Effects of a multicomponent training followed by a detraining period on metabolic syndrome profile of older adults.

AIMS: The present study sought to analyze the effects of 6-month multicomponent training (MCT) combined with a 4-month detraining on metabolic syndrome (MetS) profile among older adults with decreased functional capacity. METHODS: This quasi-experimental study included a total of 104 older adults (80.5 ± 6.0 years) and the sample was divided into a training (TRAIN, n = 55) or control group (CON). Harmonized definition was used to diagnose the MetS. Functional capacity, blood biochemical parameters, blood pressure, body composition and anthropometric measurements were assessed 3 times. Analysis of variance for repeated measures and Wilcoxon signed-rank test were used to check the differences within groups. RESULTS: TRAIN decreased diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDLC) and total fat mass during training period, whereas CON did not show any significant changes. During detraining, TRAIN increased HDLC, systolic blood pressure (SBP), waist circumference (WC) and total fat mass; and decreased glucose and fat free mass, whereas CON increased the concentration of glucose and HDLC. From baseline to post-detraining assessment, CON increased the concentration of triglycerides and the WC, while TRAIN only increased the WC (all p < 0.05). CONCLUSIONS: Exercise can be a key component in the treatment of the MetS, since MCT seems to be effective to decrease DBP and total fat mass. Nevertheless, 4-months of detraining could cause a drop of total fat mass, but no in DBP. To avoid reversibility of the benefits obtained, it could be beneficial to promote continuing exercise programs. TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT03831841.

Effects of Multicomponent Training Followed by a Detraining Period on Frailty Level and Functional Capacity of Older Adults with or at Risk of Frailty: Results of 10-Month Quasi-Experimental Study.

This study aimed: To analyze the effects of 6-month multicomponent training (MCT) and 4-month detraining on functional capacity and frailty among older adults with/at risk of frailty and to analyze the influence of frailty status on training and detraining adaptations. A total of 106 older adults (80.5 ± 6.0 years) were divided into a control (CON) or training group (TRAIN). The TRAIN performed a 6-month MCT (Eelder-fit), while CON continued their usual lifestyle. Functional capacity was assessed by the Short Physical Performance Battery (SPPB), while frailty was evaluated through Fried (FP) and the short version of the Frailty Trait Scale (FTS-5). Linear mixed models were performed to analyze group effects and to compare differences in changes within and between groups. TRAIN showed improvements in SPPB (3.2 ± 2.4), FP (-0.7 ± 1.3), and FTS-5 (-5.9 ± 5.8), whereas CON improved in SPPB (0.7 ± 2.9) and deteriorated in FTS-5 (2.8 ± 7.6) (all p < 0.05). Group effects favorable to TRAIN were found for all scales during this period (all p < 0.05). After detraining, TRAIN worsened in SPPB (-1.2 ± 2.7) and FTS-5 (4.1 ± 6.1) (both p < 0.05). No relevant differences were observed, accounting for frailty status between TRAIN subgroups. Eelder-fit improved the functional capacity and frailty of this population, whereas 4-months of detraining caused a drop of these variables except in FP.

Prevalence of Metabolic Syndrome and Association with Physical Activity and Frailty Status in Spanish Older Adults with Decreased Functional Capacity: A Cross-Sectional Study.

