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Limited functional mobility in older adults has been associated with declines in tests of motor, psychomotor, and executive function. Animal studies have demonstrated reversals in indices of motor and psychomotor function via supplementation with polyphenolic-rich foods such as blueberries. The purpose of this study was to examine whether 6 weeks of daily consumption of 2 cups of frozen blueberries affects functional mobility in older adults. Pre- and post-intervention assessments of grip strength, simple reaction time, adaptive gait, and executive function were completed for older adults (age >60 years) partially randomly assigned to a blueberry (BB) supplementation or a carrot juice drink control (CAR) group. Paired t tests were used to assess within-group effects for outcome variables in each supplementation group, and a mixed-model analysis of covariance (ANCOVA) was used to determine group (CAR vs. BB) differences. Mixed-model analysis indicated that the BB group demonstrated significant improvements relative to the CAR group in performance (i.e., number of step errors) of a challenging dual-task adaptive gait test that were independent of differences in gait speed. Within only the BB group, significant improvements were also seen in 3 other measures (i.e., usual gait speed; number of step errors during single-task adaptive gait; and gait speed during dual-task adaptive gait). These preliminary findings support the hypothesis that blueberry supplementation may provide an effective countermeasure to age-related declines in functional mobility and serve as justification for an expansion to larger trials to more fully assess this nonpharmacologic approach to maintaining optimal mobility and independence.

Objective: Age-related declines in physical activity are commonly observed in human and animal populations, but their physiologic bases are not fully understood. The authors hypothesize that a lack of available energy contributes to low levels of activity in older persons., Design: Cross-sectional analyses of relationships between physical activity level and energy availability were performed in 602 community-dwelling volunteers aged 45-91 yrs from the Baltimore Longitudinal Study of Aging. Energy expenditure was measured at rest and during a maximal 400-m walk for calculation of "available energy." Overall and vigorous physical activity levels were assessed using standardized questionnaires. General linear regression models were used to assess the relationships between available energy and general and vigorous physical activity, and stratified analyses were used to analyze the possible differential association between available energy and physical activity across high and low (peak sustained walking oxygen consumption per unit time, <18.3 ml of oxygen per kilogram per minute) levels of aerobic fitness., Results: Low available energy was associated with low levels of total physical activity (β = 64.678, P = 0.015) and vigorous activity (β = 9.123, P < 0.0001). The direct relationship between available energy and physical activity was particularly strong in persons categorized as having low aerobic fitness between available energy and physical activity with both total (β = 119.783, P = 0.022) and vigorous activity (β = 10.246, P = 0.015) and was independent of body composition and age., Conclusions: The findings from this study support the hypothesis that available energy promotes the maintenance of physical activity in older persons. The findings also run counter to the perception that age-related declines in physical activity are primarily societally or behaviorally driven.

Background: In older adults, changes in speed and stability during walking are associated with impaired balance and increased fall risk. Narrow-base walking requires increased frontal plane stability and can be used to assess postural control while walking. Performance of a concurrent cognitive task (dual task) may further increase the complexity of walking, potentially allowing identification of individuals with instability that is not detected under single-task conditions. The purpose of this study was to examine age-associated effects of a cognitive task on speed and frontal plane stability during narrow-base walking., Methods: Thirty-four healthy adults participated, categorized by age: <65, 65-74, and > or =75 years. Participants walked at a comfortable pace within a narrow path under both single- and dual-task conditions. We examined spatiotemporal variables and frontal plane center of mass (CoM) parameters using a 13-segment biomechanical model., Results: Increasing age (p <.001) and the performance of a concurrent cognitive task (p <.001) were both associated with decreased speed, with no interaction between these factors. Frontal plane CoM displacement and velocity increased with increasing age (both p <.001), but dual-task performance had no effect on these variables (both p >.450)., Conclusions: Age-associated changes in both speed and stability are observed during narrow-base walking. Among this sample of healthy older adults, the addition of a concurrent cognitive task resulted in reduced speed, with no effect on frontal plane stability. Further research is needed to determine if dual-task, narrow-base walking is a sensitive and specific approach to identifying older adults at risk for falls.

