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Huang YC, Chen SL, Dong Y, Shi Y. Association between elevated serum uric acid levels and high estimated glomerular filtration rate with reduced risk of low muscle strength in older people: a retrospective cohort study. BMC Geriatr 2023; 23:652. [PMID: 37821826 PMCID: PMC10568872 DOI: 10.1186/s12877-023-04374-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND We aimed to investigate the interaction between serum uric acid (SUA) levels with estimated glomerular filtration rate (eGFR) to low muscle strength (LMS) among older people in China. METHODS Cohort data were obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. A total of 2,822 community-dwelling adults aged 60 and above were enrolled for the follow-up. Serum uric acid was collected after 8 h of fasting, and handgrip strength was measured with a dynamometer. eGFR was calculated with an equation based on the Chinese population. A generalized additive model was employed for interaction analysis and progressively adjusted confounders. RESULTS During the follow-up, a total of 659 individuals were excluded due to the lack of grip strength data, leaving 2,163 participants for analysis. Despite the protective effect of high uric acid against low muscle strength, especially in older females, it is not statistically significant (OR = 0.69, 95%CI = 0.45-1.04, P = 0.075). Following the progressive adjustment of covariates, the association between higher eGFR and elevated SUA levels remained statistically significant in females, showing a reduced odds ratio with low muscle strength (OR = 0.82, 95%CI = 0.70-0.97, P = 0.021). However, this trend was not observed in male participants. CONCLUSIONS This Chinese population-based cohort study suggests that among older females, a higher serum uric acid level combined with a higher estimated glomerular filtration rate is linked to a reduced risk of low muscle strength. This implies that the relationship between high serum uric acid levels and the risk of low grip strength might differ by gender.
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Affiliation(s)
- Yu Cheng Huang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201220, China
| | - Si Liang Chen
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201220, China
| | - Ying Dong
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Shi
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201220, China.
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Correa RGP, Pivovarsky MLF, da Silva Santos G, Gomes ARS, Borba VZC. Factors that cause women with osteoporosis to fall. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000578. [PMID: 37252691 PMCID: PMC10665076 DOI: 10.20945/2359-3997000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/25/2022] [Indexed: 05/31/2023]
Abstract
Objective To analyze and compare intrinsic and extrinsic factors that cause falls among women receiving treatment for osteoporosis. Subjects and methods A cross-sectional study of women ≥50 years receiving treatment for osteoporosis. Participants filled out questionnaires (demographic characteristics), and researchers took anthropometric measurements of bone mineral density, handgrip strength (HGS), ankle range of motion (ROM), and gait speed (GS). We also evaluated the Timed Up and Go Test (TUGT), Five Times Sit-to-Stand Test (SST), and Falls Efficacy Scale-International (FES-I) and investigated the extrinsic factors for falls. Results We included 144 participants (71.6 [8.3 years]), who reported 133 falls. We classified participants into a non-faller group (NFG; 0 falls, n=71, 49.5%), a faller group (FG; 1 fall, n=42, 28.9%), and a recurrent-faller group (RFG; more than 1 fall, n=31, 21.5%). Most patients had an increased risk of falling according to the TUGT, SST, reduced ankle ROM, and GS (P<.005 for all). FES-I was associated with sporadic and recurrent falls. For the multivariate analysis, the number of falls was influenced by the presence of ramps (RR 0.48, 95% CI, 0.26-0.87, P=.015), uneven surfaces (RR 1.6, 95% CI. 1.05-2.43, P=.028), and antislippery adhesive on stairs (RR 2.75, 95% CI, 1.77-4.28, P<.001). Conclusion Patients receiving treatment for osteoporosis are influenced by intrinsic and extrinsic factors that cause falls. Lower-limb strength and power-discriminated participants at a higher risk of falls, but extrinsic factors varied. Only uneven floors and antislippery adhesives on stairs were associated with increased frequency of falls.
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Affiliation(s)
| | | | | | - Anna Raquel Silveira Gomes
- Departamento de Fisioterapia, Programa de Pós-graduação em Educação Física, Universidade Federal do Paraná, Curitiba, PR, Brasil
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Chen X, Han P, Zhang K, Liang Z, Yu C, Lu N, Shen Z, Chang F, Fang X, Guo Q. Physical performance and muscle strength rather than muscle mass are predictor of all-cause mortality in hemodialysis patients. Front Public Health 2023; 11:1087248. [PMID: 36926175 PMCID: PMC10011695 DOI: 10.3389/fpubh.2023.1087248] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Objectives Patients undergoing maintenance hemodialysis usually suffer a high burden of poor functional status. The aim of this study was to investigate the association between muscle mass, muscle strength as well as physical performance with all-cause mortality in hemodialysis patients. Methods 923 hemodialysis patients (565 men, mean aged 61.3 ± 12.7 years) were included from eight facilities in Tianjin and Shanghai of China from 2019 to 2021. Muscle mass was evaluated by skeletal muscle index (SMI) and muscle strength was assessed by handgrip strength. Different measures of physical performance were measured via gait speed, Timed Up and Go Test (TUGT) and short physical performance battery (SPPB). Cox proportional hazards regression models were used to determine the adjusted hazard ratios (HRs) of mortality with 95% confidence intervals (95% CIs) for baseline muscle mass, muscle strength and different measures of physical performance. Additionally, the area under the Receiver Operating Characteristic (ROC) curves were constructed to determine which index is a better predictor of mortality. Results During a median follow-up of 14 (12-17 months), 79 (8.6%) patients died. Using the Cox regression analysis, we founded that muscle strength and physical performance rather than muscle mass were significantly negatively associated with mortality. The C-index for different measures of physical performance in predicting mortality were 0.709 for SPPB, 0.7 for TUGT and 0.678 for gait speed, respectively. The C-index for muscle strength was 0.635, and the ability of prediction was significantly lower than the physical performance. Conclusions Physical performance seems to a better indicator of mortality than muscle mass and strength in hemodialysis patients. Simple measures of physical performance may be appropriately used as a screening tool targeting high-risk hemodialysis patients for the prevention of mortality.
