| [The effects of daily physical activity on QOL in the elderly] |
| Nippon Koshu Eisei Zasshi 2002
Jun;49(6):497-506. |
| OBJECTIVE: To ascertain the meaning and the influence of daily
physical activity on QOL among the elderly, we surveyed their lifestyle
exercise habits, cross-sectionally and longitudinally. METHODS: The
subjects of this study were all residents living in a certain suburb of
Nagoya-city, aged 63, 68, 73, 78, 83 years of age. They answered
questionnaires regarding their exercise, physical activity, and QOL with
six categories. The same questionnaire survey was conducted again 3 years
later, and 958 people who answered both of them were examined in this
study. The three-year-trend for physical activities, exercise habits and
QOL scores, were analyzed and a comparison of QOL was made between the
first and third year data based on the primary physical-activity-scores.
In addition we applied logistic regression analysis to investigate the
influence of physical activity changes (independent variable) on
maintaining or improving of QOL scores (dependent variable). RESULTS:
Daily physical activities were well maintained, but the percentage of
feasible activities decreased by 5-10% as the sample population aged.On
the other hand, 20 to 30% of the subjects increased their physical
activity. The more people moved, the higher the QOL scores they had in
both cross-sectional and longitudinal analyses. According to the logistic
regression analysis, baseline physical activity habits positively
contributed to most QOL change, increase in exercise tending to maintain
or improve the QOL scores. CONCLUSIONS: Daily physical activity was
relatively well maintained among the sample population, and some increased
their physical activity scores over the period studied. Those with high
values had better physical conditions and a consistently high QOL. These
results suggest that maintaining or increasing physical activity
positively influences QOL in the elderly. |
| Measurement of stand-sit and sit-stand transitions using a miniature
gyroscope and its application in fall risk evaluation in the
elderly. |
| IEEE Trans Biomed Eng 2002
Aug;49(8):843-51. |
| A new method of evaluating the characteristics of postural
transition (PT) and their correlation with falling risk in elderly people
is described. The time of sit-to-stand and stand-to-sit transitions and
their duration were measured using a miniature gyroscope attached to the
chest and a portable recorder placed on the waist. Based on a simple model
and the discrete wavelet transform, three parameters related to the PT
were measured, namely, the average and standard deviation of transition
duration and the occurrence of abnormal successive transitions (number of
attempts to have a successful transition). The comparison between two
groups of elderly subjects (with high and low fall-risk) showed that the
computed parameters were significantly correlated with the falling risk as
determined by the record of falls during the previous year, balance and
gait disorders (Tinetti score), visual disorders, and cognitive and
depressive disorders (p < 0.01). In this study, the wavelet transform
has provided a powerful technique for enhancing the pattern of PT, which
was mainly concentrated into the frequency range of 0.04-0.68 Hz. The
system is especially adapted for long-term ambulatory monitoring of
elderly people. |
| Improving cardiovascular fitness by strength or endurance training in
women aged 76-78 years. A population-based, randomized controlled
trial. |
| Age Ageing 2002 Jul;31(4):247-254. |
| BACKGROUND:there have been few population-based, randomized
controlled trials on the effects of strength or endurance training on
cardiovascular fitness in older women. OBJECTIVE:to study the effectsof
strength or endurance training on cardiovascular fitness in women aged
76-78 years. DESIGN:a population-based, randomized controlled trial.
SETTING:exercise laboratory in a university faculty of sport and health
sciences. SUBJECTS:we randomly assigned 42 medically-screened women aged
76-78 years, drawn from the population register to strength (n=16),
endurance (n=15) or control (n=11) groups. METHODS:subjects in the two
exercise groups performed a supervised, individually tailored 18-week
strength or endurance training programme. Controls continued with physical
activity at their normal level. RESULTS:the strength training group showed
an increase in cycle ergometer peak power from 68.1 to 70.3 W (P=0.035
compared with controls). Their peak power per kg body weight increased
from 1.02 to 1.05, while that of the endurance training group increased
from 0.91 to 0.93 (P=0.027 and P=0.049 respectively). Peak oxygenuptake
increased from 18.1 to 19.7 ml.kg(-1).min(-1) in the strength and from
17.1 to 18.2 in the endurance group (non-significant). Six subjects (19%)
in the exercise groups withdrew from the study because of health problems.
