Sedentary behaviour among older adults residing in flat and hilly neighbourhoods and its association with frailty and chronic disease status.

BACKGROUND: Living in hilly neighbourhoods can be associated with sedentary behaviour, but no study has compared sedentary behaviour and its associations with frailty, chronic diseases, and poor health between flat and hilly neighbourhoods among older adults. This study, therefore, compared older adults' sedentary behaviour and its association with frailty, poor health, and chronic disease status between low and hilly neighbourhoods. METHODS: This study utilised a STROBE-compliant cross-sectional design with sensitivity analyses and a common methods bias assessment. The participants were 1,209 people aged 50+ years who resided in flat (Ablekuma North, n = 704) and hilly (Kwahu East, n = 505) neighbourhoods in Ghana. The data were analysed with the independent samples t-test and hierarchical linear regression. RESULTS: Older adults in the hilly neighbourhood were more sedentary than those in the flat neighbourhood. The association between sedentary behaviour and chronic disease status was significant in both neighbourhoods, but this relationship was stronger in the hilly neighbourhood. Older adults in the flat neighbourhood reported lower sedentary behaviour at higher frailty (ß = -0.18; t = -3.2, p < 0.001), but those in the hilly neighbourhood reported higher sedentary behaviour at higher frailty (ß = 0.16; t = 3.54, p < 0.001). CONCLUSIONS: Older adults living in the hilly neighbourhood reported higher sedentary behaviour. In the hilly neighbourhood, sedentary behaviour was more strongly associated with frailty and chronic disease status. Older adults in hilly neighbourhoods may need extra support to avoid sedentary behaviour.

Use of Sensors for Fall Prediction in Older Persons: A Scoping Review.

The application of technological advances and clear articulation of how they improve patient outcomes are not always well described in the literature. Our research team investigated the numerous ways to measure conditions and behaviors that precede patient events and could signal an important change in health through a scoping review. We searched for evidence of technology use in fall prediction in the population of older adults in any setting. The research question was described in the population-concept-context format: "What types of sensors are being used in the prediction of falls in older persons?" The purpose was to examine the numerous ways to obtain continuous measurement of conditions and behaviors that precede falls. This area of interest may be termed emerging knowledge . Implications for research include increased attention to human-centered design, need for robust research trials that clearly articulate study design and outcomes, larger sample sizes and randomization of subjects, consistent oversight of institutional review board processes, and elucidation of the human costs and benefits to health and science.

Impacts of food consumption on biochemical markers and anthropometric variables of women with metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) is a group of diseases characterized by insulin resistance. MetS has high prevalence among women, which is impacted by food intake. MetS is related to high level of inflammation; however, the impacts of whole diets on biochemical and anthropometrical markers and the effects on MetS need to be further elucidated. In this case, the objective of this study was to assess the relationship between food intake, biochemical and anthropometrical markers in women with MetS. METHODS: This is a cross-sectional study, in which 1 hundred and 22 women participated in the assessment of biochemical (glycated hemoglobin, glycaemia, insulin, uric acid, total cholesterol, HDL-c, LDL-c, triglycerides, C-reactive protein) and anthropometrical (body mass, height, waist circumference - WC) variables. Participants also performed blood pressure and 24-hour dietary recall assessments. Out of the 122 participants, 44 (36%, age: 59 ± 11 years) had MetS and were included in the analysis. RESULTS: The consumption of monounsaturated fats had direct relationship with glycaemia (b = 7.48), whereas the consumption of fibers had inverse relationship with body mass (b = - 0.71) and WC (b = - 0.56). CONCLUSION: The intake of monounsaturated fats and fiber was related to higher blood sugar levels and lower body mass and WC, respectively. These relationships elucidate and highlight the significance and importance of adequate diet in women with MetS.

Associations between older African academics' physical activity, walkability and mental health: a social distancing perspective.

