Effect of concurrent aerobic and resistance circuit exercise training on fitness in older adults

The purpose of this study was to determine the physiological effects of a programmed accommodating circuit exercise (PACE) program consisting of aerobic exercise and hydraulic-resistance exercise (HRE) on fitness in older adults. Thirty-five volunteers were randomly divided into two groups [PACE group (PG) 8 men and 10 women, 68.3 (4.9) years, and non-exercise control group (CG) 7 men and 10 women, 68.0 (3.4) years). The PG participated in a 12-week, 3 days per week supervised program consisting of 10 min warm-up and 30 min of PACE (moderate intensity HRE and aerobic movements at 70% of peak heart rate) followed by 10 min cool-down exercise. PACE increased (P<0.05) oxygen uptake (O₂) at lactate threshold [PG, pre 0.79 (0.20) l min^–1, post 1.02 (0.22) l min^–1, 29%; CG, pre 0.87 (0.14) l min^–1, post 0.85 (0.15) l min^–1, –2%] and at peak O₂ [PG, pre 1.36 (0.24) l min^–1, post 1.56 (0.28) l min^–1, 15%; CG, pre 1.32 (0.29) l min^–1, post 1.37 (0.37) l min^–1, 4%] in PG measured using an incremental cycle ergometer. Muscular strength evaluated by a HRE machine increased at low to high resistance dial settings for knee extension (9–52%), knee flexion (14–76%), back extension (18–92%) and flexion (50–70%), chest pull (6–28%) and press (3–17%), shoulder press (18–31%) and pull (26–85%), and leg press (21%). Body fat (sum of three skinfolds) decreased (16%), and high-density lipoprotein cholesterol (HDLC) increased (10.9 mg dl^–1) for PG. There were no changes in any variables for CG. These results indicate that PACE training incorporating aerobic exercise and HRE elicits significant improvements in cardiorespiratory fitness, muscular strength, body composition, and HDLC for older adults. Therefore, PACE training is an effective well-rounded exercise program that can be utilized as a means to improve health-related components of fitness in older adults.     

Muscle strength,power and adaptations to resistance training in older people

Muscle strength and, to a greater extent, power inexorably decline with ageing. Quantitative loss of muscle mass, referred to as sarcopenia, is the most important factor underlying this phenomenon. However, qualitative changes of muscle fibres and tendons, such as selective atrophy of fast-twitch fibres and reduced tendon stiffness, and neural changes, such as lower activation of the agonist muscles and higher coactivation of the antagonist muscles, also account for the age-related decline in muscle function. The selective atrophy of fast-twitch fibres has been ascribed to the progressive loss of motoneurons in the spinal cord with initial denervation of fast-twitch fibres, which is often accompanied by reinnervation of these fibres by axonal sprouting from adjacent slow-twitch motor units (MUs). In addition, single fibres of older muscles containing myosin heavy chains of both type I and II show lower tension and shortening velocity with respect to the fibres of young muscles. Changes in central activation capacity are still controversial. At the peripheral level, the rate of decline in parameters of the surface-electromyogram power spectrum and in the action-potential conduction velocity has been shown to be lower in older muscle. Therefore, the older muscle seems to be more resistant to isometric fatigue (fatigue-paradox), which can be ascribed to the selective atrophy of fast-twitch fibres, slowing in the contractile properties and lower MU firing rates. Finally, specific training programmes can dramatically improve the muscle strength, power and functional abilities of older individuals, which will be examined in the second part of this review.     

