Resistance Training Improves Sleep Quality in Older Adults a Pilot Study

Older individuals, as a group, tend to experience difficulty sleeping compared to younger adults. Improving sleep in the elderly would have beneficial public health consequences. This study utilized 8 sedentary, older adults, 78.1 ± 3.1 years of age, who participated in a six-month long resistance training (RT) program. The Pittsburgh Sleep Quality Index (PSQI) was used to examine sleep quality, and a 1 repetition max test (1-RM) was used to determine upper (bench press) and lower (leg press) body strength. Total strength, defined as the sum of the bench press and leg press 1-RM results, was also reported. The training resulted in significant improvements (p < 0.05) in total (19%) and upper body (52%) strength and in sleep quality (38%). Future studies should examine the effects of strength gain/loss and time-of-day training on sleep quality.

Key Points

• Compromised sleep and deterioration of skeletal muscle mass and function are commonly found among the aged.
• Results show that RT led to improvements in upper and total body strength in older participants who trained three times per week in the morning.
• The resistance training led to improvements in sleep as measured by a self-report sleep questionnaire, the Pittsburgh Sleep Quality Index.
• The small sample size used, lack of control group, and the fact that the participants on average were characterized as “good ”sleepers at the study onset, necessitates that further investigation occur.
• We suggest that further research is required to explore the effects of RT performed at different times of the day as well as to determine the relationship between sleep gains or losses upon changes in sleep quality.

Key words: Chronic disease, resistance training, older participants, strength, sleep     

老年痴呆患者的疼痛评估进展

就老年痴呆患者认知功能障碍对疼痛评估的影响及老年痴呆患者的疼痛评估方法进行综述.提出对于痴呆患者的疼痛评估,首先要明确患者是否可以作出疼痛自我报告,重视患者的主诉,根据痴呆患者认知障碍的程度,选择合适的疼痛评估方法,或将各种工具结合起来评估其疼痛.     

High Intensity Resistance Training: Effects on Bone in Older Men and Women

There is evidence that high intensity resistance training promotes bone maintenance in older women, however, the effect of high intensity free weight training has not been investigated in older men or women. Furthermore, little is known about the chronic effect of weight training on serum insulin growth factor-I (IGF-I) in this population. We compared the effects of a moderate intensity seated resistance-training program with a high intensity standing free weight exercise program on bone mass and serum levels of IGF-I and IGFBP3 in healthy older men and women. Twenty-eight men (54.6 ± 3.2 years) and 26 nonestrogen-replaced women (52.8 ± 3.3 years) served as their own controls for 12 weeks, then were randomly assigned to a moderate or high intensity training group and trained three times/week for 24 weeks. Prior to and after the control period and at the end of training, bone mass and body composition were assessed by dual energy X-ray absorptiometry (DXA), muscle strength by isokinetic dynamometry, muscular power by Wingate Anaerobic Power Test, and IGF-I by radioimmunoassay (RIA). A repeated measures analysis of covariance (ANCOVA) revealed that high intensity training resulted in a gain in spine BMD in men (1.9%), P < 0.05, but not in women, whereas moderate intensity training produced no changes in either gender at this site. Increases were observed at the greater trochanter, P < 0.03, in men regardless of training intensity, but not in women at any hip site. However, when compared with zero, both men and women in the high intensity group demonstrated significant increases in trochanteric BMD (1.3% and 2.0%, respectively) and a decrease in femoral BMD (−1.8%). Neither circulating serum IGF-I nor IGFBP3 were altered by either training regimen, but both training programs resulted in improvements in total body strength (37.62%) and lean mass (males 4.1%, females 3.1%). We conclude that although resistance training of moderate to high intensity produced similar muscle changes in older adults, a higher magnitude is necessary to stimulate osteogenesis at the spine. However, at the spine, intensity was not sufficient to offset low levels of estrogen in early postmenopausal women. Furthermore, bone changes were not accompanied by changes in circulating serum levels of IGF-I or IGFBP3. Received: 21 July 1999 / Accepted: 11 January 2000     

