Estimating cardiorespiratory fitness in older adults using a usual-paced 400-m long-distance corridor walk.
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ABSTRACT:
SUBMITTER: Moffit RE
PROVIDER: S-EPMC8595496 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
Publications
Estimating cardiorespiratory fitness in older adults using a usual-paced 400-m long-distance corridor walk.
Moffit Reagan E RE Qiao Yujia Susanna YS Moored Kyle D KD Santanasto Adam J AJ Lange-Maia Brittney S BS Cawthon Peggy M PM Goodpaster Bret H BH Strotmeyer Elsa S ES Newman Anne B AB Glynn Nancy W NW
Journal of the American Geriatrics Society 20210716 11
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Project description:BackgroundCardiopulmonary exercise testing (CPET), the gold-standard method to quantify cardiorespiratory fitness (CRF), is not always feasible due to cost, access, and burden. The usual-paced 400 m long distance corridor walk (LDCW), a measure of mobility among older adults, may provide an alternate method to assess CRF. The purpose of this study was to develop and validate an estimating equation to estimate VO2 peak from average 400 m walking speed (WS) among participants in the Study of Muscle, Mobility and Aging (SOMMA).MethodsAt baseline, women (58%) and men age 70 years and older enrolled in SOMMA (N = 820, 76.2 ± 4.9 years, 86% Non-Hispanic White) completed a 400 m LDCW (400 m WS = 400 m/completion time in seconds) and symptom-limited maximal CPET (Modified Balke Protocol). VO2 peak (mL/kg/min) was considered the highest 30-second average oxygen consumption during CPET. Other covariates included: age, sex, race, physical activity (7-day wrist-worn accelerometer), physical function (Short Physical Performance Battery, range 0-12), perceived physical fatigability (Pittsburgh Fatigability Scale, range 0-50), and Borg Rating of Perceived Exertion (RPE, range 6-20) at completion of the 400 m LDCW. Stepwise linear regression was used. Internal validation was completed using data-splitting method (70%; 30%).ResultsMean VO2 peak was 20.2 ± 4.8 mL/kg/min and mean 400 m WS was 1.06 ± 0.2 m/s. Each 0.05 m/s increment in 400 m WS was associated with a 0.40 mL/kg/min higher VO2 peak after covariate adjustment. An estimating equation including 400 m WS, age, sex, race, and RPE was developed. Internal validation showed low overall bias (-0.26) and strong correlation (r = 0.71) between predicted and measured VO2 peak values. Bland-Altman plot and regression analyses indicated predicted VO2 peak was an acceptable alternative, despite mean underestimation of 4.53 mL/kg/min among the highly fit.ConclusionsUsual-paced 400 m LDCW strongly correlates with direct measures of CRF during CPET in older adults with lower fitness and can be used to test both fitness and function.
| S-EPMC10947881 | biostudies-literature
Project description:ObjectivesThe main purpose of the present meta-analysis was to examine the criterion-related validity of the distance- and time-based walk/run tests for estimating cardiorespiratory fitness among apparently healthy children and adults.Materials and methodsRelevant studies were searched from seven electronic bibliographic databases up to August 2015 and through other sources. The Hunter-Schmidt's psychometric meta-analysis approach was conducted to estimate the population criterion-related validity of the following walk/run tests: 5,000 m, 3 miles, 2 miles, 3,000 m, 1.5 miles, 1 mile, 1,000 m, ½ mile, 600 m, 600 yd, ¼ mile, 15 min, 12 min, 9 min, and 6 min.ResultsFrom the 123 included studies, a total of 200 correlation values were analyzed. The overall results showed that the criterion-related validity of the walk/run tests for estimating maximum oxygen uptake ranged from low to moderate (rp = 0.42-0.79), with the 1.5 mile (rp = 0.79, 0.73-0.85) and 12 min walk/run tests (rp = 0.78, 0.72-0.83) having the higher criterion-related validity for distance- and time-based field tests, respectively. The present meta-analysis also showed that sex, age and maximum oxygen uptake level do not seem to affect the criterion-related validity of the walk/run tests.ConclusionsWhen the evaluation of an individual's maximum oxygen uptake attained during a laboratory test is not feasible, the 1.5 mile and 12 min walk/run tests represent useful alternatives for estimating cardiorespiratory fitness. As in the assessment with any physical fitness field test, evaluators must be aware that the performance score of the walk/run field tests is simply an estimation and not a direct measure of cardiorespiratory fitness.
