Older adults, appendicular anthropometric measurements, and poor functional performance are predictors of sarcopenia in individuals with head and neck squamous cell carcinoma.

OBJECTIVE: To identify predictors of sarcopenia (demographical, anthropometric measurements, tumor-related clinical characteristics, performance status, and serum C-reactive protein (CRP) and albumin levels in individuals with head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS: This cross-sectional study selected diagnosed with HNSCC (n = 125). Sarcopenia was defined as low muscle strength and low physical performance. Association between sarcopenia and anthropometric assessments (weight, height, body mass index, triceps skinfold, mid-upper arm circumference [MUAC], mid-upper arm muscle circumference, mid-upper arm fat area [UFA], mid-upper arm bone free muscle area, calf circumference, and appendicular skeletal muscle mass and index), tumor clinical characteristics (anatomical site, tumor size, and cervical metastasis), performance status scale (Eastern Cooperative Oncology Group Performance Status [ECOG-PS]), and CRP and albumin levels was analyzed using binary logistic regression models. RESULTS: The diagnosis of sarcopenia was identified in 28 (22.4%) individuals with HNSCC. Being an older adult increases the odds of association with sarcopenia in individuals with HNSCC (odds ratio [OR] = 1.05). Increments in MUAC measurement reduce the odds of association with sarcopenia (OR = 0.69), while the increase in the UFA measurement increases the odds of association with sarcopenia (OR = 1.33). Poor ECOG-PS scores increase the odds of association with sarcopenia in individuals with HNSCC (OR = 5.54). CONCLUSION: Early identification of easy-to-perform, cost-effective predictors of sarcopenia tends to favor the implementation of personalized therapeutic and supportive interventions in individuals with HNSCC.

Moderate-intensity continuous training and high-intensity interval training improve cognition, and BDNF levels of middle-aged overweight men.

The prevalence of overweight and obesity is increasing worldwide, which has been associated with poor cognitive outcomes. Participating in regular physical exercise may also improve cognition, and levels of brain-derived neurotrophic factor (BDNF), but the optimal exercise prescription remains to be elucidated. The purpose of the present study is to compare the effects of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) on cognition, and serum BDNF levels in middle-aged and overweight men. Twenty-five sedentary, overweight men participated in the 8-week training intervention. Subjects were randomized into MICT (n = 12) or HIIT (n = 13) and performed exercise sessions 3x/week for 8-weeks. Cognitive function, and serum BDNF levels were assessed pre- and post-intervention. Statistical analysis was carried out using the Graph Pad Prism 7.0, and the level of significance was set at 5%. Significant improvements were observed in cognitive test scores, and BDNF levels in MICT and HIIT groups (p < 0.05). There were no significant differences in cognitive function between MICT and HIIT. The present study implicates that 8 weeks of MICT or HIIT may be a very useful non-pharmacological treatment option to improve cognitive function, and BDNF levels in middle-aged overweight men.

Molecular mechanisms of physical exercise on depression in the elderly: a systematic review.

Depressive disorders are common among the elderly. Major depressive disorder will be one of the highest healthcare costs in middle and higher income countries by 2030. It is known that physical inactivity leads to negative effects on mental health in the elderly.The purpose of this review was to explore investigate the consequences of physical exercise (aerobic and resistance exercise) on major depressive disorder among elderly, and presenting its potential biological mechanisms. This study was designed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Clinical trials or randomized clinical trials or cohort studies participated of the study design. Ten studies were evaluated and the main outcomes of each were reported. Aerobic and resistance training revealed to be effective in fighting the symptoms of depression. The most common physical exercise protocol adopted to reduce the consequences of major depressive disorder in humans was the prescription of aerobic exercise at moderate-intensity lasting 60 min per session, 3 times per week, for 24 weeks. Physical exercise enhances IGF-I and activates PGC-1α/FNDC5/Irisin pathway. Physical exercise also increases expression of BDNF and its receptor, TrkB, in the hippocampus and prefrontal cortex leading to upstream of ERK and inhibiting depressive-like behavior. Physical exercise brings mental health benefits and plays a crucial role in avoiding the development of major depressive disorder.

Physical exercise, obesity, inflammation and neutrophil extracellular traps (NETs): a review with bioinformatics analysis.

