Serum albumin and hemoglobin are associated with physical function in community-living older persons in Singapore

Association of physiological factors with grip and leg extension strength: tohoku medical megabank community-based cohort study

BACKGROUND

Upper and lower extremity muscle strength can be used to predict health outcomes. However, the difference between the relation of upper extremity muscle and of lower extremity muscle with physiological factors is unclear. This study aimed to evaluate the association between physiological data and muscle strength, measured using grip and leg extension strength, among Japanese adults.

METHODS

We conducted a cross-sectional study of 2,861 men and 6,717 women aged ≥ 20 years living in Miyagi Prefecture, Japan. Grip strength was measured using a dynamometer. Leg extension strength was measured using a hydraulic isokinetic leg press machine. Anthropometry and physiological data, including blood pressure, calcaneal ultrasound bone status, pulmonary function, carotid echography, and blood information, were assessed. We used a general linear model adjusted for age, body composition, and smoking status to evaluate the association between muscle strength and physiological factors.

RESULTS

Grip and leg extension strength were positively associated with bone area ratio, vital capacity, forced vital capacity, forced expiratory volume in one second, and estimated glomerular filtration rate, and negatively associated with waist circumference and percentage body fat mass in both the sexes. Diastolic blood pressure was positively associated with grip strength in both the sexes and leg extension strength in men, but not women. High-density lipoprotein cholesterol and red blood cell counts were positively associated with grip and leg extension strength in women, but not men. In both the sexes, pulse rate, total cholesterol, and uric acid were consistently associated with only leg extension strength, but not grip strength. In women, glycated hemoglobin demonstrated negative and positive associations with grip and leg extension strength, respectively.

CONCLUSIONS

Grip and leg extension strength demonstrated similar associations with anthropometry, pulmonary function, and estimated glomerular filtration rate, but the associations with the other factors were not always consistent.

Combined use of handgrip strength and hemoglobin as markers of undernutrition in patients with stage 3-5 chronic kidney disease

BACKGROUND AND AIMS

The early identification of undernourished patients with CKD could help instating appropriate nutritional intervention before the full development of the threatening condition known as Protein Energy Wasting (PEW). Handgrip strength (HGS) and blood hemoglobin (Hb) concentration are two parameters considered representative of nutritional status but not included among the criteria for PEW diagnosis. In the present work we investigated whether they could help identifying CKD patients at risk of undernutrition.

METHODS AND RESULTS

We performed a two-step cluster analysis to classify a cohort of 71 stage 3-5 CKD patients, none of which with PEW, according to their Hb concentration and dominant-hand HGS. Two clusters were finely separated using this method. When we compared the two groups for main body composition and nutritional variables by using t-test statistics or Mann-Whitney test, as appropriate, we found significant differences in PhA, ECW/TBW, ASMI, serum iron. Then we stratified our population by gender and performed cluster analysis as well. PhA, ECW/TBW were still significantly different in the two clusters both in M and in F, while serum iron concentration only in males and ASMI only in females.

CONCLUSION

These results suggest that either in male than in female Hb concentration and HGS may distinguish two subgroups of CKD patients with different nutritional status and disease severity. Patient belonging to either of these cluster can be easily identified by using the HGS/Hb ratio which represents the HGS normalized per gr Hb.

Association between serum albumin levels and height loss in Japanese workers: a retrospective study

BACKGROUND

Height loss starting in middle age was previously shown to be associated with high cardiovascular mortality in later life. However, the factors associated with height loss remain unknown. Since low serum albumin levels are reported to be associated with high mortality caused by cardiovascular disease, they may also contribute to height loss.

METHODS

To clarify the association between serum albumin and height loss, we conducted a retrospective study of 7637 Japanese workers who participated in general health check-ups from 2008 to 2019. Height loss was defined as the highest quartile of height loss per year.

RESULTS

Individual with high serum concentration of albumin possess beneficial influence on preventing incidence of height loss. In both men and women, serum albumin level was significantly inversely associated with height loss. After adjustment for known cardiovascular risk factors, the adjusted odd ratio (OR) and 95% confidence interval (CI) for height loss per 1 standard deviation of albumin (0.2 g/dL for both men and women) were 0.92 (0.86, 0.98) in men and 0.86 (0.79, 0.95) in women. Even when the analysis was limited to participants without hypoalbuminemia, essentially same association was observed, with fully adjusted corresponding ORs (95%CI) of 0.92 (0.86, 0.98) in men and 0.86 (0.78, 0.94) in women.