This study aimed to assess the moderating influence of neighborhood walkability on the association between physical activity (PA) and mental health among older African academics aged 50 years or more in cities with social distancing protocols in response to the Coronavirus disease 2019 (COVID-19). A total of 905 volunteer academics participated in the study. A hierarchical linear regression analysis was employed to conduct sensitivity analyses and test the study hypotheses. After controlling for sex, education and age, there was a positive association between PA and mental health. Neighborhood walkability moderated the relationship between PA and mental health, which suggests that during the pandemic PA was associated with higher mental health scores in more walkable neighborhoods. The study concludes that PA was beneficial to mental health in the social distancing context and was associated with higher mental health in more walkable neighborhoods, particularly in a social distancing context.

PredictMed: A Machine Learning Model for Identifying Risk Factors of Neuromuscular Hip Dysplasia: A Multicenter Descriptive Study.

Neuromuscular hip dysplasia (NHD) is a common and severe problem in patients with cerebral palsy (CP). Previous studies have so far identified only spasticity (SP) and high levels of Gross Motor Function Classification System as factors associated with NHD. The aim of this study is to develop a machine learning model to identify additional risk factors of NHD. This was a cross-sectional multicenter descriptive study of 102 teenagers with CP (60 males, 42 females; 60 inpatients, 42 outpatients; mean age 16.5 ± 1.2 years, range 12-18 years). Data on etiology, diagnosis, SP, epilepsy (E), clinical history, and functional assessments were collected between 2007 and 2017. Hip dysplasia was defined as femoral head lateral migration percentage > 33% on pelvic radiogram. A logistic regression-prediction model named PredictMed was developed to identify risk factors of NHD. Twenty-eight (27%) teenagers with CP had NHD, of which 18 (67%) had dislocated hips. Logistic regression model identified poor walking abilities (p < 0.001; odds ratio [OR] infinity; 95% confidence interval [CI] infinity), scoliosis (p = 0.01; OR 3.22; 95% CI 1.30-7.92), trunk muscles' tone disorder (p = 0.002; OR 4.81; 95% CI 1.75-13.25), SP (p = 0.006; OR 6.6; 95% CI 1.46-30.23), poor motor function (p = 0.02; OR 5.5; 95% CI 1.2-25.2), and E (p = 0.03; OR 2.6; standard error 0.44) as risk factors of NHD. The accuracy of the model was 77%. PredictMed identified trunk muscles' tone disorder, severe scoliosis, E, and SP as risk factors of NHD in teenagers with CP.

Using Artificial Intelligence to Identify Factors Associated with Autism Spectrum Disorder in Adolescents with Cerebral Palsy.

Autism spectrum disorder (ASD) is common in adolescents with cerebral palsy (CP) and there is a lack of studies applying artificial intelligence to investigate this field and this population in particular. The aim of this study is to develop and test a predictive learning model to identify factors associated with ASD in adolescents with CP. This was a multicenter controlled cohort study of 102 adolescents with CP (61 males, 41 females; mean age ± SD [standard deviation] = 16.6 ± 1.2 years; range: 12-18 years). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, communication abilities, behaviors, intellectual disability, motor skills, and eating and drinking abilities were collected between 2005 and 2015. Statistical analysis included Fisher's exact test and multiple logistic regressions to identify factors associated with ASD. A predictive learning model was implemented to identify factors associated with ASD. The guidelines of the "transparent reporting of a multivariable prediction model for individual prognosis or diagnosis" (TRIPOD) statement were followed. Type of spasticity (hemiplegia > diplegia > tri/quadriplegia; OR [odds ratio] = 1.76, SE [standard error] = 0.2785, p = 0.04), communication disorders (OR = 7.442, SE = 0.59, p < 0.001), intellectual disability (OR = 2.27, SE = 0.43, p = 0.05), feeding abilities (OR = 0.35, SE = 0.35, p = 0.002), and motor function (OR = 0.59, SE = 0.22, p = 0.01) were significantly associated with ASD. The best average prediction model score for accuracy, specificity, and sensitivity was 75%. Motor skills, feeding abilities, type of spasticity, intellectual disability, and communication disorders were associated with ASD. The prediction model was able to adequately identify adolescents at risk of ASD.

