Habitual exercise influences carotid artery strain and strain rate, but not cognitive function in healthy middle-aged females.

PURPOSE: Aging females are at risk of declining vascular and cognitive function. Exercise can augment both factors independently; however, the influence of exercise on their interdependence is less clearly understood. Ultrasound speckle tracking is a sensitive novel measure of arterial aging but has not previously been used in middle-aged females. We aimed to elucidate the potential interactions between vascular and cognitive variables in active aging females. METHODS: Twelve active (56 ± 5 years; [Formula: see text]: 34.5 ± 6.1 ml.kg.min-1) and 13 inactive (57 ± 4 years; 22.8 ± 2.6 ml.kg.min-1) healthy middle-aged females were included. Ultrasound speckle tracking assessed short-axis common carotid artery (CCA) compliance via peak circumferential strain (PCS) and strain rate (PSR) at rest, during, and after 3-min isometric handgrip exercise. Flow-mediated dilation (FMD) of the brachial artery was assessed using ultrasound. Cognitive function was measured using Verbal Fluency, Trail Making, Stroop, and Digit Span tests. RESULTS: PCS (P = 0.003) and PSR (P = 0.004), were higher in the active cohort. FMD was similar between groups (P > 0.05). Minimal differences in cognitive function existed between groups, although the inactive group performed better in one test of animal Verbal Fluency (P < 0.01). No associations were observed between PCS, PSR, or FMD with cognitive function (all P > 0.05). CONCLUSION: This is the first study to assess PCS and PSR in middle-aged females and demonstrates that active middle-aged females exhibit a superior carotid artery profile compared to their inactive counterparts. However, PCS and PSR of the carotid artery may not be linked with cognitive function in middle-aged females.

Sex differences in lipid profiles and treatment utilization among young adults with acute myocardial infarction: Results from the VIRGO study.

BACKGROUND: Young women with acute myocardial infarction (AMI) have higher mortality risk than similarly aged men. An adverse lipid profile is an important risk factor for cardiovascular outcomes after AMI, but little is known about whether young women with AMI have a higher-risk lipid pattern than men. We characterized sex differences in lipid profiles and treatment utilization among young adults with AMI. METHODS: A total of 2,219 adults with AMI (1,494 women) aged 18-55 years were enrolled from 103 hospitals in the United States (2008-2012). Serum lipids and lipoprotein subclasses were measured 1 month after discharge. RESULTS: More than 90% of adults were discharged on a statin, but less than half received a high-intensity dose and 12% stopped taking treatments by 1 month. For both men and women, the median of low-density lipoprotein (LDL) cholesterol was reduced to <100 mg/dL 1 month after discharge for AMI, but high-density lipoprotein (HDL) cholesterol remained <40 mg/dL. Multivariate regression analyses showed that young women had favorable lipoprotein profiles compared with men: women had higher HDL cholesterol and HDL large particle, but lower total cholesterol-to-HDL cholesterol ratio and LDL small particle. CONCLUSIONS: Young women with AMI had slightly favorable lipid and lipoprotein profiles compared with men, suggesting that difference in lipid and lipoprotein may not be a major contributor to sex differences in outcomes after AMI. In both men and women, statin remained inadequately used, and low HDL cholesterol level was a major lipid abnormality.

High-intensity interval training (HIIT) increases insulin-like growth factor-I (IGF-I) in sedentary aging men but not masters' athletes: an observational study.