CONCLUSION

Independent of known cardiovascular risk factors, higher serum albumin levels may prevent height loss among Japanese workers. While several different diseases cause hypoalbuminemia, they may not be the main reasons for the association between serum albumin and height loss. Though further research is necessary, this finding may help clarify the mechanisms underlying the association between height loss and higher mortality in later life.

Hemoglobin level is negatively associated with sarcopenia and its components in Chinese aged 60 and above

Introduction

Sarcopenia and low hemoglobin level are common in older adults. Few studies have evaluated the association between hemoglobin level and sarcopenia and with inconsistent findings. The multifaceted effects of sarcopenia on the human body and the high prevalence of anemia in the Chinese population make it necessary to explore the association between the two.

Methods

Using the China Health and Retirement Longitudinal Study (CHARLS), we explored the association between hemoglobin with sarcopenia and its components in the Chinese population aged 60 and above. Multivariate logistic and Cox proportional hazards models were constructed to examine the association of hemoglobin level with sarcopenia and sarcopenia components in individuals aged 60 years or above. The subgroup analysis covered residence, body mass index level, drinking status, and smoking status were conducted. The possible difference of associations between sexes was also explored.

Results

With a total of 3,055 people, the hemoglobin concentration in people without sarcopenia, possible sarcopenia, and sarcopenia are 14.34 ± 2.22, 14.64 ± 2.27, and 13.58 ± 2.02 g/dl, respectively. Cross-sectional analysis showed strong evidence that hemoglobin was negatively associated with sarcopenia [Odds Ratio (OR) = 0.95, 95% Confidence Interval (CI): 0.90-0.99] and low height-adjusted appendicular skeletal muscle mass (OR = 0.91, 95% CI: 0.86-0.97). On average, a per 1 g/dl higher hemoglobin level was associated with 5% lower odds of sarcopenia (OR = 0.95, 95% CI: 0.90-0.98). The cohort study of 1,022 people demonstrated a statistically significant negative association of hemoglobin level with low physical performance [Hazard Ratio (HR) = 0.92, 95% CI: 0.85-0.99], merely with sarcopenia (HR = 0.92, 95% CI: 0.84-1.00) and skeletal muscle mass (HR = 0.95, 95% CI: 0.80-1.00). Sex-specific analysis suggested hemoglobin's association with sarcopenia, muscle mass, and physical performance in all sexes, with weaker magnitudes in females. Hemoglobin in urban residents and people with high body mass index (BMI) has a larger magnitude of the negative association with sarcopenia.

Discussion

Hemoglobin level associates with sarcopenia, muscle mass, and physical performance in the Chinese population aged 60 and above, with sex-specific, residence-specific, and BMI-specific effects.

Association between Neutrophil-to-Lymphocyte Ratio and Physical Function in Older Adults: A Community-Based Cross-Sectional Study in Japan

Inflammatory responses contribute to physical decline in older adults. Clinical studies have shown that the neutrophil-to-lymphocyte ratio (NLR), a marker of inflammation, is associated with physical decline. However, its association with physical function in community-dwelling older people is still unclear. Hence, we used cross-sectional data to investigate the relationship between NLR and physical function in community-dwelling older adults. Specifically, we analyzed data corresponding to 818 individuals (336 men and 482 women) aged ≥ 75 years, all of whom participated in comprehensive health examinations, including face-to-face interviews, biochemical analyses, and physical function tests. Using these data, we performed multivariable logistic regression analysis to assess the relationship between NLR and physical function, adjusting for sex, age, education, alcohol consumption, smoking, instrumental activity of daily living, body mass index, chronic disease, physical activity, serum albumin level, and depressive mood. The results showed that a higher NLR was associated with a lower grip strength, lower knee extension strength, and slower walking speed. Importantly, the relationship between NLR and physical function was maintained after adjusting for the confounding factors. Thus, we showed a significant association between NLR and physical function, supporting the use of NLR as a marker of physical function in community-dwelling older adults.

Association between anemia and dynapenia in older adults: a population-based study

BACKGROUND

Few reports have been issued on the relationship between anemia and dynapenia in older people.

