1001
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Payne CF, Gómez-Olivé FX, Kahn K, Berkman L. Physical Function in an Aging Population in Rural South Africa: Findings From HAALSI and Cross-National Comparisons With HRS Sister Studies. J Gerontol B Psychol Sci Soc Sci 2017; 72:665-679. [PMID: 28369527 PMCID: PMC6075193 DOI: 10.1093/geronb/gbx030] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 03/13/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES We use recently-collected data from the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) cohort from Agincourt, South Africa, to describe physical functioning in this aging population, and place the overall level and age-trajectories of physical health in the context of other Health and Retirement Study (HRS) sister studies in low- and middle-income countries (LMICs). METHOD We conduct multiple regression to estimate associations of physical functioning assessed from both self-report (activities of daily living [ADL] limitation, self-reported health) and performance (grip strength, gait speed) with socio-demographic and health characteristics in HAALSI, and use fully-interacted regression models to compare age-patterns of physical functioning outcomes cross-nationally. RESULTS Gender differences in self-reported health are minimal, and men had 30% higher odds of being ADL limited controlling for socio-demographic and health characteristics. Measured physical performance is closely tied with socioeconomic conditions, but self-reported measures have a much smaller or weaker socioeconomic gradient. In international age-adjusted comparisons, the HAALSI sample had lower physical performance outcomes than most comparison populations. DISCUSSION As the first HRS sister study undertaken in Africa, HAALSI adds vital information on population aging and health in the region. Continuing waves of HAALSI data will be a key resource for understanding differences in the complex processes of disability across LMIC contexts.
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Affiliation(s)
- Collin F Payne
- Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts
| | - Francesc Xavier Gómez-Olivé
- Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Epidemiology and Global Health, Umeå University, Sweden
| | - Lisa Berkman
- Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts
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1002
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Wu H, Yu B, Meng G, Liu F, Guo Q, Wang J, Du H, Zhang W, Shen S, Han P, Dong R, Wang X, Ma Y, Chen X, Niu K. Both muscle mass and muscle strength are inversely associated with depressive symptoms in an elderly Chinese population. Int J Geriatr Psychiatry 2017; 32:769-778. [PMID: 27272735 DOI: 10.1002/gps.4522] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 04/15/2016] [Accepted: 05/16/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Few population studies have examined the association between skeletal muscle and depressive symptoms. The aim of this study was to examine whether low muscle mass and muscle strength were associated with the depressive symptoms in elderly Chinese. METHODS A cross-sectional study was conducted with 1046 elderly in Tianjin, China. Depressive symptoms were examined using the 30-item Geriatric Depression Scale. A Geriatric Depression Scale score of ≥11 was used to indicate depressive symptoms. Skeletal muscle mass was indicated using a skeletal muscle mass index (SMI) that was measured by bioimpedance analysis and muscle strength was measured by dynamometer. RESULTS In a multiple logistic regression analysis, subjects in the lowest quartile of SMI or muscle strength had a significantly higher risk for depressive symptoms compared with those in the fourth quartile. The odds ratios and 95% confidence interval for depressive symptoms risk in the lowest quartile of SMI compared with the highest after adjusting for potential confounding factors were 10.1 (2.25, 58.3) in men and 3.17 (1.07, 9.95) in women. The odds ratios (95% confidence interval) for depressive symptoms risk in the lowest quartile of muscle strength compared with the highest after adjusting for potential confounding factors were 2.55 (1.02, 6.67) in men and 4.18 (1.83, 10.2) in women. CONCLUSIONS Both muscle mass and muscle strength are inversely associated with depressive symptoms in elderly Chinese. These findings may provide novel insights linking skeletal muscle and depressive symptoms. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Bin Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Fangfang Liu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China.,Department of Rehabilitation Medicine, Cardiovascular Clinical College of Tianjin Medical University, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Jiazhong Wang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Huanmin Du
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Zhang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Suxing Shen
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Renwei Dong
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Xiuyang Wang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Yixuan Ma
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Xin Chen
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Collaborative Innovation Center of Non-communicable Disease, Tianjin Medical University, Tianjin, China
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1003
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Rochette C, Castinetti F, Brue T. [Acromegaly and Cushing's disease: Persistence of comorbidities after the control of hypersecretion]. ANNALES D'ENDOCRINOLOGIE 2017. [PMID: 28645354 DOI: 10.1016/s0003-4266(17)30074-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Acromegaly and Cushing's disease lead to common and distinct comorbidities. Currently available treatments lead to the control of hyper secretion in the majority of cases. However, the prevalence of the comorbidities does not always go back to the one of the normal population after remission. For instance, about 1/3 of acromegalic patients with diabetes and half of patients with Cushing's disease and diabetes will have normal blood glucose values after remission. In contrast, high blood pressure frequently recovers after remission in both diseases. In contrast, while patients with acromegaly improve their lipid profile, patients with Cushing's disease frequently remain hypertriglyceridemic. Many other comorbidities (cardiovascular disease, bone alterations, altered quality of life) may persist after the control of hyper secretion. The aim of this review is to focus on the outcome of patients with acromegaly and Cuhing's disease, and to suggest the optimal follow-up of such patients in a multidisciplinary approach. These points have been discussed during the 2016 European Congress of Endocrinology, notably by J.Romijn and E.Valassi.
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Affiliation(s)
- C Rochette
- Université d'Aix-Marseille, Jardin du Pharo, 58 Boulevard Charles Livon, 13284 Marseille, France; Service d'endocrinologie-diabète-maladies métaboliques, Pôle ENDO, Centre de Référence Pathologies hypophysaires Rares, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille, France
| | - F Castinetti
- Université d'Aix-Marseille, Jardin du Pharo, 58 Boulevard Charles Livon, 13284 Marseille, France; Service d'endocrinologie-diabète-maladies métaboliques, Pôle ENDO, Centre de Référence Pathologies hypophysaires Rares, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille, France; Faculté de Médecine Secteur Nord, CNRS UMR 7286 - CRN2M, Boulevard Pierre Dramard, 13015 Marseille, France
| | - T Brue
- Université d'Aix-Marseille, Jardin du Pharo, 58 Boulevard Charles Livon, 13284 Marseille, France; Service d'endocrinologie-diabète-maladies métaboliques, Pôle ENDO, Centre de Référence Pathologies hypophysaires Rares, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille, France; Faculté de Médecine Secteur Nord, CNRS UMR 7286 - CRN2M, Boulevard Pierre Dramard, 13015 Marseille, France.
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1004
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Crook S, Frei A, Ter Riet G, Puhan MA. Prediction of long-term clinical outcomes using simple functional exercise performance tests in patients with COPD: a 5-year prospective cohort study. Respir Res 2017; 18:112. [PMID: 28578705 PMCID: PMC5457551 DOI: 10.1186/s12931-017-0598-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/25/2017] [Indexed: 11/10/2022] Open
Abstract
The 1-min sit-to-stand (1-min STS) test and handgrip strength test have been proposed as simple tests of functional exercise performance in chronic obstructive pulmonary disease (COPD) patients. We assessed the long-term (5-year) predictive performance of the 1-min sit-to-stand and handgrip strength tests for mortality, health-related quality of life (HRQoL) and exacerbations in COPD patients. In 409 primary care patients, we found the 1-min STS test to be strongly associated with long-term morality (hazard ratio per 3 more repetitions: 0.81, 95% CI 0.65 to 0.86) and moderately associated with long-term HRQoL. Neither test was associated with exacerbations. Our results suggest that the 1-min STS test may be useful for assessing the health status and long-term prognosis of COPD patients. This study was registered at http://www.clinicaltrials.gov/ (NCT00706602, 25 June 2008).
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Affiliation(s)
- Sarah Crook
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Gerben Ter Riet
- Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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1005
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Yu R, Ong S, Cheung O, Leung J, Woo J. Reference Values of Grip Strength, Prevalence of Low Grip Strength, and Factors Affecting Grip Strength Values in Chinese Adults. J Am Med Dir Assoc 2017; 18:551.e9-551.e16. [DOI: 10.1016/j.jamda.2017.03.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 12/25/2022]
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1006
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Klausen HH, Bodilsen AC, Petersen J, Bandholm T, Haupt T, Sivertsen DM, Andersen O. How inflammation underlies physical and organ function in acutely admitted older medical patients. Mech Ageing Dev 2017; 164:67-75. [DOI: 10.1016/j.mad.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/07/2017] [Accepted: 04/18/2017] [Indexed: 01/11/2023]
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1007
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Wu Y, Wang W, Liu T, Zhang D. Association of Grip Strength With Risk of All-Cause Mortality, Cardiovascular Diseases, and Cancer in Community-Dwelling Populations: A Meta-analysis of Prospective Cohort Studies. J Am Med Dir Assoc 2017; 18:551.e17-551.e35. [DOI: 10.1016/j.jamda.2017.03.011] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/19/2017] [Accepted: 03/24/2017] [Indexed: 10/19/2022]
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1008
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Berr CM, Stieg MR, Deutschbein T, Quinkler M, Schmidmaier R, Osswald A, Reisch N, Ritzel K, Dimopoulou C, Fazel J, Hahner S, Stalla GK, Beuschlein F, Reincke M. Persistence of myopathy in Cushing's syndrome: evaluation of the German Cushing's Registry. Eur J Endocrinol 2017; 176:737-746. [PMID: 28325824 DOI: 10.1530/eje-16-0689] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 03/14/2017] [Accepted: 03/20/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cushing's syndrome (CS) is characterized by an excessive secretion of glucocorticoids that results in a characteristic clinical phenotype. One feature of clinical hypercortisolism is breakdown of protein metabolism translating into clinical consequences including glucocorticoid-induced myopathy. While surgery is effective in control of cortisol excess, the effect of biochemical remission on muscular function is yet unclear. METHODS In a cross-sectional study we analyzed 47 patients with CS during the florid phase (ActiveCS). 149 additional patients were studied 2-53 years (mean: 13 years) after surgery in biochemical long-term remission (RemissionCS). Also, 93 rule-out CS patients were used as controls (CON). All subjects were assessed for grip strength using a hand grip dynamometer and underwent the chair rising test (CRT). RESULTS Hand grip strength (85% vs 97% of norm, P = 0.002) and the CRT performance (9.5 s vs 7.1 s, P = 0.001) were significantly lower in ActiveCS compared to the CON group. Six months after treatment grip strength further decreased in CS (P = 0.002) and CRT performance remained impaired. The RemissionCS group (mean follow-up 13 years) had reduced hand grip strength (92% compared to normal reference values for dominant hand, P < 0.001). The chair rising test performance was at 9.0 s and not significantly different from the ActiveCS group (P = 0.45). CONCLUSION CS affects muscle strength in the acute phase, but functional impairment remains detectable also during long-term follow-up despite biochemical remission.
