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Ribeiro LW, Berndt S, Mielke GI, Doust J, Mishra GD. Factors associated with handgrip strength across the life course: A systematic review. J Cachexia Sarcopenia Muscle 2024. [PMID: 39183633 DOI: 10.1002/jcsm.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 07/24/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Muscle strength is essential for healthy ageing. Handgrip strength (HGS) has been recommended by expert bodies as the preferred measure of muscle strength, in addition to being considered a strong predictor of overall health. Cross-sectional studies have shown several potential factors associated with HGS, but a systematic review of factors predicting HGS over time has not previously been conducted. The aim of this study is to systematically review the literature on the factors associated with adult HGS [at follow-up(s) or its rate of change] across the life course. METHODS Searches were performed in MEDLINE via Ebsco, Embase and SPORTDiscus databases. Longitudinal studies assessing potential factors impacting adult HGS over time were included in the analyses. Based on previously established definitions of consistency of results, a semiquantitative analysis was conducted using the proportions of studies supporting correlations with HGS. RESULTS A total of 117 articles were included in this review. Factors associated with HGS were grouped into 11 domains: demographic, socioeconomic, genetic, early life, body composition, health markers/biomarkers, health conditions, psychosocial, lifestyle, reproductive and environmental determinants. Overall, 103 factors were identified, of which 10 showed consistent associations with HGS over time (i.e., in at least four studies with ≥60% agreement in the direction of association). Factors associated with greater declines in HGS included increasing age, male sex, higher levels of inflammatory markers and the presence of cardiovascular diseases. Education level, medication use, and self-rated health were not associated with the rate of change in HGS. Increased birth weight was associated with a stronger HGS over time, whereas depressive symptoms were linked to a weaker HGS, and smoking habits showed null associations. CONCLUSIONS Comparison between studies and estimation of effect sizes were limited due to the heterogeneity in methods. Although sex and age may be the main drivers of HGS decline, it is crucial to prioritize modifiable factors such as inflammation and cardiovascular diseases in health interventions to prevent greater losses. Interventions to improve birth weight and mental health are also likely to produce positive effects on muscle strength. Our results point to the complexity of processes involving muscle strength and suggest that the need to better understand the determinants of HGS remains.
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Affiliation(s)
- Leticia W Ribeiro
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Sara Berndt
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Jenny Doust
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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2
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van Schoor NM, de Jongh RT, Lips P, Deeg DJH, Kok AAL. Long-term trajectories of peak expiratory flow rate in older men and women show linear decline mainly determined by baseline levels. Aging Clin Exp Res 2024; 36:93. [PMID: 38627297 PMCID: PMC11021284 DOI: 10.1007/s40520-024-02735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 03/11/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Peak expiratory flow rate (PEFR) predicts mortality and other negative health outcomes. However, little evidence exists on how PEFR changes with ageing and how trajectories of change differ among older people. AIMS To identify trajectories of PEFR in older men and women, and to study characteristics associated with these trajectories. METHODS Data from the Longitudinal Aging Study Amsterdam were used, an ongoing cohort study in a representative sample of Dutch older men and women. PEFR was assessed using the Mini-Wright peak flow meter across a 13-year follow-up in 991 men and 1107 women. Trajectories were analyzed using Latent Class Growth Analysis. RESULTS Mean age was 72.5 (SD 8.4) in men and 72.4 (SD 8.4) in women. In men, three declining trajectories were identified, i.e. high, intermediate and low, with prevalences of 30%, 46% and 24%, respectively. In women, two declining trajectories were identified, i.e. high and low, with prevalences of 62 and 38%. All trajectories showed linear decline and differed mostly with regard to their intercept. Significant differences between trajectories with regard to baseline demographic, health and lifestyle characteristics were observed, e.g., men and women in the low PEFR trajectory were older, had more chronic diseases, and were more often smoker. DISCUSSION AND CONCLUSIONS Trajectories in both men and women differ mainly in baseline level of PEFR and not in rate of decline over time. Therefore, one PEFR measurement might be sufficient to give an indication of the trajectory that an older adult is likely to follow.
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Affiliation(s)
- Natasja M van Schoor
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Aging & Later Life, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands.
| | - Renate T de Jongh
- Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Paul Lips
- Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Aging & Later Life, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Almar A L Kok
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Aging & Later Life, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
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Hajek A, König HH. Reference Values and Correlates of Grip Strength in the Oldest Old: Evidence From the Representative NRW80+ (Germany). J Am Med Dir Assoc 2021; 23:898-899. [PMID: 34798006 DOI: 10.1016/j.jamda.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Johansson B, Thorvaldsson V. What Matters and What Matters Most for Survival After age 80? A Multidisciplinary Exploration Based on Twin Data. Front Psychol 2021; 12:723027. [PMID: 34630233 PMCID: PMC8492959 DOI: 10.3389/fpsyg.2021.723027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022] Open
Abstract
Given research and public interest for conditions related to an extended lifespan, we addressed the questions of what matters and what matters most for subsequent survival past age 80. The data was drawn from the population-based and multidisciplinary Swedish OCTO Twin Study, in which a sample (N = 699) consisting of identical and same-sex fraternal twin pairs, followed from age 80 until death, provided detailed data on health, physical functioning, life style, personality, and sociodemographic conditions. Information concerning date of birth and death were obtained from population census register. We estimated heritability using an ACE model and evaluated the role of multiple predictors for the mortality-related hazard rate using Cox regression. Our findings confirmed a low heritability of 12%. As expected, longer survival was associated with being a female, an apolipoprotein E (APOE) e4 allele non-carrier, and a non-smoker. Several diseases were found to be associated with shorter survival (cerebrovascular, dementia, Parkinson's, and diabetes) as well as certain health conditions (high diastolic blood pressure, low body mass index, and hip fracture). Stronger grip and better lung function, as well as better vision (but not hearing), and better cognitive function (self-evaluated and measured) was related to longer survival. Social embeddedness, better self-evaluated health, and life-satisfaction were also significantly associated with longer survival. After controlling for the impact of comorbidity, functional markers, and personality-related predictors, we found that sex, cerebrovascular diseases, compromised cognitive functioning, self-related health, and life-satisfaction remained as strong predictors. Cancer was only associated with the mortality hazard when accounting for other co-morbidities. The survival estimates were mostly in anticipated directions and contained effect sizes within the expected range. Noteworthy, we found that some of the so-called "soft-markers" remained strong predictors, despite a control for other factors. For example, self-evaluation of health and ratings of life-satisfaction provide additional and valuable information.
