Polypharmacy, physical activity, and sedentary time in older adults: A scoping review.

OBJECTIVE: To map out the studies that have investigated the associations of polypharmacy and/or potentially inappropriate medication (PIM) use with physical activity and sedentary time in older adults. METHODS: We conducted a literature search from inception to December 2022 in PubMed, Embase, Web of Science, and Scopus. INCLUSION CRITERIA: observational studies including older adults (≥60 years); English, Portuguese, and Spanish languages; any definition of polypharmacy; implicit and explicit criteria of PIM use; physical activity and/or sedentary time data. RESULTS: Fourteen cross-sectional studies were included; 11 defined polypharmacy as ≥5 medications (prevalence ranging from 9.5 % to 57 %). No study reported information on PIM use. Most studies included participants aged <80 years. Twelve studies included self-reported measures of physical activity, while two studies used accelerometer-measured physical activity. Ten studies included analyses adjusted for confounders, and nine considered polypharmacy as an outcome. All of them demonstrated an inverse association between physical activity and polypharmacy, irrespective of the definition of polypharmacy and the assessment method employed (self-reported or accelerometry). One study reported an inverse association between polypharmacy (as the exposure) and physical activity (as the outcome). None of the studies investigated the association between sedentary time and polypharmacy. CONCLUSIONS: Limited evidence suggests an inverse association between physical activity and polypharmacy in older adults. However, the relationship between PIM use, physical activity, and sedentary time remains unknown. Longitudinal studies utilizing objectively-measured physical activity and sedentary time are needed to better clarify the relationship between these movement behaviors and polypharmacy and/or PIM use in older adults.

Prospective Association of Occupational and Leisure-Time Physical Activity With Cardiovascular Risk Factors in Early Adulthood: Findings From Pelotas (Brazil) 1982 Birth Cohort.

BACKGROUND: The benefits of physical activity in health outcomes are well established. However, recent evidence suggests that benefits may differ by domain and population. Thus, we aimed to investigate the prospective association of occupational (OPA) and leisure-time physical activity (LTPA) with cardiovascular risk factors. METHODS: In 1982, the maternity hospitals of Pelotas were visited daily; those live births whose families lived in urban areas were evaluated, and their mothers were later interviewed (n = 5914). In the 2004/5 follow-up (23 y old), both OPA and LTPA were measured in 4295 participants using their respective sections of the International Physical Activity Questionnaire. In the 2012 follow-up (30 y old), the following cardiovascular risk factors were collected: high-density lipoprotein (in milligrams per deciliter), low-density lipoprotein (in milligrams per deciliter), triglycerides (in milligrams per deciliter), glucose (in milligrams per deciliter), and blood pressure (in millimeters of mercury). Multivariable linear regressions were performed to evaluate associations between OPA and LTPA with these specific cardiovascular risk factors. RESULTS: In total, 3241 participants were analyzed. Our main findings suggest that there was no association between OPA and LTPA with high- and low-density lipoprotein. There were inverse associations between OPA and lower levels of triglycerides among males (ß = -0.002; 95% confidence interval, -0.003 to -0.000) and positive associations between LTPA and higher levels of diastolic blood pressure among females (ß = 0.111; 95% confidence interval, 0.005-0.216). CONCLUSION: In conclusion, our findings suggest that there was no association, or association with limited clinical relevance, of OPA and LTPA with cardiovascular risk factors in early adulthood.

Muscle Quality in Older Adults: A Scoping Review.

