Ageing is associated with a decline in immune function termed immunosenescence. This process is characterized amongst others by less naive T-cells and more senescent phenotypes, which have been implicated in the pathogenesis of many age-related diseases. Thus far, reports regarding the long-term adaptation effects of exercise on T-cell phenotypes are scant and largely equivocal. These inconsistencies may be due to potential contributors to immunosenescence, particularly cytomegalovirus infection, which is considered a hallmark of T-cell senescence. Therefore, we sought to investigate the impact of cytomegalovirus serostatus on the distribution of peripheral T-cell subsets following long-term exercise in older women. One hundred women (aged 65 years and above) were randomized to 3 times/weekly training at either intensive strength training (3 × 10 repetitions at 80% of one-repetition maximum, n = 31), strength endurance training (2 × 30 repetitions at 40% of one-repetition maximum, n = 33), or control (passive stretching exercise, n = 36) for 6 weeks. All training sessions were supervised by trained instructors to minimize the risk of injury and to ensure that the participants adhered to the training protocol throughout the entire range of motion. The T-cell percentages and absolute blood counts were determined before and after 6 weeks (24 h–48 h after the last training session) using flow cytometry and a haematology analyser. Cytomegalovirus antibodies were measured in serum using Architect iSystem and cytomegalovirus serostatus was balanced in the three intervention groups. C-reactive protein was measured using immunonephelometry. We report for the first time that 6 weeks of strength endurance training significantly decreased senescence-prone T-cells along with a small increase in the number of CD8– naive T-cells in blood. The absolute counts of senescent-like T-cells decreased by 44% (from 26.03 ± 35.27 to 14.66 ± 21.36 cells/μL, p < 0.01) and by 51% (from 6.55 ± 12.37 to 3.18 ± 6.83 cells/μL, p < 0.05) for the CD8+ and CD8– T-cell pools, respectively. Intriguingly, these changes were observed in cytomegalovirus seropositive, but not cytomegalovirus seronegative individuals. In conclusion, the present study shows that strength endurance training leads to a reduction in circulating senescence-prone T-cells in cytomegalovirus seropositive older women. It remains to be established if monitoring of peripheral senescence-prone T-cells may have utility as cellular biomarkers of immunosenescence.

Recently, we showed that three months of resistance exercise significantly alters 18 canonical pathways related to chronic inflammation in PBMCs of older adults. In this exploratory sub-study, the aim is to explore whether resistance exercise enhances the PBMCs stress response by mimicking an acute infection through in vitro LPS stimulation. Women (≥65 years) were randomly divided into intensive strength training (IST), strength endurance training (SET), or flexibility training (as control group, CON) groups. PBMCs were isolated and cultured with and without LPS for 24 h. Their RNA was analyzed via targeted RNA sequencing of 407 inflammation-related genes, with relevant fold-changes defined as ≤0.67 or ≥1.5 (3 months vs. baseline). A pathway analysis using ingenuity pathway analyses identified significant pathways among 407 genes with p < 0.05 and z-scores of ≤−2 or ≥2. Fourteen women were included in the analyses. A total of 151 genes with a significant fold-change were identified. In the CON group, a less-pronounced effect was observed. Strength training altered 23 pathways in the LPS-stimulated PBMCs, none of which overlapped between the IST and SET groups. A balanced exercise program that includes both IST and SET could beneficially adapt the immune responses in older adults by inducing alterations in the inflammatory stress response of PBMCs through different genes and pathways.

Hand grip measures offer potential indicators for recovery after hospitalization in older adults. We investigated prospective associations of the grip indicators maximal grip strength (GSmax), fatigue resistance (FR) and grip work (GW) with post-discharge functional limitations, health-related quality of life (HRQOL) and survival in older inpatients. Grip indicators were evaluated at admission in general geriatric inpatients (GGI, n = 149) and geriatric hip fracture inpatients (HIP, n = 109). Questionnaires on functional limitations (10-40, lower is better) were collected for two weeks pre-admission, admission, three months follow-up, and six months follow-up. HRQOL (-4-10, higher is better) was assessed at admission, three months follow-up and six months follow-up. With individual growth modeling, we established the associations between grip indicators and the outcome trajectories. Three-month survival was analyzed using Cox proportional hazards models. In GGI, higher FR and GW were associated with better functional recovery from admission to three months follow-up (FR: B = -1.0 points per 10s increase, 95 %CI -1.9, -0.14; GW: B = -0.33 points per 100 kPa × s increase, 95 %CI -0.59, -0.07). HIP with higher grip indicators showed a better functional recovery towards three months follow-up (GSmax: B = -2.4 per 10 kPa increase, 95 %CI -3.9, -0.89; FR: B = -1.1, 95 %CI -2.4, 0.20; GW: B = -0.31, 95 %CI -0.61, -0.02). No or weak associations were found between grip indicators and HRQOL recovery. Hazard ratios pointed towards a better survival for better scores on grip indicators, but associations were not statistically significant. Higher FR and GW at admission were associated with better recovery post-discharge in geriatric inpatients. Future research should examine the added clinical value of grip indicators in addition to known patient characteristics.

Background Hand grip measures are promising candidate markers for recovery in geriatric patients. Aims To advance interpretation of these measures, we examined: (1) the associations between grip measures at admission and measures of frailty, daily functioning and fatigue to understand the constructs they measure; (2) alternate operational definitions of grip measures. Methods 181 geriatric inpatients completed twice daily grip measurements using the Eforto^® vigorimeter, including maximum grip strength (GSmax), fatigue resistance (FR), grip work (GW) and capacity to perceived vitality ratio (CPV). Associations with each of these measures and the outcomes frailty index (range 0-100), functional limitations (10–40), and total (4–20) and physical (20–100) fatigue were examined using linear regression. Analyses were repeated for the baseline value, average of first two measurements, within-person standard deviation of all values, and the coefficient of variation of all values for each of the grip measures. Results Associations approached statistical significance for baseline GSmax and the outcomes frailty (B=-0.09, 99%CI=--0.21, 0.02), functional limitations (B=-0.10, 99%CI=-0.20, 0) and physical fatigue (B=-0.07, 99%CI=-0.14, 0). Baseline, average and standard deviation values for FR, GW and CPV showed trends towards associations with functional limitations, but not with frailty or fatigue. Conclusions GSmax and CPV constructs overlapped more strongly with the construct of frailty than FR and GW. FR, GW and CPV overlapped with functional limitations, supporting their potential as early markers of recovery. Average values are more reliable than single values and variance measures may add additional information.