AIM

This study aimed to assess the independent association between anemia and dynapenia in older adults.

METHODS

This study was based on an analysis of the Korea National Health and Nutrition Examination Survey database (2015-2018). A total of 4812 subjects aged ≥ 65 years were included. Dynapenia was defined by a handgrip strength (HGS). The independent association between dynapenia and anemia was examined by complex-sample multivariable logistic regression analyses.

RESULTS

The geometric mean serum hemoglobin level for all study subjects was 13.73 g/dL, and the prevalence of anemia was 13.1% (men, 12.8%; women 13.4%). Anemic subjects had a significantly lower adjusted mean HGS than non-anemic controls (23.14 ± 0.45 kg vs. 24.50 ± 0.38 kg, P < 0.001). Furthermore, anemic subjects had a significantly higher odds ratio for dynapenia (OR, 1.68; 95% CI, 1.30-2.17) than subjects without anemia after adjusting for multiple confounders, and the odds ratio of dynapenia was higher for anemic men (OR, 2.06, 95% CI, 1.38-3.09).

CONCLUSION

This study indicates anemia is independently associated with dynapenia in older Koreans, especially in men, and indicates that dynapenia screening is needed in older people with anemia.

Associations of Serum Albumin With Disability in Activities of Daily Living, Mobility and Objective Physical Functioning Regardless of Vitamin D: Cross-Sectional Findings From the Chinese Longitudinal Healthy Longevity Survey

Objective

To examine the associations of serum albumin, a nutrition indicator, with disability in activities of daily living (ADL), mobility, and objective physical functioning among Chinese older adults.

Materials and Methods

Cross-sectional data of 2233 older adults (≥65 years) who participated in the 2011/2012 main survey of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the 2012 biomarker sub-study was used. Serum albumin was measured by immunoturbidimetric assay. Physical functioning included subjectively (ADL and mobility) and objectively measured disability (standing up from a chair, picking up a book from the floor, and turning around 360°). Multivariable logistic regression models were performed.

Results

After adjusting for age and sex, compared with participants in the lowest quartile group of serum albumin, those in the highest quartile group had 45% lower odds of disability in ADL (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.38, 0.80); 48% lower odds of disability in mobility (OR: 0.52; 95% CI: 0.38, 0.71); 46% lower odds of disability in standing up from a chair (OR: 0.54; 95% CI: 0.34, 0.85); and 37% lower odds of disability in picking up a book from the floor (OR: 0.63; 95% CI: 0.40, 0.97). We did not observe a statistically significant interaction effect between serum albumin and vitamin D on disability in physical functioning.

Conclusion

Serum albumin level was associated with physical functioning among Chinese older adults, regardless of vitamin D level. The findings indicate that appropriate management of poor nutritional status, in particular low serum albumin levels, may contribute to maintaining physical functioning in older adults.

Effects of flexi-bar training on muscle strength and physical performance in older people with dynapenia: the protocol of a randomised controlled trial

INTRODUCTION

Dynapenia is a new term that is used to describe the age-related loss of muscle strength. Flexi-bar training is a safe and feasible device for older people with dynapenia. This study will investigate the effects of a 12-week flexi-bar training programme on muscle strength and physical function in older people with dynapenia.

METHODS AND ANALYSIS

A total of 114 participants (aged more than 65 years) with age-related muscle loss will participate in a 12-week flexi-bar training programme. The participants will be randomly divided into three groups, namely, flexi-bar, placebo and control, with equal number of participants in each group. The assessments will be conducted at preintervention, postintervention and 12 weeks after training completion. The primary outcome is timed-up-and-go test. The secondary outcomes are five-repetition sit-to-stand test, 10-metre walking test, handgrip strength, as well as the serum albumin and haemoglobin levels.

ETHICS AND DISSEMINATION

The procedures of this study were reviewed and approved by the Human Ethics Review Board of Wuhan Brain Hospital (General Hospital of the Yangtze River Shipping) on 29 September 2020 (#L20200013). The findings of this study will be published in peer-reviewed journals and presented at conferences. The trial was registered on 6 November 2020.

TRIAL REGISTRATION NUMBER

ISRCTN14316668.

[Anaemia: What is its relationship with the frailty syndrome in elderly patients?]