Neutrophil extracellular traps (NETs) represent an innate organism defense mechanism characterized by neutrophil release of intracellular material to capture any aggressor agent. Elevated NETs release is associated with increased inflammatory response and related diseases, such as obesity. Chronic physical training is one of the main strategies to treat and prevent obesity. The relationship between physical training and NETs is still under study. The present review, followed by a bioinformatics analysis, demonstrates the meaningful connection between physical exercise, obesity, and NETs. The bioinformatics indicated TNF-α as a leading gene after the ontological analysis followed by positive-interleukin-6 regulation, chemokines, and inflammatory response regulation. The main results pointed to a relevant regulatory effect of physical training on NETs release, indicating physical exercise as a possible therapeutic target on modulating NETs and inflammation.

Motor-cognitive dual-task performance of older women evaluated using Wii Balance Board.

BACKGROUND: Single- and dual-tasks are influenced by age-related impaired postural balance. Aim of this study was to analyze the Center of Pressure (CoP) oscillation during static balance in the presence or absence of cognitive task on older women. METHODS: Thirty-one healthy older women were assessed in a stand quiet position with open/closed eyes (single-task, OE and CE) and with cognitive task (dual-task, DT) through Wii Balance Board. Sway area, total displacement and CoP oscillation (CO) based on the number of times that CoP traveled through anteroposterior and mediolateral directions. Friedman test was used to compare OE, CE and DT. Dual-task interference percentage was used to quantify the cognitive load on balance whereas Spearman correlation coefficient was used to assess the association of cognitive domains and CO. RESULTS: The CO was significantly higher in DT than in single-tasks and participants were unable to maintain their limits of stability in mediolateral direction. The cost of DT interference was 30.5%, which is partially explained by the deviation of attention from postural control to spatial and temporal orientation. CONCLUSION: Our findings show that cognitive load during DT impairs balance in mediolateral direction, thus indicating the use of WBB to assess cognitive interference on postural control.

Comparison of cognitive functions among frail and prefrail older adults: a clinical perspective.

ABSTRACTObjective:To compare cognitive function among frail and prefrail older adults. DESIGN: Cross-sectional clinical study. PARTICIPANTS: Fifty-one non-institutionalized older individuals participated in this study. MEASUREMENTS: Cognitive functions were evaluated through Mini-Mental State Examination (Global Cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Verbal Fluency Test (semantic memory/executive function). Data were compared using parametric and non-parametric bivariate tests. Binary logistic regression was used to test a frailty prediction model. Statistical significance was defined as p ≤ 0.01 to compare groups. In the regression model, the p value was set to be ≤0.05. RESULTS: Statistically significant differences were observed in global cognition, and short-term memory between frail and prefrail individuals (p ≤ 0.01). Global cognition explained 14-19% of frailty's model. CONCLUSION: According to our findings, the evaluation of cognitive functions among older persons with frailty and prefrailty provides important complementary information to better manage frailty and its progression.

Virtual Reality-Based Exercise with Exergames as Medicine in Different Contexts: A Short Review.

There is enough evidence that, nowadays, the sedentary lifestyle is one of the major health problems worldwide, linked to many chronic diseases, including mental comorbidities, systemic hypertension, metabolic dysregulation, and cancer. Although health societies recommend engagement to physical activities, there is an overwhelming number of people remaining sedentary, even knowing the health benefits of regular exercises. One of the main factors that justifies this scenario is the lack of motivation, which is a barrier to people intended to start new habits for health. Considering this previous information, new alternatives for exercises may help people engage in a healthier lifestyle. Technology has contributed to this with devices that allow movements based on virtual reality approaches, including the exergames. These are games available even in commercial devices, as video-games, that allow people to work with different physical components. Furthermore, exergames add cognitive gain through its dual-task characteristic. Moreover, due to the combination of these benefits, they are feasible to acquire, and easy to use. Exergames are not only a potential strategy to reduce sedentary lifestyle but also a good method to improve health gains and rehabilitation in different populations and pathological conditions: older adults, stroke survivors, and Parkinson's disease. In this review, we aim to demonstrate some conditions that literature supports the intervention with exergames due to its physical and cognitive benefits. Furthermore, at the end of this review, we also explore the neurobiological mechanisms behind virtual-reality based exercises.

Acute effects of exergames on cognitive function of institutionalized older persons: a single-blinded, randomized and controlled pilot study.