Handbook of Pain Relief in Older Adults. An Evidence-Based Approach

This book represents a laudable attempt to remedy under-useof pain services by the elderly. Evidence is produced of differencesin access for different age groups. However, most of the evidenceapplies to the US. Several chapters     

Cognitive Function Is Preserved in Older Adults With a Reported History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) is associated with mood and cognitive deficits in children and young adults. Evidence suggests that the effects of early‐life adversity persist throughout adulthood; however, the impact of CSA on cognition in older adults is largely unknown. This study investigated cognitive function in older adults with a reported history of CSA. Data are from a population‐based study (The Irish Longitudinal Study on Ageing) of 6,912 adults aged 50 years and older. Participants answered questions about CSA as part of a stressful life events questionnaire. Global cognition, executive function, memory (both objective and self‐rated), attention, and processing speed were measured via a comprehensive battery of tests. Anxiety and depression, other childhood adversity, health behaviours, chronic disease, and medication use were also assessed. Of the total sample, 6.5% reported CSA. These individuals were more likely to have experienced other forms of childhood adversity and to exhibit poor mental health compared to those who reported no history of CSA. Multivariate regression analyses revealed, however, that CSA was associated with better global cognition, memory, executive function, and processing speed, despite poorer psychological health in this group. Future studies should aim to investigate possible reasons for this finding.     

Effects of Whole-Body Vibration on Resistance Training for Untrained Adults

Although resistance training (RT) combined with whole-body vibration (WBV) is becoming increasingly popular among untrained adults, the additional effects of WBV on muscle fitness are still not well understood. The aim of the present study was to evaluate the effects of WBV on muscle strength, muscle power, muscle endurance, and neuromuscular activities compared with the identical RT without WBV. Thirty-three individuals (6 males and 27 females; 22-49 years old) were randomly assigned to a training program using slow-velocity RT coupled with WBV (RT- WBV group, n = 17) or an identical exercise program without WBV (RT group, n = 16). Participants performed eight exercises per 60 min session on a vibration platform (RT-WBV group, frequency, 35 Hz; amplitude, 2 mm) twice weekly for seven weeks. To evaluate the effects of WBV, the maximal isometric and isokinetic knee extension strength, maximal isometric lumbar extension strength, countermovement-jump, and the number of sit-ups were measured before and after the trial. Significantly higher increases were observed in the maximal isometric and concentric knee extension strength (p = 0.02, p = 0.04 , respectively), and maximal isometric lumbar extension strength at 60 degrees of trunk flexion (p = 0.02) in the RT-WBV group (+36.8%, +38.4%, +26.4%, respectively) in comparison to the RT group (+16.5%, +12.8%, +14.3%, respectively). A significant difference was also observed between the RT-WBV group (+8.4%) and the RT group (+4.7%) in the countermovement jump height (p = 0.02). In conclusion, the results suggest that significant additional increases in maximal isometric and concentric knee extension and lumbar extension strength, and countermovement jump height can be achieved by incorporating WBV into a slow-velocity RT program during the initial stage of regular RT in untrained healthy adults.

Key points

• A randomized controlled trial was conducted to investigate the effects of slow velocity resistance training combined with whole-body vibration on maximal muscle strength, power, muscle endurance, and neuromuscular activities in healthy untrained individuals.
• Resistance training program for lower extremities and trunk muscles were performed twice weekly for 7 weeks.
• A 7 weeks slow velocity resistance training program with whole-body vibration significantly increased maximal isometric knee extension and lumbar extension strength and power in healthy untrained individuals.

