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  • 1
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    Abstract P007: Timing Of Orthostatic Hypotension And Its Relationship With Falls In Older Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Hypertension Vol. 79, No. Suppl_1 ( 2022-09)
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 79, No. Suppl_1 ( 2022-09)
    Abstract: Background: There is inconsistent evidence on the optimal time after standing to assess orthostatic hypotension (OH). Objectives: To characterize the timing of OH after standing in older adults and the fall risk associated with OH at specific times. Methods: We performed a secondary analysis of the Study to Understand Fall Reduction and Vitamin D in You (STURDY). Blood pressure (BP) was measured in the supine position. Participants stood upright and underwent 6 standing BP measurements: 3 (M1-M3) immediately after standing, and 3 (M4-M6) after 3 minutes of standing. OH was defined as a decrease from supine systolic BP (SBP) of 20 or supine diastolic BP (DBP) of 10 mm Hg. We used generalized estimating equations to characterize changes in SBP, DBP, and OH over time. We used Cox models to examine the relationship between OH at each time point and subsequent falls. Results: There were 425 falls among 491 adults with 6,055 BP measurements and a median follow-up of 275 days. SBP/DBP decreased by a mean 9.5/2.6 mm Hg immediately after standing (M1) vs. 2.2/0.9 about 5 minutes after standing (M6). OH was observed in 32% of assessments at M1, and only 16% at M5 and M6 ( Table ). Only OH at M5 (Hazard Ratio = 1.84 [95% confidence interval = 1.17, 2.91]) and M6 (1.85 [1.03, 2.91] ) predicted higher fall risk among individual time points. However, average OH from early (M1-3) and late (M4-6) measurements, respectively, also predicted higher fall risk (M1-3 = 1.65 [1.08, 2.52] ; M4-6 = 1.73 [1.03, 2.91]). Conclusions: OH was most prevalent immediately after standing, but most informative for fall risk in late and average measurements. Multiple standing BP measurements may improve the clinical assessment of OH.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/hyp.79.suppl_1.P007
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 2
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    Patterns of Daily Physical Movement, Chronic Inflammation, and Frailty Incidence
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Medicine & Science in Sports & Exercise Vol. 55, No. 2 ( 2023-2), p. 281-288
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 55, No. 2 ( 2023-2), p. 281-288
    Abstract: Low physical activity is a criterion of phenotypic frailty defined as an increased state of vulnerability to adverse health outcomes. Whether disengagement from daily all-purpose physical activity is prospectively associated with frailty and possibly modified by chronic inflammation—a pathway often underlying frailty—remains unexplored. Methods Using the Study to Understand Fall Reduction and Vitamin D in You data from 477 robust/prefrail adults (mean age = 76 ± 5 yr; 42% women), we examined whether accelerometer patterns (activity counts per day, active minutes per day, and activity fragmentation [broken accumulation]) were associated with incident frailty using Cox proportional hazard regression. Baseline interactions between each accelerometer metric and markers of inflammation that include interleukin-6, C-reactive protein, and tumor necrosis factor-alpha receptor 1 were also examined. Results Over an average of 1.3 yr, 42 participants (9%) developed frailty. In Cox regression models adjusted for demographics, medical conditions, and device wear days, every 30 min·d −1 higher baseline active time, 100,000 more activity counts per day, and 1% lower activity fragmentation was associated with a 16% ( P = 0.003), 13% ( P = 0.001), and 8% ( P 〈 0.001) lower risk of frailty, respectively. No interactions between accelerometer metrics and baseline interleukin-6, C-reactive protein, or tumor necrosis factor-alpha receptor 1 were detected (interaction P 〉 0.06 for all). Conclusions Among older adults who are either robust or prefrail, constricted patterns of daily physical activity (i.e., lower total activity minutes and counts, and higher activity fragmentation) were prospectively associated with higher risk of frailty but not modified by frailty-related chronic inflammation. Additional studies, particularly trials, are needed to understand if this association is causal.
