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T Kostka

Publications and source records attributed to T Kostka.

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Peak anaerobic power in elderly men.

The relationship of maximal anaerobic power (Pmax) of the quadriceps muscle and corresponding optimal shortening velocity (vopt) with age, habitual physical activity (PA) and maximal oxygen consumption (VO2max) were assessed in 37 healthy older [71.1 (SD 3.8) years] men and compared to those of 16 young [22.7 (SD 3.4) years] men. The PA was evaluated using a questionnaire. The Pmax and vopt were measured on a friction loaded non-isokinetic cycle ergometer. The Pmax was expressed relative to body mass - Pmax x kg(-1), and relative to the mass of the two quadriceps muscles - Pmax x kgquad(-1). The decline of Pmax x kg(-1) from youth to advanced age (8.3% per decade) was greater than the decrease in quadriceps muscle mass (3.8% per decade), in Pmax x kgquad(-1) (5.9% per decade) and in vopt (4.3% per decade). In the older men, a negative relationship of Pmax x kg(-1) (r = -0.33) and Pmax x kgquad(-1) (r = -0.44) with age was found. Ergometer measurements were not correlated with PA activity indices or VO2max, while VO2max was positively associated with PA. In a multiple stepwise regression analysis age was the only variable that contributed significantly to Pmax x kg(-1) and Pmax x kgquad(-1) variances. Our findings indicated that in these healthy elderly men, unlike the fall in VO2max, habitual PA did not attenuate the decline in Pmax of the quadriceps muscle with age. This finding was different from a previously described relationship in older women and would suggest sex differences in determining Pmax in healthy older subjects.

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Physical activity, fitness and integrated antioxidant system in healthy active elderly women.

We have related the oxidative stress and antioxidant defence system to maximal oxygen consumption (VO2max) and physical activity in elderly women. Twenty-nine community dwelling, healthy, active women aged 66-82 years participated in this study. Physical activity was measured by a questionnaire and expressed using two physical activity indices: mean habitual daily energy expenditure (MHDEE) and daily energy expenditure corresponding to leisure time sports activities (Sports activity index). Malondialdehyde (MDA), plasma total antioxidant status (TAS), the red blood cell (RBC) superoxide dismutase (SOD) and glutathione peroxidase (GPX) as well as serum GPX activities were determined under resting conditions. MDA was correlated positively with VO2max (r = 0.42), while RBC GPX was significantly negatively associated with VO2max (r =-0.39), MHDEE (r=-0.38) and sports activity index (rho=-0.36). Our data suggest that in healthy active older women the relationship between physical activity/fitness and antioxidant defence system may be complex, and that for some parameters an unfavourable influence of strenuous exercise may exist. The findings of this cross-sectional design need to be supported in further prospective studies before the associations are accepted as real.

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Physical activity and dehydroepiandrosterone sulphate, insulin-like growth factor I and testosterone in healthy active elderly people.

OBJECTIVE: to examine the association of physical activity and cardio-respiratory fitness with dehydroepiandrosterone sulphate (DHEAS), insulin-like growth factor I (IGF-I) and testosterone in healthy elderly people. DESIGN: cross-sectional study. SETTING: university research department and department of geriatric medicine. PARTICIPANTS: 60 independent, community-dwelling elderly subjects (26 men and 34 women) aged 66-84 who volunteered to participate. MEASUREMENTS: physical activity was evaluated by the Questionnaire d'Activité Physique Saint-Etienne and expressed by three indices: mean habitual daily energy expenditure (MHDEE), daily energy expenditure (DEE) [comprising activities with intensities corresponding to at least three metabolic equivalents (MET; 3.5 ml.kg1 x min1 of oxygen consumption)] and sport activity. Cardio-respiratory fitness was expressed by maximal oxygen consumption (VO2max). RESULTS: In women, DHEAS correlated with VO2max (partial correlation: r=0.33; P=0.05), MHDEE (r=0.50; P=0.002), DEE > 3 METs (r=0.49; P=0.003) and sport activity (r=0.35; P=0.04) whereas IGF-I correlated with MHDEE (r=0.48; P=0.004). DHEAS was correlated with IGF-I (r=0.43; P < 0.02) and with testosterone (r=0.41; P < 0.02). No such correlation was found in men. CONCLUSION: lower habitual physical activity is related to lower levels of circulating DHEAS and IGF-I independently of age and anthropometric measures. Lower maximal aerobic capacity is associated with lower DHEAS concentrations, in healthy elderly women.

