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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Yin L, Urano T. Association between decreased neck circumference and impaired activities of daily living among older adults in long-term care. Geriatr Gerontol Int 2023; 23:906-911. [PMID: 37861100 DOI: 10.1111/ggi.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
AIM Assessment interventions for the decline of activities of daily living (ADLs) in older adults are crucial, as ADL decline increases hospitalization duration and mortality risk. Decreased neck circumference may result in various physical dysfunctions, including malnutrition. However, the association between neck circumference and ADLs has not been fully clarified. This study aimed to determine the association between decreased neck circumference and ADLs in older adults requiring long-term care. METHODS The study included 152 older adults deemed to require support or care under Japan's long-term care insurance system. Neck circumference was measured just below the thyroid cartilage with a measuring tape. The Barthel index was used to evaluate ADLs, and skeletal muscle mass and nutritional status were assessed by bioelectrical impedance analysis instruments. A multivariate analysis was conducted to investigate the association between neck circumference and ADLs. RESULTS Neck circumference demonstrated a significant inverse correlation with age and a significant positive correlation with body mass index, skeletal muscle mass index, phase angle, and Barthel index. In the multivariate analysis, ADLs was significantly associated with neck circumference (odds ratio [OR] = 0.51, P = 0.002) and phase angle (OR = 0.04, P < 0.001). CONCLUSIONS Neck circumference is associated with age, skeletal muscle mass, and nutritional status. Furthermore, a decrease in neck circumference is suggested as an independent risk factor for ADL decline in older adults requiring long-term care. Geriatr Gerontol Int 2023; 23: 906-911.
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Affiliation(s)
- Ryo Sato
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Yohei Sawaya
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tamaki Hirose
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Lu Yin
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tomohiko Urano
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Urano T. Neck circumference may predict sarcopenia in Japanese older adults requiring long-term care. Geriatr Nurs 2022; 47:159-163. [PMID: 35914493 DOI: 10.1016/j.gerinurse.2022.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
Several studies have established the advantage of using anthropometric measurements as indicators of sarcopenia. Nevertheless, no study has explored the association between sarcopenia and neck circumference. In this cross-sectional study, we examined the data of 90 older adults requiring long-term care to evaluate this association and establish cut-off points for individuals at risk of sarcopenia as defined by the Asian Working Group for Sarcopenia (AWGS) 2019. A significant association was found between sarcopenia and neck circumference using binomial logistic regression and receiver operating characteristic analyses. The optimal cut-off value for neck circumference associated with increased risk for sarcopenia among older adults was 32.8 cm for females and 38.0 cm for males. Given the potential of declining neck circumference as an anthropometric marker of sarcopenia, it has clinical applications in screening for sarcopenia in older adults requiring long-term care.
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Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan; Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan.
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Sun MY, Han X, Wang MY, Ning DX, Xu B, Xie LZ, Yu SB, Sui HJ. Relationship between the sectional area of the rectus capitis posterior minor and the to be named ligament from 3D MR imaging. BMC Musculoskelet Disord 2020; 21:101. [PMID: 32059665 PMCID: PMC7023802 DOI: 10.1186/s12891-020-3123-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 02/10/2020] [Indexed: 11/18/2022] Open
Abstract
Background To evaluate the maximal sectional area (SA) of the rectus capitis posterior minor (RCPmi) muscle and its potential correlation with to be named ligament (TBNL) in the suboccipital area using 3D MR imaging. Methods A total of 365 subjects underwent sagittal 3D T2WI MR imaging of the RCPmi and TBNL. Among them, 45 subjects were excluded due to a particular clinical history or poor image quality. Finally, 320 subjects met the inclusion criteria, including 138 men and 182 women. The 624 RCPmi muscles were classified into positive and negative groups according to their attachment to the TBNL. Two experienced radiologists manually measured the maximum SA of the RCPmi muscle on the parasagittal image with a 30° deviation from the median sagittal plane. The correlations between the SA and the subject’s age, height, BMI, gender, handedness, and age-related disc degeneration were tested by Spearman analysis. The SA differences between different groups were compared using independent samples t-test. Results A total of 123 RCPmi-TBNL attachments were identified in the positive group, while 501 RCPmi muscles were identified in the negative group. The SA of the 624 RCPmi muscles was 62.71 ± 28.72 mm2 and was poorly correlated with the subject’s age, BMI, or handedness, with no correlation with age-related disc degeneration. A fair correlation was found between the SA and the body height in the whole group, and poor correlation in each male/female group. The SA of the RCPmi muscle in males was significantly bigger than that in women ([75.54 ± 29.17] vs. [52.74 ± 24.07] mm2). The SA of RCPmi muscle in the positive group was significantly smaller than that in the negative group ([55.95 ± 26.76] mm2 vs. [64.37 ± 28.97] mm2). Conclusions Our results revealed a significantly smaller SA of the RCPmi in subjects with RCPmi-TBNL attachment. Besides, a larger SA of the RCPmi was correlated with the male gender. These findings suggest that the SA of the RCPmi ought to be interpreted with care for each patient since there could be considerable variations.
