Our objective was to examine the association between the time and number of stops during the 400-meter walk test (400MWT) and average daily steps and walking cadence in a German cohort of frail and sarcopenic community-dwelling older adults at first observation (FO) and individual last observation (LO) after at least 11 months. Stops during the 400MWT led to a longer time. Time in the 400MWT was significantly associated with average daily steps and walking cadence at FO and LO (24.5 ± 8.5 months). Stops alone were not associated with average daily steps and walking cadence. Gait speed under laboratory conditions can be used to estimate daily physical activity, represented by average daily steps and walking cadence, in frail and sarcopenic older adults. Physical activity (PA) is recommended for frail and sarcopenic older adults as an essential means of preventing negative health outcomes and decline in functional abilities. Our objective was to examine the association between the time and/or stops during the 400-m walk test (400MWT) and average daily steps and walking cadence in a German cohort of frail and sarcopenic community-dwelling older adults. For this sub-study the German cohort of 104 frail and sarcopenic older adults (i.e., SPRINTT) aged 80.8 ± 5.2 years was divided into participants having made none or one stop or more than one stops, referred to as non-stoppers and multi-stoppers. The characteristics and general health state (physical function, disease state, concerns about falling) at first observation (FO) and individual last observation (LO) after at least 11 months (mean 24.5 ± 8.5 months) were examined. Daily PA represented by average daily steps and walking cadence was assessed over three to seven days at FO and LO using the activPAL3 micro. Time and stops made during the 400MWT and their association with daily PA were investigated using regression with bootstrapping. Out of 104 frail and sarcopenic older adults, 84 non-stoppers (female: n = 54; 64.3

Anemia is a common and debilitating complication of chronic kidney disease (CKD), but its pathogenesis remains incompletely understood. Endostatin, an anti-angiogenic peptide that is elevated in CKD, may impair erythropoiesis through vascular dysfunction. We investigated the relationship between circulating endostatin and both prevalent and incident anemia in older adults, as well as whether kidney function modified this association. We analyzed data from 2,008 participants aged ≥ 75 years enrolled in the Screening for CKD among Older People across Europe (SCOPE) prospective cohort. Cross-sectional associations between standardized log-transformed endostatin and hemoglobin levels or prevalent anemia were assessed using linear and logistic regression, respectively. Dose-response relationships were explored across endostatin tertiles. Longitudinal analyses included 1,394 non-anemic individuals followed for two years; incident anemia was assessed using Fine-Gray competing risk models, with death treated as a competing event. Models were progressively adjusted for demographics, comorbidities, kidney function, iron status, medications, and baseline hemoglobin. Sensitivity analyses included Winsorization and subgroup interaction testing. At baseline, 405 participants (20.2

Background: Concerns about falling (CaF) are common in older adults and are associated with reduced activity and poorer health. The aim of this study was to investigate, for the first time, the long-term effects of a multi-component intervention program designed to reduce CaF on psychological, functional, biophysiological, and anthropometric aspects. Methods: 160 community-dwelling older adults (≥ 70 years) were randomly assigned to either a 4-month intervention featuring exercise and cognitive-behavioral training or to a sham control group. CaF, perceived stress, and other psychological symptoms were tracked by self-reports. Salivary cortisol and α-amylase were analyzed. Physical function, activity, and body composition were evaluated. Blood levels of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1β (IL-1β) and tumor necrosis factor-alpha (TNF-α) served as surrogate markers for inflammatory status, assessed at baseline, post-intervention, and at an 8-month follow-up. Results: All estimates are T0–T2 estimated marginal mean differences. CaF, operationalized by Falls Efficacy Scale-International (FES-I) (estimate = 3.85, p < .001), FES-I Avoidance Behavior (FES-IAB) (estimate = 2.12, p = .001) and Updated Perceived Control over Falling (UP-CoF) (estimate = −1.68, p < .001) decreased over time with no between-group differences. Functional outcomes marginally improved throughout the study. Total diurnal output of cortisol decreased (estimate = 0.66, p = .017) and of α-amylase increased (estimate = -10.07, p = .013) significantly. Inflammatory marker changes present a non-cohesive picture, as CRP and IL-10 remain stable, IL-6 (estimate = -0.06, p = .002) and IL-1β (estimate = -0.05, p = .004) increased, and TNF-α (estimate = 0.09, p < .001) decreased. Conclusion: CaF improved to a similar extent in both the intervention and sham control groups. Similarly, changes in basal stress system activity and inflammatory cytokines were highly comparable between groups. Contrary to our primary hypothesis, the intervention did not confer additional benefits over the sham control intervention with regard to reductions in CaF. Trial registration: German Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022, https://drks.de/search/de/trial/DRKS00029171. Keywords Older adults, concerns about falling, inflammation, community-dwelling, stress, cortisol