Anaemia is often unexpectedly found, or in a context of investigations into a chest pain, dyspnoea, or weakness. This disorder can be considered an indicator of health status in elderly patients, and has been related to the frailty syndrome. A systematic review was conducted on the studies published in PubMed and Google Scholar databases in the period from January 1999 to May 2019. The search was limited to those studies published regarding anaemia and its relationship to the frailty syndrome. Anaemia seems to be part of the immunosenescence process that can explain frailty syndrome in association with other metabolism, endocrine, and inflammatory disorders. It was unable to be determined if anaemia is responsible for frailty or a result of it.

Serum albumin and activities of daily living in Chinese centenarians: a cross-sectional study

BACKGROUND

Objective deterioration in activities of daily living (ADLs) exists among older population, and particularly worsens with age. Considering the criterion standard of positive aging and longevity, little information focusing on centenarians is available. This study set out to explore the relationship between serum albumin and ADLs among centenarians in long-lived areas.

METHODS

This population-based cross-sectional study investigated a full sample of Chinese centenarians in Hainan, the longest-lived area of China (n = 1002). We assessed serum albumin levels and basic and instrumental activities of daily living (BADLs and IADLs).

RESULTS

Of 1002 participants included in the analysis, 287 (28.64%) had BADL disabilities and 648 (64.67%) had IADL disabilities. The median level of serum albumin was 38.5 g/L (interquartile range, 36.2-41.3). The multivariable analyses controlling for socio-demographic characteristics, lifestyle, morbidities, and other influential factors showed that albumin level was associated with the total score of BADL (standard β = 0.335, P < 0.001) and IADL (standard β = 0.206, P < 0.001). With the increasing of albumin level, the risk of ADLs disability decreased (BADL: odds ratios [OR] = 0.835, 95% Confidence interval [CI]: 0.797-0.876; IADL: OR = 0.863, 95%CI: 0.824-0.905). In the stratified analyses, similar results were found in both sex, but were more prominent in women.

CONCLUSIONS

Higher levels of serum albumin was a protective factor for the decline of ADLs in centenarians. This association can be observed in both genders and is more pronounced in women.

Influence of Hemoglobin Level on Muscle and Physical Functions, Activities of Daily Living, and Quality of Life in Patients With Hematological Malignancies

Purpose. Patients with hematological malignancies often present with reduced muscle and physical functions, which are caused by the disease or related treatment. Moreover, patients with hematological malignancies rapidly develop low hemoglobin levels, and this may affect muscle and physical functions. This study aimed to identify the influence of hemoglobin levels on muscle and physical functions in patients with hematological malignancies. Methods. Using a cross-sectional study design, this study included 60 patients with hematological malignancies (mean age = 68.0 ± 10.2 years, women 56.7%) who were hospitalized for chemotherapy- and radiotherapy-related side effects and underwent examination for skeletal muscle mass (SMM), muscle strength, physical function, activities of daily living (ADLs), psychological status, and quality-of-life (QOL), including physical symptoms. Participants were divided into 3 groups according to tertiles of hemoglobin levels: low (n = 19), middle (n = 20), and high (n = 21). Evaluation items were compared among the 3 groups. Results. There was no significant difference among the 3 groups in terms of SMM. The low hemoglobin group showed significantly higher values of fatigue and dyspnea and lower values of muscle strength, ADLs, and QOL than the high hemoglobin group. Conclusions. Hemoglobin levels did not affect SMM; however, muscle weakness, decrease in physical function, physical symptoms such as fatigue and dyspnea, and decline in ADLs and QOL were observed in patients with low hemoglobin levels.

Markers of nutritional status and mortality in older adults: The role of anemia and hypoalbuminemia

AIM

The aim of the present study was to analyze the impact of anemia and hypoalbuminemia on mortality in a 5-year period.

METHODS

This was longitudinal population-based observational survey part of the Saúde, Bem-Estar e Envelhecimento study (Health, Well-being and Aging), carried out with 1256 older adults from the third wave of the cohort, followed for 5 years, when they were contacted for the fourth wave, in Sao Paulo, Brazil. Anemia was defined when hemoglobin was <12 g/dL for women and <13 g/dL for men, and hypoalbuminemia when serum albumin was <3.5 g/dL. Survival functions were estimated according to nutritional status in four groups: (i) without nutritional alteration; (ii) anemia only; (iii) hypoalbuminemia only; and (iv) anemia and hypoalbuminemia. Hazard ratios were calculated, following the Cox proportional hazards model, controlling for baseline covariates. All analyses considered sample weights, and were carried out using the Stata 12.