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Affiliation(s)
- Xiaoyu Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Kun Zhang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhenwen Liang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Chen Yu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ningtao Lu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Zhouyue Shen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Fengyan Chang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xin Fang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.,Department of Rehabilitation Medicine, School of Health, Fujian Medical University, Fuzhou, China
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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Zaide M, Rayner D, Khattab N, Bhatt V, Goodin C, Song JW(B, Smal J, Budd N. Physical mobility determinants among older adults: a scoping review of self-reported and performance-based measures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2153303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Vidhi Bhatt
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | | | - Justin Smal
- Manitoulin Physio Centre, M'Chigeeng, Canada
| | - Natalie Budd
- The Arthtitis and Sports Medicine Centre, Ancaster, Canada
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Gallo da Silva TT, Melo Filho J, Biesek S, Vojciechowski AS, Borba VZC, Gomes ARS. Accuracy of Tools to Differentiate Single From Recurrent Fallers Pre-Frail Older Women. Front Public Health 2022; 10:716851. [PMID: 35655457 PMCID: PMC9152280 DOI: 10.3389/fpubh.2022.716851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The objectives of this study were to analyze and compare musculoskeletal and functional performance and present cutoff points to differentiate pre-frail community-dwelling older women regarding their fall history: non fallers (0 falls), fallers (single fall), and recurrent fallers (≥2 falls). Method This is a cross-sectional, retrospective study on 90 pre-frail community-dwelling older women (71.2 ± 4.49 years) according to Fried criteria. We assessed peak torque (PT) (isokinetic dynamometer), muscle architecture/mass (ultrasound/dual-energy X-ray absorptometry), and the following functional performance: usual gait speed (UGS), fast gait speed (FGS), walking speed reserve (WSR), cadence and step length, and timed up and go. Results The recurrent fallers presented lower UGS (1.12 ± 0.18 vs. 1.29 ± 0.28 m/s; p = 0.05) and isometric PT of knee extensors than the fallers (89.88 ± 20.99 vs. 115.55 ± 23.09 Nm; p = 0.01), and lower FGS than the fallers (1.35 ± 0.26 vs. 1.5 ± 0.29 m/s; p = 0.03) and non-fallers (1.35 ± 0.26 vs. 1.52 ± 0.26 m/s; p = 0.01). The outcomes that differentiated the fallers from the non-fallers were both WSR calculated as a difference (WSRdiff) (≤0.26 m/s) and WSR calculated as a ratio (WSRratio) (≤1.25 m/s), while to differentiate the recurrent fallers from the non-fallers were FGS (≤1.44 m/s) and step length (≤73 cm). The following cutoff points might be used to differentiate recurrent fallers and fallers: UGS (≤1.12 m/s), FGS (≤1.34m/s), step length (≤73 cm), PT knee extension (≤114.2 Nm), PT knee flexion (≤46.3 Nm), and PT ankle dorsiflexion (≤22.1 Nm). Conclusion Recurrent fallers community-dwelling pre-frail older women presented a worse musculoskeletal and functional performance when compared to the non-fallers and fallers. Gait speed, step length, PT of both knee extension and flexion, and ankle dorsiflexion can be used to identify both single and recurrent fallers pre-frail older women, contributing to guide interventions and prevent falls and fractures.
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Affiliation(s)
| | - Jarbas Melo Filho
- Departament of Massage Under Graduation, Federal Institute of Paraná, Curitiba, Brazil
| | - Simone Biesek
- PhD Program in Physical Education, Federal University of Paraná, Curitiba, Brazil
| | | | - Victória Zeghbi Cochenski Borba
- Internal Medicine Department and Masters and PhD Programs, Endocrinology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
| | - Anna Raquel Silveira Gomes
- Masters and PhD Programs in Physical Education, Prevention and Rehabilitation in Physiotherapy Department, Federal University of Paraná, Curitiba, Brazil
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Chen X, Han P, Song P, Zhao Y, Zhang H, Niu J, Yu C, Ding W, Zhao J, Zhang L, Qi H, Shao X, Su H, Guo Q. Mediating Effects of Malnutrition on the Relationship between Depressive Symptoms Clusters and Muscle Function Rather than Muscle Mass in Older Hemodialysis Patients. J Nutr Health Aging 2022; 26:461-468. [PMID: 35587758 DOI: 10.1007/s12603-022-1778-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the association and mediation pathways among muscle mass, muscle function (muscle strength and physical performance), and malnutrition with depressive symptoms clusters in the older hemodialysis patients. DESIGN A multi-center cross-sectional study. SETTING AND PARTICIPANTS A total of 499 patients aged ≥ 60 on hemodialysis from seven facilities in Shanghai of China from 2020 to 2021. MEASUREMENTS Muscle mass was assessed by skeletal muscle index(SMI). Muscle strength was measured by handgrip strength, and physical performance was measured via gait speed and Timed Up and Go Test (TUGT). Nutritional status was assessed by Malnutrition Inflammation Score (MIS). Depressive symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9). Logistic regression and mediation analyses fully adjusted for all potential confounding factors. RESULTS Among 499 participants (312 men, mean age 69.2±6.6 years), 108 (21.6%) had depressive symptoms. The muscle strength, physical performance and malnutrition were associated with depressive symptoms. Furthermore, malnutrition significantly mediated the association of muscle function with total, cognitive-affective symptoms. The association of the muscle function with somatic symptoms were mediated by the nutritional status. The mediated proportions of malnutrition in the relationship between physical performance and depressive symptoms clusters were stronger in somatic symptoms than in cognitive-affective symptoms. CONCLUSIONS Our findings suggest that muscle function rather than muscle mass may contribute substantially to the development of depressive symptoms clusters in the hemodialysis via malnutrition. The malnutrition mediated stronger in the association of muscle function with somatic symptoms. These findings may help guide clinicians to better diagnose and manage depression in the context of concomitant muscle function and malnutrition.
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Affiliation(s)
- X Chen
- Qi Guo, M.D., Ph.D. Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China, Phone: 86-22-8333-6977, Fax: 86-22-8333-6977, E-mail:
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Wang J, Chen X, Sun X, Ma H, Yu Y, Yao C, Li Z, Huang L, Zhao Q. The Application of 'Timed up and Go' Test in Fall Screening of Elderly People in Shanghai: A Cross-Sectional Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:2567-2575. [PMID: 36317036 PMCID: PMC9577144 DOI: 10.18502/ijph.v50i12.7940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/23/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND We aimed to evaluate the predictive value of the 'Timed Up and Go' test (TUGT) for identifying fall risk in community-dwelling elderly. METHODS From Aug 2016 to Feb 2017, cluster sampling was conducted among residents aged over 60 from 15 communities in Songjiang district, Shanghai. Face-to-face questionnaire interviews and TUGT measures were conducted to collect data. RESULTS 6,014 participants were enrolled, with an average age 72.7±7.0 years. 637 (10.6%) elderly people had a fall experience in the past year. TUGT for the non-fall group, one-fall group and recurrent-fall group was 9.02±4.39, 10.00±5.26 and 10.78±4.51 seconds respectively (P<0.001). ROC analysis showed that the TUGT cut-off point for the elderly was 12.5 seconds and AUC was 0.573 for any-fall group and 0.613 for recurrent-fall group respectively. After adjusting for age and gender, the predictive value was not high for any-fall group (AUC=0.614) and recurrent-fall group (AUC=0.648). The TUGT cut-off point for the elderly aged below 65, 65-74, 75-84 and 85 and above was 13.52s, 12.51s, 12.51s, 12.00s, respectively. After adjustment of the confounding factors, the OR values for the risk of fall for the elderly men and women who completed TUGT longer than the cut-off point was 2.404 and 2.075 times higher than those who completed TUGT shorter than the cut-off point, respectively. CONCLUSION TUGT with the cut-off score of 12.5s has limited capability in predicting fall risk in community-dwelling elderly.
