Influence of dental occlusion on physical fitness decline in a healthy Japanese elderly population

The aim of this study was to clarify the relationship between dental occlusion and physical fitness by a longitudinal survey. A sample of 348 subjects (171 men and 177 women) aged 71 was investigated by Eichner index (EI) as an occlusal condition (Class A: no loss; Class B: partial loss; Class C: complete loss) and five types of physical fitness tests and were re-examined 8 years later. The upper 50% were sampled to analyze the correlation between each physical fitness decline and the EI at the baseline by logistic regression models. Logistic regression analyses revealed that leg extensor power (Class B vs. Class A; odds ratio = OR = 4.61, p = 0.010) and one-leg standing time with eyes open (Class C vs. Class A; OR = 4.27, p = 0.031) showed significant correlations with the EI at the baseline. In this study, partial or complete loss of occlusion was associated with a decline in leg extensor power or a decrease in one-leg standing time with eyes open. These findings suggest that maintenance of dental occlusion may prevent a decrease in activities of daily living in the elderly.     

Relationship between nutrition status and dental occlusion in community‐dwelling frail elderly people

Aim: This study aimed to determine the risk of malnutrition in some communities where the frail elderly receive public long‐term care insurance. We also clarified the dental problems in those at risk of malnutrition. Methods: A total of 716 frail elderly who lived in eight cities in Japan (240 males and 476 females with a mean age of 83.2 ± 8.6 years) were divided into three groups according to Mini Nutritional Assessment short form results: well nourished, at risk of malnutrition and malnourished. They were also divided into three groups in terms of remaining teeth occlusion and denture occlusion: group A, natural dentition with adequate function; group B, partially or fully edentulous, but maintaining functional occlusion with dentures in either or both jaws; and group C, functionally inadequate occlusion with no dentures. The relationship between nutrition status and dental occlusion was evaluated using logistic regression analysis with sex, age, activities of daily living and cognitive function as covariates. Results: The number of participants in each of the groups was as follows: 251 well nourished, 370 at risk of malnutrition and 95 malnourished. When they were divided into just two groups, (i) well nourished and (ii) at risk of malnutrition plus malnourished, in order to study malnutrition risk factors, there were significant relationships between their nutritious status and sex, Barthel index, and occlusion. Conclusion: This large‐scale cross‐sectional survey showed that loss of natural teeth occlusion was a risk factor for malnutrition among community‐dwelling frail elderly. Geriatr Gerontol Int 2013; 13: 50–54 .     

Relationship between aortic atherosclerosis and dental loss in an inner-city population

Prior studies have suggested an association between atherosclerosis and periodontal disease, both of which are more prevalent in certain minority and economically disadvantaged groups. Few studies have addressed the relationship between cardiovascular disease and dentition among ethnically diverse populations. We studied 131 subjects (60% females, age 59 +/- 15 years) who were referred for clinically indicated transesophageal echocardiography. Dental loss was more severe in patients with hypertension (P < .001), diabetes (P = .05), coronary artery disease (P = .04), and calcium channel blocker use (P = .04). On univariate analysis, maximal aortic intima-media thickness (MAIMT) was significantly correlated with dental loss (r = .40; P < .001). Age was correlated with MAIMT (R = .41; P < .001) and with dental loss (r = .57; P < .001). On multivariate analysis, dental loss (P = .03) and history of coronary artery disease (P = .04) were independent predictors of MAIMT ( R2 = .44). In this inner-city predominantly African American population, atherosclerosis and dental loss are age dependent and are interrelated independent of age.     

Relationship between multimorbidity and direct healthcare costs in an advanced elderly population

Objectives

The goal of this work was to analyze the impact of the extent of multimorbidity on health service resource utilization and, thus, direct healthcare costs of advanced elderly in the German population.

Methods

Based on a cross-sectional sample aged 72 or above in Germany (n?=?1,937), a bottom-up study assessing resource utilization and corresponding costs was performed. Main data sources were patient-reported information concerning morbidity and health service resource utilization administered via telephone interviews within the framework of the PRISCUS trial. To value resource utilization, unit costs were determined for all services under consideration. In order to estimate the impact of multimorbidity on mean annual direct costs, a cumulative multimorbidity index was constructed. Influencing factors on annual average costs were identified via multivariate linear regression models.

