CA20104 – Ne wo k on e idence-based
physical ac i i y in old age (PhysAgeNe )
Deli e able D2.3
D2.3. Open da a amewo k including PA in e en ion and
mul iple da a sou ces and bioma ke s
RCO 2 P o ide a consis en open da a amewo k o all ele an
bioma ke s and o he ac o s om RCO 1
Con ibu o s
Wo king G oup 2
Tiia Kekäläinen (WG2 leade ), Ca l-Philipp Jansen (WG2 co-leade ), E ja
Po egijs (WG2 Ad iso ), Emelyn Ma ho (Re iew g oup leade ), O gesa Qipo
(Re iew g oup leade ), Wou e Vin s (Re iew g oup leade ), Da id Beckwée
(Re iew g oup leade )
Pa icipan s in he expe discussions and e iew g oups ha e all con ibu ed
o hese esul s.
Table o Con en s
1. In oduc ion ............................................................................................................................................................................... 3
2. Resul s ........................................................................................................................................................................................... 5
2.1. Uni e sal and essen ial concep s o a iables ............................................................................................. 5
2.2. No el and p omising concep s and ecommended a iables om each e iew g oup
6
2.2.1. LOCOMOTOR AND VITALITY CAPACITY AND FUNCTION ............................................................. 6
2.2.2.NEUROMUSCULAR FUNCTION ........................................................................................................................ 6
2.2.3. COGNITIVE CAPACITY AND FUNCTION ...................................................................................................... 7
2.2.4. PSYCHOLOGICAL FACTORS .............................................................................................................................. 8
2.2.5 ENVIRONMENTAL FACTORS .............................................................................................................................. 9
3. Conclusions ............................................................................................................................................................................... 9
4. Re e ences ......................................................................................................................................................................... 10
1. INTRODUCTION
Au ho : Tiia Kekäläinen and E ja Po egijs
The Uni ed Na ion’s decade o Heal hy Ageing highligh s he g owing impo ance o
add essing he challenges associa ed wi h he ageing popula ion. Heal h bene i s o physical
ac i i y in old age a e well accep ed, bu he e is no consensus on speci ic concep s and
measu es o be used o assessing in e en ion ou comes, leading o a wide a ie y o
epo ing. When implemen ing physical ac i i y in e en ions in eal-li e se ings, a ious
ac o s a ec he up ake o he in e en ion, adhe ence o he p o ocol, and sus ained
pa icipa ion. Thus, esea ch on physical ac i i y in e en ions should assess no only
ou comes, bu also o he ac o s unc ioning as mode a o s o media o s o he in e en ions.
This equi es a holis ic ocus, encompassing no only mo e adi ional physical o biological
bioma ke s, bu also beha io al and en i onmen al ma ke s.
To ad ance he measu emen and moni o ing o ( echnology-assis ed) physical ac i i y
in e en ion ou comes as well as ac o s ela ed o hei up ake and main enance in old age,
he PhysAgeNe COST ac ion ne wo k b ough oge he esea che s om di e en Eu opean
Uni e si ies. In 2022, expe s collabo a ing in wo kg oup 2 s a ed o discuss and cla i y
biological and beha io al bioma ke s and en i onmen al ac o s comp ehensi ely. Join ly he
esul s o WG2 will es ablish equi emen s and a oadmap o u u e moni o ing o
in e en ions and e en ually lead o a amewo k o open da a and mul iple sou ce da a o
u ilizing comp ehensi e and ele an assessmen s in mul iple domains, i.e., a la ge a ie y o
bioma ke s and beha io al ma ke s, as well as en i onmen al ac o s, in echnology-assis ed
physical ac i i y (PA) and exe cise in e en ions.