INTRODUCTION: The aim of this investigation was to examine the impact high-intensity interval training (HIIT) on serum insulin-like growth factor-I (IGF-I) in active compared with sedentary aging men. METHODS: 22 lifetime sedentary (SED; 62 ± 2 years) and 17 masters' athletes (LEX; 60 ± 5 years) were recruited to the study. As HIIT requires preconditioning exercise in sedentary cohorts, the study required three assessment phases; enrollment (phase A), following preconditioning exercise (phase B), and post-HIIT (phase C). Serum IGF-I was determined by electrochemiluminescent immunoassay. RESULTS: IGF-I was higher in LEX compared to SED at baseline (p = 0.007, Cohen's d = 0.91), and phase B (p = 0.083, Cohen's d = 0.59), with only a small difference at C (p = 0.291, Cohen's d = 0.35). SED experienced a small increase in IGF-I following preconditioning from 13.1 ± 4.7 to 14.2 ± 6.0 µg·dl-1 (p = 0.376, Cohen's d = 0.22), followed by a larger increase post-HIIT (16.9 ± 4.4 µg·dl-1), which was significantly elevated compared with baseline (p = 0.002, Cohen's d = 0.85), and post-preconditioning (p = 0.005, Cohen's d = 0.51). LEX experienced a trivial changes in IGF-I from A to B (18.2 ± 6.4 to 17.2 ± 3.7 µg·dl-1 [p = 0.538, Cohen's d = 0.19]), and a small change post-HIIT (18.4 ± 4.1 µg·dl-1 [p = 0.283, Cohen's d = 0.31]). Small increases were observed in fat-free mass in both groups following HIIT (p < 0.05, Cohen's d = 0.32-0.45). CONCLUSIONS: In conclusion, HIIT with preconditioning exercise abrogates the age associated difference in IGF-I between SED and LEX, and induces small improvements in fat-free mass in both SED and LEX.

Six weeks of conditioning exercise increases total, but not free testosterone in lifelong sedentary aging men.

INTRODUCTION: Advancing age is associated with a gradual decline in circulating androgens, and the putative role of exercise training on systemic androgens remains to be adequately defined. METHODS: The present investigation examined the impact of 6 weeks of supervised exercise training on resting levels of systemic hormones in a cohort of lifelong sedentary men [SED (n = 28), 62.5 ± 5.3 years], compared with a positive control group of age-matched lifelong exercisers [LE (n = 20), 60.4 ± 4.7 years, >30 years training history]. Blood hormones were sampled pre- and post-intervention from an antecubital forearm vein and analysed using electrochemiluminescent immunoassay. Cardiorespiratory fitness ([Formula: see text]) was determined via indirect calorimetry during an incremental cycle test to volitional exhaustion. RESULTS: Analysis of variance (ANOVA) revealed a lack of significant change in any parameter amongst LE, whilst SED experienced a significant exercise-induced improvement in cardiorespiratory fitness and total testosterone (all p < 0.05). Concurrent increases in sex hormone-binding globulin (SHBG; p < 0.05) resulted in a lack of change to either bioavailable or calculated free testosterone (p > 0.05) amongst SED. CONCLUSIONS: Although resting levels of systemic total testosterone increased in response to 6 weeks of exercise training, increases in SHBG negated any potential relationship between calculated-free or bioavailable testosterone. These findings indicate that increases in bioavailable testosterone fraction are not required for cardiorespiratory fitness improvements in aging men.

Resting steroid hormone concentrations in lifetime exercisers and lifetime sedentary males.

INTRODUCTION: Advancing age in men is associated with a progressive decline in serum testosterone (T) and interactions between exercise, aging and androgen status are poorly understood. The primary aim of this study was to establish the influence of lifelong training history on serum T, cortisol (C) and sex hormone binding globulin (SHBG) in aging men. A secondary aim was to determine the agreement between serum and salivary measurement of steroid hormones in ageing men. METHODS: Serum and salivary steroid hormones (serum C, T and SHBG, and salivary measures of C and T) were determined and compared between two distinct groups; lifelong exercising males (LE [n = 20], 60.4 ± 4.7 year) and age matched lifelong sedentary individuals (SED [n = 28], 62.5 ± 5.3 years). RESULTS: T-test revealed a lack of significant differences for serum C or SHBG between LE and SED, while Mann-Whitney U revealed a lack of differences in total T (TT), bioavailable T (bio-T) or free testosterone (free-T). Further, salivary T (sal-T) did not correlate with serum markers of T in LE, SED, or when pooled (r = 0.040; p > 0.05). CONCLUSIONS: Findings from this investigation suggested that resting levels of serum T and calculated free-T was unable to distinguish between diverse lifelong training histories in aging men. Further, sal-T was not an appropriate indicator of serum T and calculated free-T values in older males and considerable caution should be exercised when interpreting sal-T measurements in aging males.

Poor levels of agreement between serum and saliva testosterone measurement following exercise training in aging men.