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Affiliation(s)
- Boo Johansson
- Department of Psychology and Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
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Ueshima J, Maeda K, Shimizu A, Inoue T, Murotani K, Mori N, Satake S, Matsui Y, Arai H. Diagnostic accuracy of sarcopenia by "possible sarcopenia" premiered by the Asian Working Group for Sarcopenia 2019 definition. Arch Gerontol Geriatr 2021; 97:104484. [PMID: 34298259 DOI: 10.1016/j.archger.2021.104484] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The Asian Working Group for Sarcopenia 2019 (AWGS 2019) proposed a simple assessment of sarcopenia called "possible sarcopenia" for the purpose of early detection and intervention of sarcopenia. The purpose of this study was to report the accuracy of possible sarcopenia against definitive sarcopenia and the characteristics of false-negative cases. MATERIALS AND METHODS This was a cross-sectional study using a research registry with outpatients aged ≥65 years who visited a frailty clinic at a geriatric hospital. The diagnosis of possible sarcopenia and sarcopenia was performed according to the AWGS 2019 criteria, using calf circumference (CC) for case-finding. The accuracy of the diagnosis of sarcopenia in participants with possible sarcopenia was evaluated by calculating sensitivity, specificity, and F-value. RESULTS Of the 349 patients (mean age, 78.0±6.0 years; 63% women) analyzed, 86 (24.6%) revealed possible sarcopenia. Possible sarcopenia predicted sarcopenia with a sensitivity of 0.893 and 0.921, specificity of 0.990 and 0.870, and F-values of 0.926 and 0.714 for men and women, respectively. When either the grip strength test or 5-time chair stand test result was examined, the sensitivity of possible sarcopenia to predict sarcopenia decreased, whereas the specificity remained at 0.990-1.000 in men and 0.890-0.940 in women. An extremely decreased CC was identified as a significant characteristic of patients with sarcopenia not detected in the simplified assessment. CONCLUSIONS The diagnostic accuracy of possible sarcopenia for definitive sarcopenia is excellent. Sarcopenia should be actively examined in patients with extremely decreased CC.
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Affiliation(s)
- Junko Ueshima
- Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Shinagawa, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Akio Shimizu
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Tatsuro Inoue
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan.
| | | | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan.
| | - Shosuke Satake
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan.
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Karunananthan S, Moodie EEM, Bergman H, Payette H, Diehr PH, Wolfson C. Physical Function and Survival in Older Adults: A longitudinal study accounting for time-varying effects. Arch Gerontol Geriatr 2021; 96:104440. [PMID: 34119809 DOI: 10.1016/j.archger.2021.104440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE OF THE STUDY Variation in physical function in older adults over time raises several methodological challenges in the study of its association with survival, many of which have largely been overlooked in previous studies. The objective of this study is to examine the relationship between time-varying measures of physical function and survival in men and women aged 70 years and over, while accounting for the time-varying effects of health and lifestyle characteristics. METHODS 1,846 women and 1,245 men in the Cardiovascular Health Study followed annually for up to 10 years beginning at age 70-74 years were included. We estimated the effect of gait speed and grip strength on survival over the subsequent year, using age as the timescale. RESULTS A 0.1m/s higher gait speed was associated with a 12% decrease in the likelihood of death in the subsequent year among women (HR 0.88, 95% CI 0.82-0.94). There was no statistically significant effect of gait speed on survival among men (HR 0.97, 95% CI 0.91 to 1.03), or of grip strength on survival among women (HR 0.97, 95% CI 0.95-1.00) or men (HR 0.99, 95% CI 0.97-1.01), over one year. CONCLUSIONS Upon using time-varying measures of physical function while accounting for time-varying effects of health and lifestyle characteristics, higher gait speed was associated with increased survival among the women in our study. We found no evidence of an association between gait speed and one-year survival in men, or between grip strength and one-year survival in women or men.
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Affiliation(s)
- Sathya Karunananthan
- Bruyère Research Institute, Ottawa, Ontario; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec.
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec
| | - Howard Bergman
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec
| | - Hélène Payette
- Research Centre on Aging, Integrated Academic Health Centre and Social Services in the Eastern Townships, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec
| | - Paula H Diehr
- Department of Health Services, University of Washington, Seattle, WA
| | - Christina Wolfson
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec; Department of Medicine, McGill University Montreal, Quebec; Research Institute of the McGill University Health Centre, Montreal, Quebec
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Malhotra R, Tareque MI, Tan NC, Ma S. Association of baseline hand grip strength and annual change in hand grip strength with mortality among older people. Arch Gerontol Geriatr 2019; 86:103961. [PMID: 31704626 DOI: 10.1016/j.archger.2019.103961] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 09/17/2019] [Accepted: 10/01/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Clinicians have increasing access to longitudinal data on hand grip strength (HGS), often measured for frailty or sarcopenia assessment, of their older clients. Evidence on the association of change in HGS with mortality is mixed. We investigated whether baseline hand grip strength (HGS) and annual change in HGS are associated with mortality among older Singaporeans. METHODS Data from a national longitudinal survey (3 waves: 2009, 2011 and 2015) of older people (≥60 years) in Singapore was utilized. All-cause mortality, until end-December 2015, was assessed primarily from administrative databases. Two datasets, with 4446 (Dataset 1: baseline HGS with mortality) and 2673 (Dataset 2: annual change in HGS with mortality) participants, with maximum follow-up time of 7 and 4.6 years respectively, were derived from the survey data. Associations of interest were assessed using Cox proportional hazard models. RESULTS 835 (18.8%) and 317 (11.9%) participants died during follow-up, with mean survival times of 3.6 and 2.6 years, in Dataset 1 and 2 respectively. The likelihood of mortality was lower by 4% (Hazard Ratio [95% Confidence Interval]: 0.96 [0.94-0.97]) for each unit (kilogram) increase in baseline HGS, and by 13% (0.87 [0.82-0.93]) for each kg increase in HGS over 1-year. CONCLUSIONS Higher (alternatively, lower) baseline HGS and an increase (alternatively, decrease) in HGS over 1-year were associated with lower (alternatively, higher) likelihood of all-cause mortality among community-dwelling older people. There is clinical value, for assessing the risk of mortality, of both the cross-sectional and longitudinal measurement of HGS among older people.