    Type of Medium: Online Resource
    ISSN: 1530-0315 , 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0000000000003048
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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    detail.hit.zdb_id: 2031167-9
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  • 3
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    Effects of Tai Chi on Beta Endorphin and Inflammatory Markers In Older Adults with Chronic Pain : 2496 Board #2 June 1 1 00 PM - 3 00 PM
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Medicine & Science in Sports & Exercise Vol. 50, No. 5S ( 2018-05), p. 618-
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 5S ( 2018-05), p. 618-
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/01.mss.0000537124.51941.3e
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 603994-7
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  • 4
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    The Relationship between Global Pain Severity and Gait Speed in Older Adults with Multisite Pain : 2583 Board #106 June 3, 9
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Medicine & Science in Sports & Exercise Vol. 48 ( 2016-05), p. 717-
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 48 ( 2016-05), p. 717-
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/01.mss.0000487152.68095.22
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 603994-7
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  • 5
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    Effects of Vitamin D on Physical Function: Results From the STURDY Trial
    Oxford University Press (OUP) ; 2022
    In:  The Journals of Gerontology: Series A Vol. 77, No. 8 ( 2022-08-12), p. 1585-1592
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 77, No. 8 ( 2022-08-12), p. 1585-1592
    Abstract: Studies of the relationship between vitamin D and physical functioning have had inconsistent results. Methods Physical functioning measures were collected for up to 2 years during a 2-stage, Bayesian, response-adaptive, randomized trial of 4 doses of vitamin D3 supplementation (200 [control], 1 000, 2 000, and 4 000 IU/day) to prevent falls. Two community-based research units enrolled adults aged ≥70 years, with elevated fall risk and serum 25-hydroxyvitamin D level of 10–29 ng/mL. The Pooled Higher Doses (PHD) group (≥1 000 IU/day, n = 349) was compared to the control group (n = 339) on changes in Short Physical Performance Battery (SPPB) score and its component tests, Timed Up-and-Go (TUG) test, 6-minute walk distance, and grip strength. Results The trial enrolled 688 participants. Mean age was 77.2 years, 56.4% were male, 79.7% White, and 18.2% Black. While the PHD and control groups both lost function over time on most outcomes, the 2 groups did not show differential change overall on any outcome. Incidence of transitioning to poor functioning on gait speed, SPPB score, or TUG test did not differ by dose group. Conclusion In older persons with low serum 25-hydroxyvitamin D level and elevated fall risk, high-dose vitamin D supplementation, ≥1 000 IU/day, did not improve measures of physical function compared to 200 IU/day. Clinical Trial Registration NCT02166333
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glab379
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2043927-1
    detail.hit.zdb_id: 1223643-3
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  • 6
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    Free-Living Gait Cadence Measured by Wearable Accelerometer: A Promising Alternative to Traditional Measures of Mobility for Assessing Fall Risk
    Oxford University Press (OUP) ; 2023
    In:  The Journals of Gerontology: Series A Vol. 78, No. 5 ( 2023-05-11), p. 802-810
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 78, No. 5 ( 2023-05-11), p. 802-810
    Abstract: Wearable devices have become widespread in research applications, yet evidence on whether they are superior to structured clinic-based assessments is sparse. In this manuscript, we compare traditional, laboratory-based metrics of mobility with a novel accelerometry-based measure of free-living gait cadence for predicting fall rates. Methods Using negative binomial regression, we compared traditional in-clinic measures of mobility (6-minute gait cadence, speed, and distance, and 4-m gait speed) with free-living gait cadence from wearable accelerometers in predicting fall rates. Accelerometry data were collected with wrist-worn Actigraphs (GT9X) over 7 days in 432 community-dwelling older adults (aged 77.29 ± 5.46 years, 59.1% men, 80.2% White) participating in the Study to Understand Fall Reduction and Vitamin D in You. Falls were ascertained using monthly calendars, quarterly contacts, and ad hoc telephone reports. Accelerometry-based free-living gait cadence was estimated with the Adaptive Empirical Pattern Transformation algorithm. Results Across all participants, free-living cadence was significantly related to fall rates; every 10 steps per minute higher cadence was associated with a 13.2% lower fall rate (p = .036). Clinic-based measures of mobility were not related to falls (p & gt; .05). Among higher-functioning participants (cadence ≥100 steps/minute), every 10 steps per minute higher free-living cadence was associated with a 27.7% lower fall rate (p = .01). In participants with slow baseline gait (gait speed & lt;0.8 m/s), all metrics were significantly associated with fall rates. Conclusion Data collected from biosensors in the free-living environment may provide a more sensitive indicator of fall risk than in-clinic tests, especially among higher-functioning older adults who may be more responsive to intervention. Clinical Trial Registration NCT02166333
