The Relationships Among Chronic Pain Subtypes, Motor Function, and Physical Activity in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study.

PURPOSE: We investigated the relationships among motor function, physical activity, and the characteristics of chronic pain (the number of pain sites, pain intensity, and pain-type). DESIGN: Cross-sectional study. SETTING: An ongoing community-based prospective study conducted in Itoshima, Japan. SUBJECTS: Community-dwelling Japanese aged 65-75 years (n = 805; 401 men, 404 women). MEASURES: Chronic pain subtypes were examined in terms of the number of pain sites, pain intensity, and pain type. Motor function was evaluated by handgrip strength, walking speed, and the 5 Times Stand-up and Sit Test (FTSST). Locomotive activity, non-locomotive activity, and sedentary time were evaluated by a tri-axial accelerometer as physical-activity parameters. ANALYSIS: Multiple regression model adjusting for age, sex, education level, employment status, subjective economic status, body mass index, cognitive function, comorbidity, current tobacco use, current alcohol consumption, and regular exercise. RESULTS: In a multivariate analysis, the subjects' walking speed was negatively associated with multisite, moderate-to-severe, and neuropathic-like pain. The FTSST was positively associated with single-site, moderate-to-severe, and neuropathic-like pain. There was no significant association between handgrip strength and any chronic pain subtypes. Locomotive activity was negatively related to multisite, moderate-to-severe, and neuropathic-like pain, but there was no clear association between the amount of non-locomotive activity, sedentary time, and chronic pain subtypes. CONCLUSION: Severe chronic pain was associated with decreased locomotion-related motor function and physical activity.

Association of the Combination of Moderate-to-Vigorous Physical Activity and Sleep Quality with Physical Frailty.

BACKGROUND: The association of the individual and combined effects of moderate-to-vigorous physical activity (MVPA) and sleep quality with physical frailty in community-dwelling older adults is still unknown. SUBJECTS AND METHODS: A cross-sectional study was conducted with a sample of older adults who had not required nursing care or support services. Physical frailty was assessed using Liu's definition based on Fried's concept. MVPA was measured by a triaxial accelerometer, and individuals who met either moderate physical activity (MPA) for ≥300 min/week, vigorous physical activity (VPA) for ≥150 min/week, or both were defined as "MVA+". "SLP+" was defined as a Pittsburgh Sleep Quality Index score of <5.5 points. RESULTS: A total of 811 participants were included in the final analysis. After adjusting for the multivariable confounding factors, the odds ratios (ORs) and 95% confidence intervals (CIs) for physical pre-frailty and frailty in the MVA-SLP+ (OR, 2.56; 95%CI, 1.80-3.62) and the MVA-SLP- group (OR, 3.97; 95%CI, 2.33-6.74) were significantly higher compared with the MVA+SLP+ group. CONCLUSION: Community-dwelling older adults who did not meet the MVPA criteria, regardless of sleep quality, had a higher prevalence of physical frailty.

Association between Active Hobby before Hospitalization and Frailty at Discharge in Patients with Acute Cardiovascular Disease.

Objectives: It is essential to identify the factors that reduce the risk of frailty at discharge in patients with cardiovascular disease. We sought to verify the association between pre-admission hobbies and frailty at discharge in patients hospitalized for acute cardiovascular diseases. Methods: We retrospectively analyzed the cases of the 269 patients admitted to our hospital with cardiovascular diseases, excluding those who required assistance with activities of daily living before admission or had missing data on hobbies or frailty. The patients' pre-admission hobbies (if any) were recorded, and the patients were then classified into the no-hobby group, inactive-hobby group, or active-hobby group. Frailty was assessed using the Cardiovascular Health Study criteria (Japanese version) on the day before discharge. We conducted a multinomial logistic regression analysis to investigate the relationship between hobbies and frailty. Results: Compared with the no-hobby group, the inactive-hobby group did not show a significantly lower odds ratio (OR) for pre-frailty and frailty. In contrast, the active-hobby group showed a significantly lower OR for pre-frailty and frailty even after adjustment (OR: 0.41, 95% confidence interval: 0.17-0.90). Regarding the components of frailty, the active-hobby group had lower ORs for slow gait speed, exhaustion, and low physical activity relative to the no-hobby group. Conclusions: Even if patients had hobbies before admission, if those hobbies were non-active, they did not reduce the risk of frailty, suggesting the need for reconsidering rehabilitation approaches during hospitalization.