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Affiliation(s)
- Rahul Malhotra
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore 169857, Singapore; Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore 169857, Singapore.
| | - Md Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205, Bangladesh.
| | | | - Stefan Ma
- Ministry of Health, Singapore 169854, Singapore
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Ahrenfeldt LJ, Scheel-Hincke LL, Kjærgaard S, Möller S, Christensen K, Lindahl-Jacobsen R. Gender differences in cognitive function and grip strength: a cross-national comparison of four European regions. Eur J Public Health 2019; 29:667-674. [PMID: 30590595 PMCID: PMC6660112 DOI: 10.1093/eurpub/cky266] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Cross-national comparison studies on gender differences have mainly focussed on life expectancy, while less research has examined differences in health across countries. We aimed to investigate gender differences in cognitive function and grip strength over age and time across European regions. METHODS We performed a cross-sectional study including 51 292 men and 62 007 women aged 50 + participating in the Survey of Health, Ageing and Retirement in Europe between 2004-05 and 2015. Linear regression models were used to examine associations. RESULTS In general, women had better cognitive function than men, whereas men had higher grip strength measures. Sex differences were consistent over time, but decreased with age. Compared with men, women had higher cognitive scores at ages 50-59, corresponding to 0.17 SD (95% CI 0.14, 0.20) but slightly lower scores at ages 80-89 (0.08 SD, 95% CI 0.14, 0.00). For grip strength, the sex difference decreased from 18.8 kg (95% CI 18.5, 19.1) at ages 50-59 to 8.5 kg (95% CI 7.1, 9.9) at age 90 + . Northern Europeans had higher cognitive scores (19.6%) and grip strength measures (13.8%) than Southern Europeans. Gender differences in grip strength were similar across regions, whereas for cognitive function they varied considerably, with Southern Europe having a male advantage from ages 60-89. CONCLUSION Our results illustrate that gender differences in health depend on the selected health dimension and the age group studied, and emphasize the importance of considering regional differences in research on cognitive gender differences.
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Affiliation(s)
- Linda Juel Ahrenfeldt
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lasse Lybecker Scheel-Hincke
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Søren Kjærgaard
- Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- OPEN – Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Karunananthan S, Moodie EE, Bergman H, Payette H, Wolfson D, Diehr PH, Wolfson C. The association between physical function and proximity to death in older adults: a multilevel analysis of 4,150 decedents from the Cardiovascular Health Study. Ann Epidemiol 2019; 35:59-65.e5. [DOI: 10.1016/j.annepidem.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/05/2019] [Accepted: 04/08/2019] [Indexed: 11/30/2022]
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Thomas ET, Guppy M, Straus SE, Bell KJL, Glasziou P. Rate of normal lung function decline in ageing adults: a systematic review of prospective cohort studies. BMJ Open 2019; 9:e028150. [PMID: 31248928 PMCID: PMC6597635 DOI: 10.1136/bmjopen-2018-028150] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/01/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To conduct a systematic review investigating the normal age-related changes in lung function in adults without known lung disease. DESIGN Systematic review. DATA SOURCES MEDLINE, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for eligible studies from inception to February 12, 2019, supplemented by manual searches of reference lists and clinical trial registries. ELIGIBILITY CRITERIA We planned to include prospective cohort studies and randomised controlled trials (control arms) that measured changes in lung function over time in asymptomatic adults without known respiratory disease. DATA EXTRACTION AND SYNTHESIS Two authors independently determined the eligibility of studies, extracted data and assessed the risk of bias of included studies using the modified Newcastle-Ottawa Scale. RESULTS From 4385 records screened, we identified 16 cohort studies with 31 099 participants. All included studies demonstrated decline in lung function-forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) with age. In studies with longer follow-up (>10 years), rates of FEV1 decline ranged from 17.7 to 46.4 mL/year (median 22.4 mL/year). Overall, men had faster absolute rates of decline (median 43.5 mL/year) compared with women (median 30.5 mL/year). Differences in relative FEV1 change, however, were not observed between men and women. FEV1/FVC change was reported in only one study, declining by 0.29% per year. An age-specific analysis suggested the rate of FEV1 function decline may accelerate with each decade of age. CONCLUSIONS Lung function-FEV1, FVC and PEFR-decline with age in individuals without known lung disease. The definition of chronic airway disease may need to be reconsidered to allow for normal ageing and ensure that people likely to benefit from interventions are identified rather than healthy people who may be harmed by potential overdiagnosis and overtreatment. The first step would be to apply age, sex and ethnicity-adjusted FEV1/FVC thresholds to the disease definition of chronic obstructive pulmonary disease. PROSPERO REGISTRATION NUMBER CRD42018087066.
