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Korsholm MB, Pødenphanth TW, Strømgaard SK, Petersen LW, Alexandersen C, Hoffmann SS, Rasmusen HK, Suetta C, Damgaard K, Pressel E, Dela F. Are statins making older persons weaker? A discontinuation study of muscular side effects. GeroScience 2024; 46:853-865. [PMID: 37225942 PMCID: PMC10828417 DOI: 10.1007/s11357-023-00817-2] [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: 12/01/2022] [Accepted: 05/02/2023] [Indexed: 05/26/2023] Open
Abstract
Thirteen percent of the Danish population are treated with a statin-half of these are in primary prevention, and most are > 65 years old. Statins have known muscular side effects (i.e., myalgia) correlated to reduced muscle performance. This study examines if years of statin treatment in older people introduce subclinical muscle discomfort and loss of muscle mass and strength. In total, 98 participants (71.1 ± 3.6 years (mean ± SD)), who were in primary prevention treatment for elevated plasma cholesterol with a statin, were included in this study. Statin treatment was discontinued for 2 months and then re-introduced for 2 months. Primary outcomes included muscle performance and myalgia. Secondary outcomes included lean mass and plasma cholesterol. Functional muscle capacity measured as a 6-min walk test increased after discontinuation (from 542 ± 88 to 555 ± 91 m, P < 0.05) and remained increased after re-introduction (557 ± 94 m). Similar significant results were found with a chair stand test (15.7 ± 4.3 to 16.3 ± 4.9 repetitions/30 s) and a quadriceps muscle test. Muscle discomfort during rest did not change significantly with discontinuation (visual analog scale from 0.9 ± 1.7 to 0.6 ± 1.4) but increased (P < 0.05) with the re-introduction (to 1.2 ± 2.0) and muscle discomfort during activity decreased (P < 0.05) with discontinuation (from 2.5 ± 2.6 to 1.9 ± 2.3). After 2 weeks of discontinuation, low-density lipoprotein cholesterol increased from 2.2 ± 0.5 to 3.9 ± 0.8 mM and remained elevated until the re-introduction of statins (P < 0.05). Significant and lasting improvements in muscle performance and myalgia were found at the discontinuation and re-introduction of statins. The results indicate a possible statin-related loss of muscle performance in older persons that needs further examination.
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Affiliation(s)
- Morten Bruun Korsholm
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
| | | | - Sofie Kirstine Strømgaard
- Department of Neurology and Geriatrics, Copenhagen University Hospital - Næstved, Slagelse and Ringsted, Slagelse, Denmark
| | - Linda Wiuff Petersen
- Department of Medicine, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark
| | - Christina Alexandersen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Sarah Samama Hoffmann
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
- Department of Neurology and Geriatrics, Copenhagen University Hospital - Næstved, Slagelse and Ringsted, Slagelse, Denmark
| | - Hanne K Rasmusen
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Charlotte Suetta
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
| | - Kirsten Damgaard
- Department of Neurology and Geriatrics, Copenhagen University Hospital - Næstved, Slagelse and Ringsted, Slagelse, Denmark
| | - Eckart Pressel
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
| | - Flemming Dela
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark.
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
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Peyrel P, Mauriège P, Frenette J, Laflamme N, Greffard K, Dufresne SS, Huth C, Bergeron J, Joanisse DR. Impact of statin withdrawal on perceived and objective muscle function. PLoS One 2023; 18:e0281178. [PMID: 37315062 DOI: 10.1371/journal.pone.0281178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/07/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND AND AIMS Statin-associated muscle symptoms (SAMS) are frequently reported. Nevertheless, few data on objective measures of muscle function are available. Recent data suggesting an important nocebo effect with statin use could confound such effects. The objective was to assess if subjective and objective measures of muscle function improve after drug withdrawal in SAMS reporters. METHODS Patients (59 men, 33 women, 50.3±9.6 yrs.) in primary cardiovascular prevention composed three cohorts: statin users with (SAMS, n = 61) or without symptoms (No SAMS, n = 15), and controls (n = 16) (registered at clinicaltrials.gov, NCT01493648). Force (F), endurance (E) and power (P) of the leg extensors (ext) and flexors (fle) and handgrip strength (Fhg) were measured using isokinetic and handheld dynamometers, respectively. A 10-point visual analogue scale (VAS) was used to self-assess SAMS intensity. Measures were taken before and after two months of withdrawal. RESULTS Following withdrawal, repeated-measures analyses show improvements for the entire cohort in Eext, Efle, Ffle, Pext and Pfle (range +7.2 to +13.3%, all p≤0.02). Post-hoc analyses show these changes to occur notably in SAMS (+8.8 to +16.6%), concurrent with a decrease in subjective perception of effects in SAMS (VAS, from 5.09 to 1.85). Fhg was also improved in SAMS (+4.0 to +6.2%) when compared to No SAMS (-1.7 to -4.2%) (all p = 0.02). CONCLUSIONS Whether suffering from "true" SAMS or nocebo, those who reported SAMS had modest but relevant improvements in muscle function concurrent with a decrease in subjective symptoms intensity after drug withdrawal. Greater attention by clinicians to muscle function in frail statin users appears warranted. TRIAL REGISTRATION This study is registered in clinicaltrials.gov (NCT01493648).