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Affiliation(s)
- Mei-Yu Sun
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Xu Han
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Meng-Yao Wang
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Dian-Xiu Ning
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | - Bin Xu
- Department of radiology, the first affiliated hospital of Dalian Medical University, Dalian, China
| | | | - Sheng-Bo Yu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, People's Republic of China
| | - Hong-Jin Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, People's Republic of China.
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Lardiés-Sánchez B, Arbones-Mainar JM, Perez-Nogueras J, Serrano-Oliver A, Torres-Anoro E, Sanz-Paris A. Neck circumference is associated with nutritional status in elderly nursing home residents. Nutrition 2019; 62:153-157. [PMID: 30913519 DOI: 10.1016/j.nut.2019.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/19/2019] [Accepted: 01/23/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Anthropometry is an easy and noninvasive method to evaluate nutritional status in institutionalized elderly people who are often bedridden. The aim of this study was to investigate the relationship between the neck circumference (NC) and nutritional status of elderly nursing home residents and to find cutoff points for NC size to identify individuals at risk of malnutrition. METHODS A cross-sectional study was developed with data collected from 352 elderly people living in five public nursing homes. Different anthropometric measures and the Mini Nutritional Assessment (MNA) were used to determine nutritional status. Receiver operating characteristic (ROC) curves were built for each anthropometric variable to determine their sensitivity and specificity for predicting the risk of malnutrition according to the MNA. RESULTS The mean age of the participants (59% females) was 83 years old. In total, 48.3% of women and 45.5% of men were at risk of malnutrition according to their MNA scores. All anthropometric measurements were highly intercorrelated in both men and women, indicating a high degree of collinearity. Bootstrapped linear regression was used to assess the strength of the association between an individuals' nutritional status and their anthropometric parameters. Calf circumference and NC presented the best predictive value with the highest sensitivity for diagnosing the risk of malnutrition in both institutionalized elderly men and women. The best cutoff points of NC to identify elderly nursing home residents at risk of malnutrition were 35.2 cm for females and 37.8 cm for males. CONCLUSIONS NC is associated with other classical anthropometric parameters and malnutrition status in elderly people living in nursing homes.
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Affiliation(s)
- Beatriz Lardiés-Sánchez
- Nutrition Department of University Hospital Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Zaragoza, Spain.