The association of objectively measured physical activity and sedentary behavior with skeletal muscle strength and muscle power in older adults: A systematic review and meta-analysis

BackgroundEngaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and mortality. Whether benefits extend to key determinants of disability and mortality, namely muscle strength and muscle power, is unclear.AimsThis systematic review aimed to describe the association of objective measures of PA and SB with measures of skeletal muscle strength and muscle power in community-dwelling older adults.MethodsSix databases were searched from their inception to June 21^st, 2020 for articles reporting associations between objectively measured PA and SB and upper body or lower body muscle strength or muscle power in community dwelling adults aged 60 years and older. An overview of associations was visualized by effect direction heat maps, standardized effect sizes were estimated with albatross plots and summarized in box plots. Articles reporting adjusted standardized regression coefficients (β) were included in meta-analyses.ResultsA total of 112 articles were included representing 43,796 individuals (range: 21 to 3726 per article) with a mean or median age from 61.0 to 88.0 years (mean 56.4 % female). Higher PA measures and lower SB were associated with better upper body muscle strength (hand grip strength), upper body muscle power (arm curl), lower body muscle strength, and lower body muscle power (chair stand test). Median standardized effect sizes were consistently larger for measures of PA and SB with lower compared to upper body muscle strength and muscle power. The meta-analyses of adjusted β coefficients confirmed the associations between total PA (TPA), moderate-to-vigorous PA (MVPA) and light PA (LPA) with hand grip strength (β = 0.041, β = 0.057, and β = 0.070, respectively, all p ≤ 0.001), and TPA and MVPA with chair stand test (β = 0.199 and β = 0.211, respectively, all p ≤ 0.001).ConclusionsHigher PA and lower SB are associated with greater skeletal muscle strength and muscle power, particularly with the chair stand test.     

Markers of inflammation and their association with muscle strength and mass: A systematic review and meta-analysis

BackgroundChronic inflammation has been associated with sarcopenia and its components skeletal muscle strength and muscle mass. The aim of this systematic review and meta-analysis was to determine the relationship between systemic inflammation, muscle strength and/or muscle mass in adults.MethodsAn electronic search using keywords such as ‘acute phase proteins, cytokines and sarcopenia, muscle mass, muscle strength’ was conducted via Pubmed, Web of Science and Embase from inception until the 30th of June 2020. A meta-analysis using correlation data was performed to determine the overall relationship between inflammation and muscle strength and muscle mass in adults.ResultsOverall, 168 articles; 149 cross-sectional articles (n = 76,899 participants, 47.0 % male) and 19 longitudinal articles (n = 12,295 participants, 31.9 % male) met inclusion criteria. Independent of disease state, higher levels of C reactive protein (CRP), Interleukin (IL)-6 and Tumor necrosis factor (TNF)α were associated with lower handgrip and knee extension strength (CRP; r = −0.10, p < 0.001, IL-6; r = −0.13, p < 0.001, TNFα; r = −0.08, p < 0.001 and CRP; r = −0.18, p < 0.001, IL-6; r = −0.11, p < 0.001, TNFα; r = −0.13, p < 0.001 respectively) and muscle mass (CRP; r = −0.12, p < 0.001, IL-6; r = −0.09, p < 0.001, TNFα; r = −0.15, p < 0.001). Furthermore, higher levels of systemic inflammatory markers appeared to be associated with lower muscle strength and muscle mass over time.ConclusionHigher levels of circulating inflammatory markers are significantly associated with lower skeletal muscle strength and muscle mass.     

Effect of nutritional supplementations on physical performance and muscle strength parameters in older people: A systematic review and meta-analysis

