community-Based Study
Andy H. Lee and Fumi Hirayama
[Abstract] [Purchase Article] [PMID: 21762091 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00016]
The General Practitioner’s Role in Promoting Physical Activity to Older Adults: A Review Based on Program Theory
Timo Hinrichs and Michael Brach
[Abstract] [Purchase Article] [PMID: 21762090 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00017]
Imaging of Glucose Uptake During Walking in Elderly Adults
Hiroyuki Shimada
[Abstract] [Purchase Article] [PMID: 21762089 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00018]
Determinants of Meeting the Public Health Recommendations for Physical Activity among Community-Dwelling Elderly Japanese
Koichiro Oka and Ai Shibata
[Abstract] [Purchase Article] [PMID: 21762088 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00019]
Physical Activity and Sport in Advanced Age: Is it Risky? – A Summary of Data from Articles Published Between 2000-2009
Ayelet Dunsky and Yael Netz
[Abstract] [Purchase Article] [PMID: 21762087 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00020]
Knee Osteoarthritis and Exercise Adherence: A Review
Ray Marks
[Abstract] [Purchase Article] [PMID: 21762086 PubMed - indexed for MEDLINE]
[BSP/CAS/E-Pub/00021]
Editorial: Physical Activity, Exercise and Aging
Yolanda Escalante and Jose M. Saavedra
[Purchase Article] [PMID: 21834790 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00022]
Two Age-Related Accumulation Profiles of Toxic Metals
Hiroshi Yasuda, Kazuya Yoshida, Yuichi Yasuda and Toyoharu Tsutsui
[Abstract] [Purchase Article] [PMID: 21834789 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00023]
Mini-Mental Parkinson (MMP) as a Dementia Screening Test: Comparison with the Mini-Mental State Examination (MMSE)
A.J. Larner
[Abstract] [Purchase Article] [PMID: 21834788 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00024]
Longevity Pathways: HSF1 and FoxO Pathways, a New Therapeutic Target to Prevent Age-Related Diseases
Felipe P. Perez, Syed S. Moinuddin, Qurrat ul ain Shamim, Dennis J. Joseph, Jorge Morisaki and Ximing Zhou
[Abstract] [Purchase Article] [PMID: 21834787 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00025]
Epidermal Cell Proliferation in Calorie-Restricted Aging Rats
Tapan K. Bhattacharyya, Paula Jackson, Minu K. Patel and J. Regan Thomas
[Abstract] [Purchase Article] [PMID: 21834786 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00026]
Influence of Essential Trace Minerals and Micronutrient Insufficiencies on Harmful Metal Overload in a Mongolian Patient with Multiple Sclerosis
Fumio Komatsu, Yasuo Kagawa, Terue Kawabata, Yoshinori Kaneko, Hideki Kudoh, Baatar Purvee, Jugder Otgon and Ulziiburen Chimedregzen
[Abstract] [Purchase Article] [PMID: 21834785 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00027]
Cognition in Non-Demented Diabetic Older Adults
Sirisha Nandipati, Xiaodong Luo, Corbett Schimming, Hillel T. Grossman and Mary Sano
[Abstract] [Purchase Article] [PMID: 22023096 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00028]
Abstracts
Age-Related Changes in Motor Cortical Properties and Voluntary Activation of Skeletal Muscle
Brian C. Clark and Janet L. Taylor
[FULL-TEXT INQUIRY] [PMID: 21529329 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00001]
Aging is associated with dramatic reductions in muscle strength and motor control, and many of these age related changes in muscle function result from adaptations in the central nervous system. Aging is associated with widespread qualitative and quantitative changes of the motor cortex. For example, advancing age has been suggested to result in cortical atrophy, reduced cortical excitability, reduced cortical plasticity, as well as neurochemical abnormalities. The associated functional effects of these changes likely influence numerous aspects of muscle performance such as muscle strength and motor control. For example, there is evidence to suggest that the muscle weakness associated with aging is partially due to impairments in the nervous system’s ability to fully activate motor neurons- particularly in the larger proximal muscle groups. In this review article we discuss age-related changes in the motor cortex, as well as the ability or lack thereof- of older adults to voluntarily activate skeletal muscle. We also provide perspectives on scientific and clinical questions that need to be addressed in the near future.
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Motor Unit and Neuromuscular Junction Remodeling with Aging
Michael R. Deschenes
[FULL-TEXT INQUIRY] [PMID: 21529328 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00002]
The neuromuscular system is one of the largest and most vital organ systems of the body. The function and mass of the neuromuscular system gradually deteriorate during the natural process of aging. The neuromuscular system is comprised of individual motor units, each of which features a single motor neuron and all the muscle fibers it innervates. Motor units also demonstrate age-related remodeling such as reduced number, muscle fiber atrophy, but an increased number of fibers per motor unit. Enabling communication between motor neurons and the muscle fibers they innervate is a specialized synapse known as the neuromuscular junction. Aging, too, elicits remodeling of this synapse joining motor nerve terminal endings with a small (< 0.1%) area of the muscle fiber’s surface called the endplate. Aged neuromuscular junctions exhibit elevations in pre-synaptic nerve terminal branching, and in the post-synaptic distribution of receptor sites for neurotransmitter. This anatomical remodeling is coupled with age-related neurophysiological alterations including increased quantal content, with a more rapid rundown of endplate potential strength during continuous stimulation of the pre-synaptic neuron. Moreover, there is a growing body of evidence indicating that aging impacts the capacity of the NMJ to adapt to increased, as well as decreased physical activity. Because of the marked increase in the number of people considered to be aged in industrialized countries, it is essential to expand our understanding of the influence of aging on the neuromuscular system, its constituent motor units, and the neuromuscular junctions which allow neural cells and muscle fibers to effectively work together.
