[This corrects the article DOI: 10.1016/j.csbj.2025.07.004.].

In 2019, climate change and air pollution in combination with non-communicable diseases were the two top threats to health, with 70% of non-communicable diseases caused by air pollution and affecting the lungs. Chronic respiratory disease (CRD) thus was placed fourth as a global cause for mortality in 2021. While physical activity is the most efficient and cost-effective tool to manage CRDs through reduction in the risk of hospital admissions, all-cause mortality, and increases in the quality of life (Garcia-Aymerich et al. 2006; Schrempft et al., 2019), two critical research gaps hinder the optimal integration of physical activity into the management of CRDs. First, the interaction between physical activity and air-pollution, and their downstream health effects are still largely unknown. When exposed to both concomitantly, the inhaled volume of pollutants is increased, thus physical activity could catalyze the risks from air pollution. Second, sex- and gender-based differences in the phenotypes of CRD and physical activity behaviors exist. Women report lower quality of life, more severe feelings of breathlessness and cough, and participate in less physical activity than men (Clougherty., 2010). The objective of INCLUDE is thus to comprehensively study the effects and implications of sex and gender on the combined effects of physical activity and air pollution exposure in older individuals with and without CRD. Methodologically, the project is multi-centric, where 180 participants over the age of 60, both sexes, and broad gender characteristics will participate in the study in either Basel, Zurich, or Barcelona (60 participants at each site). We will identify how sex and gender affect physical activity experiences and responses (1) qualitatively though semi-structured interviews; (2) quantitatively through real-world walking in higher and lower air pollution wherein cardiopulmonary responses and gait characteristics will be measured with field-based and wearable devices; and (3) with an advisory board. The expected results and impact of the INCLUDE project are to understand and quantify how sex and gender affect acute and long-term respiratory health when older individuals are concomitantly exposed to both air pollution and physical activity. Our mixed-methods research approach in combination with our advisory board will guide urban planning, policy, clinicians, and future research. References: Clougherty, J. E. (2010). A growing role for gender analysis in air pollution epidemiology. Environmental Health Perspectives, 118(2), 167–176. https://doi.org/10.1289/ehp.0900994 Garcia-Aymerich, J., Lange, P., Benet, M., Schnohr, P., & Antó, J. M. (2006). Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: A population based cohort study. Thorax, 61(9), 772–778. https://doi.org/10.1136/thx.2006.060145 Schrempft, S., Jackowska, M., Hamer, M., & Steptoe, A. (2019). Associations between social isolation, loneliness, and objective physical activity in older men and women. BMC Public Health, 19(1), 74. https://doi.org/10.1186/s12889-019-6424-y

BackgroundMeasurements of blood sphingolipids have previously been shown to predict cardiometabolic risk beyond traditional biomarkers. However, before these scores can be implemented in clinical practice, it is essential to establish lifespan trajectories and age- and sex-specific values for sphingolipid levels. This cross-sectional study aimed to characterise sphingolipid levels in clinically healthy individuals across the lifespan.MethodsSerum sphingolipids from 522 clinically healthy individuals aged 20 to 91 of the COmPLETE-Health study (48% females) were quantified using targeted liquid chromatography-tandem mass spectrometry. Associations between sphingolipids and age were assessed using multiple linear regressions adjusted for sex, cardiorespiratory fitness, and other confounding variables. Descriptive age- and sex-specific sphingolipid quantile curves were modelled using generalised additive models for location, scale, and shape.ResultsFourteen of the 21 detected sphingolipids were significantly and positively associated with age in both sexes. Notably, all four sphingolipids included in the Cardiovascular Event Risk Tests (Cer16:0, Cer18:0, Cer24:0, and Cer24:1) increased with age, whereas their respective ratios were not significantly associated with age. Females exhibited significantly higher levels than males for four sphingomyelins, two ceramides, HexCer18:0, and the Cer16:0/Cer24:0 ratio. Age- and sex-specific values across the lifespan (20 to 90 years) are provided as percentiles. Associations between cardiorespiratory fitness and sphingolipid levels varied by species.ConclusionsSerum sphingolipid levels depended on age, underscoring the need for age-specific interpretation when assessing cardiometabolic risk using sphingolipid-based scores. Conversely, sphingolipid ratios remained unaffected by age.

