RÉSUMÉ
Urinary incontinence (UI) among older people is a common problem. Several treatments are available for older people with UI including surgery, drug therapies, and behavioral interventions. Recently, much attention has been placed on the behavioral treatments for UI, including pelvic floor muscle (PFM) exercise, weight loss exercise, and thermal therapy, as they have few risks, no side effects, and are effective. These therapies are often recommended as first line treatments for older people with UI. PFM exercise programs often incorporate alternations of fast contractions that are usually held for about two to three seconds interspersed with relaxation intervals of four to five seconds, and sustained contractions, where participants hold the contraction for about eight to ten seconds followed by a relaxation interval of ten to twelve seconds between the contractions. While exercise periods vary between 3 to 24 weeks, 8 to 12 weeks seems to be the most effective length for PFM exercise. The effectiveness of PFM exercise for the improvement of UI has been validated by many studies, with improvement rates ranging widely from 17 to 84%. Also, research has shown that UI is associated with obesity. Increases in body weight cause increases in abdominal wall weight, which in turn increases intra-abdominal pressure and intra-vesicular pressure. Therefore, abdominal fat reduction from exercise may decrease intra-abdominal pressure, perhaps causing improvements in urethral sphincter contraction and, hence, decreasing UI risk. Evidence reveals that PFM exercise and fitness training targeted at reducing modifiable risk factors are effective strategies for treating UI in older people, regardless of UI type.
RÉSUMÉ
This study was conducted to examine the prevalence of undernourished elderly in community-dwelling elderly people, and to analyze the correlation between under-nutritional status and health status and physical fitness of the elderly.The subjects comprised 1758 residents (757 men and 1001 women) aged 70 or over living in Itabashi-ku, Tokyo, who took part in an interview and biochemical blood examination as part of the “OTASHA-KENSHIN”. In this study, we set the ‘under-nutrition group’ as serum albumin level ≤ 3.8 g/dL (normal group serum albumin level ≥ 3.9 g/dL). Based on this standard, 124 subjects (72 men and 52 women) were found to be undernourished. Physical fitness was measured by handgrip strength, knee extension power, and walking capability (usual and maximal walking speed).The prevalence of undernourished elderly was significantly higher in men than in women, and in those living alone or with a spouse compared with those living with children. It became clear that the lifestyle and health status of the under-nutrition group was generally poor compared with those of the normal group. Handgrip strength and knee extension power were significantly lower in the under-nutrition group than in the normal group of men. Although usual and maximal walking speed tended to be lower in the under-nutrition group, there was no significant difference. In women, a significant difference in handgrip strength, knee extension power, and walking capability was not seen between the two groups.These results suggest that an intervention program for the undernourished elderly living in the community should target an improvement not only of nutrition but also of physical fitness.
RÉSUMÉ
Background: High heart rate (HR) has been associated with an increased risk of cardiovascular disease and mortality due to all causes. The present study was conducted to examine the effect of exercise adherence on longitudinal changes in resting heart rate among a population of community-dwelling elderly.Methods: The subjects were 133 men and 209 women aged 65 and older who participated in a baseline survey in August 1992 and were subsequently followed annually for 8 years. Resting HR was measured in the sitting position. The independent variable was the longitudinal change in differences of HR (Δ) from 1996 to 2000. Dependent variables were age, heart rate, smoking habit, TMIG index of competence score, and states of exercise adherence during the period 1992-1996.Results: Multiple regression analysis showed that heart rate in 1996 and smoking in men, and heart rate, TMIG index of competence score, and exercise adherence during the period 1992-1996 in women were significantly associated with longitudinal change in HR.Conclusion: Exercise adherence reduced the increase in HR of elderly women. These results suggest the importance of exercise adherence in elderly women.