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Adaptations in Motor Unit Behavior in Elderly Adults
Minoru Shinohara
[FULL-TEXT INQUIRY] [PMID: 21529327 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00003]
Alterations in motor unit behavior associated with aging deteriorate fine or gross motor performance. In human aging, the alterations depend on muscles and the habitual activity of each muscle. This paper will discuss the current knowledge on the adaptations in major aspects of motor unit behavior including recruitment order, mean and maximal discharge rate, synchronized discharges, oscillatory discharges, and discharge variability in elderly adults to identify unresolved problems. By considering studies on disuse in young adults and training in elderly adults, future research directions are proposed to help resolve the problems.
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Skeletal Muscle Protein Balance and Metabolism in the Elderly
Christopher S. Fry and Blake B. Rasmussen
[FULL-TEXT INQUIRY] [PMID: 21529326 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00004]
The loss of lean muscle mass occurring with advancing age is termed sarcopenia. This condition often leads to a concomitant loss of strength, increased frailty and risk of falls and an overall loss of functional independence in the elderly. Muscle protein metabolism is a dynamic process characterized by the balance between the synthesis and breakdown of muscle proteins. A disturbance of this equilibrium can lead to the loss of muscle mass, and a perturbation of muscle protein turnover with aging has been proposed to play a role in the development of sarcopenia. However, basal muscle protein synthesis and breakdown rates do not differ between young and old adults, which has led to the hypothesis that older adults are resistant to anabolic stimuli. In support of this hypothesis, older adults have either no response or a blunted response to nutrients, insulin and resistance exercise, and this anabolic resistance is likely a key factor in the loss of skeletal muscle mass with aging. Recent studies have investigated potential interventions to overcome this anabolic resistance. In particular, combining resistance exercise with essential amino acid supplementation restores the muscle protein anabolic response in older men. The novel rehabilitation technique of performing light resistance exercise during blood flow restriction was also successful in overcoming the anabolic resistance to exercise. Future research is needed to determine whether these novel interventions will be successful in preventing sarcopenia and improving muscle strength and function in older adults.
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Age-Related Changes in Adult Muscle Morphology
Matthew C. Kostek and Matthew J. Delmonico
[FULL-TEXT INQUIRY] [PMID: 21529325 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00005]
Skeletal muscle undergoes numerous morphological changes from early adulthood to old age including muscle size, configuration, and structure. This review discusses these changes, considers the limitations in interpreting studies, addresses the potential health implications, and describes some mechanisms and interventions to ameliorate aging-related changes in skeletal muscle. Discussion in each section focuses on measurement and analysis techniques of muscle morphology, limitations of human research, and the discussion uses animal work to support findings in humans. We examine the discrepancies in the study of fiber type distribution with age, and special emphasis is given to two topics: fiber-type distribution and intra- and intercellular fat. Finally, training adaptations and health implications are briefly discussed. The focus of the current review is the morphological changes that occur in skeletal muscle during the normal aging process, with emphasis on human studies.
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Aging Changes in Satellite Cells and their Functions
Robert S. Hikida
[FULL-TEXT INQUIRY] [PMID: 21529324 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00006]
Vertebrate skeletal muscle fibers have two traits that make them unique: the fibers are multinucleated and their nuclei are post-mitotic. The activity and mass of the muscles in the body make them susceptible to constant injury. When this occurs, myonuclei can be increased or replaced by the adult stem cells of muscle, satellite cells (SCs). These SCs are vital for normal growth, repair and regeneration. This review collates recent studies to determine the size of the nuclear domains and its change with activity. The relationship between the percent change in myonuclear number, cross-sectional
area, and myonuclear domain indicates that the nucleus generally maintains a highly regulated domain size in spite of large variations in fiber size. The SC divides to add nuclei for growth and repair, and the SC identification and number are discussed. It is concluded that SC number does not reflect a change in regenerative ability by the muscle. However, the SC number increases with changes in muscular activity, and any reduced number of satellite cells in the elderly does not appear to reflect a decline in reparative or regenerative ability. The effects of aging on SC function are reviewed, and the significance of the SC’s connective tissue environment is emphasized as being a major factor in the decrement of the SC’s ability to repair and regenerate the aging muscle. Therefore growth factors and cytokines in the connective tissue around the SC are major influences in the decline of SC function with age.