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Affiliation(s)
- Jian Wang
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiuqin Chen
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Xiaoming Sun
- Department of General Practice, Shanghai Medical College, Fudan University, Shanghai, China
| | - Huifen Ma
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Yan Yu
- Injury Prevention Division, Shanghai Municipal Center for Disease Control and Prevetion, Shanghai, China
| | - Chunxia Yao
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Zhipeng Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Limei Huang
- Injury Prevention Division, Songjiang District Center for Disease Control and Prevention, Shanghai, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
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8
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Wang L, Song P, Cheng C, Han P, Fu L, Chen X, Yu H, Yu X, Hou L, Zhang Y, Guo Q. The Added Value of Combined Timed Up and Go Test, Walking Speed, and Grip Strength on Predicting Recurrent Falls in Chinese Community-dwelling Elderly. Clin Interv Aging 2021; 16:1801-1812. [PMID: 34675495 PMCID: PMC8502011 DOI: 10.2147/cia.s325930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/11/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose To determine whether combined performance-based models could exert better predictive values toward discriminating community-dwelling elderly with high risk of any-falls or recurrent-falls. Participants and Methods This prospective cohort study included a total of 875 elderly participants (mean age: 67.10±5.94 years) with 513 females and 362 males, recruited from Hangu suburb area of Tianjin, China. All participants completed comprehensive assessments. Methods We documented information about sociodemographic information, behavioral characteristics and medical conditions. Three functional tests—timed up and go test (TUGT), walking speed (WS), and grip strength (GS) were used to create combined models. New onsets of any-falls and recurrent-falls were ascertained at one-year follow-up appointment. Results In total 200 individuals experienced falls over a one-year period, in which 66 individuals belonged to the recurrent-falls group (33%). According to the receiver operating characteristic curve (ROC), the cutoff points of TUGT, WS, and GS toward recurrent-falls were 10.31 s, 0.9467 m/s and 0.3742 kg/kg respectively. We evaluated good performance as “+” while poor performance as “–”. After multivariate adjustment, we found “TUGT >10.31 s” showed a strong correlation with both any-falls (adjusted odds ratio (OR)=2.025; 95% confidence interval (CI)=1.425–2.877) and recurrent-falls (adjusted OR=2.150; 95%CI=1.169–3.954). Among combined functional models, “TUGT >10.31 s, GS <0.3742 kg/kg, WS >0.9467 m/s” showed strongest correlation with both any-falls (adjusted OR=5.499; 95%CI=2.982–10.140) and recurrent-falls (adjusted OR=8.260; 95%CI=3.880–17.585). And this combined functional model significantly increased discriminating abilities on screening recurrent-fallers than a single test (C-statistics=0.815, 95%CI=0.782–0.884, P<0.001), while not better than a single test in predicting any-fallers (P=0.083). Conclusion Elderly people with poor TUGT performance, weaker GS but quicker WS need to be given high priority toward fall prevention strategies for higher risks and frequencies. Meanwhile, the combined “TUGT–, GS–, WS+” model presents increased discriminating ability and could be used as a conventional tool to discriminate recurrent-fallers in clinical practice.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Peiyu Song
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Cheng Cheng
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,Department of Rehabilitation, Tianjin Huanhu Hospital, Tianjin, People's Republic of China
| | - Peipei Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Liyuan Fu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaoyu Chen
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Hairui Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xing Yu
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Lin Hou
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yuanyuan Zhang
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China
| | - Qi Guo
- Department of Rehabilitation, School of Medical Technology, Tianjin Medical University, Tianjin, People's Republic of China.,College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
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Crockett RA, Falck RS, Dao E, Hsu CL, Tam R, Alkeridy W, Liu-Ambrose T. Sweat the Fall Stuff: Physical Activity Moderates the Association of White Matter Hyperintensities With Falls Risk in Older Adults. Front Hum Neurosci 2021; 15:671464. [PMID: 34093153 PMCID: PMC8175638 DOI: 10.3389/fnhum.2021.671464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Falls in older adults are a major public health problem. White matter hyperintensities (WMHs) are highly prevalent in older adults and are a risk factor for falls. In the absence of a cure for WMHs, identifying potential strategies to counteract the risk of WMHs on falls are of great importance. Physical activity (PA) is a promising countermeasure to reduce both WMHs and falls risk. However, no study has yet investigated whether PA attenuates the association of WMHs with falls risk. We hypothesized that PA moderates the association between WMHs and falls risk. Methods: Seventy-six community-dwelling older adults aged 70–80 years old were included in this cross-sectional study. We indexed PA using the Physical Activity Score for the Elderly (PASE) Questionnaire. Falls risk was assessed using the Physiological Profile Assessment (PPA), and WMH volume (mm3) was determined by an experienced radiologist on T2-weighted and PD-weighted MRI scans. We first examined the independent associations of WMH volume and PASE score with PPA. Subsequently, we examined whether PASE moderated the relationship between WMH volume and PPA. We plotted simple slopes to interpret the interaction effects. Age, sex, and Montreal Cognitive Assessment (MoCA) score were included as covariates in all models. Results: Participants had a mean age of 74 years (SD = 3 years) and 54 (74%) were female. Forty-nine participants (66%) had a Fazekas score of 1, 19 (26%) had a score of 2, and 6 (8%) a score of 3. Both PASE (β = −0.26 ± 0.11; p = 0.022) and WMH volume (β = 0.23 ± 0.11; p = 0.043) were each independently associated with PPA score. The interaction model indicated that PASE score moderated the association between WMH volume and PPA (β = −0.27 ± 0.12; p = 0.030), whereby higher PASE score attenuated the association between WMHs and falls risk. Conclusion: PA is an important moderator of falls risk. Importantly, older adults with WMH can reduce their risk of falls by increasing their PA.
