Relationships between obesity markers and bone parameters in community-dwelling older adults.

BACKGROUND: Osteoporosis is an age-related condition that can lead to fragility fractures and other serious consequences. The literature data on the impact of obesity on bone health are contradictory. The main reasons for this discrepancy could be the imperfect nature of the body mass index (BMI) as a marker of obesity, the metabolic status (inflammation and metabolically healthy obesity), and/or heterogeneity in bone variables and architecture or sex. AIMS: To examine the relationship between bone variables and three validated obesity criteria. METHODS: In this cross-sectional study, participants were classified as obese according to their BMI, waist circumference (WC), and fat mass (FM). Bone variables and architecture were assessed using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. RESULTS: One hundred sixty-eight adults aged 55 or over (men: 68%) were included. 48 (28%) participants were obese according to the BMI, with 108 (64%) according to the FM, and 146 (87%) according to the WC. Bone variables were positively correlated with WC and BMI (Pearson's r = 0.2-0.42). In men only, the obesity measures were negatively correlated with cortical bone density (Pearson's r = - 0.32 to - 0.19) and positively correlated with cortical bone area (Pearson's r = 0.22-0.39). CONCLUSION: Our findings indicate that independent of sex and obesity criteria, when significant, being obese seems to lead to higher bone parameters than being non-obese, except for cortical bone density. Thus, in the obese population, assessing cortical density might help the physician to identify bone alteration. Further researches are needed to confirm our findings.

Reference Standard for the Measurement of Loss of Autonomy and Functional Capacities in Long-Term Care Facilities.

The vast majority of people living in long-term care facilities (LTCFs) are octogenarians (i.e., in Québec, 57.4% of the residents are age 85 or older, 26.2% are between age 75 and 84, 10.7% are between age 65 and 74, and 5.7% are below age 65 (1)), who are affected by a great loss of physical or cognitive autonomy due to illnesses and are unable to maintain their independence, safety and mobility at home. For the majority of them, their last living environment will be a LTCF. Moreover, the annual turnover in LTCFs is one-third of all residents (2) while the average length of stay is 823 days (1). Therefore the main challenges for caregivers in LTCFs are the maintenance of functional capacities and preventing patients from becoming bedridden and isolated. Measuring the level of autonomy and functional capacities is therefore a key element in the care of institutionalized people. Several validated tools are available to quantify the degree of dependence and the functional capacities of older people living in long-term care facilities. This narrative review aims to present the characteristics of the specific population living in long-term care facilities and describe the most widely used and validated tools to measure their level of autonomy and functional capacities.

Impacts of Remote Physical Exercises on Functional Status and Mobility among Community-Dwelling Pre-Disabled Seniors during the Covid-19 Lockdown.

OBJECTIVES: To assess whether remote physical exercise interventions helped maintain function in daily life, level of physical activities, basic mobility and frailty status in pre-disabled seniors during the first Covid-19 lockdown. DESIGN: This is an interventional study conducted from May 2020 to May 2021. SETTING: Community-dwelling older adults in 2 Canadian cities. PARTICIPANTS: 84 pre-disabled seniors. INTERVENTION: 12-week physical exercise programs (1 hour/ 3 times/ week) in kinesiologist-guided groups using Zoom or phone-supervised individual booklet-based home-program (n=44) vs. Control (usual life habits; n=40). MEASUREMENTS: Functional status in daily activities (OARS scale); Daily level of aerobic (TAPA-1) and strengthening/flexibility (TAPA-2) physical activities; Basic mobility abilities (SPPB: balance, lower limbs strength, walking speed; Timed Up-and-Go) and Frailty (SOF index) were assessed at baseline and at 3, 6, 9 and 12-month follow-ups. RESULTS: The participants' mean age was 78.5 ± 7.2 and 76.5 % were women. There was a group * time effect for the OARS scale (p=0.02), the TAPA-1 (p=0.06) and the TAPA-2 (p=0.007) scores. For these outcomes, scores significantly improved during the first 3 months of follow-up and then stabilised in the intervention group whereas they remained constant in the control group over time. There was an overall time effect for the SPPB (p=0.004), the 4-m walking speed (p=0.02) and for the SOF index (p=0.004), with no between-group differences. Finally, no effect was observed for the TUG. CONCLUSION: Remote home-based physical exercise interventions and monitoring during the first Covid-19 lockdown seemed to have helped maintain seniors' level of physical activities without impacting on basic mobility abilities. Further studies are needed to identify parameters of remote exercise programs that can improve daily function and mobility in this population.

