ECSS Paris 2023: OP-MH15
INTRODUCTION: Severe falls among older adults are a major cause of emergency department (ED) visits, often leading to reduced physical activity, functional decline, and diminished quality of life. While an ED presentation due to a severe fall is itself a significant risk factor for negative health outcomes, cognitive impairment further exacerbates the risk of recurrent falls and functional deterioration. Identifying the distinct needs of individuals with and without probable cognitive impairment (pCI) is crucial for tailoring secondary prevention strategies, such as balance and strength training. METHODS: Participants were recruited from the SeFallED study, which follows individuals aged ≥60 years who presented to the ED after a severe fall but were not hospitalized. Functional (SPPB) and cognitive (MoCA) performance were assessed through home-based geriatric evaluations within four weeks of the fall, and subsequently at six and 12 months. Physical activity levels were quantified using a three-axial accelerometer (activPAL4, PAL Technologies Ltd., Glasgow, UK), worn continuously for seven days at each assessment point to record step count and sedentary time. Functional outcomes were analyzed using repeated measures ANCOVA, adjusted for age. Fall incidence was assessed via monthly telephone follow-ups and analyzed with chi-square tests. RESULTS: After 12 months, valid data on recurrent falls were available for 126 older adults who are cognitively healthy (OACH, mean age 70.7, SD: 7.8; MoCA: 26.8, SD: 1.4) and 116 individuals with pCI (mean age 77.1, SD: 8.4; MoCA: 21.8, SD: 1.9). Recurrent falls were significantly more frequent in pCI (61/116) than in OACH (46/126; p = 0.012). Severe falls requiring medical attention occurred in 27 individuals with pCI, compared to 13 in OACH (p = 0.018). Despite these differences, functional performance (SPPB scores) and sensor-based measures of step count and sedentary time did not differ significantly between groups. Cognitive performance improved in both groups over time but remained significantly lower in pCI at all time points (p < 0.001), with mean scores consistently meeting MoCA criteria for pCI. CONCLUSION: These findings highlight the elevated risk of recurrent and severe falls requiring medical attention among individuals with pCI, despite comparable functional performance to OACH. This suggests that fall risk in pCI may be influenced by cognitive-motor interactions rather than functional decline alone. Further research is needed to explore mechanisms underlying these associations and develop targeted interventions to reduce fall-related risks in this high-risk population. 1. Stuckenschneider T, et al: Sentinel fall presenting to the emergency department (SeFallED) - protocol. BMC Geriatr 2022, 22(1):594.
Read CV Tim StuckenschneiderECSS Paris 2023: OP-MH15
INTRODUCTION: The age-related loss of muscle mass is partly driven by a reduction in serial sarcomere number (SSN), and further SSN loss occurs during immobilization. SSN is associated with optimal force and power production and muscle passive tension, thus immobilization-induced SSN loss is especially a concern for older individuals who are often subjected to forced muscle disuse with illness and injury. We previously showed that submaximal eccentric resistance training increased SSN and improved muscle mechanical function in old rats. The present study investigated whether this training could prevent the losses of SSN and function when performed intermittently during immobilization. METHODS: 10 old (32 months) and 10 young (8 months) rats underwent unilateral casting of the plantar flexors in a shortened position for 2 weeks. Thrice weekly, casts were removed for isokinetic eccentric resistance training of the plantar flexors with a stimulation intensity corresponding to 60% of the maximum torque development. Pre- and post-training we assessed in-vivo maximum isometric torque at ankle angles corresponding to stretched and neutral muscle lengths, the passive torque-angle relationship, and isotonic power. RESULTS: The soleus and medial gastrocnemius were harvested for SSN measurements, with the untrained leg as a control. In both old and young rats, muscles of the casted leg had smaller muscle wet weights (-20-40%, P<0.001), physiological cross-sectional area (-6-20%, P<0.001), and SSN (-7-29%, P<0.001) than the control leg. Furthermore, maximum isometric torque (-37-46%, P<0.001) and isotonic power (-≈70%, P<0.001) decreased, and maximum passive torque increased (+≈400%, P<0.001) from pre- to post-training for both age groups. These changes are similar in magnitude to what we observed previously with casting alone. CONCLUSION: Thus, irrespective of age, submaximal eccentric resistance training 3 days/week during casting did not prevent the losses of muscle contractile tissue and mechanical function.
Read CV Avery HinksECSS Paris 2023: OP-MH15
INTRODUCTION: China is becoming one of the fastest-aging countries in the world. There is sufficient evidence to show that human health will gradually decline with people aging, including a significant decrease in bone mineral density (BMD) of the elderly, and a great increase in the risk of osteoporosis in the elderly group. Different occupations have great differences in the cumulative effect of physical activity during long-term work, and the benefits of long-term physical activity during work may result in different effects on the BMD of the elderly. This study compares the BMD of the elderly in different occupations. METHODS: Using Internet to recruit elderly people who living in Beijing. The inclusion criteria of the subjects are: 60-70 years old, able to walk and communicate normally. Inviting included subjects to accept the BMD test. Before the start of the test, they are required to finish a questionnaire. The content of the questionnaire includes: the working years, the occupation, the category of the work and the level of physical activity during the working period. Standards for grouping the level of physical activity: According to the standards published by the World Health Organization (WHO), subjects are divided into physical active groups (performing 150 minutes or more of moderate to high-intensity physical activity per week) and physical inactive group (less than 150 minutes of high-intensity physical activity per week). Using the speed of sound (SOS), bone density T score (T-score), and bone density Z score (Z-score) to judge the subjects BMD situation. The independent sample T test tests the difference between different physical active groups. RESULTS: A total of 770 subjects（64.86±2.98 yrs） were recruited for this study. There are 338 people (65.44±3.03 yrs) in the physical active group and 432 people (64.92±2.64 yrs) in the physical inactive group. It is found that the physical active group in SOS, T-score, Z-score were significantly higher than inactive group（4150.35±197.17 vs. 3689.01±189.73，-0.71±3.53 vs.-1.99±0.12, 0.27±2.61 vs.-1.15±0.35， P<0.05）; For male, the physical active group had significant higher in SOS, T-score, Z-score than the inactive group（4155.61±186.09 vs. 3687.61±168.09，-0.12±0.77 vs.-1.73±0.98, 0.2±0.8 vs.-1.08±0.99, P<0.05）; For women, the physical active group has significant higher SOS and Z-score than the inactive group (4148.20±101.36 vs. 3689.57±707.20, -0.30±1.07 vs.-1.2±1.04, P<0.05). In the physical active group, female T-score and Z-score were significantly higher than female (-0.12±0.77 vs. -0.76±0.91, 0.2±0.8 vs. -0.30±1.07, P<0.05). CONCLUSION: The BMD of the elderly who are more physically active is significantly better than physically inactive during the work period. There is no significant difference in the T-score between the two groups in the female group. In summary, physical active during work helps to reduce the risk of BMD decrease, and the BMD in males is more likely to be improved by physical activity.
Read CV JiaChuan XueECSS Paris 2023: OP-MH15