The effect of age on musculoskeletal injury compensation costs in South Australian professional urban firefighters: A cohort study.

Background: Firefighting is recognised as a physically demanding occupation involving exposure to hazardous environments and activities. An aging workforce combined with the age-related decline in physical fitness may result in increased future workers' compensation expenditure for fire service organisations.

Objective: The objective of this research was to investigate the costs associated with musculoskeletal sprain and strain injury and the impacts of age and injury location on Workers' Compensation claims submitted by professional urban firefighters.

Effects of aging and endurance exercise training on cardiorespiratory fitness and cardiac structure and function in healthy midlife and older women.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in women in developed societies. Unfavorable structural and functional adaptations within the heart and central blood vessels with sedentary aging in women can act as the substrate for the development of debilitating CVD conditions such as heart failure with preserved ejection fraction (HFpEF). The large decline in cardiorespiratory fitness, as indicated by maximal or peak oxygen uptake (V̇o and V̇o, respectively), that occurs in women as they age significantly affects their health and chronic disease status, as well as the risk of cardiovascular and all-cause mortality.

Exercise in Octogenarians: How Much Is Too Little?

The global population is rapidly aging, with predictions of many more people living beyond 85 years. Age-related physiological adaptations predispose to decrements in physical function and functional capacity, the rate of which can be accelerated by chronic disease and prolonged physical inactivity. Decrements in physical function exacerbate the risk of chronic disease, disability, dependency, and frailty with advancing age.

The effect of lifelong endurance exercise on cardiovascular structure and exercise function in women.

Key Points: The beneficial effects of sustained or lifelong (>25 years) endurance exercise on cardiovascular structure and exercise function have been largely established in men. The current findings indicate that committed (≥4 weekly exercise sessions) lifelong exercise results in substantial benefits in exercise capacity ( ), cardiovascular function at submaximal and maximal exercise, left ventricular mass and compliance, and blood volume compared to similarly aged or even younger (middle-age) untrained women. Endurance exercise training should be considered a key strategy to prevent cardiovascular disease with ageing in women as well as men.

Elevated exercise blood pressure in middle-aged women is associated with altered left ventricular and vascular stiffness.

Women are at higher risk for developing heart failure with preserved ejection fraction (HFpEF). We examined the utility of peak exercise blood pressure (BP) in identifying preclinical features of HFpEF, namely vascular and cardiac stiffness in middle-aged women. We studied 47 healthy, nonobese middle-aged women (53 ± 5 yr).

Parent's Cardiorespiratory Fitness, Body Mass, and Chronic Disease Status Is Associated with Metabolic Syndrome in Young Adults: A Preliminary Study.

We sought to determine if there was an intergenerational association between parental weight, cardiorespiratory fitness (CRF), and disease status, with the prevalence of metabolic syndrome (MetSyn) in their young adult offspring. Young adults ( = 270, 21 ± 1 years, 53.3% female) were assessed for MetSyn and self-reported parent's CRF, body mass status, and disease status.

Plasma matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs and aging and lifelong exercise adaptations in ventricular and arterial stiffness.

The age-associated increase in cardiac and central arterial stiffness is attenuated with lifelong (>25 years) endurance exercise in a dose-dependent manner. Remodelling of the extracellular matrix of cardiovascular structures may underpin these lifelong exercise adaptations in structural stiffness. The primary aim was to examine whether matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) levels are associated with aging and lifelong exercise-related changes in cardiac and central arterial stiffness.

The effect of lifelong exercise frequency on arterial stiffness.

Key Points: This study examined the effect of different 'doses' of lifelong (>25 years) exercise on arterial stiffening (a hallmark of vascular ageing) in older adults. There are clear dose-dependent effects of lifelong exercise training on human arterial stiffness that vary according to the site and size of the arteries. Similar to what we have observed previously with ventricular stiffening, 4-5 days week of committed exercise over a lifetime are necessary to preserve 'youthful' vascular compliance, especially of the large central arteries.

The relationship between exercise dose and health-related quality of life with a phase III cardiac rehabilitation program.

Purpose: To quantify the relationship between the change in exercise dose and health-related quality of life (HRQoL) in a cohort of patients participating in a community-based phase-3 cardiac rehabilitation (CR) program.