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Affiliation(s)
- Christina M Berr
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Mareike R Stieg
- RG NeuroendocrinologyMax Planck Institute of Psychiatry, Munich, Germany
| | - Timo Deutschbein
- Department of Internal Medicine IDivision of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | | | - Ralf Schmidmaier
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Andrea Osswald
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Nicole Reisch
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Katrin Ritzel
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | | | - Julia Fazel
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stefanie Hahner
- Department of Internal Medicine IDivision of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Günter K Stalla
- RG NeuroendocrinologyMax Planck Institute of Psychiatry, Munich, Germany
| | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IVKlinikum der Ludwig-Maximilians-Universität München, Munich, Germany
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1009
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Karlsen T, Nauman J, Dalen H, Langhammer A, Wisløff U. The Combined Association of Skeletal Muscle Strength and Physical Activity on Mortality in Older Women: The HUNT2 Study. Mayo Clin Proc 2017; 92:710-718. [PMID: 28473035 DOI: 10.1016/j.mayocp.2017.01.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 01/11/2017] [Accepted: 01/16/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the isolated and combined associations of leg and arm strength with adherence to current physical activity guidelines with all-cause and cause-specific mortality in healthy elderly women. PATIENTS AND METHODS This was a prospective cohort study of 2529 elderly women (72.6±4.8 years) from the Norwegian Healthy survey of Northern Trøndelag (second wave) (HUNT2) between August 15, 1995, and June 18, 1997, with a median of 15.6 years (interquartile range, 10.4-16.3 years) of follow-up. Chair-rise test and handgrip strength performances were assessed, and divided into tertiles. The hazard ratio (HR) of all-cause and cause-specific mortality by tertiles of handgrip strength and chair-rise test performance, and combined associations with physical activity were estimated by using Cox proportional hazard regression models. RESULTS We observed independent associations of physical activity and the chair-rise test performance with all-cause and cardiovascular mortality, and between handgrip strength and all-cause mortality. Despite following physical activity guidelines, women with low muscle strength had increased risk of all-cause mortality (HR chair test, 1.37; 95% CI, 1.07-1.76; HR handgrip strength, 1.39; 95% CI, 1.05-1.85) and cardiovascular disease mortality (HR chair test, 1.57; 95% CI, 1.01-2.42). Slow chair-test performance was associated with all-cause (HR, 1.32; 95% CI, 1.16-1.51) and cardiovascular disease (HR, 1.41; 95% CI, 1.14-1.76) mortality. The association between handgrip strength and all-cause mortality was dose dependent (P value for trend <.01). CONCLUSION Handgrip strength and chair-rise test performance predicted the risk of all-cause and CVD mortality independent of physical activity. Clinically feasible tests of skeletal muscle strength could increase the precision of prognosis, even in elderly women following current physical activity guidelines.
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Affiliation(s)
- Trine Karlsen
- Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Javaid Nauman
- Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Håvard Dalen
- Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Arnulf Langhammer
- Faculty of Medicine, HUNT Research Center, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - Ulrik Wisløff
- Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, Australia
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1010
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Morisawa T, Ueno K, Fukuda Y, Kanazawa N, Kawaguchi H, Zaiki R, Fuzisaki H, Yoshioka H, Sasaki M, Iwata K, Koyama T, Kitai T, Furukawa Y, Takahashi T. Significance of sequential cardiac rehabilitation program through inter-hospital cooperation between acute care and rehabilitation hospitals in elderly patients after cardiac surgery in Japan. Heart Vessels 2017; 32:1220-1226. [DOI: 10.1007/s00380-017-0983-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 04/21/2017] [Indexed: 11/27/2022]
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1011
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Combining Activity-Related Behaviors and Attributes Improves Prediction of Health Status in NHANES. J Phys Act Health 2017; 14:626-635. [PMID: 28422582 DOI: 10.1123/jpah.2016-0419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND This paper tested whether a physical activity index (PAI) that integrates PA-related behaviors (ie, moderate-to-vigorous physical activity [MVPA] and TV viewing) and performance measures (ie, cardiorespiratory fitness and muscle strength) improves prediction of health status. METHODS Participants were a nationally representative sample of US adults from 2011 to 2012 NHANES. Dependent variables (self-reported health status, multimorbidity, functional limitations, and metabolic syndrome) were dichotomized. Wald-F tests tested whether the model with all PAI components had statistically significantly higher area under the curve (AUC) values than the models with behavior or performance scores alone, adjusting for covariates and complex survey design. RESULTS The AUC (95% CI) for PAI in relation to health status was 0.72 (0.68, 0.76), and PAI-AUC for multimorbidity was 0.72 (0.69, 0.75), which were significantly higher than the behavior or performance scores alone. For functional limitations, the PAI AUC was 0.71 (0.67, 0.74), significantly higher than performance, but not behavior scores, while the PAI AUC for metabolic syndrome was 0.69 (0.66, 0.73), higher than behavior but not performance scores. CONCLUSIONS These results provide empirical support that an integrated PAI may improve prediction of health and disease. Future research should examine the clinical utility of a PAI and verify these findings in prospective studies.
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1012
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Forman DE, Arena R, Boxer R, Dolansky MA, Eng JJ, Fleg JL, Haykowsky M, Jahangir A, Kaminsky LA, Kitzman DW, Lewis EF, Myers J, Reeves GR, Shen WK. Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation 2017; 135:e894-e918. [PMID: 28336790 PMCID: PMC7252210 DOI: 10.1161/cir.0000000000000483] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.
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1013
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Harada K, Suzuki S, Ishii H, Aoki T, Hirayama K, Shibata Y, Negishi Y, Sumi T, Kawashima K, Kunimura A, Shimbo Y, Tatami Y, Kawamiya T, Yamamoto D, Morimoto R, Yasuda Y, Murohara T. Impact of Skeletal Muscle Mass on Long-Term Adverse Cardiovascular Outcomes in Patients With Chronic Kidney Disease. Am J Cardiol 2017; 119:1275-1280. [PMID: 28215411 DOI: 10.1016/j.amjcard.2017.01.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 12/26/2022]
Abstract
Sarcopenia, defined as skeletal muscle loss and dysfunction, is attracting considerable attention as a novel risk factor for cardiovascular events. Although the loss of skeletal muscle is common in chronic kidney disease (CKD) patients, the relation between sarcopenia and cardiovascular events in CKD patients is not well defined. Therefore, we aimed to investigate the relation between skeletal muscle mass and major adverse cardiovascular events (MACE) in CKD patients. We enrolled 266 asymptomatic CKD patients (median estimated glomerular filtration rate: 36.7 ml/min/1.73 m2). To evaluate skeletal muscle mass, we used the psoas muscle mass index (PMI) calculated from noncontrast computed tomography. The patients were divided into 2 groups according to the cut-off value of PMI for MACE. There were significant differences in age and body mass index between the low and high PMI groups (median age: 73.5 vs 69.0 years, p = 0.002; median body mass index: 22.6 vs 24.2 kg/m2, p <0.001, respectively). During the follow-up period (median: 3.2 years), patients with low PMI had significantly higher risk of MACE than those with high PMI (31.7% and 11.2%, log-rank test, p <0.001). The Cox proportional hazard model showed that low PMI is an independent predictor of MACE in CKD patients (hazard ratio 3.98, 95% confidence interval 1.65 to 9.63, p = 0.0022). In conclusion, low skeletal muscle mass is an independent predictor of MACE in CKD patients. The assessment of skeletal muscle mass may be a valuable screening tool for predicting MACE in clinical practice.
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Affiliation(s)
- Kazuhiro Harada
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Susumu Suzuki
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshijiro Aoki
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenshi Hirayama
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yohei Shibata
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yosuke Negishi
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Sumi
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhiro Kawashima
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayako Kunimura
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusaku Shimbo
- Department of Cardiology, Kariya Toyota General Hospital, Kariya, Japan
| | - Yosuke Tatami
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiki Kawamiya
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Dai Yamamoto
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryota Morimoto
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinari Yasuda
- Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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1014
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Steele J, Fisher J, Skivington M, Dunn C, Arnold J, Tew G, Batterham AM, Nunan D, O’Driscoll JM, Mann S, Beedie C, Jobson S, Smith D, Vigotsky A, Phillips S, Estabrooks P, Winett R. A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training. BMC Public Health 2017; 17:300. [PMID: 28381272 PMCID: PMC5382466 DOI: 10.1186/s12889-017-4209-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 03/31/2017] [Indexed: 11/10/2022] Open
Abstract
It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally 'aerobic' (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in 'muscle strengthening activities' though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.