Physical activity is a cornerstone of health for older adults. Recent evidence underscores that even regular light activity, such as routine walking, offers substantial health benefits. Traditional approaches to promoting walking often overlook the importance of the local neighbourhood environment and the wide range of abilities and preferences of older adults. A personalised walking intervention – emphasizing personal preferences and local facilitators by employing Geographic information System (GIS)-based methods for communication and goal setting – might help to overcome problems of low long-term adherence to walking interventions. The MOBITEC-Routes trial aims to assess the effects of personalised, GIS-based walking promotion – versus general information on determinants of health – for mobility-limited and chronically ill older adults on walking (primary outcome) immediately after the 15-week intervention period (primary endpoint) and after another 8 months of follow-up (secondary endpoint). This prospective, two-arm, single centre randomised controlled trial targets sedentary, mobility-limited, chronically ill, and community-living older adults aged 65 + (target N = 130). Outcomes are assessed after 15 weeks of intervention and after an additional 8 months of follow-up. The experimental intervention offers personalised promotion of habitual walking, delivered by an exercise professional in face-to-face and telephone sessions. Opportunities to increase leisure as well as utilitarian walking are identified by using interactive digital maps, personalised walking routes are co-created by the exercise professional and the participant, and a personalised activity plan is developed. Behaviour change strategies are employed. The control group receives general information on determinants of health. Outcomes include walking (average steps per day; primary outcome), time spent lying, sitting, standing and stepping, physical function, life-space mobility, health-related quality of life, fall-related self-efficacy, active aging, as well as constructs of the Health Action Process Approach (HAPA) model (secondary outcomes). Effects will be analysed by analysis of covariance (ANCOVA; primary analysis intention-to-treat, complemented by per-protocol). By incorporating personal preferences and the neighbourhood environment, this intervention aims to promote walking as a sustainable and meaningful part of everyday life for mobility-limited and chronically ill older adults. If the personalised GIS-based approach is successful, it could be seamlessly integrated into preventive healthcare strategies. ISRCTN17473086 (Registration date 22/11/2024).

Left atrial (LA) function contributes essentially to left ventricular filling. LA function and exercise capacity decline with age. This study aimed to determine whether age-related changes in LA function contribute to the observed age-related decline in exercise capacity. This cross-sectional study analysed 231 healthy participants (age range 50–89, mean 67.9, SD 10.7 years, approximately 50% females in each decade) from the COmPLETE-Health cohort. Participants were free of exercise-limiting conditions, never smoked or had not smoked for at least 10 years, had no diabetes, blood pressure <160/100 mmHg and body mass index <30 kg/m2. Exercise capacity was determined using peak oxygen uptake (VO2peak) during cardiopulmonary exercise testing. LA function was assessed through speckle-tracing transthoracic echocardiography, measuring LA reservoir strain (LASr), conduit strain (LAScd) and contraction strain (LASct). Early diastolic peak mitral inflow velocity (E) and early diastolic peak mitral annular velocity (e') were obtained using pulsed-wave and tissue Doppler imaging, respectively. LA stiffness was calculated as E/e'/LASr. Multiple linear regression models were fitted for all LA functional parameters and analysed with ANOVA. Uncertainty due to missing data was accounted for by multiple imputation. LASr (F(3; 219) = 4.62, p = 0.004) and LAScd (F(3; 219) = 25.00, p < 0.0001) decreased with age, whereas LASct increased with age (F(3; 219) = 5.79, p = 0.0008). LA stiffness also increased with age (F(3; 213.8) = 14.06, p < 0.0001). Of all assessed parameters, only LA stiffness was inversely related with VO2peak, independent of age (F(3; 198.6) = 3.19, p = 0.024). In healthy middle-aged to elderly adults, increased LA stiffness was associated with decreased aerobic exercise capacity, independent of age; suggesting that LA stiffness may play a contributory role in the age-related decline of exercise capacity.

