1
|
Hammer T, Braisch U, Rothenbacher D, Denkinger M, Dallmeier D. Relationship between hemoglobin and grip strength in older adults: the ActiFE study. Aging Clin Exp Res 2024; 36:59. [PMID: 38451343 PMCID: PMC10920471 DOI: 10.1007/s40520-024-02698-7] [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: 07/21/2023] [Accepted: 01/05/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Although anemia is associated with low muscle strength, hemoglobin has been rarely studied considering ferritin. AIM To analyze the association between hemoglobin and grip strength in community-dwelling older adults. METHODS We used data from a German cohort of adults ≥ 65 years, excluding those with CRP > 10 mg/L or taking iron supplements. Grip strength (kg) was measured using a Jamar dynamometer. Analysis was performed using multiple linear regression, adjusted for established confounders. Due to interaction, age-stratified (< 80, 80 +), further sex-stratified analysis in those < 80 years old and ferritin-stratified in men < 80 years were performed. RESULTS In total, 1294 participants were included in this analysis (mean age 75.5 years, 549 (42.3%) women, 910 (70.3%) < 80 years). On average, hemoglobin and grip strength were 14.9 g/dL and 41.3 kg for men, 13.9 g/dL and 25.1 kg for women. Hemoglobin was significantly positively associated with grip strength only among women < 80 years (β 0.923 [95% CI 0.196, 1.650]). For men < 80 years, the association was significant when ferritin was ≥ 300 µg/L (β 2.028 [95% CI 0.910, 3.146]). No association was detected among those participants 80 + . DISCUSSION AND CONCLUSIONS Our data show an association between hemoglobin and grip strength only in women < 80 years old. For men < 80 years, the association was only significant with ferritin levels ≥ 300 µg/L. Considering the decreasing levels of hemoglobin and grip strength and the high prevalence of iron deficiency in older adults further analyses investigating this relationship with more iron specific parameters such as transferrin saturation are warranted.
Collapse
Affiliation(s)
- Theresa Hammer
- Research Unit on Ageing at Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Institute for Geriatric Research, Ulm University, Ulm, Germany
| | - Ulrike Braisch
- Research Unit on Ageing at Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Michael Denkinger
- Research Unit on Ageing at Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Institute for Geriatric Research, Ulm University, Ulm, Germany
- Medical Faculty, Ulm University, Ulm, Germany
| | - Dhayana Dallmeier
- Research Unit on Ageing at Agaplesion Bethesda Clinic Ulm, Ulm, Germany.
- Medical Faculty, Ulm University, Ulm, Germany.
- Department of Epidemiology, Boston University School of Public Health, Boston, USA.
| |
Collapse
|
2
|
Calcaterra L, Abellan van Kan G, Steinmeyer Z, Angioni D, Proietti M, Sourdet S. Sarcopenia and poor nutritional status in older adults. Clin Nutr 2024; 43:701-707. [PMID: 38320461 DOI: 10.1016/j.clnu.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND & AIMS The association between sarcopenia and malnutrition has been poorly studied in the older population. The purpose of this study is to address the association between sarcopenia, according to different validated definitions, and nutritional status in a large population of community-dwelling older adults. METHODS Observational, cross-sectional study of the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability, held by the "Gérontopôle" of the Toulouse University Hospital. Patients aged above 65 years who benefitted from a Dual X-ray Densitometry (DXA) during their assessment at the GFC from June 5th 2013 to January 28th 2020 were included. Sarcopenia was defined according to proposed validated definitions. The Mini Nutritional Assessment (MNA) was used to stratify nutritional status, and identify patients with a poor nutritional status (at risk of malnutrition or malnourished, MNA <24). Multiple logistic regression analyses were performed between MNA and each sarcopenia definition adjusted for confounders. RESULTS Among the 938 patients with DXA data, a total of 809 (86.2 %) subjects were included in the analysis (mean age 81.8 ± 6.9 years, 527 females (65.1 %)). Prevalence of sarcopenia ranged from 12.6 % to 44.9 %, according to various definitions. Overall 244 (30.2 %) of the patients had a poor nutritional status (MNA-score <24), Baumgartner and Newman definitions of sarcopenia were both associated with low MNA-scores (OR = 4.69, CI 3.15-6.98 and OR = 2.30, CI 1.55-3.14, respectively), EWGSOP2 "confirmed sarcopenia" definition was also associated with low MNA-scores (OR = 3.68, CI 2.30-5.89), as well as for the lean mass definition according EWGSOP2 cut-off (OR 5.22 CI 3.52-7.73). Both FNIH and EWGSOP2 "probable sarcopenia" definitions were not associated with the risk of malnutrition. CONCLUSIONS In this study, the prevalence of sarcopenia ranged from 12.6 to 44.9 % according to various definitions. A score of MNA under 24, was associated with almost all of the sarcopenia definitions. This study reinforces the concept that malnutrition and sarcopenia are strictly related. When facing malnutrition in daily clinical practice, body composition should be assessed and the proposed nutritional intervention should be tailored by these results in order to prevent the onset of late-life disability.
Collapse
Affiliation(s)
- L Calcaterra
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France; Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - G Abellan van Kan
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France.
| | - Z Steinmeyer
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - D Angioni
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| | - M Proietti
- Division of Subacute Care, IRCCS, Istituti Clinici Scientifici Maugeri, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - S Sourdet
- IHU HealthAge, Frailty Clinic, Toulouse University Hospital, La Cité de la Santé, Hôpital La Grave, Place Lange, Toulouse 31059, France
| |
Collapse
|
3
|
Svinøy OE, Hilde G, Bergland A, Strand BH. Reference values for Jamar+ digital dynamometer hand grip strength in healthy adults and in adults with non-communicable diseases or osteoarthritis: the Norwegian Tromsø study 2015-2016. Eur J Ageing 2023; 20:44. [PMID: 37999814 PMCID: PMC10673784 DOI: 10.1007/s10433-023-00791-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Hand grip strength (HGS) is a key indicator of intrinsic capacity and has shown good predictive ability for morbidity and mortality. Reference values from normative populations are valuable, and such data from the Norwegian population are scarce. Normative values for the digital Jamar+ dynamometer are largely lacking.HGS was assessed in the Norwegian Tromsø study, survey 7 in 2015-2016 for 7824 participants (9324 invited) aged 40+ using a Jamar+ digital dynamometer, and three measurements for each hand were performed following the Southampton protocol. To account for non-response, full Tromsø population data, by age, education and sex, were collected from registry data from microdata.no, a service from Statistics Norway, and were then used as post-stratification weights, to provide standardized HGS values. HGS was higher in men than in women and inversely associated with age. Men and women with a history of non-communicable diseases had lower HGS than those without these conditions, while osteoarthritis was associated with lower HGS only among men. Lower height was associated with lower HGS, especially at younger ages in men. This article provides up-to-date references values for HGS in the community-dwelling population aged 40+ with or without osteoarthritis or non-communicable diseases, in Tromsø, Norway. These reference values will guide clinicians and researchers.