Results

Mean annual direct costs of 3,315?EUR (95%?confidence interval (CI) 3,118; 3,512) at 2010 prices were caused by the involved patients: 25% of mean annual costs were due to inpatient care, 20% to outpatient physician services, 20% to pharmaceuticals, 12% to assisted living and transportation, 8% to healthcare products and dentures, 7% to rehabilitation services, 5% to outpatient nonphysician providers, and 3% to spending from compulsory long-term care insurance. Each additional comorbidity was accompanied by a cost increase of 563?EUR (95%?CI 488; 638). Participants with no diseases mentioned in the multimorbidity index caused average annual costs of 1,250?EUR. In contrast, respondents with 10?+ diseases caused the highest mean annual costs of 6,862?EUR.

Conclusion

Longer life expectancy has become commonplace and is often associated with the simultaneous occurrence of several diseases. A clear understanding of the impact of multimorbidity on costs is highly relevant for health policy decision makers. The present study provides a well-founded basis to analyze the relationship between multiple morbidity and associated costs due to healthcare resource consumption of older adults in Germany.     

Relationship between physical fitness and arterial stiffness in Korean older adults

Pulse-wave velocity (PWV) is a widely used clinical marker of arterial stiffness. Associations between several physical fitness measures and arterial stiffness have been examined. However, these results were inconsistent. Therefore, we conducted a cross-sectional study to assess the relationship between various physical fitness parameters and arterial stiffness in older adults. From January 2014 to December 2015, 1500 participants (men, n = 587; mean age, 71.78 ± 5.10 years) in South Korea were enrolled in the study. Koreans aged >65 years who agreed to participate in the study were enrolled. Individuals who were unable to exercise because of underlying conditions were excluded. VO₂ max (mL/kg/min), handgrip strength (kg), handgrip strength (kg)/body weight (kg) ratio, one-leg standing time (s), and 10-meter walking speed (m/s) were measured. The brachial-ankle pulse wave velocity (baPWV) was measured using a VP-1000 instrument. VO₂ max (mL/kg/min), handgrip (kg)/body weight (kg) ratio, one-leg standing time (s), and 10-meter walking speed (m/s) were significantly inversely associated with baPWV. This association was consistent even after adjusting for confounding factors. Our study revealed a significant association between various aspects of physical fitness and arterial stiffness. This study suggests that physical fitness is a useful predictor of arterial stiffness in older adults.     

Relationship between visceral fat accumulation and physical fitness in Japanese women

OBJECTIVE: To investigate the link between visceral fat (V) accumulation and physical fitness. DESIGN: Cross-sectional clinical investigation study. SUBJECTS: Twenty-eight overweight Japanese women with abdominal obesity (abdominal obesity) (body mass index, BMI>or=25, visceral fat area>or=100 cm2) aged 38-65 years (BMI 29.5+/-3.3 kg/m2) were enrolled in this study. They were compared with age and sex matched 28 normal weight subjects (BMI<25, visceral fat area<100 cm2) and 28 overweight subjects without abdominal obesity (overweight) (BMI>or=25, visceral fat area<100 cm2). Measurements: Fat distribution was evaluated by visceral fat and subcutaneous fat (S) areas measured by computed tomography (CT) scanning at umbilical level. Anthropometric parameters, aerobic exercise level, muscle strength, flexibility and blood examination were also investigated. RESULTS: Anthropometric and body composition parameters were significantly higher in abdominal obesity subjects than those in normal weight subjects. BMI, waist circumference, waist hip ratio and visceral fat (V) area were also significantly higher than those in overweight subjects. Reduced oxygen uptake at ventilatory threshold (VT), lowering weight bearing index (WBI), and elevation of blood enzymes were noted in abdominal obesity subjects. There were significant relationships between oxygen uptake at VT and visceral fat area, and also between oxygen uptake at VT and WBI. CONCLUSION: Reduced aerobic exercise level and WBI are characteristic and visceral fat may play an important role for the etiology in Japanese women with abdominal obesity.     