Activities of Daily Living↗

Usefulness of the prognostic inflammatory and nutritional index (PINI) in hospitalized elderly patients.

The prognostic inflammatory and nutritional index (PINI) is a simple scoring system of overall health which aggregates two blood markers of inflammatory (C-reactive protein and alpha(1)-acid glycoprotein) and of nutritional (albumin and transthyretin) states. This study was undertaken with a view to evaluate, in comparison to currently used predictive approaches, the potential usefulness of PINI to forecast hospital mortality and outcome of patients hospitalized in an acute geriatric unit. 1,066 elderly patients, aged 82.7 +/- 6.6 years and fulfilling inclusion criteria, were enrolled in the study. Logistic regression analysis and calculation of relative risk (RR) were carried out for epidemiological data with a cut-off value of 25 for PINI. Immediate mortality (7.9%) of admissions) was predicted by PINI > or = 25 (RR = 4.34). Only 387 patients (36.3%) could rejoin their residence location (home or family). A sizeable proportion of acute patients (55.8%) failed to recover and/or developed diseased states requiring chronic care management. Incapacity to return home was predicted by PINI > or = 25 (RR = 2.04). Hypoalbuminaemia < or = 30 g/L was not found a predictor of mortality but was associated with total disability (RR = 9.08). The optimal PINI cut-off value to predict mortality was calculated at 8.8 using the ROC analytic approach. We conclude that the PINI formula is helpful to predict both nearest lethality and chronic institutionalization. This scoring system should take a place within the battery of tests used to identify and to follow up acutely ill elderly patients at risk of major complications.

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Habitual physical activity and peak anaerobic power in elderly women.

The aim of this study was to investigate the relationship between maximal anaerobic power (Pmax) and corresponding optimal velocity (Vopt) and habitual physical activity (PA) on the one hand and with maximal oxygen consumption (VO2max) on the other hand, in elderly women. Twenty-nine community dwelling, healthy women aged 66-82 years participated in the study. PA was evaluated using the Questionnaire d'Activite Physique Saint-Etienne (QAPSE) and expressed using two QAPSE activity indices: mean habitual daily energy expenditure (MHDEE) and daily energy expenditure corresponding to leisure time sports activities (sports activity). The subjects' Pmax and Vopt were measured while they cycled on a friction-loaded non-isokinetic cycle ergometer. Pmax was expressed relative to body mass [Pmax/kg(W.kg-1)], and relative to the mass of two quadriceps muscles [Pmax/Quadr(W.kg-1Quadr)]. A negative relationship between Pmax/kg (Spearman's r = -0.56; P < 0.01), Pmax/Quadr (r = -0.53; P < 0.01) and Vopt (r = -0.45; P < 0.05) and age was found. Pmax/kg was positively associated with MHDEE (r = 0.51; P < 0.01) and sports activity (r = 0.58; P < 0.01), as were Pmax/Quadr and Vopt (r = 0.55; P < 0.01 and r = 0.54; P < 0.01, respectively). Pmax/kg, Pmax/Quadr and Vopt correlated positively with VO2max. The positive relationship between ergometer measurements and PA indices was similar to that between VO2max and PA. Pmax/kg was, moreover, closely related to Vopt (r = 0.77; P < 0.001). When a multiple stepwise regression analysis was used to select the variables influencing ergometer measurements, MHDEE contributed significantly to Pmax/kg variance, whereas sports activity contributed to Pmax/Quadr and Vopt variances. In conclusion, the data from this cross-sectional study suggest that in healthy elderly women habitual PA, and especially leisure time PA, alleviates the decline of the Pmax of the quadriceps muscles.

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[Methods of evaluating physical activity in the elderly].

Various methods measuring physical activity (PA) that have been used so far in older population are described. Different PA questionnaires and their potential application in routine PA assessment in that age group are discussed.

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Validation of a physical activity questionnaire in the elderly.