To investigate whether quantifying both the absolute and relative intensity of physical activity (PA) improves understanding of age, sex, and occupation-related differences in PA in healthy adults aged 20–89. In the cross-sectional COmPLETE study, participants (N = 460, 48

Introduction:Sphingolipids and ceramides have been identified as critical drivers of cardiometabolic diseases. Ceramide-based scores were developed, predicting cardiometabolic risk independently of and beyond low-density lipoprotein cholesterol. To date, it remains largely unknown whether exercise can modulate sphingolipid levels. Methods:The SphingoHIIT study was the first parallel randomized controlled trial to investigate the impact of a single session of high-intensity interval training (HIIT; 4 ×4 min at 85-95 % of maximal heart rate) on blood sphingolipid levels. Thirty-six healthy young individuals (aged 20-29 years; 50 % female) were randomly assigned to a HIIT (n = 18) or control group (physical rest, n = 18). Sphingolipid levels were measured from dried blood spots collected over three days before and at five time points after the intervention (2, 15, 30, 60 min, and 24 h). Study conditions were tightly controlled: females were tested during the early follicular phase of their menstrual cycle, and standardized meals were provided for four consecutive days before blood sampling. Results:Forty-seven sphingolipid species were acquired, including 25 ceramides, eight glycosphingolipids, eight sphingomyelins, and six sphingoid bases. After adjusting for sex, body fat mass, cardiorespiratory fitness, and daily physical activity, linear mixed models showed no significant differences in sphingolipid levels between the HIIT and control groups at any post-intervention time point. Conclusion:The present findings suggest that circulating sphingolipids are resilient to an acute bout of intensive exercise, an interesting feature for potential biomarkers of cardiometabolic risk. Future studies should investigate whether regular exercise influences sphingolipid levels and improves cardiometabolic health in different clinical populations.

Introduction Evidence indicates that sphingolipid accumulation drives complex molecular alterations promoting cardiometabolic diseases. Clinically, it was shown that sphingolipids predict cardiometabolic risk independently of and beyond traditional biomarkers such as low-density lipoprotein cholesterol. To date, little is known about therapeutic modalities to lower sphingolipid levels. Exercise, a powerful means to prevent and treat cardiometabolic diseases, is a promising modality to mitigate sphingolipid levels in a cost-effective, safe, and patient-empowering manner. Methods This randomised controlled trial will explore whether and to what extent an 8-week fitness-enhancing training programme can lower serum sphingolipid levels of middle-aged adults at elevated cardiometabolic risk (n = 98, 50% females). The exercise intervention will consist of supervised high-intensity interval training (three sessions weekly), while the control group will receive physical activity counselling based on current guidelines. Blood will be sampled early in the morning in a fasted state before and after the 8-week programme. Participants will be provided with individualised, pre-packaged meals for the two days preceding blood sampling to minimise potential confounding. An ’omic-scale sphingolipid profiling, using high-coverage reversed-phase liquid chromatography coupled to tandem mass spectrometry, will be applied to capture the circulating sphingolipidome. Maximal cardiopulmonary exercise tests will be performed before and after the 8-week programme to assess patient fitness changes. Cholesterol, triglycerides, glycated haemoglobin, the homeostatic model assessment for insulin resistance, static retinal vessel analysis, flow-mediated dilatation, and strain analysis of the heart cavities will also be assessed pre- and post-intervention. This study shall inform whether and to what extent exercise can be used as an evidence-based treatment to lower circulating sphingolipid levels. Trial registration The trial was registered on www.clinicaltrials.gov (NCT06024291) on August 28, 2023.

IntroductionPhysical activity and exercise are crucial to counteract physical and cognitive decline in old age. Home-based exergame training can be a solution to overcome physical inactivity. This systematic review aims to provide a comprehensive overview of home-based exergame interventions and evaluate their effectiveness in improving cognitive and physical functions through physical activity enhancement in older adults.Methods and analysisWe are conducting a systematic literature search including studies examining (1) community-dwelling older adults aged 60 years and older without any specific disease, (2) exergame-based exercise programs that take place at least partially in a home setting, and (3) intervention-related physical and/or cognitive outcomes. We will include randomized controlled trials and any other type of pre-post study published in English. There are no restrictions in terms of control group type and publication date. A search string was created and used in PubMed, Web of Science, Embase, Scopus and CINAHL. In addition, a hand search is carried out. This involves checking the references of the included studies and searching Google Scholar for further studies. The included studies will be summarized and, if homogeneity is sufficient, a random-effects meta-analysis will be performed. We will assess the risk of bias using RoB 2.0 and ROBINS-I.ConclusionThe findings of this systematic review will help to define the most suitable exergame programs to counteract cognitive and physical decline in older adults. Additionally, they will inform the development of effective home-based exergame systems and point to future pathways of digital rehabilitation in older adults.RegistrationProspero (ID: CRD42023374234).