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Affiliation(s)
- Elizabeth T Thomas
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Michelle Guppy
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
| | - Sharon E Straus
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Katy J L Bell
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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11
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Robitaille A, Piccinin AM, Hofer SM, Johansson B, Muniz Terrera G. An examination of the heterogeneity in the pattern and association between rates of change in grip strength and global cognition in late life. A multivariate growth mixture modelling approach. Age Ageing 2018; 47:692-697. [PMID: 29659659 PMCID: PMC6108392 DOI: 10.1093/ageing/afy048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/15/2017] [Accepted: 03/08/2018] [Indexed: 11/13/2022] Open
Abstract
Background previous research has demonstrated how older adults exhibit different patterns of change in cognitive and physical functioning, suggesting differences in the underlying causal processes. Objective to (i) identify subgroups of older adults that best account for different patterns of longitudinal change in performance on global cognition and grip strength, (ii) examine the interrelationship between global cognition and grip strength trajectories within these subgroups and (iii) identify demographic and health-related markers of class membership. Methods multivariate growth mixture models (GMM) were used to identify groups of individuals with similar developmental trajectories of muscle strength measured by grip strength, and global cognition measured by Mini Mental State Examination (MMSE). Results GMM analyses indicated high, moderate and low functioning groups. Individuals in the high and moderate classes demonstrated better cognitive and physical functioning at the start of the study and less decline than those in the low functioning group. Notably, cognitive performance was related to physical functioning at study entry only among individuals in the low functioning group. Conclusion the study demonstrates the applicability of the multivariate GMM to achieve a better understanding of the heterogeneity of various aging related processes.
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Affiliation(s)
- Annie Robitaille
- Department of Psychology, Université du Québec á Montréal, QC, Canada
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Scott M Hofer
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Boo Johansson
- Department of Psychology, University of Gothenburg, Gothenburg 405 30, Sweden
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12
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Syddall HE, Westbury LD, Shaw SC, Dennison EM, Cooper C, Gale CR. Correlates of Level and Loss of Grip Strength in Later Life: Findings from the English Longitudinal Study of Ageing and the Hertfordshire Cohort Study. Calcif Tissue Int 2018; 102:53-63. [PMID: 29058059 PMCID: PMC5760591 DOI: 10.1007/s00223-017-0337-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/03/2017] [Indexed: 12/17/2022]
Abstract
Characterisation of grip strength (GS) using isometric dynamometry is central to the definition of sarcopenia. Determinants of low GS include: older age, shorter stature, low physical activity, poor nutrition, socioeconomic disadvantage and multimorbidity. Less is known about risk factors for accelerated loss of GS. We investigated determinants of level and 8-year loss of GS in 3703 men and women (aged 52-82 years) in the English Longitudinal Study of Ageing (ELSA). Four hundred and forty-one men and women (aged 59-71 years) who participated in a 10-year follow-up of the Hertfordshire Cohort Study (HCS) were used for replication. Variables were harmonised between cohorts. Change in GS was characterised using mixed-effects models in ELSA and a residual change approach in HCS and analysed for men and women combined. Men in ELSA and HCS had higher average levels of GS at baseline, and accelerated rates of loss, compared with women. In ELSA, older age, shorter stature and multimorbidity were correlated with lower level, and accelerated rate of loss, of GS in both sexes (accelerated loss of 0.04 (95% CI 0.00-0.08) standard deviation scores per additional morbidity after multivariable adjustment). Socioeconomic disadvantage, low level of physical activity and poorer self-reported health were also correlated with low GS level, but not loss rate, after multivariable adjustment. Analysis in HCS yielded similar results. Our results identify multimorbidity as a modifiable determinant of loss of muscle strength in later life, and raise the possibility that developmental influences may impact on rate of involutional decline in muscle strength.
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Affiliation(s)
- H E Syddall
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - L D Westbury
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - S C Shaw
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- Victoria University of Wellington, Wellington, New Zealand
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
| | - C R Gale
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
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13
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Granic A, Davies K, Jagger C, M. Dodds R, Kirkwood TBL, Sayer AA. Initial level and rate of change in grip strength predict all-cause mortality in very old adults. Age Ageing 2017; 46:970-976. [PMID: 28541466 PMCID: PMC5860048 DOI: 10.1093/ageing/afx087] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/11/2017] [Indexed: 01/12/2023] Open
Abstract
Objective to investigate the associations between initial level and rate of change in grip strength (GS) and all-cause mortality in very old adults (≥85 years) over a 9.6-year follow-up. Methods prospective mortality data from 845 participants in the Newcastle 85+ Study were analysed for survival in relation to GS (kg, baseline and 5-year mean change) using Cox proportional hazards models. Results during the follow-up, 636 (75.3%) participants died. Higher baseline GS was associated with a decreased risk of mortality in all participants [hazard ratio (HR) = 0.95, 95% confidence interval (CI): 0.93-0.98, P < 0.001], men (HR = 0.97, 95% CI: 0.95-0.99, P = 0.009) and women (HR = 0.96, 95% CI: 0.94-0.99, P = 0.007) after adjustment for health, lifestyle and anthropometric factors. Overall GS slope had a downward trajectory and was determined in 602 participants: 451 experienced constant decline (negative slope) and 151 had increasing GS (positive slope) over time. Men and women with a negative slope had a 16 and 33% increased risk of mortality, respectively, with every kg/year decline in GS (P ≤ 0.005), and participants with a positive slope had a 31% decreased risk of mortality (P = 0.03) irrespective of baseline GS and key covariates. Conclusion higher baseline GS and 5-year increase in GS were protective of mortality, whilst GS decline was associated with an increased risk of mortality in the very old over 9.6 years, especially in women. These results add to the biological and clinical importance of GS as a powerful predictor of long-term survival in late life.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
| | - Karen Davies
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
- Institute of Health and Society, Newcastle University, Newcastle University, Newcastle upon Tyne, UK
| | - Richard M. Dodds
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Thomas B L Kirkwood
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Avan A Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care, Wessex, University of Southampton, Southampton, UK
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Fauth EB, Schaefer SY, Zarit SH, Ernsth-Bravell M, Johansson B. Associations Between Fine Motor Performance in Activities of Daily Living and Cognitive Ability in a Nondemented Sample of Older Adults: Implications for Geriatric Physical Rehabilitation. J Aging Health 2017; 29:1144-1159. [PMID: 27339106 PMCID: PMC5179315 DOI: 10.1177/0898264316654674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Fine motor ability (FMA) is essential in certain activities of daily living (ADL) and is considered mostly as a component of physical function. We hypothesize that cognitive ability explains significant variance in ADL-related FMA, above and beyond what is explained by physical ability (grip strength). METHOD Origins of Variance in the Old Old Study (OCTO)-Twin participants ( n = 218), aged 80+ (dementia, stroke, Parkinson's disease excluded) were assessed on depressive symptoms (Center for Epidemiologic Studies-Depression Scale [CES-D]), a cognitive battery, grip strength, and FMA. RESULTS In a series of ordinary least squares regression models, FMA was not associated with gender or depressive symptoms, but was associated with age (marginally; β = -.164, p = .051), grip strength (β = -.381, p < .01), and one cognitive measure, perceptual speed (β = -.249, p < .01). DISCUSSION In nondemented older adults, cognitive speed predicts ADL-related FMA after controlling for age and physical ability. Physical rehabilitation of FMA in ADL tasks should consider the importance of cognitive ability, even in nondemented older adults.