Testosterone (T) is a biologically important androgen that demonstrates a widely-known natural decline with advancing age. The use of salivary T (sal-T), as a determinant of systemic T, has shown promising results in recent years. However, the strength of the salivary-serum T relationship may be affected by measurement method and binding capacity with salivary proteins. The potential influence exercise may impact on this relationship is unstudied in aging men. Therefore, the aim of the present investigation was to examine the relationship of the delta change (Δ) in sal-T with Δserum T following six weeks exercise training. Fifteen sedentary (SED) males (aged 60.4 ± 5.0 years of age) and 20 lifelong exercising (LE) males (60.4 ± 4.7 years of age) were participated. Pearson's correlation coefficient revealed sal-T did not correlate with total testosterone (TT), sex hormone binding globulin (SHBG), bioactive T (bio-T), or free T (free-T) at week 0 or week 6. Δsal-T did not correlate with ΔTT, ΔSHBG, Δbio-T or Δfree-T (r = 0.271, p = 0.180; r = 0.197, p = 0.335; r = 0.258, p = 0.205; and r = 0.257, p = 0.205, respectively). In conclusion, poor levels of agreement existed between saliva and serum measurements of T in response to exercise amongst aging men.

Validation of a six second cycle test for the determination of peak power output.

The present study examined the agreement between peak power output during a standard Wingate anaerobic test (WAnT) and a six second 'all-out' test on a Wattbike Pro. Nine males (40.7 ± 19.4 yrs, 1.76 ± 0.03 cm, 82.11 ± 8.9 kg) underwent three testing protocols on separate days. The protocols consisted 30 second WAnT (WAnT30), a modified WAnT over 6 seconds (WAnT6) and a 6 second peak power test (PPT6). PPT6 was correlated with WAnT30 (r = 0.9; p < 0.001) with a mean bias of 105 W. PPT6 correlated with WAnT6 (r = 0.95; p < 0.001) with a mean bias of 74 W. WAnT6 correlated with WAnT30 (r = 0.99; p < 0.001) with a mean bias of 31 W. There was no difference in time to peak power between any trial. PPT6 resulted in significantly greater power outputs than in WAnT30 and WAnT6 (p < 0.001). We conclude that PPT6 and WAnT6 are valid measures of peak power output compared with WAnT30. This identifies that PPT6 and WAnT6 as short duration 'all-out' tests that have practical applications for researchers and coaches who wish to assess peak power output without the fatiguing effects associated with a standard WAnT.

Does chronic exercise attenuate age-related physiological decline in males?

Alteration in body composition, physical function, and substrate metabolism occur with advancing age. These changes can be attenuated by exercise. This study evaluated whether master athletes (MA [n = 20]) would have improved exercise capabilities, anthropometry, and hormone profiles when compared with age-matched sedentary counterparts (S [n = 28]). The MA group was predominantly aerobically trained with some resistance exercise incorporated in their routine. The VO(2max), peak power output, and salivary testosterone was significantly higher (p < 0.05) in the MA group, while diastolic blood pressure, systolic blood pressure, and body fat percentage were lower (p < 0.05). Cortisol, fat free mass, (FFM) and total body mass were not significantly different between groups. Salivary testosterone correlated positively with VO(2max) (r² = .320), suggesting that increased aerobic capacity is linked with higher concentrations of testosterone. These results suggest that life-long exercise is associated with favorable body composition and attenuation of the age related decline in testosterone.

Promoting exercise in older people to support healthy ageing.

As people in the UK continue to live longer, the concept of healthy ageing has become increasingly important. Regular exercise that is appropriate for the ability of each individual can have several benefits for older people, such as slowing the loss of muscle mass, increasing aerobic capacity, maintaining cognitive function and improving health-related quality of life. This article explores the benefits of various forms of exercise and physical activity in older people, and offers practical advice that can assist nurses in supporting a person-centred approach to this aspect of care.

Short-Term and Lifelong Exercise Training Lowers Inflammatory Mediators in Older Men.

