A meta-analysis: Parkinson's disease and dual-task walking.

A growing body of literature has reported the effects of dual tasks on gait performance in people with Parkinson's disease (PD). The purpose of this meta-analysis was to synthesize the existing literature and quantify the overall influence of dual tasks on gait performance in PD. A thorough literature search was conducted, and 19 studies met the stringent inclusion criteria. Two moderator variable analyses examined the dual-task effect by: (a) mean single-task gait speed for each study (≥1.1 m/s or < 1.1 m/s), and (b) the type of dual task (arithmetic, language, memory, and motor). Three main findings were revealed by a random effects model analysis. First, a strong negative effect of dual tasks on walking performance (SMD = -0.68) confirmed that gait performance is adversely affected by dual tasks in people with PD. Second, the significant negative effect of dual tasks is present regardless of the mean level of single-task gait speed in a study. Third, dual-task walking speed deteriorates regardless of the type of dual task. Together, these results confirm that dual tasks severely affect walking performances in people with PD.

Resveratrol and exercise to treat functional limitations in late life: design of a randomized controlled trial.

Skeletal muscle mitochondrial function declines with age and is a key factor in the maintenance of physical function among older adults. Research studies from animals and humans have consistently demonstrated that exercise improves skeletal muscle mitochondrial function in early and middle adulthood. However, mitochondrial adaptations to both acute and chronic exercise are attenuated in late life. Thus, there is an important need to identify adjuvant therapies capable of augmenting mitochondrial adaptations to exercise (e.g. improved mitochondrial respiration, muscle mitochondria biogenesis) among older adults. This study is investigating the potential of resveratrol supplementation for this purpose. The objective of this randomized, double-masked pilot trial is to evaluate the efficacy of resveratrol supplementation combined with a comprehensive supervised exercise program exercise for improving physical function among older adults. Moderately functioning, sedentary participants aged ≥60 years will perform 24 sessions (2 day/wk for 12 weeks) of center-based walking and resistance training and are randomly assigned to receive either (1) 500 mg/day resveratrol (2) 1000 mg/day resveratrol or (3) placebo. Study dependent outcomes include changes in 1) knee extensor strength, 2) objective measures of physical function (e.g. 4m walk test, Short Physical Performance Battery), 3) subjective measures of physical function assessed by Late Life Function and Disability Instrument, and 4) skeletal muscle mitochondrial function. This study will provide novel information regarding the therapeutic potential of resveratrol supplementation combined with exercise while also informing about the long-term clinical viability of the intervention by evaluating participant safety and willingness to engage in the intervention.

Wearable technology to reduce sedentary behavior and CVD risk in older adults: design of a randomized controlled trial.

Persons aged over 65 years account for over the vast majority of healthcare expenditures and deaths attributable to cardiovascular disease (CVD). Accordingly, reducing CVD risk among older adults is an important public health priority. Structured physical activity (i.e. exercise) is a well-documented method of decreasing CVD risk, but recent large-scale trials suggest that exercise alone is insufficient to reduce CVD events in high-risk populations of older adults. Thus adjuvant strategies appear necessary to reduce CVD risk. Accumulating evidence indicates that prolonged sedentary behavior (e.g. sitting) has detrimental health effects that are independent of engagement in recommended levels of moderate-intensity exercise. Yet clinical trials in this area are lacking. We hypothesize that exercise, when combined with a novel technology based intervention specifically designed to reduce sedentary behavior will reduce CVD risk among sedentary older adults. The purpose of this study is to evaluate the feasibility and efficacy of combining a traditional, structured exercise intervention with an innovative intervention designed to decrease sedentary behavior and increase non-exercise physical activity (NEPA). This study will provide us with critical data necessary to design and implement a full-scale trial to test our central hypothesis. Participants aged ≥60 years with moderate to high risk of coronary heart disease (CHD) events are randomly assigned to either the exercise and technology intervention (EX+NEPA) or exercise alone (EX) groups. Study dependent outcomes include changes in 1) daily activity patterns, 2) blood pressure, 3) exercise capacity, 4) waist circumference, and 5) circulating indices of cardiovascular function. This study will provide critical information for designing a fully-powered clinical trial, which could have health implications for the ever increasing population of older adults.

Age-related differences in bimanual movements: A systematic review and meta-analysis.

BACKGROUND: With increasing age motor functions decline. The additional challenges of executing bimanual movements further hinder motor functions in older adults. The current systematic review and meta-analysis determined the effects of healthy aging on performance in bimanual movements as compared to younger adults. METHODS: Our comprehensive search identified 27 studies that reported bimanual movement performance measures. Each study included a between groups comparison of older (mean age=68.79years) and younger adults (mean age=23.14years). The 27 qualified studies generated 40 total outcome measure comparisons: (a) accuracy: 18, (b) variability: 14, and (c) movement time: eight. RESULTS: Our meta-analysis conducted on a random effects model identified a relatively large negative standardized mean difference effect (ES=-0.93). This indicates that older adults exhibited more impaired bimanual movement performance in comparison to younger adults in our group of studies. Specifically, a moderator variable analysis revealed large negative effects in both accuracy (ES=-0.94) and variability (ES=-1.00), as well as a moderate negative effect (ES=-0.71) for movement time. These findings indicate that older adults displayed reduced accuracy, greater variability, and longer execution time when executing bimanual movements. CONCLUSION: These meta-analytic findings revealed that aging impairs bimanual movement performance.