To concep ualize and o de he comp ehensi e assessmen s ele an o ( echnology-assis ed)
physical ac i i y in e en ions in a heo e ical amewo k, i was decided o use he Heal hy
Ageing amewo k de eloped by he WHO (2015). While de eloped o map he aging p ocess,
i ocuses on heal hy aging, ha is, main aining unc ional abili y and o e all well-being in
olde age, a he han solely ocusing on disease managemen . The amewo k iden i ies
in insic and ex insic ac o s and linked unc ional domains, and acco ding o he li e a u e
and expe s in ol ed, hese cap u e concep s ele an o physical ac i i y in e en ions.
To acili a e opical discussions on he b oad ange o pa ame e s in he Heal hy Aging
F amewo k, WG2 was spli in o mo e speci ic expe g oups. Th ee g oups ocus on in insic
capaci y: 1) Locomo o and i ali y capaci y and unc ion, 2) Cogni i e capaci y and unc ion,
and 3) Psychological ac o s; and one g oup on ex e nal ac o s: 4) En i onmen al ac o s.
Some o hese g oups we e u he di ided in o subg oups wo king on e iews ocusing on
speci ic opics. In o al, 8 e iews ha e been o will be submi ed un il la e 2024/ea ly 2025,
p o iding he basis o de elop a da a amewo k.
We acknowledge ha while a ge ing a holis ic app oach, i was no possible o co e all
aspec s o he Heal hy Aging F amewo k. Howe e , he e iews co e a ious opics om
bioma ke s o beha io al and en i onmen al ac o s, leading o he possibili y o compiling
e idence om di e en aspec s ele an o physical ac i i y and exe cise in e en ions.
The esul s o sea ches and analyses o each e iew ha e been compa ed o each o he and
used o gene a e lis s o concep s and a iables ele an o assess in he con ex o physical
ac i i y in e en ions o echnology-assis ed physical ac i i y in e en ions in olde adul s.
Based on he expe discussions, we decided o ca ego ize he concep s and a iables in o
h ee ca ego ies.
. Va iables ha e been ca ego ized as:
1. Uni e sal and essen ial concep s o a iables o assess and epo when conduc ing
physical ac i i y in e en ions in gene al. These a e a iables ound o be ele an o all
o almos all e iew g oups, ega dless o he e iew opic. These a iables a e essen ial
o be collec ed in s udies and epo ed when planning da a sha ing.
2. No el and p omising concep s o a iables o assess when conduc ing physical ac i i y
in e en ions in gene al. These a e iden i ied based on exis ing li e a u e as well as
expe opinions du ing he e iew p ocesses.
3. Recommended a iables in pa icula physical ac i i y in e en ion con ex s.
2. RESULTS
2.1. Uni e sal and essen ial concep s o a iables
Table 1. Uni e sal and essen ial concep s o a iables o assess and epo when conduc ing
echnology-assis ed physical ac i i y in e en ion
S udy in o ma ion
De ails o examples
Name / i le
Au ho s / Con ac pe son
Objec i es
S udy design
Design
E.g. RCT
Numbe o assessmen ime poin s; and ime
poin s
Se ing
Home s. Communi y s.
Ins i u ion e c.