CONCLUSIONS:even with its limitations, the study suggests that the effect
of 18-week strength or endurance training on cardiovascular fitness among
women aged >/=75 is relatively small. Furthermore, health problems can
emerge during training programmes in medically-screened elderly
women. |
| Clinical risk factors for hip fracture in elderly women: a
case-control study. |
| J Orthop Trauma 2002 Jul;16(6):379-85. |
| OBJECTIVES: To evaluate the strength of the association between
clinical risk factors and hip fracture occurrence in elderly women.
DESIGN: A case-control study. PATIENTS/PARTICIPANTS: Medical and social
characteristics of 159 women with a first hip fracture (cases) were
compared with 159 women without a hip fracture (controls) who were matched
on age and residence. METHODS: Using conditional logistic regression
modeling, the odds ratio (OR) and the 95 percent confidence interval (95
percent CI) were estimated as measures of the relative hip fracture risk.
RESULTS: The highest hip fracture risk was associated with the
self-perceived safety of the residence at the time of injury: if it were
thought that the residence was not adequately equipped to allow safe
motion or to perform the activities of daily living safely, this was
associated with an almost sixfold increase in hip fracture risk (OR 5.8,
95 percent CI 2.5 to 13.4). The hip fracture risk was also increased by a
report of two or more other fractures before the first hip fracture (OR
2.6, 95 percent CI 1.1 to 6.3), any tendency to fall within one year of
the injury date (OR 2.3, 95 percent CI 1.8 to 4.1), and the chronic use of
psychotropic drugs (OR 2.0, 95 percent CI 1.1 to 3.7). In contrast,
ability to read a newspaper was protective against hip fracture (OR 0.3,
95 percent CI 0.2 to 0.7). CONCLUSIONS: This study suggests that these
factors may be useful for an easy identification of women at high risk for
hip fracture in the short term and, thus, who should benefit in priority
from hip fracture prevention strategies. |
| Rosiglitazone: a review of its use in the management of type 2
diabetes mellitus. |
| Drugs 2002;62(12):1805-37. |
| Rosiglitazone, a thiazolidinedione with a different side chain from
those of troglitazone and pioglitazone, reduces plasma glucose levelsand
glucose production and increases glucose clearance in patients with type 2
diabetes mellitus. Insulin sensitivity, pancreatic beta-cell functionand
surrogate markers of cardiovascular risk factors are significantly
improved by rosiglitazone. Double-blind trials of 8 to 26 weeks of
rosiglitazone 4 or 8 mg/day monotherapy indicate significant decreases in
fasting plasma glucose (-2 to -3 mmol/L with 8 mg/day) and glycosylated
haemoglobin levels [HbA(1c); -0.6 to -0.7% (-0.8 to -1.1% in drug-naive
patients) with 8 mg/day]. Significant decreases in hyperglycaemic markers
occurred when rosiglitazone was combined with metformin (HbA(1c) -0.8to
-1.0%), a sulphonylurea (-1.4%) or insulin (-1.2%) for 26 weeks versus
little change with active comparator monotherapy. Efficacy was maintained
in trials of </=2 years, and was also apparent in various ethnic
subgroups, elderly patients, and both obese and nonobese patients.
Rosiglitazone is currently not indicated in combination with injected
insulin. It should be administered in conjunction with diet and exercise
regimens. Rosiglitazone is generally well tolerated. Despite rare
individual reports of liver function abnormalities in rosiglitazone
recipients, the incidence of these in clinical trials (</=2 years'
duration) was similar to that in placebo and active comparator groups.
Fluid retention associated with rosiglitazone may be the cause of the
increased incidence of anaemia in clinical trials, and also means that
patients should be monitored for signs of heart failure during therapy.
Although bodyweight is increased overall with rosiglitazone therapy,
increases are in subcutaneous, not visceral, fat; hepatic fat is
decreased. The pharmacokinetic profile of rosiglitazone is not
substantially altered by age or renal impairment, nor are there important
drug interactions. Rosiglitazone is not indicated in patients with active
liver disease or increased liver enzymes. CONCLUSIONS: Oral rosiglitazone
4 or 8 mg/day provides significant antihyperglycaemic efficacy and is
generally well tolerated, both as monotherapy and in combination with
other antihyperglycaemic agents, in patients with type 2 diabetes mellitus
who do not have active liver disease. Long-term data are required before
conclusions can be drawn about the clinical significance of positive
changes to surrogate markers of cardiovascular disease risk and
improvements to pancreatic beta-cell function. Rosiglitazone significantly
improves insulin sensitivity and, as such, is a welcome addition to the
treatment options for patients with type 2 diabetes
mellitus. |
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