Obesity and its subsequent comorbidities are rising in prevalence in the United States. The National Center of Health Statistics reported an age-adjusted obesity (body prevalence of geriatric vulnerabilities (including pain, depression, disability, and social isolation) were compared between obese older adults with and without sarcopenia. Results and Discussion: Among obese older adults, 18% (n = 318/1600) were sarcopenic. After adjusting for age and sex, sarcopenic obese older adults had 3.7 times the odds of having 2 or more comorbid conditions (odds ratio [OR] = 3.7; 95% CI 2.2-5.0) and 6.4 times the odds of being frail (OR = 6.4; 95% CI 4.4-9.5) as compared with nonsarcopenic obese older adults. Sarcopenic obese older adults were also more likely to have 1 or more activities of daily living disabilities (OR = 3.7; 95% CI 2.5-5.4), be socially isolated (OR = 2.1; 95% CI 1.3-3.2), and report activity-limiting pain (OR = 2.0; 95% CI 1.5-2.7) as compared with nonsarcopenic obese older adults. These findings, in a nationally representative cohort, suggest obese older adults who are sarcopenic have higher rates of geriatric vulnerabilities that could impact delivery and outcomes of exercise and nutrition interventions. Conclusions: Concomitant obesity and sarcopenia are associated with higher rates of geriatric vulnerabilities among a nationally representative sample of older adults. More comprehensive interventions, beyond exercise and diet modifications, may be necessary to additionally address these newly identified social and physiological risks.

Purpose of Review This review discusses current research on the impact of specific dietary patterns and exercise, both individually and combined, on cognitive function in older adults. Recent Findings Observational evidence generally supports a relationship between diet adherence and positive cognitive outcomes related to memory, executive function, and risk for cognitive impairment; however, randomized controlled trials (RCTs) are limited. Exercise research is more extensive, showing improvements in cognitive performance after exercise interventions regardless of baseline cognitive status and noting lower incidences of cognitive impairment in people who engage in regular physical activity. Summary Evidence supports adherence to specific dietary patterns and a combination of aerobic and resistance exercise as an effective approach to mitigate age-associated cognitive decline. Further research on older adults at various stages of cognitive decline, as well as longer-term RCTs, will help determine the best clinical markers of early cognitive dysfunction, and the effectiveness of early lifestyle intervention on cognitive function.

Objective The role of exercise therapy after acute pulmonary embolism (PE) is unknown. Exercise therapy is safely used after myocardial infarction and chronic obstructive pulmonary disease. The aim of this study was to investigate the safety of exercise therapy after acute PE. Methods We implemented a 3-month exercise program after acute PE. Outcomes were death, bleeding, readmissions, recurrent events, changes in peak VO2 and quality of life (QoL). Results A total of 23 patients were enrolled and received anticoagulation; no adverse events were reported during the exercise period. One death, 1 DVT and 5 readmissions were reported due to non-exercise related reasons. Functional capacity improved as evidenced by an increased peak VO2 at 3 months (+3.9 ± 5.6 mL/kg/min; p = 0.05). Improvement in QoL was observed at 6-months on the functional (+17.0 ± 22.6, p = 0.03) and physical health factor scales (+0.9 ± 4.6, p = 0.03). Conclusion Exercise therapy is feasible and safe in appropriately anticoagulated patients after PE.

Elevations in central augmentation index (AIx) are predictive of cardiovascular disease. The objective of this study was to examine AIx immediately and 24 h following an acute bout of high-intensity functional training (HIFT) in apparently healthy young adults. A second aim compared the exercise-induced AIx recovery response between men and women. Thirty-two recreationally active younger adults ( n = 16 men) were tested. Baseline central hemodynamic measures were assessed, followed by a single bout of bodyweight HIFT. The HIFT included 4 rounds of burpees, jump squats, split squats, and walking lunges. Assessments were repeated 5, 10, 15, and 24 h post-exercise. AIx was normalized to a heart rate of 75 bpm (AIx75). There was a significant main effect of time on AIx75 across all groups ( P < 0.001) with AIx75 increasing at all acute time points compared with baseline and returning to resting values 24 h post-exercise. When examining sex differences after covarying for height and body fat percentage, the authors found no time × sex interaction ( P = 0.62), or main effect for sex ( P = 0.41), but the significant main effect of time remained ( P < 0.001). The AIx75 response to HIFT follows a similar recovery pattern as previously studied modes of exercise with no residual effects 24 h later and no differences between men and women indicating no persistent cardiovascular strain in younger adults participating in this mode of exercise.