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Affiliation(s)
| | | | - Steven H Zarit
- 2 Pennsylvania State University, University Park, PA, USA
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15
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Syddall HE, Westbury LD, Dodds R, Dennison E, Cooper C, Sayer AA. Mortality in the Hertfordshire Ageing Study: association with level and loss of hand grip strength in later life. Age Ageing 2017; 46:407-412. [PMID: 27932364 DOI: 10.1093/ageing/afw222] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Indexed: 01/18/2023] Open
Abstract
Background weak hand grip strength in later life is a risk factor for disability, morbidity and mortality and is central to definitions of sarcopenia and frailty. It is unclear whether rate of change in grip strength adds to level of grip strength as a risk factor for poor ageing outcomes. Methods study participants were 292 community-dwelling men and women whose grip strength was measured during the 1994/5 (average age 67) and 2003/5 (average age 76) phases of the Hertfordshire Ageing Study, UK. Individual rate of change in grip strength was estimated using a residual change method. Mortality was followed-up to 2011 (42 men and 21 women died). Results average grip strengths in 2003/5 were 38.4 kg (standard deviation [SD] = 8.1) and 23.7 kg (SD = 6.6) for men and women respectively. Average annualised rates of change in grip strength (2003/5 minus 1994/5) were modest owing to a healthy-participant effect (men: -0.12 kg/y, SD = 0.71; women: 0.08 kg/y, SD = 0.54) but varied widely. Mortality risk varied according to level and rate of change in grip strength (P = 0.03); death rates per 100 person years of follow-up were 6.7 (95% CI: 4.6, 9.6) among participants who lost grip over time and had low grip in 2003/5, in contrast with 0.8 (95% CI: 0.1, 5.8) among participants whose grip changed little over time and remained high in 2003/5. Conclusions levels of grip strength in later life should be considered in conjunction with estimates of change in grip strength identified by repeat measurement over time. Normative data for longitudinal change in grip strength are required.
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Affiliation(s)
- Holly Emma Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
| | - Leo David Westbury
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
| | - Richard Dodds
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
- Victoria University of Wellington, Wellington, New Zealand
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain and Northern Ireland
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Avan Aihie Sayer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
- Newcastle University Institute of Neuroscience, Newcastle Upon Tyne, United Kingdom of Great Britain and Northern Ireland
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom of Great Britain and Northern Ireland
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16
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Granic A, Davies K, Jagger C, Kirkwood TBL, Syddall HE, Sayer AA. Grip Strength Decline and Its Determinants in the Very Old: Longitudinal Findings from the Newcastle 85+ Study. PLoS One 2016; 11:e0163183. [PMID: 27637107 PMCID: PMC5026378 DOI: 10.1371/journal.pone.0163183] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 09/02/2016] [Indexed: 01/03/2023] Open
Abstract
Background Weak grip strength (GS) is a key component of sarcopenia and frailty and a powerful predictor of mortality, morbidity and disability. Despite increasing interest in understanding GS across the lifespan, little is known about GS decline in the very old (aged ≥85). We examined trajectories of GS in very old adults and identified the determinants. Methods GS (kg) was measured four times over 5 years in 319 men and 526 women participating in the Newcastle 85+ Study. A weak GS sub-cohort was identified as having strength of ≤27 kg (men), and ≤16 kg (women) at baseline and follow-up. Mixed models were used to establish trajectories of GS and associated factors in all participants, men and women, and in those with weak GS. Results Men’s mean grip strength was 24.42 (SD = 6.77) kg, and women’s 13.23 (4.42) kg (p<0.001) at baseline, with mean absolute change of -5.27 (4.90) kg and -3.14 (3.41), respectively (p<0.001) by 5-year follow-up. In the time-only mixed model, men experienced linear annual decline in GS of -1.13 (0.8) kg (β (SE), p<0.001), whilst women’s decline although slower, accelerated by -0.06 (0.02) kg (p = 0.01) over time. In the saturated model, higher baseline physical activity, height, fat-free mass, better self-rated health, and not having arthritis in hand(s) were associated with stronger GS initially in both sexes. Annual GS decline in men and participants with weak GS who were highly physically active was slower by 0.95 and 0.52 kg, respectively compared with inactive counterparts. Conclusion Grip strength decline in the very old followed linear (men) and curvilinear (women) trends. High levels of physical activity were protective of GS loss in men (but not in women) and in those with weak GS. Thus maintaining muscle strength in later life is important to reduce the morbidity and mortality in the very old.