Pain, balance, grip strength and gait parameters of older adults with and without post-chikungunya chronic arthralgia.

OBJECTIVE: To compare the levels of pain, grip strength, balance and gait in older adults with and without post-Chikungunya chronic arthralgia (PCCA). METHODS: Sixty-two older adults, 30 with and 32 without PCCA participated in the study. Pain level was assessed using a Visual Analogue Scale (VAS). Gait during a 10-m walk was assessed using inertial sensors. Semi-static balance was assessed during an eyes-closed bipedal balance test on a force platform, and grip strength was assessed using a hand dynamometer. RESULTS: Participants with PCCA presented severe levels of pain (VAS > 7.5), poorer balance, lower grip strength, walked slower, with lower cadence and stride length and higher stride time and stride length variability than participants without PCCA (P < 0.001 for all variables). CONCLUSIONS: Older adults with PCCA had high levels of pain, impaired balance and gait and lower grip strength compared to older adults without PCCA.

Effects of Holding an External Load on the Standing Balance of Older and Younger Adults With and Without Chronic Low Back Pain.

OBJECTIVE: The purpose of this study was to assess the effect of holding an external load on the standing balance of younger and older adults with and without chronic low back pain (CLBP). METHODS: Twenty participants with and 20 without CLBP participated in the study. Each group contained 10 younger (50% men) and 10 older adults (50% men). Participants were instructed to look straight ahead while standing on a force platform during two 120-second trials with and without holding an external load (10% of body mass). The center of pressure area, mean velocity, and mean frequency in the anteroposterior and mediolateral directions were measured. RESULTS: Older adults had worse standing balance than younger adults did (P < .001, d = 0.20). There were no significant balance differences between participants with and without CLBP within age groups during standing balance condition. However, holding the external load significantly increased postural instability for both age groups and CLBP status, with mean effect size across center of pressure variables of d = 0.82 for older participants without CLBP and d = 2.65 for younger participants without CLBP. These effects for people with CLBP were d = 1.65 for subgroup of older and d = 1.60 for subgroup of younger participants. CONCLUSION: Holding an external load of 10% of body mass increased postural instability of both younger and older adults with and without CLBP.

Low Physical Performance Could Be Associated with Adverse Health Outcomes over Time: Results from a Cohort of Older Adults.

A few studies on physical performance (PP) decline among community-dwelling older adults have simultaneously evaluated various outcomes in Brazil. This longitudinal cohort study aimed to verify the association between PP and health outcomes (negative health self-perception-NHSP; consultations with health professionals; disability; falls; and hospitalization) in older Brazilians (N = 476, 68 ± 6.7 years). PP assessments included Gait Speed (GS) and Timed Up and Go (TUG) tests, and changes were evaluated over time (2014 to 2019-2020). The association between the PP and the outcomes was estimated using Poisson's regression with robust variance. The physical tests were not associated with NSPH or with the number of consultations with health professionals. However, after adjustment (economic level, diet quality, physical activity, multimorbidity, depression, polypharmacy, and BMI), low PP at baseline (TUG and GS) was associated with disability at follow-up. A low TUG performance at baseline was also associated with subsequent falls (PR = 1.57, p = 0.007). A decline in GS was associated with hospitalization (PR = 1.86, p = 0.033). PP was associated with disability, falls, and hospitalization over a five- to six-year period in older Brazilians. Regular PP assessments should be conducted and low PP should be used as an indicator of the need for preventative measures to avoid poor health outcomes.

Reducing falls among geriatric rehabilitation patients: a controlled clinical trial.