Relationship between functional ability and physical fitness in juvenile idiopathic arthritis patients

OBJECTIVE: To determine the relationship between aerobic and anaerobic physical fitness and functional ability in children with juvenile idiopathic arthritis (JIA). METHODS: Eighteen children with JIA (age 7 to 14 yr., 3 male/15 female) performed a maximal aerobic exercise test and a Wingate anaerobic exercise test. Functional ability was concurrently assessed using the Childhood Health Assessment Questionnaire (CHAQ). RESULTS: A low relationship between aerobic fitness and functional ability was found (r = 0.0 to 0.4, p > 0.05, except for eating r = 0.46, p < 0.05). The correlations between anaerobic physical fitness and functional ability in JIA patients were strong (r = 0.5 to 0.75, p < 0.05). This indicated a good relationship between anaerobic fitness and functional ability. CONCLUSION: The strong association between anaerobic physical fitness and functional ability showed the importance of anaerobic physical fitness for children with JIA.     

Relationship between physical fitness and lifestyle behaviour in healthy young men.

BACKGROUND: There is substantial knowledge about the inverse association of physical fitness and CVD risk factors and CVD mortality. However, physical fitness per se might be influenced by lifestyle conditions such as physical training, smoking and drinking habits. HYPOTHESIS: We evaluated the relationship between physical fitness, physical activity, endurance training, smoking and drinking habits and blood pressure, lipids and leukocytes as surrogate cardiovascular risk markers in a large-scale cross-sectional study of healthy young men. STUDY DESIGN AND METHODS: A total of 6748 healthy young men were selected during their primary flight medical examination for military flying duties. Physical fitness was assessed by achieved physical working capacity at a heart rate of 170 beats per min (PWC170) during cycle ergometry. Parameters such as physical activity, endurance sports, smoking of cigarettes and drinking of alcoholic beverages were assessed by means of standardized questionnaires. Systolic and diastolic blood pressures were measured manually. Fasting cholesterol and triglycerides as well as white blood counts were obtained. RESULTS: Physical activity itself was not related to significant differences in the tested variables, whereas good physical fitness showed a significant association with improved blood pressure and blood lipids (P<0.001) with no detectable threshold. This effect was independent of endurance training, smoking and drinking. Whereas drinking was associated with elevated systolic blood pressure, smoking was associated with markedly increased triglycerides as well as with elevated leukocytes. CONCLUSION: Physical fitness is associated with improved blood pressure and blood lipids. This effect is independent of participating mainly in endurance or nonendurance sports, of physical activity per se, and it does not depend on smoking and drinking habits. Smoking itself revealed relevant higher inflammation independent of fitness.     

Relationship between aerobic physical fitness and ventilatory control during exercise in young swimmers

The aim of this study was to specify in young trained swimmers, during progressive exercise, whether different aerobic physical fitness goes along with differences in breathing pattern and in mouth occlusion pressure used as a non-invasive index of neuromuscular output. Ten children (aged 10.5-16 years) with high VO2 max (57.6 +/- 3.6 ml.min-1.kg-1) and ten children (aged 11-17 years) with moderate VO2 max (44 +/- 3.8 ml.min-1.kg-1) realized a maximal exercise test on a cycle ergometer. During the last minute of each power level we measured the following parameters: VO2, VCO2, VEBW, f, VTBW/TI,TI/TTOT, as well as mouth occlusion pressure (P0.1) and 'effective impedance' of the respiratory system (P0.1/VTBW/TI). Our results showed that at a same VCO2, children with high VO2 max had significantly lower P0.1, P0.1/VTBW/TI and f than children with moderate VO2 max and same VEBW/TI. At different levels of VO2, in the twenty children of the two groups, we have found significant correlations between VO2 max of each subject and P0.1 (P less than 0.01), P0.1/VTBW/TI (P less than 0.001). At a same VO2, children with a higher VO2 max showed significantly lower P0.1, P0.1/VTBW/TI at all levels of VO2 and lower VEBW and VTBW/TI at high level of VO2. At a same VE, the two groups of children showed the same values of VT/TI and f. In conclusion this study shows first, that different aerobic physical fitness does not go along with different breathing pattern, and second, that swimmers with high physical fitness have a lower ventilatory response to exercise but a higher ventilatory and neuromuscular efficiency during exercise than children with moderate physical fitness.     