Online physical exercise intervention in older adults during lockdown: Can we improve the recipe?

BACKGROUND: Recorded and live online physical exercise (PE) interventions are known to provide health benefits. However, the effects of prioritizing the number of live or recorded sessions remain unclear. AIMS: To explore which recorded-live sessions ratio leads to the best implementation and benefits in older adults. METHODS: Forty-six community-dwelling adults (> 60y.o.) were randomized into two groups completing a 12-week online PE intervention. Each group had a different ratio of live-recorded online sessions as follows: Live-Recorded-Live sessions (LRL; n = 22) vs. Recorded-Live-Recorded sessions (RLR; n = 24). RESULTS: Drop-out rates did not reach significance (LRL:14% vs. RLR: 29%, p = 0.20), and adherence was similar (> 85%) between groups. Both groups reported similar levels of satisfaction (> 70%), enjoyment (> 75%), and perceived exertion (> 60%). Both groups increased physical health and functional capacities, with greater improvements in muscle power (LRL: LRL: + 35 ± 16.1% vs. RLR: + 7 ± 13.9%; p = 0.010) and endurance (LRL: + 34.7 ± 15.4 vs. RLR: + 27.0 ± 26.5, p < 0.001) in the LRL group. DISCUSSION: Both online PE intervention modalities were adapted to the participants' capacities and led to a high level of enjoyment and retention. The greater physical improvements observed in the LRL group are likely due to the higher presence of the instructor compared to the RLR group. Indeed, participants received likely more feedback to appropriately adjust postures and movements, increasing the quality of the exercises. CONCLUSION: When creating online PE interventions containing both recorded and live sessions, priority should be given to maximizing the number of live sessions and not the number of recorded sessions.

[Physical activity in nursing homes: contributions of the SENIOR cohort]. / L'activité physique en maison de repos : contributions de la cohorte SENIOR.

The SENIOR ("Sample of Elderly Nursing homes Individuals: an Observational Research") study is a prospective follow-up of a cohort of more than 600 people living in nursing homes in Belgium. One of the objectives of this study is to investigate ways of managing frailty in order to prevent the occurrence of adverse health events. Thanks to the numerous demographic, clinical and anamnestic data collected annually, this study has shown the importance of promoting qualitative physical activity in nursing homes in order to improve the quality of life of residents. Specifically, our research showed the positive effect of physical activity programmes on weekly energy expenditure and improvement of functional abilities, motivation to engage in physical activity and quality of life. Furthermore, the possibilities to improve the motivational context of group physical activity sessions and the feasibility of innovative physical activity programmes, based on the development of a giant play mat or the organisation of competitions in nursing homes, were highlighted.

L'étude SENIOR («Sample of Elderly Nursing homes Individuals : an Observational Research¼) est un suivi prospectif d'une cohorte de plus de 600 personnes résidant en maison de repos, en Belgique. Un des objectifs de celle-ci est l'étude des pistes de prise en charge de la fragilité afin de prévenir la survenue d'événements indésirables de santé. Grâce aux nombreuses données démographiques, cliniques et anamnestiques récoltées annuellement, cette étude a permis de montrer l'importance de promouvoir l'activité physique qualitative en maison de repos afin d'améliorer la qualité de vie des résidents. Plus précisément, nos recherches ont montré l'effet positif des programmes d'activité physique sur les dépenses énergétiques hebdomadaires et l'amélioration des capacités fonctionnelles, de la motivation à pratiquer l'activité physique et de la qualité de vie. Par ailleurs, les possibilités d'améliorer le contexte motivationnel des séances d'activité physique de groupe et la faisabilité de programmes d'activité physique innovants basés sur l'élaboration d'un tapis de jeu géant ou l'organisation de compétitions en maisons de retraite, ont été mises en évidence.

Effect of a 12-Week Mixed Training on Body Quality in People Living with HIV: Does Age and HIV Duration Matter?