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Affiliation(s)
- Rachel A Crockett
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Ryan S Falck
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Elizabeth Dao
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
| | - Chun Liang Hsu
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States.,Harvard Medical School, Harvard University, Boston, MA, United States
| | - Roger Tam
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada.,School of Biomedical Engineering, The University of British Columbia, Vancouver, BC, Canada
| | - Walid Alkeridy
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Division of Geriatrics, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
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Ma W, Liu Y, Wu N, Zhang H, Han P, Wang F, Wang J, Xie F, Niu S, Hu H, Zhang C, Chen N, Zhang Y, Guo Q, Yu Y. Obesity, Even in the Metabolically Healthy, Increases the Risk of Poor Physical Performance: A Cross-Sectional Study of Older People in a Chinese Community. Clin Interv Aging 2021; 16:697-706. [PMID: 33948083 PMCID: PMC8088299 DOI: 10.2147/cia.s302167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 03/17/2021] [Indexed: 12/27/2022] Open
Abstract
Objective We examined the association between obesity and physical performance under different metabolic status. Methods The sample included 1395 Chinese community-dwelling participants (mean age, 71.88 ± 5.87 years; 40.9% men). Being metabolically healthy was defined as having the presence of < 3 of 5 components of metabolic syndrome (MetS); obesity was defined as having a BMI > 28 kg/m2. Participants were divided into four groups based on BMI (non-obese/obese) and metabolic health (healthy/unhealthy). Physical performance was measured by grip strength, 4-m walking speed, and the timed up and go test (TUGT). Results After multiple adjustments, compared with metabolically healthy non-obese group, the metabolically unhealthy obese group showed lower relative grip strength, lower 4-m walking speed, and higher TUGT (P all < 0.05), and only relative grip strength of the metabolically healthy obese group was significantly lower than that of metabolically healthy non-obese (P < 0.01). Relative grip strength was negatively associated with impaired fasting glucose (β = −0.071), elevated triglycerides (β = −0.062), abdominal obesity (β = −0.230) and general obesity (β = −0.225) (P all < 0.01). Walking speed and TUGT were only associated with general obesity, rather than other metabolic components. The associations of MetS with physical performance were mainly driven by abdominal obesity. Conclusion Even in those who are metabolically healthy, obesity (especially general obesity) increases the risk of poor physical performance. Elderly people with general obesity and MetS, whether in combination or alone, have an increased risk of muscle dysfunction, and that combination produces a higher risk of impaired mobility.
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Affiliation(s)
- Weibo Ma
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Yuewen Liu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Ning Wu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Hui Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Feng Wang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Jingru Wang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Fandi Xie
- Department of Clinical Laboratory Center, Shanghai Jiangwan Hospital, Shanghai, People's Republic of China
| | - Shumeng Niu
- Department of Clinical Laboratory Center, Shanghai Jiangwan Hospital, Shanghai, People's Republic of China
| | - Hao Hu
- Department of Clinical Laboratory Center, Shanghai Jiangwan Hospital, Shanghai, People's Republic of China
| | - Chenyu Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Nuo Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Yichen Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Ying Yu
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
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11
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Nahas PC, Rossato LT, de Branco FMS, Azeredo CM, Rinaldi AEM, de Oliveira EP. Serum uric acid is positively associated with muscle strength in older men and women: Findings from NHANES 1999-2002. Clin Nutr 2021; 40:4386-4393. [PMID: 33485707 DOI: 10.1016/j.clnu.2020.12.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND One of the causes of strength loss in older adults is the increased oxidative stress; thus, substances with antioxidants properties may have protective effects on muscle strength. Uric acid (UA) is an important antioxidant and it seems to be positively associated with muscle strength in older adults; however, the current evidence is still limited. AIM To investigate whether serum UA is associated with muscle strength in older men and women. METHODS A cross-sectional study was performed evaluating older adults aged from 50 to 85 years from National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. A total of 2361 individuals (1256 men and 1105 women) were evaluated. The peak isokinetic knee extensor strength was assessed by kinetic communicator isokinetic dynamometer; while UA levels were measured by colorimetric method. Linear regression analyses were performed to estimate the coefficients and 95% confidence intervals for muscle strength by quintiles of UA levels, adjusted for potential confounders. RESULTS In the unadjusted analyses, serum UA was positively associated with peak force in men and total sample, but not in women. However, after adjustments for confounders, UA levels were positively associated with peak force in total sample (p-trend = 0.007), men (p-trend = 0.044) and women (p-trend = 0.016). CONCLUSION Serum UA is positively associated with muscle strength in older men and women. These results suggest that UA levels seem to be a protective factor for muscle strength in older adults independent of the sex.
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Affiliation(s)
- Paula C Nahas
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Luana T Rossato
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Flávia M S de Branco
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Catarina M Azeredo
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Ana Elisa M Rinaldi
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Erick P de Oliveira
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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12
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Valenzuela PL, Maffiuletti NA, Saner H, Schütz N, Rudin B, Nef T, Urwyler P. Isometric Strength Measures are Superior to the Timed Up and Go Test for Fall Prediction in Older Adults: Results from a Prospective Cohort Study. Clin Interv Aging 2020; 15:2001-2008. [PMID: 33149561 PMCID: PMC7602904 DOI: 10.2147/cia.s276828] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022] Open
Abstract
Background Isometric strength measures and timed up and go (TUG) tests are both recognized as valuable tools for fall prediction in older adults. However, results from direct comparison of these two tests are lacking. We aimed to assess the potential of isometric strength measures and the different modalities of the TUG test to detect individuals at risk of falling. Methods This is a prospective cohort study including 24 community-dwelling older adults (≥65 years, 19 females, 88±7 years). Participants performed three variations of the TUG test (standard, counting and holding a full cup) and three isometric strength tests (handgrip, knee extension and hip flexion) at several time points (at baseline and every ~6 weeks) during a one-year follow-up. The association between these tests and the incidence of falls during the follow-up was assessed. Results Twelve participants out of 24 participants experienced falls during the follow-up. Fallers showed a significantly lower handgrip strength (-5.7 kg, 95% confidence interval: -10.4 to -1.1, p=0.019) and knee extension strength (-4.9 kg, -9.6 to -0.2, p=0.042) at follow-up, while no significant differences were found for any TUG variation. Conclusions Handgrip and knee extension strength measures - particularly when assessed regularly over time - have the potential to serve as a simple and easy tool for detecting individuals at risk of falling as compared to functional mobility measures (ie, TUG test).
