Metabolic Costs of Daily Activities in Older Adults (CHORES-XL)

Inclusion Criteria:

• Age 20+ years old
• Community dwelling adults without significant health issues
• Willingness to undergo all testing procedures
• Weight stable for at least three months
• Able to understand and speak English

Exclusion Criteria:

• Failure to provide informed consent
• A 10% enrollment limit will be applied to avid exercisers in each age decade. Avid exercises will be defined as doing structured exercise 3 or more days per week (e.g. jogging, sports etc., walkers will be permitted in the study). Based on our experience, avid exercisers volunteer for this type of research at a high rate and thus the investigators will limit these individuals to prevent a biased comparison
• Use of walker (use of a cane is permitted)
• Lower extremity amputation
• Develops chest pain or severe shortness of breath during physical stress
• Post-stroke syndrome causing ambulatory deficits (other stroke survivors permitted)
• Pacemaker
• Needs assistance with basic activities of daily living: feeding, dressing, continence, bathing, toileting, and transferring from a bed to a chair or from a chair to walking
• Lives in a nursing home; persons living in assisted or independent housing are not excluded
• For adults over the age of 60: >2 errors on the Short, portable mental status questionnaire administered after written informed consent
• Excessive alcohol or substance abuse within six months or consumption of >14 alcohol drinks/week
• For women who are child-bearing age (up to 62 years of age): pregnant or breast-feeding
• Participation in a structured weight loss program or fad diet in the last month;
• Weight reduction surgery in the past year
• Known neuromuscular disorder (Rhabdomyolysis, Myasthenia Gravis, Ataxia, Apraxia, post-polio syndrome, mitochondrial myopathy, chronic fatigue syndrome etc.)
• Diagnosed neuropathy that causes pain
• Symptomatic peripheral arterial disease
• Unable to communicate because of severe hearing loss or speech disorder
• Severe visual impairment, which would preclude completion of the assessments
• Progressive, degenerative neurologic disease, e.g., Parkinson's Disease, Multiple Sclerosis, Amyotrophic lateral sclerosis
• Severe rheumatologic or orthopedic diseases, e.g., awaiting joint replacement, active inflammatory disease; self-reported severe osteoarthritis
• Terminal illness, as determined by the participant
• Severe pulmonary disease, requiring the use of supplemental oxygen or steroid therapy
• Severe cardiac disease, including New York Heart Association Class III or IV congestive heart failure, clinically significant aortic stenosis, recent history of cardiac arrest, use of a cardiac defibrillator, or uncontrolled angina
• Other significant comorbid disease discovered during medical screening, e.g. renal failure on hemodialysis, psychiatric disorder (e.g. bipolar, schizophrenia); chronic fatigue syndrome etc…
• Liver diseases: chronic hepatitis, an inflammatory disease, or cirrhosis
• Pregnancy. Participants within childbearing age will have a pregnancy test.
• Contraindications to graded exercise testing according to the American Thoracic Society:
• Acute myocardial infarction (<6 months since event)
• Unstable angina
• Uncontrolled arrhythmias causing symptoms or hemodynamic compromise
• Syncope
• Active endocarditis
• Acute myocarditis or pericarditis
• Symptomatic severe aortic stenosis
• Uncontrolled heart failure
• Acute pulmonary embolus or pulmonary infarction
• Thrombosis of lower extremity
• Suspected dissecting aneurysm
• Uncontrolled asthmas
• Pulmonary edema
• Room air desaturation at rest < 85%
• Respiratory failure
• Acute non cardiopulmonary disorder that may affect exercise performance