Malnutrition plays a role in the development of poor physical performance, frailty and sarcopenia. The use of nutritional supplementations for improving physical performance and muscle strength parameters in older people is unclear. We therefore aimed to summarize the effect of nutritional supplementations compared to placebo on physical performance (i.e. tests more investigating physical function, utilising aerobic capacity & muscle power) and muscle strength (i.e. tests depending on muscle power) outcomes in older people in randomized controlled trials (RCTs). A literature search in major databases was undertaken until the 01st September 2018. Eligible studies were RCTs investigating the effect of nutritional supplementations vs. placebo in older people (people having an age >60 years). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were used through a random effect model. Over 4007 potentially eligible articles, 32 RCTs for a total of 4137 older participants (2097 treated and 2040 placebo) (mean age: 76.3 years; 65% females) were included. Compared to placebo, multi-nutrient supplementations significantly improved chair rise time (n = 3; SMD=-0.90; 95%CI: -1.46 to -0.33; I² = 87%). Multi-nutrients significantly improved handgrip strength when compared to placebo (n = 6; 780 participants; SMD = 0.41; 95%CI: 0.06 to 0.76; I² = 79%), as did nutritional supplementations including protein (n = 7; 535 participants; SMD = 0.24; 95%CI: 0.07 to 0.41; I² = 16%).Nutritional supplementations also led to a significant improvement in chair rise time and in handgrip strength in participants affected by frailty/sarcopenia and in those affected by medical conditions. In conclusion, nutritional supplementation can improve a number of physical performance outcomes in older people, particularly when they include multi-nutrients and in people already affected by specific medical conditions, or by frailty/sarcopenia.     

Muscle morphology and performance in master athletes: A systematic review and meta-analyses

IntroductionThe extent to which chronic exercise training preserves age-related decrements in physical function, muscle strength, mass and morphology is unclear. Our aim was to conduct a systematic review of the literature to determine to what extent chronically trained master athletes (strength/power and endurance) preserve levels of physical function, muscle strength, muscle mass and morphology in older age, compared with older and younger controls and young trained individuals.MethodsThe systematic data search included Medline, EMBASE, SPORTDiscus, CINAHL and Web of Science databases.Inclusion criteriai) master athletes mean exercise training duration ≥20 years ii) master athletes mean age of cohort >59 years) iii) at least one measurement of muscle mass/volume/fibre-type morphology and/or strength/physical function.ResultsFifty-five eligible studies were identified. Meta-analyses were carried out on maximal aerobic capacity, maximal voluntary contraction and body composition. Master endurance athletes (42.0 ± 6.6 ml kg⁻¹ min⁻1) exhibited VO_2max values comparable with young healthy controls (43.1 ± 6.8 ml kg⁻¹ min⁻¹, P = .84), greater than older controls (27.1 ± 4.3 ml kg⁻¹ min⁻¹, P < 0.01) and master strength/power athletes (26.5 ± 2.3 mlkg⁻¹ min⁻¹, P < 0.01), and lower than young endurance trained individuals (60.0 ± 5.4 ml kg⁻¹ min⁻¹, P < 0.01). Master strength/power athletes (0.60 (0.28–0.93) P < 0.01) and young controls (0.71 (0.06–1.36) P < 0.05) were significantly stronger compared with the other groups. Body fat% was greater in master endurance athletes than young endurance trained (−4.44% (−8.44 to −0.43) P < 0.05) but lower compared with older controls (7.11% (5.70–8.52) P < 0.01).ConclusionDespite advancing age, this review suggests that chronic exercise training preserves physical function, muscular strength and body fat levels similar to that of young, healthy individuals in an exercise mode-specific manner.     

Biomarkers shared by frailty and sarcopenia in older adults: A systematic review and meta-analysis

BackgroundPhysical frailty and sarcopenia show extensive clinical similarities. Whether biomarkers exist that are shared by the two conditions is presently unclear.MethodsWe conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association of frailty and/or sarcopenia with biomarkers as a primary or secondary outcome in adults aged 60 years and older. Only studies published in English that defined frailty using a validated scale and/or questionnaire and diagnosed sarcopenia according to the presence of muscle atrophy plus dynapenia or low physical function were included. Studies were identified from a systematic search of MEDLINE and SCOPUS databases from inception through August 2020. The quality of reporting of each study was assessed by using the Quality Assessment Tool for Observational Cohort, Cross-Sectional and Case-Control studies of the National Institute of Health. A meta-analysis was conducted when at least three studies investigated the same biomarker in both frailty and sarcopenia. Pooled effect size was calculated based on standard mean differences and random-effect models. Sensitivity analysis was performed based on age and the setting where the study was conducted.ResultsEighty studies (58 on frailty and 22 on sarcopenia) met the inclusion criteria and were included in the qualitative analysis. Studies on frailty included 33,160 community-dwellers, hospitalized, or institutionalized older adults (60–88 years) from 21 countries. Studies on sarcopenia involved 4904 community-living and institutionalized older adults (68–87.6 years) from 9 countries. Several metabolic, inflammatory, and hematologic markers were found to be shared between the two conditions. Albumin and hemoglobin were negatively associated with both frailty and sarcopenia. Interleukin 6 was associated with frailty and sarcopenia only in people aged < 75. Community-dwelling older adults with frailty and sarcopenia had higher levels of tumor necrosis factor alpha compared with their robust and non-sarcopenic counterparts.ConclusionsA set of metabolic, hematologic, and inflammatory biomarkers was found to be shared by frailty and sarcopenia. These findings fill a knowledge gap in the quest of biomarkers for these conditions and provide a rationale for biomarker selection in studies on frailty and sarcopenia.     

