Poor physical fitness is independently associated with mild cognitive impairment in elderly Koreans

The purpose of this study was to investigate the association between physical fitness and mild cognitive impairment (MCI) in elderly Koreans. This was a cross-sectional study that involved 134 men and 299 women aged 65 to 88 years. Six senior fitness tests were used as independent variables: 30 s chair stand for lower body strength, arm curl for upper body strength, chair-sit-and-reach for lower body flexibility, back scratch for upper body flexibility, 8-ft up-and-go for agility/dynamic balance, and 2-min walk for aerobic endurance. Global cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). Potential covariates such as age, education levels, blood lipids, and insulin resistance (IR) markers were also assessed. Compared to individuals without MMSE-based MCI, individuals with MMSE-based MCI had poor physical fitness based on the senior fitness test (SFT). There were significant positive trends observed for education level (p=0.001) and MMSE score (p<0.001) across incremental levels of physical fitness in this study population. Individuals with moderate (OR=0.341, p=0.006) and high (OR=0.271, p=0.007) physical fitness based on a composite score of the SFT measures were less likely to have MMSE-based MCI than individuals with low physical fitness (referent, OR=1). The strength of the association between moderate (OR=0.377, p=0.038) or high (OR=0.282, p=0.050) physical fitness and MMSE-based MCI was somewhat attenuated but remained statistically significant even after adjustment for the measured compounding factors. We found that poor physical fitness was independently associated with MMSE-based MCI in elderly Koreans.     

Asociación entre la realización de ejercicio e indicadores de funcionamiento físico y cognitivo. Comparativa de resultados en función de la edad

Background

Gerontology research shows the importance of physical exercise for active aging. This study demonstrates the relationship between the practice of aerobic exercise, and physical fitness (muscle strength, respiratory capacity and motor speed) and cognitive performance (memory and visual-perceptual speed) and analyzes whether age is a modulating factor of this relationship.

Material and methods

The sample included 690 subjects with an age range of 30-85 years. The level of physical exercise was assessed using self-report form. Two sub-scales were used for the evaluation of cognitive performance: Digit Span Backwards and Digit Symbol (both are sub-scales of the Wechsler Adult Intelligence Scale - WAIS). The physical fitness was assessed using bio-behavioral measurements (strength, lung capacity, speed). To test the combined effect of exercise and age on the two variables (physical fitness and cognitive performance) two separate factorial analysis of variance were performed (procedure - general linear model: Univariate).

Result

The most significant result showed that scores on cognitive performance is a function of the intensity of the physical activity (F=4.8; P<0.002). With regard to physical fitness, its relationship with physical exercise is also significant (F=4.10; P<0.007) as well as the interaction between exercise and age (F=2.2; P<0.001).

Conclusions

The intensity in achieving aerobic exercise is associated with physical fitness and cognitive performance. Age has a specific weight in the association between exercise and physical fitness, this effect is higher in the older age groups (65-74 and 75-85 years for 30-49 and 50-64 years). These data suggest the compensatory effect of exercise on decline in old age.     

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels

[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness.[Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed.[Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups.[Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.     

Associations of Sedentary Behaviour,Physical Activity,Blood Pressure and Anthropometric Measures with Cardiorespiratory Fitness in Children with Cerebral Palsy

Background

Children with cerebral palsy (CP) have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity. Poor cardiorespiratory fitness may contribute to increased cardiometabolic risk.

Purpose

The aim of this study was to determine the association between sedentary behaviour, physical activity and cardiorespiratory fitness in children with CP. An objective was to determine the association between cardiorespiratory fitness, anthropometric measures and blood pressure in children with CP.

Methods

This study included 55 ambulatory children with CP [mean (SD) age 11.3 (0.2) yr, range 6-17 yr; Gross Motor Function Classification System (GMFCS) levels I and II]. Anthropometric measures (BMI, waist circumference and waist-height ratio) and blood pressure were taken. Cardiorespiratory fitness was measured using a 10 m shuttle run test. Children were classified as low, middle and high fitness according to level achieved on the test using reference curves. Physical activity was measured by accelerometry over 7 days. In addition to total activity, time in sedentary behaviour and light, moderate, vigorous, and sustained moderate-to-vigorous activity (≥10 min bouts) were calculated.

