Mobility Limitation in Self-Described Well-Functioning Older Adults: Importance of Endurance Walk Testing

Simonsick, Eleanor M.; Newman, Anne B.; Visser, Marjolein; Goodpaster, Bret H.; Kritchevsky, Stephen B.; Rubin, Susan M.; Nevitt, Michael C.; Harris, Tamara B.

doi:10.1093/gerona/63.8.841

Cited by 127 publications

(115 citation statements)

References 32 publications

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“…Walking speed over 400 m has been shown to be significantly faster than that for the 6-MWT. 82 Test-retest reliability has been established 83 and significant associations have been reported between 400-m walk time and aerobic capacity, lower extremity strength and power, 40,84 mobility limitation 85 as well as mortality prognosis in older persons. [86][87][88][89] Minimally significant change for the 400-m walk test has been estimated at 20-30 s, while 50-60 s was suggested as criteria for substantial change.…”

Section: Adt: Body Composition and Physical Functionmentioning

confidence: 99%

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Storer¹,

Miciek²,

Travison³

2012

Asian J Androl

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Prostate cancer (PCa) is the most common visceral malignancy in men with androgen deprivation therapy (ADT) the preferred therapy to suppress testosterone production and hence tumor growth. Despite its effectiveness in lowering testosterone, ADT is associated with side effects including loss of muscle mass, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life. This review reports a survey of the literature with a focus on changes in muscle strength, physical function and body composition, due to short-term and long-term ADT. Studies in these areas are sparse, especially well-controlled, prospective randomized trials. Cross-sectional and longitudinal data (up to 2 years) for men with PCa treated with ADT as well as patients with PCa not receiving ADT and age-matched healthy men are presented when available. Based on limited longitudinal data, the adverse effects of ADT on muscle function, physical performance and body composition occur shortly after the onset of ADT and tend to persist and worsen over time. Exercise training is a safe and effective intervention for mitigating these changes and initial guidelines for exercise program design for men with PCa have been published by the American College of Sports Medicine. Disparities in study duration, types of studies and other patient-specific variables such as time since diagnosis, cancer stage and comorbidities may all affect an understanding of the influence of ADT on health, physical performance and mortality. Keywords: androgen deprivation therapy; androgen suppression; exercise prescription; exercise training; functional assessment; lean body mass; older men; prostate cancer INTRODUCTION Prostate cancer (PCa) is the most common visceral malignancy in men.1 Since the tumor is initially testosterone dependent, androgen deprivation therapy (ADT) is the preferred modality to suppress testosterone production in men with this disease. ADT has been extensively studied with surgical and chemical castration achieved via bilateral orchiectomy, use of a gonadotropin hormone-releasing hormone (GnRH) agonist or anti-androgens. Annually, about 500 000 men in the United States are treated with GnRH agonists.2 Though their effectiveness in lowering serum testosterone to castrate levels is well established, side effects are common.Testosterone and its metabolites are essential for the maintenance of muscle mass and bone mineral content. Body composition changes in men undergoing ADT place them at increased risk not only for diminished physical capacity, but also for coronary artery disease, type II diabetes and the metabolic syndrome, 3 though a recent meta-analysis suggests no increase in cardiovascular mortality. 4 In addition, ADTassociated decreases in muscle and bone mass are thought to be associated with increased fracture risk, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life (Figure 1).This narrative review focuses on changes in muscle strength, physi...

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Section: Adt: Body Composition and Physical Functionmentioning

confidence: 99%

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Storer¹,

Miciek²,

Travison³

2012

Asian J Androl

View full text Add to dashboard Cite

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“…Previous studies of self-reported mobility disability in older adults have focused on predictors of incident mobility disability rather than on outcomes. [4][5][6][7] In order to be successfully integrated into clinical practice and health policy, a marker of mobility disability must be easily accessible, such as self-report, and should predict subsequent health outcomes and health care utilization in a broad range of older adults. Therefore, our study examines a nationally representative sample of Medicare beneficiaries aged 65 years or older to determine the association between mobility disability, defined as self-reported limitations in walking 1/4 mile, and subsequent mortality, incident basic and instrumental ADL disability, and health care utilization and costs.…”

Section: Introductionmentioning

confidence: 99%

Ability to Walk 1/4 Mile Predicts Subsequent Disability, Mortality, and Health Care Costs

et al. 2010

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“…Yet, only 25 % of older adults walk outdoors on a regular basis. 10 While a host of studies have focused on the role of individual factors for encouraging or preventing outdoor mobility (e.g., functional status, self-efficacy, outcome expectations), [11][12][13][14] considerably less research has examined the importance of the urban built environment for older adults aging in place. Urban environmental barriers subjectively reported by older adults include poor access to public transportation, discontinuous or uneven sidewalks, curbs, and inadequate lighting.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place

Clarke

Gallagher

2013

J Urban Health

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Hazards in the urban built environment can create barriers to mobility among older adults aging in place. We investigated the relationship between urban built environment characteristics and 15-month trajectories of mobility disability in a sample of 1,188 older adults living in Detroit, MI, a city that has undergone rapid economic and structural decline. Data come from the Michigan Minimum Data Set for Home Care (2001Care ( -2008, an enumerative database of older adults in Michigan who qualify for federal or state-funded home and community-based long-term care through a Medicaid waiver program. Standardized assessments are made at intake and every 90 days by case managers. Built environments were assessed with a virtual audit using the "Street View" feature of Google Earth. A summary accessibility score was created for each block based on a count of the number of accessible features (e.g., continuous barrier-free sidewalks and proximity of public transportation). Using growth mixture models, two latent trajectories of outdoor mobility were identified: one capturing occasional outdoor mobility (representing 83 % of the sample) and one capturing almost no mobility outside the home. Controlling for sociodemographic and health risk factors, individuals living in more accessible environments had a 18 % higher odds of being in the more mobile group (OR01.18, 95 % CI01.01, 1.41). These findings emphasize the importance of the built environment for mobility among urban-dwelling older adults.

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Mobility Limitation in Self-Described Well-Functioning Older Adults: Importance of Endurance Walk Testing

Cited by 127 publications

References 32 publications

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Ability to Walk 1/4 Mile Predicts Subsequent Disability, Mortality, and Health Care Costs

Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place

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