Daniele Sirineu Pereira

Impact of Type-2 Diabetes Time Since Diagnosis on Elderly Women Gait and Functional Status

BACKGROUND AND PURPOSE The gait, mobility and lower-limb strength alterations of diabetic elderly women without symptoms of diabetic neuropathy in different periods of the chronic disease can contribute to an early functional diagnosis, allowing prevention of adverse outcomes like falls and disability. This could also contribute to the development of interventions, cures and physiotherapy practice for this population. The aim of this study was to verify the impact of type-2 diabetes mellitus time since diagnosis on gait and functional status of elderly women. METHODS Eighty-two diabetic elderly women without neuropathic symptoms participated and divided in two groups: 1) 49 elderly (71.4 ± 4.8 years) with less than 10 years of type-2 diabetes mellitus diagnosis, and 2) 33 elderly (70 ± 4.5 years) with 10 or more years of type-2 diabetes mellitus diagnosis. Outcomes were spatiotemporal gait parameters (speed, cadence, step length, base of support, stance time, swing time, and double support time) assessed through GAITRite® system, and functional status assessed using the Timed Up and Go test and five times sit-to-stand test. To compare spatiotemporal gait variables and performance on functional tests between groups, multivariate analysis of variance and Mann-Whitney test were performed, respectively. RESULTS The group with 10 or more years of diagnosis showed lower gait speed and smaller step length (112.3 cm/s; 59.2 cm) compared with the group with less than 10 years of diagnosis (122.9 cm/s; 62.4 cm). In relation to Timed Up and Go test and five times sit-to-stand test, there were no statistically significant differences between the groups. CONCLUSION Type-2 diabetes mellitus time since diagnosis has a negative impact on gait speed and step length, but not on functional status of the elderly women. Copyright

Isokinetic performance of knee flexor and extensor muscles in community-dwelling elderly women

Introduction The isokinetic dynamometer enables accurate assessment of muscle function. In Brazil, few studies have assessed the isokinetic muscle performance in older adults making interpretation and comparison of results with other studies.Objectives To conduct a descriptive analysis of the performance of the muscle flexor and extensor muscles of the knee joint in elderly community and compare the performance between the age groups 65-74 years and 75 years or more.Methods This is a cross sectional observational study with a convenience sample of 229 elderly community. For the analysis of muscle performance was used isokinetic dynamometer (Biodex System 3 Pro™) in the angular velocities of 60 °/s and 180 °/s. The variables evaluated were peak torque, peak torque normalized by body weight, total work normalized by body mass, total work, average power and agonist/antagonist ratio. Descriptive analysis was used to characterize the sample. For comparison between age groups was used Students t-test with α = 0.05.Results The elderly women with older age showed a statistically significant decrease in most of the variables (p < 0.05) except for the agonist and antagonist knee (p = 0.398).Conclusions The isokinetic was a sensitive tool to characterize the modifications caused by aging on muscle function. Elderly with results below the lower limits of the confidence intervals for all variables certainly has a decreased strength for the age group evaluated and must be addressed therapeutically. The results can be used as a benchmark in clinical practice and future research.

Handgrip strength, functionality and plasma levels of IL-6 in elderly women

Introduction Aging is associated with a chronic low-grade inflammatory process characterized by an increased production of inflammatory mediators. These elevated levels are predictors for muscle function (sarcopenia) and deterioration of physical performance in the elderly.Objective To investigate the correlation between sarcopenia, functional capacity, and interleukin-6 levels.Materials and methods This cross-sectional study assessed a convenience sample of elderly individuals (n = 130) using a handgrip dynamometer (JAMAR™), and the functional capacity test was performed by sitting and standing. Interleukin-6 levels were determined using high sensitivity ELISA kits. Spearman correlation coefficient was used to assess the correlation between these variables, at a significance level (α) of 0.05.Results There was significant inverse correlation between strength and function (rS = -0.273, p = 0.002) such that elderly individuals with lower peak force took longer to perform the sit-to-stand test, in contrast with the relationship between plasma interleukin-6 levels and strength (rS = -0.043, p = 0.624) or functionality (rS = -0.060, p = 0.501).Conclusion The outcome measures analyzed could predict the decline in muscle strength and functional capacity, and may be indicative of sarcopenia in elderly individuals. There was no correlation between the interleukin-6 levels and the grip strength and functional capacity of the sample investigated.

Brain-derived neurotrophic factor plasma levels are increased in older women after an acute episode of low back pain

BACKGROUND Low back pain (LBP) is a growing public health problem in old age, and it is associated with disabling pain and depressive disorders. We compared brain-derived neurotrophic factor (BDNF) plasma levels, a key neurotrophin in pain modulation, between older women after an acute episode of LBP and age-matched pain-free controls, and investigated potential differences in BDNF levels between controls and LBP subgroups based on pain severity, presence of depressive symptoms and use of analgesic and antidepressant drugs. METHODS A total of 221 participants (154 with LBP and 67 pain-free) were studied. A comprehensive assessment of sociodemographic and clinical variables was conducted including pain severity (11-point NRS), depressive symptoms (GDS-15), age, body mass index, physical activity and total number of comorbidities and medications in use. RESULTS BDNF levels in LBP group were significantly higher than controls (7515.9±3021.2; Md=7116.0 vs 6331.8±3364.0; Md=5897.5pg/mL, P=0.005). LBP subgroups exhibited higher BDNF levels than controls, regardless of pain severity, presence of depressive symptoms and use of analgesic drugs. BDNF levels were significantly higher in LBP subgroup without use of antidepressant drugs compared to both controls and LBP subgroup with use of antidepressant drugs. DISCUSSION This study provides evidence that older women with acute low back pain exhibit higher BDNF plasma levels compared to pain-free controls. Subgroup comparisons suggest that use of pain-relief drugs may influence BDNF levels. The study results offer a novel target for research on mechanisms of back pain in older adults.