Increased basal low-grade inflammation is observed with advancing age, which is augmented by physical inactivity. However, data regarding the influence of lifelong exercise training and particularly high-intensity interval training (HIIT) on inflammatory mediators in older men are scarce. Therefore, we examined effects of 6weeks of aerobic preconditioning followed by 6weeks of HIIT on inflammatory mediators [interleukin (IL)-6, homocysteine, and high-sensitivity C-reactive protein (hsCRP)] in previously sedentary older men (SED) and masters athletes (LEX). Further, we investigated whether SED exhibited greater basal inflammatory biomarkers compared to LEX. Twenty-two men (aged 62±2years) participated in the SED group, while 17 age-matched LEX men (aged 60±5years) also participated as a positive comparison group. In SED, preconditioning (P=0.030, d=0.34) and HIIT (P=0.030, d=0.48) caused a reduction in IL-6 compared to enrollment. SED homocysteine did not change throughout (P>0.57; d<0.26), while the decrease in hsCRP after preconditioning (P=0.486, d=0.25) and after HIIT (P=0.781, d=0.23) compared to enrollment was small. HIIT did not influence IL-6 or hsCRP in LEX (all P>0.42; d<0.3). Homocysteine increased from enrollment to post-HIIT in LEX (P=0.144, d=0.83), but all other perturbations were trivial. IL-6 and hsCRP were greater in SED than LEX throughout the investigation (all P<0.029; d>0.72), but homocysteine was not different (all P >0.131; d<0.41). Results of this study suggest moderate-intensity aerobic exercise and HIIT lowers IL-6 (and possible hsCRP) in previously sedentary older men. Moreover, lifelong exercise is associated with reduced concentrations of some inflammatory biomarkers in older males, and therefore, physical activity, rather than age per se, is implicated in chronic low-grade inflammation. Moreover, physical inactivity-induced inflammation may be partly salvaged by short-term exercise training.

Six weeks of high intensity interval training (HIIT) facilitates a four year preservation of aerobic capacity in sedentary older males: A reunion study.

Long-term implications of acutely increased cardiorespiratory fitness following short-term exercise interventions in older adults are unknown. In this study, we examined peak oxygen uptake (VO2peak) after 4-years of 'free-living' after a high intensity interval training (HIIT) intervention. Seventeen lifelong exercisers (LEX) and 17 previously sedentary (SED) males (55-74 years of age in 2012) were tested four years (phase D) after our previous experiment which included 6-weeks of aerobic moderate intensity exercise (phase B), followed by 6-weeks of HIIT (phase C). At all stages, a standard incremental exercise protocol on a cycle ergometer was completed to determine VO2peak. SED (P = 1.000, Cohen's d = 0.01) and LEX (P = 1.000, Cohen's d = 0.11) VO2peak at phase D was not different from phase A (enrolment). SED experienced a large decrease in VO2peak from phase C to phase D (32 ± 6 ml·kg·min-1 to 27 ± 6 ml·kg·min-1 [P < 0.001, Cohen's d = 0.81]). LEX experienced a small decrease in VO2peak from phase C to phase D (42 ± 7 ml·kg·min-1 to 39 ± 9 ml·kg·min-1 [P < 0.001, Cohen's d = 0.46]). At phase D, LEX had greater VO2peak than SED (P < 0.001, Cohen's d = 1.73). The proportion of subjects who reported discontinuing training, maintaining moderate training, and maintaining HIIT differed between groups (P = 0.023), with LEX self-reporting more HIIT, and SED self-reporting more discontinuation from exercise. Those who continued exercising experienced a reduction in VO2peak over the four years from 39 ± 7 ml·kg·min-1 to 36 ± 9 ml·kg·min-1 (N = 25, P < 0.001, Cohen's d = 0.37), and those who discontinued exercising also experienced a reduction in VO2peak from 30 ± 7 ml·kg·min-1 to 25 ± 9 ml·kg·min-1 (N = 9, P = 0.003, Cohen's d = 0.62). Four years after completing a brief period of aerobic exercise and HIIT, older males demonstrated a preservation of VO2peak, irrespective of training status (LEX or SED). However, LEX exhibited greater VO2peak than SED after 4-years of unsupervised 'free-living'. Notably, participants who discontinued exercising experienced a greater reduction in VO2peak. These data suggest that a 6 weeks of supervised HIIT can facilitate the long term.

High intensity interval training (HIIT) produces small improvements in fasting glucose, insulin, and insulin resistance in sedentary older men but not masters athletes.