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Affiliation(s)
- Paul Peyrel
- Department of Kinesiology, Université Laval, Québec, Québec, Canada
- Research Center of the University Institute of Cardiology and Pulmonology of Quebec, Québec, Québec, Canada
| | - Pascale Mauriège
- Department of Kinesiology, Université Laval, Québec, Québec, Canada
- Research Center of the University Institute of Cardiology and Pulmonology of Quebec, Québec, Québec, Canada
| | - Jérôme Frenette
- CHU de Québec - Université Laval Research Center, Québec, Québec, Canada
- Department of Rehabilitation, Université Laval, Québec, Québec, Canada
| | - Nathalie Laflamme
- CHU de Québec - Université Laval Research Center, Québec, Québec, Canada
| | - Karine Greffard
- CHU de Québec - Université Laval Research Center, Québec, Québec, Canada
| | - Sébastien S Dufresne
- Department of Health Sciences, Université du Québec à Chicoutimi, Saguenay, Québec, Canada
| | - Claire Huth
- Department of Kinesiology, Université Laval, Québec, Québec, Canada
- Research Center of the University Institute of Cardiology and Pulmonology of Quebec, Québec, Québec, Canada
| | - Jean Bergeron
- CHU de Québec - Université Laval Research Center, Québec, Québec, Canada
- Department of Laboratory Medicine and of Medicine, Université Laval, Québec, Québec, Canada
| | - Denis R Joanisse
- Department of Kinesiology, Université Laval, Québec, Québec, Canada
- Research Center of the University Institute of Cardiology and Pulmonology of Quebec, Québec, Québec, Canada
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Risk factors predictive of adverse drug events and drug-related falls in aged care residents: secondary analysis from the ReMInDAR trial. Drugs Aging 2023; 40:49-58. [PMID: 36422825 PMCID: PMC9686455 DOI: 10.1007/s40266-022-00983-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Residents of aged-care facilities have high rates of adverse drug events. This study aimed to identify risk factors for adverse drug events in aged-care residents. METHOD This was a secondary study using data from a multicentre randomised controlled trial. Data from 224 residents for whom there was 6 months of baseline information were analysed. We assessed the risk of adverse drug events and falls (post hoc) in the subsequent 6 months. Adverse events were identified via a key word search of the resident care record and adjudicated by a multidisciplinary panel using a modified version of the Naranjo criteria. Covariates identified through univariable logistic regression, including age, sex, medicines, physical activity, cognition (Montreal Cognitive Assessment), previous adverse events and health service use were included in multivariable models. RESULTS Overall, 224 residents were included, with a mean age of 86 years; 70% were female. 107 (48%) residents had an adverse drug event during the 6-month follow-up. Falls and bleeding were experienced by 73 (33%) and 28 (13%) residents, respectively. Age (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.01-1.10), weight (OR 1.02, 95% CI 1.002-1.04), previous fall (OR 2.58, 95% CI 1.34-4.98) and sedative or hypnotic medicine use (OR 1.98, 95% CI 1.52-2.60) were associated with increased risk of adverse drug events. Increased cognition (OR 0.89, 95% CI 0.83-0.95) was protective. Risk factors for falls were previous fall (OR 3.27, 95% CI 1.68-6.35) and sedative or hypnotic medicines (OR 3.05, 95% CI 1.14-8.16). Increased cognition (OR 0.88, 95% CI 0.83-0.95) was protective. CONCLUSION Our results suggest residents with a previous fall, reduced cognition, and prescription of sedative or hypnotic medicines were at higher risk of adverse drug events and should be considered for proactive prevention.
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Roughead EE, Pratt NL, Parfitt G, Rowett D, Kalisch-Ellett LM, Bereznicki L, Merlin T, Corlis M, Kang AC, Whitehouse J, Bilton R, Schubert C, Torode S, Kelly TL, Andrade AQ, Post D, Dorj G, Cousins J, Williams M, Lim R. Effect of an ongoing pharmacist service to reduce medicine-induced deterioration and adverse reactions in aged-care facilities (nursing homes): a multicentre, randomised controlled trial (the ReMInDAR trial). Age Ageing 2022; 51:6572256. [PMID: 35460410 PMCID: PMC9034696 DOI: 10.1093/ageing/afac092] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Indexed: 01/04/2023] Open
Abstract
Objective To assess the effectiveness of a pharmacist-led intervention using validated tools to reduce medicine-induced deterioration and adverse reactions. Design and setting Multicenter, open-label parallel randomised controlled trial involving 39 Australian aged-care facilities. Participants Residents on ≥4 medicines or ≥1 anticholinergic or sedative medicine. Intervention Pharmacist-led intervention using validated tools to detect signs and symptoms of medicine-induced deterioration which occurred every 8 weeks over 12 months. Comparator Usual care (Residential Medication Management Review) provided by accredited pharmacists. Outcomes Primary outcome was change in Frailty Index at 12 months. Secondary outcomes included changes in cognition, 24-hour movement behaviour by accelerometry, grip strength, weight, adverse events and quality of life. Results 248 persons (median age 87 years) completed the study; 120 in the interventionand, 128 in control arms. In total 575 pharmacist, sessions were undertaken in the intervention arm. There was no statistically significant difference for change in frailty between groups (mean difference: 0.009, 95% CI: −0.028, 0.009, P = 0.320). A significant difference for cognition was observed, with a mean difference of 1.36 point change at 12 months (95% CI: 0.01, 2.72, P = 0.048). Changes in 24-hour movement behaviour, grip strength, adverse events and quality of life were not significantly different between groups. Point estimates favoured the intervention arm at 12 months for frailty, 24-hour movement behaviour and grip strength. Conclusions The use of validated tools by pharmacists to detect signs of medicine-induced deterioration is a model of practice that requires further research, with promising results from this trial, particularly with regards to improved cognition.
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Affiliation(s)
- Elizabeth E Roughead
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Nicole L Pratt
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Gaynor Parfitt
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Debra Rowett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Lisa M Kalisch-Ellett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Luke Bereznicki
- School of Medicine, University of Tasmania, Tasmania, TAS, Australia
| | - Tracy Merlin
- Adelaide Health Technology Assessment, School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Megan Corlis
- Australian Nursing and Midwifery Federation (SA Branch), Ridleyton, SA, Australia
| | - Ai Choo Kang
- University of South Australia, Adelaide, SA, Australia
| | | | - Rebecca Bilton
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Camille Schubert
- Adelaide Health Technology Assessment, School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Stacey Torode
- University of South Australia, Adelaide, SA, Australia
| | - Thu-Lan Kelly
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Andre Q Andrade
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Dannielle Post
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Gereltuya Dorj
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Justin Cousins
- School of Medicine, University of Tasmania, Tasmania, TAS, Australia
| | | | - Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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MacKinlay E. Ageing and frailty: a spiritual perspective of the lived experience. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2020. [DOI: 10.1080/15528030.2020.1845279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Slee A, McKeaveney C, Adamson G, Davenport A, Farrington K, Fouque D, Kalantar-Zadeh K, Mallett J, Maxwell AP, Mullan R, Noble H, O'Donoghue D, Porter S, Seres DS, Shields J, Witham M, Reid J. Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients. J Ren Nutr 2020; 30:313-321. [DOI: 10.1053/j.jrn.2019.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/26/2019] [Accepted: 09/08/2019] [Indexed: 11/11/2022] Open
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Orr J, Kenny RA, McGarrigle CA. Longitudinal Associations of Religiosity and Physical Function in Older Irish Adults. J Am Geriatr Soc 2020; 68:1998-2005. [PMID: 32329903 DOI: 10.1111/jgs.16470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/04/2020] [Accepted: 03/26/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Research into the link between religion and physical function has shown inconsistent results. Most studies have used self-reported measures of physical function, and many have excluded those who are not religious and only compared levels of religious engagement within those groups that are religious. We aimed to assess the longitudinal associations of religious affiliation and religious attendance on two objective measures of physical function. DESIGN Longitudinal study using five waves of data from the Irish Longitudinal Study on Ageing (TILDA). SETTING Community-dwelling adults in Ireland. PARTICIPANTS Adults aged 50 and over who participated in two or more waves of TILDA (n = 6,122),and a supplementary analysis of a sub-sample aged 65 and over (n = 2,359). MEASUREMENTS Timed Up and Go (TUG) and grip strength were measured on at least two occasions. Data were collected approximately every 2 years over 10 years. Longitudinal linear mixed effects models were estimated to calculate the effect of religious affiliation and attendance on TUG and grip strength over time. RESULTS TUG scores increased by an average of .1 seconds with each year of age, which increased to .3 seconds by age 72 years. Grip strength scores decreased by .2 kg with each year of age and increased to -.3 kg per year by age 72. No overall differences were observed between religious affiliations in scores of TUG or grip strength. CONCLUSION Religious affiliation does not predict performance on objective physical function measures. Results are discussed with reference to the changing religious characteristics of the Irish population.