| S-EPMC4795745 | biostudies-literature
Project description:IntroductionNon-exercise estimates of cardiorespiratory fitness hold great utility for epidemiological research and clinical practice. Older adults may yield the greatest benefit from fitness estimates due to limited capacity to undergo strenuous maximal exercise testing, however, few of the previously developed non-exercise equations are suitable for use in older adults. Thus, the current study developed a non-exercise equation for estimating cardiorespiratory fitness in older adults derived from the widely used International Physical Activity Questionnaire (IPAQ).MethodsThis study was a secondary analysis of baseline data from a randomized controlled trial. Participants were community-dwelling, cognitively unimpaired older adults aged 60-80 years (n = 92). They completed the IPAQ and underwent maximal exercise testing on a cycle ergometer. Stepwise linear regression was used to determine the equation in a randomly selected, sex-balanced, derivation subset of participants (n = 60), and subsequently validated using a second subset of participants (n = 32).ResultsThe final equation included age, sex, body mass index and leisure time activity from the IPAQ and explained 61% and 55% of the variance in the derivation and validation groups, respectively (standard error of estimates = 3.9, 4.0). Seventy-seven and 81% of the sample fell within ±1SD (5.96 and 6.28 ml·kg-1·min-1) of measured VO2peak for the derivation and validation subgroups. The current equation showed better performance compared to equations from Wier et al. (2006), Jackson et al. (1990), and Schembre & Riebe (2011), although it is acknowledged previous equations were developed for different populations.ConclusionsUsing non-exercise, easily accessible measures can yield acceptable estimates of cardiorespiratory fitness in older adults, which should be further validated in other samples and examined in relation to public health outcomes.
| S-EPMC11228262 | biostudies-literature
Project description:While cardiorespiratory fitness is strongly associated with mortality and diverse outcomes, routine measurement is limited. We used smartphone-derived physical activity data to estimate fitness among 50 older adults. We recruited iPhone owners undergoing cardiac stress testing and collected recent iPhone physical activity data. Cardiorespiratory fitness was measured as peak metabolic equivalents of task (METs) achieved on cardiac stress test. We then estimated peak METs using multivariable regression models incorporating iPhone physical activity data, and validated with bootstrapping. Individual smartphone variables most significantly correlated with peak METs (p-values both < 0.001) included daily peak gait speed averaged over the preceding 30 days (r = 0.63) and root mean square of the successive differences of daily distance averaged over 365 days (r = 0.57). The best-performing multivariable regression model included the latter variable, as well as age and body mass index. This model explained 68% of variability in observed METs (95% CI 46%, 81%), and estimated peak METs with a bootstrapped mean absolute error of 1.28 METs (95% CI 0.98, 1.60). Our model using smartphone physical activity estimated cardiorespiratory fitness with high performance. Our results suggest larger, independent samples might yield estimates accurate and precise for risk stratification and disease prognostication.
| S-EPMC8295266 | biostudies-literature
Project description:BackgroundParticipation in physical activity supports greater cardiorespiratory fitness (CRF), a correlate of cognitive control. However, the relationship between muscular fitness (MF) and cognitive control is less clear. The present study investigated the differential relationship of CRF and MF with cognitive control in older adolescents.MethodsThis cross-sectional study involved students (15-17 years old, n = 541, 43% female) from 20 secondary schools who completed tests of inhibition (modified flanker task), working memory (n-back task), CRF (Progressive Aerobic Cardiovascular Endurance Run), and MF (standing long jump and push-up test). Multilevel analyses tested the association between CRF or MF and cognitive outcomes while accounting for the influence of the other fitness variable and relevant demographic factors.ResultsCRF predicted response accuracy during incongruent flanker trials, the condition requiring greater inhibition. For the working memory task, CRF predicted greater target accuracy and greater d' scores on the 1-back task, requiring lesser amounts of working memory. In the 2-back task, which requires greater amounts of working memory, CRF also predicted greater target and non-target accuracy and d' scores. Comparatively, MF did not predict any cognitive outcomes after adjustment for CRF.ConclusionCRF was selectively related to better performance during task conditions that require greater amounts of inhibition and working memory. This finding suggests that CRF, but not MF, may benefit cognitive control in older adolescents. This selective influence of CRF on older adolescents' cognition highlights the value of aerobic physical activity.