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Cellular and Molecular Mechanisms of Apoptosis in Age-related MuscleAtrophy
Amie J. Dirks-Naylor and Shannon Lennon-Edwards
[FULL-TEXT INQUIRY] [PMID: 21529323 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00007]
Age-related muscle atrophy is due to loss of muscle fibers as well as atrophy of the remaining fibers. Evidence shows that loss of myofibers may be, in part, due to apoptosis. Two major apoptotic pathways have been extensively studied which are the mitochondrion-mediated and receptor-mediated pathways. However, other pathways exist, such as the p53 pathway. To date, it is not completely clear what pathways are responsible for loss of fibers in age-related muscle atrophy. Evidence suggests that multiple pathways may play a role. In this review article the effects of aging on the mitochondrion-, receptor-, and p53-mediated apoptotic pathways in skeletal muscle are discussed.
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The Endocrine System and Sarcopenia: Potential Therapeutic Benefits
Kevin L. McIntire and Andrew R. Hoffman
[FULL-TEXT INQUIRY] [PMID: 21529322 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00008]
Age related muscle loss, known as sarcopenia, is a major factor in disability, loss of mobility and quality of life in the elderly. There are many proposed mechanisms of age-related muscle loss that include the endocrine system. A variety of hormones regulate growth, development and metabolism throughout the lifespan. Hormone activity may change with age as a result of reduced hormone secretion or decreased tissue responsiveness. This review will focus on the complex interplay between the endocrine system, aging and skeletal muscle and will present possible benefits of therapeutic interventions for sarcopenia.
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Development of Physical Disability in Older Adults
Todd Manini
[FULL-TEXT INQUIRY] [PMID: 21529321 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00009]
Demographers expect the number of older persons to double to 86.7 million— or to 20.6% of the US population— by the year 2050. As has occurred over the past decade, the health care costs associated with older age are expected to steadily increase approximately 2% per year causing both a public health and personal burden. A key component to reducing health care costs and maintaining well-being in older persons is preserving physical function throughout the lifespan. The challenge to this objective is to combat the origin of the loss of physical function through treatment of chronic disease conditions. Another approach is to enhance physical function despite the occurrence of comorbid conditions through enhancement of the neuromuscular system. The neuromuscular system provides the necessary components for all locomotion, and is thus a logical choice for preventative therapies to target. This article will give a general overview of the models and risk factors that explain the development of physical disability.
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Expression and Regulation of Excitation-Contraction Coupling Proteins in Aging Skeletal Muscle
Osvaldo Delbono
[FULL-TEXT INQUIRY] [PMID: 21529320 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00010]
Functional and structural decline of the neuromuscular system is a recognized cause of decreased strength, impaired performance of daily living activities, and loss of independence in the elderly. However, in mammals, including humans, age-related loss of strength is greater than loss of muscle mass, so the underlying mechanisms remain only partially understood. This review focuses on the mechanisms underlying impaired skeletal muscle function with aging, including external calcium-dependent skeletal muscle contraction; increased voltage-sensitive calcium channel Cav1.1 β1a-subunit and junctional face protein JP-45 and decreased Cav1.1 (α1) expression, and the potential role of these and other recently discovered molecules of the muscle T-tubule/sarcoplasmic reticulum junction in excitation-contraction uncoupling. We also examined neural influences and trophic factors, particularly insulin-like growth factor-I (IGF-1). Better insight into the triad proteins’ involvement in muscle ECC and nerve/muscle interactions and regulation will lead to more rational interventions to delay or prevent muscle weakness with aging. The focus of this review is on the proteins mediating excitation-contraction coupling (ECC) and their expression and regulation in humans and rodent models of skeletal muscle functional decline with aging. Age-dependent changes in proteins other than those related to ECC, muscle composition clinical assessment and interventions, have been extensively reviewed recently [1-3].
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The Impact of Old Age on Skeletal Muscle Energetics: Supply and Demand
David W. Russ and Ian R. Lanza
[FULL-TEXT INQUIRY] [PMID: 21529319 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00011]
Properly functioning skeletal muscle is critical for locomotion and performance of many activities of daily living. Muscle wasting and decreased function of skeletal muscle are important factors in many age-related morbidities. There are several pathways for generating ATP in skeletal muscle that allow adequate ATP supply to meet increased demand during muscle activity. A growing body of literature provides evidence that the aging process may be accompanied by changes in metabolic supply and demand during muscle contractions. Herein, we review a body of evidence that several pathways of ATP synthesis (anaerobic glycolysis, oxidative phosphorylation) may be impaired in aging skeletal muscle as well as several underlying molecular and cellular mechanisms. However, detrimental effects of aging on muscle energy metabolism are not universally accepted, particularly when physical inactivity is accounted for. We discuss this important concept as well as several potential countermeasures that may compress the period of morbidity in old age. In the second half of this review, we discuss how energetic demand of skeletal muscle is affected by aging, with specific focus on basal and contractile ATPase activity.