Coun y
Pa icipan s
Pa icipan s o al
N
Age
in yea s: mean, sd, ange
Gende /sex a io
% emale
Inclusion c i e ia
Exclusion c i e ia
Pa icipan s in e en ion g oup
N
Age
in yea s: mean, sd, ange
Gende /sex a io
% emale
Pa icipan s con ol g oup
N
Age
in yea s: mean, sd, ange
Gende /sex a io
% emale
In e en ion
Du a ion
O e all in e en ion du a ion
F equency
Numbe o sessions pe week
Supe ision
No o yes; i yes: how
Physical ac i i y componen s
Types o exe cises, in ensi y
Technology: de ice
E.g., compu e , sma phone,
wea able de ice, sma wa ch
Technology: unc ion
Speci y wha he echnology does
Ou comes
P ima y ou comes
e.g. mo o capaci y
P ima y ou come measu emen s
e.g. SPPB
2.2. No el and p omising concep s and ecommended a iables
om each e iew g oup
2.2.1. LOCOMOTOR AND VITALITY CAPACITY AND FUNCTION
Au ho : Emelyn Ma ho
A key concep in Heal hy ageing is in insic capaci y, e e ing o he physical and men al
capaci y an indi idual can d aw on a any gi en ime and consis s o 5 domains including
locomo o , psychological, senso ial, cogni i e, and i ali y domains. Locomo o and i ali y
capaci y a e wo domains o in insic capaci y and ha e ecen ly been ede ined by an expe
ask o ce ini ia ed by he WHO. A new WHO wo king de ini ion o i ali y capaci y (VC) has
been p oposed by 20 in e na ional expe s in an expe mee ing, de ining VC as "a
physiological s a e (due o no mal accele a ed biological ageing p ocesses) esul ing om he
in e ac ion be ween mul iple physiological sys ems, e lec ed in ( he le el o ) ene gy and
me abolism, neu omuscula unc ion, and immune and s ess esponse unc ions o he body"
(Bau mans e al., 2022).
Ou umb ella e iew ocused on he e ec s o exe cise on he mos p ominen ci cula p o-
and an i-in lamma o y ma ke s, bioma ke s which a e pa o he hi d domain o i ali y
capaci y, namely he immune and s ess esponse unc ions o he body. When epo ing on
hese bioma ke s, i is c ucial o epo he iming o blood sampling, as a iming wi hin 24
hou s a e he las exe cise session s ill encompasses he acu e e ec s o exe cise, while
sampling 24 hou s a e he las exe cise session is gene ally accep ed o ep esen he e ec s
on basal le els. Al hough se e al e iews and p ima y esea ch a icles, included in ou
umb ella e iew, ha e been published epo ing hese bioma ke s, he iming o sampling is
o en no epo ed clea ly ye . Mo eo e , al hough in he pas , bioma ke s we e usually
measu ed in blood samples, a ise in a icles desc ibing he use o al e na i e biological
ma e ials, such as sali a o b ea h condensa e, ha e been desc ibed. Mo eo e , a ise in pape s
desc ibing o en less in asi e sampling me hods, such as inge p icks o blood o sali a swab
ha e also been obse ed. I will hus become inc easingly impo an o consis en ly desc ibe
bo h biological ma e ials and sampling me hods since di e ences in ou come compa ed o
classical blood sampling me hods may a ise.
2.2.2. NEUROMUSCULAR FUNCTION
Au ho : O gesa Qipo
As men ioned abo e, ano he cons uc o i ali y capaci y is neu omuscula unc ion
(Bau mans e al., 2022). Neu omuscula unc ion, o en assessed h ough g ip s eng h (Dodds
e al., 2014) using a hand-held dynamome e , has been p oposed as a bioma ke o aging. In
communi y-dwelling olde adul s, i se es as a s ong p edic o o ou comes such as
disabili y, alls and mo ali y (Bohannon e al., 2019).
We ocused on he e ec s o echnology-assis ed physical ac i i y in e en ions on a) muscle
mechanical unc ion and b) on ci cula ing bioma ke s o neu omuscula unc ion in
communi y-dwelling olde adul s aged 60 yea s old and abo e.