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Affiliation(s)
- James Steele
- School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN UK
| | - James Fisher
- School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN UK
| | - Martin Skivington
- School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN UK
| | - Chris Dunn
- School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN UK
| | - Josh Arnold
- School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN UK
| | - Garry Tew
- Exercise and Health Sciences Department: Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, NE1 8ST UK
| | - Alan M. Batterham
- School of Health and Social Care, Teesside University, Middleborough, TS1 3BA UK
| | - David Nunan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary |Care Health Sciences, University of Oxford, Oxford, OX2 6GG UK
| | - Jamie M. O’Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU UK
| | - Steven Mann
- UK Active Research Institute, UK Active, London, WC1R 4HE UK
| | - Chris Beedie
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU UK
- UK Active Research Institute, UK Active, London, WC1R 4HE UK
| | - Simon Jobson
- Department of Sport & Exercise, University of Winchester, Winchester, SO22 4NR UK
| | - Dave Smith
- Department of Exercise and Sport Science, Manchester Metropolitan University, Crewe, CW1 5DU UK
| | - Andrew Vigotsky
- Department of Biomedical Engineering, Northwestern University, Evanston, IL USA
| | - Stuart Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON Canada
| | - Paul Estabrooks
- College of Public Health, University of Nebraska Medical Centre, Omaha, NE USA
| | - Richard Winett
- Psychology Department, Virginia Tech, Blacksburg, VA USA
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1015
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Lana A, Valdés-Bécares A, Buño A, Rodríguez-Artalejo F, Lopez-Garcia E. Serum Leptin Concentration is Associated with Incident Frailty in Older Adults. Aging Dis 2017; 8:240-249. [PMID: 28400989 PMCID: PMC5362182 DOI: 10.14336/ad.2016.0819] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 08/19/2016] [Indexed: 11/01/2022] Open
Abstract
Obesity has been associated with higher risk of frailty in older adults, but the pathophysiological mechanisms are unclear. No previous study has examined the association between leptin, an adipokine, and the risk of frailty in older adults, and whether this association could be explained by insulin resistance or chronic inflammation. Data were taken from 1,573 individuals without diabetes mellitus, aged ≥60 years, from the Seniors-ENRICA cohort. In 2008-2010, leptin, the homeostasis model assessment of insulin resistance (HOMA-IR) and C-reactive protein (CRP) were measured. Study participants were followed-up through 2012 to assess incident frailty, defined as at least two of the following Fried criteria: exhaustion, weakness, low physical activity, and slow walking speed. Analyses were performed with logistic regression and adjusted for the main confounders. Over a median follow-up of 3.5 years, 280 cases of incident frailty were identified. Compared to individuals in the lowest tertile of serum leptin, those in the highest tertile showed an increased risk of frailty (odds ratio [OR]: 2.12; 95% confidence interval [CI]: 1.47-3.06; p-trend <0.001). Further adjustment for the percentage of body fat led to an OR of 1.69 (95% CI: 1.11-2.61; p-trend=0.01). After additional adjustment for HOMA-IR and CRP, the OR for frailty was 1.59 (95% CI: 1.01-2.52; p-trend=0.04). Results did not vary according to sex, abdominal obesity or the percentage of body fat. Being in the highest versus lowest tertile of leptin was associated with increased risk of exhaustion (OR: 2.16; 95% CI: 1.32-3.55; p-trend=0.001) and muscle weakness (OR: 1.77; 95% CI: 1.25-2.51; p-trend=0.001), in the analyses adjusted for potential confounders and body fat. Higher leptin concentration was associated with greater risk of frailty in older adults. This association was only modestly explained by insulin resistance and chronic inflammation, as measured by CRP.
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Affiliation(s)
- Alberto Lana
- 1Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Oviedo, Spain; 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ana Valdés-Bécares
- 1Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Oviedo, Spain
| | - Antonio Buño
- 3Department of Laboratory Medicine, Hospital University La Paz, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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1016
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Handgrip strength and associated sociodemographic and lifestyle factors: A systematic review of the adult population. J Bodyw Mov Ther 2017; 21:401-413. [DOI: 10.1016/j.jbmt.2016.08.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/18/2016] [Accepted: 08/30/2016] [Indexed: 12/18/2022]
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1017
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Tracking of muscular strength and power from youth to young adulthood: Longitudinal findings from the Childhood Determinants of Adult Health Study. J Sci Med Sport 2017; 20:927-931. [PMID: 28416155 DOI: 10.1016/j.jsams.2017.03.021] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 03/15/2017] [Accepted: 03/23/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Low muscular fitness levels have previously been reported as an independent risk factor for chronic disease outcomes. Muscular fitness tracking, the ability to maintain levels measured at one point in time to another point in time, was assessed from youth to adulthood to provide insight into whether early identification of low muscular fitness in youth is possible. DESIGN Prospective longitudinal study. METHODS Study including 623 participants who had muscular fitness measures in 1985 (aged 9, 12 or 15 years) and again 20 years later in young adulthood. Measures of muscular fitness were strength (right and left grip, leg, shoulder extension and flexion measured by dynamometer, and a combined strength score) and power (standing long jump distance). RESULTS Strength and power were relatively stable between youth and adulthood; the strongest tracking correlations were observed for the combined strength score (r=0.47, p≤0.001), right grip strength (r=0.43, p≤0.001) and standing long jump (r=0.43, p≤0.001). Youth in the lowest third of muscular fitness had an increased risk of remaining in the lowest third of muscular fitness in adulthood (strength: relative risk (RR)=4.70, 95% confidence interval (CI) (3.19, 6.92); power: RR=4.06 (2.79, 5.90)). CONCLUSIONS Youth with low muscular fitness are at increased risk of maintaining a low muscular fitness level into adulthood. These findings warrant investigation into the long term effects of early interventions that focus on improving low muscular fitness levels in youth which could potentially improve adult muscular fitness and reduce future chronic disease outcomes.
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1018
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Lopes AJ, Justo AC, Ferreira AS, Guimaraes FS. Systemic sclerosis: Association between physical function, handgrip strength and pulmonary function. J Bodyw Mov Ther 2017; 21:972-977. [PMID: 29037654 DOI: 10.1016/j.jbmt.2017.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/15/2017] [Accepted: 03/27/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Systemic sclerosis (SSc) is a multisystem disease affecting the skin, respiratory system and skeletal muscles. In SSc patients, hand function disability is the major factor limiting daily activities. AIM To evaluate the association of physical function with handgrip strength and pulmonary function in SSc patients. A further aim was to assess the relationship between handgrip strength and pulmonary function in patients with SSc. METHOD A cross-sectional study in which 28 patients with SSc underwent isometric handgrip strength (IHGS) measurement and pulmonary function tests and completed the Health Assessment Questionnaire Disability Index (HAQ-DI) to measure physical function. RESULTS The HAQ-DI scores were associated with the IHGS (rs = -0.599, P = 0.001) and pulmonary function parameters, particularly the diffusion capacity for carbon monoxide (DLco; rs = -0.642, P = 0.0004). CONCLUSION In patients with SSc, the degree of physical disability is associated with both hand grip strength and pulmonary function. However, there is no relationship between handgrip strength and pulmonary function in these patients.
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Affiliation(s)
- Agnaldo José Lopes
- Rehabilitation Sciences Post-graduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil.
| | - Amanda Cristina Justo
- Rehabilitation Sciences Post-graduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil
| | - Arthur Sá Ferreira
- Rehabilitation Sciences Post-graduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil
| | - Fernando Silva Guimaraes
- Rehabilitation Sciences Post-graduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil
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1019
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Suwa M, Imoto T, Kida A, Iwase M, Yokochi T. Age-related reduction and independent predictors of toe flexor strength in middle-aged men. J Foot Ankle Res 2017; 10:15. [PMID: 28360943 PMCID: PMC5369005 DOI: 10.1186/s13047-017-0196-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 03/14/2017] [Indexed: 12/25/2022] Open
Abstract
Background Toe flexor muscles play an important role in posture and locomotion, and poor toe flexor strength is a risk factor for falls. In this cross-sectional study, we estimated the age-related change in toe flexor strength and compared it with that of handgrip strength. Independent factors predicting toe flexor and handgrip strength were also determined. Methods A total of 1401 male (aged 35–59 years) study participants were divided into five groups according to their chronological age; 35–39, 40–44, 45–49, 50–54, and 55–59 years. Toe flexor and handgrip strength, anthropometry, and resting blood pressure were measured. Fasting blood samples were collected to measure blood glucose, triglycerides, high- and low-density lipoprotein-cholesterols, and albumin. A self-administered lifestyle questionnaire was conducted. Results Decline in absolute toe flexor and handgrip strength began in the age groups 50–55 and 55–59 years, respectively. In comparison to the mean values of the youngest group, relative toe flexor strength (87.0 ± 26.6%) was significantly lower than handgrip strength (94.4 ± 13.1%) for the oldest group. Multiple regression analyses showed that independent factors predicting both toe flexor and handgrip strength were lean body mass, age, serum albumin, drinking habit, and fat mass. Additionally, fasting blood glucose, diastolic blood pressure, sleeping time and exercise habit were predicting factors of toe flexor strength but not of handgrip strength. Conclusions Age-related reduction in toe flexor strength was earlier and greater than handgrip strength, and toe flexor strength reflects body composition and metabolic status.
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Affiliation(s)
- Masataka Suwa
- Health Support Center WELPO, Toyota Motor Corporation, 1-1, Ipponmatsu, Iwakura-cho, Toyota, Aichi 444-2225 Japan
| | - Takayuki Imoto
- Health Support Center WELPO, Toyota Motor Corporation, 1-1, Ipponmatsu, Iwakura-cho, Toyota, Aichi 444-2225 Japan
| | - Akira Kida
- Health Support Center WELPO, Toyota Motor Corporation, 1-1, Ipponmatsu, Iwakura-cho, Toyota, Aichi 444-2225 Japan
| | - Mitsunori Iwase
- Toyota Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi 471-8513 Japan
| | - Takashi Yokochi
- Health Support Center WELPO, Toyota Motor Corporation, 1-1, Ipponmatsu, Iwakura-cho, Toyota, Aichi 444-2225 Japan
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1020
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Ikeno Y, Koide Y, Abe N, Matsueda T, Izawa N, Yamazato T, Miyahara S, Nomura Y, Sato S, Takahashi H, Inoue T, Matsumori M, Tanaka H, Ishihara S, Nakayama S, Sugimoto K, Okita Y. Impact of sarcopenia on the outcomes of elective total arch replacement in the elderly†. Eur J Cardiothorac Surg 2017; 51:1135-1141. [DOI: 10.1093/ejcts/ezx050] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/30/2017] [Indexed: 01/06/2023] Open
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1021
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Lopes J, Grams ST, da Silva EF, de Medeiros LA, de Brito CMM, Yamaguti WP. Reference equations for handgrip strength: Normative values in young adult and middle-aged subjects. Clin Nutr 2017; 37:914-918. [PMID: 28389120 DOI: 10.1016/j.clnu.2017.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 03/14/2017] [Accepted: 03/20/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND & AIMS Handgrip strength (HS) has been widely used as a functionality parameter of the upper limbs (UL) and general health. The measurement of HS by dynamometry is a low cost, non-invasive method of simple applicability, widely used in pulmonary rehabilitation and in critical care units. However, there are no reports in the literature of reference equations for the Brazilian population involving young and middle-aged adults. The aim of this study was to establish reference equations to predict normal HS for young and middle-aged adults through demographic and anthropometric data. METHODS This is a cross-sectional study with a sample of 80 healthy subjects (40 men and 40 women), aged 20-60 years. Inclusion criteria were: 1) BMI between 18.5 and 30 kg/m2; 2) presence of dominant hand; 3) no cardiac, pulmonary, metabolic, or neurologic diseases; 4) lack of musculoskeletal disorders; 5) no history of fractures or trauma of the UL. Anthropometric measurements of the UL were obtained by a tape (hand length and width, forearm circumference and length). The dominance of hands was defined by the Dutch Handedness Questionnaire. HS measures were obtained by a manual hydraulic dynamometer, according to the recommendations of the American Association of Hand Therapists. Data were analyzed with SPSS for Windows, version 17.0, and treated with descriptive and inferential analysis. Normality was evaluated by Kolmogorov-Smirnov. Pearson or Spearman coefficients and multiple regression analysis were also used. RESULTS HS was significantly higher for men compared to women, and also higher for the dominant hand (HSD) compared to the non-dominant hand (HSND) (p < 0.05). No significant differences were found for HS between the age groups 20-30, 30-40, 40-50 and 50-60 years (p > 0.05). No correlation was found between HS and age. A weak correlation was found between HS and BMI. A moderate correlation of HS was observed with weight and height. Finally, moderate and high correlations were found between HS and anthropometric variables of UL. The best reference equations with R2, adjusted to 0.71 and 0.70, were respectively: HSDkg = -15.490 + (10.787 × Gender male=1; female=0) + (0.558 × Forearm circumference) + (1.763 × Hand Length); HSNDkg = -9.887 + (12.832 × Gender male=1; female=0) + (2.028 × Hand Length). CONCLUSION The variability of HS is largely explained by gender, forearm circumference, and hand length.