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Affiliation(s)
| | | | - Hugo Saner
- Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Narayan Schütz
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Beatrice Rudin
- Höhere Fachschule Pflege, Berufsbildungszentrum Olten, Olten, Switzerland
| | - Tobias Nef
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Prabitha Urwyler
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Neurology, University Neurorehabilitation Unit, University Hospital Inselspital, Bern, Switzerland
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13
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Wang L, Wang X, Song P, Han P, Fu L, Chen X, Yu H, Hou L, Yu X, Zhang Y, Zhang W, Guo Q. Combined Depression and Malnutrition As an Effective Predictor of First Fall Onset in a Chinese Community-Dwelling Population: A 2-Year Prospective Cohort Study. Rejuvenation Res 2020; 23:498-507. [PMID: 32303149 DOI: 10.1089/rej.2019.2188] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This study aims to explore the single and joint effects of depression and malnutrition on the incidence of first fall onset in a Chinese community-dwelling elderly population. This cohort study consisted of 739 residents without a history of falls who were aged 60 years and older (mean age: 67.08 ± 5.79 years, female: 58.2%). Depression was defined with the Geriatric Depression Scale (GDS)-30; a score of ≥11 was considered to be depressed, while malnutrition was defined with the Mini Nutritional Assessment where a score <17 was defined as malnourished. Over a 2-year follow-up period, older adults who experienced at least one fall were allocated to the first fall onset group. The prevalence of baseline falls was 21.36%. During the 2-year follow-up, incidence of first fall onset was 13.13%. After adjusting for all confounders, depression alone (adjusted odds ratio [OR] = 3.545, 95% confidence interval [CI] = 1.318-9.535) and malnutrition alone (adjusted OR = 2.204, 95% CI = 1.183-4.108) were observed to be independent risk factors for first fall onset, while comorbidity of depression and malnutrition showed progressively increased risk of promoting first fall (adjusted OR = 8.161, 95% CI = 3.591-18.545) than those with only depression or malnutrition or without both depression and malnutrition. Malnutrition mediated 56% effects in the association between depression and first fall onset, while depression mediated 76% effects in the promoting role of malnutrition in first fall. Depression and malnutrition were found to be independent causes for promoting first fall, while mental health and nutrition should be treated as commonly prior interventions to delay first fall onset. Meanwhile, for malnourished Chinese community-dwelling older adults, avoidance or treatment of depression should be addressed at first.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.,Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Wang
- Department of neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Peiyu Song
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liyuan Fu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xioayu Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Hairui Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Wen Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Qi Guo
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
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14
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Wald P, Chocano-Bedoya PO, Meyer U, Orav EJ, Egli A, Theiler R, Bischoff-Ferrari HA. Comparative Effectiveness of Functional Tests in Fall Prediction After Hip Fracture. J Am Med Dir Assoc 2020; 21:1327-1330. [PMID: 32276783 DOI: 10.1016/j.jamda.2020.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/28/2020] [Accepted: 02/09/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To assess the validity of 4 functional tests in predicting falls within the first year after hip fracture. DESIGN Prospective study of functional tests shortly after hip surgery and incident falls during 12 months' follow-up. SETTING AND PARTICIPANTS The sample comprised 173 adults with acute hip fracture, aged 65 years and older (79% women, 77% community dwelling, mean age 84.2 years), who participated in a clinical trial of vitamin D or home exercise. METHODS We assessed 4 functional tests [Timed Up and Go test (TUG), grip strength, and knee flexor and extensor strength in the nonoperated leg] by trained study physiotherapists at baseline (1-12 days after hip fracture surgery). During 12 months' follow-up, we ascertained all fall events by monthly personal phone calls, a telephone hotline, and a patient diary. Then we compared TUG and strength test performance at baseline between future single fallers, recurrent fallers, and nonfallers over the 12-month follow-up. All analyses adjusted for age, body mass index, gender, 25-hydroxyvitamin D status at baseline, days of follow-up, and treatment allocation (the original trial tested vitamin D treatment and/or a home exercise program). RESULTS Ninety-two of 173 (53%) participants fell and experienced 212 falls. Participants who became recurrent fallers (n = 54) had significantly longer TUG times at baseline than those who did not fall (n = 81) in the following 12 months (mean TUG for recurrent fallers = 71.6 seconds, SD = 8.2 seconds, vs mean TUG for nonfallers = 51.4 seconds, SD = 6.9 seconds; P = .02). There were no significant differences in TUG times between single fallers and nonfallers. For all 3 strength tests, there were no significant differences between single fallers, recurrent fallers, and nonfallers. CONCLUSIONS AND IMPLICATIONS In this population of frail older adults recruited shortly after hip fracture surgery, only the TUG test discriminated between future recurrent fallers and nonfallers over a 12-month follow-up. Because of the high incidence and serious consequences of falls in older adults after a hip fracture, it is very important to identify practical and clinically related tests to predict repeated falls in the first year after a hip fracture, which is of great public health importance.
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Affiliation(s)
- Patricia Wald
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
| | - Patricia O Chocano-Bedoya
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
| | - Ursina Meyer
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
| | - Endel J Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andreas Egli
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
| | - Robert Theiler
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland; Department of Geriatrics, University Hospital Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland; Department of Geriatrics, University Hospital Zurich, Zurich, Switzerland; University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland.
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15
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Rossato LT, de Branco FMS, Azeredo CM, Rinaldi AEM, de Oliveira EP. Association between omega-3 fatty acids intake and muscle strength in older adults: A study from National Health and Nutrition Examination Survey (NHANES) 1999-2002. Clin Nutr 2020; 39:3434-3441. [PMID: 32201063 DOI: 10.1016/j.clnu.2020.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 02/07/2020] [Accepted: 03/02/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Muscle strength is a predictor of mortality in older adults and some dietary components are associated with this variable; however, little is known about the association between omega-3 fatty acids (ω-3) intake and strength in older adults. OBJECTIVE To assess whether ω-3 intake is associated with muscle strength in individuals over 50 years. We also aimed to evaluate whether an isocaloric substitution of dietary fatty acids types by ω-3 intake could be associated with muscle strength. METHODS This study included older adults aged from 50 to 85 y, from National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. A total of 2141 individuals (1119 men and 1022 women) were evaluated and provided complete and reliable dietary intake and isokinetic strength of the knee extensors (peak force) data. Linear regression analysis was conducted without (Model 1) and with adjustments (Model 2). Isocaloric substitution analysis was performed to evaluate whether the substitution of polyunsaturated (excluding ω-3), monounsaturated, saturated fats and ω-6 by consumption of ω-3 is associated with strength. RESULTS Total ω-3, docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and alpha-linolenic acid (ALA) intakes were positively associated with peak force in men (Model 1). However, after the adjustments for confounders (Model 2), only total ω-3 intake remained significant. Ω-3 intake was not associated with strength in women. The isocaloric substitution of saturated, polyunsaturated, monounsaturated fats and ω-6 by ω-3 was not associated with peak force. CONCLUSION The intake of total ω-3 was positively associated with muscle strength in older men, but not in older women. In addition, the substitution of other fatty acids by ω-3 intake was not associated with strength.
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Affiliation(s)
- Luana T Rossato
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Flávia M S de Branco
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Catarina M Azeredo
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Ana Elisa M Rinaldi
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Erick P de Oliveira
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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16
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Long J, Cai T, Huang X, Zhou Y, Kuang J, Wu L. Reference value for the TUGT in healthy older people: A systematic review and meta-analysis. Geriatr Nurs 2019; 41:325-330. [PMID: 31810729 DOI: 10.1016/j.gerinurse.2019.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 01/30/2023]
Abstract
The timed up and go test (TUGT) was recently proposed as a strong predictor of adverse outcomes. Few reviews have been conducted to identify a standard for the TUGT in healthy older people, and the aims of this study were to explore the source of heterogeneity and evaluate the range of reference values for the TUGT in healthy people over 60 years old stratified by age and sex. The VIP, EMBASE, Web of Science and PubMed databases were searched from January 1, 2000, to December 31, 2018. A subgroup analysis and meta-regression were used to assess heterogeneity. Thirty-four eligible studies were included. The mean TUGT results for the total population, males and females in the sample were 9.21 s [95% CI (9.11, 9.31)], 9.33 s [95% CI (7.82, 11.08)] and 8.87 s [95% CI (8.40, 9.38)], respectively. The mean TUGT results for older people in their 60 s, 70 s, and 80 s were 7.91 s [95% CI (6.62, 9.20)], 8.67 s [95% CI (7.23, 10.12)] and 11.68 s [95% CI (8.11, 15.26)], respectively. The meta-regression analysis results showed that the heterogeneity was related to age (P < 0.01). Age affects the results of the TUGT, and it is necessary to take age into consideration when conducting stratified physical evaluations for the evaluation of older people individuals' physical fitness.