2.2.3. COGNITIVE CAPACITY AND FUNCTION
Au ho : Wou e Vin s
The cogni i e domain o in insic capaci y is well s udied p e iously. In gene al, cogni i e
decline s a s om he age o 20-25 (Tucke -D op 2019). A a ce ain age, nea ly 100% o
indi iduals will su e unc ional abili y losses due o cogni i e impai men (Pe e sen 2011). An
inc easing numbe o s udies ha e shown ha physical exe cise can p e en o delay he
p ocess o cogni i e decline and decades o esea ch has led o ul illing Hill’s c i e ia o
causali y (Dupuy e al. 2024). Howe e , despi e he as amoun o wo k ha has al eady been
done and se e al hypo heses ha ha e been pos ula ed conce ning he mechanisms o he
bene icial e ec o physical exe cise on cogni ion, he e emains lack o consensus ega ding
he ole o each o hese pos ula ed mechanisms. E idence, ye mos ly om animal esea ch,
sugges s ha exe kines (all o he pep ides, me aboli es, and nucleic acids eleased in o he
bloods eam du ing and ollowing physical exe cise) can ac i a e neu ophysiological
p ocesses ela ed o neu oplas ici y, unde lying he bene icial e ec o physical exe cise on
cogni i e unc ion (Vin s e al. 2022). A challenge in his a ea is ha he numbe o disco e ed
exe kines is apidly g owing, mos wi h unknown e ec s. Conside ing only he exe kines
eleased om muscle cells (i.e. myokines), mo e han 1,000 pu a i e myokines ha e been
epo ed in li e a u e (Vin s e al. 2023).
We a e p esen ly conduc ing a li ing me a-analysis in which we plan o pe o m a media ion
analysis on he ole o myokines in he e ec o physical exe cise on cogni i e unc ion. A e
publica ion, he esul s o his me a-analysis will con inuously be upda ed e e y six mon hs o
a ime pe iod o a leas 5 yea s. The e iew is ongoing o abou wo yea s and since hen 4 o
6 new s udies we e added o he e iew yea ly. A o al o 40 s udies a e now included. The
myokines mos commonly e alua ed in s udies ha epo s physical exe cise e ec s on
cogni i e unc ion a e: BDNF, IGF-1, VEGF, I isin (neu o ophic ac o s), IL-6, TNF-α and CRP
(p o-in lamma o y ac o s) measu ed om blood samples. In gene al, cogni i e unc ions
imp o ed, neu o ophic ac o s inc eased and p o-in lamma o y ac o s dec eased ollowing
physical exe cise. Media ion analysis is now ongoing, and esul s a e expec ed by Decembe
2024.
Nex , we a e conduc ing a scoping e iew on he e ec o physical exe cise on muscle and
b ain me aboli es measu ed wi h Magne ic Resonance Spec oscopy (MRS). This echnique
allows he examina ion o me abolic changes a muscle and b ain le el. MRS is no commonly
used ye and ou goal is o compile all he indings om exe cise-induced changes in MRS
me aboli es, i espec i e o he in ended ou come, bo h in muscle and b ain. This wo k is
aimed o be published ea ly 2025 and will hope ully allow us o make ecommenda ions o
he use o his echnique in esea ch, add ess knowledge gaps and u u e di ec ions.
2.2.4. PSYCHOLOGICAL FACTORS
Au ho : Tiia Kekäläinen and Da id Beckwée
Physical ac i i y (PA) is a p o en me hod o enhance he heal h o olde adul s, bu ollowing
he in e en ion p o ocols is c ucial o achie ing op imal esul s. Acco ding o he Wo ld
Heal h O ganiza ion (WHO), adhe ence is de ined as he ‘ex en o which a pe son’s beha iou
co esponds wi h ag eed ecommenda ions om a heal hca e p o ide ’ (WHO 2003). This
means ha adhe ence e lec s how well he a ge in ensi y and olume o physical exe cises
a e main ained o e ime (Hawley-Hague e al. 2016). Pa ien s o en ace mul iple ba ie s ha
hinde hei abili y o ollow in e en ion plans e ec i ely, which a e ypically linked o a ious
aspec s o he issue. The e o e, adhe ence o exe cise is deeply oo ed in he pa icipan ’s
psychological de e minan s and beha iou (Collado-Ma eo e al. 2021).
Adhe ence o echnology is e en mo e c i ical o achie ing be e in e en ion ou comes.