Associations between various types of activity and physical frailty in older Japanese: a cross-sectional study.

BACKGROUND: Physical activity is known to help prevent physical frailty, but it is not clear which physical activities practiced alone or in combination are most closely associated with a lower risk of physical frailty. We investigated differences in the associations of exercise habit, social participation, and moderate-to-vigorous physical activity (MVPA) with physical frailty and its components among community-dwelling older Japanese adults. SUBJECTS AND METHODS: A total of 831 older adults participated in this cross-sectional study. Physical frailty was defined based on the Fried et al. criteria. Exercise habit was defined as exercising ≥ 30 min per day for ≥ 2 days per week for ≥ 1 year. Social participation was defined as participating in community activities ≥ 1/week. MVPA was defined as ≥ 300 min/week of moderate physical activity (MPA) or 150 min/week of vigorous physical activity (VPA). We classified the participants into eight groups according to the presence/absence of these activities, and we performed a logistic regression analysis to investigate the association between different activities, both alone and in combination, and physical frailty. RESULTS: The prevalence of physical pre-frailty + frailty was 74.8% in the None group, 65.0% in the Exercise habit group, 76.3% in the Social participation group, 56.5% in the MVPA group, 58.7% in the Exercise habit + Social participation group, 44.0% in the Exercise habit + MVPA group, 41.3% in the Social participation + MVPA group, and 38.0% in the All group. Compared to the None group, the groups in which participants were engaged in any combination of two or more types of activity, as well as the MVPA-alone group had significantly lower risks of physical pre-frailty + frailty. CONCLUSION: Community-dwelling older Japanese adults who engaged in MVPA or any combination of two or more types of physical activity as defined herein had lower risks of physical pre-frailty and frailty.

Relationship Between Chronic Pain Types (Nociceptive and Neuropathic-Like Symptoms) and Frailty in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study.

Purpose: Chronic pain may accelerate the development of frailty in older adults through a variety of mechanisms. There are no published investigations of the influence of neuropathic-like symptoms on physical frailty. We investigated the association between chronic pain types (nociceptive and neuropathic-like symptoms) and frailty in community-dwelling Japanese older adults. Participants and Methods: This was a population-based cross-sectional study conducted in 2017 in the city of Itoshima, Japan of 917 participants aged 65-75 years, not in need of long-term care, who had completed the physical function tests and questionnaires administered at measurement sessions held at community centers at three sites over a 1- to 2-month period. Their chronic pain types were classified as no-chronic pain, nociceptive pain, and neuropathic-like symptoms according to their painDETECT scores. Frailty phenotypes were defined by the following five components: unintentional weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. A logistic regression model was used to compute the odds ratios (ORs) and 95% confidence interval (CIs) for frailty status outcomes. Results: The prevalence of pre-frailty was 51.9%, and that of frailty was 5.1%. In multinomial logistic regression analyses, compared to the no-chronic pain group, the OR for the presence of pre-frailty among the participants with nociceptive pain was 1.54 (95% CI: 1.04-2.30, p=0.03), and the OR for the presence of frailty among the participants with neuropathic-like symptoms was 4.37 (95% CI: 1.10-17.37, p=0.04). The neuropathic sensory symptoms of burning, tingling/prickling, and numbness were each associated with frailty, but not with the risk of pre-frailty. Conclusion: Neuropathic-like symptoms were significantly associated with the presence of frailty in community-dwelling Japanese older adults. Chronic pain types might have different effects on frailty status.

Association of Frailty and Depressive Symptoms With the Establishment of Exercise Habits in Patients Undergoing Outpatient Cardiac Rehabilitation.