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Affiliation(s)
- Jordão Lopes
- Rehabilitation Service, Hospital Sírio-Libanês, São Paulo, SP, Brazil
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1022
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García-Hermoso A, Carrillo HA, González-Ruíz K, Vivas A, Triana-Reina HR, Martínez-Torres J, Prieto-Benavidez DH, Correa-Bautista JE, Ramos-Sepúlveda JA, Villa-González E, Peterson MD, Ramírez-Vélez R. Fatness mediates the influence of muscular fitness on metabolic syndrome in Colombian collegiate students. PLoS One 2017; 12:e0173932. [PMID: 28296952 PMCID: PMC5352003 DOI: 10.1371/journal.pone.0173932] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 02/28/2017] [Indexed: 12/28/2022] Open
Abstract
The purpose of this study was two-fold: to analyze the association between muscular fitness (MF) and clustering of metabolic syndrome (MetS) components, and to determine if fatness parameters mediate the association between MF and MetS clustering in Colombian collegiate students. This cross-sectional study included a total of 886 (51.9% women) healthy collegiate students (21.4 ± 3.3 years old). Standing broad jump and isometric handgrip dynamometry were used as indicators of lower and upper body MF, respectively. Also, a MF score was computed by summing the standardized values of both tests, and used to classify adults as fit or unfit. We also assessed fat mass, body mass index, waist-to-height ratio, and abdominal visceral fat, and categorized individuals as low and high fat using international cut-offs. A MetS cluster score was derived by calculating the sum of the sample-specific z-scores from the triglycerides, HDL cholesterol, fasting glucose, waist circumference, and arterial blood pressure. Linear regression models were used to examine whether the association between MF and MetS cluster was mediated by the fatness parameters. Data were collected from 2013 to 2016 and the analysis was done in 2016. Findings revealed that the best profiles (fit + low fat) were associated with lower levels of the MetS clustering (p <0.001 in the four fatness parameters), compared with unfit and fat (unfit + high fat) counterparts. Linear regression models indicated a partial mediating effect for fatness parameters in the association of MF with MetS clustering. Our findings indicate that efforts to improve MF in young adults may decrease MetS risk partially through an indirect effect on improvements to adiposity levels. Thus, weight reduction should be taken into account as a complementary goal to improvements in MF within exercise programs.
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Affiliation(s)
- Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Hugo Alejandro Carrillo
- Grupo GRINDER, programa de Educación Física y Deportes, Universidad del Valle, Santiago de Cali, Colombia
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC, Colombia
| | - Andrés Vivas
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC, Colombia
| | | | - Javier Martínez-Torres
- Grupo GICAEDS, Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá DC, Colombia
| | - Daniel Humberto Prieto-Benavidez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC, Colombia
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Emilio Villa-González
- PROFITH ‘‘PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain
| | - Mark D. Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, United States of America
- Global REACH, University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC, Colombia
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1023
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Wu IC, Lin CC, Liu CS, Hsu CC, Chen CY, Hsiung CA. Interrelations Between Mitochondrial DNA Copy Number and Inflammation in Older Adults. J Gerontol A Biol Sci Med Sci 2017; 72:937-944. [DOI: 10.1093/gerona/glx033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 02/23/2017] [Indexed: 01/13/2023] Open
Affiliation(s)
- I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chin-San Liu
- Department of Neurology and Vascular and Genomic Research Center, Changhua Christian Hospital, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Ching-Yu Chen
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Chao A. Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
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1024
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Abstract
Frailty is defined as a biological syndrome reflecting impaired physiologic reserve and heightened vulnerability to stressors. The evolving profile of heart failure (HF), increased survival of aging patients with complex comorbidities in parallel with the growing population undergoing mechanical circulatory support as lifetime therapy, means that advanced HF specialists are becoming aware of the burden of frailty and its downstream consequences on postintervention outcomes in these patients. The limited data available to date suggest that frailty is highly prevalent in patients with advanced HF and appears to provide prognostic information not captured by traditional risk assessment.
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Affiliation(s)
- Emer Joyce
- Section of Heart Failure and Cardiac Transplant Medicine, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, J3-4, Cleveland, OH 44195, USA.
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1025
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Yaginuma Y, Abe T, Thiebaud RS, Kitamura T, Kawanishi M, Fukunaga T. Can Handgrip Strength Improve Following Body Mass-Based Lower Body Exercise? Biores Open Access 2017; 6:19-27. [PMID: 28451471 PMCID: PMC5385419 DOI: 10.1089/biores.2017.0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Knee extension strength (KES) improves following body mass-based lower body exercise training; however, it is unknown whether this type of exercise increases handgrip strength (HGS) as a result of a cross-education effect in older individuals. Our aim was to investigate the effect of a body mass-based exercise intervention on HGS and KES in older adults. At baseline, 166 subjects started a 12-week intervention program, and 160 (108 women and 52 men) subjects completed the study. A self-selected group of 37 older adults (21 women and 16 men) served as a control group. HGS, KES, and ultrasound-derived anterior thigh muscle thickness (anterior thigh MT) were measured at baseline and post-testing, and relative strength of the knee extensor (KES/anterior thigh MT) was calculated. A linear regression model controlling for baseline values of body–mass index, % body fat, fat-free mass, HGS, chair stand time, anterior thigh MT, and KES/body mass ratio found a significant difference between control and training groups for KES post-testing values (p = 0.001) and anterior thigh MT post-testing values (p = 0.012), but not for HGS post-testing values (p = 0.287). Our results suggest that increases in lower body strength and muscle size following a 12-week lower body mass-based exercise intervention fail to translate into improvements in HGS.
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Affiliation(s)
- Yu Yaginuma
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kagoshima, Japan
| | - Takashi Abe
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kagoshima, Japan
| | - Robert S Thiebaud
- Department of Kinesiology, Texas Wesleyan University, Fort Worth, Texas
| | - Takahiro Kitamura
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kagoshima, Japan
| | - Masashi Kawanishi
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kagoshima, Japan
| | - Tetsuo Fukunaga
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kagoshima, Japan
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1026
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Klausen HH, Petersen J, Bandholm T, Juul-Larsen HG, Tavenier J, Eugen-Olsen J, Andersen O. Association between routine laboratory tests and long-term mortality among acutely admitted older medical patients: a cohort study. BMC Geriatr 2017; 17:62. [PMID: 28249621 PMCID: PMC5333426 DOI: 10.1186/s12877-017-0434-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/25/2017] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Older people have the highest incidence of acute medical admissions. Old age and acute hospital admissions are associated with a high risk of adverse health outcomes after discharge, such as reduced physical performance, readmissions and mortality. Hospitalisations in this population are often by acute admission and through the emergency department. This, along with the rapidly increasing proportion of older people, warrants the need for clinically feasible tools that can systematically assess vulnerability in older medical patients upon acute hospital admission. These are essential for prioritising treatment during hospitalisation and after discharge. Here we explore whether an abbreviated form of the FI-Lab frailty index, calculated as the number of admission laboratory test results outside of the reference interval (FI-OutRef) was associated with long term mortality among acutely admitted older medical patients. Secondly, we investigate other markers of aging (age, total number of chronic diagnoses, new chronic diagnoses, and new acute admissions) and their associations with long-term mortality. METHODS A cohort study of acutely admitted medical patients aged 65 or older. Survival time within a 3 years post-discharge follow up period was used as the outcome. The associations between the markers and survival time were investigated by Cox regression analyses. For analyses, all markers were grouped by quartiles. RESULTS A total of 4,005 patients were included. Among the 3,172 patients without a cancer diagnosis, mortality within 3 years was 39.9%. Univariate and multiple regression analyses for each marker showed that all were significantly associated with post-discharge survival. The changes between the estimates for the FI-OutRef quartiles in the univariate- and the multiple analyses were negligible. Among all the markers investigated, FI-OutRef had the highest hazard ratio of the fourth quartile versus the first quartile: 3.45 (95% CI: 2.83-s4.22, P < 0.001). CONCLUSION Among acutely admitted older medical patients, FI-OutRef was strongly associated with long-term mortality. This association was independent of age, sex, and number of chronic diagnoses, new chronic diagnoses, and new acute admissions. Hence FI-OutRef could be a biomarker of advancement of aging within the acute care setting.