BACKGROUND: Improvements on balance, gait and cognition are some of the benefits of exergames. Few studies have investigated the cognitive effects of exergames in institutionalized older persons. AIMS: To assess the acute effect of a single session of exergames on cognition of institutionalized older persons. METHODS: Nineteen institutionalized older persons were randomly allocated to Wii (WG, n = 10, 86 ± 7 year, two males) or control groups (CG, n = 9, 86 ± 5 year, one male). The WG performed six exercises with virtual reality, whereas CG performed six exercises without virtual reality. Verbal fluency test (VFT), digit span forward and digit span backward were used to evaluate semantic memory/executive function, short-term memory and work memory, respectively, before and after exergames and Δ post- to pre-session (absolute) and Δ % (relative) were calculated. Parametric (t independent test) and nonparametric (Mann-Whitney test) statistics and effect size were applied to tests for efficacy. RESULTS: VFT was statistically significant within WG (-3.07, df = 9, p = 0.013). We found no statistically significant differences between the two groups (p > 0.05). Effect size between groups of Δ % (median = 21 %) showed moderate effect for WG (0.63). DISCUSSION: Our data show moderate improvement of semantic memory/executive function due to exergames session. It is possible that cognitive brain areas are activated during exergames, increasing clinical response. CONCLUSION: A single session of exergames showed no significant improvement in short-term memory, working memory and semantic memory/executive function. The effect size for verbal fluency was promising, and future studies on this issue should be developed. PROTOCOL NUMBER OF BRAZILIAN REGISTRY OF CLINICAL TRIALS: RBR-6rytw2.

The Role of Physical Activity on Mood State and Functional Skills of Elderly Women.

INTRODUCTION: Ageing is associated with several physical, psychological and behavioral changes. These changes are closely related with global health and functional capacity in the elderly. Mood disturbances are common among the elderly and may significantly increase apathy, resulting in decreased habitual physical activity levels. MATERIALS AND METHODS: The purpose of this cross-sectional study was to evaluate the mood state and functional motor capacities of elderly women engaged in a public physical activity program in Brazil and compare them with physically inactive elderly. Thirty elderly women were included in the study and categorized into two groups: physically active group, composed of participants enrolled on a public physical activity program (n = 16, 69±5 years) and physically inactive group (n = 14, 68±4 years). Total mood disturbance was assessed using the Profile of Mood States, whereas functional motor capacity was evaluated with the Sitting and Rising test. Independent t test and Mann-Whitney U] were used to compare groups. RESULTS: The physically active group had lower total mood disturbance (p=0.02), confusion (p<0.01), tension (p<0.01), hostility (p=0.05) and fatigue (p=0.01) compared to the physically inactive group. There were no group differences regarding vigor, depression and sitting and rising performance (p>0.05). CONCLUSION: Lack of difference in functional motor capacity between the physically active and inactive elderly may be explained by the absence of exercise systematization in these programs.

Effects of Physical Exercise on Cerebral Blood Velocity in Older Adults: A Systematic Review and Meta-Analysis.

As the older population grows, there is an increasing interest in understanding how physical exercise can counteract the changes seen with aging. The benefits of exercise to general health, and especially to the cardiovascular system, have been a topic of discussion for decades. However, there is still a need to elucidate the effects of training programs on the cerebrovascular blood velocity in older people. This systematic review and meta-analysis aimed to investigate the effect of physical exercise on the cerebral blood velocity in older people (PROSPERO CRD42019136305). A search was performed on PubMed, Web of Science, EBSCO, ScienceDirect, and Scopus from the inception of this study to October 2023, retrieving 493 results, of which 26 were included, analyzing more than 1000 participants. An overall moderate risk of bias was found for the studies using the Cochrane risk-of-bias tools for randomized and non-randomized clinical trials. The pooled results of randomized trials showed that older people who underwent physical exercise presented a statistically significant increase in cerebral blood velocity (3.58; 95%CI = 0.51, 6.65; p = 0.02). This result indicates that physical exercise is important to help maintain cerebral health in older adults.

Different criteria for body mass index classification for excess weight screening in children aged six to ten years.

