Chronic endurance exercise training prevents aging‐related cognitive decline in healthy older adults: a randomized controlled trial
Antonio MuscariClaudia GiannoniLucia PierpaoliAnnalisa BerzigottiPasqualino Maietta LatessaElia FoschiCarlo RavaioliG PoggiopolliniGiampaolo BianchiDonatella MagalottiClaudio TentoniMarco Zoli
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Abstract Objective To evaluate the effects of endurance exercise training (EET) on the cognitive status of healthy community‐dwelling older adults. Methods A randomized controlled trial was conducted involving community‐dwelling older adults from the town of Pianoro (northern Italy). We randomized 120 healthy subjects aged 65–74 years, both genders, to treatment ( N = 60) and control ( N = 60) groups. The treatment consisted of 12 months of supervised EET in a community gym, 3 h a week. All participants were assessed both at baseline and after 12 months on an intention‐to‐treat analysis. Cognitive status was assessed by one single test (Mini Mental State Examination, MMSE). Anthropometric indexes, routine laboratory measurements and C‐reactive protein (CRP) were also assessed. Results The control group showed a significant decrease in MMSE score (mean difference −1.21, 95% CI −1.83/−0.60, p = 0.0002), which differed significantly ( p = 0.02) from the treatment group scores (−0.21, 95% CI −0.79/0.37, p = 0.47). The odds ratio for the treated older adults to have a stable cognitive status after 1 year, as compared to the control group, was 2.74 (95% CI 1.16/6.48) after adjustment for age, gender, educational level and several other possible confounders. Blood pressure, body mass index, waist circumference and serum cholesterol did not differ significantly between the two groups, while CRP decreased only in the treatment group. Conclusions A 12‐month EET intervention may reduce the progression of age‐related cognitive decline in healthy older adults. Copyright © 2009 John Wiley & Sons, Ltd.Keywords:
Mini–Mental State Examination
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C-reactive protein, a marker of chronic, low-grade inflammation, is strongly associated with current central adiposity, and has been linked to elevated risk of cardiovascular disease. Less is known about the contribution of longitudinal change in waist circumference to current inflammation. We evaluated the extent to which current waist circumference and change over an 11-year interval contribute independently to low-grade systemic inflammation measured in a group of 1,294 women, 35-69 years, participating in the Cebu Longitudinal Nutrition and Health Survey in the Philippines. Waist circumference was measured at the time of blood draw for CRP analysis in 2005 and during an earlier survey in 1994. A waist circumference delta variable was constructed by subtracting current circumference from past circumference. We used logistic regression models to predict having an elevated plasma CRP concentration (3 mg L(-1) < CRP < 10 mg L(-1)). Waist circumference in 2005 was a strong predictor of elevated CRP (OR 1.10, 95% CI = 1.08, 1.12, P < 0.001). In combined models, increase in circumference over 11 years was a significant and independent predictor of elevated CRP risk (OR = 1.023, 95% CI = 1.00, 1.05, P < 0.05). Considering the average increase over time, the cumulative risk of elevated CRP due to increased central adiposity was 25.7%. However, women who reduced their waist circumference between 1994 and 2005 had greatly reduced risk (6.2%), suggesting that even long-term inflammatory burden can be reversed by weight loss. Although current waist circumference is an important contributor to risk of elevated systemic inflammation in this as in other populations, history of central adiposity may be an independent phenomenon.
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We evaluated the accuracy of self-reported home-assessed and self-measured waist circumference in 101 men and eighty-three women aged 28-67 years. The main outcome measures were subjects' self-reported and self-measured waist circumference, and self-classification according to the previously defined waist action level 1 (940 mm in men, 800 mm in women) and action level 2 (1020 mm in men, 880 mm in women), and waist circumference measured by the investigator using the 'Waist Watcher' tape-measure, as the reference method. The mean errors (95% CI limits of agreement) for subjects' self-reported waist circumference (self-reported minus reference; mm) were -67 (95% CI -210, 77) in men and -43 (95% CI -211, 123) in women, and for self-measured waist circumference (mm) using the 'Waist Watcher' (self-measured minus reference) were -5 (95% CI -62, 52) in men and -4 (95% CI -50, 42) in women. The proportions of subjects classified into waist action level 1 or action level 2 by the investigator were used as the reference method. Self-reported waist circumference of men and women respectively would be classified correctly in different categories based on action level 1 with sensitivities of 58.3 and 78.7%, and specificities of 92.5 and 91.7%, and action level 2 with sensitivities of 35.3 and 44.9%, and specificities of 98.5 and 90.7%. Using the 'Waist Watcher' with different colour bands based on the action levels, male and female subjects respectively classified themselves into correct categories according to action level 1 with sensitivities of 100 and 95.7%, and specificities of 95.1 and 97.2%, and according to action level 2 with sensitivities of 97.1 and 100%, and specificities of 100% for both sexes. Only 2% of the sample misclassified themselves into the wrong categories according to waist circumference action levels. In conclusion, people tend to underestimate their waist circumference, but the 'Waist Watcher' tape-measure offers advantages over self-reported home-assessed measurement, and may be used as a screening tool for self-classifying the risk of ill health through intra-abdominal fat accumulation.