Association between physical activity, physical performance, and inflammatory biomarkers in an elderly population: the InCHIANTI study

BACKGROUND: Our aim was to determine the association between physical activity and physical performance, and inflammatory biomarkers in elderly persons. METHODS: One thousand four persons aged 65 years or more, participants in a cross-sectional population-based study, were included. Interviewers collected information on self-reported physical activity during the previous year. Moreover, 841 participants performed a 400-meter walking test to assess physical performance. Plasma concentrations of inflammatory biomarkers were determined. RESULTS: Compared to sedentary men, men practicing light and moderate-high physical activity had a significantly lower erythrocyte sedimentation rate (-0.33 and -0.40 mm/h; p =.023 and p =.006, respectively), fibrinogen level (-43 and -39 mg/dL; p =.001 and p =.004, respectively), and logarithm of C-reactive protein (CRP) (-0.43 and -0.73 mg/L; p =.025 and p <.001, respectively), whereas only those men practicing moderate-high physical activity had a significantly lower uric acid level (-0.57 mg/dL; p =.023), log(interleukin 6) levels (-0.33 pg/mL; p =.014), and log(tumor necrosis factor-alpha) (-0.31 pg/mL; p =.030). In women, those practicing light and moderate-high physical activity had significantly lower uric acid (-0.45 and -0.34 mg/dL; p =.001 and p =.039, respectively) and log(interleukin 6) levels (-0.18 and -0.30 pg/mL; p =.043 and p =.004, respectively); only those women practicing moderate-high physical activity had significantly lower log(CRP) (-0.31 mg/L; p =.020). In women, when the analysis was adjusted for body mass index, the association between physical activity and CRP was no longer significant. Similar findings were observed when we carried these analyses according to physical performance. CONCLUSIONS: Current physical activity practice and performance are associated with inflammatory biomarkers. A significant beneficial association is already observed with light physical activity practice and intermediate performance.     

Relationship between peripheral neuropathy and cognitive performance in the elderly population

There are only a few studies that have shown an association of peripheral neuropathy with cognitive impairment in elderly individuals. Therefore, we investigated the relationship between cognitive performance and peripheral neuropathy.From the database of the National Health and Nutrition Examination Survey (NHANES, 1999–2002), each participant completed a household interview, physical performance test, questionnaire regarding personal health, and Digit Symbol Substitution Test (DSST) to evaluate cognitive performance. The severity of peripheral neuropathy was assessed based on the number of insensate areas in both feet during monofilament examination. We used the multivariate linear regression to analyze the association of the DSST findings with insensate areas of the worse foot.There were 828 participants in our study from NHANES 1999 to 2002; their mean age was 69.96 ± 7.38 years, and 51.3% were male. The β coefficients of the number of insensate areas associated with the DSST findings were all negative values, and the absolute value increased as the number of insensate areas increased. After adjustment for pertinent variables, the correlations remained significantly negative (all P for trend <.001). In addition, subgroup analysis showed no gender differences in the negative association, but this association was not significant in obese participants (P > .05).Our study provides evidence that the severity of peripheral neuropathy is significantly negatively correlated with cognitive performance.     