Aims To investigate how physical activity (PA) volume, intensity, duration, and fragmentation are associated with the risk of all-cause and cardiovascular disease mortality. To produce centile curves for PA volume and intensity representative of US adults.Methods and results This study is based on the observational 2011-2014 National Health and Nutrition Examination Survey (NHANES). Adults (age, >= 20) with valid accelerometer, covariate, and mortality data were included. Average acceleration (AvAcc), intensity gradient (IG), and total PA served as proxies for volume, intensity, and duration of PA, respectively. Weighted Cox proportional hazard models estimated associations between outcome and PA metrics. In 7518 participants (52.0% women, weighted median age of 49), there were curvilinear inverse dose-response relationships of all-cause mortality risk (81-month follow-up) with both AvAcc [-14.4% (95% CI, -8.3 to -20.1%) risk reduction from 25th to 50th percentile] and IG [-37.1% (95% CI, -30.0 to -43.4%) risk reduction from 25th to 50th percentile], but for cardiovascular disease (CVD) mortality risk (n = 7016, 82-month follow-up) only with IG [-41.0% (95% CI, -26.7 to -52.4%) risk reduction from the 25th to 50th percentile]. These relationships plateau at AvAcc: similar to 35-45 mg and IG: -2.7 to -2.5. Associations of PA with all-cause and cardiovascular disease mortality are primarily driven by intensity and secondary by volume. Centile curves for volume and intensity were generated.Conclusion Intensity is a main driver of reduced mortality risk suggesting that the intensity of PA rather than the quantity matters for longevity. The centile curves offer guidance for achieving desirable PA levels for longevity. This study shows that the distribution of the intensity of physical activity accumulated across the day may be more important for mortality reduction than the quantity (volume), underscoring the relevance of integrating physical activity of higher intensity into daily routines for health optimization. Higher physical activity intensity is more closely associated with reduced mortality risk than physical activity volume, particularly for cardiovascular disease mortality.We provide initial evidence suggesting health benefits when accumulating intense physical activity in continuous bouts rather than sporadically across the day. Graphical Abstract

Abstract Background The University of Jyvaskyla Active Aging Scale (UJACAS) assesses active aging through willingness, ability, opportunity, and frequency of involvement in activities. Recognizing the lack of a German version, the Finnish original was translated (UJACAS-G). This study aimed: (1) to evaluate the test-retest reliability of UJACAS-G; and (2) to explore correlations with health-related parameters (concurrent validity). Methods The study (test-retest design) targeted healthy older adults aged 65+. Reliability of UJACAS-G (total and subscores) was assessed using Bland-Altman analyses and Intraclass Correlation Coefficients (ICCs). Furthermore, correlations (Spearman’s rho) between UJACAS-G scores and physical function (walking speed, handgrip strength, balance, 6-minute walk distance), physical activity (International Physical Activity Questionnaire), life-space mobility (Life-Space Assessment), and health-related quality of life (Short Form-36 Health Survey) were calculated. Results Bland-Altman analyses (N = 60; mean age 72.3, SD 5.9 years; 50% women) revealed mean differences close to zero and narrow limits of agreement for all scores (total score: mean difference −1.9; limits −31.7 to 27.9). The ability subscore showed clustering at its upper limit. ICC was 0.829 (95% CI 0.730 to 0.894) for the total score and ranged between 0.530 and 0.876 for subscores (all p-values < 0.001). The total score correlated with walking speed (rho = 0.345; p = 0.008), physical activity (rho = 0.279; p = 0.033) and mental health (rho = 0.329; p = 0.010). Conclusions UJACAS-G is reliable for assessing active aging among German-speaking healthy older adults. A potential ‘ceiling effect’ regarding the ability subscore should be considered when applying UJACAS-G to well-functioning populations. Analyses of concurrent validity indicated only weak correlations with health-related parameters.