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Affiliation(s)
| | - Janne Petersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Bandholm
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Physical Therapy, Physical Medicine & Rehabilitation Research – Copenhagen (PMR-C), Copenhagen University Hospital, Hvidovre, Denmark
| | | | - Juliette Tavenier
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - Jesper Eugen-Olsen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - Ove Andersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
- The Emergency Department, Copenhagen University Hospital, Hvidovre, Denmark
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1027
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Intramuscular Adipose Tissue and the Functional Components of Sarcopenia in Hospitalized Geriatric Patients. Geriatrics (Basel) 2017; 2:geriatrics2010011. [PMID: 31011021 PMCID: PMC6371171 DOI: 10.3390/geriatrics2010011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 12/25/2022] Open
Abstract
Intramuscular adipose tissue (IMAT) could be an important missing value in the assessment of sarcopenia. This study tries to determine the relation between IMAT, muscle strength, functionality and mortality. In addition, the relation with nutritional status is screened. For six months, all patients admitted to the University Geriatric Center of Antwerp were evaluated for strength (hand grip), functionality (short physical performance battery—SPPB) and nutritional status. After one year, patients/relatives were contacted to obtain a current health status (mortality). A total of 303 patients were included at a mean age of 83.0 ± 6.4 years. The mean percentage of IMAT was 29.2% ± 13.0% (range 3.2%–86.2%). There was a negative correlation between IMAT and both grip strength and SPPB. SPPB was positively correlated with both grip strength and muscle mass. There was a positive correlation between IMAT and mortality. There was a negative correlation between grip strength, SPPB and mortality. IMAT did not have a clear relation with nutritional status. IMAT should be addressed in the work-up of sarcopenia, as it is correlated with muscle strength, functionality and mortality. In this cohort of hospitalized geriatric patients, there is a mean of about one-third of measured muscle volume that appears to be adipose tissue.
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1028
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Weinstein G. Childhood conditions and current physical performance among non-institutionalized individuals aged 50+ in Israel. Eur J Ageing 2017; 13:335-347. [PMID: 28190995 DOI: 10.1007/s10433-016-0380-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Adverse socioeconomic conditions in childhood have been previously linked with high risk of various health conditions. However, the association with future physical function has been less studied. Hand grip strength and chair-rising time are objective measures of physical capability indicating current and future health outcomes. The aim of this study was to test the hypothesis that perceived socio-economic status in childhood is related to current measures of physical function, among Israeli participants of the Survey of Health, Ageing and Retirement in Europe project. The study included 2300 participants aged 50 years or older (mean age 68 ± 10; 56 % women). Generalized linear regression models were used to examine the associations of childhood wealth and number of books in residence with grip strength and time to complete five rises from a chair. Logistic regression models were used to assess the relationships between the early life conditions and the ability to perform the physical tests. Adjustment was made for current income or household wealth, and for demographic, anthropometric, health, and life-style measures. Being wealthy and having a large number of books at home in childhood was associated with a stronger hand grip and a better chair-rise test performance. These associations were more robust in women compared to men, and persisted after adjustment for potential covariates. In addition, childhood wealth and number of books were associated with lower risk of being unable to perform the tests. Thus, early-life programming may contribute to physical function indicators in mid- and late-life.
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Affiliation(s)
- Galit Weinstein
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa, Israel
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1029
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Relationship between exercise capacity and urinary liver-type fatty acid-binding protein in middle-aged and older individuals. Clin Exp Nephrol 2017; 21:810-817. [PMID: 28197733 DOI: 10.1007/s10157-017-1385-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND The underlying mechanism linking the decline in exercise capacity with renal dysfunction remains unclear. Urinary liver-type fatty acid-binding protein (L-FABP) levels reflect the degree of peritubular capillary blood flow, an important factor for renal dysfunction with aging. The aim of this study was to examine the relationship between exercise capacity and urinary L-FABP levels. METHODS This was a cross-sectional study of 187 middle-aged and older individuals (aged 50-83 years) without chronic kidney disease (CKD). We assessed urinary L-FABP levels, peak oxygen consumption ([Formula: see text]), and grip strength. RESULTS Urinary L-FABP levels inversely correlated with both [Formula: see text] (r s = -0.349) and grip strength (r s = -0.485). When the participants were divided into four groups according to the median values of aerobic fitness and muscular strength ([Formula: see text] and grip strength), urinary L-FABP levels were the highest in participants with lower levels of aerobic fitness and muscular strength (2.95 ± 1.43 μg/g creatinine) and the lowest in the participants with higher levels of aerobic fitness and muscular strength (1.33 ± 0.76 μg/g creatinine). The difference between the two groups was significant (P < 0.001). CONCLUSION Our results demonstrate that both [Formula: see text] and grip strength were inversely associated with urinary L-FABP levels in middle-aged and older individuals without CKD. This suggests that a decline in exercise capacity is associated with a reduction in peritubular capillary blood flow, providing a novel insight into the underlying mechanism linking the decline in exercise capacity to the development of renal dysfunction.
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1030
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Chia KSW, Faux SG, Wong PKK, Holloway C, Assareh H, McLachlan CS, Kotlyar E. Randomised controlled trial examining the effect of an outpatient exercise training programme on haemodynamics and cardiac MR parameters of right ventricular function in patients with pulmonary arterial hypertension: the ExPAH study protocol. BMJ Open 2017; 7:e014037. [PMID: 28167746 PMCID: PMC5293990 DOI: 10.1136/bmjopen-2016-014037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Pulmonary hypertension (PH) is a potentially life-threatening condition characterised by elevated pulmonary artery pressure. Early stage PH patients are often asymptomatic. Disease progression is associated with impairment of right ventricular function and progressive dyspnoea. Current guidelines recommend exercise training (grade IIa, level B). However, many questions remain regarding the mechanisms of improvement, intensity of supervision and optimal frequency, duration and intensity of exercise. This study will assess the effect of an outpatient rehabilitation programme on haemodynamics and cardiac right ventricular function in patients with pulmonary arterial hypertension (PAH), a subgroup of PH. METHODS AND ANALYSIS This randomised controlled trial involves both a major urban tertiary and smaller regional hospital in New South Wales, Australia. The intervention will compare an outpatient rehabilitation programme with a control group (home exercise programme). Participants will be stable on oral PAH-specific therapy. The primary outcome measure will be right ventricular ejection fraction measured by cardiac MRI. Secondary outcomes will include haemodynamics measured by right heart catheterisation, endurance, functional capacity, health-related quality of life questionnaires and biomarkers of cardiac function and inflammation. ETHICS APPROVAL AND DISSEMINATION Ethical approval has been granted by St Vincent's Hospital, Sydney (HREC/14/SVH/341). Results of this study will be disseminated through presentation at scientific conferences and in scientific journals. TRIAL REGISTRATION NUMBER ACTRN12615001041549; pre-results.
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Affiliation(s)
- Karen S W Chia
- University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia
- Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia
| | - Steven G Faux
- Sacred Heart Rehabilitation, St Vincent's Health, Coffs Harbour, New South Wales, Australia
- University of New South Wales, Coffs Harbour, New South Wales, Australia
- St Vincent's Hospital Sydney, Coffs Harbour, New South Wales, Australia
| | - Peter K K Wong
- University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia
- Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia
- Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia
| | - Cameron Holloway
- University of New South Wales, Coffs Harbour, New South Wales, Australia
- St Vincent's Hospital Sydney, Coffs Harbour, New South Wales, Australia
| | - Hassan Assareh
- University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia
- Epidemiology and Health Analytics Department, Western Sydney Local Health District, Coffs Harbour, New South Wales, Australia
| | - Craig S McLachlan
- University of New South Wales Rural Clinical School, Coffs Harbour, New South Wales, Australia
| | - Eugene Kotlyar
- University of New South Wales, Coffs Harbour, New South Wales, Australia
- St Vincent's Hospital Sydney, Coffs Harbour, New South Wales, Australia
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1031
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Armenian SH, Chemaitilly W, Chen M, Chow EJ, Duncan CN, Jones LW, Pulsipher MA, Remaley AT, Rovo A, Salooja N, Battiwalla M. National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Cardiovascular Disease and Associated Risk Factors Working Group Report. Biol Blood Marrow Transplant 2017; 23:201-210. [PMID: 27590105 PMCID: PMC5526451 DOI: 10.1016/j.bbmt.2016.08.019] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022]
Abstract
A number of studies have shown that autologous and allogeneic hematopoietic cell transplantation (HCT) contribute to an increased incidence of cardiovascular disease (CVD) and worsening of cardiovascular risk factors that could contribute to further CVD over time. These observations, combined with a notable increase in the number of survivors after HCT in recent years, highlight the need for studies aimed at modifying risk or preventing these outcomes by changing specific approaches and/or post-HCT interventions. To address these issues, the National Heart, Lung and Blood Institute and National Cancer Institute co-sponsored an international initiative on late effects after HCT. This report summarizes the major gaps in knowledge along with detailed recommendations regarding study priorities from the Cardiovascular Disease and Associated Risk Factors Committee, a multidisciplinary panel of international experts. The committee calls for specific studies aimed at understanding and preventing arterial disease and cardiac dysfunction (heart failure, valvular disease, and arrhythmias), as well as decreasing cardiovascular risk factors (hypertension, hyperglycemia, dyslipidemia, and sarcopenic obesity) after HCT.