Statins are used for cardiovascular prevention, but their potential impact on muscle health in adults aged ≥ 75 years remains unclear. To assess whether statin use is associated with adverse changes in muscle strength, skeletal muscle mass, and physical performance in older adults. Data were drawn from the SCOPE study including 2,282 participants aged ≥ 75 years with complete baseline data on statin use and muscle outcomes. Muscle strength was assessed via handgrip strength, muscle mass via skeletal muscle index (SMI), and physical performance via the Short Physical Performance Battery (SPPB). Outcomes were measured at baseline and after two years. Associations with statin use were analysed cross-sectionally and longitudinally, stratified by sex, and adjusted for confounders. At baseline, 1,107 participants (48.5

Objective: The objective of this analysis was to assess the agreement of telephone-based Falls Efficacy Scale-International (FES-I) interviews versus face-to-face interviews in older adults. We examined whether the two modes of data collection differed in reporting concerns about falling (CaF). Methods: Data were drawn from the FEARFALL study, a longitudinal randomized controlled trial on stress and functional health in older adults with CaF. FES-I scores of 123 participants aged 70 years and older were collected via both telephone and face-to-face interviews. Differences in total scores, item-level differences, and regression models were analyzed to identify potential influencing factors. Results: Telephone interviews yielded lower FES-I scores than face-to-face interviews ( p < .001; d = -0.34). Agreement between the two modes was moderate (ICC = 0.67) with a high correlation ( r = 0.71), with heterogeneity at the item level. Two items showed significant deviations (Item 4: “bathing/showering”, p adj < .001, d = 0.36; Item 10: “answer telephone”, p adj < .001, d = 0.34). Age was significantly associated with mode-related score differences ( β = -0.326, 95% CI [-0.58, -0.07], p = .013). Conclusion: The telephone FES-I may be suitable for group-level comparisons and large-scale screenings. However, it is not equivalent to face-to-face interviews for clinical decisions in individual cases, particularly among people aged 70 years and older. Mode effects should be considered in study design and clinical interpretation. Future research should further examine potential mechanisms such as cognitive and sensory factors.

METHODS:To address the substantial disability and healthcare burden associated with falls in older adults, the aim of this study is to use a new 3-year operationalization of fall occurrence profiles to identify factors linked with persistent falling. Data were obtained from the multicenter SCOPE study, which followed 2461 community-dwelling adults (median age 80.0 and IQR 6.0; 56.1% women) across seven European countries, with assessments at baseline and after 1 and 2 years. Variables included demographics, comorbidities, medication use, functional status, mood, quality of life, and kidney function. Fall-related data included number, location, cause, and consequences. Participants were classified as Persistent-Fallers (falls at all three timepoints), Quasi Persistent-Fallers (falls in two), and Transient-Fallers (one fall episode). Logistic regression assessed predictors of being Persistent-Fallers vs. Transient-Fallers, and vs. Quasi Persistent-Fallers. RESULTS:Across the study, 894 falls occurred in Persistent-Fallers (n = 137), 919 in Quasi-Persistent Fallers (n = 299), and 695 in Transient-Fallers (n = 524). Most falls occur outdoors and during ambulation. Persistent-Fallers showed poorer physical performance, worse health, and higher proportion of indoor falls. Transient-Fallers were more likely to fall outdoors but sustain a higher risk of fractures per fall. Quasi-Persistent Fallers displayed intermediate characteristics. In fully adjusted models, higher comorbidity burden, presence of lower urinary tract symptoms and poorer self-rated health were significantly associated with persistent falling. CONCLUSIONS:This study reveals distinct faller profiles. Persistent-Fallers reflect frailty and linked to overall medical burden and functional decline; Transient-Fallers are generally healthier, fall outdoors more often, and their falls more often lead to fractures, possibly due to lower risk awareness falls; Quasi-Persistent Fallers exhibit characteristics that fall between those of the other two groups.