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The Effects of Age on Precision Pinch Force Control Across Five Days of Practice
Karen L. Francis, Priscilla G. MacRae, Waneen W. Spirduso and Tim Eakin
[Purchase Article] [PMID: 21762095 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00012]
The effects of age on control of fingertip forces, across five days of practice, were determined for an isometric precision pinch grip task. The task involved controlling a computer cursor so that it traveled upward and horizontally on a 45 degree template line by applying X-axis isometric force with contraction of the thumb, and Y-axis force with the index finger. Upon reaching a reverse circle target, the cursor was returned to the start by controlling the steady release of isometric force. Participants’ control across the 6 segments of the template line (3 applying force and 3 segments releasing force) was examined. Healthy participants comprised three age groups: Y20 (mean = 21 + 4 years), O70 (mean =70 + 3 years) and O80 (mean = 79 + 3 years). The results indicated that 1) overall the Y20 group was faster in completing the task than the O80 group, 2) age differences in task duration time (speed) increased over 4 days, 3) the Y20 and O70 groups, but not the O80 group, improved performance (increased accuracy and decreased within-participant variability for time and accuracy) with practice, 4) circle target proximity (segments 3 and 6) was a potent factor; all groups were slower, less accurate, and less consistent irrespective of force direction in the segments approaching a circle target goal (reverse/ end). A task maneuver preceding a directional reversal of force modulation, from increasing to decreasing, was the most difficult element for the O80 group followed by the O70 and Y20 groups. These old adults improved tracing accuracy and consistency, but not performance speed with practice on this precision pinch force control task.
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Compensating, Controlling, Resigning and Accepting-Older Person’s Perception of Physical Decline
Anna Ekwall, Ingalill Rahm Hallberg and Jimmie Kristensson
[Purchase Article] [PMID: 21762094 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00013]
It is important to know about how frail older people experience their physical decline and how they adapt to their bodily changes so that the health system can design preventive interventions targeting this group early on in the disability process. The aim of this study was to explore how older people perceive their physical decline. The study is qualitative in design and based on interviews with older persons, who were in an acute care process. Fourteen people, five men and nine women, aged 74 – 92 years (mean 81 years) were included in the study. Content analysis was used. The main finding was that physical decline was marked as occurring in two dimensions. One dimension was the physical decline and its impact on the individual’s physical body (labelled individual body). The other dimension was the impact on the body in its environmental context such as the home or the society (labelled contextual body). The strategies for adapting constituted the two sub-themes, which were labeled compensating/controlling and accepting/resignation. The strategies were executed both on an intellectual level and practical level. For healthcare workers striving to increase physical activity, knowledge about how closely related self-image and physical ability are is useful when helping the frail older people. Increasing coping strategies for handling the general life situation may be a useful way of increasing physical activity and making it feel meaningful, despite the person’s frail health situation with limited physical and sometimes psychological resources.
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Effects of Tai Chi Exercise on Physical and Psychological Health of Older People
H. Blake and H. Hawley
[Purchase Article] [PMID: 21762093 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00014]
Tai Chi is a traditional Chinese form of conditioning exercise derived from martial arts and rooted in eastern philosophy and Chinese Medicine. Based on the inter-relatedness of mind, body and spirit this form of exercise focuses on producing an inner calmness which is thought to have both physical and psychological therapeutic value. This article provides a brief overview of selected current evidence examining the relationship between Tai Chi and physical, neurocognitive and psychosocial outcomes in older people. This is an emerging and growing area of research and improvements have often been reported in health functioning, physical and emotional health, reducing falls, fear of falling and risk of falls, and possibly enhancing cardiovascular functioning in older adults although the effects on bone density, cognitive and immunological functioning are less clear. Results overall are inconsistent and health improvements have not been evident in all studies. Tai Chi is becoming increasingly popular in practice, and more recent evidence is emerging which is based on experimental and longitudinal designs, although many of the proposed benefits of Tai Chi are yet to be validated in large, randomised controlled trials.
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How Does the Treadmill Affect Gait in Parkinson’s Disease?
Olalla Bello and Miguel Fernandez-Del-Olmo
[Purchase Article] [PMID: 21762092 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00015]
Parkinson’s disease (PD) is clinically characterized by symptoms of akinesia, rigidity, and resting tremor, which are related to a dopaminergic deficiency of the nigrostriatal pathway. Disorders of gait are common symptoms of PD that affect the quality of life in these patients. One of the main focuses of physical rehabilitation in PD is to improve the gait deficits in the patients. In the last decade, a small number of studies have investigated the use of the treadmill for the rehabilitation of gait in PD patients. Although, the results of these studies are promising,the mechanisms underlying the therapeutic effect of the treadmill in PD are still largely unknown. This paper reviews 10 years of investigation of treadmill training in PD, focusing on the possible mechanisms involved in the therapeutic effect of the treadmill. Understanding these mechanisms may improve the prescription and design of physical therapy programs for PD patients.
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Physical Activity and Urinary Incontinence in Older Adults: A Community-Based Study
Andy H. Lee and Fumi Hirayama
[Purchase Article] [PMID: 21762091 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00016]
Background: Urinary incontinence (UI) is a distressing condition that affects the lifestyle of older people. To investigate the relationship between UI and physical activity among older adults, a community-based study was conducted in Japan.
