Muscle Mass and Muscle Strength Relationships to Balance: The Role of Age and Physical Activity.

OBJECTIVE: To investigate the relations of balance to muscle mass (MM) and muscle strength (MS), depending on age and physical activity, which is of particular importance to functional independence in older people. METHODS: This cross-sectional study included 802 volunteers (69.82 ± 5.60 years). The Fullerton Advanced Balance scale was used to assess balance and a composite score, including arm curl and chair stand tests for assessing MS. MM was estimated by dual-energy X-ray absorptiometry and physical activity by questionnaire. RESULTS: Greater MM (r = .26, p < .001) and MS (r = .53, p < .001) were positively correlated to balance. The old-old adults and less active individuals attained lower balance. Notably, moderation and subsequent simple slope analyses revealed that the relations of balance, MM, and MS were larger in less active and the old-old adults. CONCLUSIONS: The old-old and less active adults were more prone to muscle weakness and balance impairments. Tailored interventions should particularly consider these vulnerable groups.

Motor performance, body fatness and environmental factors in preschool children.

The first aim of this study was to investigate the relationship between motor performance and body fatness among 3- to 5-year-old children. The second aim was to assess whether this relationship works similarly for boys and girls. We also investigated whether socioeconomic status (SES) and geographical area when children are aged 3 years old predicts the motor performance of 4 and 5-yr-old children. Motor performance was assessed through the Preschool Test Battery, while body fatness was estimated through body mass index (BMI). SES and geographical area were assessed via parent proxy-report questionnaires. BMI was negatively associated with standing long jump. The association of BMI and motor performance was not statistically different for boys and girls. Children from low SES performed better than high SES peers in tennis ball throw for distance. Rural children were better performers than urban peers in standing long jump. Rural area at baseline was also predictor of standing long jump and tennis ball throw for distance at time 1 and 2. In conclusion, BMI had a negative association with standing long jump and the relationship of BMI with all motor tests was similar for boys and girls. SES and rural area were predictors of motor performance.

Tracking of gross motor coordination in Portuguese children.

The purpose of this study was to investigate the tracking of gross motor coordination (GMC) and to profile children at 6 years of age who consistently showed higher stability patterns in different levels of GMC. The participants were 245 children (123 boys and 122 girls) who were assessed longitudinally from 6 to 9 years of age. GMC was assessed using the Korperkoordinationtest fur Kinder (KTK) test battery. Anthropometry, physical activity, and health- and performance-related physical fitness were also measured. Cohen's kappa (κ) was used to estimate tracking. Tracking was poor for all GMC tests (0.17 ≤ κ ≤ 0.38) and moderate for the GMC motor quotient (MQ) in both boys and girls (0.44 ≤ κ ≤ 0.45). Instability at the extremes was low in GMC tests and negligible for MQ. Children who consistently showed high GMC levels during the 4 years of follow-up were lighter, had lower body mass index and subcutaneous fat, and showed higher scores in physical fitness tests at 6 years of age than those who consistently had low GMC levels. In conclusion, GMC showed low-to-moderate tracking over time in childhood. However, children who consistently demonstrated high GMC levels over time had healthier profiles at 6 years of age.

High-Density Lipoprotein Cholesterol Level Relates to Working Memory, Immediate and Delayed Cued Recall in Brazilian Older Adults: The Role of Cognitive Reserve.

AIMS: The present study set out to investigate the relation of the high-density lipoprotein cholesterol (HDL-C) level to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. METHODS: We assessed tests of working memory, immediate and delayed cued recall in 701 older adults from Amazonas, Brazil. The HDL-C level was derived from fasting blood samples. In addition, we interviewed individuals on their education, past occupation, and cognitive leisure activity. RESULTS: A critically low HDL-C level (<40 mg/dL) was significantly related to lower performance in working memory, immediate and delayed cued recall. Moderation analyses suggested that the relations of the HDL-C level to working memory and delayed cued recall were negligible in individuals with longer education, a higher cognitive level of the job, and greater engagement in cognitive leisure activity. CONCLUSION: Cognitive reserve accumulated during the life course may reduce the detrimental influences of a critically low HDL-C level on cognitive functioning in old age.

Correlates of health-related quality of life in young-old and old-old community-dwelling older adults.