BackgroundRemote health care delivery, including the use of digital health interventions, is emerging as a tool for assessing and managing physical function, but its design and implementation often overlook the needs and preferences of older adult end users. ObjectiveThe primary aim of this modified Delphi process was to develop consumer consensus on preferences for remote assessment and management of physical function in older adults. MethodsResearch and consumer experts of the Remote Assessment and Management of Physical Function in Older Adults (RAMP) Working Group co-developed the Round 1 Delphi survey, which was advertised to consumers (adults aged ≥60 years) via international clinical and research networks and social media between August and November 2023. The online survey presented 23 Delphi statements for which respondents reported their level of agreement using an 11-point Likert scale (0-10; scores ≥7 indicated agreement). Statements were classified as having “strong agreement” and achieving consensus if ≥80% of participants indicated agreement. Statements classified as having “moderate” (70%-80% of participants indicated agreement) or “low” (<70% of participants indicated agreement) agreement were revised or rejected. Revised statements were presented to participants in Round 2 (January to February 2024), and the final consensus statements were consolidated into recommendations. ResultsA total of 654 consumers (75.7% female) with a mean age of 69.0 (SD 6.0) years from 15 countries (5 continents) were included in analyses in Round 1. Of 23 statements, 13 achieved consensus, with the strongest agreement observed for statements relating to the importance of physical function for quality of life and performing activities of daily living (6 statements; agreement 97.6%-99.5%). Two statements regarding privacy and security concerns when using technology (agreement 20.8%) and the inability to perform physical function assessments or exercise at home (agreement 15.5%) were rejected with low agreement. The remaining 8 statements (agreement 49.5%-79.5%) were modified into 7 new statements for the Round 2 survey, which was completed by 526 (80.4%) respondents from Round 1. Five of seven Round 2 statements were accepted with strong agreement (agreement 80%-82.7%), including the importance of addressing personal preferences for self- versus clinician-led remote interventions, group versus individual exercise, and availability of necessary resources (eg, technology and exercise equipment). ConclusionsEighteen statements achieved consensus and were translated into 7 recommendations highlighting that older adults recognize physical function as a health priority, would value more information about it, and are willing to participate in remote assessment and management interventions (including via digital health) to maintain or improve it. These recommendations also reinforce that interventions should be easily accessible and meet individual preferences of consumers.

Abstract Background Concerns about falling (CaF) are commonly assessed using the Falls Efficacy Scale-International (FES-I), but telephone versus face-to-face interviews may influence responses. The objective of this secondary paired method-comparison analysis was to assess agreement between telephone and face-to-face FES-I total scores in older adults and to explore whether the two administration modes differed at the total-score and item levels. Methods Data were drawn from the FEARFALL study, a longitudinal randomized controlled trial on stress and functional health in older adults with CaF. FES-I scores of 123 participants aged 70 years and older were collected via both telephone and face-to-face interviews. Differences in total scores, item-level differences, and regression models were analyzed to identify potential influencing factors. Results FES-I scores obtained during the telephone-first assessment were lower than those obtained at the subsequent face-to-face assessment ( p < .001; d = -0.34). Agreement between the two modes was moderate to good (ICC = 0.67). In addition, the two assessment modes showed a high correlation ( r = .71) with heterogeneity at the item level. Three items showed significant deviations (Item 4: “bathing/showering”, p adj = 0.007, d = 0.36; Item 10: “answer telephone”, p adj = 0.005, d = 0.34; Item 14: “uneven ground” p adj = 0.015, d = 0.32). Age was significantly associated with mode-related score differences ( B = -0.326, 95% CI [-0.58, -0.07], p = .013). Conclusion The telephone FES-I may be suitable for group-level comparisons and large-scale screenings. However, the interchangeability of telephone and face-to-face interview for individual clinical use remains uncertain. Since telephone assessment was always performed first and the time interval between assessments varied, the observed differences cannot be attributed to administration mode alone. Further studies specifically designed to compare administration modes are needed. Trial registration German Clinical Trials Register (DRKS00029171), registered 22 July 2022.