The purpose of this study was to validate a physical activity (PA) questionnaire, Questionnaire d'Activité Physique Saint-Etienne (QAPSE), in an homogenous population of elderly subjects and to estimate its potential for application in routine PA assessments in that age group. A group of 65 (31 men and 34 women) community dwelling, healthy people aged 65-84 years volunteered to participate in a validation substudy comparing maximal oxygen uptake (VO2 max) and anthropometric data. VO2 max correlated positively with mean habitual daily energy expenditure (MHDEE) (r = 0.56, P < 0.0001), greater than 3MET (metabolic equivalent) daily energy expenditure (DEE) activity (r = 0.371, P = 0.002), leisure activity (r = 0.368, P = 0.003), sports activity (r = 0.461, P < 0.0001), basic daily activity (r = 0.325, P = 0.008) and moving DEE activity (r = 0.273, P = 0.028) in both sexes, with MHDEE (r = 0.366, P = 0.043) and moving DEE activity (r = 0.388, P = 0.031) in the men and with MHDEE (r = 0.624; P < .0001), greater than 3MET DEE activity (r = 0.513, P = 0.002), leisure activity (r = 0.388, P = 0.024) and sports activity (r = 0.683, P < 0.001) in the women. The MHDEE was positively correlated with body mass (r = 0.464) and with fat free mass (r = 0.639) and negatively correlated with percentage body fat (r = -0.501). In a reproducibility sub-study (n = 44) a paired Student's t-test, based on mean differences between the two administrations of the questionnaire did not reach statistical significance for any of the QAPSE activity scores studied. Test-retest correlation coefficients ranged from 0.648 for moving score to 0.967 for MHDEE with correlation coefficient P values being less than 0.001 for all of the QAPSE activity scores. We concluded that QAPSE demonstrated excellent repeatability and good validity in relation to physical fitness and anthropometric data in the population of these healthy elderly volunteers.

Activities of Daily Living↗

[Physiological characteristics and the level of risk factors for ischemic heart disease in marathon runners between 30 and 59 years of age].

The results of anthropometric, biochemical, cardiological and performance capacity studies in the 37 marathon runners, 113 men systematically practising recreational training programme with a domination of endurance exercises and 44 healthy men with little leisure time physical activity have been compared. In comparison with a group of physically non-active persons, the marathon runners are characterized by considerably higher physical working capacity, slimmer figure, lower resting heart rate, lower diastolic blood pressure, high concentration of HDL cholesterol and lower cholesterol: HDL cholesterol index. However, these differences are minimal in comparison with other systematically training persons, and with regard to the majority of factors statistically insignificant. It seems that for reaching the physiological effects desired from the point of view of ischemic heart disease prevention the endurance training of lower capacity and intensity would be sufficient.

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Usefulness of calf circumference measurement in assessing the nutritional state of hospitalized elderly people.

BACKGROUND: Malnutrition is a widespread but largely unrecognized problem in aged patients, more so as it is a contributing factor to the increased morbidity and mortality in this age group. Since direct measurements of body composition are not possible in a large number of patients, good anthropometric reference data are fundamental in assessing the nutritional state of elderly people. OBJECTIVE: To examine the efficacy of calf circumference (CC) measurement for assessing the nutritional state of the elderly. METHODS: The nutritional state was assessed by anthropometric and biological measurements in 911 elderly patients consecutively admitted to a geriatric unit. In the first instance, univariate analysis was performed for CC and other nutritional parameters. Linear and multiple stepwise regressions were performed to study the association between anthropometric or biological parameters and CC. At a later stage, the specificity, sensitivity and the optimal cutoff CC were established for 2 groups of patients: malnourished and controls. Finally, patients were classified according to this cutoff in order to verify the efficacy of CC in assessing their nutritional state. RESULTS: The results of univariate analysis showed significant correlations between CC and other nutritional anthropometric markers (r = 0.706, p < 0.0001 with body mass index (BMI) and r = 0.661, p < 0.0001 with fat free mass) and biological markers (r = 0.219, p < 0.0001 with albumin and r = 0.162, p < 0.0001 with transthyretin). Multiple regression confirmed associations between CC and tricipital skinfold thickness (p < 0.0001), fat free mass (p < 0.0001), BMI (p < 0.0001), and serum albumin (p < 0.0001; r(2) = 0.561). The optimal cutoff for CC was found to be 30.5 cm for both men (sensitivity 73.2%, specificity 72.8%) and women (sensitivity 78.8%, specificity 61.1%). The classification of patients according to this discriminating factor was confirmed for the optimal cutoff value. CONCLUSION: Calf circumference is a pertinent marker of nutritional state. The cutoff of 30.5 cm provides a good diagnostic capacity.

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