老年肌少症患者动静态平衡功能与其他体适能指标的相关性

目的 探讨社区老年肌少症患者动静态平衡功能与其他多方面体适能指标的相关性。 方法 采取方便抽样法,招募于苏州大学周围多个卫生服务中心门诊就诊及体检的社区老年肌少症患者178例,知情同意后纳入测试,最终完成所有测试项目者110例。采用闭眼单腿站立测试评估静态平衡功能,起立-步行计时测试(TUGT)评估动态平衡功能。对患者行6min步行试验(6MWT)、肱二头肌屈举试验、30s座椅站立试验、抓背试验、座椅体前倾试验及体质量指数测量。采用SPSS 23.0统计软件进行数据分析。采用Spearman相关分析及多重线性回归分析法,分析动静态平衡功能与其他体适能指标之间的关系。 结果 社区老年肌少症患者闭眼单腿站立时长(2.66±0.64)s,TUGT用时(7.68±0.22)s。与未合并其他慢性疾病患者相比,合并其他慢性疾病者闭眼单脚站立时长显著降低[1.83(1.03,2.88)和2.83(1.41,3.81)s],差异有统计学意义(P<0.05)。与无规律运动患者相比,有规律运动者TUGT时长显著降低[7.27(6.43,8.29)和7.73(7.03,8.76)s],差异有统计学意义(P<0.05)。闭眼单腿站立时长与6MWT距离、抓背试验距离及座椅体前倾距离呈显著正相关(r =0.607,0.286,0.361;P<0.05),与年龄呈显著负相关(r =-0.300;P<0.05)。TUGT时长与年龄呈显著正相关(r =0.413;P<0.001),与6MWT、肱二头肌屈举次数、30s座椅站立次数、抓背试验距离和座椅体前倾距离呈显著负相关(r =-0.538,-0.605,-0.759,-0.274,-0.366;P<0.05)。多元线性回归分析结果显示,合并其他慢性疾病及6MWT距离是闭眼单腿站立时长的影响因素(β=1.181,0.008;P<0.05);合并其他慢性病、肱二头肌屈举次数、30s座椅站立次数和抓背试验距离是TUGT时长的影响因素(β=-0.859,-0.197,-0.342,-0.053;P<0.05)。结论 社区肌少症老年人中,合并其他慢性疾病是动静态平衡功能共同的显著影响因素,步行能力是静态平衡功能的显著影响因素,上下肢肌力和柔韧性素质是动态平衡功能的显著影响因素。     

Constructing an index of physical fitness age for Japanese elderly based on 7-year longitudinal data: sex differences in estimated physical fitness age

A standardized method for assessing the physical fitness of elderly adults has not yet been established. In this study, we developed an index of physical fitness age (fitness age score, FAS) for older Japanese adults and investigated sex differences based on the estimated FAS. Healthy elderly adults (52 men, 70 women) who underwent physical fitness tests once yearly for 7 years between 2002 and 2008 were included in this study. The age of the participants at the beginning of this study ranged from 60.0 to 83.0 years. The physical fitness tests consisted of 13 items to measure balance, agility, flexibility, muscle strength, and endurance. Three criteria were used to evaluate fitness markers of aging: (1) significant cross-sectional correlation with age; (2) significant longitudinal change with age consistent with the cross-sectional correlation; and (3) significant stability of individual differences. We developed an equation to assess individual FAS values using the first principal component derived from principal component analysis. Five candidate fitness markers of aging (10-m walking time, functional reach, one leg stand with eyes open, vertical jump and grip strength) were selected from the 13 physical fitness tests. Individual FAS was predicted from these five fitness markers using a principal component model. Individual FAS showed high longitudinal stability for age-related changes. This investigation of the longitudinal changes of individual FAS revealed that women had relatively lower physical fitness compared with men, but their rate of physical fitness aging was slower than that of men.     

Relationship between zinc intake, physical activity, and blood levels of high-density lipoprotein cholesterol in a healthy elderly population

We investigated the relationship between level of exercise, ingestion of zinc supplements, and serum high-density lipoprotein (HDL) cholesterol levels in 270 healthy men and women over age 60. After controlling for sex, alcohol intake, and body mass, there was a significant positive correlation between level of exercise and serum HDL cholesterol in the 180 subjects not taking supplemental zinc (r = 0.26, P = .005) but not for those subjects taking supplemental zinc (r = -0.18, P = .14). Multiple regression analysis showed a significant interaction of zinc intake and activity level on HDL cholesterol (P = .04). In 22 subjects who were ingesting greater than 15 mg of supplemental, elemental zinc daily, cessation of zinc supplements for 8 weeks was associated with a significant increase in HDL cholesterol levels (2.0 mg/dL; P = .04). The change in HDL after stopping zinc was positively correlated with the level of exercise of the subjects (r = .41, P = .05). Thus supplemental zinc ingestion appears to block the exercise-induced increase in serum HDL cholesterol in a healthy population.     