Objective: To assess whether patients undergoing outpatient cardiac rehabilitation who have frailty and depressive symptoms at discharge are less likely than those without these condition to establish positive exercise habits. Design: A retrospective cohort study that involved the assessment of frailty and depressive symptoms at the end of a 3-month course of cardiac rehabilitation. Frailty was defined as the patient noting 3 or more items using the criteria of Fried et al, while depressive symptoms were delineated by Patient Health Questionnaire-9 (PHQ-9) scores of 10 or greater. Setting: General hospital (1048 beds) with outpatient cardiac rehabilitation in a suburb location in Japan. Participants: 344 individuals underwent outpatient cardiac rehabilitation during the January 1, 2019-June 1, 2022, study period. Of these, 48 individuals were excluded because they did not complete the course and 54 were excluded because they lacked outcome data. Finaly, 242 individuals (mean age: 68.2±11.1 years) were analyzed. Interventions: Not applicable. Main Outcome Variable: The establishment of an exercise habit defined as exercising at least 2 days per week and 30 minutes per day. Results: Participants were divided into 4 groups depending upon the presence or absence of frailty and depressive symptoms: non-frail with no reported depressive symptoms (173 subjects), frailty-only (21 subjects), depressive symptoms-only (38 subjects), and frailty and depressive symptoms (10 subjects). Compared with patients who were not depressed and not frail, those with frailty only (odds ratio [OR]: 0.43, 95% confidence interval: 0.21-0.88, P=.02) and those with frailty and depressive symptoms (OR: 0.21, 95% confidence interval: 0.05-0.82, P=.025) had significantly lower ORs for establishing exercise habits. After multivariate adjustment, the OR of establishing an exercise habit was significantly lower in those with only frailty (OR: 0.35, 95% confidence interval: 0.14-0.85, P=.005). Conclusions: This study, while limited by the small number of subjects with both frailty and depressive symptoms, indicates that interventions to prevent frailty during hospitalization and cardiac rehabilitation may be essential for cardiovascular disease patients with frailty whether or not associated with depressive symptoms.

Association between Walking Habit and Physical Frailty among Community-Dwelling Older Adults.

The aim of this cross-sectional study was to determine whether older adults who practice walking have a lower risk of physical frailty than those who do not. The study subjects were 846 older adults and were not certified as needing support or nursing care. The subjects were classified as being physically frail or pre-frail or being robust, according to the revision of the Cardiovascular Health Study criteria. We classified the subjects by questionnaire into a no-exercise group, walking-only group, walking plus other exercise group, and exercise other than walking group. In logistic regression analyses, the odds ratio (OR) and 95% confidence interval (95%CI) were shown. Compared to the no-exercise group, the OR (95%CI) for physical frailty was 0.85 (0.48-1.49) for the walking-only group, 0.54 (0.36-0.83) for the walking plus other exercise group, and 0.67 (0.47-0.97) for the exercise other than walking group. In the components of physical frailty, the walking plus other exercise group and the exercise other than group had significantly lower ORs for exhaustion. Older adults who only practiced walking as an exercise do not have lower risks of physical frailty and pre-frailty. Older adults who combine walking with other exercises or practice non-walking exercises have lower risks of them.

Knee extensor muscle strength as a predictor of peak oxygen uptake in patients with heart disease.

[Purpose] The mortality rate increases when peak oxygen uptake is less than 5 metabolic equivalents, and peak oxygen uptake correlates with knee extensor muscle strength. This study aimed to determine the knee extensor muscle strength at peak oxygen uptake corresponding to 5 metabolic equivalents. [Participants and Methods] We enrolled 45 consecutive patients (29 males and 16 females; average age, 63.6 ± 13.7 years) with heart disease receiving outpatient rehabilitation with us. We performed cardiopulmonary exercise testing with a bicycle ergometer to measure peak oxygen uptake. We investigated the relationship between peak oxygen uptake and isometric knee extensor muscle strength divided by the body weight (kgf/kg). The cutoff value for knee extensor muscle strength with peak oxygen uptake corresponding to 5 metabolic equivalents was calculated. [Results] Knee extensor muscle strength was significantly positively associated with peak oxygen uptake. The cutoff value for knee extensor muscle strength at peak oxygen uptake corresponding to 5 metabolic equivalents was 0.46 kgf/kg. [Conclusion] In this study, the cutoff value for knee extensor muscle strength for achieving peak oxygen uptake corresponding to 5 metabolic equivalents in patients with heart disease was 0.46kgf/kg.