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Affiliation(s)
- Antoneta Granic
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University, and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - Karen Davies
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University, and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
- Institute of Health and Society, Newcastle University, Baddiley-Clark, Richardson Road, Newcastle upon Tyne, United Kingdom
| | - Thomas B. L. Kirkwood
- Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Holly E. Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Avan A. Sayer
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University, and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- NIHR Collaboration for Leadership in Applied Health Research and Care, Wessex, University of Southampton, Southampton, United Kingdom
- * E-mail:
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17
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Petersen I, Pedersen NL, Rantanen T, Kremen WS, Johnson W, Panizzon MS, Christiansen L, Franz CE, McGue M, Christensen K, Hamdi NR, Krueger RF, Reynolds C. G×E Interaction Influences Trajectories of Hand Grip Strength. Behav Genet 2015; 46:20-30. [PMID: 26318288 DOI: 10.1007/s10519-015-9736-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/11/2015] [Indexed: 12/20/2022]
Abstract
Age-related decline in grip strength predicts later life disability, frailty, lower well-being and cognitive change. While grip strength is heritable, genetic influence on change in grip strength has been relatively ignored, with non-shared environmental influence identified as the primary contributor in a single longitudinal study. The extent to which gene-environment interplay, particularly gene-environment interactions, contributes to grip trajectories has yet to be examined. We considered longitudinal grip strength measurements in seven twin studies of aging in the Interplay of Genes and Environment across Multiple Studies consortium. Growth curve parameters were estimated for same-sex pairs, aged 34-99 (N = 10,681). Fisher's test for mixture distribution of within-monozygotic twin-pair differences (N = 1724) was performed on growth curve parameters. We observed significant gene-environment interaction on grip strength trajectories. Finally, we compared the variability of within-pair differences of growth curve parameters by APOE haplotypes. Though not statistically significant, the results suggested that APOE ɛ2ɛ2/ɛ2ɛ3 haplotypes might buffer environmental influences on grip strength trajectories.
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Affiliation(s)
- Inge Petersen
- The Danish Twin Registry, Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Taina Rantanen
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - William S Kremen
- Department of Psychiatry and Center for Behavioral Genomics, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare Center, La Jolla, CA, USA
| | - Wendy Johnson
- Department of Psychology and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Matthew S Panizzon
- Department of Psychiatry and Center for Behavioral Genomics, University of California, San Diego, La Jolla, CA, USA
| | - Lene Christiansen
- The Danish Twin Registry, Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Carol E Franz
- Department of Psychiatry and Center for Behavioral Genomics, University of California, San Diego, La Jolla, CA, USA
| | - Matt McGue
- The Danish Twin Registry, Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Kaare Christensen
- The Danish Twin Registry, Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Nayla R Hamdi
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Chandra Reynolds
- Department of Psychology, University of California - Riverside, Riverside, CA, USA
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18
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Buchman AS, Wilson RS, Leurgans SE, Bennett DA, Barnes LL. Change in motor function and adverse health outcomes in older African-Americans. Exp Gerontol 2015. [PMID: 26209439 DOI: 10.1016/j.exger.2015.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We tested whether declining motor function accelerates with age in older African-Americans. METHODS Eleven motor performances were assessed annually in 513 older African-Americans. RESULTS During follow-up of 5 years, linear mixed-effect models showed that motor function declined by about 0.03 units/year (Estimate, -0.026, p<0.001); about 4% more rapidly for each additional year of age at baseline. A proportional hazard model showed that both baseline motor function level and its rate of change were independent predictors of death and incident disability (all p's<0.001). These models showed that the additional annual amount of motor decline in 85 year old persons at baseline versus 65 year old persons was associated with a 1.5-fold higher rate of death and a 3-fold higher rate of developing Katz disability. CONCLUSIONS The rate of declining motor function accelerates with increasing age and its rate of decline predicts adverse health outcomes in older African-Americans.
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Affiliation(s)
- Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, United States; Department of Neurological Sciences, Rush University Medical Center, United States.
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, United States; Department of Behavioral Sciences, Rush University Medical Center, United States.
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, United States; Department of Neurological Sciences, Rush University Medical Center, United States.
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, United States; Department of Neurological Sciences, Rush University Medical Center, United States.
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, United States; Department of Neurological Sciences, Rush University Medical Center, United States; Department of Behavioral Sciences, Rush University Medical Center, United States.
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19
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Fouasson-Chailloux A, Abraham P, Vielle B, Laporte I, Omarjee L, Ouedraogo N. The correlation of the "Walking Estimated-Limitation Calculated by History" (WELCH) questionnaire with treadmill maximal walking time is not impaired by age, in patients with claudication. Qual Life Res 2015; 24:1857-64. [PMID: 25578404 DOI: 10.1007/s11136-015-0915-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE The "Walking Estimated-Limitation Calculated by History" (WELCH) questionnaire is a short four-item questionnaire that estimates the walking capacity of a patient in comparison with relatives, friends or people the same age. As such, it should be relatively insensitive to age, yet this has never been tested. METHODS A prospective study was performed among 525 patients presenting vascular-type claudication. Patients were grouped into quintiles of age-from quintile 1 for the youngest patients to quintile 5 for the oldest ones. Patients completed a self-administered questionnaire and then had their maximal walking time (MWT) measured on a treadmill. We estimated the coefficient of correlation, the slope and the intercept of the relationship between the WELCH score and the MWT, then the accuracy of a WELCH score under 25 to predict the ability to walk for 5 min on a treadmill. RESULTS The slopes of the relationships and the correlation coefficients were not significantly different in each quintile, but a significant shift in the intercept of regressing lines was found with age. Nevertheless, the accuracy in predicting treadmill results from the WELCH score with a cut-off point of 25 was, respectively, 68.6, 72.4, 80.0, 72.4 and 73.3 % in quintiles 1, 2, 3, 4 and 5 (p = 0.45). CONCLUSIONS The relationship of MWT on a treadmill and the WELCH score is slightly influenced by age, but a score superior to 25 seems to be of equal discriminatory performance in different quintiles of age to predict the ability to walk for 5 min on a treadmill. This makes this cut-off limit of interest for routine use, regardless of age.