Technologies can enhance exe cise up ake and long- e m adhe ence by o e coming many
pe cei ed ba ie s o exe cise. Addi ionally, compa ed o adi ional ehabili a ion,
echnologies such as se ious games can use engaging ideos and images, making hem mo e
a ac i e and accep able, as well as mo e e ec i e due o he highe di e si y o asks ha can
be ained. These echnologies can p o ide imely eedback, con inuous moni o ing, and
ou come assessmen , he eby in o ming he ins uc o o pe sonalized adap a ions.
Howe e , when using echnology, use s’ adhe ence o he echnology i sel (in addi ion o he
in e en ion) is a dis inc ac o ha needs o be conside ed (Payne e al. 2015). Technological
in e en ions o en su e om apidly declining e en ion a es (Chen e al. 2015). Mo eo e ,
many comme cially a ailable heal h echnologies a e no well-g ounded in beha iou al heo y
and ha e no been ho oughly es ed o hei e icacy (Payne e al. 2015). The apid pace o
new echnology de elopmen makes i inc easingly challenging o esea che s o de elop,
pilo - es , and e alua e in e en ions be o e such echnologies become ou da ed o obsole e
(Bake e al. 2014).
Hence, he aim o ou scoping e iew is o iden i y psychological and mo i a ional ac o s ha
con ibu e o olde people’s adhe ence when hey use echnology o suppo physical ac i i y
in e en ions. This wo k is cu en ly (in No embe 2024) in p og ess and aimed o be
submi ed in ea ly 2025.
2.2.5 ENVIRONMENTAL FACTORS
Au ho : Ca l-Philipp Jansen
Despi e he as -g owing domain o echnology-assis ed PA in e en ions in olde adul s, he
ole o en i onmen al ac o s is s ill eme ging in his ield. S udies iden i ied in his scoping
e iew mainly ocused on social en i onmen al ac o s, ollowed by physical en i onmen al
ac o s. S udies ha in eg a e socioeconomic and sys emic en i onmen al ac o s in
echnology-assis ed PA in e en ions a e sca ce. Included en i onmen al ac o s we e ound
o play a suppo i e ole in achie ing bene icial e ec s o echnology-assis ed PA in e en ions.
S udies e iewed we e, howe e , he e ogeneous in ha en i onmen al ac o s included we e
pa o he expe imen al design, e ec modi ie s, o ou comes. The e is a signi ican po en ial
o a be e unde s anding o in e en ion ou comes, and be e ailo ing o in e en ion
p og ams when sys ema ically including en i onmen al aspec s in echnology-assis ed PA
in e en ions in olde adul s.
F om his e iew, he aining deli e y modes (indi idual s. g oup and independen s. ace-
o- ace s. emo e/ i ual suppo ) seems o be an impo an con ex ual ac o o conside .
Fu he mo e, pe cei ed social suppo and social in e ac ions du ing aining acili a e
in e en ion adhe ence and ou comes.
3. CONCLUSIONS
Au ho : Tiia Kekäläinen
The PhysAgeNe COST ac ion ne wo k WG2 has ocused on unde s anding ele an concep s
and ac o s o assess and epo in ( echnology-assis ed) physical ac i i y in e en ions o
olde adul s. These concep s and a iables p o ide a basis o an open da a amewo k.
I is impo an o no e ha mos o he e iews a e s ill in p og ess, and he inal ema ks,
pa icula ly o a iable ca ego ies 2 (no el and p omising concep s) and 3 ( ecommended
a iables in speci ic con ex s), will be epo ed la e . P elimina y esul s sugges ha mo e
esea ch is needed in mos a eas o iden i y and ecommend speci ic a iables. We will
con inue he expe discussions and open da a amewo k de elopmen when he esul s o
he e iews a e eady in 2025. This ongoing wo k will con inue o e ine hese concep s and
con ibu e o he de elopmen o obus , e idence-based s a egies o imp o ing he heal h
and well-being o olde adul s h ough echnology-assis ed physical ac i i y in e en ions.
