Open Access
Sit to stand muscle power reference values and their association with adverse events in Colombian older adults
(Nature Research, 2022) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ordóñez-Mora, Leidy Tatiana; Cano Gutiérrez, Carlos Alberto; Campo-Lucumí, Florelba; Pérez Sousa, Miguel A.; Ciencias de la Salud; Osasun Zientziak
Recently, a valid method to assess lower-body muscle power based on a sit-to-stand feld test (STS) has been published. Our study aimed to describe lower-body muscle power in older individuals aged≥ 60 years and examine the relationship of muscle weakness with adverse events according to gender- and age-specifc muscle weakness cut-of points. A total of 3689 Colombian older adults (57.6% women, age 69.1 ± 6.9 years) from the 2015 Survey on Health, Well-Being, and Aging in Latin America and the Caribbean (SABE) participated in this study. Lower-body muscle power normalized to body mass was estimated by the fve-repetitions STS test. Anthropometric, physical performance and clinical characteristics were collected. Age-specifc percentiles using the LMS method, cut-of points and association with adverse events were calculated. Lower-body muscle power was greater in men than among women (2.2 ± 0.7 vs. 1.6 ± 0.5W·kg−1, respectively; p < 0.001) at all ages. Muscle power ranked in the 50th percentile between 2.38 and 1.30W·kg−1 in men, whereas women ranked between 1.79 and 1.21 W·kg−1. According to the cut-of points, lower-limb muscle power < 1 standard deviation in men was associated with having dynapenia, poor gait speed, cognitive impairment and mental, visual, hearing and memory problems. While, women were associated with having sarcopenia, dynapenia, poor gait speed, cognitive impairment, mental, hearing and memory problems, dementia and hospitalizations of> 24 h in the last year. Overall, participants with poor lower-limb muscle power had a signifcantly higher risk of adverse events [in men: odds ratio (OR)= 1.51, 95% confdence interval (CI) = 1.19–1.91, p < 0.001; in women: OR= 1.52, 95% CI = 1.27–1.87, p = 0.001] than their stronger counterparts. This study is the frst to describe lower-limb muscle power values and cutof points among a nationally representative sample of Colombian older adults. In men, 7 of the 14 adverse events studied were associated with lower muscle strength, whereas in women, it was 9 of the 14 adverse events.
Open Access
Reference values for handgrip strength and their association with intrinsic capacity domains among older adults
(Wiley, 2019) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; García Hermoso, Antonio; Cano Gutiérrez, Carlos Alberto; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Objective The purposes of this study were three-fold: (i) to describe handgrip strength in older individuals aged >= 60 years in Colombia; (ii) to identify sex-specific and age-specific muscle weakness cut-off points in older adults; and (iii) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut-off points, as compared with their weaker counterparts. Methods A cross-sectional study was conducted in Colombia, among 5237 older adults aged >= 60 years old (58.5% women, 70.5 +/- 7.8 years), according to 'SABE Survey 2015'. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e. locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socio-economic status, urbanicity, body mass index, smoking status, alcohol intake, drug use, physical activity, and co-morbid chronic diseases. Sex-stratified analyses were conducted with logistic regression models. Results Handgrip strength was greater among men than among women (26.7 +/- 8.5 vs. 16.7 +/- 5.7 kg, respectively, P < 0.001) at all ages. Weak handgrip strength cut-off points ranged from 17.4 to 8.6 and from 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity [in men, odds ratio (OR) = 0.62, 95% confidence interval (CI) 0.53 to 0.71; P < 0.001; and in women, OR = 0.79, 95% CI 0.68 to 0.92; P = 0.002] than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR = 0.47, 95% CI 0.29 to 0.78; P = 0.004) than their weaker counterparts. Conclusions This study is the first to describe handgrip strength values and cut-off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut-off points, non-weakness was associated with a decreased odds of intrinsic capacity impairments. These cut-off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.
Open Access
Sub maximal ergospirometry parameters in untrained non-frail octogenarian subjects
(MDPI, 2022) Cofre-Bolados, Cristian; Ferrari, Gerson; Valdivia-Moral, Pedro; Vidal Díaz, Félix Andrés; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background and objectives: the prevalence of chronic diseases increases with age, and in octogenarian elderly, a cardiorespiratory test with gas analysis is more effective in determining the risk of mortality than applying the conventional risk factors. Materials and Methods: 25 untrained non-frail octogenarian subjects (four men) performed a submaximal test with gas analysis, which was stopped after the second ventilatory threshold (VT2) was reached. The variables analyzed were oxygen consumption at the first threshold (VO2 VT1); ventilatory class (VE/VCO2); oxygen uptake efficiency slope (OUES); cardiorespiratory optimal point (COP); oxygen pulse difference between VT2 and VT1 (diff. VO2/HR VT2-VT1). Results: the variables were classified categorically based on cut-off points present in the literature, where the variable with the highest percentage of altered cases was dif. VO2/HR VT2-VT1 at 48%; followed by VO2 VT1 at 40%, OUES at 36%, COP at 32%, and VE/VCO2 at 24%. Chi-square analysis between the measured parameters defined that normal and altered variables were related to each other, except for the variable VE/VCO2 and OUES. Conclusions: it was found that the main altered variable was the oxygen pulse and the least altered variable was VCO2/VCO2; there was only a statistically significant difference in a pair of OUES vs. VE/VCO2 variables.