PURPOSE: This study aimed (1) to examine the role of potential correlates of HRQoL in a large representative sample of older adults, and (2) to investigate whether the relationships between HRQoL and potential factors differ as a function of HRQoL component (physical vs. mental) and/or age cohort (young-old vs. old-old). METHODS: This cross-sectional study included 802 older adults aged 60-79 years old. HRQoL was assessed using the SF-36 questionnaire. Functional fitness was assessed using the Senior Fitness Test. Physical activity was measured via the Baecke questionnaire. Demographic information, mental and health features were obtained through questionnaires. RESULTS: A multiple regression analysis showed that BMI (ß = -0.15, p = 0.001), body strength (ß = 0.21, p < 0.001), aerobic endurance (ß = 0.29, p < 0.001), physical activity (ß = 0.11, p = 0.007), depressive symptoms (ß = -0.19, p < 0.001), falls (ß = -0.19, p < 0.001), and living alone (ß = -0.16, p < 0.001) were all significantly related to HRQoL-SF-36 total score. The positive relation with aerobic endurance was significantly higher for the physical component of HRQoL, while the negative relation with living alone was significantly higher for the mental component. The positive relation of HRQoL with physical activity was significantly higher in old-old compared to young-old adults. CONCLUSION: This data suggest that body composition, functional fitness, psycho-social factors, and falls are important correlates of HRQoL in old age. There are HRQoL-component and age-cohort differences regarding these correlates, underlying the need for specific strategies at the community level to promote HRQoL in older adults.

The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailty.

BACKGROUND: It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. METHODS: We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. RESULTS: Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. CONCLUSIONS: Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.

Change, stability and prediction of gross motor co-ordination in Portuguese children.

BACKGROUND: The knowledge about intra- and inter-individual variation can stimulate attempts at description, interpretation and prediction of motor co-ordination (MC). AIM: To analyse change, stability and prediction of motor co-ordination (MC) in children. SUBJECTS AND METHODS: A total of 158 children, 83 boys and 75 girls, aged 6, 7 and 8 years, were evaluated in 2006 and re-evaluated in 2012 at 12, 13 and 14 years of age. MC was assessed through the Kiphard-Schilling's body co-ordination test and growth, skeletal maturity, physical fitness, fundamental motor skills (FMS), physical activity and socioeconomic status (SES) were measured and/or estimated. RESULTS: Repeated-measures MANOVA indicated that there was a significant effect of group, sex and time on a linear combination of the MC tests. Univariate tests revealed that group 3 (8-14 years) scored significantly better than group 1 (6-12 years) in all MC tests and boys performed better than girls in hopping for height and moving sideways. Scores in MC were also higher at follow-up than at baseline. Inter-age correlations for MC were between 0.15-0.74. Childhood predictors of MC were growth, physical fitness, FMS, physical activity and SES. Biological maturation did not contribute to prediction of MC. CONCLUSION: MC seemed moderately stable from childhood through adolescence and, additionally, inter-individual predictors at adolescence were growth, FMS, physical fitness, physical activity and SES.

Skeletal Muscle and Physical Activity in Portuguese Community-Dwelling Older Adults.

The aims of this study were to describe age- and sex-related differences in total body skeletal muscle (TB-SM) mass and to determine the variance explained by physical activity (PA). This cross-sectional study included 401 males and 402 females, aged 60-79 years. TB-SM was determined by dual-energy x-ray absorptiometry (DXA) and PA by Baecke questionnaire. Statistical analysis included t test, ANOVAs, Pearson correlations, and multiple regression analysis. TB-SM mass was higher in the youngest age group when compared with the oldest in males and females. Males had greater TB-SM values than females. PA made a significant and positive contribution to the variation in TB-SM, ß = 0.071; p = .016. Sex, height, fat mass, and PA explained 77% of the variance in TB-SM. The oldest cohorts and females had lower TB-SM than the younger cohorts and males. This study suggests that PA exerts a significant role in the explanation of TB-SM.

Gross motor coordination and weight status of Portuguese children aged 6-14 years.