Collapse
Affiliation(s)
- Odd-Einar Svinøy
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, OsloMet - Oslo Metropolitan University, Oslo, Norway.
| | - Gunvor Hilde
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Bjørn Heine Strand
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
4
|
Rambukwella R, Westbury LD, Pearse C, Ward KA, Cooper C, Dennison EM. Hospital admissions and mortality over 20 years in community-dwelling older people: findings from the Hertfordshire Cohort Study. Aging Clin Exp Res 2023; 35:2751-2757. [PMID: 37704837 PMCID: PMC10628036 DOI: 10.1007/s40520-023-02554-0] [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: 07/31/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Demographic changes worldwide are leading to pressures on health services, with hospital admissions representing an important contributor. Here, we report admission types experienced by older people and examine baseline risk factors for subsequent admission/death, from the community-based Hertfordshire Cohort Study. METHODS 2997 participants (1418 women) completed a baseline questionnaire and clinic visit to characterize their health. Participants were followed up from baseline (1998-2004, aged 59-73 years) until December 2018 using UK Hospital Episode Statistics and mortality data, which report clinical outcomes using ICD-10 coding. Baseline characteristics in relation to the risk of admission/death during follow-up were examined using sex-stratified univariate logistic regression. RESULTS During follow-up, 36% of men and 26% of women died and 93% of men and 92% of women had at least one hospital admission; 6% of men and 7% of women had no admissions and were alive at end of follow-up. The most common types of admission during follow-up were cardiovascular (ever experienced: men 71%, women 68%) and respiratory (men 40%, women 34%). In both sexes, baseline risk factors that were associated (p < 0.05) with admission/death during follow-up were older age, poorer SF-36 physical function, and poorer self-rated health. In men, manual social class and a history of smoking, and in women, higher BMI, not owning one's home, and a minor trauma fracture since age 45, were also risk factors for admission/death. CONCLUSIONS Sociodemographic factors were related to increased risk of admission/death but a small proportion experienced no admissions during this period, suggesting that healthy ageing is achievable.
Collapse
Affiliation(s)
- Roshan Rambukwella
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Leo D Westbury
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Camille Pearse
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- Victoria University of Wellington, Wellington, New Zealand.
| |
Collapse
|
5
|
Xiong L, Zeng Z, Wang S, Liao T, Wang X, Wang X, Yang G, Li Y, Li L, Zhu J, Zhao P, Yang S, Kang L, Liang Z. The association of handgrip strength with all-cause and cardiovascular mortality: results from the National Health and Nutrition Examination Survey database prospective cohort study with propensity score matching. Front Nutr 2023; 10:1183973. [PMID: 37781126 PMCID: PMC10541216 DOI: 10.3389/fnut.2023.1183973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To investigate the association between handgrip strength (HGS) with all-cause and cardiovascular disease (CVD) mortality in US adults. Method We analyzed data from the National Health and Nutrition Examination Survey (NHANES) prospective cohort study (2011-2014) with 10,470 participants. The cox regression analysis, Kaplan-Meier survival curves, fitted curves, ROC curves, and propensity score-matched analysis (PSM) with inverse probability of treatment weighting (IPTW), SMRW (PSM with repeated weights), PA (pairwise algorithm), and OW (overlap weighting) regression analysis were performed to assess the relationship between HGS and all-cause and CVD mortality. Results The low HGSs (men <37.4 kg, women <24 kg), was found to be associated with higher all-cause and CVD mortality in a reverse J-shaped curve (p < 0.05). Adjusting for multiple covariates including age, BMI, race, education level, marriage status, smoking and alcohol use, and various comorbidities, the hazard ratio (HR) for all-cause mortality in the lowest HGS quintile 1 (Q1) was 3.45 (2.14-5.58) for men and 3.3 (1.88-5.79) for women. For CVD mortality, the HR was 2.99 (1.07-8.37) for men and 10.35 (2.29-46.78) for women. The area under the curve (AUC) for HGS alone as a predictor of all-cause mortality was 0.791 (0.768-0.814) for men and 0.780 (0.752-0.807) for women (p < 0.05), while the AUC for HGS and age was 0.851 (0.830-0.871) for men and 0.848 (0.826-0.869) for women (p < 0.05). For CVD mortality, the AUC for HGS alone was 0.785 (95% CI 0.738-0.833) for men and 0.821 (95% CI 0.777-0.865) for women (p < 0.05), while the AUC for HGS and age as predictors of all-cause mortality was 0.853 (0.861-0.891) for men and 0.859 (0.821-0.896) for women (p < 0.05). The HGS Q1 (men <37.4 kg and women <24 kg) was matched separately for PSM. After univariate, multivariate Cox regression models, PSM, IPTW, SMRW, PA, and OW analyses, women had 2.37-3.12 and 2.92-5.12 HRs with low HGS for all-cause and CVD mortality, while men had 2.21-2.82 and 2.33-2.85 for all-cause and CVD mortality, respectively (p < 0.05). Conclusion Adults with low HGS exhibited a significantly increased risk of both all-cause and CVD mortality, regardless of gender. Additionally, low HGS served as an independent risk factor and predictor for both all-cause and CVD mortality.
Collapse
Affiliation(s)
- Lijiao Xiong
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Zhaohao Zeng
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Shuojia Wang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
- Post-Doctoral Scientific Research Station of Basic Medicine, Jinan University, Guangzhou, China
| | - Tingfeng Liao
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Xiaohao Wang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Xinyu Wang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Guangyan Yang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Yanchun Li
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Lixing Li
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Jing Zhu
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Pengfei Zhao
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Shu Yang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Lin Kang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Zhen Liang
- Department of Geriatrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| |
Collapse
|
6
|
Sin MK, Lee JA, Murphy PJM, Charles Faselis, Ahmed A. Upper extremity weakness: A novel risk factor for non-cardiovascular mortality among community-dwelling older adults. Arch Gerontol Geriatr 2023; 112:105021. [PMID: 37058816 PMCID: PMC10330262 DOI: 10.1016/j.archger.2023.105021] [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: 02/01/2023] [Revised: 03/13/2023] [Accepted: 04/05/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Aging-associated upper extremity weakness has been shown to be associated with adverse health outcomes in older adults, but less is known about the association between impaired upper extremity function and cause-specific mortalities. METHODS Among the 5512 prospective community-based longitudinal Cardiovascular Health Study participants, 1438 had difficulty with one of the three upper extremity functions of lifting, reaching, or gripping. We assembled a propensity score-matched cohort in which 1126 pairs of participants with and without difficulty with upper extremity function, balanced on 62 baseline characteristics including geriatric and functional variables such as physical and cognitive function. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities associated with upper extremity weakness were estimated in the matched cohort. RESULTS Matched participants had a mean age of 73.1 years, 72.5% were women, and 17.0% African American. During 23 years of follow-up, all-cause mortality occurred in 83.7% (942/1126) and 81.2% (914/1126) of participants with and without upper extremity weakness, respectively (HR, 1.11; 95% CI, 1.01-1.22; p = 0.023). Upper extremity weakness was associated with a higher risk of non-cardiovascular mortality, occurring in 595 (52.8%) and 553 (49.1%) of participants, respectively (HR, 1.17; 95% CI, 1.04-1.31; p = 0.010), but had no association with cardiovascular mortality (30.8% vs 32.1% in those with and without upper extremity weakness, respectively; HR, 1.03; 95% CI, 0.89-1.19; p = 0.70). CONCLUSION Among community-dwelling older adults, upper extremity weakness had a weak, albeit independent, significant association with all-cause mortality, which was primarily driven by a higher risk of non-cardiovascular mortality. Future studies need to replicate these findings and understand the underlying reasons for the observed associations.