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Affiliation(s)
- Joanna Orr
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James' Hospital, Dublin, Ireland
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8
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Verde Z, García de Diego L, Chicharro LM, Bandrés F, Velasco V, Mingo T, Fernández-Araque A. Physical Performance and Quality of Life in Older Adults: Is There Any Association between Them and Potential Drug Interactions in Polymedicated Octogenarians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214190. [PMID: 31671923 PMCID: PMC6862508 DOI: 10.3390/ijerph16214190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/18/2019] [Accepted: 10/28/2019] [Indexed: 01/16/2023]
Abstract
Older adults are at increased risk of several cytochrome P450 (CYP) drug interactions that can result in drug toxicity, reduced pharmacological effect, and adverse drug reactions. This study aimed to assess the prevalence of potential CYP interactions referring to the most clinically relevant drugs and exploring the relationship between them and quality of life and physical performance in Spanish octogenarians. Institutionalized and community-dwelling octogenarians (n = 102) treated at three primary care centers, were recruited by a research nurse. Anthropometric measurements, chronic diseases, prescribed drugs, quality of life, physical performance, mobility skills, hand grip strength and cognitive status data were collected. Potential CYP drug-drug interactions (DDIs) were selected referring to the main CYP implicated in their metabolism. The 72.2% of recruited octogenarians presented potentially inappropriate CYP inhibitor-substrate or CYP inductor-substrate combinations. Analyzing the EuroQol Visual Analogue scale (EQ-VAS) results, patients with a potential CYP DDI perceived worse health status than patients without it (p = 0.004). In addition, patients with a potential CYP DDI presented worse exercise capacity, kinesthetic abilities, or mobility than those who didn’t present a potential interaction (p = 0.01, p = 0.047, and p = 0.02, respectively). To investigate and control factors associated with loss of muscle strength and poor quality of life, polypharmacy and DDIs could help institutions in the management of physical frailty.
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Affiliation(s)
- Zoraida Verde
- Department of Biochemistry, Molecular Biology and Physiology, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain.
| | - Laura García de Diego
- Department of Nursery, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain.
| | - Luis M Chicharro
- Cátedra Complutense Diagnostic and Innovation, Universidad Complutense, 28040 Madrid, Spain.
| | - Fernando Bandrés
- Cátedra Complutense Diagnostic and Innovation, Universidad Complutense, 28040 Madrid, Spain.
- Department of Toxicology and Health Sanitary, Universidad Complutense, 28040 Madrid, Spain.
| | - Verónica Velasco
- Department of Nursery, Universidad de Valladolid, 47005 Valladolid, Spain.
| | - Teresa Mingo
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain.
| | - Ana Fernández-Araque
- Department of Nursery, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain.
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MORVILLE THOMAS, DOHLMANN TINELOVSØ, KUHLMAN ANJABIRK, SAHL RONNIEG, KRIEGBAUM MARGIT, LARSEN STEEN, DELA FLEMMING, HELGE JØRNWULFF. Aerobic Exercise Performance and Muscle Strength in Statin Users—The LIFESTAT Study. Med Sci Sports Exerc 2019; 51:1429-1437. [DOI: 10.1249/mss.0000000000001920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Syddall HE, Simmonds SJ, Carter SA, Robinson SM, Dennison EM, Cooper C. The Hertfordshire Cohort Study: an overview. F1000Res 2019; 8:82. [PMID: 30828442 PMCID: PMC6381804 DOI: 10.12688/f1000research.17457.1] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 12/24/2022] Open
Abstract
The Hertfordshire Cohort Study is a nationally unique study of men and women born in the English county of Hertfordshire in the early part of the 20
th century. Records that detail their health in infancy and childhood have been preserved, their sociodemographic, lifestyle, medical and biological attributes have been characterised in later life, and routinely collected data on their hospital use and mortality have been acquired. This paper provides an overview of the study since its inception in the 1980s, including its methods, findings, and plans for its future.
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Affiliation(s)
- Holly E Syddall
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK
| | | | - Sarah A Carter
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK
| | - Sian M Robinson
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, Hampshire, SO16 6YD, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton, Hampshire, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, Hampshire, SO16 6YD, UK.,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, Oxfordshire, OX3 7LD, UK
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11
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Dias VDN, Lemos AFD, Lima Filho BFD, Lira MDGDA, Cavalcanti FADC, Gazzola JM. Palmar strength and sociodemographic, clinical-functional, and psycho-cognitive factors in elderly with Diabetes Mellitus. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: An important consequence of the aging of people with DM2 is physical disability, particularly the loss of mobility. Objective: To determine sociodemographic, clinical-functional, and psycho-cognitive factors related to the reduction in hand grip strength (HGS) in elderly patients with type 2 diabetes mellitus (DM2) and to verify the relationship between HGS and fragility. Method: This is an observational cross-sectional study with 156 elderly individuals aged 60 years and over, both male and female, diagnosed with DM2. The participants were assessed according to sociodemographic, clinical-functional, psycho-cognitive, and functional mobility data. HGS was evaluated using a manual dynamometer. The tests performed were: Mann-Whitney or Kruskal-Wallis, and Chi-square. The level of significance was set at 5% (p < 0.05). Results: A significant relationship was observed between HGS and each of the following: sex (p < 0.001), age range (p = 0.04), marital status (p = 0.004), physical activity (p = 0.06), number of conditions diagnosed (p = 0.002), use of insulin therapy (p = 0.03), complaint of pain in lower limb power (p < 0.001), falls in the last year (p = 0.004), fear of falling (p = 0.003), Mini-Mental State Examination (p = 0.01), Geriatric Depression Scale (p = 0.008), fragility phenotype (p < 0.001). Conclusion: HGS was reduced in elderly women with DM2, those who did not have a marital life had five or more diseases diagnosed with insulin therapy, did not engage in regular physical activity, complained of lower limb pain, had a history of two or more falls in the last year, had a fear of falling, had a cognitive deficit, had depressive symptoms, and were fragile.