Methods: A total of 700 men and 300 women (mean age 66.2, SD 7.7 years) were recruited from the community in middle and southern Japan. The International Consultation on Incontinence Questionnaire-Short Form was administered by face-to-face interviews to ascertain UI status. Habitual physical activity levels (walking, moderate and vigorous activities) were assessed using the International Physical Activity Questionnaire and measured in terms of energy expenditure as
metabolic equivalent tasks (MET).
Results: The prevalence of UI was 7.2% (n = 49) among the 683 eligible male participants and 27.5% (n = 82) among the 298 female participants, who had experienced urine leakage for 2.6 (SD 1.9) years and 4.2 (SD 5.1) years, respectively. Habitual walking levels were lower among incontinent subjects than others without the condition. The adjusted risk of UI was 0.36 (95% confidence interval (CI) 0.14, 0.92) for men and 0.43 (95% CI 0.20, 0.96) for women, when comparing frequent walkers with over 1000 MET minutes of walking per week to completely sedentary participants. The prevalence of UI also decreased with total and moderate activity levels, but the corresponding reductions in risk were not statistically significant.
Conclusion: The finding of an inverse association between UI and walking has important implications for the prevention and treatment of this distressing condition.
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The General Practitioner’s Role in Promoting Physical Activity to Older Adults: A Review Based on Program Theory
Timo Hinrichs and Michael Brach
[Purchase Article] [PMID: 21762090 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00017]
Positive influences of physical activity both on many chronic diseases and on preservation of mobility are well documented. But chronically ill or mobility restricted elderly living in their own homes are difficult to reach for interventions. The general practitioner's (GP) surgery offers one of the few opportunities to give advice for physical activity to those people.
We used program theory to sound out knowledge on GP-centered physical activity counseling. The "conceptual theory" (evidence for training effects in old age) and the "implementation theory" (unique position of the GP) were reviewed narratively. The "action theory" (effects of GP counseling) was reviewed systematically. According to program theory, appropriate MeSH (Medical subject headings) concepts were Aged OR Aged, 80 and over (Target group), Physicians, Family OR Primary Health Care (Implementation/Setting), Counseling OR Patient Education as Topic OR Disease Management OR Health promotion (Intervention), Exercise OR Motor Activity OR Physical Fitness OR Sports (Determinants). The resulting six review papers (Pubmed, 2000-2009) were presented using the STARLITE mnemonic.
Authors agree, that the GP plays a central role in the promotion of physical activity to elderly people, but there is conflicting evidence concerning counseling effectiveness. Utilizing behavioral change strategies and the collaboration between GPs and specialised professions are recommended and currently under research.
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Imaging of Glucose Uptake During Walking in Elderly Adults
Hiroyuki Shimada
[Purchase Article] [PMID: 21762089 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00018]
Gait disorders have been identified as one of the most influential physical impairments associated with deterioration in daily living activities among the elderly. A better understanding of the mechanisms responsible for gait disorders is important for developing intervention strategies for the elderly. In recent years, positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG) have been used to monitor glucose uptake by skeletal muscle during exercise. This review discusses recent studies in which FDG PET has been used to measure muscular glucose uptake, differences between young adults and the elderly in muscular glucose uptake during walking, and the usefulness of FDG PET for determining the effects of exercise intervention in the elderly.
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Determinants of Meeting the Public Health Recommendations for Physical Activity among Community-Dwelling Elderly Japanese
Koichiro Oka and Ai Shibata
[Purchase Article] [PMID: 21762088 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00019]
Background: Although regular physical activity can facilitate healthy aging, improve functional capacity, and prevent chronic diseases in the elderly, many of the Japanese elderly are not sufficiently active. Thus, examining the determinants is an important prerequisite for designing effective programs. The present study investigated the demographic, behavioral, psychosocial, and environmental determinants of meeting the national pedometer-determined physical activity
recommendations for the elderly Japanese.
Method: Data were analyzed for 137 community-dwelling elderly Japanese aged 70 to 89 years (47% male, mean age =74.5 years), who completed a questionnaire and wore a pedometer. Demographic (gender, age, marital status), behavioral (BMI, smoking, alcohol consumption), psychosocial (self-efficacy, social support, health professional advice), and environmental (perceived neighborhood environment) variables were self-reported. Averaged daily steps were obtained using 1-year pedometer measurements. Based on the national physical activity recommendations in Japan (males: 6700 steps; females: 5900 steps), the participants were divided into two categories—sufficiently active and insufficiently active. An adjusted logistic regression model was utilized.
Results: Totally, 47.4% of the participants (males: 51.5%; females: 43.8%) met the national recommendations. When adjusting for all other variables, a higher self-efficacy for exercise (AOR = 1.16; 95% CI: 1.04-1.28) and positive perception of the neighborhood environment (AOR = 1.43; 95% CI: 1.03-1.98) significantly influenced the meeting of the national recommendations.
