It is unclear if physical activity (PA) can prevent or reverse frailty. We examined different doses and types of PA and their association with the onset and severity of frailty. Health, Aging and Body Composition (Health ABC) study participants (N = 2,964) were followed for 5 years, with frailty defined as a gait speed of less than 0.60 m/s and/or inability to rise from a chair without using one's arms. Individuals with one impairment were considered moderately frail and those with both severely frail. We examined PA doses of volume and intensity, activity types (eg, lifestyle vs exercise activities), and their associations with incident frailty and transition to severe frailty in those who became frail. Adjusted models indicated that sedentary individuals had significantly increased odds of developing frailty compared with the exercise active group (adjusted odds ratio [OR] = 1.45; 95% confidence interval [CI]: 1.04–2.01), whereas the lifestyle active did not. Number of diagnoses was the strongest predictor of incident frailty. In those who became frail during follow-up (n = 410), there was evidence that the sedentary (adjusted OR = 2.80; 95% CI: 0.98–8.02) and lifestyle active (adjusted OR = 2.81; 95% CI: 1.22–6.43) groups were more likely to have worsening frailty over time. Despite the strong relationship seen between comorbid conditions and onset of frailty, this observational study suggests that participation in self-selected exercise activities is independently associated with delaying the onset and the progression of frailty. Regular exercise should be further examined as a potential factor in frailty prevention for older adults.

(1) To examine the reliability of a new clinical measure of simultaneous walking with performance of a working memory task, the Walking and Remembering Test (WART). (2) To compare older adult to younger adult WART performance to illustrate preliminary validity. Convenience sample of 25 young adults (ages 22-35) and 25 older adults (ages 65-86) performed the WART twice. Subjects walked 6.1 meters at their fastest safe speed along a path requiring a narrowed base of support in both single and dual-task (with simultaneous digit span task) conditions. Reductions in walking and cognitive performance were examined in the dual-task condition for older adults as compared to younger adults. Walking time, step accuracy, digit span memory accuracy, and dual-task costs for walking and cognitive tasks. Inter-rater reliability ICC (2,1) values were > or = .97 for walking time and digit span accuracy. Rater agreement of steps off the path was excellent (93%) for young adults and good (76%) for older adults. Test-retest reliability ICC (2,1) values for walking time were > or = .79. Older adults were slower and remembered shorter digit spans, and demonstrated greater dual-task costs for digit span accuracy and steps off the path than younger adults, but relative dual-task costs for walking time were not significantly different between groups. The WART is a reliable clinical measure of dual-task memory and walking that can be administered safely with community-dwelling older adults. Expected greater dual-task costs for older adults were observed, but not as strongly as anticipated in this group of very active subjects. The WART provides information that may be useful in targeting patients for intervention to reduce risk of falls in dual-task conditions, but needs validation with older adults across a greater range of walking ability.

Biomechanical measures of postural stability, while generally useful in neuroscience and physical rehabilitation research, may be limited in their ability to detect more subtle influences of attention on postural control. Approximate entropy (ApEn), a regularity statistic from nonlinear dynamics, recently has demonstrated relatively good measurement precision and shown promise for detecting subtle change in postural control after cerebral concussion. Our purpose was to further explore the responsiveness of ApEn by using it to evaluate the immediate, short-term effect of secondary cognitive task performance on postural control in healthy, young adults.

Background and Purpose. Footwear is not consistently standardized in the administration of the Functional Reach Test (FRT), Timed Up & Go Test (TUG), and 10-Meter Walk Test (TMW). This study was conducted to determine whether footwear affected performance on these tests in older women. Subjects. Thirty-five women, aged 65 to 93 years, were recruited from assisted living facilities and retirement communities. Methods. Each subject performed the FRT, TUG, and TMW while wearing walking shoes, wearing dress shoes, and barefooted. Because of space constraints at the facilities where the testing was performed, 22 subjects performed the FRT and TUG on a linoleum floor and 13 subjects performed the tests on a firm, low-pile, carpeted floor. All 35 subjects completed the TMW on a firm, low-pile, carpeted floor. One-way repeated-measures analyses of variance (ANOVAs) and a Tukey Honestly Significant Difference test were used to compare the outcomes for the 3 footwear conditions, with separate ANOVAs conducted for the different floor surfaces for the FRT and TUG. Results. Subjects performed better on the FRT when barefooted or wearing walking shoes compared with when they wore dress shoes, regardless of floor surface. Differences were found among all footwear conditions for the TUG performed on the linoleum floor and for the TMW. For these tests, the women moved fastest in walking shoes, slower barefooted, and slowest wearing dress shoes. Conclusion and Discussion. Footwear should be documented and should remain constant from one test occasion to another when the FRT, TUG, and TMW are used in the clinic and in research. Footwear intervention may improve performance of balance and gait tasks in older women.

To examine associations between measures of static and dynamic balance and performance of mobility tasks in older adults. A cross-sectional analysis from 95 community dwelling participants (mean age 80.9 years, range 65 -03 years). Participants performed tests of static (tandem stance) and dynamic (360 degrees turn) balance and mobility (walking speed and timed chair rise). Associations among balance and mobility measures were examined using correlation and logistic regression. Static and dynamic balance were moderately associated (r = -.462). Relationships between dynamic balance and mobility were stronger than those between static balance and mobility. The association between dynamic balance and walking speed was particularly strong (r = -.701 ). Using logistic regression, age, and balance performance were significant predictors for outcomes of walking speed (dichotomized to < .0 m/s, >/= .0 m/s), and timed chair rise (dichotomized to 3.6 s). Faster 360 degrees turn times were independently associated with faster walking speed and chair rise time. Mobility tasks require both dynamic and static balance. As falls are a major health risk for older adults, including brief assessments of dynamic and static balance in the examination of older adults provides valuable information about physical function and mobility.