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12
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Hand strength in patients with RA correlates strongly with function but not with activity of disease. Adv Rheumatol 2018; 58:20. [DOI: 10.1186/s42358-018-0020-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 07/13/2018] [Indexed: 11/10/2022] Open
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Abstract
PURPOSE OF REVIEW This review examined studies published within the last 16 months that investigated the relationship between statins and physical activity. RECENT FINDINGS These recent studies suggest that statins do not adversely affect cardiorespiratory fitness, muscle strength, athletic performance, or physical activity adherence. One recent study comparing patients with statin-associated myalgia and nonstatin-using controls did report that statins are associated with a slowing of time to peak power output, increased abdominal adiposity, and insulin resistance. Statin users also had different muscle gene expression than controls, but conclusions are limited by the design of that study. SUMMARY Previous reports suggest that statin-associated muscle symptoms such as myalgia, cramps, and weakness occur more frequently in physically active individuals, but the recent studies we reviewed do not provide additional support for this possibility. Well-designed clinical trials are needed to determine whether different statins or statin doses evoke statin-associated muscle symptoms or muscle damage that may reduce cardiorespiratory fitness and adherence to physical activity.
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Prasitsiriphon O, Pothisiri W. Associations of Grip Strength and Change in Grip Strength With All-Cause and Cardiovascular Mortality in a European Older Population. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2018; 12:1179546818771894. [PMID: 29881318 PMCID: PMC5987902 DOI: 10.1177/1179546818771894] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 03/28/2018] [Indexed: 12/31/2022]
Abstract
Objective: (1) To examine the associations between 3 measures of grip strength: static
grip strength, change in grip strength, and the combination of grip strength
and its change, with all-cause and cardiovascular mortality, and (2) to
determine which measure is the most powerful predictor of all-cause and
cardiovascular mortality among the European older population. Method: Data come from the first 4 waves of the Survey of Health, Ageing and
Retirement in Europe (SHARE). A Cox proportional hazard model and a
competing risk regression model were used to assess the associations. To
determine the best predictor, Akaike information criterion was applied. Results: Grip strength and the combination of grip strength and its change were
associated with all-cause and cardiovascular mortality. Change in grip
strength was correlated with only all-cause mortality. Among the 3 measures,
the static measure of grip strength was the best predictor of cardiovascular
mortality whereas the combined measure is that of all-cause mortality. Discussion: Grip strength is a significant indicator of all-cause and cardiovascular
mortality. The combination of grip strength and its change can be used to
increase the accuracy for prediction of all-cause mortality among older
persons.
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Affiliation(s)
- Orawan Prasitsiriphon
- College of Population Studies, Chulalongkorn University, Bangkok, Thailand.,Population program, International Institute for Applied Systems Analysis (IIASA), Vienna, Austria
| | - Wiraporn Pothisiri
- College of Population Studies, Chulalongkorn University, Bangkok, Thailand
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Noyes AM, Thompson PD. The effects of statins on exercise and physical activity. J Clin Lipidol 2017; 11:1134-1144. [PMID: 28807461 DOI: 10.1016/j.jacl.2017.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE We sought to review studies examining the effect of statins on symptoms of exercise tolerance, markers of muscle injury and activity levels in physical active individuals. BACKGROUND Statin therapy reduces atherosclerotic cardiovascular disease (CVD) events. Regular physical activity is also associated with reduced CVD events, but statin therapy can produce muscle complaints, which may be more frequent in physically active individuals. We reviewed the literature to determine the effects of statins on symptoms, exercise performance and activity levels in physically active individuals. METHODS We performed a PubMed search to identify English language articles reporting on statins and their effect on athletic/exercise performance, and symptoms in active individuals. RESULTS We identified 65 articles, 32 of which provided sufficient information to be included in this review. Seventeen of the 32 studies examined the incidence of myalgia while exercising on statins, and showed that myalgia was increased in 8 of the 17 (47%) of these studies. Of the 17 studies examining the effects of statin therapy on muscle injury, 6 (35%) studies reported that statins augment the increase in creatine kinase (CK) produced by exercise. There were 10 studies that examined statin effects on aerobic exercise performance, only 3 of which (33%) concluded that statins decreased performance. Two (25%) of the 8 studies examined the effects of statins on muscular strength and suggested that statins decreased muscular strength, whereas 2 (25%) reported increased strength. Statins did not consistently affect physical activity levels since statins were associated with an increase in activity in 3 of the 5 studies examining habitual exercise. None of the studies showed a relationship between statins use and exercise and an increase in myalgia or a decrease in exercise performance. There was also no correlation between intensity of statin therapy and an effect on these variables. CONCLUSION Statins may increase the incidence of exercise-related muscle complaints and in some studies augment the exercise-induced rise in muscle enzymes, but statins do not consistently reduce muscle strength, endurance, overall exercise performance or physical activity.
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Affiliation(s)
- Adam M Noyes
- Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Paul D Thompson
- Division of Cardiology, Department of Medicine, Hartford Hospital, Hartford, CT, USA
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16
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Kilsby AJ, Sayer AA, Witham MD. Selecting Potential Pharmacological Interventions in Sarcopenia. Drugs Aging 2017; 34:233-240. [DOI: 10.1007/s40266-017-0444-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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17
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Southern WM, Nichenko AS, Shill DD, Spencer CC, Jenkins NT, McCully KK, Call JA. Skeletal muscle metabolic adaptations to endurance exercise training are attainable in mice with simvastatin treatment. PLoS One 2017; 12:e0172551. [PMID: 28207880 PMCID: PMC5313210 DOI: 10.1371/journal.pone.0172551] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/06/2017] [Indexed: 01/02/2023] Open
Abstract
We tested the hypothesis that a 6-week regimen of simvastatin would attenuate skeletal muscle adaptation to low-intensity exercise. Male C57BL/6J wildtype mice were subjected to 6-weeks of voluntary wheel running or normal cage activities with or without simvastatin treatment (20 mg/kg/d, n = 7-8 per group). Adaptations in in vivo fatigue resistance were determined by a treadmill running test, and by ankle plantarflexor contractile assessment. The tibialis anterior, gastrocnemius, and plantaris muscles were evaluated for exercised-induced mitochondrial adaptations (i.e., biogenesis, function, autophagy). There was no difference in weekly wheel running distance between control and simvastatin-treated mice (P = 0.51). Trained mice had greater treadmill running distance (296%, P<0.001), and ankle plantarflexor contractile fatigue resistance (9%, P<0.05) compared to sedentary mice, independent of simvastatin treatment. At the cellular level, trained mice had greater mitochondrial biogenesis (e.g., ~2-fold greater PGC1α expression, P<0.05) and mitochondrial content (e.g., 25% greater citrate synthase activity, P<0.05), independent of simvastatin treatment. Mitochondrial autophagy-related protein contents were greater in trained mice (e.g., 40% greater Bnip3, P<0.05), independent of simvastatin treatment. However, Drp1, a marker of mitochondrial fission, was less in simvastatin treated mice, independent of exercise training, and there was a significant interaction between training and statin treatment (P<0.022) for LC3-II protein content, a marker of autophagy flux. These data indicate that whole body and skeletal muscle adaptations to endurance exercise training are attainable with simvastatin treatment, but simvastatin may have side effects on muscle mitochondrial maintenance via autophagy, which could have long-term implications on muscle health.