Conclusions: The findings clarified the need to identify effective intervention strategies to promote physical activity and suggest that an intervention design that accounts for these determinants may more effectively promote physical activity among the elderly Japanese.
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Physical Activity and Sport in Advanced Age: Is it Risky? – A Summary of Data from Articles Published Between 2000-2009
Ayelet Dunsky and Yael Netz
[Purchase Article] [PMID: 21762087 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00020]
Background: The benefits of physical activity in old age are well documented. However, studies have shown that older adults are insufficiently active. One of the reported barriers to physical activity is fear of injuries.
Objective: To review available data on the rate of injuries related to sport and purposeful physical activity in advanced aged.
Methods: A systematic review of reports published in English, identified by searching four data bases and the reference lists of reviewed articles. Eligible reports were full articles in a peer-reviewed journal, and the study report had to include the injury rate of individuals aged 45 and above and the kind of activities that led to the injury. Seven reports met the inclusion criteria.
Results: Studies on injuries in advanced age are scarce, and lack information on the rate of injuries relative to the extent of exercise. The rate of injuries occurring during physical activity in advanced age, based on existing data, is very low compared to other ages. The injury rate of men is almost twice that of women. Men tend to get injured while engaging in ball games and bicycling, while women mostly during exercise. The most frequent reported injuries in the general population including older adults are strains and sprains, followed by fractures in the lower and upper extremities.
Conclusions: Since older adults are being encouraged to increase their habitual physical activity even beyond the basic recommended guidelines, more studies are needed to assess the risk of injuries relative to the extent of exercise.
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Knee Osteoarthritis and Exercise Adherence: A Review
Ray Marks
[Purchase Article] [PMID: 21762086 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00021]
Individuals with knee osteoarthritis, a painful debilitating joint disease affecting many aging adults, are commonly encouraged to pursue a variety of exercise regimens. However, very few studies have specifically focused on barriers and facilitators of exercise adherence as related to knee osteoarthritis.
This review focuses on what is known about exercise adherence, as well as those factors that influence exercise adherence, both generally, and in the context of knee osteoarthritis. To this end, a wide array of related studies were retrieved and reviewed. The objective was to better understand the relationship between this disabling health condition and exercise, and factors that might specifically determine long-term exercise participation among this population.
Results of this search revealed: 1) strong support for the application of exercise to allay the progression and/or severity of knee osteoarthritis and its consequences, but poor adherence rates in reality; 2) a vast array of disease-associated, as well as other exercise adherence barriers; 3) many recommendations for promoting exercise adherence including improving the nature of the patient-provider relationship, and the importance of individualized exercise prescriptions.
It is concluded that life-long exercise is crucial for maximizing the well-being and function of adults with knee osteoarthritis, but recommendations to exercise are often pursued inconsistently. To encourage exercise adherence among this cohort, a comprehensive individualized assessment, active patient involvement in the decision-making process, and long-term monitoring are indicated.
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Editorial: Physical Activity, Exercise and Aging
Yolanda Escalante and Jose M. Saavedra
[Purchase Article] [PMID: 21834790 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00022]
There is a general aging of the population in developed countries. This aging, coupled with the low birth rate, means that there are already some countries in which the number of deaths exceeds the number of births. Aging does not, however, have to be seen as a disease, but rather as a complex process inherent to all the structures of the organism which leads to a progressive decline whose degree of involvement varies according to the individual and the environment in which they are living. In this context, it is well documented that physical activity – physical exercise in particular – is beneficial for the population as a whole. In the elderly, the specific benefits are improved or maintained endurance, strength, and flexibility, thus enabling improvement also in functional capacity and autonomy, and in the response to certain diseases. This makes "Physical Activity, Exercise, and Aging" a topic of major current relevance.
The Special Issue presented here consists of ten high quality articles involving researchers and academics from eight countries (Australia, Germany, Israel, Japan, Spain, Sweden, the United Kingdom, and the United States of America). Each article has been rigorously peer reviewed by at least two referees from 11 countries (in addition to the eight above: Belgium, Finland, and Vietnam), involving over 40 researchers and 20 institutions. Six of the contributions are of original research. Theydeal with the effects of physical activity in general and exercise programs in particular (Tai Chi and walking), the imaging of glucose uptake, the perception of physical decline, psychological and physical health, and precision pinch force control and urinary incontinence. Another of these papers presents public health recommendations among community-dwelling elderly. There are also four contributions which review and update the literature. Two of them deal are on the effects of exercise (with treadmill) on Parkinson's disease and knee osteoarthritis, a third on the general practitioner's promotion of physical activity, and a fourth on the risks involved in physical activity performed by the elderly, which obviously also exist.
Finally, we wish to thank the Editor-in-Chief, Prof. Debomoy K. Lahiri for the trust and responsibility deposited in us for the preparation of this Special Issue. We hope and trust that it will meet with the approval of the readers of Current Aging.