RESULTS

After the 5-year period, 12.3% of the participants died, and 8.2% were lost to follow up. Those who died had lower hemoglobin and albumin concentrations (13.4 g/dL and 3.7 g/dL) compared with survivors (14.3d/dL and 3.9 g/dL; P < 0.001). The crude death rate was 27.6/1000 person-years for participants in group i, 124.3 in group ii, 116.0 in group iii and 222.8 in group iv (P < 0.001). In the final Cox models, group 2 and 3 had a similar effect (hazard ratio 2.23, P = 0.020; 2.53, P = 0.005; respectively) and group 4 had a higher risk (hazard ratio 3.36; P = 0.004).

CONCLUSIONS

Anemia and hypoalbuminemia are important markers for death in older adults, and have an additive effect on mortality. Because they are common and cost-effective biomarkers, their use should be encouraged in geriatric evaluation for all health professionals and in population settings, such as primary care. Geriatr Gerontol Int 2018; 18: 177-182.

Physical frailty in older people with severe aortic stenosis

BACKGROUND

Assessment of physical frailty is important among elderly with severe aortic stenosis (AS) when considering treatment.

AIMS

We aimed to: (1) investigate the prevalence of physical frailty in older people with severe AS and (2) examine factors related to physical frailty.

METHODS

A total of 125 consecutive elderly AS patients (mean age 84.6 ± 4.4 year) were enrolled. Physical frailty was defined as scoring ≤8 points on the short physical performance battery (SPPB). Factors likely related to physical frailty, including cardiac function, nutritional and metabolic status, kidney function, medical history, and comorbidities, were evaluated. Logistic regression analyses were used to examine which factors were related to physical frailty.

RESULTS

Physical frailty was prevalent in 38.4 %. After sex and age adjusted, the following were significantly related to physical frailty: LVEF (adjusted OR per 10 % decrease: 1.39, p < 0.05), the Mini Nutritional Assessment-Short Form (adjusted OR per 1 point decrease: 1.21, p < 0.05), serum albumin (adjusted OR per 1 g/dL decrease: 2.64, p < 0.05), HDL-C (adjusted OR per 10 mg/dL decrease: 1.52, p < 0.01), eGFR (adjusted OR per 10 mL/min decrease: 1.59, p < 0.05), grip strength (adjusted OR per 10 kg decrease: 3.60, p < 0.01), coronary heart disease (adjusted OR: 2.78, p < 0.01), cerebrovascular disease (adjusted OR: 6.06, p < 0.01), and musculoskeletal disorders (adjusted OR: 3.28, p < 0.01).

CONCLUSIONS

The prevalence of physical frailty is high and related to nutritional status, comorbidities, and cardiac status.

Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients

Background

Anaemia is a common problem in hospitalized older patients and is recognized as a risk factor for a significant number of adverse outcomes. Data of the effect of anaemia on functional status during hospitalization and mortality after discharge are limited. Aim of the study is to examine whether there is an association between anaemia, hand grip strength, gait speed and basic activities of daily living (ADL) during hospitalization and mortality 1 year after discharge in geriatric patients.

Methods

In a prospective study, data on age, sex, body mass index, Mini-Mental State Examination (MMSE), main clinical diagnosis, number of comorbidities, hand grip strength, gait speed, ADL, haemoglobin, C-reactive protein and estimated Glomerular filtration ratio (eGFR) were recorded in 220 older patients, admitted to the acute geriatric ward of a university hospital. Anaemia was defined as a haemoglobin level <13 g/dL for men and <12 g/dL for women and was further specified into severe (haemoglobin level <10 g/dL for both men and women) and moderate anaemia (haemoglobin between 10 and 12 g/dL for women and 10 and 13 g/dL for men). Gait speed (in meters per second) was calculated after a 4.5 m walk and hand grip strength (in kilogram) was assessed with a hydraulic hand dynamometer. Functionality was assessed in the six basic activities of daily living. Information about the vital status was obtained 1 year after discharge with a telephone call. Analysis of covariance (ANCOVA) was used to examine the effect of the anaemia status on the walking speed, hand grip strength and premorbid ADL index and logistic regression analysis was used to examine whether anaemia could be identified as risk factors for mortality 12 months after discharge.