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Affiliation(s)
- William M. Southern
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States of America
| | - Anna S. Nichenko
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States of America
| | - Daniel D. Shill
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States of America
| | - Corey C. Spencer
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States of America
| | - Nathan T. Jenkins
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States of America
| | - Kevin K. McCully
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States of America
| | - Jarrod A. Call
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States of America
- Regenerative Bioscience Center, University of Georgia, Athens, Georgia, United States of America
- * E-mail:
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18
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Boban M, Barisic M, Persic V, Zekanovic D, Medved I, Zulj M, Vcev A. Muscle strength differ between patients with diabetes and controls following heart surgery. J Diabetes Complications 2016; 30:1287-92. [PMID: 27368124 DOI: 10.1016/j.jdiacomp.2016.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 05/20/2016] [Accepted: 06/04/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND The aim of our study was to analyze muscle strength in patients with recent surgical treatment for ischemic and combined ischemic-valvular heart disease, based on existence of diabetes mellitus. Connections existing between muscle strength and patient characteristics or conventional diagnostic tests were analyzed as well. METHODS Study prospectively included consecutive patients scheduled for cardiovascular rehabilitation 0-3months after heart surgery. Diagnostics covered drug utilization, anthropometrics, demographics, echocardiography, conventional laboratory, echocardiography, bioelectrical impedance analysis (BIA), and hand grip test (HGT). HGT was analyzed for dominant hand. RESULTS Patients with diabetes had significantly weaker muscle strength on HGT than controls; 29.4±12.2kg vs. 38.2±14.7kg (p=0.029), respectively. ROC analysis for HGT and existence of diabetes mellitus were significant; ≤40kg had sensitivity of 89.7% (95%CI: 72.6-97.8), specificity 43.7% (31.9-56.0); AUC 0.669 (0.568-0.760); p=0.002. HGT significantly correlated with hematocrit (Rho CC=0.247; p=0.013), whilst other laboratory or echocardiographic parameters were insignificant (all p>0.05). HGT also correlated with body weight (Rho CC=0.510; p<0.001); height (Rho CC=0.632; p<0.001); waist circumference (Rho CC=0.388; p<0.001); waist-to-hip ratio (Rho CC=0.274; p=0.006) and BIA (Rho CC=-0.412; p<0.001). CONCLUSIONS In postoperative recovery of patients with diabetes, muscle strength assessed by HGT is decreased and in relation with nutritional status. Clinically resourceful connections of HGT were also found to hematocrit and utilization of loop diuretics.
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Affiliation(s)
- Marko Boban
- Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Croatia; Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia.
| | - Mijana Barisic
- Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Croatia
| | - Viktor Persic
- Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Croatia; Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia
| | | | - Igor Medved
- Department of Cardiac Surgery, Medical Faculty University of Rijeka, University Hospital Centre "Rijeka", Croatia
| | - Marinko Zulj
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia
| | - Aleskandar Vcev
- Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia
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De Spiegeleer A, Petrovic M, Boeckxstaens P, Van Den Noortgate N. Treating sarcopenia in clinical practice: where are we now? Acta Clin Belg 2016; 71:197-205. [PMID: 27112427 DOI: 10.1080/17843286.2016.1168064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Sarcopenia - or the loss of muscle mass, strength and function with ageing - represents an important health issue of the twenty-first century because of its devastating effects in addition to an increased prevalence of aged people. The devastating health effects of sarcopenia are multiple: an increased falls risk, a decreased physical ability and quality of life and an independent increase of all-cause mortality. Although the ultimate remedy for sarcopenia yet has to be found, some interventions have proven their merit and might be of practical use in clinical practice, especially for geriatricians, who deal most with sarcopenia. This review intends to summarize the current therapeutic interventions, their proposed mechanism of action as well as their clinical value. The results of our review highlight the importance of exercise (50% resistance training, 50% endurance training), nutrition (25-30 g proteins with essential amino acids every meal and long-chain ω-3 fatty acids) and limitation of alcohol and smoking. In addition, studies also suggest a place for vitamin D (aim serum levels >30 ng/L), testosterone (aim serum levels >300 ng/dL) and creatine (15-20 g/d for five days, thereafter 3-5 g/d). In conclusion, although more studies are needed to elucidate the exact effectiveness and safety of many sarcopenia interventions, the current evidence already provides clinically useful information, which might benefit the patient with (pre-)sarcopenia.
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20
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Associations Between Statin Use and Physical Function in Older Adults from The Netherlands and Australia: Longitudinal Aging Study Amsterdam and Australian Longitudinal Study on Women’s Health. Drugs Aging 2016; 33:437-45. [DOI: 10.1007/s40266-016-0370-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology 2016; 17:567-80. [PMID: 26936444 PMCID: PMC4889622 DOI: 10.1007/s10522-016-9641-0] [Citation(s) in RCA: 619] [Impact Index Per Article: 77.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 02/19/2016] [Indexed: 12/24/2022]
Abstract
Regular physical activity helps to improve physical and mental functions as well as reverse some effects of chronic disease to keep older people mobile and independent. Despite the highly publicised benefits of physical activity, the overwhelming majority of older people in the United Kingdom do not meet the minimum physical activity levels needed to maintain health. The sedentary lifestyles that predominate in older age results in premature onset of ill health, disease and frailty. Local authorities have a responsibility to promote physical activity amongst older people, but knowing how to stimulate regular activity at the population-level is challenging. The physiological rationale for physical activity, risks of adverse events, societal and psychological factors are discussed with a view to inform public health initiatives for the relatively healthy older person as well as those with physical frailty. The evidence shows that regular physical activity is safe for healthy and for frail older people and the risks of developing major cardiovascular and metabolic diseases, obesity, falls, cognitive impairments, osteoporosis and muscular weakness are decreased by regularly completing activities ranging from low intensity walking through to more vigorous sports and resistance exercises. Yet, participation in physical activities remains low amongst older adults, particularly those living in less affluent areas. Older people may be encouraged to increase their activities if influenced by clinicians, family or friends, keeping costs low and enjoyment high, facilitating group-based activities and raising self-efficacy for exercise.