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Affiliation(s)
- Alban Fouasson-Chailloux
- CHU Angers, Laboratory for Vascular Investigations, University Hospital, 4 rue Larrey, 49933, Angers Cedex 09, France
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20
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Abstract
Research on healthy ageing lacks an agreed conceptual framework and has not adequately taken into account the growing evidence that social and biological factors from early life onwards affect later health. We conceptualise healthy ageing within a life-course framework, separating healthy biological ageing (in terms of optimal physical and cognitive functioning, delaying the onset of chronic diseases, and extending length of life for as long as possible) from changes in psychological and social wellbeing. We summarise the findings of a review of healthy ageing indicators, focusing on objective measures of physical capability, such as tests of grip strength, walking speed, chair rises and standing balance, which aim to capture physical functioning at the individual level, assessing the capacity to undertake the physical tasks of daily living. There is robust evidence that higher scores on these measures are associated with lower rates of mortality, and more limited evidence of lower risk of morbidity, and of age-related patterns of change. Drawing on a research collaboration of UK cohort studies, we summarise what is known about the influences on physical capability in terms of lifetime socioeconomic position, body size and lifestyle, and underlying physiology and genetics; the evidence to date supports a broad set of factors already identified as risk factors for chronic diseases. We identify a need for larger longitudinal studies to investigate age-related change and ethnic diversity in these objective measures, the dynamic relationships between them, and how they relate to other component measures of healthy ageing. Robust evidence across cohort studies, using standardised measures within a clear conceptual framework, will benefit policy and practice to promote healthy ageing.
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Affiliation(s)
- Diana Kuh
- MRC University Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, UK
| | - Sathya Karunananthan
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Howard Bergman
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Rachel Cooper
- MRC University Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, UK
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21
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Hansen AW, Beyer N, Flensborg-Madsen T, Grønbæk M, Helge JW. Muscle strength and physical activity are associated with self-rated health in an adult Danish population. Prev Med 2013; 57:792-8. [PMID: 24029557 DOI: 10.1016/j.ypmed.2013.08.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 08/26/2013] [Accepted: 08/31/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe associations of muscle strength, physical activity and self-rated health. METHOD Isometric muscle strength by maximal handgrip strength (HGS) or muscle strength by 30s repeated chair stand test (30s-CS) was combined with leisure time physical activity. Using logistic regression odds ratio was calculated for good self-rated health according to the combined associations among 16,539 participants (59.7% women), mean age 51.9 (SD: 13.8) years, from a cross-sectional study in Denmark 2007-2008. RESULTS Good self-rated health was positively associated with higher levels of physical activity and greater muscle strength. Regarding HGS the highest OR for good self-rated health was in the moderate/vigorous physically active participants with high HGS (OR=6.84, 95% CI: 4.85-9.65 and OR=7.34, 95% CI: 5.42-9.96 for men and women, respectively). Similarly the highest OR for good self-rated health was in the moderate/vigorous physically active participants with high scores in the 30s-CS test (6.06, 95% CI: 4.32-8.50 and 13.38, 95% CI: 9.59-18.67 for men and women, respectively). The reference groups were sedentary participants with low strength (HGS or 30s-CS). CONCLUSION The combined score for physical activity level with either HGS or 30s-CS was strongly positively associated with self-related health.
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Affiliation(s)
- Andreas W Hansen
- National Institute of Public Health, University of Southern Denmark, Denmark.
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22
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Schilling OK, Wahl HW, Reidick O. Trajectories of Depressive Symptoms in Advanced Old Age. GEROPSYCH-THE JOURNAL OF GERONTOPSYCHOLOGY AND GERIATRIC PSYCHIATRY 2013. [DOI: 10.1024/1662-9647/a000079] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study applied a growth mixture approach to intraindividual trajectories of depressive symptoms in advanced old age. Data from 124 elders born 1912–1922, repeatedly assessed on five occasions between 2009–2012, revealed three prototypical patterns: (1) stably low depressive symptoms (expected frequency 28%), (2) stability at major depression level (29%), (3) increase from low to high depressive symptoms (43%). The links of each pattern with functional ability, handgrip strength, and visual acuity were analyzed. High baseline levels of functional abilities and visual acuity, and concurrent stability of functional abilities increased the probability of the “stably low” pattern, but none predicted the increase pattern. We conclude that focus on diverse intraindividual change patterns adds to the understanding of depression in advanced old age.
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Affiliation(s)
- Oliver K. Schilling
- Department of Psychological Ageing Research, Institute of Psychology, University of Heidelberg, Germany
| | - Hans-Werner Wahl
- Department of Psychological Ageing Research, Institute of Psychology, University of Heidelberg, Germany
| | - Ortrun Reidick
- Department of Psychological Ageing Research, Institute of Psychology, University of Heidelberg, Germany
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23
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Aging reduces the accuracy of self-reported walking limitation in patients with vascular-type claudication. J Vasc Surg 2012; 56:1025-31. [DOI: 10.1016/j.jvs.2012.03.258] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 03/21/2012] [Accepted: 03/21/2012] [Indexed: 11/18/2022]
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24
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Cooper R, Hardy R, Aihie Sayer A, Ben-Shlomo Y, Birnie K, Cooper C, Craig L, Deary IJ, Demakakos P, Gallacher J, McNeill G, Martin RM, Starr JM, Steptoe A, Kuh D. Age and gender differences in physical capability levels from mid-life onwards: the harmonisation and meta-analysis of data from eight UK cohort studies. PLoS One 2011; 6:e27899. [PMID: 22114723 PMCID: PMC3218057 DOI: 10.1371/journal.pone.0027899] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 10/27/2011] [Indexed: 11/19/2022] Open
Abstract
Using data from eight UK cohorts participating in the Healthy Ageing across the Life Course (HALCyon) research programme, with ages at physical capability assessment ranging from 50 to 90+ years, we harmonised data on objective measures of physical capability (i.e. grip strength, chair rising ability, walking speed, timed get up and go, and standing balance performance) and investigated the cross-sectional age and gender differences in these measures. Levels of physical capability were generally lower in study participants of older ages, and men performed better than women (for example, results from meta-analyses (N = 14,213 (5 studies)), found that men had 12.62 kg (11.34, 13.90) higher grip strength than women after adjustment for age and body size), although for walking speed, this gender difference was attenuated after adjustment for body size. There was also evidence that the gender difference in grip strength diminished with increasing age,whereas the gender difference in walking speed widened (p<0.01 for interactions between age and gender in both cases). This study highlights not only the presence of age and gender differences in objective measures of physical capability but provides a demonstration that harmonisation of data from several large cohort studies is possible. These harmonised data are now being used within HALCyon to understand the lifetime social and biological determinants of physical capability and its changes with age.