OBJECTIVE: This scoping review aimed to map out currently available definitions and assessment methods of muscle quality in older adults. DESIGN: Scoping review. SETTING AND PARTICIPANTS: All available studies. METHODS: Four databases (PubMed, EMBASE, Web of Science, and Cochrane Library) were searched from inception to May 2022. Title, abstract, and full-text screening were undertaken by 2 reviewers independently. Observational and experimental studies were eligible for inclusion if there was a clear description of muscle quality assessment in individuals aged 60+ years. RESULTS: A total of 96 articles were included. Several definitions and assessment methods of muscle quality were identified and divided into 2 main domains: (1) functional domain, and (2) morphological domain. A total of 70% and 30% of the included studies assessed muscle quality in the functional and morphological domains, respectively. In the functional domain, most studies defined muscle quality as the ratio of knee extension strength by leg lean mass (45.9%). In the morphological domain, most studies defined muscle quality as the echo intensity of quadriceps femoris by ultrasound (50.0%). CONCLUSIONS AND IMPLICATIONS: There is a substantial heterogeneity of definitions and assessment methods of muscle quality in older adults. Herein, we propose a standardized definition of muscle quality to include terminology, domain, and assessment methods (tests, tools, and body sites). Such standardization may help researchers, clinicians, and decision makers use muscle quality as a potential marker of "skeletal muscle health" in older adults.

Spin and reporting in systematic reviews with meta-analysis of randomized clinical trials in restorative dentistry.

OBJECTIVE: To estimate the prevalence of spin and completeness of reporting of systematic reviews with metanalysis (SRMAs) in restorative dentistry. METHODS: Inclusion criteria were SRMAs of randomized clinical trials of restorative dentistry on survival, success, or failure rates of treatment in humans, with no language or year restriction. SRMAs performed with non-RCTs were excluded. PubMed/MEDLINE, Web of Science, Scopus, Embase, and Cochrane Collaboration Library were searched from inception to April 2022. Outcomes were the prevalence of spin (primary outcome) and completeness of reporting (secondary outcome) in the abstract and full text. Data were reported through means and standard deviations or absolute and relative frequencies. Spin in each item was considered low when occurring in less than 25% of the papers, moderate (25 to 75%), or high (more than 75%). RESULTS: We identified 7029 studies and 49 unique manuscripts were included. There was a moderate presence of spin in the abstracts and low in full texts. In the abstracts, 65.9% did not report adverse events; while in the abstract and full text, more than 16% reported a conclusion containing recommendations for clinical practice not supported by the findings. Regarding completeness of reporting, there was poor reporting for most items in the abstract while there was an adequate report in full texts, except for register name and registration number (not reported in 32.7%). CONCLUSIONS: Abstract of SRMAs in restorative dentistry should be better reported. Spin and poor reporting were more frequent in the abstracts, which misleads readers and could lead to inadequate clinical recommendations. CLINICAL SIGNIFICANCE: Spin and incomplete reporting are a threat to evidence-based practice, especially in systematic reviews. Therefore, care providers, researchers, and other stakeholders should be aware of the possibility of spin in systematic reviews and other sources to prevent misinterpretation, which could lead to inadequate decisions and treatments.

Systematic reviews on the success of dental implants present low spin of information but may be better reported and interpreted: An overview of systematic reviews with meta-analysis.

OBJECTIVE: To estimate the prevalence of spin and completeness of reporting of systematic reviews with metanalysis (SRMAs) in implant dentistry. STUDY DESIGN AND SETTING: Inclusion criteria were SRMAs of randomized clinical trials of implant dentistry on survival, success, or failure rates in humans, with no language restriction. Three databases were searched from inception to May 2021. Main outcomes were prevalence of spin (primary outcome) and completeness of reporting (secondary outcome) in abstracts and full texts. RESULTS: We identified 2481 SRMAs and 45 unique manuscripts were included. There was a low presence of spin in the abstracts and full text, except for adverse events, in which 51.1% (in the abstract) failed to mention any adverse event for summarized interventions. There was an adequate report of SRMAs in the full text except for prospective register (33.3% not reported). However, there was an incomplete report for most items in the abstract considering PRISMA-A checklist. CONCLUSION: In general, the included SRMAs presented a (a) low prevalence of spin (except for adverse events in the abstract); (b) adequate completeness of reporting in the full text (except for prospective register); and (c) incomplete report for most items in the abstracts.