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22
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Antihypertensive and Statin Medication Use and Motor Function in Community-Dwelling Older Adults. J Am Med Dir Assoc 2016; 17:220-4. [PMID: 26597419 PMCID: PMC4769919 DOI: 10.1016/j.jamda.2015.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/07/2015] [Accepted: 10/07/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To investigate whether the use of antihypertensive and statin medication in very old adults is associated with the level of motor performance. DESIGN Cross-sectional study. SETTINGS A community-based study recruited from over 40 residential facilities across the metropolitan Chicago area. PARTICIPANTS Community-dwelling very old adults (n = 1520; mean age 80.2; standard deviation 7.7). MEASUREMENTS Eleven motor performances were summarized using a composite motor score. All prescription and over the counter medications taken by participants were inspected and coded using the Medi-Span Data Base System. Demographic characteristics and medical history were obtained by means of detailed interview and medical examinations. RESULTS In multiple linear regression models, antihypertensive medications were associated with global motor score [β = -0.075, standard error (SE) 0.011, P < .001]. Thus, motor function in an individual with antihypertensive medication, was on average, about 7.5% lower than an age-, sex-, and education-matched individual without antihypertensive medication. The number of antihypertensive medications, which were being used had an additive effect, such that a reduction in the level of motor function was observed with each additional medication, and receiving 3 or more antihypertensive medications was associated with about a 15% reduction in the level of motor function. The association between antihypertensive medications and motor function was robust, and remained unchanged after adjusting for confounding by indication using several potentially confounding variables: smoking, hypertension, diabetes, stroke, congestive heart failure, myocardial infarction, and intermittent claudication (β = -0.05, SE 0.015, P = .001). In contrast, the use of statin medications was not related to motor function (unadjusted: β = 0.003, SE 0.015, P = .826; fully adjusted: β = 0.018, SE 0.014, P = .216). CONCLUSIONS The use of antihypertensive medications is associated with a lower level of motor function in very old adults. The nature of this association warrants further investigation.
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23
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Rengo JL, Callahan DM, Savage PD, Ades PA, Toth MJ. Skeletal muscle ultrastructure and function in statin-tolerant individuals. Muscle Nerve 2015; 53:242-51. [PMID: 26059690 DOI: 10.1002/mus.24722] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2015] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Statins have well-known benefits on cardiovascular mortality, though up to 15% of patients experience side effects. With guidelines from the American Heart Association, American College of Cardiology, and American Diabetes Association expected to double the number of statin users, the overall incidence of myalgia and myopathy will increase. METHODS We evaluated skeletal muscle structure and contractile function at the molecular, cellular, and whole tissue levels in 12 statin tolerant and 12 control subjects. RESULTS Myosin isoform expression, fiber type distributions, single fiber maximal Ca(2+) -activated tension, and whole muscle contractile force were similar between groups. No differences were observed in myosin-actin cross-bridge kinetics in myosin heavy chain I or IIA fibers. CONCLUSIONS We found no evidence for statin-induced changes in muscle morphology at the molecular, cellular, or whole tissue levels. Collectively, our data show that chronic statin therapy in healthy asymptomatic individuals does not promote deleterious myofilament structural or functional adaptations.
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Affiliation(s)
- Jason L Rengo
- Department of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Damien M Callahan
- Department of Medicine, University of Vermont, College of Medicine, Burlington, Vermont, USA.,Department of Molecular Physiology and Biophysics, University of Vermont, College of Medicine, Burlington, Vermont, USA
| | - Patrick D Savage
- Department of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Philip A Ades
- Department of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA.,Department of Medicine, University of Vermont, College of Medicine, Burlington, Vermont, USA
| | - Michael J Toth
- Department of Medicine, University of Vermont, College of Medicine, Burlington, Vermont, USA.,Department of Molecular Physiology and Biophysics, University of Vermont, College of Medicine, Burlington, Vermont, USA
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Panza GA, Taylor BA, Dada MR, Thompson PD. Changes in muscle strength in individuals with statin-induced myopathy: A summary of 3 investigations. J Clin Lipidol 2015; 9:351-6. [DOI: 10.1016/j.jacl.2015.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/05/2015] [Accepted: 01/18/2015] [Indexed: 10/24/2022]
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25
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Lenardt MH, Grden CRB, Sousa JAVD, Reche PM, Betiolli SE, Ribeiro DKDMN. [Factors associated with loss of handgrip strength in long-lived elderly]. Rev Esc Enferm USP 2015; 48:1006-12. [PMID: 25626499 DOI: 10.1590/s0080-623420140000700007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/18/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of reduced grip strength and associated factors in long-lived elderly, who are users of primary health care. METHOD Cross-sectional quantitative study, data were collected during the period of January to December of 2013, by applying tests and questionnaires. The convenience sampling was comprised of 157 seniors. RESULTS The findings indicate that the reduction in grip strength presents a moderate prevalence (25.5%), predominantly among females (19.1%), in the age group of 80-89 years (18.5%) and in those with lower educational levels (15.9%). The association between reduced grip strength and the variables of age and body mass index showed a statistical significance. CONCLUSION Investigations about the handgrip strength are essential for identifying clinical conditions of Brazilian long-lived elderly, and contribute to the development of plans towards the management of frailty.
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26
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Witham MD, Syddall HE, Dennison E, Cooper C, McMurdo MET, Sayer AA. ACE inhibitors, statins and thiazides: no association with change in grip strength among community dwelling older men and women from the Hertfordshire Cohort Study. Age Ageing 2014; 43:661-6. [PMID: 24522120 DOI: 10.1093/ageing/afu008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND vascular disease has been postulated to contribute to muscle dysfunction in old age. Previous studies examining the effects of cardiovascular drugs on muscle function have shown conflicting results. We therefore examined the association of angiotensin converting enzyme (ACE) inhibitor, thiazide and statin use with decline in grip strength in a well-characterised cohort. METHODS we analysed prospectively collected data from the Hertfordshire Cohort Study (HCS). For each medication, participants were divided into no baseline use/no use at follow-up, baseline use/no use at follow-up, no baseline use but use at follow-up and use at baseline and follow-up. For each group, annualised decline in grip strength (kg per year) was calculated, then adjusted for baseline age, height, weight, baseline grip strength, indices of ischaemic heart disease and hypertension. Analyses were conducted separately for males and females. RESULTS 639 participants were included in the analysis, mean age 65 years. 321 (50%) were male; mean follow-up time was 4.4 years. There were no differences in baseline grip between baseline users and non-users of any drug class. Adjusted grip strength change per year was similar for each group of ACE inhibitor use (P > 0.05). Similar analyses revealed no significant between-group differences for statin or thiazide use. Analysis of dropout rates by medication use revealed no evidence of selection bias. CONCLUSION use of ACE inhibitors, statins or thiazides was not associated with differences in grip strength decline in healthy older people in the HCS.
