Appendicular and mid-thigh lean mass are associated with muscle strength, physical performance, and dynamic balance in older persons at high risk of falls

Balance and Strength Measures are Associated With Mortality in Older Men

OBJECTIVES

As people age, rates of morbidity and mortality are heterogenous. Balance and strength performance may contribute to this, offering modifiable risk factors for mortality. We aimed to compare relationships of balance and strength performance with all-cause and cause-specific mortality.

DESIGN

The Health in Men Study, a cohort study, using wave 4 as baseline for analyses (2011-2013).

SETTING AND PARTICIPANTS

1335 older men (>65 years old), initially recruited April 1996-January 1999 in Western Australia, were included.

METHODS

Physical tests included a strength (knee extension test) and balance measure (modified Balance Outcome Measure for Elder Rehabilitation (mBOOMER) Score), derived from baseline physical assessments. Outcome measures included all-cause, cardiovascular, and cancer mortality, ascertained via the WADLS death registry. Data were analyzed using Cox proportional hazards regression models (age as analysis time, adjusted for sociodemographic data, health behaviors, and conditions).

RESULTS

Four hundred seventy-three participants died before the end of follow-up (December 17, 2017). Better performance on both the mBOOMER score and knee extension test was associated with lower likelihood of all-cause [hazard ratio (HR) 0.83, 95% CI 0.80-0.87, and HR 0.96, 95% CI 0.95-0.98, respectively] and cardiovascular mortality (HR 0.82, 95% CI 0.77-0.87, and HR 0.96, 95% CI 0.94-0.98, respectively). Better mBOOMER score performance was associated with lower likelihood of cancer mortality (HR 0.90, 95% CI 0.83-0.98) only when including participants with prior cancer.

CONCLUSIONS AND IMPLICATIONS

In summary, this study demonstrates an association of poorer performance in both strength and balance with future all-cause and cardiovascular mortality. Notably, these results clarify the relationship of balance with cause-specific mortality, with balance equaling strength as a modifiable risk factor for mortality.

The Effects of Graded Protein Intake in Conjunction with Progressive Resistance Training on Skeletal Muscle Outcomes in Older Adults: A Preliminary Trial

Many studies have evaluated the effects of resistance training (RT) and protein intake to attenuate the age-related loss of skeletal muscle. However, the effects of graded protein intake with conjunctive RT in older adults are unclear. Older adults (n = 18) performed 10 weeks of whole-body RT with progressions to intensity and volume while consuming either a constant protein (CP) diet (0.8−1.0 g/kg/d) with no protein supplement or a graded protein (GP) diet progressing from 0.8 g/kg/d at week 1 to 2.2 g/kg/d at week 10 with a whey protein supplement. Data were collected prior to commencement of the RT protocol (PRE), after week 5 (MID), and after week 10 (POST). Dual Energy X-ray Absorptiometry derived lean/soft tissue mass, ultrasonography derived muscle thickness, and a proxy of muscle quality were taken at PRE and POST, while isokinetic dynamometry derived peak torque were taken at PRE, MID, and POST. This study demonstrated the feasibility of the RT protocol (attendance = 96%), and protein intake protocol (CP in range all weeks; GP deviation from prescribed = 7%). Peak torque, muscle quality scores, and appendicular lean/soft tissue mass demonstrated the main effects of time (p < 0.05) while no other main effects of time or group * time interactions were seen for any measure. In conclusion, RT improved appendicular lean/soft tissue mass, peak torque, and muscle quality, with no differential effects of graded or constant protein intake.