Key words: Vibration, novice, adults, exercise, strength, power     

Effect of Home-Based Well-Rounded Exercise in Community-Dwelling Older Adults

The purpose of this study was to assess the efficacy of a home-based well-rounded exercise program (WREP) in older adults. Forty sedentary community-dwelling older adults were randomly assigned to an exercise group (n = 23; aged 62-80 yr, average: 69.2 ± 5.2; 12 men and 11 women) or a control group (n = 17; aged 63-85 yr, average: 70.1 ± 6.6; 5 men and 12 women). The exercise group performed a 12-wk WREP which included aerobic exercise (walking) on about 3 days·wk^-1 for 37 min·day^-1; elastic band-based resistance exercises for the major muscle groups on about 3 days·wk^-1 for 26 min; and flexibility exercises (stretching) on about 4 days·wk^-1 for 19 min·day^-1. General physical characteristics, functional strength (Arm Curl [AC], Chair Stand [CS]), dynamic balance and agility (Up & Go [UG]), flexibility (Back Scratch [BS], Sit & Reach [SR]), and endurance (12-min walk [12-MW]) were measured. Following the 12-wk home-based WREP, improvements were observed in AC, CS, UG, BS, SR and 12-MW for the exercise group but not for the control group. These results suggest that the home-based WREP can improve overall fitness in older adults.

Key Points

• Walking, elastic band exercise and stretching were prescribed as a Well-Rounded Exercise Program for older adults.
• By combining aerobic, resistance and flexibility exercises, a Well-Rounded Exercise Program was effective for improving endurance, functional strength, dynamic balance and agility, and flexibility.
• Community-based exercise classes motivated older adults to perform home-based exercises.

Key words: Physical fitness, aerobic exercise, resistance exercise, flexibility exercise, adherence     

Effects of Vibration Training and Detraining on Balance and Muscle Strength in Older Adults

The purpose of this study was to analyze the effects of 2 days/week versus 4 days/week of Whole Body Vibration (WBV) during eight weeks of WBV training on health-related quality of life (SF-36), balance and lower body strength, as well as short-term detraining (3 weeks) on balance and lower body strength among older adults. Thirty-four older adults were randomly assigned to a control group (Control; n = 11) or to one of the vibration training groups: WBV 2 days/week (WBV_2d; n = 11) or WBV 4 days/week (WBV_4d; n = 12). The WBV groups exercised for 8 weeks, following 3 weeks of detraining. Lower body strength increased significantly (p < 0.05) for both groups, WBV_2d and WBV_4d, after 8-week training. A significant reduction in strength was observed following 3 weeks of detraining only in WBV_2d group (p < 0.05). All variables of the SF-36 and the balance test did not change after intervention in any group. 2 days/week and 4 days/week of WBV during 8 weeks showed the same improvements on muscle strength. 3 weeks of detraining did not reverse the gains in strength made during 32 sessions of WBV.

Key points

• 2 days and 4 days per week of WBV training during 8 weeks showed the same improvements on muscle strength.
• 3 weeks of detraining did not reverse the gains in strength made during 32 sessions of WBV exercise.
• 3 weeks of detraining did reverse the gains in strength made during 16 sessions of WBV exercise.

Key words: Whole-body vibrations, posturography, dose-response, equilibrium     

回忆疗法对养老机构老年人抑郁情绪的影响

目的 探讨回忆疗法改善养老机构老年人抑郁情绪的效果.方法 用老年抑郁量表(GDS)筛选出符合研究要求的老年人74人,随机分成对照组(38人)和干预组(36人).对照组正常生活,干预组在此基础上进行为期6周的回忆性心理干预,分别在干预前及干预6周后测评老年人抑郁状态,并进行对比分析.结果 干预后干预组GDS评分显著低于本组干预前及对照组干预后(均P＜0.01).结论 回忆疗法有助于缓解养老机构老年人的抑郁情绪,提高老年人对环境的适应能力.     

Pain at Multiple Sites Is Associated With Prevalent and Incident Fractures in Older Adults