Results

Multiple regression analyses revealed that vigorous activity (β = 0.339, p<0.01), sustained moderate-to-vigorous activity (β = 0.250, p<0.05) and total activity (β = 0.238, p<0.05) were associated with level achieved on the shuttle run test after adjustment for age, sex and GMFCS level. Children with high fitness spent more time in vigorous activity than children with middle fitness (p<0.05). Shuttle run test level was negatively associated with BMI (r² = -0.451, p<0.01), waist circumference (r² = -0.560, p<0.001), waist-height ratio (r² = -0.560, p<0.001) and systolic blood pressure (r² = -0.306, p<0.05) after adjustment for age, sex and GMFCS level.

Conclusions

Participation in physical activity, particularly at a vigorous intensity, is associated with high cardiorespiratory fitness in children with CP. Low cardiorespiratory fitness is associated with increased cardiometabolic risk.     

Contribution of physical fitness component to health status in middle-aged and elderly males

This study determined the physical fitness component that contributes to improving and maintaining health status for each age group as well as quantifying the degree of the relationship between health status and physical fitness in middle-aged and elderly males. The participants were 995 males aged 30 to 69 years. Ten physical fitness tests and medical checkups were performed. The participants were divided into a healthy group and an unhealthy group according to health status. Multiple discriminant analysis was applied to the multivariate data. Correct discriminant probabilities of the multiple discriminant function to discriminate the healthy and unhealthy groups for males ranged from 67.0% to 75.1%. These findings suggest that there is a relatively high relationship between the health status and physical fitness level for middle-aged and elderly males. With each individual's discriminant score calculated using the multiple discriminant function as the index of the degree of health, the Pearson's correlation coefficient of the discriminant score and the performance in each physical fitness test were calculated. The age change between 30 and 69 years old was classified into five patterns according to the contribution. The result of this study is considered to be useful as objective data to prepare an exercise program considering the contribution of the physical fitness component of health status.     

Valoración de la fuerza,la flexibilidad,el equilibrio,la resistencia y la agilidad en función del índice de masa corporal en mujeres mayores activas

Introduction

Overweight and obesity are increasing at an alarming rate among older people. This is mainly because this population is predominantly sedentary. The aim of this study was to classify, according to the body mass index (BMI), a group of older active women and to evaluate the different basic physical abilities as a function of this.

Material and methods

The BMI and fitness were evaluated in 60 elderly active women (mean age: 66.14 ± 6.59 years) using the 2-minute step test, arm curl test, chair stand test, back scratch test, chair-sit and reach-test, flamenco test, and 8-foot up-and-go test.

Results

It was found that 52.23% of the women studied had a normal BMI and 47.76% were slightly overweight. There were no cases of obesity or underweight. Women with normal BMI had better values in all tests than overweight women. Significant differences were found in the flamenco test (P < .05), and 8-foot up-and-go test (P < .01).

Conclusions

Older women who usually do physical activity had a normal or slightly overweight BMI. It was also found that women with lower BMI have better resistance, flexibility, balance and strength.     

Contribution of physical fitness component to health status in middle-aged and elderly females

This study determined the physical fitness component that contributes to improving and maintaining health status for each age group as well as quantifying the degree of the relationship between health status and physical fitness in middle-aged and elderly females. The participants were 2,371 females aged 30 to 69 years. Ten physical fitness tests and medical checkups were performed. The participants were divided into a healthy group and an unhealthy group according to health status. Multiple discriminant analysis was applied to the multivariate data. Correct discriminant probabilities of the multiple discriminant function to discriminate the healthy and unhealthy groups for females ranged from 63.0% to 77.5%. These results suggest that there is a relatively high relationship between health status and physical fitness level for middle-aged and elderly females. With each individual's discriminant score calculated by the obtained multiple discriminant function as the index of the degree of health, the Pearson's correlation coefficient of the discriminant score and the performance in each physical fitness test were calculated. The aging change from 30 to 69 years old was classified into four patterns according to the contribution. The result of this study is considered to be useful as objective data to prepare an exercise program considering the contribution of the physical fitness component of health status.     