We examined age-related differences in frontal plane stability during performance of narrow base (NB) walking relative to usual gait. A cross-sectional analysis of participants from the Baltimore Longitudinal Study of Aging (BLSA) was performed on data from the BLSA Motion Analysis Laboratory. Participants were 34 adults aged 54-92 without history of falls. We measured step error rates during NB gait and spatial-temporal parameters, frontal plane stability, and gait variability during usual and NB gait. There was a non-significant age-associated linear increase in step error rate (P=0.12) during NB gait. With increasing age, step width increased (P=0.002) and step length and stride velocity decreased (P<0.001), especially during NB gait. Age-associated increases in medio-lateral (M-L) center of mass (COM) peak velocity (P<0.001) and displacement (P=0.005) were also greater during NB compared to usual gait. With increasing age there was greater variability in stride velocity (P=0.001) and step length (P<0.001) under both conditions. Age-associated differences related to M-L COM stability suggest that the quantification of COM control during NB gait may improve identification of older persons at increased falls risk.

The aging process is often paralleled by decreases in muscle and increases in fat mass. At the extreme these two processes lead to a condition known as "sarcopenic obesity" (Roubenoff R. Ann NY Acad Sci 904: 553-557, 2000). Research suggests that inflammatory cytokines produced by adipose tissue, especially visceral fat, accelerate muscle catabolism and thus contribute to the vicious cycle that initiates and sustains sarcopenic obesity. We tested the hypothesis that obesity and poor muscle strength, hallmarks of sarcopenic obesity, are associated with high circulating levels of proinflammatory cytokines in a random sample of the residents of two municipalities in the Chianti geographic area (Tuscany, Italy). The study sample consisted of 378 men and 493 women 65 yr and older with complete data on anthropometrics, handgrip strength, and inflammatory markers. Participants were cross-classified according to sex-specific tertiles of waist circumference and grip strength and according to a cut point for obesity of body mass index > or =30 kg/m(2). After adjusting for age, sex, education, smoking history, physical activity, and history of comorbid diseases, components of sarcopenic obesity were associated with elevated levels of IL-6, C-reactive protein, IL-1 receptor antagonist, and soluble IL-6 receptor (P < 0.05). Our findings suggest that global obesity and, to a greater extent, central obesity directly affect inflammation, which in turn negatively affects muscle strength, contributing to the development and progression of sarcopenic obesity. These results suggest that proinflammatory cytokines may be critical in both the development and progression of sarcopenic obesity.

The influence of insulin-like growth factor-2 (IGF2) genotype on total body fat-free mass (FFM), muscle strength, and sustained power (SP) was evaluated repeatedly at approximately 2-yr intervals in two cohorts from the Baltimore Longitudinal Study of Aging. Cohort 1 was comprised of 94 men tested for isometric grip strength and SP. Cohort 2 was comprised of 246 men and 239 women tested for total body FFM and isokinetic peak torque. Subjects were retrospectively genotyped for the IGF2 gene's ApaI polymorphism. Differences between genotype groups for total FFM, strength, and SP at first visit, at peak age (35 yr), at age 65, and across the adult age span were analyzed using either two-sample t-tests or mixed-effects models, depending on the specific comparisons made. Isokinetic arm strength at the time of first visit was lower in A/A men than in G/G men (P < 0.05). Compared with G/G women, A/A women had lower total body FFM, lower isokinetic arm and leg strength at the time of first visit, and lower values at age 35 (all P < 0.05) for these muscle phenotypes. Furthermore, this difference between the genotype groups was maintained at age 65 and across the adult age span (P < 0.05). No genotype-associated differences in rates of loss of grip strength or SP were found in cohort 1. These results from cohort 2 support the hypothesis that variation within a gene known to influence developing muscle affects muscle mass and muscle function in later life.

We studied the association of the G-174C promoter polymorphism in the interleukin-6 gene (IL6) with total body fat and fat-free mass (FFM) in 242 men and women (IL6 genotypes: G/G, n = 87; G/C, n = 100; C/C, n = 55) across the adult age span (21-92 years). In men, but not women (significant genotype by sex interactions; p =.023-.048), the C/C group exhibited significantly lower total FFM than the G/G group (54.7 +/- 0.8 kg vs 57.2 +/- 0.7 kg, respectively, p =.020), as well as significantly lower FFM of the lower limbs compared with the G/G group (18.4 +/- 0.3 kg vs 19.8 +/- 0.3 kg, respectively, p =.004). No significant genotype differences were observed in total body fat mass in either men or women. The results indicate that the IL6 G-174C polymorphism is significantly associated with FFM in men but not women.