Collapse
Affiliation(s)
- Mo-Kyung Sin
- College of Nursing, Seattle University, 901 12th Ave, P.O. BOX 222000, Seattle, WA 98122-1090, United States.
| | - Jung-Ah Lee
- School of Nursing, University of California, Irvine, CA, United States
| | - Patrick J M Murphy
- College of Nursing, Seattle University, 901 12th Ave, P.O. BOX 222000, Seattle, WA 98122-1090, United States
| | - Charles Faselis
- Veterans Affairs Medical Center, Washington, DC, United States; School of Medicine, George Washington University, Washington, DC, United States; School of Medicine, Uniformed Services University, Washington, DC, United States
| | - Ali Ahmed
- Veterans Affairs Medical Center, Washington, DC, United States; School of Medicine, George Washington University, Washington, DC, United States; School of Medicine, Georgetown University, Washington, DC, United States
| |
Collapse
|
7
|
Chen X, Yan B, Gill TM. Childhood Circumstances and Health Inequality in Old Age: Comparative Evidence from China and the USA. SOCIAL INDICATORS RESEARCH 2022; 160:689-716. [PMID: 35359349 PMCID: PMC8963775 DOI: 10.1007/s11205-020-02436-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 06/14/2023]
Abstract
This paper estimates the extent to which childhood circumstances contribute to health inequality in old age and evaluates the importance of major domains of childhood circumstances to health inequalities in the USA and China. We link two waves of the China Health and Retirement Longitudinal Study in 2013 and 2015 with the newly released 2014 Life History Survey, and two waves of the Health and Retirement Study in 2014 and 2016 with the newly released 2015 Life History Mail Survey in the USA, to quantify health inequality due to childhood circumstances for which they have little control. Using the Shapley value decomposition approach, we show that childhood circumstances may explain 7-16 and 14-30% of health inequality in old age in China and the USA, respectively. Specifically, the contribution of childhood circumstances to health inequality is larger in the USA than in China for self-rated health, mental health, and physical health. Examining domains of childhood circumstance, regional and rural/urban status contribute more to health inequality in China, while family socioeconomic status contributes more to health inequality in the USA. Our findings support the value of a life course approach in identifying the key determinants of health in old age. Distinguishing sources of health inequality and rectifying inequality due to early childhood circumstances should be the basis of policy promoting health equity.
Collapse
Affiliation(s)
- Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, USA
- Department of Economics, Yale University, New Haven, USA
| | - Binjian Yan
- College of Economics and Management, Nanjing Agricultural University, Nanjing, China
| | - Thomas M Gill
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, USA
| |
Collapse
|
8
|
Koyama S, Otobe Y, Suzuki M, Kimura Y, Ishiyama D, Kojima I, Masuda H, Kusumi H, Yamada M. Relationship between the Kihon Checklist and all-cause hospitalization among community-dwelling older adults. Geriatr Gerontol Int 2021; 22:132-137. [PMID: 34942681 DOI: 10.1111/ggi.14331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/01/2021] [Accepted: 11/24/2021] [Indexed: 11/27/2022]
Abstract
AIM To examine the relationship between the Kihon Checklist (KCL) and incidence of hospitalization among community-dwelling older adults. METHOD We analyzed the cohort data of 2920 community-dwelling adults aged ≥65 years, who were living independently in a city in Shiga prefecture. We investigated the frailty status, instrumental activities of daily living, physical function, nutritional status, oral function, homebound status, cognitive function and mood using the KCL in the baseline survey. The outcome was incident all-cause hospitalization in the 2-year period. Logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the relationships between the frailty status and each domain of the KCL as well as all-cause hospitalization. RESULTS The prevalence of frailty, pre-frailty and robustness were 29.7%, 34.5% and 35.8%, respectively. During the 2-year follow-up period, 417 participants (14.3%) underwent an incident of all-cause hospitalization. The participants with frailty (adjusted OR 1.38, 95% CI 1.05-1.81) had a significantly elevated incidence of hospitalization according to the multivariate analysis compared with patients with robustness, but not in participants with pre-frailty (adjusted OR 1.07, 95% CI 0.82-1.40). Participants with low physical function (adjusted OR 1.45, 95% CI 1.12-1.87) and depressed mood (adjusted OR 1.35, 95% CI 1.08-1.70) had a significantly elevated incidence of hospitalization according to multivariate analysis compared with non-risk. CONCLUSION These results suggest that older adults with frailty are more likely to be hospitalized and that the KCL may be the screening tool to estimate the hospitalization risk. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2021; ••: ••-••.
Collapse
Affiliation(s)
- Shingo Koyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Yuhei Otobe
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Mizue Suzuki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Yosuke Kimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,College of Science and Engineering, Health and Sports Technology Course, Kanto Gakuin University, Yokohama, Japan
| | - Daisuke Ishiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Iwao Kojima
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Hiroaki Masuda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Haruhiko Kusumi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Minoru Yamada
- Faculty of Human Sciences, University of Tsukuba, Tokyo, Japan
| |
Collapse
|
9
|
Kim SH, Hurh K, Park Y, Jang SI, Park EC. Synergistic associations of visual and self-reported hearing acuity with low handgrip strength in older adults: a population-based cross-sectional study. BMC Geriatr 2021; 21:513. [PMID: 34563124 PMCID: PMC8466740 DOI: 10.1186/s12877-021-02470-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND It is unclear whether visual and hearing acuity are independently or synergistically associated with muscle strength. We aimed to examine the associations of visual and self-reported hearing acuity with low handgrip strength and the additive interaction between visual and hearing acuity on low handgrip strength in people over 60 years. METHOD Data of 3,075 individuals aged over 60 years from the 2017 and 2018 Korea National Health and Nutrition Examination Survey were used for this cross-sectional study. Low handgrip strength was defined based on the 20th percentile of the study population (< 30.4 kg for male and < 17.7 kg for female). Visual and self-reported hearing acuity were each divided into three categories: good, moderate, and impaired. Multiple logistic regression and relative excess risk due to interaction (RERI) were performed. RESULTS Of the 3,075 participants, 993 (32.3 %) demonstrated low handgrip strength. Low handgrip strength was more prevalent in participants with moderate (adjusted odds ratio [AOR] = 1.54, 95 % confidence interval [CI] = 1.12-2.12) and impaired visual acuity (AOR = 2.00, 95 % CI = 1.34-2.96). Both moderate and impaired self-reported hearing acuity were significantly associated with low handgrip strength (moderate: AOR = 1.25, 95 % CI = 1.01-1.55; impaired: AOR = 1.66, 95 % CI = 1.15-2.38). The more severe the sensory function decline, the higher the association with muscle weakness. Moreover, combined sensory impairments were associated with deteriorating low handgrip strength (AOR = 8.38), with significantly strong additive interactions (RERI = 2.61, 95 % CI = 2.52-2.70). CONCLUSIONS Awareness is needed regarding the risk of reduced muscle strength in individuals with moderate and impaired sensory function. Older people with sensory function decline in clinical settings may benefit from programs such as exercise prescription to prevent muscle weakness.