Development of a baseball-specific battery of tests and a testing protocol for college baseball players

In this study, the relationship between the physical fitness of college baseball players found from 6 field tests and a performance evaluation by coaches was investigated. The purpose was to ascertain whether the results would be similar to those obtained in a previous study. The subjects of the study were 43 college baseball players (mean age, 20.7 +/- 1.4 years; mean athletic career, 10.9 +/- 2.6 years). Referring to the previous study, the field tests of physical fitness were composed of 6 items: throwing distance, back strength, medicine ball throwing, standing long jump, T-test, and base running. For capabilities in batting, fielding, and running, the coach's evaluation was expressed by T scores. The results of the analysis indicated that those players with high evaluation scores had significantly better test results in comparison with those players who were rated low in the evaluation. Although the multiple regression models of the previous study were associated with a middle goodness of fit, a significant correlation was found between physical fitness found in the field tests and performance. The results from a partial correlation analysis indicated a significant correlation between the following: batting evaluation with back strength (p < 0.01) and medicine ball throwing (p <0.01); fielding evaluation with throwing distance (p < 0.05); and running evaluation with medicine ball throwing (p < 0.01), standing long jump (p < 0.05), T-test (p < 0.01), and base running (p < 0.01). It is certain that the performance of college baseball players is related to their physical fitness.     

The physical characteristics of the members during the International Biomedical Expedition to the Antarctic

Twelve male medical scientists formed the International Biomedical Expedition to the Antarctic (IBEA). Their physical characteristics and maximum oxygen uptakes (VO2max) were measured in association with three series of thermal tolerance tests in Sydney, twice before and once after going to the Antarctic. In the Antarctic they lived in tents and spent 15 days travelling by motor toboggan. Their body mass (BM) and skinfold thickness (SFT) were measured four times during the 69 days the expedition spent in the field. The characteristics of the group were (ranges): age 26-52 years, height 1680-1889 mm, BM 58.5-103.4 kg, fatness 16-34% BM and VO2max 33-49 ml X kg-1 X min-1. In the Antarctic 9 men lost between 0.7 and 5.5 kg (mean 2.7 kg) of BM with a decrease in SFT, whilst 2 men increased BM by 1.2 and 1.9 kg without change in SFT. One man retired early from the expedition. BM and SFT were regained and physical fitness lost during the return voyage to Australia. Consequently there was no difference in average SFT between the pre- and post-Antarctic laboratory tests, but BM was greater after the Antarctic implying gains in fat free mass. VO2max was lower in the final laboratory tests than in the tests before Antarctica.     

Changes in physical activity and fitness after 3 months of home Wii Fit™ use

The purpose of this study was to examine changes in physical activity and fitness variables in members of 8 volunteer families after 3 months of home use of the Wii Fit? interactive video game. Pre and postintervention measurements were obtained from 21 subjects relative to physical activity (5 days of accelerometry), aerobic fitness (graded treadmill test), muscular fitness (push-ups), flexibility (sit-and-reach test), balance (composite equilibrium score), and body composition (body mass index and % body fat). Use characteristics of the Wii Fit? device were also determined. A series of 2 (age group) × 2 (time) repeated measures analyses of variance were conducted to assess changes over time and between adults and children. Three months of home Wii Fit? use revealed no significant age group × time interactions or main effects of group or time for daily physical activity, muscular fitness, flexibility, balance, or body composition. An age group × time interaction (p = 0.04) was observed in peak VO2 (ml·kg(-1)·min(-1)) with children displaying a significant (p = 0.03) increase after 3 months of Wii Fit? use, whereas adults showed no significant (p = 0.50) change. Daily Wii Fit? use per household declined by 82% (p < 0.01) from 21.5 ± 9.0 min·d(-1) during the first 6 weeks to 3.9 ± 4.0 min·d(-1) during the second 6 weeks. Most measures of health-related fitness in this exploratory study remained unchanged after 3 months of home use of the popular Wii Fit? whole-body movement interactive video game. Modest daily Wii Fit? use may have provided insufficient stimulus for fitness changes.     

Physical Fitness Percentiles of German Children Aged 9–12 Years: Findings from a Longitudinal Study

Background

Generating percentile values is helpful for the identification of children with specific fitness characteristics (i.e., low or high fitness level) to set appropriate fitness goals (i.e., fitness/health promotion and/or long-term youth athlete development). Thus, the aim of this longitudinal study was to assess physical fitness development in healthy children aged 9–12 years and to compute sex- and age-specific percentile values.

