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Published on: January 28, 2020
Using cardiorespiratory fitness to operationalize vitality: a path analysis on the hierarchical structure of
Ruby Yu1, Derek Lai1, Grace Leung1
1The Chinese University of Hong Kong, Hong Kong.
Insights
Cardiorespiratory fitness (CRF), measured by VO2 max, is a valid indicator of vitality, an upstream domain of intrinsic capacity. This finding helps operationalize vitality in older adults.
Area of Science:
- Gerontology
- Physiology
- Public Health
Background:
- The operationalization of vitality, a key component of intrinsic capacity (IC), lacks consensus.
- No prior studies have explored cardiorespiratory fitness (CRF) as a potential indicator of vitality.
Purpose of the Study:
- To determine if vitality precedes other IC domains.
- To validate cardiorespiratory fitness (CRF), specifically maximal oxygen consumption (VO2 max), as a measure of vitality.
Main Methods:
- Longitudinal cohort study of 561 older adults.
- Path analyses used VO2 max and handgrip strength (as a vitality reference) to predict changes in instrumental activities of daily living (IADL).
- Other intrinsic capacity domains were also analyzed.
Main Results:
- The VO2 max model showed adequate fit, comparable to the handgrip strength model.
- VO2 max demonstrated significant total and indirect effects on IADL, primarily mediated by the locomotor domain.
- The mean age of participants was 75.5 years.
Conclusions:
- Vitality is confirmed as an upstream domain within intrinsic capacity.
- Maximal oxygen consumption (VO2 max) is a valid indicator for operationalizing the concept of vitality.
Background:
There is a lack of consensus about the operationalization of vitality, which is one of the intrinsic capacity (IC) domains. In particular, no study has investigated whether cardiorespiratory fitness (CRF) can be considered a vitality indicator.
Objective:
To examine whether vitality is the upstream domain of IC, and establish the validity of CRF as a vitality indicator, using maximal oxygen consumption (VO2 max) as a representative.
Methods:
561 older adults from a longitudinal cohort study were included. Variables under consideration were VO2 max, other IC domains, instrumental activities of daily living (IADL), and handgrip strength, which was considered an already validated indicator of vitality. Using handgrip strength as the reference point, path analyses were performed to examine whether VO2 max followed a similar hierarchical structure in predicting change in IADL difficulty through other IC domains.
Results:
The mean age of the participants was 75.5 years. The path model in which vitality was measured by VO2 max demonstrated adequate fit, which was similar to the model in which vitality was measured by handgrip strength. Regarding the path coefficients, the model using VO2 max demonstrated significant total and indirect effects. Notably, the indirect effect was due to the locomotor domain (standardized coefficient = -0.148, p < .001), but not the cognitive or psychological domain.
Conclusion:
Vitality is the upstream domain of IC. VO2 max can be considered an indicator to operationalize the vitality concept.
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