Strength and speed training for elders with mobility disability.

The purpose of this study was to pilot test a function-focused exercise intervention consisting of strength and gait-speed training in elders with reduced walking speed, decreased walking endurance, and functional impairment. Twelve participants, 77.2 years old (+/-7.34), whose usual gait speed was <0.85 m/s, with walking endurance of <305 m in 5 min, and who were functionally impaired participated in a moderate-intensity exercise intervention. The training occurred 3 times per week, 75 min per session, for 3 months and combined 4 weeks of gait-speed training, walking exercise, and functional strengthening. The participants demonstrated mean usual gait speeds (> or =1.0 m/s), endurance (> or =350 m), and functional ability (> or =10 score on performance battery) that were within normal limits after 12 weeks of training. Fastest gait speed (> or =1.5 m/s) and muscle strength also improved significantly. Improvements were maintained during follow-up testing after 3-6 months. In summary, a 12-week intervention for frail, mobility-disabled participants led to improvements in walking, function, and strength.

Amino acid supplementation decreases plasma and liver triacylglycerols in elderly.

OBJECTIVE: Hypertriglyceridemia is a risk factor for coronary heart disease. The aim of this study was to determine the effect of amino acid (AA) supplementation on plasma, liver, and muscle lipid concentrations and insulin sensitivity in the elderly. METHODS: Twelve impaired glucose tolerant elderly (mean +/- SD 67.0 +/- 5.6 y of age, seven women and five men) ingested 11 g of essential AAs plus arginine twice a day for 16 wk, after a 7-wk control run-in. Diet and activity were not otherwise modified. Plasma lipid concentrations and oral glucose tolerance were measured every fourth week and tissue lipid concentrations (magnetic resonance spectroscopy) every eighth week. RESULTS: No changes in plasma lipids were observed during the control run-in. AA supplementation lowered plasma triacylglycerol (TG; P < 0.001), total cholesterol (P = 0.048), and very low-density lipoprotein cholesterol (P < 0.001) concentrations. Plasma TG decreased approximately 20% from the initial value of 1.45 +/- 0.18 mmol/L (mean +/- SE, 128 +/- 16 mg/dL), with the greatest decrease in the subjects starting out with the highest concentrations (r = -0.83). Similarly, liver fat content (liver TG/Intralipid standard) decreased approximately 50% from the initial value of 0.34 +/- 0.06 (P = 0.021, n = 8), with the greatest decrease in the subjects who initially had the highest values (r = -0.86). Intramuscular fat content and insulin sensitivity did not change. CONCLUSION: Diet supplementation with AAs lowers plasma TG, total cholesterol, and very low-density lipoprotein cholesterol concentrations and liver lipid content in impaired glucose tolerant elderly. AA supplementation may have a potential role in the treatment of hypertriglyceridemia or hepatic steatosis.

Effect of amino acid supplementation on muscle mass, strength and physical function in elderly.

BACKGROUND & AIMS: With advancing age there is a gradual decline in muscle mass, strength and function. The aim of this study was to determine if regular intake of a nutritional supplement containing essential amino acids (EAA)+arginine could reverse these responses in elderly subjects. METHODS: Twelve glucose intolerant subjects (67.0+/-5.6 (SD) years, 7 females, 5 males) ingested 11 g of EAA+arginine two times a day, between meals for 16 weeks. Diet and activity were not otherwise modified. Lean body mass (DEXA) was measured every fourth week. Maximal leg strength was tested and functional tests were performed at week 0, 8, 12, and 16. RESULTS: Lean body mass (LBM) increased during the study (p=0.038). At week 12, the average increase in LBM was 1.14+/-0.36 (SE) kg (p<0.05 vs baseline), whereas at week 16, the increase was 0.60+/-0.38 kg (NS vs baseline). The lower extremity strength measure score (sum of individual knee flexors and extensors' one repetition maximum, n=10) was 127.5+/-21.8 kg at baseline, and average increase during the study was 22.2+/-6.1% (p<0.001). Improvements were also observed in usual gait speed (p=0.002), timed 5-step test (p=0.007), and timed floor-transfer test (p=0.022). CONCLUSION: Supplementation of the diet with EAA+arginine improves lean body mass, strength and physical function compared to baseline values in glucose intolerant elderly individuals.

Comparison of spatiotemporal and energy cost of the use of 3 different walkers and unassisted walking in older adults.

OBJECTIVE: To compare temporal, spatial, and oxygen costs of gait while elderly subjects walked without an assistive device, with a new assistive device, and with 2 other commercially available assistive devices. DESIGN: Descriptive, repeated measures. SETTING: University-based research laboratory. PARTICIPANTS: Thirteen healthy older subjects who could walk without an assistive device. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Gait speed, normalized gait speed, cadence, stride lengths, 5-minute walk distance and gait speed, oxygen consumption (Vo2) per meter walked, respiratory exchange ratio (RER) per meter walked, and minute ventilation per meter walked. RESULTS: Gait speed, normalized gait speed, and stride lengths decreased when the Merry Walker device was used, compared with walking without an assistive device. Outcome measures when walking with either the wheeled walker or the WalkAbout did not differ significantly from walking without a device except for a faster cadence with the WalkAbout. The distance walked and gait speed were decreased and the RER and minute ventilation were increased during the 5-minute walk with the Merry Walker compared with normal walking. The Vo2 was higher with the wheeled walker and Merry Walker than when walking without an assistive device, but there was no difference when the WalkAbout was used. CONCLUSIONS: Older adults walked in the new assistive device, the WalkAbout, with parameters that did not differ significantly from their gait without a device. The oxygen demands of walking were similar to unassisted walking for the WalkAbout, but were higher for the wheeled walker and Merry Walker. These results may help guide the prescription of assistive devices for older adults.