BACKGROUND: The impact of HIV duration on exercise adaptations has not yet been studied. Moreover, the age at which subjects living with HIV are the most responsive to exercise is not clear. AIMS: Investigate the effect of a mixed exercise training program on physical performance changes in individuals living with HIV and explore if age or HIV duration influence these adaptations in men. METHODS: In this feasibility study, participants followed a 12-week mixed exercise training program, three times/week, 45 min/session. Physical performance including functional capacities (normal 4-m walking test, 6min walking test), grip strength (hand dynamometer), muscle power, body composition (android and gynoid fat masses, appendicular lean mass) were evaluated pre- and post-intervention. Subgroup analysis according to the median age of the participants (age<50yrs vs. age≥50yrs) and median HIV duration (HIV<20yrs vs. HIV≥20yrs) were performed in men. RESULTS: A total of 27 participants (age: 54.5±6.8yrs, men: 85%; HIV duration: 19.3±7.6yrs) were included. At the end of the intervention, significant increases compared to baseline were seen in grip strength (p=0.017), leg power (p<0.001), normal walking speed (p<0.001) and 6-min walking distance (p=0.003). Following the intervention, parameters improved similarly in both age groups. However improvement was greater in those with HIV>20yrs than those with a shorter infection duration, with change (%) on total (p<0.001), android (p=0.02), and gynoid (p=0.05) fat masses as well as appendicular lean mass index (p=0.03). CONCLUSION: Mixed exercise training seems to be an effective intervention to improve physical performance in individuals living with HIV. In addition, this study suggests that neither age nor HIV duration has influence on the effect of mixed training in this population.

Assessing Physical Performance in Older Adults during Isolation or Lockdown Periods: Web-Based Video Conferencing as a Solution.

During the COVID-19 pandemic, face-to-face assessments were limited. Fortunately, older adults have access to web-technology (60%). Thus, we aimed to explore if assessing physical performance remotely is as reliable and valid as in person. At the end of the first lockdown, 15 older adults agreed to perform two similar evaluations in remote and face-to-face conditions. Functional capacities [5-repetitions Sit-to-Stand (STS); unipodal balance, 4-m walking speed (normal (NWS); fast (FWS)), 3-m Timed-Up and Go (normal (nTUG); fast (fTUG))] and muscle power and endurance were assessed. Fast walking speed was moderately reliable. Unipodal balance, NWS and nTUG were highly reliable (ICC>0.7). fTUG, STS, muscle endurance and power were extremely reliable (ICC>0.9). For absolute reliability, SEM varied from 15.54 to 5.14%. Finally, the MDC varied from 43.07 to 14.21%. Assessing functional capacities and muscle function remotely is as reliable and valid as a face-to-face assessment and should be considered as a clinical practice.

Feasibility and Acceptability of Remote Physical Exercise Programs to Prevent Mobility Loss in Pre-Disabled Older Adults during Isolation Periods Such as the COVID-19 Pandemic.

This study aimed to assess the feasibility and acceptability of remote physical exercise (PE) to prevent mobility loss among pre-disabled older adults during the COVID-19 lockdowns. Participants followed a 12-week PE remote program in Zoom© supervised groups (Web-Ex group, n=11) or phone-supervised individual booklet-based home-program (Booklet group, n=33). The total rate of adherence was 82.5% in the Web-Ex group and 85.8% in the Booklet group. The level of satisfaction was « a lot ¼ for 60% of the participants in the Web-ex group and for 37.9% of those included in the Booklet group. Respectively 10% and 31% of the participants rated the difficulty as « low ¼ in the web-ex and Booklet groups. Remote physical exercise using a web technology or booklets at home with regular and personalized follow-up during the lockdown was feasible and acceptable among pre-disabled seniors.

Nutrition to Prevent or Treat Cognitive Impairment in Older Adults: A GRADE Recommendation.

Aging is associated with cognitive declines leading to mild cognitive impairments or Alzheimer disease. Nutrition appear to protect from aging. Some dietary factors could either increase or protect against cognitive declines. This article aimed to provide GRADE recommendations related to nutrition aspects able to prevent or to treat cognitive impairments. A comprehensive literature review was performed using Medline database. The GRADE approach was used to classify quality of the existing evidence (systematic review or meta-analysis).The GRADE process led us to formulate seven key nutritional recommendations to manage cognitive declines, but did not allow us to do it for protein, vitamin B or antioxidants. Thus, 1) adherence to a Mediterranean diet (GRADE 1B); 2) high-level of consumption of mono- or poly- unsaturated fatty acids combined to a low consumption of saturated fatty acids (GRADE 1B); 3) high consumption of fruits and vegetables (GRADE 1B); 4) higher vitamin D intake (GRADE 1C) than the recommended daily allowance. In addition, a ketogenic diet, a low consumption of whole-fat dairy products or a caloric restriction are promising nutritional habits although the evidence does not yet support widespread uptake (GRADE 2C). In conclusion, nutrition is an important modifiable factor to prevent or protect against cognitive decline. Nevertheless, more studies are required to determine specific guidelines such as duration and amounts of nutrients to help older adult to maintain a healthy cognitive life.