Coronary artery disease (CAD) remains a leading cause of death worldwide and imposes a substantial socioeconomic burden on healthcare. Improving risk stratification in clinical practice could help to combat this burden. As amino acids are biologically active metabolites whose involvement in CAD remains largely unknown, this study investigated associations between circulating amino acid levels and CAD phenotypes. A high-coverage quantitative liquid chromatography-mass spectrometry approach was applied to acquire the serum amino acids profile of age- and sex-coarsened-matched patients with CAD (n = 46, 66.9 years, 74.7% male) and healthy individuals (n = 120, 67.4 years, 74.7% male) from the COmPLETE study. Multiple linear regressions were performed to investigate associations between amino acid levels and (a) the health status (CAD vs. healthy), (b) the number of affected coronary arteries, or (c) the left ventricular ejection fraction. Regressions were adjusted for age, sex, daily physical activity, sampling, and fasting time. Urea cycle amino acids (ornithine, citrulline, homocitrulline, aspartate, and arginine) were significantly and negatively associated with CAD, the number of affected coronary arteries, and the left ventricular ejection fraction. Lysine, histidine, and the glutamine/glutamate ratio were also significantly and negatively associated with the CAD phenotypes. Overall, patients with CAD displayed lower levels of urea cycle amino acids, highlighting a potential role for urea cycle amino acid profiling in cardiovascular risk stratification.Trial registrationThe study was registered on https://www.clinicaltrials.gov (NCT03986892) on June 5, 2019.

Background:Patients recovering from COVID-19 often present with impaired health and persisting symptoms such as exercise intolerance ⩾3 months post-infection. Uncertainty remains about long-term recovery. We aimed to review studies examining cardiac function, macro- or microvascular function, blood biomarkers and physical activity in adult patients post-COVID-19 and highlight current knowledge gaps. Results:Using echocardiography, persistent cardiac involvement of the left ventricle was observed in a fraction of patients both hospitalized and non-hospitalized. Ventricular dysfunction was often subclinical but may partly contribute to exercise intolerance post-COVID-19. Endothelial dysfunction was seen on micro- and macrovascular levels using retinal vessel imaging methods and brachial artery flow-mediated dilation, respectively. Studies reporting blood biomarkers of disease-specific impairment and endothelial dysfunction yielded upregulated inflammation, hypercoagulability, organ and endothelial damage up to several months after infection. Omics' scale lipid profiling studies provide preliminary evidence of alterations in several lipid subspecies, mostly during acute COVID-19, which might contribute to subsequent endothelial and cardiometabolic dysfunction. Yet, more robust evidence is warranted. Physical activity may be reduced up to 6 months post-COVID-19. However, studies measuring physical activity more precisely using accelerometry are sparse. Overall, there is growing evidence for long-term multiple organ dysfunction. Conclusion:Research combining all the above methods in the search for underlying mechanisms of post-COVID-19 symptoms is mostly missing. Moreover, studies with longer follow-ups (i.e. ⩾18 months) and well-matched control groups are lacking. The findings may aid the development of rehabilitation regimes for post-COVID-19 syndrome. Condensed abstract:This review examined cardiac function, vascular function, blood biomarkers and physical activity in patients post-COVID-19. Evidence suggests long-term dysfunction in multiple organ systems and exercise intolerance due to various factors, including endothelial damage and, in some patients, subclinical ventricular dysfunction. We highlight knowledge gaps for further research to aid post-COVID-19 rehabilitation.

PURPOSE:Lower extremity physical function (LEPF) is a key component for mobility and is impacted in stroke-related disability. A reduction in LEPF can have a significant impact on an individual's Quality of Life (QoL). The aim of this study is to characterise the relationship between LEPF and QoL. METHODS:The MOBITEC-Stroke Study is a longitudinal cohort-study including patients with their first occurrence of ischaemic stroke. Using a linear mixed-effects model, the relationship between LEPF (timed up-and-go performance (TUG); predictor) and QoL (Stroke Specific Quality of Life scale (SS-QoL); outcome) at 3 and 12 months post stroke was investigated and adjusted for sex, age, Instrumental Activities of Daily Living (IADL), fear of falling (Falls Efficacy Scale-International Version, FES-I), and stroke severity (National Institute of Stroke Severity scale, NIHSS), accounting for the repeated measurements. RESULTS:Data of 51 patients (65 % males, 35% females) were analysed. The mean age was 71.1 (SD 10.4) years, median NIHSS score was 2.0. SS-QoL was 201.5 (SD 20.5) at 3 months and 204.2 (SD 17.4) at 12 months; the mean change was 2.7 (95% CI -2.4 to 7.7), p= 0.293. A positive association was found between baseline TUG performance (estimate log score -13.923; 95% CI -27.495 to -0.351; p=0.048) and change in SS-QoL score in multivariate regression analysis. CONCLUSION:Higher LEPF (i.e better TUG performance) at baseline, was associated with an improvement in QoL from 3- to 12-months post stroke. These results highlight the critical role of physical function, particularly baseline LEPF, in influencing the QoL of stroke survivors.