Background Remote methods may help older adults improve their physical function, but understanding the perspectives of experts who deliver this care is critical. This modified Delphi process aimed to develop expert consensus on effectiveness, feasibility and implementation of remote assessment and management of physical function in older adults. Methods This online Delphi process included experts involved in supporting older adults to maintain or improve their health. The Round 1 survey presented 33 Delphi statements assessed using an 11-point Likert scale (0-10; ≥7 indicated agreement). Statements with strong (≥80%), moderate (50-<80%) and low (<50%) agreement were accepted, revised, or rejected, respectively. Revised statements were presented in Round 2, and accepted statements were consolidated into key messages. Results In total, 108 respondents (67% female; mean [SD] age 41.4 [10.9] years) from 16 countries (five continents) completed Round 1. Fourteen statements were accepted (88-100% agreement) and 10 were rejected (8-39% agreement). The remaining nine statements (52-69% agreement) were revised, and two new statements were developed for Round 2, which was completed by 89 (82%) respondents. Five Round 2 statements were accepted (82-93% agreement). Seven key messages were developed from 19 accepted statements, highlighting that remote care should be accessible to older adults with requisite capabilities, is feasible for older adults and health professionals with adequate support and training, and requires guidelines, policies, and further research to support wider adoption. Conclusions The findings of this Delphi process can inform the implementation of remote care approaches for assessing and managing physical function in older adults.

BACKGROUND:Obesity in older persons may increase the risk of falls, but this relationship may vary depending on body composition and cultural behaviors, which may vary across regions and ethnic groups. This study aims to explore the differences in the association between increased BMI and falls among Asian and Caucasian populations, using data from the Malaysian Elders Longitudinal Research (MELoR), the Bavarian Research Association-Sarcopenia and Osteoporosis (FORMOsA) and the 3rd Health Check for European Prospective Investigation of Cancer-Norfolk (EPIC-NORFOLK) studies. METHODS:We analyzed baseline data from the MELoR, FORMOsA, and EPIC-NORFOLK cohorts, focusing on older women aged ≥65 years (MELoR), ≥70 years (FORMOsA), and ≥55 years (EPIC-NORFOLK). We assessed body mass index (BMI), body composition, fall risk, and physical performance (gait speed, handgrip strength) to explore the relationship between BMI and falls, conducting cross-country and ethnic subgroup analyses. Statistical analysis was performed using multivariable logistic regression to controlling for confounding factors. RESULTS:A total of 10,265 participants aged 55 and over were eligible to be included. The prevalence of people with falls was higher in FORMOsA (54.4%) compared to both MELoR (22.5%) and EPIC-NORFOLK (26.9%) cohorts. It found significant differences in age, gender, BMI, body fat, and fall prevalence across the three cohorts. BMI was significantly associated with fall risk in both the MELoR and FORMOsA studies, but not the EPIC-NORFOLK study. The relationship between BMI and falls remained unchanged after adjustment for age, gender, marital status, education level, smoking status, number of medications and medical comorbidities. CONCLUSION:Intercontinental and international variations were observed in the relationship between BMI and falls among adults aged 55 and older. While higher BMI was linked to increased fall risk in some populations, these associations varied by body composition and country, suggesting the need for culturally tailored fall prevention strategies among older persons.

Concerns about falling (CaF) are common in older adults and are associated with increased falls. Although cautious gait—a gait pattern linked to CaF—has been described, the specific gait parameters most strongly associated with CaF remain unclear. This study investigates the association between gait characteristics at normal and maximal gait speed and CaF in community-dwelling older adults. This cross-sectional analysis merged data from two studies including participants aged 65 years and older: the FEARFALL-study, an intervention study to reduce CaF and improving walking stability, and from the MOGA-study, investigating the harmonization of supervised short-walk test protocols. Gait analysis was performed using an instrumented walkway and CaF was assessed by the Falls Efficacy Scale International (FES-I). Multiple stepwise regression models were used to explore the association of gait parameters with CaF and the associations of individual FES-I items with gait speed. Data from 261 participants (MOGA-study n = 150; FEARFALL-study n = 111; mean age 80.0 (± 4.6) years; 67% women) were analysed. Increasing FES-I levels were associated with decreasing walking performance across most gait parameters. Normal walking speed explained 24.9% of the variance in FES-I increasing to 29.2% by adding maximum gait speed and walk ratio. Four FES-I items dedicated to dynamic balance could be used to screen for cautious gait (adjusted R2 = .201). Gait variables, especially gait speed, are strongly associated with CaF. FES-I items related to dynamic balance might be used to screen for cautious gait in community-dwelling older adults.

