Rationale: Sarcopenia is a major problem and is common in community-dwelling elderly. In daily practice, there is need for low cost and easily assessable measurement tools to assess depletion of skeletal muscle (SM) mass, for example as one of the indicators of sarcopenia. Bio-electrical impedance analysis (BIA) is often used to estimate body composition, whereas ultrasound measurement is an upcoming and promising tool, as it is quick, easy to use and inexpensive in comparison with other tools that assess SM mass. Ultrasound could assess site-specific loss of SM mass and determine myoesteatosis. Therefore, in this pilot study we aimed to assess agreement between muscle thickness of rectus femoris (RF) by ultrasound and SM mass by BIA in an older population. Methods: Twenty-six older adults (mean± standard deviation (SD) age 64 ±5.0 y, 62% women) from the Hanze Health and Ageing Study were included. SM mass by BIA was estimated using the Janssen equation. Muscle thickness of RF was assessed by analyzing ultrasound images from the right leg. Two non-parametric tests were used for analysis. Correlation between ultrasound and BIA was assessed with Spearman Rho. Agreement was determined with Kendall’s coefficient of concordance (Kendall’s W). In both tests a score ≥ 0.7 was considered a strong correlation.Results: Mean (±SD) RF thickness was 18.9 (±3.8) mm. Median SM mass (Interquartile range) was 23.5 (20.8-34.7) kg. Correlation between RF thickness and SM mass was moderately positive (Spearman r=0.611; P = 0.001), whereas Kendall’s W showed a strong agreement (W= 0.835; P=0.002).Conclusion: Ultrasound measurement of RF showed an acceptable agreement with skeletal muscle mass assessed by BIA in our sample of older adults. Therefore, ultrasound could be a promising portable tool to estimate muscle size.
BackgroundIn 2015, Amsterdam became part of the WHO Age Friendly City community, thereby accepting the responsibility to work towards a more age friendly Amsterdam. To study senior citizens’ needs and wishes concerning the age friendliness of their neighbourhood, the municipality asked the Amsterdam University of Applied Science to set up two pilot projects in two neighbourhoods. Aim was to 1) gain insight in seniors’ views and wishes regarding an age friendly city, and 2) reflect on the experiences with working with senior co-researchers. MethodologyThe study followed a Participatory Action Research approach with research teams consisting of seniors as co-researchers and professional researchers. We chose two neighbourhoods with distinct characteristics: the Indische Buurt which is centrally located, vibrant, multicultural, and strongly gentrifying, and Buitenveldert, a suburban and spacious neighbourhood, with less facilities and a dominance of well-to-do senior citizens. In both areas, we recruited senior co-researchers to form the research teams. They generally lived in, or close to, the pilot neighbourhood, and varied in age and ethnical background. The aim was to put the co-researchers in the lead during the entire research process. However, it differed between the neighbourhoods which type of researcher was in the lead. As a team, they formulated the main research question, constructed a topic list for interviews with older citizens, convened the interviews, analysed the data, wrote the report, and presented the results. During the entire process, they were supported by professional researchers.Both research teams interviewed 40 senior citizens, who were recruited through the co-researchers’ networks, professional care organisations, neighbourhood communities, and local media. We intended to gather a sample representative for the neighbourhood population. In the Indische Buurt, this proved to be difficult, since the relatively large Turkish and Moroccan communities were difficult to get into contact with, and it was hard to find co-researchers from those communities who could have provided a way in. Process and outcomesWe will share some of the results, but we will mainly reflect on the research process. ProcessRegarding the process, we found some differences between the two neighbourhoods. In the Indische Buurt, it took much effort to find co-researchers, since the seniors we encountered said to be too busy with other neighbourhood activities. We did recruit a small group of four co-researchers of different ethnical background, but sadly lacking Turkish and Moroccan seniors. They started with a very limited research experience and experienced ownership, which greatly increased during the process. At the finalisation of the project, the group ceased to be, but the outcomes were followed up by existing groups and organisations in the neighbourhood.In Buitenveldert, a large group of co-researchers was recruited in no-time, bearing more resemblance to an action group than a research group. They were generally highly educated and some already had research experience. The group proved to be pro-active, had a strong feeling of ownership, and worked in constant collaboration with the ‘professional’ researchers, respecting each other’s knowledge and skills. At the finalisation of the project, the group remained active as partner of the local government. OutcomesConcerning the content of the outcomes, we found some expected differences and unexpected similarities. For instance, we expected to find different outcomes concerning housing and facilities between the neighbourhoods. Indeed, in Buitenveldert, housing was already age friendly whereas facilities were scarce and geographically far apart. Yet, in the Indische Buurt, housing was poorly equipped for physically impaired seniors, but facilities were abundant and close by.We also found that, in both neighbourhoods, senior citizens were reluctant to share their limitations and ask for support, despite differences in neighbourhood, ethnicity, age etc. Of course, this can be expected of seniors from the ‘silent generation’. However, they seemingly shared these emotions more easily with their peers than with professional researchers. ConclusionThe social-cultural context of the neighbourhood impacts the research process. Overall, co-research appears to be a fruitful method to involve senior citizens in decisions concerning the improvement of their neighbourhood. Aims and content of the workshopWe aim to:• present our reflections on the participative process of working with senior co-researchers in Amsterdam• exchange and discuss with the participants of the workshop the lessons learned on how to facilitate citizens’ participation in the community• discuss similar and future projects and possibilities for collaboration among the participants of the workshopContent of the workshop• Presentation• Exchange and discussion in small groups • Plenary discussion on possible collaboration projects aiming to enhance citizens’ participation in the community
Objective: In myocardial perfusion single-photon emission computed tomography (SPECT), abdominal activity often interferes with the evaluation of perfusion in the inferior wall, especially after pharmacological stress. In this randomized study, we examined the effect of carbonated water intake versus still water intake on the quality of images obtained during myocardial perfusion images (MPI) studies. Methods: A total of 467 MIBI studies were randomized into a carbonated water group and a water group. The presence of intestinal activity adjacent to the inferior wall was evaluated by two observers. Furthermore, a semiquantitative analysis was performed in the adenosine subgroup,using a count ratio of the inferior myocardial wall and adjacent abdominal activity. Results: The need for repeated SPECT in the adenosine studies was 5.3 % in the carbonated water group versus 19.4 % in the still water group (p = 0.019). The inferior wall-to-abdomen count ratio was significantly higher in the carbonated water group compared to the still water group (2.11 ± 1.00 vs. 1.72 ± 0.73, p\0.001). The effect of carbonated water during rest and after exercise was not significant. Conclusions: This randomized study showed that carbonated water significantly reduced the interference of extra-cardiac activity in adenosine SPECT MPI. Keywords: Extra-cardiac radioactivity, Myocardial SPECT, Image quality enhancement, Carbonated water