OBJECTIVES: To construct age- and gender-specific percentiles for gross motor coordination (MC) tests and to explore differences in gross MC in normal-weight, overweight and obese children. METHODS: Data are from the "Healthy Growth of Madeira Study," a cross-sectional study carried out in children, aged 6-14 years. All 1,276 participants, 619 boys and 657 girls, were assessed for gross MC (Körperkoordinations Test für Kinder, KTK), anthropometry (height and body mass), physical activity (Baecke questionnaire) and socioeconomic status (SES). Centile curves for gross MC were obtained for boys and girls separately using generalized additive models for location, scale and shape. RESULTS: A significant main effect for age was found in walking backwards and moving sideways. Boys performed significantly better than girls on moving sideways. At the upper limit of the distributions, interindividual variability was higher in hopping on one leg (girls) and jumping and moving sideways (boys and girls). One-way ANCOVA, controlling for age, physical activity and SES, indicated that normal-weight children scored significantly better than their obese peers in all gross MC tests. Overweight boys and girls also scored significantly better than their obese colleagues in some MC tests. CONCLUSIONS: These centile curves can be used as reference data in Portuguese children and youth, aged 6-14 years. Being overweight or obese was a major limitation in MC tests and, therefore, of the children's health- and performance-related physical fitness.

Zygosity Differences in Height and Body Mass Index of Twins From Infancy to Old Age: A Study of the CODATwins Project.

A trend toward greater body size in dizygotic (DZ) than in monozygotic (MZ) twins has been suggested by some but not all studies, and this difference may also vary by age. We analyzed zygosity differences in mean values and variances of height and body mass index (BMI) among male and female twins from infancy to old age. Data were derived from an international database of 54 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins), and included 842,951 height and BMI measurements from twins aged 1 to 102 years. The results showed that DZ twins were consistently taller than MZ twins, with differences of up to 2.0 cm in childhood and adolescence and up to 0.9 cm in adulthood. Similarly, a greater mean BMI of up to 0.3 kg/m2 in childhood and adolescence and up to 0.2 kg/m2 in adulthood was observed in DZ twins, although the pattern was less consistent. DZ twins presented up to 1.7% greater height and 1.9% greater BMI than MZ twins; these percentage differences were largest in middle and late childhood and decreased with age in both sexes. The variance of height was similar in MZ and DZ twins at most ages. In contrast, the variance of BMI was significantly higher in DZ than in MZ twins, particularly in childhood. In conclusion, DZ twins were generally taller and had greater BMI than MZ twins, but the differences decreased with age in both sexes.

The CODATwins Project: The Cohort Description of Collaborative Project of Development of Anthropometrical Measures in Twins to Study Macro-Environmental Variation in Genetic and Environmental Effects on Anthropometric Traits.

For over 100 years, the genetics of human anthropometric traits has attracted scientific interest. In particular, height and body mass index (BMI, calculated as kg/m2) have been under intensive genetic research. However, it is still largely unknown whether and how heritability estimates vary between human populations. Opportunities to address this question have increased recently because of the establishment of many new twin cohorts and the increasing accumulation of data in established twin cohorts. We started a new research project to analyze systematically (1) the variation of heritability estimates of height, BMI and their trajectories over the life course between birth cohorts, ethnicities and countries, and (2) to study the effects of birth-related factors, education and smoking on these anthropometric traits and whether these effects vary between twin cohorts. We identified 67 twin projects, including both monozygotic (MZ) and dizygotic (DZ) twins, using various sources. We asked for individual level data on height and weight including repeated measurements, birth related traits, background variables, education and smoking. By the end of 2014, 48 projects participated. Together, we have 893,458 height and weight measures (52% females) from 434,723 twin individuals, including 201,192 complete twin pairs (40% monozygotic, 40% same-sex dizygotic and 20% opposite-sex dizygotic) representing 22 countries. This project demonstrates that large-scale international twin studies are feasible and can promote the use of existing data for novel research purposes.

Skeletal maturation, fundamental motor skills and motor coordination in children 7-10 years.

Relationships between skeletal maturation and fundamental motor skills and gross motor coordination were evaluated in 429 children (213 boys and 216 girls) 7-10 years. Skeletal age was assessed (Tanner-Whitehouse 2 method), and stature, body mass, motor coordination (Körperkoordinations Test für Kinder, KTK) and fundamental motor skills (Test of Gross Motor Development, TGMD-2) were measured. Relationships among chronological age, skeletal age (expressed as the standardised residual of skeletal age on chronological age) and body size and fundamental motor skills and motor coordination were analysed with hierarchical multiple regression. Standardised residual of skeletal age on chronological age interacting with stature and body mass explained a maximum of 7.0% of the variance in fundamental motor skills and motor coordination over that attributed to body size per se. Standardised residual of skeletal age on chronological age alone accounted for a maximum of 9.0% of variance in fundamental motor skills, and motor coordination over that attributed to body size per se and interactions between standardised residual of skeletal age on chronological age and body size. In conclusion, skeletal age alone or interacting with body size has a negligible influence on fundamental motor skills and motor coordination in children 7-10 years.