Introduction:Concerns about falling (CaF) are common in older adults and may act as a chronic stressor affecting physical activity, psychological well-being and physiological regulation. This study examined the impact of a 16-week multimodal exercise intervention on CaF, stress pathways, and peripheral inflammation in older adults. Methods:In the randomized, controlled FEARFALL study, 160 community-dwelling older adults (aged ≥70 years) were assigned to either an intervention group (IG) or a sham control group (SCG). The IG received a multimodal exercise program, while the SCG engaged in low-intensity activities. Three psychological questionnaires were used to assess CaF: Falls Efficacy Scale-International [FES-I] (fear of falling); Falls Efficacy Scale-International Avoidance Behavior [FES-IAB] (avoidance behavior); Updated Perceived Control of Falling Scale [UP-CoF] (perceived control). Hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) activity was determined using saliva samples (cortisol, alpha-amylase), inflammatory markers using blood samples (C-reactive protein [CRP], Interleukin 6 [IL-6]). Results:There were significant improvements in CaF over time and perceived control in both groups (FES-I: β = -6.645, 95 %-CI [-10.56, -2.73], p = .001; UP-CoF: β = 3.911, 95 %-CI [1.24, 6.58], p = .004). Diurnal cortisol slope normalized after the intervention (β = -0.014, 95 %-CI [-0.03, 0.00], p = .014), while other neuroendocrine and inflammatory markers remained unchanged. Conclusion:A multimodal short-term intervention reduced psychological aspects of CaF, while physiological stress and inflammatory parameters may require more intensive or longer-term interventions. Findings support CaF as a biopsychosocial stressor and highlight the efficacy of multimodal programs in enhancing coping in older adults.

INTRODUCTION:Falls among older adults are frequent and will remain a health concern. We describe fall characteristics among older adults living independently in the community based on location, severity, and sex. METHODS:As part of the SCOPE study, fall occurrence, location, causes, circumstances, and consequences were reported by 1,754 community-dwelling older adults across Europe at baseline (F0), 12-month follow-up (FU12), and 24-month follow-up (FU24). A geriatric assessment that included demographics, clinical and medication assessment, depression, Cumulative Illness Rating Scale, blood and urine examination, hand grip strength, and fear of falling was performed. Falls characteristics were described, and a multivariate logistic regression analysis was performed to examine the probability of being severely injured because of a fall, inside or outdoors. RESULTS:Data on falls revealed 938 falls at baseline, 773 falls at FU12, and 797 falls at FU24. Approximately 70% of these falls resulted in no injury or untreated injuries, while 8.5% led to bone fractures. Most falls (54.8%) occurred outdoors, primarily during ambulation (64.6%). About 50% of the falls were due to trips, slips, or bumping into objects, while 20.3% were due to balance and gait impairments. Women experienced falls about 30% more frequently than men. CONCLUSIONS:Our findings offer new insights into the patterns of falls by location, sex, and injury type. This may help suggest ways of preventing falls. It is reasonable to recommend that older adults train their balance and specifically balance reactive responses to a situation whenever balance is lost accidently and unexpectedly.