Results

Overall, 106 (48 %) patients had anaemia. Hand-grip strength, gait speed and ADL score were not significantly different between anaemic and non-anaemic hospitalized geriatric patients. After adjustment for age, sex, body mass index, eGFR, MMSE, number of comorbidities and main clinical diagnosis, the means for hand-grip strength were 17.3, 19.9 and 19.1 kg (p = 0.38); for gait speed 0.57, 0.52 and 0.47 m/s (p = 0.28); and for the ADL score 3.50, 3.05 and 3.30 (p = 0.75) in patients with severe, moderate and without anaemia, respectively. In the unadjusted model, the odds ratio for mortality 1 year after discharge was 2.72 (95 % CI 1.20–6.14) and 4.70 (95 % CI 1.91–11.77) for moderate and severe anaemia, respectively, with no anaemia as the reference group. After adjustment for several confounders, a haemoglobin level less than 10 g/dl (OR 3.87; 95 % CI 1.25–11.99) remained significantly associated with an increased mortality over that 1 year period.

Conclusion

Our results do not support that anaemia on admission is associated with a decline in physical performance (hand grip strength and gait speed) and functionality (ADL) during hospitalization in older patients. However, severe anaemia is a significant risk factor for an increased mortality over a 1 year period after discharge.

Low Hemoglobin A1c Increases the Risk of Disability in Community-dwelling Older Non-diabetics Adults

OBJECTIVE

To describe the health characteristics of individuals with low HbA1c levels and evaluate the association between HbA1c level and disability or all-cause mortality in non-diabetic older adults.

DESIGN

Prospective observational cohort study.

SETTING

Seongnam, Gyeongi Province, Korea.

PARTICIPANTS

Among the 1,000 community-dwelling Koreans ≥ 65 years of age who were followed for 5 years, 760 non-diabetic individuals were analyzed.

MEASUREMENTS

Activities of Daily Living (ADL) and Instrumental ADL (IADL) were evaluated and mortality data were obtained from the National Statistics Office of Korea.

RESULTS

The mean age was 76.3 (SD 9.0) years, and 319 subjects (42.0%) were male. Lower level of HbA1c was associated with less frequent hypertension and less frequent use of aspirin or statin, and lower values of body mass index, hematocrit, total iron-binding capacity, albumin, and cholesterol level. The participants were categorized into 3 groups according to their HbA1c (group I, < 5.5%; group II, 5.5~5.9%; and group III, 6.0 ~ 6.4%). Although, there was no significant difference in functional status according to baseline HbA1c level, disability was more frequently observed as the HbA1c level decrease (18.3% in group I, 12.5% in group II, and 5.3% in group III, p=0.029) at the 5-year follow-up evaluation. There were 172 deaths (22.6%) during the follow-up period. There was no significant difference in mortality among the groups, however, group I had a 2.071-fold higher risk for the incident disability or mortality over group III after adjusting age, gender, and possible confounder (95% CI: 1.040 ~ 4.124, p=0.038).

CONCLUSIONS

Lower level of HbA1c was associated with an increased risk of disability in non-diabetic older adults.

Blood biomarkers and functional disability among extremely longevous individuals: a population-based study

BACKGROUND

Several blood biomarkers have been linked to functional disability, a health problem in general populations. However, there are limited data for evaluating the potential association of biomarkers with functional disability in an extremely longevous (95+) population.

METHODS

We used data from 420 extremely longevous individuals from the Rugao longevity cohort, a population-based association study conducted in Rugao, a longevity town in China. Functional disability was assessed by the Katz Index of Independence in activities of daily living. Blood biomarkers, including serum lipid, lipoprotein cholesterol, serum albumin, and lymphocyte count, were correlated with activities of daily living.

RESULTS

Among extremely longevous women, following the degree of functional disability, serum albumin and lymphocyte count decreased significantly (all p for trend < .001). In a univariate model, serum albumin (β = -0.279, p < .001), lymphocyte count (β = -0.187, p < .001), and neutrophil count (β = 0.140, p = .012) were found to be significantly associated with activities of daily living in women. After adjustment for other covariates, the significance remained. Notably, multivariate regression analysis revealed independent effects of all the three biomarkers on activities of daily living (β = -0.242, -0.185, and 0.143, all p < .05). We did not observe any association in men.