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Affiliation(s)
- Miles D Witham
- Section of Ageing and Health, University of Dundee, Ninewells Hospital, Dundee DD1 9SY, UK
| | - Holly E Syddall
- MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton SO16 6YD, UK
| | - Elaine Dennison
- MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton SO16 6YD, UK
| | - Marion E T McMurdo
- Department of Medicine, University of Dundee, Ninewells Hospital, Dundee DD1 9SY, UK
| | - Avan Aihie Sayer
- MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital Tremona Road, Southampton SO16 6YD, UK
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Verschuur C, Agyemang-Prempeh A, Newman TA. Inflammation is associated with a worsening of presbycusis: Evidence from the MRC national study of hearing. Int J Audiol 2014; 53:469-75. [DOI: 10.3109/14992027.2014.891057] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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28
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Macedo AF, Taylor FC, Casas JP, Adler A, Prieto-Merino D, Ebrahim S. Unintended effects of statins from observational studies in the general population: systematic review and meta-analysis. BMC Med 2014; 12:51. [PMID: 24655568 PMCID: PMC3998050 DOI: 10.1186/1741-7015-12-51] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/28/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Efficacy of statins has been extensively studied, with much less information reported on their unintended effects. Evidence from randomized controlled trials (RCTs) on unintended effects is often insufficient to support hypotheses generated from observational studies. We aimed to systematically assess unintended effects of statins from observational studies in general populations with comparison of the findings where possible with those derived from randomized trials. METHODS Medline (1998 to January 2012, week 3) and Embase (1998 to 2012, week 6) were searched using the standard BMJ Cohort studies filter. The search was supplemented with reference lists of all identified studies and contact with experts in the field. We included prospective studies with a sample size larger than 1,000 participants, case control (of any size) and routine health service linkage studies of over at least one year duration. Studies in subgroups of patients or follow-up of patient case series were excluded, as well as hospital-based cohort studies. RESULTS Ninety studies were identified, reporting on 48 different unintended effects. Statins were associated with lower risks of dementia and cognitive impairment, venous thrombo-embolism, fractures and pneumonia, but these findings were attenuated in analyses restricted to higher quality studies (respectively: OR 0.74 (95% CI 0.62 to 0.87); OR 0.92 (95% CI 0.81 to 1.03); OR 0.97 (95% CI 0.88 to 1.05); OR 0.92 (95% CI 0.83 to 1.02)); and marked heterogeneity of effects across studies remained. Statin use was not related to any increased risk of depression, common eye diseases, renal disorders or arthritis. There was evidence of an increased risk of myopathy, raised liver enzymes and diabetes (respectively: OR 2.63 (95% CI 1.50 to 4.61); OR 1.54 (95% CI 1.47 to 1.62); OR 1.31 (95% CI 0.99 to 1.73)). CONCLUSIONS Our systematic review and meta-analyses indicate that high quality observational data can provide relevant evidence on unintended effects of statins to add to the evidence from RCTs. The absolute excess risk of the observed harmful unintended effects of statins is very small compared to the beneficial effects of statins on major cardiovascular events.
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Affiliation(s)
- Ana Filipa Macedo
- Cochrane Heart Group, London School of Hygiene and Tropical Medicine, London, UK
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Fiona Claire Taylor
- Cochrane Heart Group, London School of Hygiene and Tropical Medicine, London, UK
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Juan P Casas
- Cochrane Heart Group, London School of Hygiene and Tropical Medicine, London, UK
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Cardiovascular Science, University College London, London, UK
| | - Alma Adler
- Cochrane Heart Group, London School of Hygiene and Tropical Medicine, London, UK
| | - David Prieto-Merino
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Shah Ebrahim
- Cochrane Heart Group, London School of Hygiene and Tropical Medicine, London, UK
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Sayer AA, Robinson SM, Patel HP, Shavlakadze T, Cooper C, Grounds MD. New horizons in the pathogenesis, diagnosis and management of sarcopenia. Age Ageing 2013; 42:145-50. [PMID: 23315797 PMCID: PMC3575121 DOI: 10.1093/ageing/afs191] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia is the age-related loss of skeletal muscle mass and function. It is now recognised as a major clinical problem for older people and research in the area is expanding exponentially. One of the most important recent developments has been convergence in the operational definition of sarcopenia combining measures of muscle mass and strength or physical performance. This has been accompanied by considerable progress in understanding of pathogenesis from animal models of sarcopenia. Well-described risk factors include age, gender and levels of physical activity and this knowledge is now being translated into effective management strategies including resistance exercise with recent interest in the additional role of nutritional intervention. Sarcopenia is currently a major focus for drug discovery and development although there remains debate about the best primary outcome measure for trials, and various promising avenues to date have proved unsatisfactory. The concept of 'new tricks for old drugs' is, however, promising, for example, there is some evidence that the angiotensin-converting enzyme inhibitors may improve physical performance. Future directions will include a deeper understanding of the molecular and cellular mechanisms of sarcopenia and the application of a lifecourse approach to understanding aetiology as well as to informing the optimal timing of interventions.
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Affiliation(s)
- Avan Aihie Sayer
- Academic Geriatric Medicine, University of Southampton, Southampton, UK.