Concerns about falling (CaF) in older adults are associated with decreased activity and negative health outcomes. The aim of this study was to examine associations between CaF, stress system activity, and low-grade inflammation in community-dwelling older adults. In the randomized-controlled FEARFALL study, N = 160 older adults (≥70 years) were enrolled (mean age: 79.5; 73.8 % women); data from 102 were analyzed. The Falls Efficacy Scale-International (FES-I), the FES-I Avoidance Behavior (FES-IAB) and Updated Perceived Control over Falling Scale (UP-CoF) were used to assess CaF. Saliva samples were analyzed to determine stress system activity (cortisol, alpha-amylase). Inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6]) were determined in blood. A higher UP-CoF score was significantly associated with higher individual cortisol values (β = 0.01, 95 %-CI [0.00, 0.01], p = .047) and was marginally associated with a steeper diurnal cortisol decline (p = .059). No significant associations were found between CaF and alpha-amylase or its parameters (AAR, slope, AUCg). IL-6 was significantly associated with age (β = 0.01, 95 %-CI [0.00, 0.01], p = .019) and BMI (β = 0.27, 95 %-CI [0.00, 0.02], p = .004), while CRP also showed a significant association with BMI (β = 0.01, 95 %-CI [0.00, 0.02], p = .004). There were no significant associations between CaF and inflammatory markers. Perceived control over falls is associated with physiological cortisol dynamics and may play a role in regulating the stress system activity in older adults. These findings show that psychological factors, such as perceived control, may influence stress regulation in older adults.

One possibility for maintaining mobility in older age is cycling. We investigated the impact of the multicomponent “ Safer Cycling in Older Age” (SiFAr) intervention on psychological and physiological stress. Participants were 98 community-dwelling older adults (73.4 ± 5.4 years). Bedtime cortisol, hair cortisol concentrations, and C-reactive protein were measured before and after the 8-week SiFAr intervention and at follow-up. Additionally, acute stress responses were assessed during the second and seventh training sessions using salivary alpha-amylase and cortisol assessments. We found a decrease in acute perceived stress, anxiety, fear of falling, and uncertainty during the cycling trainings. Moreover, long-term perceived stress significantly decreased. No significant changes were found for any of the physiological stress measures. We conclude that cycling had a positive impact on perceived stress and wellbeing. Further research with more intense trainings is needed to fully understand the associations between cycling in older age and physiological stress.

Sarcopenia, characterized by decreased skeletal muscle mass and strength, is classified as "primary" (due to aging) or "secondary" (due to diseases). MicroRNA-22-3p (miR-22) regulates muscle differentiation and function. We assessed the diagnostic value of circulating miR-22 levels in patients with primary and secondary sarcopenia. miR-22 levels were evaluated in 61 older adults from the "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) study and in 176 heart failure (HF) patients from the "Studies Investigating Co-morbidities Aggravating HF" (SICA-HF). miR-22 expression profile was measured in serum by miR-specific TaqMan quantitative real-time PCR. In SPRINTT, 33 participants (54.1%) had primary sarcopenia. Subjects with primary sarcopenia had slower gait speed (0.7 [0.6-0.8] vs. 0.8 [0.7-1.0] m/s; p < 0.001) than those without sarcopenia. Multivariate analysis showed miR-22 as an independent predictor of sarcopenia (adjusted OR 3.087, 95% CI 1.441-6.611, p = 0.004). In SICA-HF, 28 patients (15.9%) had secondary sarcopenia. Sarcopenic HF patients were older (74.5 [68.7-80.2] vs. 68.4 [60.9-74.8] years; p = 0.001), had lower left ventricular ejection fraction (31.1 [26.2-47.5] vs. 40.0 [30.0-55.0] %; p = 0.025), lower handgrip strength (31.1 ± 6.0 vs. 37.0 ± 13.0 kg; p = 0.016) and lower absolute peak oxygen uptake (1181.3 ± 379.5 vs. 1593.0 ± 487.0 mL/min; p < 0.001) compared with those without sarcopenia. Multivariate logistic regression analysis showed miR-22 as significantly associated with sarcopenia in HF patients (adjusted OR 0.409, 95% CI 0.193-0.867, p = 0.020). miR-22 levels are significantly associated with both primary and secondary sarcopenia, suggesting its potential as a novel epigenetic biomarker of skeletal muscle dysfunction.

