RecruitingNot ApplicableNCT05028309

Effects of Obesity in the Aged

Sponsor

University of Texas Southwestern Medical Center

Enrollment

72 participants

Start Date

Dec 1, 2021

Study Type

INTERVENTIONAL

Conditions

Obesity Aging

Summary

The overall objective of this application is to investigate the effects of obesity on lung function, exercise tolerance, and DOE in older obese adults as compared with older adults without obesity, using a novel probe for mechanically unloading the thorax at rest and during exercise. The investigators will use 1) continuous negative cuirass pressure, and 2) assisted biphasic cuirass ventilation to decrease obesity-related effects in older obese adults. Our approach will be to examine respiratory function, exercise tolerance, and DOE with and without mechanical unloading in older obese men and women (65-75 yr), including those with respiratory symptoms (defined by a score of 1 or 2 on the modified Medical Research Council Dyspnea Scale), as compared with older adults without obesity. Specific Aims: The investigators will test the following hypotheses in older adults with and without obesity: Aim 1) Obesity will decrease respiratory function but to a greater extent in older obese adults with respiratory symptoms, (as evidenced by altered pulmonary function and breathing mechanics at rest); Aim 2) Obesity will decrease exercise tolerance (as evidenced by peak V•O2 in ml/min/kg, i.e., physical fitness), but not cardiorespiratory fitness (as evidenced by peak V•O2 in % of predicted based on ideal body wt), except in older obese adults with respiratory symptoms where both may be reduced during graded cycle ergometry. Aim 3) Obesity will increase DOE but to a greater extent in older obese adults with respiratory symptoms as evidenced by increased ratings of perceived breathlessness (sensory \& affective dimensions) during exercise. Aim 4) Mechanical unloading of the thorax will improve respiratory function, submaximal exercise tolerance, and DOE in older obese adults, but to a greater extent in older obese adults with respiratory symptoms.

Eligibility

Min Age: 65 YearsMax Age: 75 Years

Inclusion Criteria12

Nonsmokers who have no history of smoking
No personal history of significant mental illness
No weight loss dietary restrictions
No current or past history of significant substance or alcohol abuse
No history, evidence, or uncontrolled symptoms of heart disease
No history of uncontrolled hypertension
No current medications that may interfere with exercise capacity
No recent history or indication of asthma
No musculoskeletal abnormality that would preclude exercise
No serious health conditions that would preclude study goals or participation in exercise (per PI \& medical staff \& preliminary or follow up testing; including significant other diseases, occult asthma, prior surgeries-especial lung or abdominal, or history of chemotherapy that could affect lung or heart function)
Only postmenopausal women will be included.
Women on hormone replacement therapy will be allowed to participate if the dosage remains similar during the entire protocol.

Exclusion Criteria4

Volunteers with a mMRC score of 3 or 4 will be excluded due to likeliness of underlying disease.
Individuals participating in regular vigorous conditioning exercise such as running, jogging, aerobics, cycling, or swimming more than three times per week will be excluded. However, if subjects have an exceedingly high exercise capacity (greater than 2 SD of predicted), they will be excluded.
Maximal cycle ergometry test will be used to determine if further participation in testing is appropriate for the participant (e.g., normal exercise test, exclude presence of provokable ECG changes suggestive of heart disease, or dangerous arrhythmias or exercise induced hypertension or bronchoconstriction. If the participant develops an abnormal ECG or shows other signs of exercise intolerance or if signs of cardiovascular disease are noted during the exercise test, it will be terminated and the participant will be referred to their personal physician for further evaluation (see DMSP).
Premenopausal women will be excluded.

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Interventions

OTHERMechanical unloading of the Thorax using an external cuirass

External cuirass (i.e., a plastic shell over the thorax) will be used to mechanically unload the chest wall. The cuirass has different operating modes. It can generate a constant negative pressure over the chest wall (e.g., -20cmH2O) or it can be triggered off mouth flow so it can generate a negative pressure on the chest wall during inspiration (e.g., -21cmH2O) and a positive pressure during expiration (e.g., +7cmH2O).