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Haerer W, Delbaere K, Bartlett H, Lord SR, Rowland J. Relationships between HMG-CoA reductase inhibitors (statin) use and strength, balance and falls in older people. Intern Med J 2012; 42:1329-34. [DOI: 10.1111/j.1445-5994.2011.02622.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 09/30/2011] [Indexed: 11/26/2022]
Affiliation(s)
- W. Haerer
- Royal Melbourne Institute of Technology; Melbourne Victoria Australia
| | - K. Delbaere
- Falls and Balance Research Group, Neuroscience Research Australia; University of New South Wales; Sydney New South Wales Australia
| | - H. Bartlett
- Queensland University of Technology; Brisbane Queensland Australia
| | - S. R. Lord
- Falls and Balance Research Group, Neuroscience Research Australia; University of New South Wales; Sydney New South Wales Australia
| | - J. Rowland
- The Prince Charles Hospital; Brisbane Queensland Australia
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Pozos-López T, Navarrete-Reyes AP, Ávila-Funes JA. Is frailty associated with cardiovascular drug use? J Am Geriatr Soc 2012; 59:1977-9. [PMID: 22091520 DOI: 10.1111/j.1532-5415.2011.03610_12.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Aparicio VA, Carbonell-Baeza A, Ruiz JR, Aranda P, Tercedor P, Delgado-Fernández M, Ortega FB. Fitness testing as a discriminative tool for the diagnosis and monitoring of fibromyalgia. Scand J Med Sci Sports 2011; 23:415-23. [DOI: 10.1111/j.1600-0838.2011.01401.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2011] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | - P. Aranda
- Department of Physiology; Institute of Nutrition and Food Technology; University of Granada; Granada; Spain
| | - P. Tercedor
- Department of Physical Education and Sport; School of Sports Sciences; University of Granada; Granada; Spain
| | - M. Delgado-Fernández
- Department of Physical Education and Sport; School of Sports Sciences; University of Granada; Granada; Spain
| | - F. B. Ortega
- Department of Biosciences and Nutrition; Unit for Preventive Nutrition; NOVUM; Karolinska Institutet; Huddinge; Sweden
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Taipale HT, Bell JS, Gnjidic D, Sulkava R, Hartikainen S. Muscle strength and sedative load in community-dwelling people aged 75 years and older: a population-based study. J Gerontol A Biol Sci Med Sci 2011; 66:1384-92. [PMID: 21934126 DOI: 10.1093/gerona/glr170] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Use of psychotropic and sedative drugs has been associated with impaired muscle strength. Muscle weakness predicts important outcomes for older people including functional disability and mortality. The objective of this study was to investigate if the use of drugs with sedative properties is associated with poorer muscle strength. METHODS Seven-hundred community-dwelling participants, aged 75 years and older, enrolled in the population-based Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) study in 2004 were included in the present analyses. Data on demographics, diagnostics, and drug use were collected during standardized interviews, conducted by trained nurses and verified through medical records. Physiotherapists conducted objective tests of handgrip strength, knee extension strength, and the five repeated chair stands test. Sedative load was calculated using a previously published model for each participant. RESULTS Twenty-one percent of the participants (n = 147) had a sedative load of 1-2 and 8% (n = 58) had a sedative load 3 or more. After adjusting for covariates, participants with sedative load more than 0 had poorer performance on grip strength (p = .009), knee extension strength (p = .02), and five chair stands (p = .003) than nonusers of drugs with sedative properties. Increasing sedative load was associated with poorer grip strength. CONCLUSIONS Use of drugs with sedative properties was associated with impaired muscle strength. Although we adjusted for diagnoses affecting physical function, the possibility of confounding by indication cannot be entirely excluded. Given that muscle strength is predictive of functional disability and mortality, further attention should be directed toward conducting regular reviews of drug therapy and reducing use of sedative drugs.
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Affiliation(s)
- Heidi T Taipale
- Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
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Scott D, Blizzard L, Fell J, Jones G. The epidemiology of sarcopenia in community living older adults: what role does lifestyle play? J Cachexia Sarcopenia Muscle 2011; 2:125-134. [PMID: 21966639 PMCID: PMC3177044 DOI: 10.1007/s13539-011-0036-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 07/14/2011] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND: Sarcopenia, the age-related decline in skeletal muscle mass and function, is a relatively poorly understood process which may play an important role in the incidence of physical disability and falls in older adults. Evidence demonstrates that both genetic and environmental factors contribute to increased susceptibility for sarcopenia development, yet some of these factors may represent unavoidable consequences of ageing. METHODS: A review of literature, generally from epidemiological research, was performed to examine the influence that potentially modifiable lifestyle factors (general physical activity, dietary nutrient intake and sun exposure), as well as chronic disease and medication use, may have on sarcopenia progression. RESULTS: The review demonstrated that while physical activity, nutrient intake and sun exposure often decline during ageing, each may have important but differing benefits for the prevention of muscle mass and functional declines in older adults. Conversely, age-related increases in the prevalence of chronic diseases and the subsequent prescription of pharmacotherapy may exacerbate sarcopenia progression. CONCLUSIONS: The prevalence of poor physical activity, diet and sun exposure, as well as chronic disease and medication use, within older adult populations may be modifiable through simple lifestyle and health care interventions. As such, these factors may represent the most effective targets for sarcopenia prevention during the ageing process.
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Affiliation(s)
- David Scott
- Institute for Health and Social Science Research, CQUniversity Australia, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Leigh Blizzard
- Menzies Research Institute, University of Tasmania, Hobart, TAS Australia
| | - James Fell
- School of Human Life Sciences, University of Tasmania, Launceston, TAS Australia
| | - Graeme Jones
- Menzies Research Institute, University of Tasmania, Hobart, TAS Australia
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Bear-Lehman J. 2010 President's Invited Lecture: a vision for clinical research--from the clinic to the community. J Hand Ther 2011; 24:73-7. [PMID: 21106345 DOI: 10.1016/j.jht.2010.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 08/23/2010] [Indexed: 02/09/2023]
Affiliation(s)
- Jane Bear-Lehman
- Department of Occupational Therapy, New York University, New York, NY 10012, USA.
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Gonçalves GH, Gomes DA, Teixeira MDM, Shimano SGN, Shimano AC, Fonseca MDCR. Força de preensão palmar e pinça digital em diferentes grupos de pilotos da Academia da Força Aérea brasileira. FISIOTERAPIA E PESQUISA 2010. [DOI: 10.1590/s1809-29502010000200009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pilotos da Academia de Força Aérea (AFA) brasileira, durante vôos, realizam movimentos com grande solicitação da musculatura da mão que comanda o manche, o que pode modificar a força muscular. Este estudo teve por objetivo analisar as forças musculares isométricas de preensão palmar e pinças polpa-a-polpa, trípode e lateral de três grupos de pilotos da AFA. Foram avaliados 15 pilotos da Esquadrilha da Fumaça (EDA), 16 instrutores de vôo (PI) e 6 pilotos em treinamento (PT), todos do sexo masculino. Para a avaliação, o posicionamento corporal dos pilotos seguiu a padronização da Sociedade Americana de Terapeutas da Mão e a ordem dos movimentos analisados foi predefinida, evitando fadiga muscular. A força muscular isométrica máxima foi coletada em uma contração sustentada por 6 segundos. Os resultados mostram diferenças significativas na preensão, com superioridade das mãos dominantes em relação às não-dominantes em todos os grupos, tendo ainda o grupo EDA obtido valores significativamente superiores em relação aos demais. Nas medidas da pinça trípode, o grupo EDA apresentou significativos valores superiores aos do grupo PT, sendo encontrados valores das mãos dominantes superiores aos das não-dominantes nos grupos EDA e PI. Conclui-se que o treino específico da musculatura da mão durante o vôo, a especificidade e o período de treinamento interferem na força muscular isométrica da mão.
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