Methods

Two-hundred and forty children (88 girls, 152 boys) participated in this study and were tested for their physical fitness. Physical fitness was assessed using the 50-m sprint test (i.e., speed), the 1-kg ball push test, the triple hop test (i.e., upper- and lower- extremity muscular power), the stand-and-reach test (i.e., flexibility), the star run test (i.e., agility), and the 9-min run test (i.e., endurance). Age- and sex-specific percentile values (i.e., P₁₀ to P₉₀) were generated using the Lambda, Mu, and Sigma method. Adjusted (for change in body weight, height, and baseline performance) age- and sex-differences as well as the interactions thereof were expressed by calculating effect sizes (Cohen’s d).

Results

Significant main effects of Age were detected for all physical fitness tests (d = 0.40–1.34), whereas significant main effects of Sex were found for upper-extremity muscular power (d = 0.55), flexibility (d = 0.81), agility (d = 0.44), and endurance (d = 0.32) only. Further, significant Sex by Age interactions were observed for upper-extremity muscular power (d = 0.36), flexibility (d = 0.61), and agility (d = 0.27) in favor of girls. Both, linear and curvilinear shaped curves were found for percentile values across the fitness tests. Accelerated (curvilinear) improvements were observed for upper-extremity muscular power (boys: 10–11 yrs; girls: 9–11 yrs), agility (boys: 9–10 yrs; girls: 9–11 yrs), and endurance (boys: 9–10 yrs; girls: 9–10 yrs). Tabulated percentiles for the 9-min run test indicated that running distances between 1,407–1,507 m, 1,479–1,597 m, 1,423–1,654 m, and 1,433–1,666 m in 9- to 12-year-old boys and 1,262–1,362 m, 1,329–1,434 m, 1,392–1,501 m, and 1,415–1,526 m in 9- to 12-year-old girls correspond to a “medium” fitness level (i.e., P₄₀ to P₆₀) in this population.

Conclusions

The observed differences in physical fitness development between boys and girls illustrate that age- and sex-specific maturational processes might have an impact on the fitness status of healthy children. Our statistical analyses revealed linear (e.g., lower-extremity muscular power) and curvilinear (e.g., agility) models of fitness improvement with age which is indicative of timed and capacity-specific fitness development pattern during childhood. Lastly, the provided age- and sex-specific percentile values can be used by coaches for talent identification and by teachers for rating/grading of children’s motor performance.     

The influence of multiple administration of a psychomotor test on performance and learning

Exercise scientists frequently use criterion measure tests to assess levels of motor performance and physical fitness or to evaluate the success of their intervention programs. During this process, the same motor test might be administered multiple times. The aim of the present study was to examine whether familiarization with a psychomotor test would influence performance and/or learning. One hundred thirty (n = 130) primary school students participated in the study. Participants were randomly divided into two groups, experimental (n = 60, mean age = 10.74 years old, minimum = 9.08, maximum = 11.83) and control (n = 70, mean age = 10.68 years old, minimum = 9.5, maximum = 11.79). The flamingo balance test was used to examine the postulated hypothesis. Initially, both groups executed the balance test. Then, only the experimental group performed two additional trials, one trial every 3 days. A final trial was administered to all participants, followed by a retention trial 1 week later. The results revealed that both groups improved their performance. The experimental group outperformed the control group. The retention trial showed that performance levels for both groups continued to improve, suggesting that familiarization with the test influenced not only performance but learning as well. Exercise scientists who implement psychomotor tests, such as balance tests, for evaluative purposes should be aware that performance improvement does not necessary represent changes in individuals' performance, but it may reflect individuals' familiarization with the test.     