OBJECTIVE: To evaluate the agreement between body mass index (BMI) parameters applied to children aged six to ten years in the city of Montes Claros (MG), Brazil with national and international criteria, also calculating their sensitivity and specificity regarding excess weight screening. METHODS: A sample comprising 4151 children aged six to ten years was assessed, with height and body mass determined for BMI calculation. The obtained values were classified according to cutoff points established by the World Health Organization (WHO), International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), Conde & Monteiro, and a recent local proposal. The agreement index between the mentioned criteria was calculated and thereafter the sensitivity and specificity. RESULTS: The local proposal was proven to be highly consistent in most combinations, especially concerning the excess weight criteria of the World Health Organization (WHO) (k=0.895). Regarding excess weight, the local proposal presented sensitivity and specificity values of 0.8680 and 0.9956, respectively, indicating high BMI discrimination power. CONCLUSIONS: The locally applied BMI parameters for children aged six to ten years represent a valid, highly viable and practical proposal for excess weight screening in this population group, improving professional decision-making in their follow-up.

U-SMILE: a brief version of the Short Multidimensional Inventory on Lifestyle Evaluation.

INTRODUCTION: Lifestyle Medicine comprises six domains: diet, substance use, physical activity, stress management, social connection, and sleep. The comprehensive assessment of lifestyle is challenging, but the "Short Multidimensional Inventory on Lifestyle Evaluation" (SMILE) was developed to fill out this gap. In this paper, we describe the development and the psychometric properties (internal consistency, concurrent and convergent validity) of a shorter version of the SMILE among university students. METHODS: Data from a cross-sectional study including 369 students from 10 Brazilian universities were used. Considering a theoretical nomological net, we performed exploratory factor analysis to obtain the most parsimonious, interpretable and good-fitting model. RESULTS: The final model was called U-SMILE, comprised 24 items, and presented acceptable internal consistency (Cronbach's α = 0.73, McDonald's ω = 0.79). To evaluate the concurrent validity of the U-SMILE, we compared it to the original SMILE and found a high correlation between the instruments (Spearman's r= 0.94). Furthermore, we evaluated convergent validity by examining the U-SMILE correlation with the PHQ-9 (Spearman's r= -0.517), and GAD-7 (Spearman's r= -0.356), two validated instruments to screen for depression and anxiety, respectively. DISCUSSION: Our findings suggest that the U-SMILE is a valid instrument for assessing lifestyle among university students. We recommend that the use of U-SMILE to evaluate overall lifestyle scores rather than individual domain scores. Finally, we discuss the importance of clarifying the definitions of lifestyle and related constructs in future research.

Increased Depression and the Worsening of Depressive Symptoms Associated with Physical Inactivity during the COVID-19 Pandemic: A Two-Phase Cross-Sectional Study.

The COVID-19 pandemic has increased the incidence of depression and other mental disorders in the general population, influenced by various individual and contextual factors. Physical activity (PA) interventions offer a promising approach to mitigating the negative mental health effects of the pandemic. This study aims to analyze the association between PA and depressive symptoms. A total of 785 individuals aged 37.4 ± 13.2 years (72.5% female) were evaluated at two different time points: the first between 2018 and 2019, and the second during the COVID-19 pandemic in 2020. Depressive symptoms, demographic, and socioeconomic data were assessed using the Beck Depression Inventory to estimate depressive symptoms. Frequency analysis and binary and multinomial regression were employed for data analysis. The prevalence of mild depressive symptoms increased from 23.1% before the pandemic to 35.1% during the pandemic. Our findings reveal that practicing PA before the pandemic was a protective factor (OR: 0.19; 95% CI: 0.13, 0.30; p < 0.001) against mild depressive symptoms. Additionally, individuals who continued to practice PA during the pandemic had a lower chance of presenting mild (OR: 0.21; 95% CI: 0.15, 0.30) and moderate/severe (OR: 0.15; 95% CI: 0.08, 0.27) symptoms. Furthermore, our study shows that PA, which was already a protective factor before the pandemic, remained protective during the pandemic, even for those with the highest levels of depression.

Alzheimer's disease genes and proteins associated with resistance and aerobic training: An in silico analysis.