The aim of this study was to investigate whether 6 weeks' high intensity interval training (HIIT; 6 × 30 s sprints at 40% peak power, once every five days) following 6 weeks' of aerobic preconditioning could favourably affect fasting insulin, glucose, and the homeostatic model assessment of insulin resistance (HOMA1-IR) in sedentary older men compared with masters athletes. A secondary aim was to establish whether lifelong exercisers (LEX) exhibited improved fasting insulin, glucose, and HOMA1-IR, compared to sedentary older males (SED). Twenty-two males (62 ±â€¯2 years) comprised the SED group and 17 males (60 ±â€¯5 years) were enrolled as LEX. Participants were tested at phase A (baseline), B (after preconditioning), and C (post-HIIT). There was no effect of time (P = 0.116) or interaction (P = 0.727) on insulin. However, there was an effect of group (P < 0.001). In terms of magnitude, HIIT induced a small decrease in SED insulin compared to baseline (15.8 ±â€¯8.1 uIU·ml-1 at baseline and 14.0 ±â€¯7.8 uIU·ml-1 post-HIIT; Cohen's d = 0.23) and compared to post-preconditioning (17.5 ±â€¯9.7 uIU·ml-1; Cohen's d = 0.40). LEX insulin was unchanged throughout (all differences were trivial). Insulin was lower in LEX than SED at phase A (P < 0.001, Cohen's d = 1.31), B (P = 0.023, Cohen's d = 0.78), and C (P = 0.004, Cohen's d = 1.01). There was no effect of time (P = 0.290), group (P = 0.166), or interaction (P = 0.153) for glucose. In terms of magnitude, HIIT produced a small reduction in SED glucose compared to baseline (5.7 ±â€¯1.3 mmol·l-1 at baseline and 5.3 ±â€¯0.9 mmol·l-1 post-HIIT; Cohen's d = 0.36), and compared to phase B (5.6 ±â€¯0.8 mmol·l-1, Cohen's d = 0.35). LEX glucose was unchanged throughout (all changes were trivial). SED had moderately higher blood glucose than LEX at phase A (Cohen's d = 0.49), and B (Cohen's d = 0.63), but only a trivial difference existed at phase C (Cohen's d = 0.15). There was no effect of time (P = 0.110), or interaction (P = 0.569) on HOMA1-IR. However, there was an effect of group (P = 0.002). In terms of magnitude, SED HOMA1-IR was unchanged from phase A to B (4.2 ±â€¯3.0 and 4.5 ±â€¯2.9 arbitrary units respectively [Cohen's d = 0.10]). However, at C (3.5 ±â€¯2.6) there was a small decrease compared to B (Cohen's d = 0.36), and A (Cohen's d = 0.25). LEX experienced a small increase in HOMA1-IR from phase A to B (1.6 ±â€¯1.3 and 2.3 ±â€¯2.8 respectively [Cohen's d = 0.32]), followed by a small decrease from B to C (1.7 ±â€¯1.1 at phase C [Cohen's d = 0.28]), and a trivial change from A to C (Cohen's d = 0.08). HOMA1-IR was lower in LEX than SED at baseline (P = 0.002, Cohen's d = 1.12), after preconditioning (P = 0.024, Cohen's d = 0.77), and post-HIIT (P = 0.014, Cohen's d = 0.90). Results of this study provide preliminary evidence that HIIT preceded by preconditioning can induce small improvements in fasting insulin, glucose, and HOMA1-IR in sedentary older men compared with masters athletes.

Prevention of Nosocomial Catheter-Associated Urinary Tract Infections Through Computerized Feedback to Physicians and a Nurse-Directed Protocol.

Catheter-associated urinary tract infections (CAUTIs) represent the most common nosocomial infection. The authors' baseline rate of CAUTI for general medical service was elevated at 36 per 1000 catheter-days. The medical literature has consistently linked inappropriate catheter use with the development of CAUTI. The baseline data also revealed a high rate of inappropriate use of indwelling urinary catheters. Using the dual modalities of technology through prompts in the computerized order/entry system and handheld bladder scanners, as well as in combination with staff education and nurse empowerment, the authors were successful in reducing the use and duration of urinary catheters as well as the incidence of CAUTI. In subsequent data collection cycles over the following 2 years, 81% reduction in device use and a 73% reduction in the clinical end point of nosocomial CAUTI (36/1000 catheter-days to 11/1000 catheter-days; P < .001) was demonstrated.

High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men.