Orthostatic hypotension and physical functioning in older adults: A systematic review and meta-analysis

BackgroundOrthostatic hypotension (OH) may negatively affect physical functioning and aggravate morbidities, but existing evidence is contradictory.MethodsMEDLINE (from 1946), PubMed (from 1966) and EMBASE databases (from 1947) were systematically searched for studies on the association of OH and physical functioning in older adults, categorized as: balance, gait characteristics, walking speed, Timed Up and Go time, handgrip strength (HGS), physical frailty, exercise tolerance, physical activity, activities of daily living (ADL), and performance on the Hoehn and Yahr scale (HY) and Unified Parkinson’s Disease Rating Scale (UPDRS). Study quality was assessed using the Newcastle Ottawa Scale.ResultsForty-two studies were included in the systematic review (29,421 individuals) and 29 studies in the meta-analyses (23,879 individuals). Sixteen out of 42 studies reported a significant association of OH with worse physical functioning. Meta-analysis showed a significant association of OH with impaired balance, ADL performance and HY/UPDRS III performance, but not with gait characteristics, mobility, walking speed, TUG, HGS, physical frailty, exercise tolerance, physical activity and UPDRS II performance.ConclusionsOH was associated with impaired balance, ADL performance and HY/UPDRS III performance, but not with other physical functioning categories. The results suggest that OH interventions could potentially improve some aspects of physical functioning.     

抗阻训练对绝经后女性身体成分、膝关节肌肉力量及动态平衡能力的影响

目的：探讨抗阻训练对绝经后女性身体成分、膝关节屈伸肌力及动态平衡能力的影响。方法：将25 名绝 经女性随机分为抗阻训练组和对照组,抗阻训练前后测试绝经后女性身体成分（ 体质量、体脂肪量、肌肉量、左 右下肢肌肉量）,左、右膝关节屈、伸肌力及动态平衡能力。结果：12 周抗阻训练可使绝经后女性体脂肪量显著 下降,左右下肢肌肉量及全身肌肉量均显著增加,而体质量在抗阻训练前后无显著差异;此外,12 周抗阻训练可 使绝经后女性左、右膝关节屈、伸肌肌力显著增加,闭眼状态下总体稳定指数、前后方向稳定指数及左右方向稳 定指数显著下降。结论：12 周抗阻训练可显著降低绝经后女性身体脂肪量、增加下肢肌肉量及膝关节肌肉力量, 改善动态平衡能力,对于预防绝经后女性跌倒及提高绝经后女性生存质量有重要意义。     

Changes in electromyographic activity,muscle fibre and force production characteristics during heavy resistance/power strength training in middle‐aged and older men and women