Background: Stroke often results in physical impairments. Physical activity is crucial for rehabilitation, enhancing mobility, strength, and overall health. This study examines the association between Timed Up-and-Go (TUG) test performance and changes in physical activity to improve lower extremity physical function. Methods: The MOBITEC-Stroke Cohort Study (“Recovery of mobility function and life-space mobility after ischemic stroke”) included patients with a first incidence of stroke. Data assessed 3 and 12 months after stroke were used for analysis. Linear regression model adjusted for age, sex, instrumental activities of daily living, Falls Efficacy Scale-International, modified Ranking Scale, and National Institutes of Health Stroke Scale-score was used to examine the relationship between lower extremity physical function (i.e., TUG) and change in physical activity (i.e., minutes of physical activity measured with a wrist-worn accelerometer over 1 week). Results: Longitudinal data of 49 patients (65% male, mean age 71.2 (SD: 10.4) years) were analyzed. Mean daily physical activity was 291.6 (SD: 96.2) min at 3 months and 298.9 (SD: 94.4) min at 12 months, with a change from 3 to 12 months of 7.3 min (95% CI: −9.4 to 24.0; p = 0.394) post-stroke. We observed significant relationships between the baseline TUG performance and the change in total physical activity over 9 months ( p = 0.011) and between the change of TUG performance over time and the change in total physical activity ( p = 0.022). Conclusion: Our findings indicate that better initial lower extremity physical function and higher improvements in function over time are associated with a greater increase in physical activity levels after stroke. This suggests that interventions aimed at maintaining and improving lower extremity physical function may positively affect physical activity levels.

Introduction: Arterial hypertension is a global healthcare burden that affects macrovascular and microvascular structure and function and can promote vascular end-organ damage. This study aimed 1) to evaluate differences in microvascular health between normotensive individuals and patients with arterial hypertension and 2) to assess the effects of short-term high-intensity interval training (HIIT) on microvascular health in the subgroup with arterial hypertension as add-on treatment to antihypertensive medication.Methods: In the cross-sectional part, central retinal arteriolar (CRAE) and venular diameter equivalent (CRVE), arteriolar-to-venular diameter ratio (AVR), and retinal oxygen saturation (O2-saturation) were investigated in 19 normotensive healthy controls (mean age 56 +/- 7 years) and 41 patients with arterial hypertension (mean age 59 +/- 7 years). In the subsequent randomized controlled trial (RCT), patients with arterial hypertension were randomized to an intervention group (HIIT 3x/week) or a control group that received standard physical activity recommendations after baseline assessment. Assessments of retinal vessel biomarkers and patients` characteristics were repeated after the intervention period of 8 weeks.Results: In the cross-sectional part, individuals with normal blood pressure (BP) showed lower body mass index (BMI), body fat, 24 h systolic and diastolic BP, higher peak oxygen uptake, wider CRAE (174 +/- 17 mu m vs. 161 +/- 17 mu m, p = 0.009), and higher AVR (0.84 +/- 0.05 vs. 0.79 +/- 0.05, p = 0.003) compared to patients with hypertension. In the RCT, patients with arterial hypertension showed reduced BMI and fasting glucose levels after HIIT and control condition. In addition, the intervention group reduced body fat percentage (27.0 +/- 5.5 vs. 25.8 +/- 6.1, p = 0.023) and increased peak oxygen uptake (33.3 +/- 5.7 vs. 36.7 +/- 5.1, p < 0.001). No changes in BP were found in either group. The intervention group showed narrower CRVE (beta-4.8 [95 % CI,-8.85,-0.81] p = 0.020) and higher AVR (0.03 [0.01, 0.04] p < 0.001) after eight weeks of HIIT compared to the control group. No statistically significant changes in retinal O2-saturation were found in either group.Conclusion: Short-term HIIT proved to be an effective treatment to ameliorate hypertension-induced retinal microvascular abnormalities in patients with hypertension. Retinal vessel diameters may prove to be a sensitive biomarker to quantify treatment efficacy at the microvascular level, at the earliest possible stage in patients with hypertension.