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Affiliation(s)
- Saro H Armenian
- Department of Population Sciences, City of Hope, Duarte, California.
| | - Wassim Chemaitilly
- Pediatric Medicine Department, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Marcus Chen
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Eric J Chow
- Clinical Research and Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Christine N Duncan
- Pediatric Stem Cell Transplant Center, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Lee W Jones
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael A Pulsipher
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California
| | - Alan T Remaley
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Alicia Rovo
- Department of Hematology, University Hospital of Bern, Bern, Switzerland
| | - Nina Salooja
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Minoo Battiwalla
- Hematopoietic Transplantation Section, National Heart, Lung, and Blood Institute, Bethesda, Maryland
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1032
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Gomez-Arbelaez D, Bellido D, Castro AI, Ordoñez-Mayan L, Carreira J, Galban C, Martinez-Olmos MA, Crujeiras AB, Sajoux I, Casanueva FF. Body Composition Changes After Very-Low-Calorie Ketogenic Diet in Obesity Evaluated by 3 Standardized Methods. J Clin Endocrinol Metab 2017; 102:488-498. [PMID: 27754807 DOI: 10.1210/jc.2016-2385] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/12/2016] [Indexed: 02/04/2023]
Abstract
CONTEXT Common concerns when using low-calorie diets as a treatment for obesity are the reduction in fat-free mass, mostly muscular mass, that occurs together with the fat mass (FM) loss, and determining the best methodologies to evaluate body composition changes. OBJECTIVE This study aimed to evaluate the very-low-calorie ketogenic (VLCK) diet-induced changes in body composition of obese patients and to compare 3 different methodologies used to evaluate those changes. DESIGN Twenty obese patients followed a VLCK diet for 4 months. Body composition assessment was performed by dual-energy X-ray absorptiometry (DXA), multifrequency bioelectrical impedance (MF-BIA), and air displacement plethysmography (ADP) techniques. Muscular strength was also assessed. Measurements were performed at 4 points matched with the ketotic phases (basal, maximum ketosis, ketosis declining, and out of ketosis). RESULTS After 4 months the VLCK diet induced a -20.2 ± 4.5 kg weight loss, at expenses of reductions in fat mass (FM) of -16.5 ± 5.1 kg (DXA), -18.2 ± 5.8 kg (MF-BIA), and -17.7 ± 9.9 kg (ADP). A substantial decrease was also observed in the visceral FM. The mild but marked reduction in fat-free mass occurred at maximum ketosis, primarily as a result of changes in total body water, and was recovered thereafter. No changes in muscle strength were observed. A strong correlation was evidenced between the 3 methods of assessing body composition. CONCLUSION The VLCK diet-induced weight loss was mainly at the expense of FM and visceral mass; muscle mass and strength were preserved. Of the 3 body composition techniques used, the MF-BIA method seems more convenient in the clinical setting.
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Affiliation(s)
| | - Diego Bellido
- Division of Endocrinology, Complejo Hospitalario Universitario de Ferrol and Coruña University, 15405 Ferrol, Spain
| | - Ana I Castro
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
| | | | - Jose Carreira
- Family Medicine, Sanitary Area of Ferrol, 15405 Ferrol, Spain
| | - Cristobal Galban
- Intensive Care Division, Complejo Hospitalario Universitario de Santiago, 15706 Santiago de Compostela, Spain
| | - Miguel A Martinez-Olmos
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
| | - Ana B Crujeiras
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
| | - Ignacio Sajoux
- Medical Department PronoKal Group, 08009 Barcelona, Spain; and
| | - Felipe F Casanueva
- Division of Endocrinology, Department of Medicine, and
- Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III, 15706 Santiago de Compostela, Spain
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1033
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Jones GR, Roland KP, Neubauer NA, Jakobi JM. Handgrip Strength Related to Long-Term Electromyography. Arch Phys Med Rehabil 2017; 98:347-352. [DOI: 10.1016/j.apmr.2016.09.133] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/22/2016] [Accepted: 09/22/2016] [Indexed: 11/25/2022]
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1034
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Lambert J, Ghadry-Tavi R, Knuff K, Jutras M, Siever J, Mick P, Roque C, Jones G, Little J, Miller H, Van Bergen C, Kurtz D, Murphy MA, Jones CA. Targeting functional fitness, hearing and health-related quality of life in older adults with hearing loss: Walk, Talk 'n' Listen, study protocol for a pilot randomized controlled trial. Trials 2017; 18:47. [PMID: 28129779 PMCID: PMC5273835 DOI: 10.1186/s13063-017-1792-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/10/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Hearing loss (HL) is a disability associated with poorer health-related quality of life including an increased risk for loneliness, isolation, functional fitness declines, falls, hospitalization and premature mortality. The purpose of this pilot trial is to determine the feasibility and acceptability of a novel intervention to reduce loneliness, improve functional fitness, social connectedness, hearing and health-related quality of life in older adults with HL. METHODS This 10-week, single-blind, pilot randomized control trial (RCT) will include a convenience sample of ambulatory adults aged 65 years or older with self-reported HL. Following baseline assessments, participants will be randomized to either intervention (exercise, health education, socialization and group auditory rehabilitation (GAR)) or control (GAR only) groups. The intervention group will attend a local YMCA twice a week and the control group once a week. Intervention sessions will include 45 min of strengthening, balance and resistance exercises, 30 min of group walking at a self-selected pace and 60 min of interactive health education or GAR. The control group will attend 60-min GAR sessions. GAR sessions will include education about hearing, hearing technologies, enhancing communication skills, and psychosocial support. Pre-post trial data collection and measures will include: functional fitness (gait speed, 30-s Sit to Stand Test), hearing and health-related quality of life, loneliness, depression, social participation and social support. At trial end, feasibility (recruitment, randomization, retention, acceptability) and GAR will be evaluated. DISCUSSION Despite evidence suggesting that HL is associated with declines in functional fitness, there are no studies aimed at addressing functional fitness declines associated with the disability of HL. This pilot trial will provide knowledge about the physical, mental and social impacts on health related to HL as a disability. This will inform the feasibility of a larger RCT and preliminary evidence about the initial effects of a novel, community-based, holistic intervention addressing both the negative psychosocial and functional physical effects of HL among older adults. TRIAL REGISTRATION ClinicalTrials.gov, NCT02662192 . Registered on 14 January 2016.
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Affiliation(s)
- Justin Lambert
- Faculty of Medicine, Southern Medical Program, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Rouzbeh Ghadry-Tavi
- Faculty of Medicine, Southern Medical Program, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Kate Knuff
- Faculty of Medicine, Southern Medical Program, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Marc Jutras
- Faculty of Medicine, Southern Medical Program, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Jodi Siever
- Faculty of Medicine, Southern Medical Program, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Paul Mick
- Faculty of Medicine, Department of Surgery, Division of Otolaryngology, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Carolyn Roque
- Faculty of Medicine, Southern Medical Program, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Gareth Jones
- Faculty of Health and Social Development, School of Health and Exercise Science, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Jonathan Little
- Faculty of Health and Social Development, School of Health and Exercise Science, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Harry Miller
- Faculty of Medicine, Southern Medical Program, University of British Columbia, Okanagan campus, Kelowna, BC Canada
- Irving K. Barber School of Arts and Social Sciences, Psychology, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | | | - Donna Kurtz
- Faculty of Health and Social Development, School of Nursing, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Mary Ann Murphy
- Irving K. Barber School of Arts and Social Sciences, Sociology and School of Social Work, University of British Columbia, Okanagan campus, Kelowna, BC Canada
| | - Charlotte Ann Jones
- Southern Medical Program, #321 Reichwald Health Sciences Center, 1088 Discovery Ave, Kelowna, BC V1V-1V7 Canada
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1035
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No association between grip strength and cardiovascular risk: The CoLaus population-based study. Int J Cardiol 2017; 236:478-482. [PMID: 28129924 DOI: 10.1016/j.ijcard.2017.01.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/10/2017] [Accepted: 01/19/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Decreased grip strength (GS) is predictive of cardiovascular (CV) disease but whether it improves CV risk prediction has not been evaluated. We assessed the predictive value of low GS on incident CV events and overall mortality taking into account CV risk equations in a population-based study from Switzerland. METHODS 2707 adults (54.8% women, age range 50-75years) were followed for a median time of 5.4years. GS was assessed using a hydraulic hand dynamometer. CV absolute risk at baseline was assessed using recalibrated SCORE, Framingham and PROCAM risk equations. Incident CV events were adjudicated by an independent committee. RESULTS 160 deaths and 188 incident CV events occurred during follow-up. On bivariate analysis, low GS was associated with increased incident CV events: hazard ratio (HR) and (95% confidence interval) 1.76 (1.13-2.76), p<0.01 but not with overall mortality: HR=1.51 (0.94-2.45), p=0.09. The association between low GS and incident CV events disappeared after adjusting for baseline CV risk: HR=1.23 (0.79-1.94), p=0.36; 1.34 (0.86-2.10), p=0.20 and 1.47 (0.94-2.31), p=0.09 after adjusting for SCORE, Framingham and PROCAM scores, respectively. CONCLUSION Low GS is not predictive of incident CV events when taking into account CV absolute risk.
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1036
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Population Muscle Strength Predicts Olympic Medal Tallies: Evidence from 20 Countries in the PURE Prospective Cohort Study. PLoS One 2017; 12:e0169821. [PMID: 28107362 PMCID: PMC5249146 DOI: 10.1371/journal.pone.0169821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 12/22/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND National sporting achievement at the Olympic Games is important for national pride and prestige, and to promote participation in sport. Summer Olympic Games medal tallies have been associated with national wealth, and also social development and healthcare expenditure. It is uncertain however, how these socioeconomic factors translate into Olympic success. The objective of this study was therefore to examine the relationship between population muscle strength and Olympic medal tallies. METHODS AND RESULTS This study of handgrip strength represents a cross-sectional analysis of the Prospective Urban Rural Epidemiology (PURE) study, which is an ongoing population cohort study of individuals from high-, middle-, and low-income countries. Within participating countries, households from both urban and rural communities were invited to participate using a sampling strategy intended to yield a sample that was representative of the community. Households were eligible if at least one member was aged 35-70 years and if they intended living at the same address for a further four years. A total of 152,610 participants from these households, located in 21 countries, were included in this analysis. Handgrip strength was measured using a Jamar dynanometer. Olympic medal tallies were made over the five most recent Summer Games. There was a significant positive association between national population grip strength (GS) and medal tally that persisted after adjustment for sex, age, height, average daily caloric intake and GDP (total and per capita). For every 1kg increase in population GS, the medal tally increased by 36% (95% CI 13-65%, p = 0.001) after adjustment. Among countries that won at least one medal over the four most recent Summer Olympic Games, there was a close linear relationship between adjusted GS and the natural logarithm of the per capita medal tally (adjusted r = 0.74, p = 0.002). CONCLUSIONS Population muscle strength may be an important determinant of Summer Olympic Games medal success. Further research is needed to understand whether population muscle strength is modifiable, and whether this can improve Olympic medal success. Extreme outcomes may reflect the average attributes of the population from which the individual experiencing the extreme outcome is drawn.