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glac013
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 7
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    Visual Impairment and Objectively Measured Physical Activity in Middle-Aged and Older Adults
    Oxford University Press (OUP) ; 2021
    In:  The Journals of Gerontology: Series A Vol. 76, No. 12 ( 2021-11-15), p. 2194-2203
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 76, No. 12 ( 2021-11-15), p. 2194-2203
    Abstract: Vision loss is associated with increased risk of falls and restricted physical activity, yet the relationship between multiple vision measures and objectively measured physical activity, especially activity patterns, in mid-to-late life is not well understood. Method This study included 603 participants aged 50 years and older (mean age = 73.5) in the Baltimore Longitudinal Study of Aging who had the following assessments: presenting and best-corrected visual acuity, contrast sensitivity, visual fields, stereo acuity, and free-living physical activity using a wrist-worn ActiGraph accelerometer for 7 days. Linear regression models were used to examine the association between vision measures and daily activity counts, active minutes, and activity fragmentation (defined as an active-to-sedentary transition probability), adjusting for potential confounders. Mixed-effects models estimated differences in activity by time of day comparing those with and without each visual impairment. Results In the fully adjusted model, worse presenting visual acuity, contrast sensitivity, and visual fields were associated with fewer activity counts, less active time, and more fragmented activity patterns (p & lt; .05 for all). Participants with presenting or best-corrected visual acuity impairment had 19.2 and 29.3 fewer active minutes (p = .05 and p = .03, respectively) per day. Visual field impairment was associated with 268 636 fewer activity counts (p = .02), 46.2 fewer active minutes (p = .02) per day, and 3% greater activity fragmentation (p = .009). Differences in activity levels tended to be greatest from 6 am to 6 pm (p & lt; .05). Conclusions Older adults with visual impairment have restricted and more fragmented patterns of daily activity. Longitudinal studies to quantify the long-term impacts of visual impairments on activity decline are warranted.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glab103
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 8
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    Chronic Pain and Risk of Injurious Falls in Community-Dwelling Older Adults
    Oxford University Press (OUP) ; 2021
    In:  The Journals of Gerontology: Series A Vol. 76, No. 9 ( 2021-08-13), p. e179-e186
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 76, No. 9 ( 2021-08-13), p. e179-e186
    Abstract: Fall injuries are a leading cause of death in older adults. The potential impact of chronic pain characteristics on risk for injurious falls is not well understood. This prospective cohort study examined the relationship between chronic pain and risk for injurious falls in older adults. Method The MOBILIZE Boston Study enrolled 765 community-dwelling adults aged 70 years and older living in and around Boston, Massachusetts. Chronic pain characteristics, including pain severity, pain interference, and pain distribution, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Occurrence of falls and fall-related injuries were recorded using monthly fall calendar postcards and fall follow-up interviews during the 4-year follow-up period. Results Negative binomial regression models showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls adjusting for potential confounders. Participants in the highest third of pain interference scores had a 61% greater risk of injurious falls compared to those reporting little or no pain interference. Compared to no pain, multisite pain was associated with a 57% greater risk of injurious falls. Stratified by gender, the association was only significant in women. In the short term, moderate-to-severe pain in a given month was associated with increased risk of injurious falls in the subsequent month. Conclusions Global pain measures are associated with increased risk of injurious falls in older adults. Pain assessment should be incorporated into fall risk assessments. Interventions are needed to prevent fall injuries among elders with chronic pain.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glaa249