Age-related effects on fitness performance in elite-level soccer referees

Elite soccer referees usually achieve the peak of their officiating careers at an average age that is considerably older than that observed in competitive matched soccer players. As ageing has been reported to negatively affect physical performance, the aim of this study was to investigate the effect of ageing on fitness performance in elite-level soccer referees. Thirty-six elite-level soccer referees were grouped into young (Y, n = 12), average (A, n = 14), and old (O, n = 10) groups, according to their age and observed for field test performance (countermovement jump [CMJ], 50-m and 200-m sprints, and 12-minute running for distance). Results showed a significant age effect on CMJ (r = -0.52, p < 0.001), 200 m (r = 0.51, p < 0.001), and 12-minute time trial running (r = -0.52, p < 0.001). Y jumped higher than A and O groups (p < 0.05) and were faster than O over 200 m (p < 0.05). No group effect was observed for 12-minute run and 50-m performance (p > 0.05), respectively. Sixteen of the 36 referees were further examined for selected physiological variables and grouped into 2 equal (n = 8) age groups (young and old, Y1 and O1, respectively). Vo(2)max was higher in Y1 (p < 0.05), but O1 attained performances similar to Y1 running at selected blood lactate speeds (4 mmol L(-1), p > 0.05). Although older referees demonstrated acceptable fitness levels, younger officials should ensure that they develop appropriate levels of aerobic and anaerobic fitness to be able to match the demands placed upon them while refereeing throughout their careers. To promote this, fitness test standards should be age related.     

Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis

Background

Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.

Methods and Findings

Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.

Conclusions

Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.     

Biological age versus physical fitness age in women

The purpose of this study was to determine whether adult women who are in a state of high physical fitness are in a good state biologically, in terms of biological and physical fitness ages as estimated by statistical means. The subjects were 65 healthy Japanese women (aged 20-64 years). Biological and physical fitness ages were estimated from the data for 18 physiological function tests and 5 physical fitness tests, respectively, by a principal component model. The correlation coefficient between biological and physical fitness ages was 0.70 (P less than 0.01), which was generally regarded as a high correlation. Therefore, those who were in a state of high physical fitness were considered to be in good biological condition. This result is in good agreement with the results (r = 0.72) from adult men, on whom we reported previously. A statistical analysis to ascertain the relative importance of each contributory variable associated with the variance in biological age suggested that routine clinical evaluation of blood pressure and lipid metabolism might play an important role in determining not only the presence and severity of vascular disease but also the rate of biological aging in women.     

Relationship of beta(3)-adrenergic receptor polymorphism with metabolic syndrome and oxidative stress parameters in postmenopausal women

INTRODUCTION: Some studies indicate, that the Trp(64)/Arg(64) polymorphism of beta(3)-adrenergic receptor (ADRB3) is associated with obesity, insulin resistance and earlier onset of type 2 diabetes mellitus. The aim of our study was evaluation of frequency of this ADRB3 polymorphism and his association with metabolic syndrome parameters and oxidative stress in postmenopausal women. MATERIAL AND METHODS: We performed the study among 94 women, aged 50-60, selected randomly from Wroclaw city population. Estimation of anthropometric parameters, densitometry (total body fat, android and gynoid deposits--using DPX(+) Lunar, USA device) and biochemical estimations such as lipid profile, glucose, insulin, estradiol and FSH serum level (using commercial kits) were carried out. Oxidative stress was estimated by measurement of thiobarbituric-reactive substances (TBARS) serum concentration, using Yagi method, on spectrofluorimeter Perkin-Elmer LS55. Blood for analysis was collected before, direct after and 6 h after the 30-minutes physical test using cycloergometer. ADRB3 genotyping was performed by PCR and mini-sequencing using ABI 310 sequencer (Applied Biosystems). RESULTS: The frequency of Trp(64)/Arg(64) genotype in investigated population was 15.8%. The Arg(64)/Arg(64) genotype had only one woman. Women bearing Trp(64)/Arg(64) genotype showed higher mean serum level of triglycerides and lower serum level of HDL-cholesterol in comparison to women bearing Trp(64)/Trp(64) genotype, however without statistical significance (p > 0.05) (respectively, means +/- SD for triglycerides: 140.3 +/- 64.1 vs. 113.9 +/- 56.2 mg/dl; and for HDL-cholesterol: 60.9 +/- 11.9 vs. 67.0 +/- 16.9 mg/dl). Both groups did not differ in any other investigated anthropometric nor biochemical parameter. CONCLUSIONS: 1. The Trp(64)/Arg(64) polymorphism of beta(3)-adrenergic receptor could be associated with lipid profile disorders observed in metabolic syndrome in postmenopausal women, however it should be explained basing on the study with more included subjects. 2. The Trp(64)/Arg(64 )polymorphism of beta(3)-adrenergic receptor has no influence on oxidative stress intensification after standardized physical effort in postmenopausal women.     

