Search

Background: This study examines the relationship between physical and mental function and frailty, independently and in conjunction with polypharmacy, among older adults. Methods: This cross-sectional study consisted of 368 participants aged ≥60 years. The participants were categorized into either robust or frail groups using Fried's frailty phenotype. Physical functions were assessed using grip strength, gait speed, Timed Up and Go (TUG), the Five Chair Sit to Stand Test (FCSST) and the Six-Minute Walk Test (SMWT). Mental functions were assessed using cognitive function and depression. Cognitive function was measured using Mini-Mental State Examination (MMSE). Depression was assessed with the Korean version of the Short Geriatric Depression Scale (SGDS). Results: The mean age of study population was 75.4 years. In this population, we identified 78.8% (n = 290) robust participants and 21.2% (n = 78) frail participants. The study examined frailty status (frail vs. non-frail) and frailty with and without polypharmacy using multivariate logistic regressions, adjusting for age and sex. In the logistic regression model estimating the risk of frailty, after adjustments for age, sex, BMI, and number of medications, individuals with low SMWT showed a significantly increased risk of frailty, with an odds ratio (OR) of 8.66 and a 95% confidence interval (CI) of 4.55–16.48. Additionally, global cognitive function was associated with a 1.97-fold increase in frailty risk (95% CI: 1.02–3.67). Moreover, in models adjusted for age, sex, and BMI to assess frailty risk linked to polypharmacy, the TUG, SMWT, and SGDS all showed increased risks, with ORs of 3.65 (95% CI: 1.07–12.47), 5.06 (95% CI: 1.40–18.32), and 5.71 (95% CI: 1.79–18.18), respectively. Conclusions: Physical function (SMWT, FCSST, TUG) and mental function (depression, cognition) were associated with frailty. By comprehensively examining these factors, we will gain valuable insights into frailty and enable more precise strategies for intervention and prevention. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine how physical function, physical activity, and sleep are related to depressive symptoms in older adults using a nonlinear model. The participants were 283 Korean older adults aged 65 and older who met the study inclusion criteria. Depressive symptoms were measured using the shortened version of the Geriatric Depression Scale in Korean (SGDS-K). Physical activity and sleep time were objectively quantified by continuously monitoring participants over 20 consecutive days using a triaxial accelerometer. Physical function was evaluated using five distinct measurements: grip strength, gait speed, the Timed Up and Go Test (TUG), the Six-Minute Walk Test (SMWT), and the Five Times Sit to Stand Test (FTSST). The SMWT, gait speed, and MVPA exhibited a nonlinear relationship with depressive symptoms. However, other physical functions showed linear relationships. Also, sleep time showed a U-shaped trend starting at approximately 390 min. After adjusting for age, sex, drinking, and smoking in the logistic regression model, SMWT, MVPA, and sleep time were significantly associated with depressive symptoms. The outcomes highlight the importance of considering multiple factors in understanding depression among the elderly, particularly the intricate interactions between these elements and biological rhythms. [ABSTRACT FROM AUTHOR]