Potential Efficacy of Pragmatic Exercise Program (SPRINT) during Hospitalization in Older Adults on Health Care and Physical Performance: A Pilot Study.

OBJECTIVES: Immobilization contribute to iatrogenic decline in hospitalized older adult. Implementing physical activity (PA) seems to be one of the best and easy solution. However, PA interventions are poorly integrated into usual care and those available are either non-specific, need supervision or requested human/material resources. Thus, we aimed to assess the effect of a pragmatic, unsupervised, and specific PA program (SPRINT) on health care practice and functional capacities in hospitalized older patients. DESIGN: Single arm interventional pragmatic pilot study. SETTING: Geriatric Assessment Unit (GAU). PARTICIPANTS: Of the 39 patients (> 65 years) hospitalized in a GAU and eligible, 19 agreed to participate (AP) and 20 declined (N-AP). INTERVENTION: One of the 4 PA programs, developed by our team, was allocated according to mobility profile. Individual functional capacities (i.e. balance, walking speed, functional mobility profile (PFMP)), active time (METS> 1.5: min), length of hospitalization (LOS), discharge orientation were assessed at admission and discharge of GAU. RESULTS: Baseline characteristics of the 2 groups were comparable. At discharge, the AP group improved more on walking speed (0.57 ± 0.21 vs. 0.64 ± 0.19; p = 0.013), Berg balance scale (41.8 ± 13.7 vs. 45.1 ± 9.7; p = 0.017) and PFMP (54.0 ± 7.1 vs 55.1 ± 5.5; p = 0.042) than the N-AP group. The LOS was significantly shorter in AP group compared to the N-AP group (5 vs. 36 days; p = 0.026) and more subjects in the AP group were oriented at home without health or social services (89.5 vs. 60%; p=0.065). CONCLUSION: SPRINT appears effective to counteract iatrogenic decline and decreased the LOS. Moreover, this simple pragmatic PA tool seems to improve the life trajectory and healthcare practice in aging population. Further researches are needed to confirm these promising pragmatic results.

Clinical Impact of Nutritional Status and Energy Balance in Elderly Hospitalized Patients.

OBJECTIVES: This study aimed 1) to assess the nutritional status of patients hospitalized in a geriatric ward using the recent Global Leadership Initiative on Malnutrition (GLIM) criteria, 2) to determine the balance between the energy intake (EI) with an enriched diet and the energy requirement (ER) using indirect calorimetry, and 3) to assess whether undernutrition is associated with 1-year outcome. DESIGN: This is a prospective cross-sectional study. SETTING: This study was performed in a geriatric unit. PARTICIPANTS: Patients of this geriatric unit were eligible for the study if they agreed to participate and if they did not meet the exclusion criteria (presence of malignant tumour, uncontrolled heart or renal failure, thyroidal disease, uncontrolled sepsis, oedema of the lower limbs, wearing of a pacemaker, biological thyroid dysfunction and inability to perform walking tests). MEASUREMENTS: Rest energy expenditure (REE) was measured by indirect calorimetry within the week of hospitalization. Total energy expenditure (TEE) was obtained by multiplying REE by a physical activity level coefficient and energy expenditure that was related to thermogenesis (i.e., 10% of the total amount of energy ingested over 24 h) was added. Food intake was measured over a 3-day period. Undernutrition was defined using MNA and the criteria of the GLIM leadership. Clinical outcomes included 1-year institutionalisation and mortality. RESULTS: Seventy-nine patients (84.9 ± 5.3 years) were included. A total of 21 (26.6 %) patients were found undernourished. REE was 1088 ± 181kcal/day (17.8 ± 2.9 kcal/kg/day) and TEE was 1556 ± 258 kcal/day (25.4 ± 4.2 kcal/kg/day). Weight-adjusted REE and TEE were higher in undernourished patients compared to those well-nourished (19.8 ± 3.1 vs. 17.1 ± 2.6 kcal/day and 28.4±4.5 vs. 24.4±3.7 kcal/day) (p<0.05). The lower was the Body Mass Index (BMI), the higher was the energy needs (p<0.01). EI was significantly greater than energy requirements (difference requirements - intake with enriched diet = -354 ± 491 kcal/day; p<0.0001). This difference did not depend on BMI (p=0.82), appendicular skeletal mass index (ASMI) (p=0.63), or the presence of undernutrition (p=0.33). At 1-year follow-up, 15 (19%) patients died and 20 (25.6%) were institutionalized. On multivariable analysis, male gender (OR=5.63; p=0.015) and undernutrition (OR=7.29; p=0.0043) emerged as independently associated with death. On multivariable analysis, only ASMI (OR 0.59 (0.35-0.99), p=0.044) and activities of daily living (ADL) (OR 1.14 (1.00-1.30), p=0.043) were significantly associated with institutionalization. CONCLUSIONS: Undernutrition as assessed by the GLIM criteria remains common in elderly patients hospitalized in a geriatric unit and is associated with increased 1-year mortality but not with institutionalization. Energy requirements are higher in undernourished patients and in patients with a low BMI. Enriched energy intakes could sufficiently cover the energy needs of this population.