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Affiliation(s)
- JingWen Long
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - TianPan Cai
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - XiaoYing Huang
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - YuePing Zhou
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China
| | - Jie Kuang
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China.
| | - Lei Wu
- Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang University, 461 BaYi St, Nanchang 330006, PR China.
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17
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Cao L, Li L, Wang L, Li S, Chen Y, Yuan S, Huang L. Effects of silent myocardial ischemia on functional fitness and physical independence in 60–79-year-old adults. SPORTS MEDICINE AND HEALTH SCIENCE 2019; 1:44-48. [PMID: 35782458 PMCID: PMC9219263 DOI: 10.1016/j.smhs.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective Methods Results Conclusion
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18
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Ibrahim N'I, Sharkawi Ahmad M, Zulfarina MS, Zaris SNASM, Nor Azlin ZA, Naina Mohamed I, Mohamed N, Mokhtar SA, Shuid AN. Physical function assessment of older adults with lower body fractures at 3 months post-discharge from hospital. Ther Clin Risk Manag 2019; 15:201-210. [PMID: 30774356 PMCID: PMC6357875 DOI: 10.2147/tcrm.s189748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and purpose Physical function assessment can be performed to assess functional mobility among older adults, especially after a traumatic incident such as lower body fracture (LBF). The objective of this study was to evaluate physical function of older patients with LBF after 3 months of discharge from the hospital. Patients and methods A total of 89 patients were followed up at the discharge phase. Four independent variables were tested: age, sex, type of fracture, and use of a walking aid before fracture. Mobility and strength were assessed with the Timed Up and Go (TUG) test and hand-grip strength (HGS) test, respectively. Results The majority of the patients were ≥65 years old (64%), female (61.8%), of Chinese ethnicity (50.6%), and had a hip fracture (51.7%). The mean time for TUG test was 26.11 seconds, while mean HGS was 19.02 kg. We found significant differences in TUG test scores with respect to all independent variables tested: age (P=0.026), sex (P=0.011), fracture type (P<0.001), and use of a walking aid before fracture (P=0.004). Significant differences were also detected in HGS test scores with respect to all independent variables tested: age (P<0.001), sex (P<0.001), fracture type (P<0.001), and use of a walking aid before fracture (P=0.035). Conclusion Increasing age, female sex, having a hip fracture, and use of a walking aid before fracture predicted reduction in the physical function and strength among older adults with LBF.
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Affiliation(s)
- Nurul 'Izzah Ibrahim
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia,
| | - Mohd Sharkawi Ahmad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia,
| | - Mohamed S Zulfarina
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia,
| | | | | | - Isa Naina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia,
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia,
| | - Sabarul Afian Mokhtar
- Department of Orthopedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ahmad Nazrun Shuid
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia,
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19
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Fu L, Yu X, Zhang W, Han P, Kang L, Ma Y, Jia L, Yu H, Chen X, Hou L, Wang L, Guo Q. The Relationship Between Sleep Duration, Falls, and Muscle Mass: A Cohort Study in an Elderly Chinese Population. Rejuvenation Res 2019; 22:390-398. [PMID: 30565504 DOI: 10.1089/rej.2018.2102] [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] [Indexed: 12/31/2022] Open
Abstract
Epidemiological studies report that more than half of the people over the age of 65 years suffer from variable sleep problems. In this study, we conducted a cohort study to investigate the relationship between sleep duration, muscle mass, and function within a community-dwelling, elderly Chinese population. Our study population consisted of residents living in the township central hospital of suburban Tianjin, China. We measured muscle strength and walking speed. We divided sleep duration into the following four groups: <7 hours, 7-8 hours, >8-9 hours, and >9 hours. A total of 902 participants completed the 3-year follow-up. We observed a U-shaped relationship between sleep duration and fall risk. Compared with the 7-8-hour group, fall risk within the <7-hour group was 3.67 (2.59, 5.42) times higher and fall risk within the >9-hour group was 2.35 (1.29, 3.52) times higher. After adjustment, muscle mass declined by -6.82% (-11.27%, -3.83%) in the <7-hour group. In summary, we observed a U-shaped relationship between sleep duration and falls. Short sleep duration has a negative relationship with muscle mass decline in a community-dwelling, elderly Chinese population.
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Affiliation(s)
- Liyuan Fu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.,Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Wen Zhang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.,Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Li Kang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Yixuan Ma
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liye Jia
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Hairui Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lu Wang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China.,Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
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Zhang M, Liu T, Li C, Wang J, Wu D. Physical performance and cognitive functioning among individuals with diabetes: Findings from the China Health and Retirement Longitudinal Study Baseline Survey. J Adv Nurs 2018; 75:1029-1041. [PMID: 30397937 DOI: 10.1111/jan.13901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/31/2018] [Accepted: 10/08/2018] [Indexed: 01/21/2023]
Abstract
AIMS The purpose of this study was to examine individual associations of each physical performance measure with domains of cognitive functioning and to determine best physical performance measures strongly associated with each domain of cognitive functioning among middle-aged and older adults with diabetes. BACKGROUND Tests of physical performance are strongly correlated with cognitive decline in general elderly population. However, far less is known about individual associations of each individual physical performance measure with domains of cognitive functioning among individuals with diabetes. DESIGN The study employed a retrospective, cross-sectional design. METHODS Baseline data from a national baseline survey collected from May 2011-March 2012 were used. A total of 17,314 individuals aged ≥45 years completed the baseline survey. Diabetes was confirmed for 1,905 participants and these individuals were included in this study. RESULTS When grip strength, walking speed, repeated chair stands and standing balance test were added in the regression models, walking speed was the only variable that was significantly associated with figure drawing and grip strength was the only variable that was significantly associated with episodic memory, orientation/attention and overall cognitive score. CONCLUSION Since grip strength was the most important factor associated with several domains of cognitive functioning, strategies that improve grip strength in patients with diabetes are prudent. Early interventions to increase levels of physical activity may be important to improve both grip strength and cognitive functioning in this growing population with diabetes.