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1037
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Stessman J, Rottenberg Y, Fischer M, Hammerman-Rozenberg A, Jacobs JM. Handgrip Strength in Old and Very Old Adults: Mood, Cognition, Function, and Mortality. J Am Geriatr Soc 2017; 65:526-532. [PMID: 28102890 DOI: 10.1111/jgs.14509] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine the trajectory of handgrip strength (HGS) from age 70 to 90 and its association with mood, cognition, functional status, and mortality. DESIGN Prospective follow-up of an age-homogenous representative community-dwelling cohort (born 1920-21) in the Jerusalem Longitudinal Cohort Study (1990-2015). SETTING Home-based assessment. PARTICIPANTS Subjects aged 70 (n = 327), 78 (n = 384), 85 (n = 1187), and 90 (n = 406), examined in 1990, 1998, 2005, and 2010, respectively. MEASUREMENTS Handgrip strength (kg) (dynamometer), low HGS defined as sex-specific lowest quartile grip; geriatric assessment; all-cause mortality (1990-2015). RESULTS Mean HGS declined between age 70 and 90 from 21.3 ± 7.2 to 11.5 ± 5.6 kg in women and from 35.3 ± 8.4 to 19.5 ± 8.2 kg in men. Cross-sectional associations were observed between low HGS and poor functional measures (age 70-90), lower educational and financial status, smoking, and diabetes mellitus (ages 78-90). After adjustment for baseline education, self-rated health, physical activity, diabetes mellitus, depression, and cognition, low HGS predicted subsequent activity of daily living dependence from age 78 to 85 (odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.04-6.89) and 85 to 90 (OR = 2.31, 95% CI = 1.01-5.30), whereas the adjusted ORs for activities of daily living difficulty and depression failed to achieve significance. HGS did not predict subsequent cognitive decline. Survival rates were significantly lower in participants with low HGS (Quartile 1) than in those with normal HGS (Quartiles 2, 3, 4) throughout follow-up from ages 78 to 85, 85 to 90, and 90 to 95. Similarly, after adjusting for sex, education, self-rated health, body mass index, hypertension, diabetes mellitus, ischemic heart disease, and smoking, a low HGS was associated with significantly higher mortality. CONCLUSIONS Mean HGS declined progressively with age, and participants in the lowest age-specific quartile of HGS had a higher risk of subsequent functional decline and mortality.
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Affiliation(s)
- Jochanan Stessman
- Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Yakir Rottenberg
- Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Oncology, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Matan Fischer
- Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Internal Medicine, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Aliza Hammerman-Rozenberg
- Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Jeremy M Jacobs
- Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel
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1038
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García-Esquinas E, Rodríguez-Artalejo F. Association between serum uric acid concentrations and grip strength: Is there effect modification by age? Clin Nutr 2017; 37:566-572. [PMID: 28139280 DOI: 10.1016/j.clnu.2017.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/19/2016] [Accepted: 01/11/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Given that some of the deleterious effects of uric acid (UA) on health are greater in younger than in older subjects, and that age is strongly associated with skeletal muscle composition and function, this study tested the hypothesis that the association between UA and muscle strength differs by age. METHODS Cross-sectional analysis with 3595 individuals who participated in NHANES 2011-2012. Serum uric acid was determined by the uricase-peroxidase technique. Grip strength was calculated as the average of the best measure obtained in each hand with a Takei digital grip strength dynamometer. Linear regression models were adjusted for the main confounders. RESULTS In individuals aged 20-40 years, the beta coefficients (95% CI) of muscle strength as dependent variable and UA as independent variable comparing the second and third to the lowest tertile of UA were -0.45 kg (-1.46; 0.57) and -2.36 kg (-3.27; -1.44), respectively, p-linear trend ≤0.01. By contrast, in subjects aged 40-60 years the corresponding beta coefficients were 0.21 kg (-1.00; 1.42) and -0.45 kg (-2.10; 1.20), p-linear trend: 0.60; and for subjects ≥60 years they were 0.58 kg (-3.27; 1.65) and 1.57 kg (0.63; 2.50), p-linear trend <0.01. These results held after numerous sensitivity analyses. CONCLUSION The association between UA and muscle strength differed depending on age: while a negative link was observed in adults aged 20-40 years, this relationship disappeared later in life, and was reversed after the age of 60. Future research should evaluate if uric acid targets for individuals with hyperuricemia should consider patients age and muscle strength.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain; CIBER of Epidemioloy and Public Health (CIBERESP), Madrid, Spain.
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain; CIBER of Epidemioloy and Public Health (CIBERESP), Madrid, Spain
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1039
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Physical Health Indicators Improve Prediction of Cardiovascular and All-cause Mortality among Middle-Aged and Older People: a National Population-based Study. Sci Rep 2017; 7:40427. [PMID: 28079182 PMCID: PMC5227916 DOI: 10.1038/srep40427] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/05/2016] [Indexed: 11/08/2022] Open
Abstract
The effectiveness of established methods for stratifying cardiovascular risk, for example, the Framingham risk score (FRS), may be improved by adding extra variables. This study evaluated the potential benefits of adding physical health indicators (handgrip strength, walking speed, and peak expiratory flow) to the FRS in predicting cardiovascular and all-cause mortality by using a nationwide population-based cohort study data. During median follow-up of 4.1 years, 67 of 911 study subjects had died. In Cox regression analysis, all additional physical health indicators, except walking speed, significantly predicted cardiovascular and all-cause mortality (P < 0.05). Compared with the conventional FRS, c statistics were significantly increased when dominant handgrip strength or relative handgrip strength (handgrip strength adjusted for body mass index), or combination with walking speed or peak expiratory flow were incorporated into the FRS prediction model, both in the whole cohort and also in participants who did not have prevalent cardiovascular diseases at baseline. In conclusion, dominant or relative handgrip strength are simple and inexpensive physical health indicators that substantially improve the accuracy of the FRS in predicting cardiovascular and all-cause mortality among middle-aged and older people.
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1040
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Impact of physical growth, body adiposity and lifestyle on muscular strength and cardiorespiratory fitness of adolescents. J Bodyw Mov Ther 2017; 21:896-901. [PMID: 29037646 DOI: 10.1016/j.jbmt.2017.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/20/2016] [Accepted: 01/04/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the impact of physical growth, body adiposity and lifestyle on cardiorespiratory fitness and muscle strength of pubescent and post-pubescent adolescents. METHODS Cross-sectional study with 1132 adolescents (14-19 years) in Brazil. Aerobic fitness was measured using the modified Canadian Aerobic Fitness Test. Muscle strength was assessed using manual dynamometer. Maturational stages were defined through the Tanner criteria. RESULTS Boys at pubertal maturation stage showed higher VO2max values than those at the post-pubertal stage when the influence of body adiposity and lifestyle was disregarded. Girls at pubertal maturation stage showed higher VO2max values than those in the post-pubertal stage when the influence of age was disregarded. For muscle strength, no significant differences were found. CONCLUSIONS The variables that influence the association between VO2max and maturational stage are different for boys and girls.
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1041
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Celis-Morales CA, Lyall DM, Anderson J, Iliodromiti S, Fan Y, Ntuk UE, Mackay DF, Pell JP, Sattar N, Gill JM. The association between physical activity and risk of mortality is modulated by grip strength and cardiorespiratory fitness: evidence from 498 135 UK-Biobank participants. Eur Heart J 2017; 38:116-122. [PMID: 28158566 PMCID: PMC5837781 DOI: 10.1093/eurheartj/ehw249] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/03/2016] [Accepted: 05/30/2016] [Indexed: 11/13/2022] Open
Abstract
Aims It is unclear whether the potential benefits of physical activity differ according to level of cardiorespiratory fitness (CRF) or strength. The aim of this study was to determine whether the association between physical activity and mortality is moderated by CRF and grip strength sufficiently to inform health promotion strategies. Methods and Results 498 135 participants (54.7% women) from the UK Biobank were included (CRF data available in 67 702 participants). Exposure variables were grip strength, CRF, and physical activity. All-cause mortality and cardiovascular disease (CVD) events were the outcomes. 8591 died over median 4.9 years [IQR 4.3–5.5] follow-up. There was a significant interaction between total physical activity and grip strength (P < 0.0001) whereby the higher hazard of mortality associated with lower physical activity was greatest among participants in the lowest tertile for grip strength (hazard ratio, HR:1.11 [95% CI 1.09–1.14]) and lowest among those in the highest grip strength tertile (HR:1.04 [1.01–1.08]). The interaction with CRF did not reach statistical significance but the pattern was similar. The association between physical activity and mortality was larger among those in the lowest tertile of CRF (HR:1.13 [1.02–1.26]) than those in the highest (HR:1.03 [0.91–1.16]). The pattern for CVD events was similar. Conclusions These data provide novel evidence that strength, and possibly CRF, moderate the association between physical activity and mortality. The association between physical activity and mortality is strongest in those with the lowest strength (which is easily measured), and the lowest CRF, suggesting that these sub-groups could benefit most from interventions to increase physical activity.
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Affiliation(s)
- Carlos A. Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Donald M. Lyall
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Jana Anderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Stamatina Iliodromiti
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
- Reproductive and Maternal Medicine, School of Medicine, University of Glasgow, Glasgow G12 8QQ, UK
| | - Yu Fan
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Uduakobong E. Ntuk
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Daniel F. Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Jill P. Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Jason M.R. Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
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1042
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Zempo H, Isobe M, Naito H. Link between blood flow and muscle protein metabolism in elderly adults. ACTA ACUST UNITED AC 2017. [DOI: 10.7600/jpfsm.6.25] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hirofumi Zempo
- Japan Society for the Promotion of Science
- Graduate School of Health and Sports Science, Juntendo University
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Hisashi Naito
- Graduate School of Health and Sports Science, Juntendo University
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1043
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Balogun S, Winzenberg T, Wills K, Scott D, Jones G, Aitken D, Callisaya ML. Prospective Associations of Low Muscle Mass and Function with 10-Year Falls Risk, Incident Fracture and Mortality in Community-Dwelling Older Adults. J Nutr Health Aging 2017; 21:843-848. [PMID: 28717816 DOI: 10.1007/s12603-016-0843-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Purpose: To compare the performance of low muscle mass and function with falls risk, incident fracture and mortality over 10 years. METHODS 1041 participants (50% women; mean age 63±7.5 years) were prospectively followed for 10 years. Falls risk was measured using the Physiological Profile Assessment, fractures were self-reported and mortality was ascertained from the death registry. Appendicular lean mass (ALM) was assessed using dual energy X-ray absorptiometry. Four anthropometric: (ALM/height2, ALM/body mass index, ALM/weight×100, a residuals method of ALM on height and total body fat) and four performance-based measures: (handgrip strength, lower-limb muscle strength, upper and lower-limb muscle quality) were examined. Participants in the lowest 20% of the sex-specific distribution for each anthropometric and performance-based measure were classified has having low muscle mass or function. Regression analyses were used to estimate associations between each anthropometric and performance-based measure at baseline and 10-year falls risk, incident fractures and mortality. RESULTS Mean falls risk z-score at 10 years was 0.64 (SD 1.12), incident fractures and mortality over 10 years were 16% and 14% respectively. All baseline performance-based measures were significantly associated with higher falls risk score at 10 years. Low handgrip (RR 1.55, 95% CI: 1.09, 2.20) and ALM/body mass index (RR 1.54, 95% CI: 1.14, 2.08) were the only significant predictors of fracture and mortality respectively. CONCLUSIONS Low handgrip strength, a simple and inexpensive test could be considered in clinical settings for identifying future falls and fractures. ALM/ body mass index could be most suitable in estimating 10-year mortality risk, but requires specialised equipment.