BACKGROUND: This study examined a programme of pre-conditioning exercise with subsequent high intensity interval training (HIIT) on blood pressure, echocardiography, cardiac strain mechanics and maximal metabolic (MET) capacity in sedentary (SED) aging men compared with age matched masters athletes (LEX). METHODS: Using a STROBE compliant observational design, 39 aging male participants (SED; n=22, aged 62.7±5.2yrs) (LEX; n=17, aged=61.1±5.4yrs) were recruited to a study that necessitated three distinct assessment phases; enrolment (Phase A), following pre-conditioning exercise in SED (Phase B), then following 6weeks of HIIT performed once every five days by both groups before reassessment (Phase C). Hemodynamic, echocardiographic and cardiac strain mechanics were obtained at rest and maximal cardiorespiratory and chronotropic responses were obtained at each measurement phase. RESULTS: The training intervention improved systolic, mean arterial blood pressure, rate pressure product and heart rate reserve (each P<0.05) in SED and increased MET capacity in both SED and LEX (P<0.01) which was amplified by HIIT. Echocardiography and cardiac strain measures were unremarkable apart from trivial increase to intra-ventricular septum diastole (IVSd) (P<0.05) and decrease to left ventricular internal dimension diastole (LVId) (P<0.05) in LEX following HIIT. CONCLUSIONS: A programme of preconditioning exercise with HIIT induces clinically relevant improvements in blood pressure, rate pressure product and encourages recovery of heart rate reserve in SED, while improving maximal MET capacity in both SED and LEX without inducing any pathological cardiovascular remodeling. These data add to the emerging repute of HIIT as a safe and promising exercise prescription to improve cardiovascular function and metabolic capacity in sedentary aging.

One session of high-intensity interval training (HIIT) every 5 days, improves muscle power but not static balance in lifelong sedentary ageing men: A randomized controlled trial.

BACKGROUND: Declining muscle power during advancing age predicts falls and loss of independence. High-intensity interval training (HIIT) may improve muscle power, but remains largely unstudied in ageing participants. METHODS: This randomized controlled trial (RCT) investigated the efficacy of a low-frequency HIIT (LfHIIT) intervention on peak muscle power (peak power output [PPO]), body composition, and balance in lifelong sedentary but otherwise healthy males. METHODS: Thirty-three lifelong sedentary ageing men were randomly assigned to either intervention (INT; n = 22, age 62.3 ±â€Š4.1 years) or control (n = 11, age 61.6 ±â€Š5.0 years) who were both assessed at 3 distinct measurement points (phase A), after 6 weeks of conditioning exercise (phase B), and after 6 weeks of HIIT once every 5 days in INT (phase C), where control remained inactive throughout the study. RESULTS: Static balance remained unaffected, and both absolute and relative PPO were not different between groups at phases A or B, but increased significantly in INT after LfHIIT (P < 0.01). Lean body mass displayed a significant interaction (P < 0.01) due to an increase in INT between phases B and C (P < 0.05). CONCLUSIONS: 6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men.

Exercise training improves free testosterone in lifelong sedentary aging men.

As the impact of high-intensity interval training (HIIT) on systemic hormones in aging men is unstudied to date, we investigated whether total testosterone (TT), sex hormone-binding globulin (SHBG), free testosterone (free-T) and cortisol (all in serum) were altered following HIIT in a cohort of 22 lifelong sedentary (62 ± 2 years) older men. As HIIT requires preconditioning exercise in sedentary cohorts, participants were tested at three phases, each separated by six-week training; baseline (phase A), following conditioning exercise (phase B) and post-HIIT (phase C). Each measurement phase used identical methods. TT was significantly increased following HIIT (~17%; P < 0.001) with most increase occurring during preconditioning (~10%; P = 0.007). Free-T was unaffected by conditioning exercise (P = 0.102) but was significantly higher following HIIT compared to baseline (~4.5%; P = 0.023). Cortisol remained unchanged from A to C (P = 0.138). The present data indicate a combination of preconditioning, and HIIT increases TT and SHBG in sedentary older males, with the HIIT stimulus accounting for a small but statistically significant increase in free-T. Further study is required to determine the biological importance of small improvements in free-T in aging men.

Lifelong exercise, but not short-term high-intensity interval training, increases GDF11, a marker of successful aging: a preliminary investigation.