The effects of a 6‐month resistance training (2 day/week) designed to develop both strength and power on neural activation by electromyographic activity (EMG) of the agonist and antagonist knee extensors, muscle fibre proportion and areas of type I, IIa, and IIb of the vastus lateralis (VL) as well as maximal concentric one repetition maximum (1 RM) strength and maximal and explosive isometric strength of the knee extensors were examined. A total of 10 middle‐aged men (M40; 42 ± 2), 11 middle‐aged women (W40; 39 ± 3), 11 elderly men (M70; 72 ± 3) and 10 elderly women (W70; 67 ± 3) served as subjects. Maximal and explosive strength values remained unaltered during a 1‐month control period. After the 6‐month training maximal isometric and 1RM strength values increased in M40 by 28 ± 14 and 27 ± 7% (P < 0.001), in M70 by 27 ± 17 and 21 ± 9% (P < 0.001), in W40 by 27 ± 19 and 35 ± 14% (P < 0.001) and in W70 by 26 ± 14 and 31 ± 14% (P < 0.001), respectively. Explosive strength improved in M40 by 21 ± 41% (P < 0.05), in M70 by 21 ± 24% (P < 0.05), in W40 by 32 ± 45% (NS) and in W70 by 22 ± 28% (P < 0.05). The iEMGs of the VL and vastus medialis (VM) muscles increased during the training in M40 (P < 0.001 and 0.05), in M70 (P < 0.001 and 0.05), in W40 (P < 0.001 and 0.05) and in W70 (P < 0.001 and 0.05). The antagonist biceps femoris (BF) activity during the isometric knee extension remained unaltered in M40, in W40, and in M70 but decreased in W70 (from 42 ± 34 to 32 ± 26%; P < 0.05) during the first 2 months of training. Significant increases occurred during the training in the mean fibre areas of type I in W70 (P < 0.05) and of overall type II along with a specific increase in IIa in both W40 (P < 0.05) and in W70 (P < 0.05), while the changes in the male groups were not statistically significant. The individual percentage values for type II fibres at pretraining correlated with the individual values for 1 RM strength in both W70 (r=0.80; P < 0.05) and M70 (r=0.61; P < 0.05) and also at post‐training for maximal isometric torque in W70 (r=0.77, P < 0.05). The findings support the concept of the important role of neural adaptations in strength and power development in middle‐aged and older men and women. The muscle fibre distribution (percentage type II fibres) seems to be an important contributor on muscle strength in older people, especially older women. Women of both age groups appear to be hypertrophically responsive to the total body strength training protocol performed two times a week including heavier and lower (for fast movements) loads designed for both maximal strength and power development, while such a programme has limited effects on muscle hypertrophy in men.     

Unsupervised home-based resistance training for community-dwelling older adults: A systematic review and meta-analysis of randomized controlled trials

BackgroundWe aimed to summarize evidence on the safety, adherence and effectiveness of home-based resistance training (UHBRT) for improving health-related endpoints in community-dwelling older adults.MethodsRandomized controlled trials of UHBRT in older adults (≥60yrs) were included after a systematic search (PubMed, CINAHL, PsycInfo, SPORTDiscus, Web of Science, MEDLINE, Cochrane Central Register of Controlled Trials) until 02/19/2021. Adverse events and adherence rates were assessed as indicators of feasibility. Other endpoints included physical (muscle strength, muscle power, balance, physical performance) and mental-related measures (cognition, quality of life [QoL]) as well as other health-related variables (body composition, physical activity levels, falls).Results21 studies (N = 4,053) were included. No major adverse events were reported, with adherence averaging 67 % (range 47–97 %). UHBRT significantly improved lower-limb muscle strength (Hedges' g = 0.33; 95 % confidence interval [CI] = 0.11−0.57), muscle power measured through the sit-to-stand test (g = 0.44; 95 %CI = 0.06−0.84), and balance (assessed with the postural sway, g = 0.32; 95 %CI = 0.16−0.49). No benefits were found for other strength indices (handgrip strength), balance (single leg stance and functional reach test), physical performance (walking speed, TUG and SPPB), QoL, nor for the risk or rate of falls (all p > 0.05, g<0.61). No meta-analysis could be performed for the remaining endpoints.ConclusionsAlthough efforts are needed to increase adherence, preliminary evidence suggests that UHBRT can be safe and modestly effective for improving some measures of lower-limb muscle strength, balance, and muscle power in community-dwelling older adults. However, no benefits were found for other physical fitness measures, QoL or falls. More evidence is therefore needed to draw definite conclusions.     