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2043927-1
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  • 9
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    Motor and Physical Function Impairments as Contributors to Slow Gait Speed and Mobility Difficulty in Middle-Aged and Older Adults
    Oxford University Press (OUP) ; 2022
    In:  The Journals of Gerontology: Series A Vol. 77, No. 8 ( 2022-08-12), p. 1620-1628
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 77, No. 8 ( 2022-08-12), p. 1620-1628
    Abstract: Motor function affects ability to perform daily activities and maintain independence. Yet, the interrelatedness of upper and lower extremity motor impairments and the magnitude of their contribution to slow gait and mobility difficulty are not well investigated. Methods Participants in the Baltimore Longitudinal Study of Aging (N = 728, aged 50–99) completed motor and physical function tests including grip and knee extension strength, pegboard, finger tapping, standing balance, chair stands, fast-paced 400-m walk, and usual gait speed. Slow gait was defined as usual gait speed & lt;1.0 m/s. Mobility difficulty was defined as self-reported difficulty walking ¼ mile or climbing stairs. Structural equation modeling examined the interrelationships of motor measures and their contributions to slow gait and mobility difficulty, adjusting for demographics and comorbidities. Results Poorer manual dexterity (−0.571 standard deviation [SD] units, p & lt; .001) and lower muscle strength (upper and lower extremity; −0.447 SD units, p = .014) were most strongly associated with slow gait speed, followed by slower chair stand pace (−0.195 SD units, p = .002) and greater lap time variation (0.102 SD units, p = .028). Lower muscle strength (−0.582 SD units, p = .001) was most strongly associated with mobility difficulty, followed by slower chair stand pace (−0.322 SD units, p & lt; .001), slower gait speed (−0.247 SD units, p & lt; .001), and poorer standing balance (−0.190 SD units, p = .043). Conclusions Components of manual dexterity and strength were the strongest correlates of slow gait and mobility difficulty in mid-to-late life. Longitudinal studies examining relationships between changes in these motor parameters and mobility are needed to elucidate possible causal effects.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glac001
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2043927-1
    detail.hit.zdb_id: 1223643-3
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  • 10
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    Musculoskeletal Pain Characteristics and Objectively Measured Physical Activity in Older Adults
    Oxford University Press (OUP) ; 2024
    In:  The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences Vol. 79, No. 4 ( 2024-04-01)
    Details
    In: The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, Oxford University Press (OUP), Vol. 79, No. 4 ( 2024-04-01)
    Abstract: Pain is associated with reports of restricted physical activity (PA), yet the association between musculoskeletal pain characteristics and objectively measured PA quantities and patterns in late life is not well understood. Methods A total of 553 adults (mean age 75.8 ± 8.4 years, 54.4% women) in the Baltimore Longitudinal Study of Aging (BLSA) completed a health interview and subsequent 7-day wrist-worn ActiGraph assessment in the free-living environment between 2015 and 2020. Pain characteristics, including pain presence in 6x sites (ie, shoulders, hands/wrists, low back, hip, knees, and feet), pain laterality in each site, and pain distribution were assessed. PA metrics were summarized into total daily activity counts (TAC), activity fragmentation, active minutes/day, and diurnal patterns of activity. Linear regression models and mixed-effects models examined the association between pain characteristics and PA outcomes, adjusted for demographics and comorbidities. Results Unilateral knee pain was associated with 184 070 fewer TAC (p = .039) and 36.2 fewer active minutes/day (p = .032) compared to those without knee pain. Older adults with shoulder pain or hand/wrist pain had more active minutes compared to those without pain (p  & lt; .05 for all). For diurnal patterns of activity, participants with knee pain had fewer activity counts during the afternoon (12:00 pm to 5:59 pm). Analyses stratified by sex showed that these associations were only significant among women. Conclusions Our study highlights the importance of assessing pain laterality in addition to pain presence and suggests that pain interferes with multiple aspects of daily activity. Longitudinal studies are needed to assess the temporality of these findings.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glae039
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2043927-1
    detail.hit.zdb_id: 1223643-3
    SSG: 12
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