The relationship between ciliary neurotrophic factor (CNTF) genotype and muscle strength was examined in 494 healthy men and women across the entire adult age span (20-90 yr). Concentric (Con) and eccentric (Ecc) peak torque were assessed using a Kin-Com isokinetic dynamometer for the knee extensors (KE) and knee flexors (KF) at slow (0.52 rad/s) and faster (3.14 rad/s) velocities. The results were covaried for age, gender, and body mass or fat-free mass (FFM). Individuals heterozygous for the CNTF null (A allele) mutation (G/A) exhibited significantly higher Con peak torque of the KE and KF at 3.14 rad/s than G/G homozygotes when age, gender, and body mass were covaried (P < 0.05). When the dominant leg FFM (estimated muscle mass) was used in place of body mass as a covariate, Con peak torque of the KE at 3.14 rad/s was also significantly greater in the G/A individuals (P < 0.05). In addition, muscle quality of the KE (peak torque at 3.14 rad x s(-1) x leg muscle mass(-1)) was significantly greater in the G/A heterozygotes (P < 0.05). Similar results were seen in a subanalysis of subjects 60 yr and older, as well as in Caucasian subjects. In contrast, A/A homozygotes demonstrated significantly lower Ecc peak torque at 0.52 rad/s for both KE and KF compared with G/G and G/A groups (P < 0.05). No significant relationships were observed at 0.52 rad/s between genotype and Con peak torque. These data indicate that individuals exhibiting the G/A genotype possess significantly greater muscular strength and muscle quality at relatively fast contraction speeds than do G/G individuals. Because of high positive correlations between fast-velocity peak torque and muscular power, these findings suggest that further investigations should address the relationship between CNTF genotype and muscular power.

61 biopsies of normal skin from the deltoid area and lesional skin from various sites from 48 patients with systemic lupus erythematosus (SLE) were studied for the presence of properdin, C3, C4, and immunoglobulins (IgG, IgM, and IgA) in the dermal-epidermal junction (DEJ) using direct and indirect immunofluorescence. Properdin was present in 50% of normal and 40% of lesional skins. Properdin was present without C4 in only 2 of 38 nonlesional skin biopsies and in only 2 of 20 lesions. There was no significant difference in incidence of deposition of any of the six proteins studied between nonlesional and lesional skin. The frequency of deposition of each of the proteins correlated with clinical disease activity. The presence of proteins in the DEJ did not correlate with the presence of active renal disease at the time of biopsy nor with previously documented active nephritis. In addition, no other single clinical manifestation correlated with the presence of DEJ deposition of any protein studied. IgA was not demonstrated in the DEJ of nonlesional skin of 16 patients in remission and was present in 7 of 23 patients with active disease (P less than 0.05). Deposition of properdin in lesional skin correlated with the presence of extracutaneous disease activity (P less than 0.05). Analysis of serologic studies on serum obtained at the time of biopsy revealed a statistically significant correlation between C4 and C3 (r = 0.67). This correlation was stronger than that between properdin and C4 (r = 0.37). Titer of antinuclear antibody and percent of DNA binding correlated better with C4 levels than with properdin levels. Serum properdin levels were significantly lower in patients with active disease than in those in remission (P less than 0.05). Serum properdin levels were significantly lower in patients with properdin deposits in lesional skin than in those without properdin deposits. The data suggest that both alternative and classical pathways are activated in patients with clinically active SLE.

To assess the relative roles of the classic and alternative pathways of complement activation in chronic discoid lupus erythematosus (CDLE), serum levels of properdin, C3, and C4, and deposition of these proteins in the dermal-epidermal junction (DEJ) of 20 CDLE patients were compared to the findings in patients with clinically active and inactive SLE. Properdin was demonstrated in the DEJ of 10 of 14 (71%) histologically typical skin lesions from patients with CDLE, usually in association with deposits of immunoglobulin, C3, and C4. Properdin levels in CDLE patients were significantly increased (137 +/- 34%) (P less than 0.05) when compared to normal controls (101 +/- 18%) or to patients with clinically active SLE (89 +/- 32%). C3, C4, DNA-binding, and antinuclear antibody tests in CDLE were indistinguishable from those in normals, but significantly different from patients with active SLE (P less than 0.05). The complement profiles of patients with clinically inactive SLE resembled those of CDLE patients more closely than those of active SLE patients.