Collapse
Affiliation(s)
- Seung Hoon Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Yoonsik Park
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
| |
Collapse
|
10
|
Huang CH, Hsu CC, Yu PC, Peng LN, Lin MH, Chen LK. Hospitalization-associated muscle weakness and functional outcomes among oldest old patients: A hospital-based cohort study. Exp Gerontol 2021; 150:111353. [PMID: 33892132 DOI: 10.1016/j.exger.2021.111353] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
AIM To investigate the prognostic significance of hospitalization-associated muscle weakness for short-term and long-term functional declines among oldest old hospitalized patients. METHODS We conducted a retrospective cohort study in the Geriatric Evaluation and Management Unit (GEMU) of a tertiary medical center in Taiwan. Data from patients admitted to the GEMU were collected, including demographic characteristics, underlying diseases, functional assessments, and nutritional status. Handgrip strength was measured at admission and before discharge, and hospitalization-associated muscle weakness was defined accordingly. Functional status was ascertained by a telephone survey, and functional decline was defined based on a comparison with each patient's functional status before discharge. RESULTS Overall, data from 555 patients were retrieved, and 431 patients (mean age: 86.0 ± 6.2 years, 78.5% males) were included in the study, with a mean Barthel Index score of 74.7 ± 20.8, Mini-Mental State Examination (MMSE) score of 19.1 ± 6.8, Geriatric Depression Scale (GDS-5) score of 2.2 ± 1.6, Mini-Nutritional Assessment-Short Form (MNA-SF) score of 8.9 ± 3.0, Cumulative Illness Rating Scale-Geriatric (CIRS-G) score of 2.2 ± 0.9, and the regular use of 6.7 ± 3.5 medications. Patients with a 1-month postdischarge functional decline had significantly lower body weight and body mass index, more severe frailty and more hospitalization-associated muscle weakness. Patients with a 6-month postdischarge functional decline had lower body weight, BMI, MMSE scores, MNA-SF scores, handgrip strength, Barthel Index scores, and Braden Scale scores. BMI (OR: 0.815, 95% CI: 0.691-0.962, P = 0.015) and hospitalization-associated muscle weakness (OR: 1.227, 95% CI: 1.147-1.332, P < 0.001) were significantly associated with a 1-month postdischarge functional decline. Hospitalization-associated muscle weakness (OR: 1.067, 95% CI: 1.035-1.101, P < 0.001), the risk of pressure sores (Braden Scale, OR: 0.767, 95% CI: 0.646-0.910, P = 0.002), and BMI (OR: 0.914, 95% CI: 0.838-0.998, P = 0.045) were independently associated with a 6-month postdischarge functional decline. CONCLUSIONS Hospitalization-associated muscle weakness significantly predicts functional decline among oldest old patients hospitalized for acute conditions. Further interventional studies are needed to examine the causal relationship between hospitalization-associated muscle weakness and clinical outcomes.
Collapse
Affiliation(s)
- Chieh-Han Huang
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Chia Hsu
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan
| | - Pei-Chin Yu
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Neuroscience, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan
| | - Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.
| | - Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| |
Collapse
|
11
|
Westbury LD, Syddall HE, Fuggle NR, Dennison EM, Harvey NC, Cauley JA, Shiroma EJ, Fielding RA, Newman AB, Cooper C. Relationships Between Level and Change in Sarcopenia and Other Body Composition Components and Adverse Health Outcomes: Findings from the Health, Aging, and Body Composition Study. Calcif Tissue Int 2021; 108:302-313. [PMID: 33191483 PMCID: PMC7881954 DOI: 10.1007/s00223-020-00775-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022]
Abstract
We investigated how baseline values and rates of decline in components of sarcopenia and other body composition parameters relate to adverse clinical outcomes using the Health, Aging, and Body Composition Study. 2689 participants aged 70-79 years were studied. Appendicular lean mass, whole body fat mass, and total hip BMD were ascertained using DXA; muscle strength by grip dynamometry; and muscle function by gait speed. Baseline values and 2-3 year conditional changes (independent of baseline) in each characteristic were examined as predictors of mortality, hospital admission, low trauma fracture, and recurrent falls in the subsequent 10-14 years using Cox regression (generalized estimating equations used for recurrent falls) with adjustment for sex, ethnicity, age, and potential confounders. Lower levels and greater declines in all parameters (excluding hip BMD level) were associated (p < 0.05) with increased rates of mortality; fully-adjusted hazard ratios per SD lower gait speed and grip strength were 1.27 (95% CI 1.19, 1.36) and 1.14 (1.07, 1.21), respectively. Risk factors of hospital admission included lower levels and greater declines in gait speed and grip strength, and greater declines in hip BMD. Lower levels and greater declines in fat mass and hip BMD were associated with low trauma fracture. Lower gait speed, higher fat mass, and both lower levels and greater declines in grip strength were related to recurrent falls. Lower baseline levels and greater declines in musculoskeletal parameters were related to adverse outcomes. Interventions to maximize peak levels in earlier life and reduce rates of age-related decline may reduce the burden of disease in this age group.
Collapse
Affiliation(s)
- Leo D Westbury
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Holly E Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Nicholas R Fuggle
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Victoria University of Wellington, Wellington, New Zealand
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Eric J Shiroma
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Baltimore, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
| |
Collapse
|
12
|
Río X, Larrinaga-Undabarrena A, Coca A, Guerra-Balic M. Reference Values for Handgrip Strength in the Basque Country Elderly Population. BIOLOGY 2020; 9:E414. [PMID: 33255485 PMCID: PMC7760619 DOI: 10.3390/biology9120414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
Strength training is currently the most recommended primary therapeutic strategy to prevent and reverse the decline of muscle mass, strength, and functional deterioration associated with age. The aim is to provide reference values of handgrip strength (HGS) in the Basque Country population and compare the values with other populations. A total of 1869 subjects from the health-promoting programme for adults and older adults run by the Bilbao City Council were assessed using HGS with a digital dynamometer and anthropometric data measured by Tanita to obtain the mean values according to age distribution. From the 1869 subjects, 87.5% were women and 12.5% men. The HGS was higher among men than women, 32.4 ± 6.6 versus 20.1 ± 4.7 kg, respectively, p < 0.001 at all ages. Weak HGS cut-off points by age groups ranged from 31.0 to 23.8 and from 18.9 to 12.4 in men and women, respectively. The sample data were compared (d, t, and α) with those of other populations in all age groups (group > 60 years at 95% df, p < 0.05). A health-promoting programme appears to be effective in the general population in obtaining better values in the HGS test as age increases.
Collapse
Affiliation(s)
- Xabier Río
- Faculty of Psychology and Education, Physical Activity and Sports Sciences, University of Deusto, 48007 Bizkaia, Spain; (A.L.-U.); (A.C.)
| | - Arkaitz Larrinaga-Undabarrena
- Faculty of Psychology and Education, Physical Activity and Sports Sciences, University of Deusto, 48007 Bizkaia, Spain; (A.L.-U.); (A.C.)
| | - Aitor Coca
- Faculty of Psychology and Education, Physical Activity and Sports Sciences, University of Deusto, 48007 Bizkaia, Spain; (A.L.-U.); (A.C.)
| | - Myriam Guerra-Balic
- Faculty of Psychology, Education Sciences and Sport Blanquerna, University of Ramon Llul, 08022 Barcelona, Spain;
| |
Collapse
|
13
|
Poor sleep quality and physical performance in older adults. Sleep Health 2020; 7:205-211. [PMID: 33223446 DOI: 10.1016/j.sleh.2020.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to examine the association between sleep quality and physical performance among a group of UK community-dwelling older adults, according to sex. METHODS Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Physical performance was assessed using a short physical performance battery (SPPB), a timed up-and-go, and a hand-grip strength test. RESULTS Of 591 eligible study members, 401 completed the Pittsburgh Sleep Quality Index. In regression analyses, men who reported poor sleep quality were significantly more likely to have a poor SPPB score, even after adjustment for confounding factors (OR = 2.54, 95% CI 1.10-5.89, P= .03). The direction of the relationship was reversed among women, where those who reported poor sleep were less likely to have a low SPPB score (OR = 0.36, 95% CI 0.15-0.85, P = .02). Poor sleep quality was associated with poorer hand-grip strength among women (regression coefficient = -0.34 z score, 95% CI -0.64, -0.04, P = .03), but this relationship was not observed among men (regression coefficient = 0.28 z score, 95% CI -0.01, 0.57, P = .06). CONCLUSION We found evidence of an association between poor sleep quality and poorer physical performance in older adults, though there appear to be important sex differences.
