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1.  Heterogeneity of Physical Function Responses to Exercise Training in Older Adults 
OBJECTIVES
To describe the inter-individual variability in physical function responses to supervised, resistance and aerobic exercise training interventions in older adults.
PARTICIPANTS
Ninety-five older (65–79 years), overweight and obese (body mass index [BMI] ≥27 kg/m2), sedentary men and women.
INTERVENTION
Five-months of either 4 d/wk of aerobic training (AT, n=40) or 3 d/wk of resistance training (RT, n=55).
MEASUREMENTS
Physical function assessments: global measure of lower extremity function (short physical performance battery; SPPB), 400-meter walk, peak aerobic capacity (VO2peak), and knee extensor strength.
RESULTS
On average, both exercise interventions significantly improved physical function. For AT, there was a 7.9% increase in VO2peak; individual absolute increases varied from 0.4–4.3 ml/kg/min and four participants (13%) showed no change or a decrease in VO2peak. For RT, knee extensor strength improved an average of 8.1%, but individual increases varied from 1.2–63.7 Nm, and 16 participants (30%) showed no change or a decrease in strength. Majority of participants improved 400-m walk time, usual gait speed, chair rise time, and SPPB with AT, and improved usual gait speed, chair rise time, and SPPB with RT; but, there was wide variation in the magnitude of improvement. Compliance was only related to change in 400-m walk time following RT (r= −0.31; p<0.05).
CONCLUSION
Despite sufficient levels of adherence to both exercise interventions, some participants did not improve function, and the magnitude of improvement varied widely. Additional research is needed to identify factors that optimize responsiveness to exercise to maximize its functional benefits in older adults.
doi:10.1111/jgs.13322
PMCID: PMC4373970  PMID: 25752778
aerobic training; resistance training; muscle strength; peak aerobic capacity; response variability
2.  Chronic Inflammation Is Associated With Low Physical Function in Older Adults Across Multiple Comorbidities 
Background
Chronic subclinical inflammation may contribute to impaired physical function in older adults; however, more data are needed to determine whether inflammation is a common mechanism for functional decline, independent of disease or health status.
Methods
We examined associations between physical function and inflammatory biomarkers in 542 older men and women enrolled in four clinical studies at Wake Forest University between 2001 and 2006. All participants were at least 55 years and had chronic obstructive pulmonary disease, congestive heart failure, high cardiovascular risk, or self-reported physical disability. Uniform clinical assessments were used across studies, including grip strength; a Short Physical Performance Battery (SPPB; includes balance, 4-m walk, and repeated chair stands); inflammatory biomarker assays for interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP); and anthropometric measures.
Results
Higher levels of CRP and IL-6, but not TNF-α, were associated with lower grip strength and SPPB scores and longer times to complete the 4-m walk and repeated chair stands tests, independent of age, gender, and race. More importantly, these relationships were generally independent of disease status. Further adjustment for fat mass, lean mass, or percent body fat altered some of these relationships but did not significantly change the overall results.
Conclusions
Elevated CRP and IL-6 levels are associated with poorer physical function in older adults with various comorbidities, as assessed by a common battery of clinical assessments. Chronic subclinical inflammation may be a marker of functional limitations in older persons across several diseases/health conditions.
doi:10.1093/gerona/gln038
PMCID: PMC2657165  PMID: 19196644
Inflammation; Physical function; Aging; Comorbidities

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