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Affiliation(s)
- Meng Zhang
- Nursing Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Tingting Liu
- Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas
| | - Changwei Li
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Jing Wang
- School of Nursing, The Office of Nursing Research and Scholarship, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Yu H, Chen X, Dong R, Zhang W, Han P, Kang L, Ma Y, Jia L, Fu L, Hou L, Yu X, Wang L, Zhu X, Yang F, Guo Q. Clinical relevance of different handgrip strength indexes and cardiovascular disease risk factors: A cross-sectional study in suburb-dwelling elderly Chinese. J Formos Med Assoc 2018; 118:1062-1072. [PMID: 30522855 DOI: 10.1016/j.jfma.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/10/2018] [Accepted: 11/01/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Reduced muscle strength, as measured by handgrip strength (HS), has been associated with an increased risk of cardiovascular disease (CVD). The aim of this study was to examine the association between different HS indexes and CVD risk factors in elderly Chinese individuals. We also determine optimal cutoffs of HS indexes for predicting CVD risk factors. METHODS Data were obtained from 603 men and 789 women aged ≥60 years (average age 66.8 ± 6.4 y). These study participants were recruited in the suburb area of Tianjin, China. An individual was considered a patient when they exhibited any one of three CVD risk factors: diabetes mellitus, hypertension and dyslipidemia. All participants were interviewed face-to-face. In addition, serum samples were collected from all participants, and all participants underwent measures of anthropometry and HS. RESULTS The optimal cutoffs were 0.376 of HS/weight in men and 0.726 of HS/body fat mass in women for predicting diabetes mellitus. The adjusted odds ratios (ORs) of at least one CVD risk factor for those with low muscle strength identified by HS/body fat mass were 2.14 (95% confidence interval [CI]: 1.53, 3.44; p < 0.001) in men and 2.32 (95% CI: 1.60, 3.29; p < 0.001) in women. CONCLUSION HS/body fat mass appear to be the index best associated with CVD risk factors except diabetes mellitus in men. The optimal cutoffs of HS indexes have the potential to identify elderly adults at risk of CVD.
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Affiliation(s)
- Hairui Yu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China; Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Renwei Dong
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Wen Zhang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Li Kang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Yixuan Ma
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liye Jia
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Liyuan Fu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Lu Wang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Xiaodong Zhu
- Department of Neurology, Tianjin Medical University, Tianjin, China
| | - Fengying Yang
- Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China; Department of Rehabilitation Medicine, Tianjin Medical University, Tianjin, China.
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Mühlberg A, Museyko O, Bousson V, Pottecher P, Laredo JD, Engelke K. Three-dimensional Distribution of Muscle and Adipose Tissue of the Thigh at CT: Association with Acute Hip Fracture. Radiology 2018; 290:426-434. [PMID: 30457478 DOI: 10.1148/radiol.2018181112] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Purpose To evaluate determinants of hip fracture by assessing soft-tissue composition of the upper thigh at CT. Materials and Methods In this retrospective analysis of prospectively collected data, CT studies in 55 female control participants (mean age, 73.1 years ± 9.3 [standard deviation]) were compared with those in 40 female patients (mean age, 80.2 years ± 11.0) with acute hip fractures. Eighty-seven descriptors of the soft-tissue composition were determined. A multivariable best subsets analysis was used to extract parameters best associated with hip fracture. Results were adjusted for age, height, and weight. Results of soft-tissue parameters were compared with bone mineral density (BMD) and cortical bone thickness. Areas under the receiver operating characteristic curve (AUCs) adjusted for multiple comparisons were determined to discriminate fracture. Results The hip fracture group was characterized by lower BMD, lower cortical thickness, lower relative adipose tissue volume of the upper thigh, and higher extramyocellular lipid (EML) surface density. The relative volume of adipose tissue combined with EML surface density (model S1) was associated with hip fracture (AUC, 0.85; 95% confidence interval [CI]: 0.78, 0.93), as well as trochanteric trabecular BMD combined with neck cortical thickness (model B2) (AUC, 0.84; 95% CI: 0.75, 0.92). The model including all four parameters provided significantly better (P < .01) discrimination (AUC, 0.92; 95% CI: 0.86, 0.97) than model S1 or B2. Conclusion In addition to bone mineral density and geometry of the proximal femur, the amount of adipose tissue of the upper thigh and the distribution of the adipocytes in the muscles are significantly associated with acute hip fracture at CT. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Alexander Mühlberg
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Oleg Museyko
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Valérie Bousson
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Pierre Pottecher
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Jean-Denis Laredo
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
| | - Klaus Engelke
- From the Institute of Medical Physics (A.M., O.M., K.E.) and Department of Medicine 3 (K.E.), University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Henkestr 91, Erlangen 91052, Germany; and Department of Radiology, AP-HP, Hôpital Lariboisière and Université Paris Diderot, Paris, France (V.B., P.P., J.D.L.)
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Engelke K, Museyko O, Wang L, Laredo JD. Quantitative analysis of skeletal muscle by computed tomography imaging-State of the art. J Orthop Translat 2018; 15:91-103. [PMID: 30533385 PMCID: PMC6260391 DOI: 10.1016/j.jot.2018.10.004] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 02/06/2023] Open
Abstract
The radiological assessment of muscle properties-size, mass, density (also termed radiodensity), composition, and adipose tissue infiltration-is fundamental in muscle diseases. More recently, it also became obvious that muscle atrophy, also termed muscle wasting, is caused by or associated with many other diseases or conditions, such as inactivity, malnutrition, chronic obstructive pulmonary disorder, cancer-associated cachexia, diabetes, renal and cardiac failure, and sarcopenia and even potentially with osteoporotic hip fracture. Several techniques have been developed to quantify muscle morphology and function. This review is dedicated to quantitative computed tomography (CT) of skeletal muscle and only includes a brief comparison with magnetic resonance imaging. Strengths and limitations of CT techniques are discussed in detail, including CT scanner calibration, acquisition and reconstruction protocols, and the various quantitative parameters that can be measured with CT, starting from simple volume measures to advanced parameters describing the adipose tissue distribution within muscle. Finally, the use of CT in sarcopenia and cachexia and the relevance of muscle parameters for the assessment of osteoporotic fracture illustrate the application of CT in two emerging areas of medical interest.