Collapse
|
14
|
Yan B, Chen X, Gill TM. Health Inequality among Chinese Older Adults: The Role of Childhood Circumstances. JOURNAL OF THE ECONOMICS OF AGEING 2020; 17:10.1016/j.jeoa.2020.100237. [PMID: 32064224 PMCID: PMC7021249 DOI: 10.1016/j.jeoa.2020.100237] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This paper examines the extent to which childhood circumstances contribute to health inequality in old age and how the contributions may vary across key dimensions of health. We link the China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015 with its Life History Survey in 2014 to quantify health inequality due to childhood circumstances for which they have little control. We evaluate comprehensive dimensions of health ranging from cognitive health, mental health, physical health, self-rated health to mortality. Our analytic sample includes about 8,000 Chinese persons age above 60. Using the Shapley value decomposition approach, we first show that childhood circumstances may explain 1-23 percent of health inequality in old age across multiple health outcomes. Second, while both direct health-related circumstances and indirect health-related circumstances contribute significantly to health inequality, the latter tends to be more sizable. Our findings support the value of a life course approach in identifying the key determinants of health in old age.
Collapse
Affiliation(s)
- Binjian Yan
- College of Economics and Management, Nanjing Agricultural University and Department of Health Policy and Management, Yale School of Public Health
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health and Department of Economics, Yale University
| | - Thomas M Gill
- Department of Internal Medicine, School of Medicine, Yale University
| |
Collapse
|
15
|
Fu L, Zhang Y, Shao B, Liu X, Yuan B, Wang Z, Chen T, Liu Z, Liu X, Guo Q. Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults - a prospective observational study. BMC Cardiovasc Disord 2019; 19:266. [PMID: 31775633 PMCID: PMC6882174 DOI: 10.1186/s12872-019-1241-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/28/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. METHODS A total of 212 patients with mean age 63.8 ± 6.3 who underwent cardiac surgery participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the association between grip strength grouping and complications. RESULTS We found that 36 patients had 30-day complications. EuroSCORE were 2.15 ± 1.52 and 2.42 ± 1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p < 0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After regrouped characteristic information by grip recovery cutoff point, we found that percentage of the estimated 6 min walk distance (41.5 vs 48.3, p = 0.028) and hospitalization time (7.2 vs 6.1, p = 0.042) had worse trends in lower recovery group. CONCLUSIONS Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups. TRIAL REGISTRATION Our research was registered on Research Registry website, the registry number was ChiCTR1800018465. Date: 2018/9/20. Status: Successful.
Collapse
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
| | - Yuanyuan 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
| | - Bohan Shao
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Xiangjing Liu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Bo Yuan
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Zhengqing Wang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Tienan Chen
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Zhigang Liu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Xiaocheng Liu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China. .,College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, 279 Zhouzhu Highway, Pudong New Area, Shanghai, 201318, China.
| |
Collapse
|
16
|
Račić M, Pavlović J, Ivković N. Handgrip Strength Cut-Off Values for the Undernutrition Risk Screening among Elderly Men and Women in Bosnia and Herzegovina. J Aging Res 2019; 2019:5726073. [PMID: 31781394 PMCID: PMC6875213 DOI: 10.1155/2019/5726073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/19/2019] [Accepted: 10/04/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To determine the optimal cut-off points of handgrip strength (HGS) to identify the undernutrition risk among individuals older than 65 years of age in Bosnia and Herzegovina. DESIGN Cross-sectional study. SETTING Towns of Sarajevo, Foca, Rogatica, and Pale in Bosnia and Herzegovina. PARTICIPANTS 300 community-dwelling older adults and 146 nursing home residents. Comprehensive Geriatric multidimensional assessment (CGA) was carried out to evaluate general health, functional, and cognitive capabilities. Nutritional status and undernutrition risk were assessed by Mini Nutritional Assessment (MNA) and Seniors in the Community: risk evaluation for eating and nutrition, version II (SCREEN II). HGS was measured with a Smedley dynamometer. RESULTS According to the classification of nutritional status by MNA, 42% of community-dwelling men and 39% of community-dwelling women were at undernutrition risk. The undernutrition risk was significantly higher among nursing home residing men (89%) and women (78%) (p < 0.001). When nutritional status was assessed by SCREEN II, 100% on nursing home residents, 86% of community-dwelling men and 80% of women were identified as having a high risk for undernutrition. Per MNA, HGS cut-off thresholds were 23.50 kgF (65-74 years) and 19.50 kgF (≥75 years) for men; 15.50 kgF (65-74 years) and 13.50 kgF (≥75 years) for women. Per SCREEN II, cut-points were 28.50 kgF (65-74 years) and 24.50 kgF (≥75 years) for men; 24.50 kgF (65-74 years), 19.50 kgF (≥75 years for women). CONCLUSION HGS can be a useful instrument to identify undernutrition risk among the elderly patients. This study provides threshold for men and women older than 65 years of age in Bosnia and Herzegovina.
Collapse
Affiliation(s)
- Maja Račić
- Thomas J. Stephens & Associates Research Center, 3635 W Altadena Ave, Phoenix 85029, USA
| | - Jelena Pavlović
- Department of Nursing, Faculty of Medicine in Foca, University of East Sarajevo, Studentska 5, 7330 Foca, Bosnia and Herzegovina
| | - Nedeljka Ivković
- Department of Oral Rehabilitation, Faculty of Medicine in Foca, University of East Sarajevo, Studentska 5, 7330 Foca, Bosnia and Herzegovina
| |
Collapse
|
17
|
Bohannon RW. Grip Strength: An Indispensable Biomarker For Older Adults. Clin Interv Aging 2019; 14:1681-1691. [PMID: 31631989 PMCID: PMC6778477 DOI: 10.2147/cia.s194543] [Citation(s) in RCA: 406] [Impact Index Per Article: 81.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/13/2019] [Indexed: 12/20/2022] Open
Abstract
Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator of concurrent overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multimorbidity, and quality of life. Evidence is also provided for a predictive link between grip strength and all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. Consequently, the routine use of grip strength can be recommended as a stand-alone measurement or as a component of a small battery of measurements for identifying older adults at risk of poor health status.
Collapse
Affiliation(s)
- Richard W Bohannon
- Department of Physical Therapy, Campbell University, Lillington, NC, USA
| |
Collapse
|
18
|
Kim GR, Sun J, Han M, Park S, Nam CM. Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing. BMJ Open 2019; 9:e027019. [PMID: 31072857 PMCID: PMC6527975 DOI: 10.1136/bmjopen-2018-027019] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To examine whether reduced handgrip strength, as a marker of muscle weakness, is linked with the risk of cardiovascular, cancer and all-cause mortality among older adults. DESIGN We used data from the 2006 to 2014 Korean longitudinal study of ageing study. Estimates of handgrip strength were collected using a handheld dynamometer. Cox proportional hazard models with time-varying covariates were used to estimate HRs and their 95% CIs for all-cause mortality. The cause-specific hazards regression analysis was also used to model cardiovascular and cancer mortality, by treating deaths from the cause of interest as events and other causes of death as censored. PARTICIPANTS 5859 participants aged 50 years or older were followed up until death or until the date of censoring (31 December 2014). PRIMARY OUTCOME MEASURES The study outcomes of interest were all-cause, cardiovascular and cancer mortality. RESULTS Of the participants included in analyses, 515 individuals (8.8%) died, reflecting an overall crude mortality rate of 11.0 deaths per 1000 person-years. Participants in the lowest handgrip strength tertile showed an increased risk of all-cause and cardiovascular mortality evidenced by a multivariable adjusted HRs of 1.90 (95% CI 1.33 to 2.73) and 1.59 (95% Cl 1.08 to 2.34), respectively. However, there were no significant differences in the rates of cancer-related death, with HR of 1.29 (95% CI 0.92 to 1.81 [lowest vs highest tertile; p trend=0.21]). CONCLUSION These results demonstrate that lower handgrip strength is an independent predictor of mortality among a population-based sample of Korean elderly; highlighting the importance of interventions targeted at enhancing muscle strength for improvements in survival at older ages.