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Two Age-Related Accumulation Profiles of Toxic Metals
Hiroshi Yasuda, Kazuya Yoshida, Yuichi Yasuda and Toyoharu Tsutsui
[Purchase Article] [PMID: 21834789 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00023]
In order to investigate the body burden levels of toxic metals in Japanese, five toxic metal concentrations in scalp hair samples from 28,424 subjects from infant to elderly were determined with inductively coupled plasma mass spectrometry (ICP-MS). The geometric mean of hair mercury concentrations showed a high-significant age-correlated increase (r = 0.341, p < 0.0001) with a peak at the 6th decade of life and then decreased with further aging in both sexes. The mean mercury concentrations in male adults were significantly higher than those in female (p < 0.001), indicating the gender difference (male > female) in mercury accumulation. Arsenic also showed a similar accumulation profile with agedependency and gender difference in adult subjects. In contrast, cadmium, lead and aluminium exhibited another type of accumulation profile: the highest burden level was observed in infants aged 0-3 years old for every element in both sexes. In addition, cadmium was found to have a character accumulating in aged females, with significant age-dependency (r = 0.134, p < 0.0001) and gender difference (female > male).
These findings suggest that toxic metals are classified into two families on the basis of their accumulation profiles, and that the three elements of mercury, arsenic and cadmium which accumulate age-dependently in adults, may play a role in aging process and higher burden with them may lead to acceleration of aging.
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Mini-Mental Parkinson (MMP) as a Dementia Screening Test: Comparison with the Mini-Mental State Examination (MMSE)
A.J. Larner
[Purchase Article] [PMID: 21834788 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00024]
Background: As populations age, screening instruments for cognitive impairment and dementia will become of increasing importance in clinical practice. Mini-Mental Parkinson (MMP), a derivative of the Mini-Mental State Examination (MMSE), was originally described as a cognitive screening instrument for use in Parkinson’s disease. Its item content addresses some of the acknowledged shortcomings of the MMSE. Pragmatic use of MMP in general cognitive clinics has not previously been examined.
Aim: To compare the performance of two scales, Mini-Mental Parkinson (MMP) and the Mini-Mental State Examination (MMSE), as cognitive screening instruments for dementia in a memory clinic population.
Methods: MMP was administered prospectively to 201 consecutive new patient referrals independent of other tests used to establish dementia diagnosis according to standard diagnostic criteria (DSM-IV). Diagnostic utility of MMP for dementia was measured and compared with MMSE.
Results: MMP proved easy to use and acceptable to patients. Optimal test accuracy (0.86) was at MMP cutoff of ≤ 17/32, with sensitivity 0.51, specificity 0.97, positive predictive value 0.83, negative predictive value 0.87, and area under Receiver Operating Characteristic curve 0.89. Using a higher cutoff (≤ 29/32), MMP sensitivity was 1.00 with specificity 0.70. MMP scores correlated with MMSE (r = 0.93) and diagnostic agreement was high (k = 0.85).
Conclusions: MMP is a useful screening instrument in the memory clinic setting, with patients who fall below the designated cutoff requiring further investigation to ascertain a cause for their cognitive impairment.
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Longevity Pathways: HSF1 and FoxO Pathways, a New Therapeutic Target to Prevent Age-Related Diseases
Felipe P. Perez, Syed S. Moinuddin, Qurrat ul ain Shamim, Dennis J. Joseph, Jorge Morisaki and Ximing Zhou
[Purchase Article] [PMID: 21834787 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00025]
Modern medicine is directed towards the prevention, detection and cure of individual diseases. Yet, current medical models inadequately describe aging-associated diseases. We now know that failure in longevity pathways including oxidative stress, multisystem dysregulation, inflammation, sarcopenia, protein deposition and atherosclerosis are associated with age-related diseases. Such longevity pathways are potential targets for therapeutic intervention. Interventions in specific pathways have been shown to ameliorate and postpone the aging phenotype by activation of multiple genes. The strategy that we propose in this paper is to apply interventions simultaneously on complementary longevity pathways to achieve a synergistic result. For instance, aging is known to attenuate the HSF1 pathway leading to production of very toxic beta-amyloid fibrils. Consequently, the FoxO pathway is activated, resulting in the formation of less toxic high molecular weight aggregates as a defense mechanism. Thus the simultaneous upregulation of the HSF1 and FoxO pathways could potentially decrease protein deposition and proteotoxicity, thereby retarding or possibly preventing the onset of neurodegenerative diseases. Modulating these two pathways may also delay the onset of other age-related pathologies including cognitive decline, cancer, diabetes and cardiovascular disease due to its multi-gene effect. In this paper, we will discuss the role of several agents on the simultaneous modulation of these two central longevity pathways. The aging of western societies makes prevention of age-related diseases a pressing priority.
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Epidermal Cell Proliferation in Calorie-Restricted Aging Rats
Tapan K. Bhattacharyya, Paula Jackson, Minu K. Patel and J. Regan Thomas
[Purchase Article] [PMID: 21834786 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00026]
Calorie restriction (CR) has been known to produce many beneficial health effects, and lowered cell proliferation from CR has been shown to produce anti-cancer effects in some tissues. In this study the rate of epidermal cell proliferation in aging Fischer 344 rats from ad libitum fed (AL) and CR colonies was assessed in relation to changes in epidermal thickness with age. Proliferating cell nuclear antigen (PCNA) was detected using immunohistochemical method on paraffin sections in the epidermis of dorsal skin and footpad in these animals obtained from the National Institute on Aging. The proliferating cell index was compared with morphometric measurement of epidermis in young, young adult and old animals (six per group). Data were analyzed by Excel and SPSS 14.0 softwares for statistical evaluation. Two-way analysis of variance (ANOVA) was applied to data to test the effects of age, diet, and age-diet interaction.