Musculoskeletal pain is common and typically occurs at multiple sites. Pain has been shown to be associated with falls risk; however, whether an increased risk for falls associated with multisite pain (MSP) translates into an increased risk of fractures has not been investigated. This study aimed to examine the association of number of painful sites with prevalent and incident fractures. Data from a longitudinal population-based study of older adults (mean age 63 years) were utilized. Follow-up was performed at 2.6, 5.1, and 10.7 years later, respectively. Presence/absence of pain at the neck, back, hands, shoulders, hips, knees, and feet was assessed by questionnaire at baseline. Participants were classified into three groups according to the total number of painful sites: zero to two, three to four, and five to seven. Fractures were self-reported at each time point. BMD was measured by DXA. Falls risk was calculated based on the Short-Form Physiological Profile Assessment. Log-binomial regression was used for the analyses. There were 450 fractures at baseline and 154 new fractures reported during a mean follow-up period of 10.7 years (range 9.2 to 12.5 years). In multivariable analyses, number of painful sites was associated with prevalent fractures at any and nonvertebral site. Furthermore, participants with five to seven painful sites had an increased risk of incident fractures at any site (RR 1.69; 95% CI, 1.13 to 2.53); major site, including the femur, radius, ulnar, vertebral, rib, and humerus (RR 2.17; 95% CI 1.12 to 4.22); and vertebral site (RR 6.44, 95% CI, 1.64 to 25.33) compared with those with pain at zero to two sites. These associations remained statistically significant after further adjustment for falls risk and BMD. Pain at multiple sites was associated with incident fracture risk in a dose-response manner, suggesting that widespread pain is an independent contributor to fracture risk. The potential for pain management in fracture prevention warrants further exploration. © 2019 American Society for Bone and Mineral Research.     

Long-Term Exercise in Older Adults: 4-Year Outcomes of Music-Based Multitask Training

Prospective controlled evidence supporting the efficacy of long-term exercise to prevent physical decline and reduce falls in old age is lacking. The present study aimed to assess the effects of long-term music-based multitask exercise (i.e., Jaques-Dalcroze eurhythmics) on physical function and fall risk in older adults. A 3-year follow-up extension of a 1-year randomized controlled trial (NCT01107288) was conducted in Geneva (Switzerland), in which 134 community-dwellers aged ≥65 years at increased risk of falls received a 6-month music-based multitask exercise program. Four years following original trial enrolment, 52 subjects (baseline mean ± SD age, 75 ± 8 years) who (i) have maintained exercise program participation through the 4-year follow-up visit (“long-term intervention group”, n = 23) or (ii) have discontinued participation following original trial completion (“control group”, n = 29) were studied. They were reassessed in a blind fashion, using the same procedures as at baseline. At 4 years, linear mixed-effects models showed significant gait (gait speed, P = 0.006) and balance (one-legged stance time, P = 0.015) improvements in the long-term intervention group, compared with the control group. Also, long-term intervention subjects did better on Timed Up & Go, Five-Times-Sit-to-Stand and handgrip strength tests, than controls (P < 0.05, for all comparisons). Furthermore, the exercise program reduced the risk of falling (relative risk, 0.69; 95 % confidence interval, 0.5–0.9; P = 0.008). These findings suggest that long-term maintenance of a music-based multitask exercise program is a promising strategy to prevent age-related physical decline in older adults. They also highlight the efficacy of sustained long-term adherence to exercise for falls prevention.     

Effect of Dementia on Outcomes After Surgically Treated Hip Fracture in Older Adults

BackgroundHip fractures are associated with increased mortality and functional limitations. However, the effect that dementia has on these outcomes in individuals in aged care settings after fracture is not well established. This study examined the association of dementia with post-hip fracture mortality, permanent residential aged care entry, transition care use, and change in activities of daily living (ADL) needs.MethodsA retrospective cohort study using data from the Registry of Senior Australians (2003-2015) was conducted. Individuals with a hip fracture while receiving aged care services were included. Associations of dementia with mortality, risks of transition and permanent care use, and ADL needs progression were estimated using multivariable Cox, Fine-Gray, and logistic regression methods, respectively.ResultsOf 4771 individuals evaluated, 76% were women, the median age was 86 years (IQR 82-90), and 71% already lived in permanent residential aged care at the time of fracture. Within two years of their hip fracture, 50.4% (95% CI 48.9%-51.8%) of individuals died, 16.2% (95% CI 14.2%-18.2%) entered a transition care program, 59.1% (95% CI 56.5%-61.7%) entered permanent residential aged care, and 32% had greater ADL needs. Dementia was associated with higher risk of two-year mortality (HR = 1.19, 95% CI 1.09-1.30), 90-day entry into permanent care (sHR = 1.96, 95% CI 1.60-2.38), and increased likelihood of ADL limitations (OR = 1.36, 95% CI 1.00-1.85). Minor differences were seen in transition care use by dementia status.ConclusionDementia is a strong risk factor for mortality after hip fractures in individuals in aged care settings and associated with a high risk of entry into permanent care.Level of EvidencePrognostic level III.     