| S-EPMC7856563 | biostudies-literature
Project description:ObjectiveAge-related hippocampal atrophy is associated with memory loss in older adults, and certain hippocampal subfields are more vulnerable to age-related atrophy than others. Cardiorespiratory fitness (CRF) may be an important protective factor for preserving hippocampal volume, but little is known about how CRF relates to the volume of specific hippocampal subfields, and whether associations between CRF and hippocampal subfield volumes are related to episodic memory performance. To address these gaps, the current study evaluates the associations among baseline CRF, hippocampal subfield volumes, and episodic memory performance in cognitively unimpaired older adults from the Investigating Gains in Neurocognition Trial of Exercise (IGNITE) (NCT02875301).MethodsParticipants (N = 601, ages 65-80, 72% female) completed assessments including a graded exercise test measuring peak oxygen comsumption (VO2peak) to assess CRF, cognitive testing, and high-resolution magnetic resonance imaging of the hippocampus processed with Automated Segmentation of Hippocampal Subfields (ASHS). Separate linear regression models examined whether CRF was associated with hippocampal subfield volumes and whether those assocations were moderated by age or sex. Mediation models examined whether hippocampal volumes statistically mediated the relationship between CRF and episodic memory performance. Covariates included age, sex, years of education, body mass index, estimated intracranial volume, and study site.ResultsHigher CRF was significantly associated with greater total left (B = 5.82, p = 0.039) and total right (B = 7.64, p = 0.006) hippocampal volume, as well as greater left CA2 (B = 0.14, p = 0.022) and dentate gyrus (DG; B = 2.34, p = 0.031) volume, and greater right CA1 (B = 3.99, p = 0.011), CA2 (B = 0.15, p = 0.002), and subiculum (B = 1.56, p = 0.004) volume. Sex significantly moderated left DG volume (B = -4.26, p = 0.017), such that the association was positive and significant only for males. Total left hippocampal volume [indirect effect = 0.002, 95% CI (0.0002, 0.00), p = 0.027] and right subiculum volume [indirect effect = 0.002, 95% CI (0.0007, 0.01), p = 0.006] statistically mediated the relationship between CRF and episodic memory performance.DiscussionWhile higher CRF was significantly associated with greater total hippocampal volume, CRF was not associated with all underlying subfield volumes. Our results further demonstrate the relevance of the associations between CRF and hippocampal volume for episodic memory performance. Finally, our results suggest that the regionally-specific effects of aging and Alzheimer's disease on hippocampal subfields could be mitigated by maintaining higher CRF in older adulthood.
| S-EPMC11694150 | biostudies-literature
Project description:BackgroundCardiorespiratory fitness is often impaired following stroke, and peak oxygen consumption (VO2peak) is an important prognostic value of all-cause mortality. The primary objective was to investigate whether functional walk tests assessed in the subacute phase after stroke added value in predicting VO2peak in chronic stroke, in addition to age, sex and functional dependency. Secondary objectives were to investigate associations between daily physical activity and functional walk tests, and with VO2peak in chronic stroke.MethodsThis prospective cohort study included eligible participants originally included in the randomized controlled trial Life After Stroke. Functional walk tests, i.e., six-minute walk test (6MWT) and maximal gait speed, were assessed at inclusion and 18 months later. VO2peak [ml/kg/min] was assessed by a cardiopulmonary exercise test on a treadmill 20 months after inclusion. Daily physical activity was measured by a uniaxial accelerometer (activPAL) at 18-month follow-up.ResultsNinety-two community-dwelling individuals, with a mean (SD) age of 69.2 (10.6) years and 33 (35.9%) women, were included 3 months after stroke onset. Eighty-three (90.2%) participants had a modified Rankin Scale (mRS) score of 1 or 2, indicating functional independence. An overall assessment of four prediction models indicated the combination of age, sex, mRS and 6MWT as predictors to be the best fitted model in predicting VO2peak (adjusted R2 = 0.612). Secondary results showed statistically significant, but not clinically significant, associations between daily physical activity and functional walk tests, and with VO2peak.Conclusions6MWT add significant value to the prediction of mean VO2peak in the chronic phase in mild strokes, in combination with age, sex and functional dependency. This prediction model may facilitate clinical decisions and rehabilitation strategies for mildly affected stroke survivors in risk of low levels of VO2peak. Future studies should validate the model in various stages after stroke and in patients moderately and severely affected.
