Fatigability and functional performance among older adults with low-normal ankle-brachial index: Cross-sectional findings from the Baltimore Longitudinal Study of Aging

The Journals of Gerontology: Series A

Zipunnikov

et al. 2020

Self Cite

Background Deficits in energy production and utilization have been linked to higher fatigue and functional decline with aging. Lesser known is whether individuals with a combination of low peak energy capacity and high energy costs for mobility (eg, impaired energy regulation) are more likely to experience the onset and progression of high fatigability with aging. Methods Participants in the Baltimore Longitudinal Study of Aging (n = 651, 49.0% male, mean age 71.9, range 50–94) with ≥2 visits who completed fatigability (Borg rating of perceived exertion [RPE] after a 5-minute 1.5 mph treadmill walk), slow walking energy expenditure (VO2 mL/kg/min), and peak walking energy expenditure (VO2 mL/kg/min), testing between 2007 and 2018. The longitudinal association between each measure of energy expenditure, a ratio of energy cost-to-capacity, and perceived fatigability was modeled using mixed effects models adjusted for age, body composition, and comorbidities. Time to higher perceived fatigability (RPE ≥ 10) was modeled using Cox proportional hazards models. Results In continuous analyses, higher slow walking energy expenditure (p < .05) and a higher cost ratio (p ≤ .001) were associated with greater perceived fatigability over time. Cox proportional hazards models using tertiles of the cost ratio suggest that, compared to those in the lowest tertile, those in the middle and highest tertiles had 1.89 (95% confidence interval [CI]: 1.57–5.16) and 2.85 (95% CI: 1.05–3.40) times greater risk of developing higher fatigability, respectively. Conclusion Findings suggest that strategies to prevent fatigability should consider methods to improve energy regulation by targeting both the independent and combined effects of declining peak capacity and rising energy costs for mobility with aging.

Section: Discussionmentioning

confidence: 99%

Longitudinal Association Between Energy Regulation and Fatigability in Mid-to-Late Life

Schrack

The Journals of Gerontology: Series A

Zipunnikov

et al. 2020

Self Cite

“…In well-functioning older adults, higher perceived fatigability (i.e., feeling more significant levels of exhaustion after completing slow treadmill walk) has been associated with lower objective physical activity (Richardson et al, 2015; Wanigatunga et al, 2018), subjective and performance-based mobility (Simonsick et al, 2016, 2018), and worse inflammatory biomarker levels (Cooper et al, 2019; Wanigatunga et al, 2019). High perceived fatigability is also more prevalent in those with a history of disease including preclinical cardiovascular disease (Qiao et al, 2019), peripheral artery disease (Martinez-Amezcua et al, 2018), cancer (Gresham et al, 2018), cognition (Salerno et al, 2020), and sleep (Alfini et al, 2020). Although several popular adages: It takes as much energy to wish as it does to plan—Eleanor Roosevelt, American Political Figure Our fatigue is often caused not by work, but by worry, frustration and resentment—Dale Carnegie, American Writer Age is not measured by years.…”

mentioning

confidence: 99%

Traits and treadmills: Association between personality and perceived fatigability in well-functioning community-dwelling older adults.

Chan

Terracciano

et al. 2021

Psychology and Aging

Self Cite

Physical fatigability, or susceptibility to physical fatigue, is strongly associated with aging, disease, and disability. Over the lifecourse, personality traits are also connected to numerous age-related vulnerabilities and resistance-yet, their longitudinal association with fatigability remains unknown. Well-functioning community-dwelling volunteers aged ≥50 (N = 995) from the Baltimore Longitudinal Study of Aging (BLSA) were assessed over an average of 2 years on personality traits (NEO-PI-R; openness, conscientiousness, extraversion, agreeableness, and neuroticism) and perceived fatigability [Borg Rating of Perceived Exertion (RPE) after a 5-min slow treadmill walk; 6 (low) to 20 (high) exertion]. Linear and multinomial logistic regression models examined cross-sectional associations [treating fatigability continuously and by RPE category: low (6-7), intermediate (8-9), and high (10+)]. Generalized estimating equations (GEE) tested longitudinal associations. All models were adjusted for demographics and comorbid conditions. In cross-sectional models, openness, β = −.09 RPE (SE =.03); p < .01, conscientiousness, β = −.07 (.03); p < .05, and extraversion, β = −.10 (.03); p < .01, were negatively associated with fatigability. In parallel, lower openness, OR: .98, 95% CI [.96-1.00], conscientiousness, OR: .98, 95% CI [.96-1.00], and extraversion, OR: .97, 95% CI [.95-.99], corresponded with higher odds of having high versus low fatigability. In longitudinal models (mean follow-up time 2 ± 2 years), openness, conscientiousness, and extraversion associations remained significant and did not change over time (Trait × Year p values > .34). Together, findings suggest that personality plays a role in the perceived tolerance of fatigue in wellfunctioning older adults.

“…The participants of the BLSA, even those with obesity, are healthier than the general population, making the findings less generalizable. In the general population, in which the prevalence of chronic conditions is higher, it is likely that the association between adiposity and fatigability would be even greater because of the coexistence of several factors that increase fatigability, such as cardiovascular diseases , chronic inflammation , and cancer , among others. Furthermore, because of the cross‐sectional design, we were unable to assess temporality of the adiposity and fatigability association or how change in adiposity affects change in fatigability.…”

Section: Discussionmentioning

confidence: 99%

Association Between Adiposity and Perceived Physical Fatigability in Mid‐ to Late Life

Martínez-Amezcua

Simonsick

et al. 2019

Obesity

Self Cite

Objective Compare and contrast the associations between measures of adiposity and fat distribution and perceived fatigability among well-functioning individuals in mid-to-late life. Methods In 1,054 adults (70.4 years ±12.4, 52% female), adiposity was measured as: Body Mass Index (BMI), percent fat (DEXA), waist and hip circumferences, and waist-to-height ratio. In a subset of 383 visceral fat (CT) was measured. Perceived fatigability was evaluated after a 5-min, treadmill walk (1.5 mph) using the Borg rating of perceived exertion (RPE, ranging 6–20). Associations between adiposity measures and perceived fatigability were assessed using regression models adjusting for age, sex, race, smoking, and comorbidities. Results All adiposity measures, except subcutaneous fat, were positively associated with perceived fatigability after adjustment (p<0.05 for all). Standardized coefficients indicate that BMI, hip circumference, and visceral fat have the strongest associations with fatigability. Associations between BMI and fatigability were present only among those above the threshold for overweight, and strongest in those aged ≥65. Moreover, BMI was only associated with fatigability among participants with higher waist circumference. Conclusions Measures of adiposity – particularly central adiposity- are strongly associated with fatigability, suggesting that weight management may be an effective target for curbing fatigability and maintaining quality of life with aging.