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Affiliation(s)
- Rachel Cooper
- MRC Unit for Lifelong Health and Ageing, Division of Population Health, University College London, London, United Kingdom.
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Abstract
BACKGROUND AND AIMS Chair rise performance, which is simple to assess in a home or clinic setting, has been used as a method of predicting leg power deficit in older adults. More recently, chair rise performance has been assessed in younger populations as a baseline for assessment of subsequent age-related declines in function and power. However, as rising from a chair repeatedly not only requires lower limb strength and power but also good balance and coordination, it may not be purely a measure of leg power especially among these younger, well functioning groups who are yet to experience agerelated declines and deficits in function. The aim of this study was to assess whether chair rise performance can be considered as a predictor of leg power, and hence of deficits in this, in men and women in mid-life. We assessed the relationship of chair rise performance with leg extensor power (LEP), measured using the Nottingham Power Rig (NPR), and with standing balance performance. METHODS LEP was measured in a clinic setting in a sub-sample of 81 men and 93 women from the MRC National Survey of Health and Development, a nationally representative cohort born in Britain in 1946. The time taken to rise from a chair 10 times and standing balance time were assessed during home visits at the same age. RESULTS Increasing LEP was associated with better chair rise performance among those who completed 10 chair rises in ≥15 seconds, after adjustment for body size (p=0.008). Better standing balance performance was associated with better chair rise performance in men, but not women. CONCLUSIONS That LEP and standing balance are both related to chair rise time in men suggests that chair rise time should not be thought of purely as a proxy measure of leg power in middle-aged populations. This has implications for longitudinal studies which want to study age-related decline in chair rise performance.
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Ribom EL, Mellström D, Ljunggren Ö, Karlsson MK. Population-based reference values of handgrip strength and functional tests of muscle strength and balance in men aged 70-80 years. Arch Gerontol Geriatr 2010; 53:e114-7. [PMID: 20708281 DOI: 10.1016/j.archger.2010.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 07/11/2010] [Accepted: 07/14/2010] [Indexed: 11/18/2022]
Abstract
With aging, the incidence of falls and fractures increases. There has during the last decades been secular changes in demographics so that the proportion of elderly increases in society. Hence, there is an increasing need for clinicians to be able to make a solid appraisal of the elderly patient's functional capacity, as to identify individuals with an increased risk to fall. If high risk individuals could be targeted fall preventive strategies might be implemented in specific risk cohorts. This would require reference values for muscle strength tests and functional tests, in order to defined high risk individuals performing inferior. From the MrOS Sweden cohort, 999 subjects aged 70-80 years were evaluated. Muscle strength and functional performance was tested by timed-stands test, 6-m and 20-cm narrow walk tests and Jamar handgrip strength test. Normative data is presented. With increasing age, there was a 10-18% successively decline in performance throughout the entire age span. This study provides reference values for handgrip strength and functional muscle tests in 70-80 years old men. The decline in the test values with increasing age, infer the use of age-specific normative data when using these tests both in clinical and research settings.
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Affiliation(s)
- Eva L Ribom
- Department of Surgical Sciences, Uppsala University, Entrance 85, 1 Stairs, Physiotherapy Ward, SE-751 85 Uppsala, Sweden.
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Oksuzyan A, Maier H, McGue M, Vaupel JW, Christensen K. Sex differences in the level and rate of change of physical function and grip strength in the Danish 1905-cohort study. J Aging Health 2010; 22:589-610. [PMID: 20453156 DOI: 10.1177/0898264310366752] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The study was conducted to examine sex differences in the initial level and rate of change in physical function and grip strength. METHOD The baseline survey included 2,262 Danes born in 1905 and alive in 1998 and followed-up in 2000, 2003, and 2005. Hence, the authors fully used the power of having a cohort with multiple assessments in late life and virtually complete follow-up of lifespan (through December 2008). Latent growth curve modeling was used. RESULTS Men had higher initial levels and rates of decline in strength score and grip strength. Lifespan was positively correlated with intercepts and slopes. DISCUSSION The Danish data suggested that the longest-living individuals have higher initial levels of strength score and grip strength and smaller rate of change. The data further suggested that the initial level of strength score and grip strength was more predictive of mortality than the rate of change was, and the predictive effects were similar in men and women.
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Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, Skinner JS, Skinner JS. Exercise and Physical Activity for Older Adults. Med Sci Sports Exerc 2009; 41:1510-30. [PMID: 19516148 DOI: 10.1249/mss.0b013e3181a0c95c] [Citation(s) in RCA: 2334] [Impact Index Per Article: 155.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Puig-Domingo M, Serra-Prat M, Merino MJ, Pubill M, Burdoy E, Papiol M. Muscle strength in the Mataró aging study participants and its relationship to successful aging. Aging Clin Exp Res 2008; 20:439-46. [PMID: 19039286 DOI: 10.1007/bf03325150] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND AIMS Successful aging is a worldwide aim, but its related factors and instruments of measurement are currently hotly debated. To investigate the relationship between muscle strength and functional capacity, and its association with successful aging. METHODS A population-based cross-sectional study was performed in Mataró (Spain). Included in the study were 313 subjects (153 men, 160 women) aged 70 years and over. Physical and cognitive functions were assessed, as well as muscle strength, nutritional status, lifestyle factors, and associated morbidities. RESULTS A state of successful aging (SA), defined as optimal functional and cognitive capacities with absence of cancer, stroke, cardiovascular or pulmonary chronic diseases, was found in 20% of women and 32% of men. SA was associated with higher muscle strength in comparison with the non-SA condition. Muscle strength measurements were higher in men, and decreased with age, poor balance, decreased functional capacity, and impaired cognitive status. It was also associated with higher academic level, regular exercise, and nutritional status in both genders. Multivariate analysis showed that independent variables related to SA were: hand grip, arthrosis, deafness and unipodal balance test, but not age or gender. CONCLUSIONS Muscle strength is positively associated with the successful aging condition, and may be one of its functional links, reflecting the integrated health status of old men and women. The systematic inclusion of the measurement of muscle strength may be helpful in clinical evaluation of the elderly.
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