RÉSUMÉ
The purpose of this study was to examine the validity of physical performance tests (test battery) for assessing functional fitness required for activities of daily life in older persons with chronic disease. This test battery consisted of 4 items: arm curl, walking around two cones, moving beans with chopsticks, and functional reach. Seventy-one persons (aged 66.7±7.8 yr) with either hemiplegia, Parkinson's disease (PD), or chronic obstructive pulmonary disease (COPD) served as subjects. There were significant differences among standard test scores in each rate of progression of the disease in all hemiplegia groups (Stages III, IV, V), and COPD groups (Stages 1, 2, 3) (Kruskal-Wallis'<I>H</I>=22.3 and 7.3, respectively) . In PD groups, there was no significant difference between standard scores in Stages II and III (Mann-Whitney's <I>U</I>=4.0) . However, the rank order correlation coefficient between the ranking in standard test score and the ranking in physical independence assessed by a medical doctor and a public health nurse was significant (ρ=0.57, <I>P</I><0.05) . All tests were safely applied for all subjects. These results suggest that our test battery may be applicable to a majority of older persons with various chronic diseases. Furthermore, the variability of standard test scores was greater than the clinical subjective ratings by Stage, which suggests that such a classification may provide a better description of disease progress/functional fitness.
RÉSUMÉ
The purposes of this study were to examine the loss of bone mineral density (BMD) with increasing age and to investigate the relationship between the BMD and body composition. Cross-sectional measurements of total body and regional (head, arms, legs, trunk, ribs, pelvis and spine) BMD and body composition were made in 112 Japanese healthy women, aged 20 to 87 years, by dual-energy X-ray absorptiometry (DXA) . The mean peak BMD for the trunk, ribs, and pelvis was observed at the age of 40-49 years, in the arms and spine at the age of 30-39 years, and in the head, legs, and total body at the age of 20-29 years. The loss of spine BMD appears to begin prior to BMD loss in other regions and the rate of bone loss as a function of aging was readily apparent. Appendicular bone loss did not occur until age 49 yr, accelerated from ages 50 to 69 yr, and then decelerated somewhat after age 70 yr. In this cross-sectional analysis, we found cumulative loss of BMD from peak to 80-89 yr of age was 31.2% for the spine, 25.0% for the total body, and 21.5% for the ribs. To examine the relationship between the BMD and body composition, multiple regression analysis was performed with total body and regional BMD as the dependent variable and fat-free mass (FFM) and fat mass as the independent variable. From this analysis, the results indicated that FFM was a significant predictor of total body and regional BMD but did not evaluate the effects of exercise or other potential variables that might affect BMD. In conclusion, our findings indicate that spine bone loss begins prior to the loss of compact bone, and the rate of bone loss in the spine due to aging was greater than that of other specific regions. Secondly, FFM and fat mass are related to total and regional BMD in Japanese women with the strongest relationship being FFM.
RÉSUMÉ
The purpose of this study was to investigate activity fitness of daily living of elderly women in Korea. The subjects were 253 elderly women ranging in age from 65 to 84 years. Twenty items related to the activity fitness of daily living were measured. The Pearson's correlation coefficients between the performance test items and age were significant (<I>P</I><0.05) and the score of all items remarkably decreased with advancing age. In order to extract activity fitness of daily living, the principal component analysis was applied to the 20×20 correlation matrix. The first principal component was interpreted as fundamental activity fitness (FAF) of daily living. The results of the comparison clearly indicated that the 75-79 and 80-84 age groups were inferior in FAF of daily living. Furthermore, in order to analyze the factorial structure of these elderly women, extracted factors were rotated with normal varimax criterion. The activity fitness (AF) of daily living were categorized to 7 factors : muscular strength and movement of the whole body, flexibility, balance, coordination of upper limbs, agility of upper and lower limbs, endurance, and reaction time. Results of the comparison of AF factors showed that a decline with advancing age was significant for muscular strength and movement of the whole body. The prediction equations of FAF were developed using multiple regression analyses. Results indicated that 8 selected items from 7 factors were significant predictors of the dependent variable FAF. Equally clarified was that 3 of our 8 items could be excluded, while still yielding comparable precision in predicting FAF. On the basis of all our analyses and considering the practicability of the measurement, we recommend the equation FAFS=1.504 X<SUB>1</SUB>-0.838 X<SUB>2</SUB>-0.489 X<SUB>3</SUB>-0.363 X<SUB>4</SUB>-0.686 X<SUB>5</SUB>+68.71, with an R=0.850; where FAFS=fundamental activity fitness score, X<SUB>1</SUB>=arm curl, X<SUB>2</SUB> walking around two chairs in a figure 8, X<SUB>3</SUB>=one foot tapping in a sitting position, X<SUB>4</SUB>=sit and reach, X<SUB>5</SUB> carrying beans using chopsticks, which can predict FAF with high precision in elderly Korean women.