BACKGROUND: Exercise appears to be a viable intervention for maintaining cognitive function and regaining functional autonomy, and perhaps even contributing to a slower progression of Alzheimer's Disease (AD). OBJECTIVE: To explore different neuroplasticity pathways modulated by aerobic and strength training, determine whether signaling pathways overlapped for each specific training method (aerobic and strength training), and evaluate whether there is a functional relationship between APOE and APP gene expression with aerobic training modulated by BDNF; and strength training modulated by IGF-1. METHODS: An in silico analysis was performed to analyze the connection between exercise types and neuroplasticity as a protective factor in AD. The platform provides a protein-protein interaction network translated into known and predicted interactions. A score > 0.70 was determined as high confidence and the network was considered significant when the Protein-Protein Interaction Enrichment was <0.01. RESULTS: Multiple functional associations considered significant between the analyzed proteins. The results of our gene network model support that exercise, both aerobic and strength, can modulate genes that affect hippocampal neuroplasticity and neurogenesis, which may delay cognitive decline and Alzheimer's related symptoms. CONCLUSION: The investigation about the functional association of aerobic training via BDNF in the modulation of APP, APOE, and MAPT genes in the hippocampus seems to be established, while strength training seems to induce the production of IGF-1 and IGF-1R, modulating AKT1.

Spatial navigation in older adults with mild cognitive impairment and dementia: A systematic review and meta-analysis.

In this systematic review and meta-analysis, we compared the spatial navigation performance of older adults with mild cognitive impairment (MCI), Alzheimer's Disease (AD), and other dementias, using healthy older adults as controls. In addition, we evaluated the possible influence of the environment type (virtual and real), protocol (object- or environment-based), and the navigation mode (active and passive navigation) on spatial navigation task performance. In total, 1372 articles were identified and 24 studies were included in the meta-analysis. We found a large effect size on the spatial navigation performance of patients with cognitive decline (standardized mean difference (SMD) = 0.87, confidence interval (CI95%) = 0.62-1.09, p < 0.001), especially amnestic MCI (SMD = 1.10, CI95% = 0.71-1.49, p < 0.001) and patients with AD (SMD = 1.60, CI95% = 1.25-1.95, p < 0.001). However, the tasks did not identify mixed and vascular dementia (SMD = 0.92, CI95% = -0.33-2.18, p = 0.15 and SMD = 0.65, CI95% = -0.67-1.97, p = 0.33, respectively). Spatial navigation ability assessed using the Floor Maze Test showed the largest effect size in differentiating healthy older adults and patients with cognitive decline (SMD = 1.98,CI95% = 1.00-2.97, p < 0.001). In addition, tasks that require walking showed the greatest differences between the two groups. These results suggest that spatial navigation impairment is important, but disease-specific behavioral biomarker of the dementia pathology process that can be identified even in the early stages.

Malnutrition Is Associated With Impaired Functional Status in Older People Receiving Home Care Nursing Service.

Objective: This study aimed to explore the magnitude and significance of associations among nutritional status, functional status, comorbidities, age, and gender in older adults receiving assistance from the in-home nursing care service. Method: In this cross-sectional study, 210 home-dwelling persons 65 years or older who received in-home nursing care service were evaluated. Demographic variables, nutritional status, comorbidities, and the dependency levels of activities of daily living were analyzed. To assess the correlation among the factors that influence nutritional status, a theoretical model was developed and adjusted using the path analysis model. Results: The primary finding is that functional status is directly associated with nutritional status (ß = 0.32; p < 0.001) and severity of comorbidities is indirectly associated with nutritional status (ß = -0.07; p < 0.017). Conclusion: The elicited outcomes in this study reinforce the concept that nutritional status is linked with functional status in older adults receiving in-home care nursing service.

Acute response of prefrontal cortex in institutionalized older adults undergoing a single exergames session.

Virtual reality-based exercise (exergames) improves cognition of the elderly but the neurophysiological effects are poorly understood. The hypothesis herein established is that an ultrafast neurophysiological adaptation occurs in prefrontal cortex of elderly after completion of a single exergames session. To reinforce the aforementioned hypothesis, individuals living in a Long-Term Care Home (LTCH) participated in the study and were randomly allocated into two groups (Virtual Reality Group, VRG, n = 5; and Active Control Group, ACG n = 5). VRG performed six exercises with exergames and ACG performed exercises with the same VRG movements but with no virtual reality. Assessment of frontal cortical activity at rest and during cognitive testing via electroencephalographic activity (EEG) was performed before and immediately after the intervention. Significant decrease in relative power of EEG (RPEEG) Beta brainwave (-29 ± 18%) in the left prefrontal cortex of VRG compared to ACG (4 ± 9%) (p = 0.007). A slight improvement on semantic fluency in VRG (ES=0.21) was noted. An ultrafast prefrontal cortical adaptation may occur as an effect of a single exergames session, causing a small improvement on cognition of institutionalized elderly.