OBJECTIVE: To evaluate the effectiveness of an intervention programme to reduce falls among geriatric rehabilitation patients. DESIGN: Pre/post-test design with independent pre-test and matched post-test samples. SETTING: Inpatient geriatric wards in a rehabilitation hospital. PARTICIPANTS: Seventy-six matched pairs (n = 152) of geriatric rehabilitation patients from one control and one intervention ward participated in the study, and 36 nursing staff surveys were completed. INTERVENTION: The intervention programme was developed based on interviews and systematic reviews. Educational materials were distributed to patients and families, and preventive measures were implemented. MAIN OUTCOME MEASURES: The rates of falls before and after the intervention both within and between the wards were compared, and surveys were completed. RESULTS: The matched patients presented no significant differences on age, gender or medical conditions. The falls rates, proportion of fallers and length of stay was higher among those in the control ward (P< 0.043). The percentage of fallers and the rate of falls/1000 patient days were lower on the intervention ward after implementation: odds ratio (95% confidence interval) = -2.9 (-6.6, -1.2) and -1.8 (-6.0, 0.5). Thirty of 36 respondents considered the tool to be helpful and beneficial for use on other wards. CONCLUSION: The intervention programme was effective in reducing falls among geriatric rehabilitation patients.

Factors associated with the completion of falls prevention program.

Falls and fear of falling can affect independence and quality of life of older adults. Falls prevention programs may help avoiding these issues if completed. Understanding factors that are associated with completion of falls prevention programs is important. To reduce fear of falling and increase activity levels, a Matter of Balance (MOB) and un Asunto de Equilibrio (ADE) workshops were offered to 3420 older adults in South Florida between 1 October 2008 and 31 December 2011. Workshops were conducted in English or Spanish over eight, 2-hour sessions. Participants completed a demographic and a pre-post questionnaire. Factors associated with program completion were identified using logistic regression. For MOB, females were more likely to complete the program (OR = 2.076, P = 0.02). For ADE, females, moderate and extreme interference by falls in social activities were found to affect completion (OR = 2.116, P = 0.001; OR = 2.269, P = 0.003 and OR = 4.133, P = 0.008, respectively). Different factors predicted completion of both programs. Awareness of these factors can help lower the attrition rates, increase benefits and cost effectiveness of program. Future research needs to explore why certain groups had a higher likelihood of completing either program.

Low blood lead concentrations and thyroid function of American adults.

Lead is often present in our environment, but its effect on thyroid function is still unclear. In this study, multiple linear regressions were performed between log-transformed blood lead levels and thyroid function parameters of 4652 adults from the 2007-2008 National Health and Nutrition Examination Survey. The models were adjusted for age, gender, race/ethnicity, smoking, alcohol consumption, body mass index, physical activity, iodine intake, medications, and bone mineral density. Blood lead concentrations (mean: 1.52 ± 1.20 µg/dL [range 0.18-33.12]) were inversely associated with total thyroxine (regression coefficients [ß]: -0.22 [95% CI: -0.34, -0.09] in the general population, but were not correlated with thyroid stimulating hormone, total or free triiodothyronine, nor free thyroxine. Blood lead may have no effect on the thyroid function; however, it could be associated with decreased concentrations in thyroid-binding proteins.

Biomechanics and performance when using a standard and a vertical computer mouse.

OBJECTIVE: to compare the biomechanics and performance while using a vertical computer mouse (VM) and a standard mouse (SM). METHODS: muscle activation (electromyography), forearm movements (electrogoniometers), performance (Fitts' Law test) and satisfaction (questionnaire) of 16 subjects were evaluated. RESULTS: there were significant differences between the VM and the SM, respectively, on motion (28° vs. 42° pronation, p = 0.001; 5° ulnar vs. 7° radial deviation, p = 0.016) and muscle activity (13% vs. 16% of extensor carpi activity, p = 0.006; 10% vs. 13% extensor digitorum activity, p = 0.001). VM user satisfaction was good (68); however, time to target was longer (4.2 vs. 3.4 s, p < 0.001). CONCLUSIONS: using the VM decreased wrist pronation and lowered wrist extensor muscle activity, but additional training and familiarisation time may be required to improve user performance. PRACTITIONER SUMMARY: Using a vertical mouse can decrease the exposure to biomechanical risk factors for computer mouse use-related musculoskeletal disorders. Using a vertical computer mouse resulted in less wrist pronation and lower wrist extensor muscle activity. But, training and familiarisation are required.