Lifelong exercise is associated with regulation of skeletal mass and function, reductions in frailty, and successful aging. Yet, the influence of exercise on myostatin and myostatin-interacting factors is relatively under examined in older males. Therefore, we investigated whether serum total myostatin, free myostatin, follistatin, and growth and differentiation factor 11 (GDF11) were altered following high-intensity interval training (HIIT) in a group of 13 lifelong sedentary (SED; 64 [6] years) and 11 lifelong exercising (LEX; 62 [6] years) older males. SED follistatin was moderately greater than LEX pre-HIIT (Cohen's d = 0.66), and was largely greater post-HIIT (Cohen's d = 1.22). The HIIT-induced increase in follistatin was large in SED (Cohen's d = 0.82) and absent in LEX (Cohen's d = 0.03). GDF11 was higher in LEX pre-HIIT (Cohen's d = 0.49) and post-HIIT (Cohen's d = 0.63) compared to SED HIIT resulted in no change to GDF11 in LEX or SED (Cohen's d = 0.00-0.03). Peak power output and GDF11 were correlated (r = 0.603), independent of grouping. Differences in GDF11 with lifelong exercise training, paired with the correlation between GDF11 and peak power output, suggested that GDF11 may be a relevant myostatin-interacting peptide to successful aging in humans, and strategies to maintain this need to be further explored.

Prevention of nosocomial catheter-associated urinary tract infections through computerized feedback to physicians and a nurse-directed protocol.

Catheter-associated urinary tract infections (CAUTIs) represent the most common nosocomial infection. The authors' baseline rate of CAUTI for general medical service was elevated at 36 per 1000 catheter-days. The medical literature has consistently linked inappropriate catheter use with the development of CAUTI. The baseline data also revealed a high rate of inappropriate use of indwelling urinary catheters. Using the dual modalities of technology through prompts in the computerized order/entry system and handheld bladder scanners, as well as in combination with staff education and nurse empowerment, the authors were successful in reducing the use and duration of urinary catheters as well as the incidence of CAUTI. In subsequent data collection cycles over the following 2 years, 81% reduction in device use and a 73% reduction in the clinical end point of nosocomial CAUTI (36/1000 catheter-days to 11/1000 catheter-days; P < .001) was demonstrated.

Impact of low-volume, high-intensity interval training on maximal aerobic capacity, health-related quality of life and motivation to exercise in ageing men.

There is a demand for effective training methods that encourage exercise adherence during advancing age, particularly in sedentary populations. This study examined the effects of high-intensity interval training (HIIT) exercise on health-related quality of life (HRQL), aerobic fitness and motivation to exercise in ageing men. Participants consisted of males who were either lifelong sedentary (SED; N = 25; age 63 ± 5 years) or lifelong exercisers (LEX; N = 19; aged 61 ± 5 years). [Formula: see text] and HRQL were measured at three phases: baseline (Phase A), week seven (Phase B) and week 13 (Phase C). Motivation to exercise was measured at baseline and week 13. [Formula: see text] was significantly higher in LEX (39.2 ± 5.6 ml kg min(-1)) compared to SED (27.2 ± 5.2 ml kg min(-1)) and increased in both groups from Phase A to C (SED 4.6 ± 3.2 ml kg min(-1), 95 % CI 3.1 - 6.0; LEX 4.9 ± 3.4 ml kg min(-1), 95 % CI 3.1-6.6) Physical functioning (97 ± 4 LEX; 93 ± 7 SED) and general health (70 ± 11 LEX; 78 ± 11 SED) were significantly higher in LEX but increased only in the SED group from Phase A to C (physical functioning 17 ± 18, 95 % CI 9-26, general health 14 ± 14, 95 % CI 8-21). Exercise motives related to social recognition (2.4 ± 1.2 LEX; 1.5 ± 1.0 SED), affiliation (2.7 ± 1.0 LEX; 1.6 ± 1.2 SED) and competition (3.3 ± 1.3 LEX; 2.2 ± 1.1) were significantly higher in LEX yet weight management motives were significantly higher in SED (2.9 ± 1.1 LEX; 4.3 ± 0.5 SED). The study provides preliminary evidence that low-volume HIIT increases perceptions of HRQL, exercise motives and aerobic capacity in older adults, to varying degrees, in both SED and LEX groups.