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Background: The effect of home-based exercise training on neurovascular control in heart failure patients is unknown. Aims: To test the hypothesis that home-based training would maintain the reduction in muscle sympathetic nerve activity (MSNA) and forearm vascular resistance (FVR) acquired after supervised training. Methods and results: Twenty-nine patients (54 T 1.9 years, EF < 40%) were randomised into two groups: untrained control (n = 12) and exercise trained (n = 17). Both groups underwent assessment of Quality of Life (QoL), MSNA, and forearm blood flow. The exercise group underwent a 4-month supervised training program followed by 4 months of home-based training. After the initial 4 months of training, patients in the exercise group showed a significant increase in peak VO 2 and reduction in MSNA, compared to the untrained group, but this was not maintained during 4 months of home-based training. In contrast, the decrease in FVR (56 T 3 vs. 46 T 4 vs. 40 T 2 U, p = 0.008) and the improvement in QOL that were achieved during supervised training were maintained during home-based training. Conclusions: Home-based training following supervised training is a safe strategy to maintain improvements in QoL and reduction in FVR in chronic heart failure patients, but is an inadequate strategy to maintain fitness as estimated by peak VO 2 or reduction in neurohumoral activation.

Objective: This study aimed to verify the validity of BAI in predicting %BF in a sample of Brazilian women Design and Methods: A total of 102 women (average age 60.3 6 9.8) were assessed. To determine percentage body fat (% BF), dual-energy X-ray absorptiometry (DXA) was used as the "gold standard." To evaluate the association between body adiposity index (BAI) and % BF assessed by DXA, we used Pearson's correlation coefficient. Paired sample t-test was used to test differences in mean % BF between BAI and DXA. To evaluate the concordance between % BF measured by DXA and estimated by BAI, we used the Lin's concordance correlation coefficient and the agreement analysis of Bland-Altman. Results: The correlation between % BF obtained by DXA and that estimated by BAI was r 5 0.65, P < 0.001. Paired t-test showed significant mean difference between methods (P < 0.0001). Lin's concordance correlation coefficient was C_b 5 0.73, which is classified as poor, while the Bland-Altman plots showed BAI underestimating % BF in relation to the used criterion measure in a large portion of the sample. Conclusions: Results of the present study show that BAI presented low agreement with % BF measured by DXA, which is not recommended for % BF prediction in this studied sample.

Objective: To compare the health-related quality of life (HRQL) indicators between institutionalized and community-dwelling elderly men and women. Method: This was a cross-sectional study with a sample of 496 elderly men and women, surveyed by researchers at a private hospital that attends institutionalized and community-dwelling elderly. HRQL (World Health Organization Quality of Life), daily living activities (Katz questionnaire), and instrumental daily living activities (Lawton questionnaire), mini-mental state examination, handgrip strength test, and function capacity (timed up and go test) were obtained. Results: Institutionalized men presented higher scores in physical and psychological domains of HRQL compared to elderly men living alone (p<0.05). Among women, the scores in all domains (physical, psychological, relationship, and environment) were similar between institutionalized and community-dwelling individuals. Conclusion: Institutionalized elderly men reported better scores in physical and psychological domains of HRQL compared to their community-dwelling pairs, while both institutionalized and community-dwelling elderly women presented similar HRQL.

Greater memory performance was associated with greater moderate to vigorous physical activity levels and walking capacity in patients with symptomatic peripheral artery disease. Clinical interventions focused on improving moderate to vigorous physical activity levels and walking capacity may provide important therapies to potentially enhance cognitive health in patients with peripheral artery disease.

Chronic degenerative conditions are very common in the elderly. According to medical literature, there is a correlation between cognitive impairment among elders and arterial hypertension/hyperglycemia which in turn are common diseases among the elderly population worldwide. Nonetheless, data on the association between cognitive impairment and Metabolic Syndrome (MetS) remains controversial.OBJECTIVETo compare the cognitive status of Brazilian elderly outpatients with and without MetS.METHODSA cross-sectional case-control study with 49 subjects (25 MetS and 24 controls) who underwent a global geriatric and neuropsychological assessment was carried out. The scores for cognitive abilities (sustained attention, alternating attention, immediate memory, working memory, memory - immediate recall, memory - delayed recall, memory - recognition, executive function, ideomotor praxis, constructive praxis, naming ability, verbal fluency) were compared with the data for the normal population and differences between case and control groups were analyzed using Student's t-test or the Mann-Whitney test.RESULTSForty-five patients (91.8%) were female, with a mean age of 73.9±5.9 years, and 3.0±1.0 years of schooling. A significant difference (p<0.01) was found between case and control groups regarding the MetS components. For cognitive abilities, no statistically significant difference was detected between the groups and all subjects presented low cognitive scores.CONCLUSIONThe results obtained in the present study showed that MetS was not associated with cognitive impairment in this population. Further prospective studies are necessary to investigate the influence of well-controlled MetS on cognitive performance among elders.

BackgroundDepressive symptoms are independently associated with an increased risk of cardiovascular disease (CVD) among individuals with non-diagnosed CVD. The mechanisms underlying this association, however, remain unclear. Inflammation has been indicated as a possible mechanistic link between depression and CVD.ObjectivesThis study evaluated the association between persistent depressive symptoms and the onset of low-grade inflammation.MethodsFrom a database of 1,508 young (mean age: 41 years) individuals with no CVD diagnosis who underwent at least two routine health evaluations, 134 had persistent depressive symptoms (Beck Depression Inventory - BDI ≥ 10, BDI+) and 1,374 had negative symptoms at both time points (BDI-). All participants had been submitted to repeated clinical and laboratory evaluations at a regular follow-up with an average of 26 months from baseline. Low-grade inflammation was defined as plasma high-sensitivity C-Reactive Protein (CRP) concentrations > 3 mg/L. The outcome was the incidence of low-grade inflammation evaluated by the time of the second clinical evaluation.ResultsThe incidence of low-grade inflammation was more frequently observed in the BDI+ group compared to the BDI- group (20.9% vs. 11.4%; p = 0.001). After adjusting for sex, age, waist circumference, body mass index, levels of physical activity, smoking, and prevalence of metabolic syndrome, persistent depressive symptoms remained an independent predictor of low-grade inflammation onset (OR = 1.76; 95% CI: 1.03-3.02; p = 0.04).ConclusionsPersistent depressive symptoms were independently associated with low-grade inflammation onset among healthy individuals.

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