| S-EPMC8328339 | biostudies-literature
Project description:AimThe primary aim was to assess the efficacy of self-paced sprint interval training (SIT) with low-volume high-intensity interval training (LV-HIIT) when performed without encouragement on improving cardiorespiratory fitness (CRF). A secondary aim was to explore whether the effort exerted during protocols [power output (PO) and heart rate (HR)] influenced the change in CRF.MethodsIn a randomised cross-over design, 82 previously inactive adults (m/f: 26/56, 28 ± 10 years, BMI 25 ± 3 kg m-2) undertook 6-weeks of self-paced SIT (4-8 × 30 s with 120 s recovery) or LV-HIIT (6-10 × 1 min with 1 min recovery) separated by a 4-week washout period. Sessions were completed 3×/week using WattBikes, and a target of >80% HRmax was suggested during the intervals. Markers of cardio-metabolic health were assessed before and after each intervention.ResultsTraining increased VO2peak (SIT +3.1 ± 0.4 mL kg-1 min-1, LV-HIIT +2.7 ± 1.2 mL kg-1 min-1, P < 0.001) and decreased body fat % (P = 0.002), aortic pulse wave velocity (P = 0.002) and glucose tolerance 120 min following an oral glucose tolerance test (P = 0.024), with no difference between protocols (P > 0.05). When grouping participants into tertiles based on HR and PO responses (n = 27), those achieving a low HR had similar changes in VO2peak compared to the high HR group in both interventions (P > 0.05). For LV-HIIT, participants in the highest tertile for peak PO had a greater change in VO2peak compared to all other participants (Low 1.8 ± 4.1 mL kg-1 min-1, Medium 1.9 ± 3.3 mL kg-1 min-1, High 4.3 ± 3.6 ml kg-1 min-1, P = 0.020).DiscussionSix-weeks of self-paced SIT and LV-HIIT induce comparable improvements in CRF, body composition, arterial stiffness and glucose tolerance. Importantly, higher HR did not elicit superior changes in CRF, but PO achieved during LV-HIIT may influence improvements.
| S-EPMC11835828 | biostudies-literature
Project description:Age-related cognitive impairment has been associated with arterial stiffening and decreased cardiorespiratory fitness. The aims of this cross-sectional study were to compare cognitive function domains and cardiovascular parameters in older adults (≥ 65 years old) with high and normal aortic stiffness (via carotid-femoral pulse wave velocity, cfPWV) and to explore relationships among cfPWV, carotid intima-media thickness, cardiorespiratory fitness, and cognitive function. Vascular and cognitive function were measured in older adults with either normal or high cfPWV. Cognitive function was measured via an intensive one-time neuropsychological battery, while cfPWV by applanation tonometry, carotid intima-media thickness and function (i.e., distensibility) by ultrasonography, and cardiorespiratory fitness (i.e., VO2peak) by a submaximal exercise test. Correlations among age, VO2peak, carotid intima-media thickness, cfPWV, and cognitive function were performed along with a series of multivariate analyses of variance. Compared with NAS, participants with HAS had greater aortic, carotid, and brachial blood pressures but similar cardiorespiratory fitness and carotid intima-media thickness and distensibility. Participants with NAS exhibited better neuropsychological performance in executive function and attention and overall cognitive function than those with HAS. When controlling for age, visual scanning and perception scores were correlated with cfPWV and VO2peak. Our findings suggest that certain cognitive domains for older adults are associated with their cardiorespiratory fitness and aortic stiffness.
| S-EPMC8425270 | biostudies-literature
Project description:Declining episodic memory is common among otherwise healthy older adults, in part due to negative effects of aging on hippocampal circuits. However, there is significant variability between individuals in severity of aging effects on the hippocampus and subsequent memory decline. Importantly, variability may be influenced by modifiable protective physiological factors such as cardiorespiratory fitness (CRF). More research is needed to better understand which aspects of cognition that decline with aging benefit most from CRF. The current study evaluated the relation of CRF with learning rate on the episodic associative learning (EAL) task, a task designed specifically to target hippocampal-dependent relational binding and to evaluate learning with repeated occurrences. Results show higher CRF was associated with faster learning rate. Larger hippocampal volume was also associated with faster learning rate, though hippocampal volume did not mediate the relationship between CRF and learning rate. Furthermore, to support the distinction between learning item relations and learning higher-order sequences, which declines with aging but is largely reliant on extra-hippocampal learning systems, we found learning rate on the EAL task was not related to motor sequence learning on the alternating serial reaction time task. Motor sequence learning was also not correlated with hippocampal volume. Thus, for the first time, we show that both higher CRF and larger hippocampal volume in healthy older adults are related to enhanced rate of relational memory acquisition.
| S-EPMC7850579 | biostudies-literature