Relationship between brachial-ankle pulse wave velocity and cognitive function in an elderly community-dwelling population with metabolic syndrome

Arterial stiffness (AS) and metabolic syndrome (MS) may correlate with poor cognitive function in elderly people. However, few studies have evaluated this relationship in a healthy, community-dwelling elderly population. Our aim was to evaluate a relationship between the AS measured by pulse wave velocity (PWV) and cognitive function and to know whether the relationship is influenced by the presence of MS. Our study population was community-dwelling healthy people in Geumsan province, Republic of Korea. A total of 370 participants without a history of cerebrovascular disease were evaluated with the Korean version of the mini-mental state examination (K-MMSE) and have measured the brachial-ankle PWV (baPWV). Correlation between baPWV and cognitive status and effect of MS were measured. Negative correlation between PWV and cognitive function was found in the older subjects (> or = 60 years of age) with MS (r=-0.38; p<0.05). In the receiver operating characteristic (ROC) curve, the cut-off score was 1800.8 cm/s with 67% sensitivity and 78% specificity. Aging (older than 60 years) and the presence of MS may affect synergistically cognitive decline in the elderly population. The baPWV can be a useful predictor for cognitive decline in elderly healthy community-dwelling population with MS.     

Associations between objectively assessed physical fitness levels and sleep quality in community-dwelling elderly people in South China

Sleep and Breathing - The aim of this study was to explore associations between objectively assessed physical fitness levels and sleep quality in community-dwelling elderly people in South China....     

Relationship between lifestyle activities and physical functions in elderly persons utilizing care facilities

The purpose of this study was to examine the relationship between outdoor-activity areas and physical functions such as muscle strength, postural balance, gait function, and to identify the physical functions related to accomplishment of outdoor activity in elderly persons utilizing outpatient rehabilitation facilities. Furthermore, we investigated the relationship among physical, social and intellectual activities and physical functions. The subjects were 265 elderly persons (average age: 80.3 +/- 7.0). They were classified into the indoor-activity group, neighborhood outdoor-activity group and long-distance outdoor-activity group, and functional differences among the three groups were examined. The Barthel index, one-leg standing time, timed up-and-go test and performance-oriented mobility assessment were significantly different among the three groups. These results suggested that physical functions have a close relationship with extension of the activity area. Based on 95% confidence intervals, elderly subjects with more than 95 points on the Barthel index seemed able to do neighborhood outdoor activities. Those who can finish timed up-and-go test in less than 18 seconds, and obtain 26 points in performance-oriented mobility assessment may be able to do long-distance outdoor-activities using a bus. Furthermore, it was found that physical function was largely affected by physical activity such as exercise habituation and house keeping. In conclusion the difference of the activity area as well as extended activities of ADL influenced the physical function, which was critical to prevent functional decline in elderly persons.     

Relationship between the number of remaining teeth and physical activity in community-dwelling elderly

The relationship between oral health and general health in the elderly has been much studied. However, further studies focussing on the influence of oral health on the quality of life (QOL) among the elderly are required. The goal of this study was to evaluate the relationship between oral health and physical or cultural activities. Subjects were 101 community-dwelling elderly persons who were functionally independent (mean age 70.3). Oral health status was evaluated according to the number of remaining teeth and the number of functional teeth. Physical and cultural activities were evaluated from self-reported information. The relationship between oral health and physical or cultural activities was examined by logistic regression analysis. About 60% of subjects took part in cultural activities, and less than half actively exercised (leisure sports, 33.6%; travel, 42.6%). Persons with 20 or more remaining teeth were more active in leisure sports (Odds ratio (OR)=4.86, 95% confidence interval (CI)=1.34, 17.38) and travel (OR=5.42, 95% CI=1.63, 18.08) than those with fewer than 20 remaining teeth. These results suggest that the number of remaining teeth is associated with physical activity in elderly persons.