Current step-count estimation techniques use either an accelerometer or gyroscope sensors to calculate the number of steps. However, because of smartphones unfixed placement and direction, their accuracy is insufficient. It is necessary to consider the impact of the carrying position on the accuracy of the pedometer algorithm, because of people carry their smartphones in various positions. Therefore, this study proposes a carrying-position independent ensemble step-counting algorithm suitable for unconstrained smartphones in different carrying positions. The proposed ensemble algorithm comprises a classification algorithm that identifies the carrying position of the smartphone, and a regression algorithm that considers the identified carrying position and calculates the number of steps. Furthermore, a data acquisition system that collects (i) label data in the form of the number of steps estimated from the Force Sensitive Resistor (FSR) sensors, and (ii) input data in the form of the three-axis acceleration data obtained from the smartphones is also proposed. The obtained data were used to allow the machine learning algorithms to fit the signal features of the different carrying positions. The reliability of the proposed ensemble algorithms, comprising a random forest classifier and a regression model, was comparatively evaluated with a commercial pedometer application. The results indicated that the proposed ensemble algorithm provides higher accuracy, ranging from 98.1% to 98.8%, at self-paced walking speed than the commercial pedometer application, and the machine learning-based ensemble algorithms can effectively and accurately predict step counts under different smart phone carrying positions. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have shown that aerobic and resistance exercises, including leisure time physical activity help to reduce the risk of cognitive decline. Recently potential of cognitive training using immersive virtual reality (VR) has been growing in the non‐pharmacological interventions for mild cognitive impairment (MCI). However, there are not enough studies comparing the impact of two different interventional approaches on cognition and brain function especially on MCI patients. Therefore, we investigated the effectiveness of two non‐pharmacological intervention using VR and aerobic‐and resistance physical exercise (PE) on cognitive and brain function of older adults with MCI. Method: This study included 99 participants (70.8 ± 5.4) with MCI randomly assigned to PE, VR, and control group. The PE training consisted of aerobic and resistance exercise performed for 50 mins 5 times/week for 12 weeks. The immersive VR‐based cognitive training consisted of series of cognitive games. 24 sessions of VR training (three days/week) were performed, and each session was 100 mins long. Global cognitive function was measured with Mini‐Mental State Examination (MMSE) test. Resting‐state electroencephalography (EEG) of neural oscillatory activity in different frequency bands was measured. Physical function was measured with hand grip strength (HGS), gait speed and timed up and go test. Result: After the intervention period, VR significantly enhanced global cognition (p<0.045) and HGS (p<0.001) whereas PE significantly improved HGS (p<0.001) compared to baseline. One way Analysis of variance (ANOVA) of resting state EEG showed decreased theta/beta power ratio (TBR) (p<0.018) in the central region of the brain in PE group compared to the control group. Although not significant, VR group also showed decreased TBR compared to control group. Conclusion: Our study findings suggest that VR based cognitive training enhances both global cognition and physical function of older adults with MCI. The decrease in resting state TBR in PE and VR group also indicated improved attention. Further studies should peruse the effect of VR exergaming intervention, a combination of PE and cognitive games, to yield peak benefits on MCI patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the effectiveness of a combined‐exercise intervention program on cognitive and physical functions. Method: In a randomized controlled trial, we enrolled 167 individuals with mild cognitive impairment (MCI). The definition of MCI was based on medical evaluations through a clinical interview conducted by a dementia specialist. Cognitive assessments were performed by neuropsychologists according to standardized methods, including the MMSE and frontal cognitive function, both at baseline and at 6 months follow‐up. The program comprised physical activity and behavior modification, exercise (aerobic and resistance), and a cognitive and exercise combined intervention program. Result: Analysis of the subjects for group‐time interactions revealed that the exercise group exhibited a significantly improved attention, working memory, and executive function. Total habitual physical activity levels during intervention were associated with improvements in cognitive function, gait performance and the SPPB score, and the associations were stronger for those who are 75 and older are more likely than for <75, and those who have prefrail than frail individuals. Conclusion: The 6‐month combined intervention improved cognitive function and physical function in patients with cognitive impairment relative to controls. Encouraging and motivating older adults, particularly old‐older adults and prefrail individual, to improve moderate physical activity under supervision, during ongoing intervention, may be more beneficial to prevent cognitive decline and improve exercise adherence. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between a virtual reality (VR) intervention program and cognitive, brain and physical functions in high-risk older adults. In a randomized controlled trial, we enrolled 68 individuals with mild cognitive impairment (MCI). The MCI diagnosis was based on medical evaluations through a clinical interview conducted by a dementia specialist. Cognitive assessments were performed by neuropsychologists according to standardized methods, including the Mini-Mental State Examination (MMSE) and frontal cognitive function: trail making test (TMT) A & B, and symbol digit substitute test (SDST). Resting state electroencephalogram (EEG) was measured in eyes open and eyes closed conditions for 5 minutes each, with a 19-channel wireless EEG device. The VR intervention program (3 times/week, 100 min each session) comprised four types of VR game-based content to improve the attention, memory and processing speed. Analysis of the subjects for group–time interactions revealed that the intervention group exhibited a significantly improved executive function and brain function at the resting state. Additionally, gait speed and mobility were also significantly improved between and after the follow-up. The VR-based training program improved cognitive and physical function in patients with MCI relative to controls. Encouraging patients to perform VR and game-based training may be beneficial to prevent cognitive decline. [ABSTRACT FROM AUTHOR]

This study investigated the effectiveness of electrical muscle stimulation (EMS) with resistance exercise training (ERT) and resistance exercise training (RT) on physical and brain function in middle-aged and older women. Method: Forty-eight participants were randomly allocated into three groups: (i) ERT (n = 16), (ii) RT (n = 16), and (iii) control group (n = 16). The intervention session was 50 min long and performed three times/week for four weeks. The ERT group performed quadriceps setting, straight leg raises, and ankle pump exercises while constantly receiving EMS on their quadriceps muscle on both legs. The RT group performed the same exercise without EMS. Physical function was measured using skeletal muscle mass index (SMI), handgrip strength, gait speed, five times sit-to-stand test (FTSS) and timed up-and-go test (TUG). Brain function was assessed with electroencephalogram measurement of whole brain activity. Results: After four-week intervention, significant improvements were observed in SMI (p < 0.01), phase angle (p < 0.05), and gait speed (p < 0.05) in the ERT group compared to the control group. ERT also increased muscle strength (p < 0.05) and mobility in lower limbs as observed in FTSS and TUG tests (p < 0.05) at post-intervention compared to the baseline. In the ERT group, significant positive changes were observed in Beta1 band power, Theta band power, and Alpha1 band whole brain connectivity (p < 0.005) compared to the control group. Conclusions: Our findings showed that ERT can improve muscle and brain function in middle-aged and older adults during a four-week intervention program whereas significant improvements were not observed with RT. Therefore might be one of the feasible alternative intervention to RT for the prevention of muscle loss whilst improving brain function for middle-aged and older population.