French translation and validation of the Achilles Tendon Total Rupture Score "ATRS".

BACKGROUND: To provide a cross-cultural French adaptation of the Achille's Tendon Total Rupture Score (ATRS) and to assess its psychometric performances. METHOD: The ATRS questionnaire was first translated and inter-culturally adapted into French according to international guidelines. Then, 95 subjects were recruited to complete the French version of the ATRS twice (2 weeks of interval). The SF-36 and VISA-A were used as comparative questionnaires. The psychometric properties of the questionnaire were evaluated (test-retest reliability, internal consistency, construct validity, floor/ceiling effects). RESULTS: Thetest-retest reliability was excellent (ICC of 0,966 (95% CI:0.644-0.879)) and the internal consistency very high (Cronbach's alpha of 0,98). The convergent and divergent construct validity were also confirmed. Finally, none of the subjects obtained the lowest score (0) or the maximal score (100) to the questionnaire. CONCLUSION: A valid and reliable French version of the ATRS is now available.

Relevance to assess and preserve muscle strength in aging field.

According to the revised European consensus on sarcopenia, muscle strength is the primary parameter of sarcopenia and is associated with adverse outcomes or physical limitation. This literature review aims to clarify how and why to measure and preserve muscle strength in older population. Overall, the relationship between muscle strength and physical function is impacted by level of muscle mass, the degree of obesity (BMI), age and physical activity. Therefore, these factors are to be considered in the evaluation of muscle strength. It is necessary to have objective, reliable and sensitive tools to assess muscle strength, in different populations to detect and quantify weakness, to adapt physical exercises to patients' capacity and to evaluate the effects of treatment. Handgrip strength measurement might be reasonable for clinical practice while the measurement of knee flexors/extensors strength with both 1RM and dynamometers is increasingly important yet restricted by the requirement of special equipment. Physical activity and nutrition are two important behavioral factors to maintain muscle strength. Combined exercise and nutrition interventions improved muscle strength to a more prominent degree than exercise or nutrition alone.

[Frailty in nursing home : contribution of the SENIOR study]. / Apports de la cohorte liégeoise SENIOR dans l'étude de la fragilité en maison de repos.

Over the past 20 years, clinicians and researchers have shown increasing interest in frailty. However, there is still no consensus regarding its operational definition. An interesting definition in this context could be the one that best predicts functional decline and the occurrence of negative health outcomes. Moreover, frailty could be avoided, delayed and sometimes cured by the implementation of targeted interventions. The SENIOR cohort, a longitudinal study of nursing home residents, initiated in 2013, aims to contribute to the understanding of risk factors, consequences and dynamic of frailty. It also contributes to its management. This cohort is of great interest among scientists. Because of the large number of demographic, clinical and anamnestic data collected each year, the SENIOR study could fill the gap in the literature related to the frailty.