Introduction:The shape of the oral glucose tolerance test (OGTT) curve is an early predictor of metabolic disturbances. In this study, we analyzed which parameters are associated with different OGTT-curve shapes (CS) in healthy middle-aged and older adults. Methods:In the cross-sectional Enable Study, 354 participants were comprehensively phenotyped. Based on a 2-hour OGTT, CS was classified according to the presence (polyphasic) or absence (monophasic, mp) of a rise in plasma glucose of more than 4.5 mg/dL after the first decline of the plasma glucose level. Associations between CS and age, sex, anthropometric, metabolic, and inflammatory parameters were analyzed by binomial logistic regression. Results:Curve shape was mp in 77.4% of the participants without age group difference, but a higher frequency was observed in men (89.3%) compared to women (65.5%, P < .001). The odds of mp CS increased with higher fasting GLP-1 (odds ratio [OR], 1.066; 95% CI, 1.006-1.133; P < .05) and 1-hour plasma glucose (OR, 1.054; 95% CI, 1.037-1.072; P < .001) and lower 2-hour plasma glucose (OR, 0.975; 95% CI, 0.959-0.992; P < .01). Conclusion:In healthy adults, mp CS was widespread and associated with more unfavorable metabolic parameters. A higher fasting GLP-1 level was associated with an mp CS.

The present study aimed to determine the acute effects of high-intensity dynamic resistance training (HI-DRT) and whole-body electromyostimulation (WB-EMS) on markers of bone formation and resorption in young healthy women. Using a crossover design, 17 students of dentistry (26.5 ± 4.0 years, 21.5 ± 2.5 kg/m2) were randomly assigned to begin either with HI-DRT (five exercises, three sets to repetition maximum) or 20 min of non-superimposed, low-frequency (85 Hz), intermitted (6 s impulse/4 s impulse break) WB-EMS. The study outcome parameters were total Procollagen Type-1 N-Terminal Propeptide (P1NP) and Type-I Collagen Cross-Linked C-Telopeptide (CTX), which were sampled immediately prior to and 15 min post intervention. ANCOVA was applied to determine the main effects, i.e., differences in pre–post changes in CTX and P1NP between the interventions. No participant was lost to follow-up or reported adverse effects related to the exercises. Briefly, we observed significant differences (p = 0.019, d′ = 1.19) for changes in P1NP that were maintained in the HI-DRT (p = 0.446) and decreased in the WB-EMS group (p = 0.002). In contrast, we did not observe differences for HI-DRT- vs. WB-EMS-induced CTX changes (p = 0.509; d′ = 0.134). In summary, while HI-DRT provides significantly more favorable effects on bone formation markers compared to WB-EMS, the clinical significance of this finding in predicting the general effectiveness of an exercise protocol on bone strength remains to be determined. (Clinical trials.gov; registration date: 2025-02-06; ID: NCT06813092.)

Abstract Background Maintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function. Methods In this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale—International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up. Discussion This study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia. Trial registration German Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022.

INTRODUCTION:Sarcopenia, heart failure (HF), and chronic kidney disease (CKD) are common among the older people. Our objective was to evaluate the frequency of sarcopenia, among community-dwelling older adults with HF, possible causative factors, and the additive factor of CKD. METHODS:A cross-sectional analysis of 1,420 older people living in the community was carried out. Participants (aged 75 years and more) came from a European multicenter prospective cohort (SCOPE study). Global geriatric assessment including short physical performance battery, handgrip strength test, and bioelectrical impedance analysis was performed. Previous known HF was defined as physician-diagnosed HF registered in the patient's medical record or the use of HF-related medications, regardless of left ventricular ejection fraction (LVEF). Sarcopenia was defined by the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Estimated glomerular filtration rate was calculated using Berlin Initiative Study (BIS) to define the stages of CKD. Two-year mortality was also collected. RESULTS:A total of 226 (15.9%) participants had a prior chronic HF diagnosis, with a median age of 80.0 (5.0), and 123 (54.4%) were women. Using EWGSOP2 definition, 11.5% HF and 10.7% in non-HF participants met diagnostic criteria for sarcopenia. In multivariate analyses, only a lower body mass index (BMI) (odds ratios [OR], 0.82; 95% confidence interval [CI], 0.73-0.93) and lower short physical performance battery score (OR, 0.81; 95% CI, 0.69-0.96) were associated with sarcopenia. Patients with HF and sarcopenia have a similar all-cause mortality risk but higher 2-year cardiovascular mortality risk (p = 0.047). DISCUSSION/CONCLUSION:One out of ten community-dwelling older adults with concurrent clinical stable chronic HF, without considering LVEF, have sarcopenia. Lower BMI and poor physical performance are associated with sarcopenia in this population, but not CKD.