Does the coexistence of pain and depressive symptoms accelerate cognitive decline?

OBJECTIVES: Investigate whether the coexistence of pain and depressive symptoms is a risk factor for cognitive decline in individuals aged 50 or older. METHOD: Longitudinal trajectory study involving 4,718 participants from the English Longitudinal Study of Ageing (ELSA). Joint pain was self-reported, and intensity was classified as mild, moderate/intense. Depressive symptoms were investigated using the Centre for Epidemiologic Studies Depression Scale (CES-D-8 ≥ 4). The sample was divided into six groups: no pain and no depression (NP/NDe), mild pain and no depression (MP/NDe), moderate/intense pain and no depression (M-IP/NDe), no pain and depression (NP/De), mild pain and depression (MP/De), and moderate/intense pain and depression (M-IP/De). The outcome of interest was performance in memory, executive function, and global cognition. Generalised linear mixed models were used to analyse performance in the cognitive domains and global cognition score as a function of pain and depressive symptoms during 12 years of follow-up. RESULTS: Over time, individuals with M-IP/De had a greater memory decline (-0.038 SD/year, 95%CI: -0.068 to -0.007) and the global cognition score (-0.033 SD/year, 95%CI: -0.063 to -0.002) than those with NP/NDe. CONCLUSION: The coexistence of moderate/intense pain and depressive symptoms is a risk factor for the decline of global cognition and memory.

Prediction of Reduced Gait Speed Using 5-Time Sit-to-Stand Test in Healthy Older Adults.

OBJECTIVES: To determine the accuracy of the 5-time stand-to-sit (5TSTS) test for the identification of older adults with reduced gait speed. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A total of 559 community-dwelling older adults were included in the study, divided into groups of women (n = 465) and men (n = 94). METHODS: 5TSTS and gait speed were assessed. Multiple linear regression analysis with adjustment was performed in order to determine the association between 5TSTS and gait speed, followed by the receiver operating characteristic (ROC) curve for the identification of the usefulness of 5TSTS to discriminate older adults with reduced gait speed. Based on the ROC curve, we identified the area under the curve, the sensitivity, specificity, and cutoff points of the 5TSST. Statistical analyses were made using the SPSS software (version 25.0), and a significance level of 5% (P ≤ .05) was adopted. RESULTS: The 5TSTS showed correlation with gait speed. Additionally, 5TSTS was able to discriminate reduced gait speed with moderate accuracy (P < .05; AUC between 0.7 and 0.8). For women, the cutoff scores for 5TSTS to identify gait speed <0.8 m/s was 14.15 seconds; for gait speed <1.0 m/s, it was 12.67 seconds. For men, the cutoff scores for 5TSTS to identify gait speed <0.8 m/s was 14.67 seconds, and for gait speed <1.0 m/s, it was 13.63 seconds. CONCLUSION AND IMPLICATIONS: The 5TSTS is clinically useful and can be an alternative assessment for discriminating community-dwelling older adults with reduced gait speed, when the gait evaluation is not feasible. The study also suggests different cutoff values for 5TSTS considering the gait speeds <0.8 and <1.0 m/s for older women and men, respectively.

Accuracy of the step test to evaluate lower limb muscle strength in community-dwelling older women.

OBJECTIVE: to investigate the accuracy of the step test (ST) to evaluate total lower limb muscle strength (LLMS) in older women. DESIGN: observational cross-sectional study. METHODS: 119 community-dwelling older women were submitted to the ST and LLMS evaluation (isometric peak torque of eight muscle groups of the dominant lower limb). The capacity of the ST to discriminate older women with reduced LLMS was measured using ROC curve, followed by the posttest probability (PoTP) calculation. RESULTS: a ST score of 0.24 cm per cm of participant's height presents a sensitivity of 63.3%, specificity of 77%; enhances the PoTP from 48% to 72% for positive test and decreases the PoTP from 48% to 31% for negative test. CONCLUSION: the ST may complement the clinical screening of reduced LLMS in older women, given that it is a simple and quick low-cost test and allows the evaluation of each lower limb separately.