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保健指導には，BMI（Body Mass Index，以下BMI）を初め，多くの健康指標が用いられているが，ウエスト値は，研究が少ないのが現状である．そこで，ウエスト値とBMIの関連，食生活・日常生活習慣との関連を明らかにするために調査を行った．A建設会社に勤務する35歳以上の男性社員213名を対象とし，定期健康診断時に，自記式質問紙と，ウエスト値測定，血液生化学検査による調査を行った．BMI，収縮期血圧，拡張期血圧，中性脂肪，GPT，γ-GTP，空腹時血糖値での異常値群は，正常値群と比較し，有意にウエスト値が太かった（p＜0.04）．ウエスト値と日常生活習慣の関連においては，揚げ物および外食を週4-5回以上摂取している群（p＝0.004），運動習慣が週に2-3回以下の群（p＝0.025）はウエスト値が有意に太かった．ロジスティック解析では，ウエスト値に関連が見られたものが疾病の有無（オッズ比2.10，p＝0.046），検査値異常の有無（オッズ比3.54，p＝0.009）であった．以上より，ウエスト値は健康指標の1つとして使用可能と考えられ，揚げ物や外食を控えたり，運動習慣を改善したりすることでウエスト値をコントロールし，内臓肥満予防に繋げることが出来るのではないかと考える．
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Objective To explore the relationship of body mass index(BMI) and waist circumference to blood pressure and hypertension prevalence in employees in Shougang Shuicheng iron and steel corporation.Methods Two thousand four hundred and ninety-six employees in Shougang Shuicheng iron and steel corporation were surveyed using a multi-stage random cluster sampling method.Medical examination included blood pressure measurement(SBP and DBP),height,BMI and waist circumference.Results The BMI was(23.18±3.34) kg·m-2and waist circumference was(80.37±10.02) cm.Among the 2 496 employees,the overweight and obesity accounted for 38.22%(954/2 496) and abdominal obesity accounted for 36.26%(905/2 496).The hypertension prevalence in male participants(BMI:18,≥18-24,≥24-28,≥28 kg·m-2or waist circumference:75,≥75-85,≥85 cm) were significantly higher than that in female participants(all P0.05).The hypertension prevalence in male participants(BMI 24 kg·m-2,waist circumference 85 cm;BMI 24 kg·m-2,waist circumference ≥85 cm;BMI 24-27.9 kg·m-2,waist circumference85 cm;BMI 24-27.9 kg·m-2,waist circumference ≥85 cm;BMI ≥28 kg·m-2,waist circumference ≥85 cm) were obviously higher than that in female participants(BMI24 kg·m-2,waist circumference80 cm;BMI24 kg·m-2,waist circumference ≥80 cm;BMI 24-27.9 kg·m-2,waist circumference80 cm;BMI 24-27.9 kg·m-2,waist circumference≥80 cm;BMI≥28 kg·m-2,waist circumference≥80 cm)(P0.05 or P0.01).Conclusion The hypertension prevalence in male employees is significantly higher than that in female employees in Shougang Shuicheng iron and steel corporation.The control of BMI and waist circumference is beneficial to the prevention of hypertension.
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Introduction: Metabolic syndrome is a group of conditions that can increase the risks of coronary heart disease and diabetes. Although waist circumference is a useful tool in primary care units it doesn't exist a Cuban cut-off point of waist circumference to diagnose the metabolic syndrome. Objective:To establish a cut-off point level of waist circumference for the diagnosis of the metabolic syndrome by making a study at Camilo Cienfuegos community in Havana city. Methods:It was made a cross sectional study in 116 adults at Camilo Cienfuegos community in 2009. Waist circumference was measured taking into consideration the Adult treatment panel criteria (ATP III).ROC curve was obtained by using SPSS system plotting the values of waist circumference related to metabolic syndrome. Results:They were established 89,5 cm and 93 cm as cut-off points of waist circumference to diagnose metabolic syndrome in women and men respectively. Conclusions:The established cut-off point level of waist circumference in women to diagnose the metabolic syndrome is similar to the one proposed by the ATP III criteria.
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The purpose of this investigation was to examine if premenopausal women in the United States had increases in abdominal obesity and waist circumference during the years 1994-2012. Utilizing data collected by the Centers for Disease Control and Prevention s National Health and Nutrition Examination Survey, a total of 14,707 female participants between the ages of 18-44 years were identified and their data analyzed. A single factor analysis of variance was completed to determine statistical significance. Results indicate a significant increase in waist circumference from years 1994-2012 (p < .001). The average waist circumference was 90.99 ± 16.54 cm and average weight was 72.92 ± 20.05 kg. From baseline to 1999 the largest increase in average waist circumference was observed with an increase of 3.82 cm. These findings bring to attention the importance of the problem of increasing abdominal obesity and waist circumference in the United States.
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Objective: The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. Methods: A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Results: Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. Conclusions: In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.
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