Methods: A retrospective, pre-experimental (no control group) design of 58 participants that completed a phase-3, 12-week exercise-based CR program was used to test the current hypothesis. Self-reported HRQoL (36-Item Short Form Health Survey Version 2, SF-36v2) was assessed prior and after completing the CR program.

Effects of Sedentary Aging and Lifelong Exercise on Left Ventricular Systolic Function.

Purpose: The current study examined whether age-related changes in left ventricular (LV) longitudinal systolic function is an adaptation to a more sedentary lifestyle and can be preserved by lifelong exercise training.

Methods: A cross-sectional examination of 18 sedentary young (37 ± 6 yr), 29 sedentary seniors (71 ± 5 yr, 0-3 exercise sessions per week), and 26 seniors (68 ± 5 yr) who had performed a committed level (four to seven exercise sessions per week) of lifelong (>25 yr) exercise. Invasive right heart catheterization (pulmonary capillary wedge pressure) and noninvasive measures of LV function were collected at the following conditions: 1) supine rest, 2) during LV unloading (lower body negative pressure), and 3) LV loading (saline infusion).

Prevalence of metabolic syndrome and metabolic syndrome components in young adults: A pooled analysis.

Metabolic syndrome (MetSyn) represents a clustering of different metabolic abnormalities. MetSyn prevalence is present in approximately 25% of all adults with increased prevalence in advanced ages. The presence of one component of MetSyn increases the risk of developing MetSyn later in life and likely represents a high lifetime burden of cardiovascular disease risk.

Lifelong Physical Activity Regardless of Dose Is Not Associated With Myocardial Fibrosis.

Background: Recent reports have suggested that long-term, intensive physical training may be associated with adverse cardiovascular effects, including the development of myocardial fibrosis. However, the dose-response association of different levels of lifelong physical activity on myocardial fibrosis has not been evaluated.

Methods And Results: Seniors free of major chronic illnesses were recruited from predefined populations based on the consistent documentation of stable physical activity over >25 years and were classified into 4 groups by the number of sessions/week of aerobic activities ≥30 minutes: sedentary (group 1), <2 sessions; casual (group 2), 2 to 3 sessions; committed (group 3), 4 to 5 sessions; and Masters athletes (group 4), 6 to 7 sessions plus regular competitions.

The effect of 1 year of Alagebrium and moderate-intensity exercise training on left ventricular function during exercise in seniors: a randomized controlled trial.

Sedentary aging leads to left ventricular (LV) and vascular stiffening due in part to advanced glycation end-products (AGEs) cross-linking of extracellular matrix proteins. Vigorous lifelong exercise ameliorates age-related cardiovascular (CV) stiffening and enhances exercise LV function, although this effect is limited when exercise is initiated later in life. We hypothesized that exercise training might be more effective at improving the impact of age-related CV stiffening during exercise when combined with an AGE cross-link breaker (Alagebrium).

Cardiovascular response to exercise training in the systemic right ventricle of adults with transposition of the great arteries.

Key Points: Patients with transposition of the great arteries (TGA) and systemic right ventricles have premature congestive heart failure; there is also a growing concern that athletes who perform extraordinary endurance exercise may injure the right ventricle. Therefore we felt it essential to determine whether exercise training might injure a systemic right ventricle which is loaded with every heartbeat. Previous studies have shown that short term exercise training is feasible in TGA patients, but its effect on ventricular function is unclear.

Heart rate recovery after maximal exercise is blunted in hypertensive seniors.

Abnormal heart rate recovery (HRR) after maximal exercise may indicate autonomic dysfunction and is a predictor for cardiovascular mortality. HRR is attenuated with aging and in middle-age hypertensive patients, but it is unknown whether HRR is attenuated in older-age adults with hypertension. This study compared HRR among 16 unmedicated stage 1 hypertensive (HTN) participants [nine men/seven women; 68 ± 5 (SD) yr; awake ambulatory blood pressure (BP) 149 ± 10/87 ± 7 mmHg] and 16 normotensive [control (CON)] participants (nine men/seven women; 67 ± 5 yr; 122 ± 4/72 ± 5 mmHg).

Impact of lifelong exercise "dose" on left ventricular compliance and distensibility.

Background: Sedentary aging has deleterious effects on the cardiovascular system, including decreased left ventricular compliance and distensibility (LVCD). Conversely, Masters level athletes, who train intensively throughout adulthood, retain youthful LVCD.