Au cours des deux dernières décennies, la documentation traitant de la fragilité s'est faite de plus en plus abondante. Toutefois, il n'existe toujours pas de définition opérationnelle et de critères universellement reconnus pour décrire la fragilité. Les critères cliniques de fragilité doivent être prédictifs du risque de déclin fonctionnel et d'événements péjoratifs de santé. Dans cette optique, identifier précocement les sujets fragiles permet d'agir sur les facteurs de risque et d'éviter les évolutions défavorables. La cohorte SENIOR, une étude longitudinale de personnes âgées résidant en maison de repos initiée en 2013, a pour objectif de contribuer à la compréhension des facteurs de risque, des conséquences et de la trajectoire de la fragilité. Elle a aussi pour but d'apporter des pistes de prise en charge. Cette cohorte suscite beaucoup d'intérêt dans le monde de la recherche scientifique. En effet, grâce aux nombreuses données démographiques, cliniques et anamnestiques récoltées annuellement, elle permet d'apporter des éléments de réponses aux problématiques liées à la fragilité des personnes âgées.

Impact of frailty status on the cost of drugs and dietary supplements prescribed to nursing home residents: the SENIOR cohort.

BACKGROUND: The financial impact associated with drug consumption has been poorly investigated among frail subjects and, specifically, in nursing home settings. AIMS: To determine the association of the average monthly cost of the drugs and dietary supplements consumed by nursing home residents with their frailty status. METHODS: This is an analysis of the first follow-up year of the SENIOR cohort. All participants were classified into "frail" or "non-frail" categories according to Fried's criteria at baseline. Monthly bills from the pharmacy were analysed to determine the association between the average monthly cost of the drugs and dietary supplements consumed and frailty status. RESULTS: A sample of 87 residents (83.8 ± 9.33 years and 75.9% women) from the SENIOR cohort was included. The prevalence of frailty was 28%. The median number of medications consumed each day was 9 (6-12) (no difference between frail and non-frail subjects; p = 0.15). The overall median monthly cost was € 109.6, of which 49% was covered by Belgian social security and the remaining balance was paid by the patient. When comparing the drug expenses of the frail subjects and the non-frail subjects, the overall average monthly cost did not differ between the 2 groups (p = 0.057). Nevertheless, the expenditure remaining to be paid by the residents, after the Belgian social security intervention, was significantly higher among the frail residents (€ 65.7) than among the non-frail residents (€ 47.6; p = 0.017). CONCLUSIONS: Frailty status has an impact on the expenditures related to the consumption of drugs.

Muscle adaptation in response to a high-intensity interval training in obese older adults: effect of daily protein intake distribution.

BACKGROUND: Aging is associated with declines in muscle mass, strength and quality, leading to physical impairments. An even protein distribution in daily meals has recently been proposed along with adequate total protein intake as important modulators of muscle mass. In addition, due to its short duration, high-intensity interval training (HIIT) has been highlighted as a promising intervention to prevent physical deterioration. However, the interaction between daily protein intake distribution and HIIT intervention in elderlies remain unknown. OBJECTIVE: To investigate muscle adaptation following HIIT in older adults according to daily protein intake distribution. METHODS: Thirty sedentary obese subjects who completed a 12-week elliptical HIIT program were matched [criteria: age (± 2 years), sex, BMI (± 2 kg/m2)] and divided a posteriori into 2 groups according to the amount of protein ingested at each meal: < 20 g in at least one meal (P20-, n = 15, 66.8 ± 3.7 years) and ≥ 20 g in each meal (P20+, n = 15, 68.1 ± 4.1 years). Body composition, functional capacity, muscle strength, muscle power, physical activity level, and nutritional intakes were measured pre- and post-intervention. A two way repeated ANOVA was used to determine the effect of the intervention (HIIT) and protein distribution (P20- vs P20+, p < 0.05). RESULTS: No difference was observed at baseline between groups. Following the HIIT intervention, we observed a significant decrease in waist and hip circumferences and improvements in functional capacities in both P20- and P20 + group (p < 0.05). However, no protein distribution effect was observed. CONCLUSION: A 12-week HIIT program is achievable and efficient to improve functional capacities as well as body composition in obese older adults. However, consuming at least 20 g of proteins in every meal does not further enhance muscle performance in response to a 12-week HIIT intervention.

French translation and validation of the "Anterior Knee Pain Scale" (AKPS).