Metabolic syndrome (MetS) is a cluster of medical conditions associated with several health disorders. MetS and frailty can be related to prolonged physical deconditioning. There is a need to know whether there is concordance between the different ways of diagnosing it and to know their prevalence in Spanish older adults. Thus, the aims of this study were to describe the prevalence of MetS; to analyse the concordance between different definitions to diagnose MetS; and to study the associations between MetS, frailty status, and physical activity (PA) in older adults with decreased functional capacity. This report is a cross-sectional study involving 110 Spanish older adults of ages ≥65 years with decreased functional capacity. Clinical criteria to diagnose MetS was defined by different expert groups. Anthropometric measurements, blood biochemical analysis, frailty status, functional capacity, and PA were assessed. The Kappa statistic was used to determine the agreement between the five MetS definitions used. Student's t-test and the Pearson chi-square test were used to examine differences between sex, frailty, and PA groups. The sex-adjusted prevalence of MetS assessed by the National Cholesterol Education Program-Third Adult Treatment Panel was 39.4% in men and 32.5% in women. The International Diabetes Federation and the Harmonized definitions had the best agreement (k = 1.000). The highest odds ratios (ORs) of cardiometabolic risk factors to develop MetS were elevated triglycerides (37.5) and reduced high-density lipoprotein cholesterol (27.3). Central obesity and hypertension prevalence were significantly higher in the non-active group (70.7% and 26.8%, respectively), compared to the active group (50.0% and 7.7%, respectively). Moreover, the active group (OR = 0.85, 95% CI = 0.35, 2.04) and active women group (OR = 0.77, 95% CI = 0.27, 2.20) appeared to show a lower risk of developing this syndrome. MetS is highly prevalent in this sample and changes according to the definition used. It seems that sex and frailty do not influence the development of MetS. However, PA appears to decrease central obesity, hypertension, and the risk of developing MetS.

Health economic evaluation of exercise interventions in people over 60 years old: A systematic review.

This systematic review was conducted to examine the cost-effectiveness of exercise interventions in community-dwelling older adults. A systematic search for articles published in English or Spanish was carried out in PubMed, Web of Science and Cochrane Library that covered the period from the respective start date of each database to October 2021. Methodological quality was assessed with the Physiotherapy Evidence Database scale and quality of economic evaluation with the Quality of Health Economic Studies and Consolidated Health Economic Evaluation Reporting Standards. A total of 12 out of 15 studies on exercise programmes for older adults reported cost-effective results. The most cost-effective training appears to be a multicomponent training programme, including aerobic exercise, muscle-strengthening of lower extremities, and balance and stretching training. The training methodology should be of progressive moderate or vigorous intensity performed at least twice per week with each session lasting 60 min for ≥6 months. The exercise programme should be delivered as a group-based intervention, doing extra exercise at home to increase the cost-effectiveness. These findings suggest that exercise interventions in non-institutionalized older people are a cost-effective tool. Sex, age, cognitive status, frailty, frequency and training duration could modify the cost-effectiveness of exercise interventions. Systematic review registration. PROSPERO CRD42021231530 (date of registration: 20/02/2021).

Impact of the Home Confinement Related to COVID-19 on the Device-Assessed Physical Activity and Sedentary Patterns of Spanish Older Adults.

The main objective of this study was to device-assess the levels of physical activity and sedentary behaviour patterns of older adults during the situation prior to the COVID-19 pandemic, home confinement, and phase-0 of the deescalation. We also aimed to analyse the effectiveness of an unsupervised home-based exercise routine to counteract the potential increase in sedentary behaviour during the periods within the pandemic. A total of 18 noninstitutionalized older adults(78.4 ± 6.0 y.), members of the Spanish cohort of the EXERNET-Elder 3.0 project, participated in the study. They were recommended to perform an exercise prescription based on resistance, balance, and aerobic exercises during the pandemic. Wrist triaxial accelerometers (ActiGraph GT9X) were used to assess the percentage of sedentary time, physical activity, sedentary bouts and breaks of sedentary time. An ANOVA for repeated measures was performed to analyse the differences between the three different periods. During home quarantine, older adults spent more time in sedentary behaviours (71.6 ± 5.3%) in comparison with either the situation prior to the pandemic (65.5 ± 6.7%) or the ending of isolation (67.7 ± 7.1%) (all p < 0.05). Moreover, participants performed less bouts of physical activity and with a shorter duration during home quarantine (both p < 0.05). Additionally, no differences in the physical activity behaviours were found between the situation prior to the pandemic and the phase-0 of deescalation. According to our results, the home confinement could negatively affect health due to increased sedentary lifestyle and the reduction of physical activity. Therefore, our unsupervised exercise program does not seem to be a completely effective strategy at least in this period.