Open Access
Lipidomic signatures from physically frail and robust older adults at hospital admission
(Springer, 2022) Ramírez Vélez, Robinson; Martínez Velilla, Nicolás; Correa Rodríguez, María; López Sáez de Asteasu, Mikel; Zambom Ferraresi, Fabrício; Palomino Echeverría, Sara; García Hermoso, Antonio; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua, 2186/2014; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, 420/2019
Identifying serum biomarkers that can predict physical frailty in older adults would have tremendous clinical value for primary care, as this condition is inherently related to poor quality of life and premature mortality. We compared the serum lipid profile of physically frail and robust older adults to identify specific lipid biomarkers that could be used to assess physical frailty in older patients at hospital admission. Forty-three older adults (58.1% male), mean (range) age 86.4 (78–100 years) years, were classified as physically frail (n = 18) or robust (n = 25) based on scores from the Short Physical Performance Battery (≤ 6 points). Non-targeted metabolomic study by ultra-high performance liquid chromatography coupled to mass spectrometry (UHPLC-MS) analysis with later bioinformatics data analysis. Once the significantly different metabolites were identified, the KEGG database was used on them to establish which were the metabolic pathways mainly involved. Area under receiver-operating curve (AUROC) analysis was used to test the discriminatory ability of lipid biomarkers for frailty based on the Short Physical Performance Battery. We identified a panel of five metabolites including ceramides Cer (40:2), Cer (d18:1/20:0), Cer (d18:1/23:0), cholesterol, and hosphatidylcholine (PC) (14:0/20:4) that were significantly increased in physically frail older adults compared with robust older adults at hospital admission. The most interesting in the physically frail metabolome study found with the KEGG database were the metabolic pathways, vitamin digestion and absorption, AGE-RAGE signaling pathway in diabetic complications, and insulin resistance. In addition, Cer (40:2) (AUROC 0.747), Cer (d18:1/23:0) (AUROC 0.720), and cholesterol (AUROC 0.784) were identified as higher values of physically frail at hospital admission. The non-targeted metabolomic study can open a wide view of the physically frail features changes at the plasma level, which would be linked to the physical frailty phenotype at hospital admission. Also, we propose that metabolome analysis will have a suitable niche in personalized medicine for physically frail older adults.
Open Access
Safety and effectiveness of long-term exercise interventions in older adults: a systematic review and meta-analysis of randomized controlled trials
(Springer, 2020-02-04) García Hermoso, Antonio; Ramírez Vélez, Robinson; López Sáez de Asteasu, Mikel; Martínez Velilla, Nicolás; Zambom Ferraresi, Fabrício; Valenzuela, Pedro L.; Lucía, Alejandro; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background Physical exercise is benefcial to reduce the risk of several conditions associated with advanced age, but to our knowledge, no previous study has examined the association of long-term exercise interventions (≥1 year) with the occurrence of dropouts due to health issues and mortality, or the efectiveness of physical exercise versus usual primary care interventions on health-related outcomes in older adults (≥ 65 years old). Objective To analyze the safety and efectiveness of long-term exercise interventions in older adults. Methods We conducted a systematic review with meta-analysis examining the association of long-term exercise interventions (≥1 year) with dropouts from the corresponding study due to health issues and mortality (primary endpoint), and the efects of these interventions on health-related outcomes (falls and fall-associated injuries, fractures, physical function, quality of life, and cognition) (secondary endpoints). Results Ninety-three RCTs and six secondary studies met the inclusion criteria and were included in the analyses (n=28,523 participants, mean age 74.2 years). No diferences were found between the exercise and control groups for the risk of dropouts due to health issues (RR=1.05, 95% CI 0.95–1.17) or mortality (RR=0.93, 95% CI 0.83–1.04), although a lower mortality risk was observed in the former group when separately analyzing clinical populations (RR=0.67, 95% CI 0.48–0.95). Exercise signifcantly reduced the number of falls and fall-associated injuries, and improved physical function and cognition. These results seemed independent of participants’ baseline characteristics (age, physical function, and cognitive status) and exercise frequency. Conclusions Long-term exercise training does not overall infuence the risk of dropouts due to health issues or mortality in older adults, and results in a reduced mortality risk in clinical populations. Moreover, exercise reduces the number of falls and fall-associated injuries, and improves physical function and cognition in this population.