Effect of Strength and Endurance Training on Cognition in Older People

The purpose of this study was to investigate the effect of moderate strength and endurance training on cognition evaluated by event-related potentials (ERP) in older people. Thirty-six adults, aged 60-85 years, were randomly divided into three groups: sedentary control (C), strength training (ST), and endurance training (ET). Participants performed functional fitness tests and ERP data were recorded before and after nine weeks of training. Training involved three sessions per week. Functional fitness test performance improved significantly in the ST and ET groups. The latencies of the N1, N2, and P2 components and the amplitudes of the N1P2, P2N2, and N2P3 components differed significantly between groups (p < 0.05). After training, the latencies of the P2 and N2 components at the Fz and Cz sites, decreased significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components at the Fz site and the N1P2 and N2P3 components at the Cz site, increased significantly in the ST group compared with the ET group. After training, the latencies of N1, N2, and P2 components shortened significantly, and the amplitudes of the N1P2, P2N2, and N2P3 components increased significantly in the ST group compared with the C group. The latencies of the N2 and P2 components shortened significantly in the ET group compared with the C group, although the amplitudes of the ERP recordings did not differ significantly between groups. These data suggest that strength training might facilitate early sensory processing and cognitive functioning in older individuals.

Key Points

• Strength training may have facilitating effects on early information processing and cognition in older people.
• It is interesting that only small improvements in functional fitness affected cognitive performance.
• More research is needed to determine how the different exercise regimens contribute to discrete changes in CNS functioning and how such changes affect the P3 component of the ERP.

Key Words: Exercise training, cognitive function, aging, event-related potentials, functional fitness     

回忆疗法对养老机构老年人抑郁情绪的影响

目的探讨回忆疗法改善养老机构老年人抑郁情绪的效果。方法用老年抑郁量表（GDS）筛选出符合研究要求的老年人74人,随机分成对照组（38人）和干预组（36人）。对照组正常生活,干预组在此基础上进行为期6周的回忆性心理干预,分别在干预前及干预6周后测评老年人抑郁状态,并进行对比分析。结果干预后干预组GDS评分显著低于本组干预前及对照组干预后（均P〈0.01）。结论回忆疗法有助于缓解养老机构老年人的抑郁情绪,提高老年人对环境的适应能力。     

Effects of Nordic Walking Compared to Conventional Walking and Band-Based Resistance Exercise on Fitness in Older Adults

The purpose of this study was to compare the effects of Nordic walking with conventional walking and band-based resistance exercise on functional fitness, static balance and dynamic balance in older adults. Volunteers (n = 65) were divided into four groups: Nordic walking (NW), conventional walking (CW), resistance (RES), and control. Each group performed activity 50-70 min·day⁻¹ (warm-up 10-15 min, main exercise 30-40, and cool down 10-15 min), 3 days·week⁻¹ (NW and CW) or 2 day·week⁻¹ (RES) for 12 wks. Upper-body strength improved (p < 0. 05) in the RES (22.3%) and the NW (11.6%) groups compared to the CW and control groups. Cardio- respiratory fitness improved more in the NW (10.9%) and CW (10.6%) groups compared to the RES and control groups. Upper- and lower-body flexibility also improved in all exercise groups compared to the control group. There were no improvements in balance measures in any group. While all modes of exercise improved various components of fitness, Nordic walking provided the best well-rounded benefits by improving upper-body strength, cardiovascular endurance, and flexibility. Therefore, Nordic walking is recommended as an effective and efficient mode of concurrent exercise to improve overall functional fitness in older adults.

Key Points

• Nordic walking, conventional walking, and resistance training are beneficial for older adults.
• Nordic walking and conventional walking both improve cardio-respiratory fitness while resistance training does not.
• Nordic walking provides additional benefits in upper-body muscular strength compared to conventional walking.
• Nordic walking is an effective and efficient mode of exercise to improve overall fitness in older adults.

Key words: Walking, resistance exercise, concurrent exercise, aging, functional fitness