The following significant effects were noted: (I) age and age-diet effects in dorsal skin epidermal width, and PCNA; (II) age, and diet effect on footpad epidermal thickness, and PCNA index. There was a trend of increasing epidermal thickness in the dorsal skin in normally feeding aging rats which was depressed with CR in the two younger groups. PCNA index showed a trend of attrition from young to old. The thickness of epidermis in foot pad showed a curvilinear trend in both AL and CR groups with lowest mean values in the old group, and more predominant effect in CR-exposed animals. The proliferation index in the foot pad demonstrated a trend of reduction in old specimens with lower mean values in each corresponding CR age group. This report agrees with CR-inhibited cell proliferation reported in many organs by other investigators, and the observed results might have been caused by physiological or endocrine mechanisms affecting the epithelium in these calorie-restricted animals.
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Influence of Essential Trace Minerals and Micronutrient Insufficiencies on Harmful Metal Overload in a Mongolian Patient with Multiple Sclerosis
Fumio Komatsu, Yasuo Kagawa, Terue Kawabata, Yoshinori Kaneko, Hideki Kudoh, Baatar Purvee, Jugder Otgon and Ulziiburen Chimedregzen
[Purchase Article] [PMID: 21834785 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00027]
Parkinson’s disease and other neurological disorders are prevalent in Mongolia. Our previous studies revealed a significant correlation of these diseases with high oxidative stress due to a high body burden of harmful metals, such as manganese, iron, lead, cadmium, and aluminum. This report describes a 37-year-old male Mongolian patient with multiple sclerosis and essential micronutrient deficiency. This patient demonstrated high oxidative stress, as shown by high urinary 8-hydroxy-2'-deoxyguanosine levels of 14.7 and 14.3 ng/mg creatinine (crea), although his hair levels of these toxic metals were markedly lower than other Mongolians. In addition, this patient was deficient not only in various essential minerals, including selenium, magnesium, copper, cobalt, vanadium, and nickel, but also in micronutrients such as vitamin B6, C, E, folic acid, niacin, and β-carotene. Furthermore, after taking 2,3-dimercaptosuccinic acid, a chelating agent, urinary excretion of lead, cadmium, manganese, aluminum, iron, copper, and lithium were increased 156-, 8.4-, 7.6-, 4.3-, 3.3-, 2.1-, and 2.1-fold, respectively. These results suggest that this patient suffered from a deficiency in micronutrients such as essential minerals and vitamins, which resulted in a disturbance in the ability to excrete harmful metals into the urine and hair. It is possible that a deficiency of micronutrients and a high burden of heavy metals play a role in the pathogenesis of multiple sclerosis. Nutritional treatment may be an effective approach to this disease.
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Cognition in Non-Demented Diabetic Older Adults
Sirisha Nandipati, Xiaodong Luo, Corbett Schimming, Hillel T. Grossman and Mary Sano
[Purchase Article] [PMID: 22023096 PubMed - indexed for MEDLINE] [BSP/CAS/E-Pub/00028]
Evidence links diabetes mellitus to cognitive impairment and increased risk of Alzheimer's disease (AD) and suggests that insulin therapy improves cognition. With an increasing percentage of the US elderly population at high risk for diabetes and AD, the evidence of an association between diabetes and poor cognition in non-demented elderly may have implications for diagnosis, prevention and treatment of cognitive decline including AD.
In our study, we hypothesized that diabetic elders with normal cognition would demonstrate poorer cognitive outcomes than non-diabetic elders and that diabetic elders receiving diabetes treatment would demonstrate better outcomes than those not receiving treatment.
Data were evaluated from the National Alzheimer’s Coordinating Center’s Uniform Data Set (UDS). The UDS consists of clinical and neuropsychological assessments of a sample of elderly research subjects recruited from thirty-one Alzheimer’s Disease Centers nationwide. The UDS provides a unique opportunity to study cognition in a nationally recruited sample with structured neuropsychological tests.
We examined the impact of diabetes and diabetes treatment on cognitive measures in 3421 elderly research subjects from 2005-2007 with normal cognition. We performed linear regression analyses to compare cognitive scores between diabetic subjects and non-diabetic subjects. Diabetic subjects had lower scores than non-diabetic subjects including attention, psychomotor function and executive function, but no differences in memory or semantic memory language. There was no association between diabetes treatment and cognitive scores.
These subtle but significant cognitive deficits in diabetic subjects compared to non-diabetic subjects may contribute to difficulty with compliance with complex diabetes medication regimens. A specific role of diabetes as a risk for cognitive impairment will require longitudinal study.
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