Functional fitness and physical activity of Portuguese community-residing older adults.

The purposes of this study were to generate functional-fitness norms for Portuguese older adults, to determine age and sex differences, and to analyze the physical activity-associated variation in functional fitness. The sample was composed of 802 older adults, 401 men and 401 women, age 60-79 yr. Functional fitness was assessed using the Senior Fitness Test. Physical activity level was estimated via the Baecke questionnaire. The P50 values decreased from 60 to 64 to 75 to 79 yr of age. A significant main effect for age group was found in all functional-fitness tests. Men scored significantly better than women in the chair stand, 8-ft up-and-go, and 6-min walk. Women scored significantly better than men in chair sit-and-reach and back scratch. Active participants scored better in functional-fitness tests than their average and nonactive peers. This study showed a decline in functional fitness with age, better performance of men, and increased proficiency in active participants.

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults.

This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.

Exploring Mediation Effects of Gait Speed, Body Balance, and Falls in the Relationship between Physical Activity and Health-Related Quality of Life in Vulnerable Older Adults.

The present study aimed to examine whether gait speed (GS), body balance (BB), and falls mediated the relationship between physical activity (PA) and health-related quality of life (HRQoL) in community-dwelling older adults. This is a cross-sectional study that included 305 men and 314 women (69.5 ± 5.6 years), residing in the Autonomous Region of Madeira, Portugal. HRQoL and PA were assessed using the SF-36 and Baecke Questionnaires, respectively. While BB was obtained by the Fullerton Advance Balance (FAB) scale, GS by the 50-foot (15 m) walk test, and the frequency of falls was obtained by self-report. According to the analyses, when GS and BB were placed concomitantly as mediators, the direct effect revealed by the model revealed a non-significant relationship between PA and falls. Thus, in the context of falls, GS and BB partially mediated the association between PA and HRQoL in approximately 29.7%, 56%, and 49.2%, respectively. The total HRQoL model explained a variance of 36.4%. The results can help to understand the role that GS, BB, and falls play in the relationship between PA and HRQoL of the vulnerable older adult population.

Prediction of adult height in girls: the Beunen-Malina-Freitas method.

The purpose of this study was to validate and cross-validate the Beunen-Malina-Freitas method for non-invasive prediction of adult height in girls. A sample of 420 girls aged 10-15 years from the Madeira Growth Study were measured at yearly intervals and then 8 years later. Anthropometric dimensions (lengths, breadths, circumferences, and skinfolds) were measured; skeletal age was assessed using the Tanner-Whitehouse 3 method and menarcheal status (present or absent) was recorded. Adult height was measured and predicted using stepwise, forward, and maximum R (2) regression techniques. Multiple correlations, mean differences, standard errors of prediction, and error boundaries were calculated. A sample of the Leuven Longitudinal Twin Study was used to cross-validate the regressions. Age-specific coefficients of determination (R (2)) between predicted and measured adult height varied between 0.57 and 0.96, while standard errors of prediction varied between 1.1 and 3.9 cm. The cross-validation confirmed the validity of the Beunen-Malina-Freitas method in girls aged 12-15 years, but at lower ages the cross-validation was less consistent. We conclude that the Beunen-Malina-Freitas method is valid for the prediction of adult height in girls aged 12-15 years. It is applicable to European populations or populations of European ancestry.

Genetic and environmental influences on human height from infancy through adulthood at different levels of parental education.

Genetic factors explain a major proportion of human height variation, but differences in mean stature have also been found between socio-economic categories suggesting a possible effect of environment. By utilizing a classical twin design which allows decomposing the variation of height into genetic and environmental components, we tested the hypothesis that environmental variation in height is greater in offspring of lower educated parents. Twin data from 29 cohorts including 65,978 complete twin pairs with information on height at ages 1 to 69 years and on parental education were pooled allowing the analyses at different ages and in three geographic-cultural regions (Europe, North America and Australia, and East Asia). Parental education mostly showed a positive association with offspring height, with significant associations in mid-childhood and from adolescence onwards. In variance decomposition modeling, the genetic and environmental variance components of height did not show a consistent relation to parental education. A random-effects meta-regression analysis of the aggregate-level data showed a trend towards greater shared environmental variation of height in low parental education families. In conclusion, in our very large dataset from twin cohorts around the globe, these results provide only weak evidence for the study hypothesis.