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Affiliation(s)
- S Balogun
- Dr Michele L. Callisaya, Menzies Institute for Medical Research, Tasmania, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia; , Phone: (03) 6226 4785, Fax: (03) 6226 7704
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1044
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Sagner M, McNeil A, Puska P, Auffray C, Price ND, Hood L, Lavie CJ, Han ZG, Chen Z, Brahmachari SK, McEwen BS, Soares MB, Balling R, Epel E, Arena R. The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan. PROGRESS IN PREVENTIVE MEDICINE 2017. [DOI: 10.1097/pp9.0000000000000002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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1045
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Chan YK, David AM, Mainland C, Chen L, Stewart S. Applying Heart Failure Management to Improve Health Outcomes: But WHICH One? Card Fail Rev 2017; 3:113-115. [PMID: 29387463 DOI: 10.15420/cfr.2017:11:1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report on our learning from many years of research testing the value of nurse-led, multidisciplinary, home-based management of heart failure. We discuss and highlight the key challenges we have experienced in testing this model of care relative to alternatives and evolving patient population. Accordingly, we propose a pragmatic approach to adapt current models of care to meet the needs of increasingly complex (and costly) patients with multimorbidity.
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Affiliation(s)
- Yih-Kai Chan
- Mary MacKillop Institute for Health Research, Australian Catholic University,Melbourne, Australia
| | - Alice M David
- Mary MacKillop Institute for Health Research, Australian Catholic University,Melbourne, Australia
| | - Caitlyn Mainland
- Mary MacKillop Institute for Health Research, Australian Catholic University,Melbourne, Australia
| | - Lei Chen
- Mary MacKillop Institute for Health Research, Australian Catholic University,Melbourne, Australia
| | - Simon Stewart
- Mary MacKillop Institute for Health Research, Australian Catholic University,Melbourne, Australia
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1046
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Fukuda T, Bouchi R, Takeuchi T, Nakano Y, Murakami M, Minami I, Izumiyama H, Hashimoto K, Yoshimoto T, Ogawa Y. Association of diabetic retinopathy with both sarcopenia and muscle quality in patients with type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2017; 5:e000404. [PMID: 28761661 PMCID: PMC5530250 DOI: 10.1136/bmjdrc-2017-000404] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/29/2017] [Accepted: 04/26/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To examine whether the existence and severity of diabetic retinopathy (DR) could be associated with the prevalent sarcopenia and muscle quality in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This is a cross-sectional study of 316 patients with type 2 diabetes (mean age 65±12 years; 38% female). Body compositions were measured by the dual-energy X-ray absorptiometry. Patients were divided into three groups: patients without DR (NDR), with non-proliferative DR (NPDR) and proliferative DR (PDR). Sarcopenia was diagnosed according to the criteria for Asians, using both skeletal muscle index (SMI) and grip strength (kg). Muscle quality was also determined by the grip strength divided by SMI. Logistic regression analyses were carried out to assess the cross-sectional association of the severity of DR with sarcopenia. In addition, linear regression analyses were performed to determine the associations between DR and muscle quality. Selection of covariates in the multivariate logistic and linear regression analyses was done by a stepwise procedure. RESULTS Among the patients examined, NDR, NPDR and PDR were diagnosed in 261, 38 and 17 patients, respectively. The prevalence of sarcopenia significantly increased along with the progression of DR. Multivariate logistic regression analysis showed that PDR is significantly associated with sarcopenia (OR 7.78, 95% CI 1.52 to 39.81, p=0.014) and low muscle strength (OR 6.25, 95% CI 1.15 to 33.96, p=0.034). Multivariate linear regression analysis additionally showed that the existence of DR was significantly associated with the muscle quality (standardized β -0.136, p=0.005 for NPDR, standardized β -0.146, p=0.003 for PDR). CONCLUSIONS This study provides evidence that PDR is significantly associated with sarcopenia, and the existence of DR increases the risk for low muscle quality in patients with type 2 diabetes.
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Affiliation(s)
- Tatsuya Fukuda
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryotaro Bouchi
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takato Takeuchi
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yujiro Nakano
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masanori Murakami
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Isao Minami
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Izumiyama
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Center for Medical Welfare and Liaison Services, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koshi Hashimoto
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Preemptive Medicine and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takanobu Yoshimoto
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihiro Ogawa
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- CREST, Japan Agency for Medical Research and Development, Tokyo, Japan
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1047
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Taani MH, Kovach CR, Buehring B. Muscle Mechanography: A Novel Method to Measure Muscle Function in Older Adults. Res Gerontol Nurs 2017; 10:17-24. [DOI: 10.3928/19404921-20161209-03] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/11/2016] [Indexed: 12/23/2022]
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1048
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Hamasaki H. Lower Extremity Skeletal Muscle Mass, but Not Upper Extremity Skeletal Muscle Mass, Is Inversely Associated with Hospitalization in Patients with Type 2 Diabetes. J Diabetes Res 2017; 2017:2303467. [PMID: 28848767 PMCID: PMC5564125 DOI: 10.1155/2017/2303467] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/30/2017] [Indexed: 12/25/2022] Open
Abstract
AIM To investigate the association of skeletal muscle mass with metabolic parameters and hospitalization in patients with type 2 diabetes. METHODS A retrospective observational study was conducted in patients with type 2 diabetes between May 2013 and November 2015. Body composition was measured by bioelectrical impedance analysis. Multiple regression analysis was performed to identify the association between skeletal muscle mass and metabolic parameters. Cox proportional hazard analysis was performed to assess the association between skeletal muscle mass and hospitalization. RESULTS A total of 121 patients were enrolled in this study. The mean age of patients was 59.4 ± 14.2 years. During a mean follow-up of 730 ± 253 days, three patients (2.8%) died and 79 patients (65.3%) were admitted to our hospital. After adjustment for age, sex, height, and weight, it was found that lower extremity skeletal muscle mass (LSM) was inversely associated with brachial-ankle pulse wave velocity (β = -0.108, P = 0.008). Moreover, LSM was significantly associated with reduced risk of hospitalization (hazard ratio = 0.752; 95% confidence interval, 0.601-0.942; P = 0.013). In contrast, upper extremity skeletal muscle mass (USM) did not exhibit any significant association. CONCLUSION LSM, but not USM, is important for managing patients with type 2 diabetes. This trial is registered with UMIN000023010.
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Affiliation(s)
- Hidetaka Hamasaki
- Hamasaki Clinic, Kagoshima, Japan
- Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
- *Hidetaka Hamasaki:
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1049
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Loprinzi PD. An Initial Assessment of Secular Trends in Muscular Strength Among Children, Adolescents, and Adults Across the Lifespan: National Sample of Americans. Am J Health Promot 2016; 32:705-707. [DOI: 10.1177/0890117116684890] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: Adequate muscular strength has important implications for morbidity and early mortality prevention. There are no data on the recent trends in muscular strength across lifespan, which was this study’s purpose. Design: Cross-sectional. Setting: 2011 to 2012 and 2013 to 2014 waves of the National Health and Nutrition Examination Survey across the United States. Participants: The analyzed sample included 12 295 participants aged 6 to 85 years. Measures: Muscular strength was assessed via a handgrip dynamometer. Analysis: Adjusted Wald test. Results: As expected, men (vs women) had greater grip strength, with grip strength declining as age increased. Central to the focus of this study, there were no changes in absolute or relative grip strength across the waves for any of the evaluated populations (considering age, gender, and race–ethnicity). Conclusion: These findings demonstrate that muscular grip strength, across all age, gender, and race–ethnicity populations in the United States, has not changed in the 2 successive 2-year time windows, contained over a 4-year period.
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Affiliation(s)
- Paul D. Loprinzi
- Jackson Heart Study Vanguard Center of Oxford, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science, and Recreation Management, University of Mississippi, Oxford, MS, USA
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1050
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The Prevalence of Oropharyngeal Dysphagia in Danish Patients Hospitalised with Community-Acquired Pneumonia. Dysphagia 2016; 32:383-392. [PMID: 28004179 DOI: 10.1007/s00455-016-9765-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 11/25/2016] [Indexed: 10/20/2022]
Abstract
Community-acquired pneumonia (CAP) and oropharyngeal dysphagia (OD) are prevalent conditions in the elderly. The aim of this study was to explore the relationship between CAP, OD, and frailty in patients admitted to a department of respiratory medicine at a regional hospital. The outcome was mortality during hospitalization and within 30 days of discharge and rehospitalization within 30 days of discharge. A total of 154 consecutive patients (54.5% male, mean age 77.4 years (SD 11.51)) hospitalized because of CAP from September 1, 2013 to March 31, 2014 at North Denmark Regional Hospital were included in this study. The volume-viscosity swallow test was conducted for each patient. A total of 34.42% patients presented with OD. Patients with OD and CAP presented significant differences in age, CURB-65, and dementia compared with those of patients with CAP alone. The majority lived in nursing homes, had a lower body mass index, Barthel 20 score, and handgrip strength, and had poor oral health compared with patients with CAP only. Patients with OD presented an increased length of stay in hospital (P < 0.001), intra-hospital mortality (P < 0.001), and 30-day mortality rate (P < 0.001) compared with those of patients with CAP only. Their rate of rehospitalization 0-30 days after discharge was also increased (P < 0.001) compared with that of patients with CAP only. Thus, OD is related to frailty and poor outcome.
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