The frailty, characterized by reduced physiological function is closely related to a fall, disability, institutionalization, hospitalization, and mortality in the elderly. A reduced physical fitness is a major phenotype of the frailty. The purpose of this study was to investigate the relationship among pre-frailty, physical activity (PA) and functional fitness in the community dwelling elderly women. The study participants were elderly women (n=338, 70.6±4.2years) aged over 65 who took part in the Korean Healthy Fitness Criteria study for the National Fitness Award Project in 2015. The pre-frailty was defined using the Cardiovascular Health Study frailty criteria. PA was assessed using the International PA Questionnaire (IPAQ). The participants were classified as regular PA participants if they meet the World Health Organization (WHO) PA recommendation for the elderly. Functional fitness was assessed using the composite of the National Fitness Award fitness testing for the elderly. Quality of life was evaluated using EuroQoL visual analogue scale and WHO quality of life assessment. As the results, the pre-frail elderly women were significantly older and obese (body mass index, percent body fat, waist circumference) than the healthy elderly. The pre-frail elderly presented significant decreases in walking, moderate intensity, and total PA compared to the healthy elderly even after adjusted for age and percent body fat. However, no significant difference was found in vigorous-intensity activity between the pre-frail and healthy elderly. Also, the pre-frail elderly women showed the decrease in functional fitness and quality of life compared to the healthy elderly. Regular PA was associated with high levels of muscular endurance and coordination in healthy and pre-frail elderly. In pre-frail elderly, high levels of cardiorespiratory endurance was associated with PA. In conclusion, regular PA is inversely associated with fitness decline in healthy and pre-frail community-dwelling elderly women. Regular PA might attenuate fitness decline in pre-frail elderly women.
Purpose The purpose of this study were to assess physiological and biochemical characteristics in elderly women with osteosarcopenic obesity (OSO), and to analyze relationships among irisin, adipokines and bone metabolism markers. Methods 126 elderly women were selected and among them 10 women were classified into OSO group (76.9±5.2 yrs) and 14 women were classified as a NOSO group (72.9±5.6 yrs). Physique, body composition and bone mineral density were measured. Senior fitness tests were 30-s chair stand, 30-s arm curl, chair sit-and-reach, back scratch, 8-foot up-and-go, grip strength, and 2-min step test. Isokinetic muscle strength was measured by isokinetic dynamometer (Cybex 770, USA). Nutrition intake and physical activity were administered. Biochemical parameters including irisin, FNDC-5, leptin, adiponectin, CTx, 25(OH)D, osteocalcin, and PTH were measured. All data were analyzed by SAS 9.4. Independent t-test was applied to compare between OSO and NOSO groups. Multiple regression analysis was used. The level of significance was set at .05. Results The results of the study showed that there were significantly high for waist circumference, hip circumference, WHR, and BMI in OSO group compared to those of NOSO group. Higher results were also obtained for fat tissue and percent body fat but significantly low for lumbar bone mineral density. OSO group showed significant lower results for grip strength and 2-min step test compared to NOSO group. Peak torque, and relative peak torque at 60° were significantly lower for left and right knee flexion in OSO group. Protein intake was significantly low in OSO group, but no difference was obtained in level of physical activity between two groups. Irisin was significantly related to adiponectin, FNDC-5 and osteocalcin in explaining 35.2%, 81.5% and 92.1% of the variance, respectively. Conclusions This study shows that elderly women with OSO have higher results for physique and body composition parameters except body height. However, lower values were obtained for functional fitness, and isokinetic muscle strength. OSO may have more risks for metabolic syndrome, bone fractures, fall, lack of daily physical activity and limit of locomotion due to the imbalance of quadriceps and biceps femoris in non dominant leg. This study suggests that criteria and mechanism of OSO should be clarified by follow-up study.
Frailty in older adults is related to an increased risk for poor health outcomes including falls, disability, hospitalization and mortality. The purpose of this study was to determine the thresholds of a functional fitness associated with frailty for community-dwelling woman aged 65 or older. In this study, the National Fitness Award(NFA) items for elderly were utilized as the physical function and fitness testing for korean elderly women. The total of 444 community-dwelling woman completed the testings. Frailty status was classified by the Japan LTCI system ‘Kihon Checklist’ in the study. The prevalence of the frailty was 19.1% in the study. The frail elderly were older and showed higher obesity index such as weight, body mass index (BMI), percent body fat and waist circumference than the normal elderly. After adjusting for age and BMI which was related to frailty, fitness testing items were compared depending on frailty. As the result, the frail elderly showed significantly lower fitness levels in grip strength, 30-second chair stand test, timed up and go, figure-of-8 walk around two cones, and 2-minute step test than the normal elderly. When the fitness cut-off values were analyzed using the ROC curve, also, grip strength: 34.13%, 30-second chair stand test: 14 reps, timed up and go: 7.09 seconds, figure-of-8 walk around two cones: 30.88 seconds, and 2-minute step test: 93 reps. In addition, based on the cut-off values of each fitness item, the group with a low fitness level showed a 1.86 to 3.09 higher odds ratio of frailty than the group with a high fitness level, even after age and BMI were adjusted. In conclusion, these findings indicate that the fitness cut-off values in this study are fitness levels for preventing frailty of Korean elderly women and there will be a need for a large-scale study including subdivided fitness cut-off values for each age group and targets elderly men as well.