Usability and effects on gait of an optimized schoolchildren backpack.

BACKGROUND: Backpacks used by children is a global concern, because may cause musculoskeletal discomforts and pain. OBJECTIVE: The purpose of this study was to test the usability and effects on gait kinematics wearing the Trunkpack versus a traditional backpack and no backpack. METHODS: Twenty-four children (9 to 11 years old) from a public school participated in this study. The usability was evaluated after a five-week testing period using a questionnaire. Gait kinematics was evaluated (Vicon) when the children were wearing a standard backpack, an optimized backpack (Trunkpack), and no backpack. Both backpacks were loaded with 10% of body weight. RESULTS: Was observed more trunk, hip and knee flexion when the children carried a standard backpack in comparison using the Trunkpack and not carrying a backpack (p < 0.01). The Trunkpack and no backpack were similar. The Trunkpack was well accepted by the schoolchildren (81% positive responses), 79% liked the head opening, 88% liked the waist straps, and 83% liked the facility to put and take objects in and out of the Trunkpack. CONCLUSION: Trunkpack requires less postural adjustments during gait than a standard backpack. Gait kinematics with the Trunkpack was comparable to the gait without carrying a backpack.

Willingness of Older Adults From Culturally Diverse Populations to Participate in COVID-19 Related Treatment Trials and Associated Factors.

This survey study aimed to assess the willingness of culturally diverse older adults to participate in COVID-19 research. The majority of the 276 participants were women (81%, n = 223) and Black/African American (62%, n = 172) or White Hispanic (20%, n = 56). A key finding from the survey was less than 1 of 10 respondents would be likely to participate in COVID-19 related research if given the opportunity. There were no differences observed by gender, race or ethnicity. Implications of these findings are considered. These study findings indicate continued effort and better messaging strategies are required to increase awareness that COVID-19 related research needs to include culturally diverse older adults to ensure vaccines and treatments are efficacious in different populations.

Changes in Physical Performance among Community-Dwelling Older Adults in Six Years.

Changes in physical performance (PP) occur with aging, and understanding the magnitude of these changes over time is important. This study evaluated changes in Gait Speed (GS) and Timed Up and Go (TUG) performance and their association with related factors among community-dwelling older adults over a period of five to six years. A cohort study of 476 older adults with baseline assessment conducted in 2014 and reassessment in 2019-2020 was carried out. Associations between PP changes over time and sociodemographic, behavioral, and health variables were evaluated using mixed linear models. Approximately 68% of the participants declined PP; 20% had no relevant change in GS and 9% in TUG time (sustained PP); 12% increased GS, and 23% decreased TUG time (improved PP). Being male (p = 0.023), living without a partner/separated (p = 0.035), higher education (p = 0.019), and alcohol consumption in the prior month (p = 0.045) were associated with decreased GS, while older age (p < 0.001), having lower socioeconomic status (p < 0.004), physical inactivity (p = 0.017), and being overweight (p = 0.007) were associated with increased TUG time. PP declined for most participants. Factors most strongly associated with PP decline are non-modifiable. The high prevalence of PP decline over time signals the importance of including physical tests in yearly health assessments.

Urinary heavy metals and associated medical conditions in the US adult population.

Health effects of heavy metals have been widely investigated, but further evaluation is required to comprehensively delineate their toxicity. Using data from the 2007-2008 National Health and Nutrition Examination Survey, a multivariate logistic regression analysis was performed on 1,857 adults to examine the relationship between urinary heavy metals and various medical conditions. Cardiovascular diseases were correlated to cadmium (OR: 4.94, 95% CI: 1.48-16.56) and lead (OR: 5.32, 95% CI: 1.08-26.21). Asthma was related to tungsten (OR: 1.72, 95% CI: 1.15-2.59) and uranium (OR: 1.52, 95% CI: 1.01-2.28). Hepatotoxicity was associated with molybdenum (OR: 3.09, 95% CI: 1.24-7.73) and uranium (OR: 4.79, 95% CI: 1.74-13.19). Surprising inverse relationships occurred for excessive weight with lead (OR: 0.72, 95% CI: 0.52-0.98), reduced visual acuity with cobalt (OR: 0.65, 95% CI: 0.44-0.95) and cesium (OR: 0.52, 95% CI: 0.35-0.77). This study supports some previous evidence of potential relationships and provides insights for future research.