Objectives: The purpose of this study was to test the hypothesis that preservation of LVCD may be possible with moderate lifelong exercise training.

The effect of lifelong exercise dose on cardiovascular function during exercise.

An increased "dose" of endurance exercise training is associated with a greater maximal oxygen uptake (Vo2max), a larger left ventricular (LV) mass, and improved heart rate and blood pressure control. However, the effect of lifelong exercise dose on metabolic and hemodynamic response during exercise has not been previously examined. We performed a cross-sectional study on 101 (69 men) seniors (60 yr and older) focusing on lifelong exercise frequency as an index of exercise dose.

Cardiovascular effects of 1 year of alagebrium and endurance exercise training in healthy older individuals.

Background: Lifelong exercise training maintains a youthful compliance of the left ventricle (LV), whereas a year of exercise training started later in life fails to reverse LV stiffening, possibly because of accumulation of irreversible advanced glycation end products. Alagebrium breaks advanced glycation end product crosslinks and improves LV stiffness in aged animals. However, it is unclear whether a strategy of exercise combined with alagebrium would improve LV stiffness in sedentary older humans.

Effects of age and aerobic fitness on myocardial lipid content.

Background: Aging and sedentary lifestyles lead to cardiac atrophy, ventricular stiffening, and impaired diastolic function. Both conditions are marked by increased adiposity, which can lead to ectopic fat deposition in nonadipocyte tissues including the myocardium. The effect of excess intramyocardial fat on cardiac function in nonobese individuals is unknown.

Hemodynamic responses to rapid saline loading: the impact of age, sex, and heart failure.

Background: Hemodynamic assessment after volume challenge has been proposed as a way to identify heart failure with preserved ejection fraction. However, the normal hemodynamic response to a volume challenge and how age and sex affect this relationship remain unknown.

Methods And Results: Sixty healthy subjects underwent right heart catheterization to measure age- and sex-related normative responses of pulmonary capillary wedge pressure and mean pulmonary arterial pressure to volume loading with rapid saline infusion (100-200 mL/min).

The effect of age-related differences in body size and composition on cardiovascular determinants of VO2max.

Background: A reduction in maximal stroke volume (SVmax) and total blood volume (TBV) has been hypothesized to contribute to the decline in maximal oxygen uptake (VO2max) with healthy aging. However, these variables have rarely been collected simultaneously in a board age range to support or refute this hypothesis. It is also unclear to what extent scaling size-related cardiovascular determinants of VO2max affects the interpretation of age-related differences.

The effect of exercise training on left ventricular relaxation and diastolic suction at rest and during orthostatic stress after bed rest.

A marked reduction in upright stroke volume (SV) contributes substantially to orthostatic intolerance after exposure to spaceflight or bed rest. It is unclear whether slowed left ventricular (LV) relaxation and diastolic suction contribute to the reduction in SV or whether these changes are influenced by exercise training while in bed. Twenty-seven healthy adults completed 5 weeks of -6 deg head-down bed rest (HDBR).

Effect of healthy aging on left ventricular relaxation and diastolic suction.

Doppler ultrasound measures of left ventricular (LV) active relaxation and diastolic suction are slowed with healthy aging. It is unclear to what extent these changes are related to alterations in intrinsic LV properties and/or cardiovascular loading conditions. Seventy carefully screened individuals (38 female, 32 male) aged 21-77 were recruited into four age groups (young: <35; early middle age: 35-49; late middle age: 50-64 and seniors: ≥65 yr).

The larger exercise stroke volume in endurance-trained men does not result from increased left ventricular early or late inflow or tissue velocities.

Aim: To determine whether the larger exercise stroke volume in senior endurance-trained athletes results from an attenuation of age-related alterations in left ventricular (LV) early diastolic filling or a more vigorous late filling.

Methods: Body composition (DEXA), VO(2)peak, stroke volume (CO(2) rebreathing) and Doppler measures of early and late mitral inflow and mitral annular velocities were collected at seated upright rest and heart rate-matched exercise (100 and 120 bpm) in trained and untrained younger (18-30 years) men and trained and untrained older (60-80 years) healthy men.

Results: Ageing had a greater effect than training status on seated rest mitral inflow and tissue Doppler imaging parameters, as shown by a lower peak early-to-late mitral inflow velocity ratio (E/A ratio) and slower peak early mitral annular velocity (Em) in older compared with younger men.