Background Gait changes with aging have been investigated, but few studies have examined a wide range of gait parameters across the adult lifespan. This study aimed to investigate gait differences across age groups stratified by sex. Methods This cross-sectional study included 629 healthy, normal-weight (i.e., BMI < 30 kg/m(2)) participants from Switzerland of the COmPLETE cohort study, aged 20 to over 90 years. Gait metrics were assessed using an inertial measurement unit (IMU)-based gait analysis system, including speed, cycle duration variability, asymmetry, stride length, cycle duration, cadence, double support, stance (time foot is on the ground during a gait cycle), swing (time foot is in the air during a gait cycle), loading (early part of the stance phase), foot-flat (mid-stance phase when foot is flat), and pushing (late stance phase leading to toe-off) phases. Percentile curves were calculated using generalized additive models for location, scale, and shape. Results Gait data from 545 participants (273 men and 272 women) were analyzed. Participants were equally distributed across the seven age decades, with an average of 40 men and 40 women representing every decade. Both men and women showed a reduction in gait speed and stride length, and an increase in cycle duration variability and asymmetry with aging. Gait speed and stride length declined across the age groups, with a significant difference found in participants aged 80 to 91 compared to younger age groups. Significance Age-related changes in gait parameters were seen in both men and women. These may be attributed to the typical decline in muscle strength, balance, coordination, and neuromuscular function. The results of this study contribute to the understanding of gait changes throughout the lifespan and can be used for comparison with other populations and as reference values for individual patients.

Introduction: Growing scientific evidence indicates that sphingolipids predict cardiometabolic risk, independently of and beyond traditional biomarkers such as low-density lipoprotein cholesterol. To date, it remains largely unknown if and how exercise, a simple, low-cost, and patient-empowering modality to optimise cardiometabolic health, influences sphingolipid levels. The SphingoHIIT study aims to assess the response of circulating sphingolipid species to a single session of high-intensity interval training (HIIT). Methods: This single-centre randomised controlled trial (RCT) will last 11 days per participant and aim to include 32 young and healthy individuals aged 20-29 (50% females). Participants will be randomly allocated to the HIIT (n= 16) or control groups (physical rest, n= 16). Participants will self-sample fasted dried blood spots for three consecutive days before the intervention (HIIT versus rest) to determine baseline sphingolipid levels. Dried blood spots will also be collected at five time points (2, 15, 30, 60min, and 24h) following the intervention (HIIT versus rest). To minimise the dietary influence, participants will receive a standardised diet for four days, starting 24 hours before the first dried blood sampling. For females, interventions will be timed to fall within the early follicular phase to minimise the menstrual cycle's influence on sphingolipid levels. Finally, physical activity will be monitored for the whole study duration using a wrist accelerometer. Ethics and dissemination: The Ethics Committee of Northwest and Central Switzerland approved this protocol (ID 2022–00513). Findings will be disseminated in scientific journals and meetings. Trial Registration The trial was registered on www.clinicaltrials.gov (NCT05390866, https://clinicaltrials.gov/ct2/show/NCT05390866) on May 25, 2022.

Abstract Background and Objectives Current definitions of older adults’ mobility do not cover the full range of influencing factors and do not consider nursing home residents. The present study reports expert ratings from a Delphi study regarding factors influencing the mobility of long-term nursing home residents. Research Design and Methods We invited 129 professionals with expertise in a field relevant to research on mobility in older adults such as health care, medicine, or human movement science to participate in a Delphi study comprising 3 rounds of online questionnaires. Up to 40 experts participated in each round. In the first round, we used open-ended questions to solicit possible definitions, contextual factors, and assessment tools. In the second round, the participants used Likert scales (1–10) to rate their suitability. In the final round, we presented a definition based on consensus as well as the top-rated contextual factors and assessment tools from the first 2 rounds for a final rating of agreement. Results The experts showed broad agreement on the final version of the mobility definition, with 8.9 ± 1.4 (mean ± standard deviation) out of 10 points. The experts also showed broad consensus on the selected contextual factors, with 8.4 ± 1.8 points to 8.9 ± 1.2 points (out of 10 points). This was also the case for the top 3 assessment tools selected from results of previous rounds, which showed an agreement of 7 or more points (out of 10 points) by 81.6% to 100% of all experts in the different categories. Discussion and Implications Given that an interdisciplinary group of experts considered various hitherto neglected contextual factors as relevant, the Delphi survey and its results imply the need for an updated interdisciplinary and holistic understanding of mobility in nursing home residents and can provide a basis for putting it into practice.