CONCLUSIONS

We found significant associations between serum albumin, lymphocyte count, and neutrophil count and physical disability even after adjustment for potential confounders in extremely longevous women, which call for further study. The findings provide preliminary but crucial clues for future studies specifically aimed at exploring the longitudinal relationships of interest before proceeding with interventions.

The association of hemoglobin concentration with disability and decreased mobility among older Brazilians

OBJECTIVE

To examine the association between hemoglobin concentration and disability and mobility difficulty among older adults living in São Paulo, Brazil.

DESIGN

Cross-sectional study.

SETTING

Population-based study conducted in São Paulo, Brazil.

PARTICIPANTS

Adults age 60 and over (n=1,256) from the third data collection wave of the SABE Study (Health, Well-being, and Aging) conducted in 2010.

MEASUREMENTS

Two outcome measures were included in the analyses: 1) a difficulty to perform at least one of the instrumental activities of daily living (IADL) and 2) mobility difficulty, which was assessed using the Short Physical Performance Battery (SPPB). Logistic regression models assessed the association between hemoglobin and each of the outcome measures. All analyses were adjusted for sociodemographic and health characteristics.

RESULTS

The prevalence of IADL disability was 26.8% and 10.7% of participants had mobility difficulty. The mean hemoglobin concentration was significantly lower in older adults who already presented disability (13.7g/dL versus 14.4g/dL among independent elderly) or decreased mobility (13.4g/dL versus 14.3g/dL among elderly with preserved mobility). Higher values of hemoglobin concentration were associated with lower the risk of IADL disability (OR=0.88; p=0.04) and mobility difficulty (OR=0.81; p=0.02). Hemoglobin concentrations showed a dose-response effect in the probability of each outcome.

CONCLUSIONS

Lower hemoglobin concentration was associated with a higher probability of IADL disability and mobility difficulty, showing a clear dose-response effect.

Factors Associated with Performance-based Physical Function of Older Veterans of the PLAAF: A Pilot Study

[Purpose] This study investigated the factors associated with performance-based physical function of older veterans of the People’s Liberation Army Air Force of China (PLAAF). [Subjects and Methods] A cross-sectional survey of 146 older veterans of the PLAAF was carried out. Their physical function was measured using the Chinese Mini-Physical Performance Testing (CM-PPT). The demographics and health status (including physical measures, blood chemical tests, chronic diseases, and number of morbidities) were collected from health examination reports and computer records of case history. Cognition was measured using the Mini-Mental Status Examination (MMSE). [Results] In multiple linear regressions, age, MMSE, Parkinsonism, and chronic obstructive pulmonary disease were independently associated with CM-PPT, while previous stroke and albumin level reached borderline statistical significance. The association between the number of morbidities and CM-PPT was significant after adjustment for MMSE and demographics. The CM-PPT of low (0 or 1), medium (2 to 4) and high count (5 or more) morbidities were 11.3±3.9, 10.2±4.1, 6.1±3.8 respectively, and the difference among these three groups was significant. [Conclusion] Some modified conditions and the number of chronic diseases might be associated with the physical function of older veterans of the PLAAF.

Nutritional screening tools and anthropometric measures associate with hospital discharge outcomes in older people

AIM

To examine the association of nutritional screening tools (NSTs) and anthropometric measures with hospital outcomes in older people.

METHODS

In 172 patients aged ≥70 years admitted to a Geriatric Evaluation Management Unit (GEMU), nutritional status was measured using the Mini-Nutritional Assessment (MNA), MNA-short form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Simplified Nutritional Appetite Questionnaire, calf circumference (CC), mid-arm circumference (MAC) and BMI.

RESULTS

Malnutrition according to the MNA occurred in 53 (31%) patients. Functional change was associated with GNRI (Beta coefficient (β), 95% CI = 0.17, 0.001-0.33) and CC (β, 95% CI = 0.17, 0.01-0.33); GEMU length of stay was associated with MNA-SF-BMI (β, 95% CI = -0.02, -0.003 to -0.004) and MNA-SF-CC (β, 95% CI = -0.02, -0.003 to -0.001). MAC was associated with discharge to higher level of care (OR, 95% CI = 0.88, 0.81-0.96).

CONCLUSION

In hospitalised older people, admission NSTs and anthropometric measures associate with discharge outcomes.