Collapse
Affiliation(s)
- Gyu Ri Kim
- Department of Biostatistics, Yonsei University Graduate School of Public Health, Seoul, The Republic of Korea
| | - Jiyu Sun
- Preventive Medicine, Yonsei University College of Medicine, Seoul, The Republic of Korea
| | - Minkyung Han
- Department of Public Health, Yonsei University Graduate School of Public Health, Seoul, The Republic of Korea
| | - Sohee Park
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, The Republic of Korea
| | - Chung Mo Nam
- Preventive Medicine, Yonsei University College of Medicine, Seoul, The Republic of Korea
| |
Collapse
|
19
|
Lindhardt T, Loevgreen SM, Bang B, Bigum C, Klausen TW. A targeted assessment and intervention at the time of discharge reduced the risk of readmissions for short-term hospitalized older patients: a randomized controlled study. Clin Rehabil 2019; 33:1431-1444. [DOI: 10.1177/0269215519845032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The aim of this study was to test and compare the effect of (1) a systematic discharge assessment with targeted advice and (2) a motivational interview followed by a home visit. Design: This was a three-armed randomized controlled study. Setting: This study was conducted in the Medical department in a university hospital. Subjects: Patients ⩾65 years of age with health problems at discharge participated in the study. Interventions: Group A ( n = 117): patients were informed of health problems and self-care interventions; Group B ( n = 116): a motivational conversation targeting activities of daily living with a home care nurse and a home visit. Main measures: The main measures of this study were readmissions, handgrip strength, chair-to-stand test, health-related quality of life, depression signs, mortality, and call on municipality services. Results: Risk of readmission was reduced for intervention groups by 30% (A; P = 0.26) and 22 % (B; P = 0.46). Mean number of days to first readmission was 49.5 (±51.0) days for the control group ( n = 116) and 57.9 (±53.6) and 67.2 (±58.1) days for the intervention groups A ( P = 0.43) and B ( P = 0.10), respectively. Mean loss of handgrip strength was 10.6 (±16.6) kg for men in the control group and 7 (±19.2) and 1.4 (±17.1) kg for the intervention groups A ( P = 0.38) and B ( P = 0.01), respectively. Health-related quality of life improved with 0.3 (±23.7) points in the control group and 7.4 (±24.4) and 3.2 (±22.3) points in the intervention groups A ( P = 0.04) and B ( P = 0.37), respectively. In total, 17 (16.3%) in the control group were provided with assistive devices after three months and 8 (7.3%) and 19 (17.6%) in the intervention groups A ( P = 0.04) and B ( P = 0.81), respectively. Conclusion: The interventions reduced the risk of readmission and improved handgrip strength, quality of life, and use of assistive devices.
Collapse
Affiliation(s)
- Tove Lindhardt
- Department of Internal Medicine, Copenhagen University Hospital, Herlev, Denmark
| | | | - Brigitte Bang
- Department of Internal Medicine, Copenhagen University Hospital, Herlev, Denmark
| | - Catja Bigum
- Eye Department, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Tobias W Klausen
- Department of Haematology, Copenhagen University Hospital, Herlev, Denmark
| |
Collapse
|
20
|
Ramírez-Vélez R, Correa-Bautista JE, García-Hermoso A, Cano CA, Izquierdo M. Reference values for handgrip strength and their association with intrinsic capacity domains among older adults. J Cachexia Sarcopenia Muscle 2019; 10:278-286. [PMID: 30843369 PMCID: PMC6463468 DOI: 10.1002/jcsm.12373] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/03/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The purposes of this study were three-fold: (i) to describe handgrip strength in older individuals aged ≥60 years in Colombia; (ii) to identify sex-specific and age-specific muscle weakness cut-off points in older adults; and (iii) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut-off points, as compared with their weaker counterparts. METHODS A cross-sectional study was conducted in Colombia, among 5237 older adults aged ≥60 years old (58.5% women, 70.5 ± 7.8 years), according to 'SABE Survey 2015'. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e. locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socio-economic status, urbanicity, body mass index, smoking status, alcohol intake, drug use, physical activity, and co-morbid chronic diseases. Sex-stratified analyses were conducted with logistic regression models. RESULTS Handgrip strength was greater among men than among women (26.7 ± 8.5 vs. 16.7 ± 5.7 kg, respectively, P < 0.001) at all ages. Weak handgrip strength cut-off points ranged from 17.4 to 8.6 and from 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity [in men, odds ratio (OR) = 0.62, 95% confidence interval (CI) 0.53 to 0.71; P < 0.001; and in women, OR = 0.79, 95% CI 0.68 to 0.92; P = 0.002] than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR = 0.47, 95% CI 0.29 to 0.78; P = 0.004) than their weaker counterparts. CONCLUSIONS This study is the first to describe handgrip strength values and cut-off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut-off points, non-weakness was associated with a decreased odds of intrinsic capacity impairments. These cut-off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.
Collapse
Affiliation(s)
- Robinson Ramírez-Vélez
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C., Colombia
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C., Colombia
| | - Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Carlos Alberto Cano
- Instituto de Envejecimiento, Semillero de Neurociencias y Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Mikel Izquierdo
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C., Colombia.,Department of Health Sciences, Navarrabiomed, CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Pamplona, Public University of Navarre, Navarre, Spain
| |
Collapse
|
21
|
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.
Collapse
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
| | | |
Collapse
|
22
|
Callahan KE, Lovato L, Miller ME, Marsh AP, Fielding RA, Gill TM, Groessl EJ, Guralnik J, King AC, Kritchevsky SB, McDermott MM, Manini T, Newman AB, Rejeski WJ. Self-Reported Physical Function As a Predictor of Hospitalization in the Lifestyle Interventions and Independence for Elders Study. J Am Geriatr Soc 2018; 66:1927-1933. [PMID: 30281796 PMCID: PMC6277208 DOI: 10.1111/jgs.15468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/17/2018] [Accepted: 05/15/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To explore whether baseline scores on the Mobility Assessment Tool-short form (MAT-sf), a brief, animated, computer-based means of assessing mobility that predicts mobility disability, are associated with number of hospitalizations and time to first hospitalization over a median follow-up of 2.7 years. DESIGN Post hoc analysis of prospectively gathered data from the Lifestyle Interventions and Independence for Elders (LIFE) Study, a randomized clinical trial of lifestyle interventions to preserve mobility in older adults. SETTING Eight U.S. academic medical centers. PARTICIPANTS Of 1,635 sedentary community-dwelling older adults enrolled in LIFE, 1,574 completed baseline physical function screening including the MAT-sf, with baseline scores ranging from 30.2 (low function) to 69.8 (high function) on a scale from 30 to 80. MEASUREMENTS Number of hospitalizations and time to first hospitalization, adjusted for age, sex, race, living alone, clinical site, baseline comorbidities, number of prescription medications, and cognition. RESULTS Of the 1,557 participants with data regarding hospitalization status, 726 (47%) had at least 1 hospitalization; 78% of these had 1 or 2 hospitalizations. For every 10-point lower MAT-sf score, the rate of all hospitalizations was 19% higher in those with lower scores (adjusted rate ratio=1.20, 95% confidence interval (CI)=1.08-1.32, p<.001). Lower baseline MAT-sf scores were also associated with greater risk of first hospitalization (adjusted hazard ratio=1.20, 95% CI=1.09-1.32, p<.01, per 10-point lower MAT-sf score). CONCLUSION Low MAT-sf scores identify older adults at risk of hospitalization; further study is needed to test interventions to reduce hospitalizations in these individuals.