Work-related respiratory symptoms and lung function among solderers in the electronics industry: a meta-analysis.

OBJECTIVE: Research on the respiratory effect of exposure to solder fumes in electronics workers has been conducted since the 1970s, but has yielded inconsistent results. The aim of this meta-analysis was to clarify the potential association. METHODS: Effect sizes with corresponding 95% confidence intervals (CIs) for odds of respiratory symptoms related to soldering and spirometric parameters of solderers were extracted from seven studies and pooled to generate summary estimates and standardized mean differences in lung function measures between exposed persons and controls. RESULTS: Soldering was positively associated with wheeze after controlling for smoking (meta-odds ratio: 2.60, 95% CI: 1.46, 4.63) and with statistically significant reductions in forced expiratory volume in 1 s (FEV1) (-0.88%, 95% CI: -1.51, -0.26), forced vital capacity (FVC) (-0.64%, 95% CI: -1.18, -0.10), and FEV1/FVC (-0.35%, 95% CI: -0.65, -0.05). However, lung function parameters of solderers were within normal ranges [pooled mean FEV1: 97.85 (as percent of predicted), 95% CI: 94.70, 100.95, pooled mean FVC: 94.92 (as percent of predicted), 95% CI: 81.21, 108.64, and pooled mean FEV1/FVC: 86.5 (as percent), 95% CI: 78.01, 94.98]. CONCLUSIONS: Soldering may be a risk factor for wheeze, but may not be associated with a clinically significant impairment of lung function among electronics workers.

Association between Domains of the Clinical-Functional Vulnerability Index and Falls History in Older Adults: A Cross-Sectional Study.

Objectives: The study aimed to determine which domains, sets, and isolated or combined questions of the Clinical-Functional Vulnerability Index (CFVI-20) are associated with falls history in older adults. Methods: Instruments used were the CFVI-20 assessment and reported falls during the last year. The receiver operating characteristics (ROC) curves identified the performance of the CFVI-20 domains and questions in identifying older adults with and without falls history, while logistic regression identified relevant questions to identify fall history. Results: This study included 1725 individuals (71.9 ± 7.3 years). The area under the curve (AUC) between the CFVI-20 and fall history was 0.69. The mobility domain presented the largest AUC (0.71; p < 0.01), and most isolated domains showed low AUCs (0.51 to 0.58). Isolated questions were limited to identifying fallers. The regression analysis identified 7 questions of the CFVI-20 with falls. Conclusions: The CFVI-20 general score identified older adults with a fall history. When considered in isolation, most domains were limited to identifying falls, except for the mobility domain. Combining the CFVI-20 questions enabled identification of fallers.

Balance Differences between North and South American Older Adults: A Cross-Sectional, Age and Sex Matched Study.

This study aimed to characterize the risk of falling in low-, moderate- and high-risk participants from two different geographical locations using a portable force-plate. A sample of 390 older adults from South and North America were matched for age, sex, height and weight. All participants performed a standardized balance assessment using a force plate. Participants were classified in low, moderate and high risk of falling. No differences were observed between South and North American men, nor comparing North American men and women. South American women showed the significantly shorter center of pressure path length compared to other groups. The majority of the sample was categorized as having low risk of falling (male: 65.69% and female: 61.87%), with no differences between men and women. Moreover, no differences were found between North vs. South Americans, nor between male and female groups compared separately. In conclusion, South American women had better balance compatible with the status of the 50-59 years' normative age-range. The prevalence of low falls risk was~61-65%; the prevalence of moderate to high risk was~16-19%. The frequency of fall risk did not differ significantly between North and South Americans, nor between males and females.