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Affiliation(s)
- Klaus Engelke
- FAU, Department of Medicine 3, University Hospital, Erlangen, Germany
- Friedrich-Alexander University Erlangen-Nuremberg, Institute of Medical Physics, Erlangen, Germany
| | - Oleg Museyko
- Friedrich-Alexander University Erlangen-Nuremberg, Institute of Medical Physics, Erlangen, Germany
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Jean-Denis Laredo
- AP-HP, Department of Radiology, Hôpital Lariboisière, Assistance Publique des Hôpitaux de Paris & Université Paris Diderot, Paris, France
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Zuo M, Gan C, Liu T, Tang J, Dai J, Hu X. Physical Predictors of Cognitive Function in Individuals With Hypertension: Evidence from the CHARLS Basline Survey. West J Nurs Res 2018; 41:592-614. [PMID: 29742988 DOI: 10.1177/0193945918770794] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The purpose of the study was to examine the independent associations of each individual physical performance measure (i.e., grip strength, walking speed, repeated chair stands, and balance test) with subdomains of cognitive function and to determine predictors for each subdomain of cognitive function. A secondary data analysis was performed using a nationally representative middle-aged and older sample of hypertensive population. The findings showed that after adding all four physical performance measures, stronger grip strength was significantly associated with better visuospatial abilities, episodic memory, orientation/attention, and overall cognitive function. In addition, faster walking speed and faster repeated chair stands were strongly associated with better episodic memory and overall cognitive function, respectively. Because grip strength was significantly associated with several subdomains of cognitive functioning, it seems conceivable that increasing physical activity would improve both grip strength and cognitive function in patients with hypertension.
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Affiliation(s)
- Manhua Zuo
- Hubei University for Nationalities Medical College, Enshi, Hubei Province, China
- Sichuan University, Chengdu, Sichuan Province, China
| | - Changping Gan
- Sichuan University, Chengdu, Sichuan Province, China
| | - Tingting Liu
- University of Arkansas Eleanor Mann School of Nursing, Fayetteville, AR, USA
| | - Jun Tang
- The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei Province, China
| | - Jianping Dai
- The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei Province, China
| | - Xiuying Hu
- Sichuan University, Chengdu, Sichuan Province, China
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The effect of primary total knee arthroplasty on the incidence of falls and balance-related functions in patients with osteoarthritis. Sci Rep 2017; 7:16583. [PMID: 29185496 PMCID: PMC5707373 DOI: 10.1038/s41598-017-16867-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/18/2017] [Indexed: 02/05/2023] Open
Abstract
Knee osteoarthritis (OA) is an established risk factor for falls and balance impairment. This study investigated the incidence of falls, balance-related outcomes and risk factors for falls before and after primary total knee arthroplasty (TKA). Three hundred seventy-six OA patients scheduled to undergo TKA were included. Falls data within the preoperative, first postoperative and second postoperative years were collected, balance-related functions were assessed using the Assessment of Quality of Life (AQoL), WOMAC, Falls Efficacy Scale International (FES-I), Activities-specific Balance Confidence (ABC), knee extension strength, Berg Balance Scale (BBS) and Timed Up and Go (TUG) before surgery and 1 and 2 years after surgery. Compared with preoperative values, the incidence of falls significantly decreased (14.89%, 6.23% and 3.14% within the preoperative, first postoperative and second postoperative years, respectively) and the AQoL, WOMAC, FES-I, ABC, knee extension strength, BBS and TUG significantly improved after TKA. Logistic regression analysis revealed that Kellgren-Lawrence grade ≥ 3 of the contralateral knee was an independent risk factor for falls before and after TKA. Conclusively, primary TKA is associated with a reduced incidence of falls and improved balance-related functions, and the contralateral knee should be considered in the design of fall-prevention strategies in patients with OA.
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26
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Zhang N, Chow SKH, Leung KS, Lee HH, Cheung WH. An animal model of co-existing sarcopenia and osteoporotic fracture in senescence accelerated mouse prone 8 (SAMP8). Exp Gerontol 2017; 97:1-8. [PMID: 28711604 DOI: 10.1016/j.exger.2017.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/26/2017] [Accepted: 07/11/2017] [Indexed: 12/14/2022]
Abstract
Sarcopenia and osteoporotic fracture are common aging-related musculoskeletal problems. Recent evidences report that osteoporotic fracture patients showed high prevalence of sarcopenia; however, current clinical practice basically does not consider sarcopenia in the treatment or rehabilitation of osteoporotic fracture. There is almost no report studying the relationship of the co-existing of sarcopenia and osteoporotic fracture healing. In this study, we validated aged senescence accelerated mouse prone 8 (SAMP8) and senescence accelerated mouse resistant 1 (SAMR1) as animal models of senile osteoporosis with/without sarcopenia. Bone mineral density (BMD) at the 5th lumbar and muscle testing of the two animal strains were measured to confirm the status of osteoporosis and sarcopenia, respectively. Closed fracture was created on the right femur of 8-month-old animals. Radiographs were taken weekly post-fracture. MicroCT and histology of the fractured femur were performed at week 2, 4 and 6 post-fracture, while mechanical test of both femora at week 4 and 6 post-fracture. Results showed that the callus of SAMR1 was significantly larger at week 2 but smaller at week 6 post-fracture than SAMP8. Mechanical properties were significantly better at week 4 post-fracture in SAMR1 than SAMP8, indicating osteoporotic fracture healing was delayed in sarcopenic SAMP8. This study validated an animal model of co-existing sarcopenia and osteoporotic fracture, where a delayed fracture healing might be resulted in the presence of sarcopenia.
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Affiliation(s)
- Ning Zhang
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Simon Kwoon Ho Chow
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, People's Republic of China
| | - Kwok Sui Leung
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Ho Hin Lee
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Wing Hoi Cheung
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, People's Republic of China.
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27
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Roshanravan B, Gamboa J, Wilund K. Exercise and CKD: Skeletal Muscle Dysfunction and Practical Application of Exercise to Prevent and Treat Physical Impairments in CKD. Am J Kidney Dis 2017; 69:837-852. [PMID: 28427790 DOI: 10.1053/j.ajkd.2017.01.051] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/04/2017] [Indexed: 12/25/2022]
Abstract
Patients with chronic kidney disease experience substantial loss of muscle mass, weakness, and poor physical performance. As kidney disease progresses, skeletal muscle dysfunction forms a common pathway for mobility limitation, loss of functional independence, and vulnerability to disease complications. Screening for those at high risk for mobility disability by self-reported and objective measures of function is an essential first step in developing an interdisciplinary approach to treatment that includes rehabilitative therapies and counseling on physical activity. Exercise has beneficial effects on systemic inflammation, muscle, and physical performance in chronic kidney disease. Kidney health providers need to identify patient and care delivery barriers to exercise in order to effectively counsel patients on physical activity. A thorough medical evaluation and assessment of baseline function using self-reported and objective function assessment is essential to guide an effective individualized exercise prescription to prevent function decline in persons with kidney disease. This review focuses on the impact of kidney disease on skeletal muscle dysfunction in the context of the disablement process and reviews screening and treatment strategies that kidney health professionals can use in clinical practice to prevent functional decline and disability.
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Affiliation(s)
- Baback Roshanravan
- Division of Nephrology, Department of Medicine, University of Washington Kidney Research Institute, Seattle, WA.
| | - Jorge Gamboa
- Vanderbilt University Medical Center, Nashville, TN
| | - Kenneth Wilund
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL
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