Collapse
Affiliation(s)
- Kathryn E. Callahan
- Wake Forest School of Medicine, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine; Sticht Center for Healthy Aging and Alzheimer’s Prevention
| | - Laura Lovato
- Wake Forest School of Medicine, Public Health Sciences
| | | | - Anthony P. Marsh
- Wake Forest University, Department of Health and Exercise Science
| | | | | | - Erik J. Groessl
- University of California, San Diego, Health Services Research Center
| | | | - Abby C. King
- Stanford University School of Medicine, Departments of Health Research and Policy and of Medicine
| | - Stephen B. Kritchevsky
- Wake Forest School of Medicine, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine; Sticht Center for Healthy Aging and Alzheimer’s Prevention
| | | | | | - Anne B. Newman
- University of Pittsburgh, Graduate School of Public Health
| | - W. Jack Rejeski
- Wake Forest University, Department of Health and Exercise Science
| |
Collapse
|
23
|
Crawford A, McAna J, Lee S, Dieter W. Utilizing Patient-Specific Factors to Predict Costs in Home-Based Medicare Part B Outpatient Physical Therapy. Popul Health Manag 2018; 22:162-168. [PMID: 29957155 DOI: 10.1089/pop.2018.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The US health care system faces rising costs related to population aging, among other factors. One aspect of the high costs related to aging is Medicare outpatient therapy expenditures, which in 2010 totaled $5.642B for ∼4.7 million beneficiaries. Given the magnitude of these costs and the need to maximize value, this study developed and tested a predictive model of outpatient therapy costs. Retrospective analysis was performed on electronic medical record data from October 31, 2014-September 30, 2016 for 15,468 Medicare cases treated by physical therapists associated with a large, national rehabilitation provider. The analysis was a multiple linear regression of cost per case by 27 predictor variables: age group, sex, recent hospitalization, community vs. facility residence, the 10 states served, time from admission to initial evaluation, initial functional limitation reporting level, functional limitation reporting category, and 9 chronic conditions. The model was designed to be predictive and includes only variables available at the start of a case. The model was statistically significant (P < .0001) but explained only 7.4% of the variance in cost. Of the predictor variables, 16 had statistically significant effects. Those most highly predictive included state in which service was provided (8 of the 16 effects), and 3 variables indicating physical functioning at initial evaluation (initial functional limitation category and level, and residence in community vs. facility). There is need for more research focusing on the effects of specific types of treatment, and also for a more proactive model for outpatient therapy reimbursement that emphasizes prevention as well as treatment.
Collapse
Affiliation(s)
- Albert Crawford
- 1 Jefferson College of Population Health, Philadelphia, Pennsylvania
| | - John McAna
- 1 Jefferson College of Population Health, Philadelphia, Pennsylvania
| | - Sonia Lee
- 1 Jefferson College of Population Health, Philadelphia, Pennsylvania
| | - William Dieter
- 2 PT Clinical Services , FOX Rehabilitation, Cherry Hill, New Jersey
| |
Collapse
|
24
|
Sayer AA, Gill TM. Commentary: Value of the life course approach to the health care of older people. Int J Epidemiol 2018; 45:1011-1013. [PMID: 27880692 DOI: 10.1093/ije/dyw106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- A A Sayer
- Ageing Geriatrics & Epidemiology, Institute of Neuroscience and Institute for Ageing, Newcastle University, UK, .,NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.,MRC Lifecourse Epidemiology, University of Southampton, Southampton, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care: Wessex, Southampton, UK and
| | - T M Gill
- Yale School of Medicine, Department of Medicine, New Haven, CT, USA
| |
Collapse
|
25
|
Sikder T, Maimon G, Sourial N, Tahiri M, Teasdale D, Bernier P, Fraser SA, Demyttenaere S, Bergman S. Assessing the Effect of Preoperative Nutrition on Upper Body Function in Elderly Patients Undergoing Elective Abdominal Surgery. JPEN J Parenter Enteral Nutr 2017; 42:566-572. [PMID: 28406753 DOI: 10.1177/0148607117703956] [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: 10/25/2016] [Accepted: 03/18/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Malnutrition among elderly surgical patients has been associated with poor postoperative outcomes and reduced functional status. Although previous studies have shown that nutrition contributes to patient outcomes, its long-term impact on functional status requires better characterization. This study examines the effect of nutrition on postoperative upper body function over time in elderly patients undergoing elective surgery. METHODS This is a 2-year prospective study of elderly patients (≥70 years) undergoing elective abdominal surgery. Preoperative nutrition status was determined with the Subjective Global Assessment (SGA). The primary outcome was handgrip strength (HGS) at 1, 4, 12, and 24 weeks postsurgery. Repeated measures analysis was used to determine whether SGA status affects the trajectory of postoperative HGS. RESULTS The cohort included 144 patients with a mean age of 77.8 ± 5.0 years and a mean body mass index of 27.7 ± 5.1 kg/m2 . The median (interquartile range) Charlson Comorbidity Index was 3 (2-6). Participants were categorized as well-nourished (86%) and mildly to moderately malnourished (14%), with mean preoperative HGS of 25.8 ± 9.2 kg and 19.6 ± 7.0 kg, respectively. At 24 weeks, 64% of well-nourished patients had recovered to baseline HGS, compared with 44% of mildly to moderately malnourished patients. Controlling for relevant covariates, SGA did not significantly affect the trajectory of postoperative HGS. CONCLUSION While HGS values over the 24 weeks were consistently higher in the well-nourished SGA group than the mildly to moderately malnourished SGA group, no difference in the trajectories of HGS was detected between the groups.
Collapse
Affiliation(s)
- Tarifin Sikder
- Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Surgery, St Mary's Hospital Center, McGill University, Montreal, Canada
| | - Geva Maimon
- Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Nadia Sourial
- Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Mehdi Tahiri
- Department of Surgery, St Mary's Hospital Center, McGill University, Montreal, Canada.,Department of Surgery, Jewish General Hospital, McGill University, Montreal, Canada
| | - Debby Teasdale
- Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Paule Bernier
- Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Shannon A Fraser
- Department of Surgery, Jewish General Hospital, McGill University, Montreal, Canada
| | | | - Simon Bergman
- Department of Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Surgery, Jewish General Hospital, McGill University, Montreal, Canada
| |
Collapse
|
26
|
A Cross-Sectional Study of Nutrient Intake and Health Status among Older Adults in Yogyakarta Indonesia. Nutrients 2017; 9:nu9111240. [PMID: 29137185 PMCID: PMC5707712 DOI: 10.3390/nu9111240] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 12/21/2022] Open
Abstract
Many communities around the world, particularly developing countries including Indonesia, are experiencing population ageing. There is little knowledge regarding the impact of malnutrition, or its prevalence within rural compared to urban areas, on the nutritional, functional and mental status of community-living older residents in these countries. Hence, a cross-sectional study was conducted to determine socio-demographic and anthropometric characteristics, nutritional, mental and functional status, and energy and nutrient intake of community-dwelling Indonesians from both rural and urban areas of Yogyakarta. Older individuals were included in the study if they had been living in Yogyakarta for the last year and were aged ≥65 years (n = 527; mean ± SD age of 74 ± 7 years). Rural compared with urban participants had a lower level of education and income, more hospital admissions, less dietary protein intake, lower cognitive function, poorer nutritional status and grip strength, but faster gait speed while being more dependent on assistance to perform daily activities (all p < 0.05). Cognitive function was more strongly associated than nutritional status with physical function. Rural older Indonesians living in Yogyakarta were more likely than urban older people to be malnourished and cognitively impaired, and to have associated reductions in functional capacity and independence. Strategies to improve cognitive function and nutritional status are therefore important for the wellbeing of Indonesian citizens.