The effect of whole body vibration exposure on muscle or bone morphology and function in older adults: A systematic review of the literature

Context and objective

The aim of this study was to examine the effect of whole body vibration (WBV), a novel exercise modality, on muscle or bone morphology and function in older adults.

Methods

A literature search of published randomised controlled trials (RCTs) was conducted using multiple databases and hand searching for study designs reporting the effects of WBV in older adults on any outcomes related to muscle function, or muscle or bone morphology. Concomitant exercise was only included if the control group performed the same exercise as the active WBV group, but without vibration.

Results

Six RCTs met the inclusion criteria of this review, three reporting measures of muscle only, two assessing bone measures only and one detailing measures of both bone and muscle. Study design varied greatly across the six trials and only six of 35 musculoskeletal outcomes analysed were statistically significant. All statistically significant improvements were of muscle function.

Conclusions

The published literature to date provides only weak support for the efficacy of WBV exposure for muscle function, muscle morphology, or bone architecture in older adults. Irregularities in study design and WBV protocols across the literature and poor quality trials contribute to this inconsistency, revealing the need for more uniformity in future trials. Future research should be more robust in design, include larger cohorts, longer interventions and standardisation of protocols. They should also investigate the optimal dose–response relationships and variation in vibration characteristics, to determine the true efficacy, clinical relevance, and underlying mechanisms of muscle and bone adaptations.     

Thresholds of handgrip strength for all-cause,cancer, and cardiovascular mortality: A systematic review with dose-response meta-analysis

BackgroundWhile handgrip strength is associated with all-cause and cause-specific mortality, whether such associations are dose-dependent is largely unknown. Therefore, we conducted a systematic review on the dose-response relationship of handgrip strength with all-cause mortality, cancer, and cardiovascular mortality.MethodsThe data source included three electronic databases (PubMed/MEDLINE, Web of Science and Scopus) from inception to 8 February 2022. Prospective cohort studies of healthy adults with objective measures of handgrip strength were included. Two researchers independently screened studies, extracted data, and assessed risk of bias. We used estimates regarding handgrip strength categories to conduct a random forest model, and a two-stage random-effects hierarchical meta-regression model pooling study-specific estimates for dose-response relationship. Outcomes included all-cause, cancer, and cardiovascular mortality.ReultsForty-eight studies comprising 3,135,473 participants (49.6% women, age range 35–85 years) were included. Random forest models showed a significant inverse association between handgrip strength and all-cause and cause-specific mortality. Dose-response meta-analyses showed that higher levels of handgrip strength significantly reduced the risk of all-cause mortality within 26–50 kg (Higgin´s I² =45.7%) in a close-to-linear inverse fashion. Cancer and cardiovascular mortality displayed a trend towards a U-shaped association with a significant risk reduction between 16 and 33 kg (Higgin´s I² =77.4%), and a close-to-linear inverse shaped and significant risk reduction ranging from 24 to 40 kg (Higgin´s I² =79.7%) respectively.ConclusionThere is strong evidence for an association between lower handgrip strength with higher all-cause, cancer, and cardiovascular mortality risk. The dose-response relationship of handgrip strength substantially varies depending on the cause of mortality.     