Age,sex, and temporary resident originated prescribing units (ASTRO-PUs): new weightings for analysing prescribing of general practices in England.

OBJECTIVE--To derive demographic weightings to replace the existing system of prescribing units used in analysing prescribing by general practitioners in England. DESIGN--The prescribing data for one year from a sample of 90 practices in 80 family health service authority areas were used to calculate the relative frequency with which items were prescribed, for each sex, in nine age bands and for temporary residents. Data on the variation in cost per item by age and sex then allowed estimates to be made of the relative costs for these groups. Integer values for both the item based and cost based weightings were obtained by conversion to optimal integer scales. MAIN OUTCOME MEASURES--Item based and cost based weightings for each of the 18 age-sex groups and for temporary residents. The cost based weightings were considered more appropriate to the context in which the new system was to be used. RESULTS--Prescribing costs increased noticeably, for both sexes, in the middle years (ages 35-64). Compared with the existing system, the cost based weightings (ASTRO-PUs) gave greater weight to patients aged 45 and over, especially those in the 55-64 age band, at the expense of younger patients. Children under 5 received twice as many items as those aged 5-14, but the inexpensiveness of their drugs made the cost based weightings of the two groups equal. Similarly, women were generally given more items than men, but at a lower average cost per item, which reduced differences between the sexes in the cost based weightings. Costs for patients aged 75 and over, compared with those aged 65-74, were higher only for women. CONCLUSIONS--The cost based weightings proposed are believed to reflect the present distribution of prescribing costs, in relation to age and sex, in English general practice. They are intended for use in analyses at practice level.     

Fitness level of adult economically active population in the Republic of Croatia estimated by EUROFIT system

The study presents the results of the EUROFIT CROATIA project that was conducted according to the instructions of Council of Europe. The aim of the study was evaluation of fitness level of the employed Croatian population. The measurements comprised EUROFIT battery of tests as well as Baecke's questionnaire for evaluation of habitual physical activity. The sample was comprised of 1628 active inhabitants, 18-60 years of age, all of who were employed and living in Croatia. The obtained results of functional, motor and morphological characteristics were presented according to the sex and age. The results shower poor aerobic capacity, high obesity indicators and low motor performance in both sexes, which pointed to the increased risk for developing many cardiovascular or musculo-skeletal diseases. The overall fitness level of Croatian population showed to be unsatisfactory and it should be improved by engagement in sports-recreational activities.     

Physiological characteristics of masters-level cyclists

Although a considerable amount of research is available describing the physiological characteristics of competitive young-adult cyclists, research describing these same characteristics in Masters-level cyclists is rare. Therefore, the purpose of this study was to describe and compare the effect of aging on physiological fitness parameters of Masters-level cyclists in an attempt to provide normative fitness data. Thirty-two male cyclists (35-73 years) completed one 15-minute economy test and one graded exercise test (GXT) on a cycle ergometer. During the GXT, maximal oxygen uptake ([latin capital V with dot above]o2max), maximal heart rate (HRmax), the first (VT1) and second (VT2) ventilatory thresholds, and peak power output (PPO) were recorded. For the purpose of analysis, subjects were allocated into three age groups (35-45 years, 45-54 years, >=55 years). Maximal oxygen uptake and absolute PPO were significantly lower among subjects 55 years and older (45.9 +/- 4.6 mL x kg(-1) x min(-1) and 324 +/- 51 W, respectively) compared with the 45- to 54-year group (54.2 +/- 6.6 mL x kg(-1) x min(-1) and 392 +/- 36 W, respectively), and both were significantly less compared with the 35- to 44-year group (60.7 +/- 5.1 mL x kg(-1) x min(-1) and 434 +/- 32 W, respectively). Maximal heart rate was significantly greater in both the 35- to 44-year and 45- to 54-year age groups compared with the >=55-year group. The first ventilatory threshold was significantly greater in the subjects who were 55 years and older group compared with the 35- to 44-year and 45- to 54-year age groups, and VT2 was significantly greater in subjects 55 years and older compared with the 35- to 44-year group. Economy was not different amongst groups. In conclusion, increases in age resulted in a significant reduction in fitness parameters across age groups. The comparison of the fitness characteristics of Masters-level cyclists with established young-adult cyclist data should be avoided, because this may lead to inaccurate assessments of fitness.