| | - Jose M Arbones-Mainar
- Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Zaragoza, Spain; Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, University Hospital Miguel Servet, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain; Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutricion (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | | | | | | | - Alejandro Sanz-Paris
- Nutrition Department of University Hospital Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Zaragoza, Spain
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Yoshida S, Tohara H, Nakagawa K, Hara K, Yamaguchi K, Nakane A, Yoshimi K, Ariya C, Kurosawa Y, Minakuchi S. Relationship between jaw-opening force and neck circumference in healthy older individuals. Geriatr Gerontol Int 2019; 19:330-334. [PMID: 30746827 DOI: 10.1111/ggi.13620] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/24/2018] [Accepted: 01/06/2019] [Indexed: 12/23/2022]
Abstract
AIM In recent years, the relationships of arm circumference and calf circumference with swallowing function have been reported. However, the efficacy of using the neck circumference, which is closer to the swallowing-related muscles, has never been verified. Jaw-opening force, an indicator of suprahyoid muscle strength, is known to be useful for screening for dysphagia. The aim of the present study was to identify the relationships between neck circumference and swallowing-related muscle strength, and to clarify the association between these variables in older individuals. METHODS A total of 104 healthy, independent older individuals, aged ≥65 years (36 men, 68 women, mean age 71.5 ± 4.5 years, range 65-83 years), participated in the study. Neck circumference, arm circumference, calf circumference, jaw-opening force and repetitive saliva swallowing test scores were measured. Multiple regression analysis was carried out to determine the relationship between neck circumference and jaw-opening force, between neck circumference and repetitive saliva swallowing test score, and to identify variables affecting jaw-opening force and neck circumference. RESULTS The participants' mean body mass index was 22.8 ± 2.9 (range 15.8-32.4). Sex and neck circumference, but not arm or calf circumference, were significant independent factors related to jaw-opening force. Independent factors affecting neck circumference were sex, body mass index, jaw-opening force and arm circumference, but not repetitive saliva swallowing test score. CONCLUSIONS In healthy older individuals, neck circumference was more strongly related to jaw-opening force than were arm or calf circumference. This suggested that neck circumference could be useful for evaluating swallowing-related muscle strength non-invasively and easily. Geriatr Gerontol Int 2019; 19: 330-334.
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Affiliation(s)
- Saori Yoshida
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruka Tohara
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuharu Nakagawa
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koji Hara
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Yamaguchi
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayako Nakane
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kanako Yoshimi
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chantaramanee Ariya
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukiko Kurosawa
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Minakuchi
- Division of Gerontology and Gerodontology, Department of Gerodontology, Tokyo Medical and Dental University, Tokyo, Japan
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Wakabayashi H, Matsushima M. Neck Circumference Is Not Associated with Dysphagia but with Undernutrition in Elderly Individuals Requiring Long-term Care. J Nutr Health Aging 2016; 20:355-60. [PMID: 26892586 DOI: 10.1007/s12603-015-0587-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose was to assess the association between neck circumference, dysphagia, and undernutrition in elderly individuals requiring long-term care. DESIGN Cross-sectional study. SETTING Geriatric health services facilities, acute hospitals, and the community. PARTICIPANTS Elderly individuals ≥65 years of age with dysphagia or possible dysphagia (N=385). MEASUREMENTS Neck circumference, the Dysphagia Severity Scale (DSS) and the Mini Nutritional Assessment Short Form (MNA-SF). RESULTS Participants included 130 males and 255 females with a mean age (± standard deviation) of 83 ± 8.0 years. Sixty-six were in acute hospitals, 195 were in geriatric health services facilities, and 124 were community-dwelling. The mean neck circumference in males and females was 37.1 ± 3.0 cm and 33.3 ± 3.3 cm, respectively. Based on the DSS, 81 participants were within normal limits, 137 had dysphagia without aspiration, and 167 had dysphagia with aspiration. The MNA-SF revealed that 173 were malnourished, 172 were at risk of malnutrition, and 40 had a normal nutritional status. Neck circumference was not significantly correlated with the DSS (r=-0.080) but was significantly correlated with the MNA-SF (r=0.183) in the Spearman rank correlation analysis. In the logistic regression, neck circumference was not independently associated with the DSS after adjusting for the MNA-SF, the Barthel Index, age, sex, setting, and cerebrovascular disorders. However, the multiple regression analysis showed that neck circumference had an independent effect on the MNA-SF after adjusting for the Barthel Index, age, sex, setting and cerebrovascular disorders. CONCLUSIONS Neck circumference is not associated with dysphagia but with undernutrition in elderly individuals requiring long-term care.
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Affiliation(s)
- H Wakabayashi
- Hidetaka Wakabayashi, Department of Rehabilitation Medicine, Yokohama City University Medical Center, 4-57 Urafune-chou, Minami ward, Yokohama City, Japan 232-0024, E-mail: , Tel: +81-45-261-5656; Fax: +81-45-253-9955
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