Muscle performance,morphology and metabolic capacity during strength training and detraining: A one leg model

Summary To investigate biochemical, histochemical and contractile properties associated with strength training and detraining, six adult males were studied during and after 10 weeks of dynamic strength training for the quadriceps muscle group of one leg, as well as during and after a subsequent 12 weeks of detraining. Peak torque outputs at the velocities tested (0–270·s^–1) were increased (p<0.05) by 39–60% and 12–37% after training for the trained and untrained legs, respectively. No significant changes in peak torques were observed in six control subjects tested at the same times. Significant decreases in strength performance of the trained leg (16–21%) and untrained leg (10–15%) were observed only after 12 weeks of detraining. Training resulted in an increase (p0.05) in the area of FTa (21%) and FTb (18%) fibres, while detraining was associated with a 12% decrease in FTb fibre cross-sectional area. However, fibre area changes were only noted in the trained leg. Neither training nor detaining had any significant effect on the specific activity of magnesium-activated myofibrillar ATPase or on the activities of enzymes of phosphagen, glycolytic or oxidative metabolism in serial muscle biopsy samples from both legs. In the absence of any changes in muscle enzyme activities and with only modest changes in FT fibre areas in the trained leg, the significant alterations in peak torque outputs with both legs suggest that neural adaptations play a prominent role in strength performance with training and detraining.This study was funded by a grant from the Natural Sciences and Engineering Research Council of Canada     

The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: A systematic review and meta-analysis

This systematic review and meta-analysis investigates the impact of cognitive training and general mental stimulation on the cognitive and everyday functioning of older adults without known cognitive impairment. We examine transfer and maintenance of intervention effects, and the impact of training in group versus individual settings. Thirty-one randomised controlled trials were included, with 1806 participants in cognitive training groups and 386 in general mental stimulation groups. Meta-analysis results revealed that compared to active controls, cognitive training improved performance on measures of executive function (working memory, p = 0.04; processing speed, p < 0.0001) and composite measures of cognitive function (p = 0.001). Compared to no intervention, cognitive training improved performance on measures of memory (face-name recall, p = 0.02; immediate recall, p = 0.02; paired associates, p = 0.001) and subjective cognitive function (p = 0.01). The impact of cognitive training on everyday functioning is largely under investigated. More research is required to determine if general mental stimulation can benefit cognitive and everyday functioning. Transfer and maintenance of intervention effects are most commonly reported when training is adaptive, with at least ten intervention sessions and a long-term follow-up. Memory and subjective cognitive performance might be improved by training in group versus individual settings.     

Time course for strength and muscle thickness changes following upper and lower body resistance training in men and women

 The purpose of this study was to investigate the time course of skeletal muscle adaptations resulting from high-intensity, upper and lower body dynamic resistance training (WT). A group of 17 men and 20 women were recruited for WT, and 6 men and 7 women served as a control group. The WT group performed six dynamic resistance exercises to fatigue using 8–12 repetition maximum (RM). The subjects trained 3 days a week for 12 weeks. One-RM knee extension (KE) and chest press (CP) exercises were measured at baseline and at weeks 2, 4, 6, 8, and 12 for the WT group. Muscle thickness (MTH) was measured by ultrasound at eight anatomical sites. One-RM CP and KE strength had increased significantly at week 4 for the female WT group. For the men in the WT group, 1 RM had increased significantly at week 2 for KE and at week 6 for CP. The mean relative increases in KE and CP strength were 19% and 19% for the men and 19% and 27% for the women, respectively, after 12 weeks of WT. Resistance training elicited a significant increase in MTH of the chest and triceps muscles at week 6 in both sexes. There were non-significant trends for increases in quadriceps MTH for the WT groups. The relative increases in upper and lower body MTH were 12%–21% and 7%–9% in the men and 10%–31% and 7%–8% in the women respectively, after 12 weeks of WT. These results would suggest that increases in MTH in the upper body are greater and occur earlier compared to the lower extremity, during the first 12 weeks of a total body WT programme. The time-course and proportions of the increase in strength and MTH were similar for both the men and the women. Accepted: 6 September 1999     

Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials

Combining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines. However, it remains unclear what combination strategies are most beneficial for cognitive and physical outcomes. We aimed to compare the efficacy of the three main types of combination strategies (simultaneous, sequential or exergaming) to either intervention alone or control in older adults. Randomized controlled trials of combined cognitive and physical training were included in multivariate and network meta-analyses. In cognitively healthy older adults and mild cognitive impairment, the effect of any combined intervention relative to control was small and statistically significant for overall cognitive (k = 41, Hedges’ g = 0.22, 95 % CI 0.14 to 0.30) and physical function (k = 32, g = 0.25, 95 % CI 0.13 to 0.37). Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise. For physical outcomes, simultaneous and sequential training showed comparable efficacy as exercise alone and significantly exceeded all other control conditions. Exergaming ranked low for both outcomes. Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training.     