Balance and mobility relationships in older adults: A representative population-based cross-sectional study in Madeira, Portugal.

BACKGROUND: Balance and mobility impairments are important modifiable risk factors associated with falls in older people. PURPOSE: To investigate how different functional fitness components relate to balance and mobility, after controlling for age, sex, body mass index (BMI), and different physical activity (PA) domains. METHODS: This representative cross-sectional study included 802 individuals, 401 males and 401 females (69.8 ± 5.6 years) from Madeira, Portugal. The Fullerton Advance Balance (FAB) scale was used to assess balance. Mobility in terms of gait velocity, cadence, stride length, and gait stability ratio (GSR) were assessed using the 50-foot Walk test. PA was assessed through a face-to-face interview using the Baecke questionnaire, and functional fitness was assessed with Senior Fitness tests (strength, flexibility, and aerobic endurance). RESULTS: Balance and mobility were negatively associated with age and BMI, and positively related to PA and functional fitness. Moreover, male presented better performance in balance and mobility. Hierarchical multiple regression analyses showed that functional fitness explained the highest amount of variance in balance and all mobility parameters (over and above age, sex, BMI, and PA). Specifically, entering functional fitness components significantly increased explained variance in FAB (+19%), gait velocity (+25%), cadence (+15%), stride length (+9%), and GSR (+ 31%). In these models, aerobic endurance consistently had the strongest contribution. CONCLUSION: Strength, flexibility, and especially aerobic endurance, over and above non-modifiable variables like age and sex, are crucial for maintaining or improving balance and mobility and, thereby, prevent falls in older people.

Parental Education and Genetics of BMI from Infancy to Old Age: A Pooled Analysis of 29 Twin Cohorts.

OBJECTIVE: The objective of this study was to analyze how parental education modifies the genetic and environmental variances of BMI from infancy to old age in three geographic-cultural regions. METHODS: A pooled sample of 29 cohorts including 143,499 twin individuals with information on parental education and BMI from age 1 to 79 years (299,201 BMI measures) was analyzed by genetic twin modeling. RESULTS: Until 4 years of age, parental education was not consistently associated with BMI. Thereafter, higher parental education level was associated with lower BMI in males and females. Total and additive genetic variances of BMI were smaller in the offspring of highly educated parents than in those whose parents had low education levels. Especially in North American and Australian children, environmental factors shared by co-twins also contributed to the higher BMI variation in the low education level category. In Europe and East Asia, the associations of parental education with mean BMI and BMI variance were weaker than in North America and Australia. CONCLUSIONS: Lower parental education level is associated with higher mean BMI and larger genetic variance of BMI after early childhood, especially in the obesogenic macro-environment. The interplay among genetic predisposition, childhood social environment, and macro-social context is important for socioeconomic differences in BMI.

Sex differences in relation patterns between health-related quality of life of older adults and its correlates: a population-based cross-sectional study in Madeira, Portugal.

A population-based cross-sectional study aimed to examine sex differences in health-related quality of life (HRQoL) of older adults, and investigate whether the relation patterns between HRQoL and its correlates differed between sexes. A stratified proportional and representative sample included 802 volunteers, aged 60-79. HRQoL (36-item Short Form Health Survey), functional fitness (Senior Fitness Test), physical activity (PA) (Baecke questionnaire), demographic information and health features (questionnaires) were assessed. Men showed significantly higher HRQoL (P<0.001). Body mass index, body strength, aerobic endurance, PA, depressive symptoms, falls, and living alone were significantly related to HRQoL. With sex as moderator, these relations were not significant, except for PA (ß=0.12, P=0.004). A significant interaction of sex with PA on HRQoL (ß=0.08, P=0.037) was found, indicating that this relation was higher in men. A similar relation pattern was found for HRQoL physical component. HRQoL and its correlates differed between sexes, demanding a sex specific approach to promote HRQoL.