PURPOSE: To linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. METHODS: The translation part was performed in six stages, according to international guidelines: (i) two initial translations from English to French; (ii) synthesis of the two translations; (iii) backward translations into the original language; (iv) expert committee to compare the backward translations with the original questionnaire; (v) pre-final version testing and (VI) expert committee appraisal. To validate the French version of the Anterior Knee Pain Scale, we assessed its validity, reliability and floor/ceiling effects. To do this, volunteer patients from the French part of Belgium and from France, with patellofemoral pain were asked to answer the French version of the Anterior Knee Pain Scale at baseline and after 7 days, as well as the generic SF-36 questionnaire. RESULTS: The Anterior Knee Pain Scale was translated without any major difficulties. A total of 101 subjects aged 34.5 ± 11.4 years (58.4% of women) were included in this study. Results indicated an excellent test-retest reliability (Intra-class correlation coefficient (ICC) = 0.97, 95%CI: 0.96-0.98), a high internal consistency (Cronbach's alpha = 0.87), a consistent construct validity (high correlations with the SF-36 questionnaire were found with domains related to physical function (r = 0.80), physical role (r = 0.70) and pain (r = 0.64)) and low or moderate correlations with domains related to mental health (r = 0.26), vitality (r = 0.32) and social function (r = 0.41). Moreover, no floor/ceiling effects have been found. CONCLUSIONS: A valid French version of the Anterior Knee Pain Scale is now available and can be used with confidence to better assess the disease burden associated with patellofemoral pain. It was successfully cross-culturally adapted into French. Implications for rehabilitation The results on psychometric properties of the French Anterior Knee Pain Scale are comparable with six validated versions obtained for the Finnish, the Turkish, the Chinese, the Dutch, the Thai and the Persian populations. The French translated version of the Anterior Knee Pain Scale is a reliable and valid instrument for assessing the functional limitations associated with patellofemoral pain. The test-retest reliability of the French Anterior Knee Pain Scale was excellent, the internal consistency was high and the construct validity was consistent. There were no floor/ceiling effects.

Prevalence of sarcopenia in a population of nursing home residents according to their frailty status: results of the SENIOR cohort.

OBJECTIVE: To investigate the relationship between frailty and sarcopenia, by evaluating the prevalence of sarcopenia among frail, pre-frail and robust elderly nursing home residents in Belgium. METHODS: This is an analysis of baseline data collected from the SENIOR (Sample of Elderly Nursing home Individuals: an Observational Research) cohort. All subjects received a sarcopenia evaluation, based on the definition proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). The frailty evaluation was primarily based on FRIED's definition but also on 9 other operational definitions. RESULTS: A total of 662 subjects (73.1% of women) were included in this analysis (mean age: 83.2±8.99 years). The prevalence of sarcopenia was 38.1% whereas the prevalence of frail and pre-frail persons was respectively 24.7% and 61.4%. Among frail, pre-frail and robust subjects, respectively 47%, 38.9% and 16.3% were diagnosed sarcopenic. The prevalence of sarcopenia according to ten different operational definitions of frailty ranged between 32.8 % (i.e. Frail scale Status and Frailty Index) and 47% (i.e. Fried definition). CONCLUSION: This research highlights that over a third of nursing home residents are sarcopenic and the percentage is almost 50% among frail subjects; those latter constitute about 1 in 4 of the population of nursing home residents studied here.

Prevalence of Frailty in Nursing Home Residents According to Various Diagnostic Tools.

BACKGROUND: Although the theoretical foundations of frailty are well established in the literature, it remains an evolving concept lacking any unique definition or diagnostic criteria for use in clinical practice and epidemiological research. No consensus exists about the accurate prevalence rates of frailty. The various operational definitions of frailty can at least partly explain such discrepancies. OBJECTIVE: To compare the prevalence of frailty, measured with different diagnostic tools, among elderly nursing home residents. DESIGN: This is an analysis of baseline data collected among the SENIOR (Sample of Nursing home Elderly Individuals: an Observational Research) cohort. SETTING: Nursing homes. POPULATION: A total of 662 volunteer subjects from 28 nursing homes were included in this analysis. Among them, the mean age was 83.2 ± 8.99 years and 484 (72.5%) of them were women. MEASUREMENT: The percentages of frail and non-frail subjects were calculated according to 10 different definitions. RESULTS: Prevalence of frailty varies from 1.70% (Frailty Index) to 76.3% (Groningen Frailty Indicator) depending on the tool used. CONCLUSIONS: The prevalence of frailty is highly dependent on the diagnostic tool used. It would be necessary to reach a consensus on which diagnostic tools to use if one wishes to have comparable data obtained in epidemiological studies.