Protein intake and physical function in older adults: A systematic review and meta-analysis

BackgroundThe present study explored cross-sectional and longitudinal associations between protein intake and physical function in older adults.MethodsWe conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and measures of physical function in older adults. Cross-sectional, case-control, and longitudinal cohort studies that investigated the association between protein intake and physical function as a primary or secondary outcome in people aged 60 + years were included. Studies published in languages other than English, Italian, Portuguese, or Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences (SMD), MD, log odds ratio (OR) and Z-score..ResultsTwenty-two cross-sectional studies examined a total of 11,332 community-dwellers, hospitalized older adults, and elite senior athletes with a mean age of approximately 75 years. The pooled analysis indicated that a protein intake higher than the recommended dietary allowance (RDA) was significantly associated with higher Short Physical Performance Battery (SPPB) scores (SMD: 0.63, 95% CI: 0.27, 0.99, P-value: 0.0006), faster walking speed, greater lower-limb (SMD: 0.22, 95% CI: 0.04, 0.40, P-value: 0.02) and isometric handgrip strength (Z-score: 0.087, 95% CI: 0.046–0.128, P-value: 0.0001), and better balance (SMD: 0.33, 95% CI: 0.05, 0.62, P-value: 0.02). Nine longitudinal studies investigated 12,424 community-dwelling and native older adults with a mean age of approximately 85 years. A protein intake higher than the current RDA was not associated with lower decline in either isometric handgrip strength (logOR: 0.99, 95% CI: 0.97–1.02, P-value= 0.67) or walking speed (logOR: 0.92, 95% CI: 0.77–1.10, P-value= 0.35).ConclusionsA protein intake higher than the RDA is cross-sectionally associated with better physical performance and greater muscle strength in older adults. However, a high consumption of proteins does not seem to prevent physical function decline over time.     

Relationship between depression and frailty in older adults: A systematic review and meta-analysis

AimDepression and frailty are prevalent and burdensome in older age. However, the relationships between these entities are unclear and no quantitative meta- analysis exists. We conducted a systematic review and meta-analysis to investigate the associations between depression and frailty.MethodsTwo authors searched major electronic databases from inception until November-2016 for cross-sectional/longitudinal studies investigating depression and frailty. The strength of the reciprocal associations between frailty and depression was assessed through odds ratios (ORs) adjusted for potential confounders.ResultsFrom 2306 non duplicated hits, 24 studies were included. The overall prevalence of depression in 8023 people with frailty was 38.60% (95% CI 30.07–47.10, I² = 94%). Those with frailty were at increased odds of having depression (OR adjusted for publication bias 4.42, 95%CI 2.66–7.35, k = 11), also after adjusting for potential confounders (OR = 2.64; 95%CI: 1.59–4.37, I² = 55%, k = 4). The prevalence of frailty in 2167 people with depression was 40.40% (95%CI 27.00–55.30, I² = 97%). People with depression were at increased odds of having frailty (OR = 4.07, 95%CI 1.93–8.55, k = 8). The pooled OR for incident frailty, adjusted for a median of 7 confounders, was 3.72 (95%CI 1.95–7.08, I² = 98%, k = 4), whilst in two studies frailty increased the risk of incident depression with an OR = 1.90 (95%CI 1.55–2.32, I² = 0%).ConclusionThis meta-analysis points to a reciprocal interaction between depression and frailty in older adults. Specifically, each condition is associated with an increased prevalence and incidence of the other, and may be a risk factor for the development of the other. However, further prospective investigations are warranted.