Collapse
|
27
|
Shaw SC, Dennison EM, Cooper C. Epidemiology of Sarcopenia: Determinants Throughout the Lifecourse. Calcif Tissue Int 2017; 101:229-247. [PMID: 28421264 PMCID: PMC5544114 DOI: 10.1007/s00223-017-0277-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/30/2017] [Indexed: 12/25/2022]
Abstract
Sarcopenia is an age-related syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength; it is a major contributor to the risk of physical frailty, functional impairment in older people, poor health-related quality of life and premature death. Many different definitions have been used to describe sarcopenia and have resulted in varying estimates of prevalence of the condition. The most recent attempts of definitions have tried to integrate information on muscle mass, strength and physical function and provide a definition that is useful in both research and clinical settings. This review focuses on the epidemiology of the three distinct physiological components of sarcopenia, and highlights the similarities and differences between their patterns of variation with age, gender, geography and time and the individual risk factors that cluster selectively with muscle mass, strength and physical function. Methods used to measure muscle mass, strength and physical functioning and how differences in these approaches can contribute to the varying prevalence rates will also be described. The evidence for this review was gathered by undertaking a systematic search of the literature. The descriptive characteristics of muscle mass, strength and function described in this review point to the urgent need for a consensual definition of sarcopenia incorporating these parameters.
Collapse
Affiliation(s)
- S C Shaw
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK.
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, OX3 7LE, UK.
| |
Collapse
|
28
|
Mendes J, Amaral TF, Borges N, Santos A, Padrão P, Moreira P, Afonso C, Negrão R. Handgrip strength values of Portuguese older adults: a population based study. BMC Geriatr 2017; 17:191. [PMID: 28835211 PMCID: PMC5569490 DOI: 10.1186/s12877-017-0590-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/17/2017] [Indexed: 12/19/2022] Open
Abstract
Background Handgrip strength is used to identify sarcopenia and frailty phenotypes, being a potential predictor of mortality in older adults. However, uniformity is lacking in the reference values. This study aimed to describe handgrip strength values of older population aged ≥65 years in Portugal, considering the possible influence of anthropometric parameters. Methods A cross-sectional study was conducted in Portugal, among 1500 older adults aged ≥65 years old, according to “The Nutrition UP 65 Study Protocol”. Demographic data were collected and cognitive performance, subjective general health, physical activity, anthropometric parameters and nutritional status were assessed and analysed. Handgrip strength data was obtained with a Jamar dynamometer. A Pubmed/Medline search was carried out to compare handgrip strength data between Portuguese older adults and other older populations. Results Handgrip strength was higher among men than among women (30.3 ± 9.2 Kgf vs 18 ± 5.4 Kgf, p < 0.001, respectively). In general, handgrip strength values of Portuguese older adults were lower than other older populations. In our sample, age, cognitive and nutritional status, self-reported sitting time and practice of physical activity were significantly correlated with handgrip strength in both sexes. Concerning anthropometric parameters, height was the most significantly correlated with handgrip strength (r = 0.34, p < 0.001, in women and r = 0.40, p < 0.001, in men). Conclusion This study described, for the first time, handgrip strength values of Portuguese population aged ≥65 years, according to age and to sex-specific tertiles of height. The definition of handgrip strength reference values in this age group merits further reflection.
Collapse
Affiliation(s)
- Joana Mendes
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal. .,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal. .,Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.
| | - Teresa F Amaral
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - Nuno Borges
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal
| | - Alejandro Santos
- I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.,The Research Centre in Physical Activity, Health and Leisure, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - Rita Negrão
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal.,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal
| |
Collapse
|
29
|
Klausen HH, Bodilsen AC, Petersen J, Bandholm T, Haupt T, Sivertsen DM, Andersen O. How inflammation underlies physical and organ function in acutely admitted older medical patients. Mech Ageing Dev 2017; 164:67-75. [DOI: 10.1016/j.mad.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/07/2017] [Accepted: 04/18/2017] [Indexed: 01/11/2023]
|
30
|
Dennison EM, Sayer AA, Cooper C. Epidemiology of sarcopenia and insight into possible therapeutic targets. Nat Rev Rheumatol 2017; 13:340-347. [PMID: 28469267 DOI: 10.1038/nrrheum.2017.60] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Musculoskeletal ageing is a major public health concern owing to demographic shifts in the population. Sarcopenia, generally defined as the age-related loss of muscle mass and function, is associated with considerable risk of falls, loss of independence in older adults and hospitalization with poorer health outcomes. This condition is therefore associated with increased morbidity and health care costs. As with bone mass, muscle mass and strength increase during late adolescence and early adulthood, but begin to decline substantially from ∼50 years of age. Sarcopenia is characterized by many features, which include loss of muscle mass, altered muscle composition, infiltration with fat and fibrous tissue and alterations in innervation. A better understanding of these factors might help us to develop strategies that target these effects. To date, however, methodological challenges and controversies regarding how best to define the condition, in addition to uncertainty about what outcome measures to consider, have delayed research into possible therapeutic options. Most pharmacological agents investigated to date are hormonal, although new developments have seen the emergence of agents that target myostatin signalling to increase muscle mass. In this review we consider the current approaching for defining sarcopenia and discuss its epidemiology, pathogenesis, and potential therapeutic opportunities.
Collapse
Affiliation(s)
- Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,School of Biological Sciences, Victoria University of Wellington, Kelburn Parade, Wellington 6012, New Zealand
| | - Avan A Sayer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,Institute of Neuroscience, Henry Wellcome Building, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne NE1 7RU, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University, Campus for Ageing and Vitality, Westgate Road, Newcastle upon Tyne NE4 5PL, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DN, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.,NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford OX3 7LD, UK
| |
Collapse
|
31
|
Lin CS, Lin SY, Chou MY, Chen LY, Wang KY, Chen LK, Lin YT, Loh CH. Hospitalization and associated factors in people with Alzheimer's disease residing in a long-term care facility in southern Taiwan. Geriatr Gerontol Int 2017; 17 Suppl 1:50-56. [PMID: 28436191 DOI: 10.1111/ggi.13033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 01/04/2023]
Abstract
AIM It has been reported that many people with dementia require hospitalizations. The objective of the present study was to determine predictive factors for hospitalizations in people with dementia. METHODS A total of 70 individuals with dementia living in a veterans' home in southern Taiwan were consecutively enrolled. During prospective follow up, all hospitalization events were recorded. RESULTS The mean age of residents with dementia was 86.1 ± 4.0 years, and the mean follow-up time for this population was 2.2 ± 1.1 years. Among individuals, 62.9% suffered from malnutrition or were at risk of malnutrition (minimal nutritional assessment-short form score ≤11), and 8.6% of individuals had a body mass index of <18.5 Kg/m2 . There were 52 (74.3%) individuals who had previously fallen. Overall, 51 of 70 residents were hospitalized during the follow-up period. In those individuals with previous falls, there was a significantly increased risk of hospitalization (odds ratio 5.61, 95% CI 1.18-26.7). Furthermore, three factors were significantly associated with the risk of fall, including handgrip strength, malnutrition and Mini-Mental State Examination score. CONCLUSIONS The results of the present study showed that hospitalization was a frequent event in residents with dementia living in a long-term care facility. The major predictor for hospital admission was history of a previous fall. Screening those with dementia for history of injurious falls and associated risk factors for falling could help identify those at risk of hospitalization, thus necessitating a comprehensive intervention to reduce hospitalization. Geriatr Gerontol Int 2017; 17 (Suppl. 1): 50-56.
Collapse
Affiliation(s)
- Chu-Sheng Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Aging and Health Research Center, National Yang Ming University
| | - Shih-Yi Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Yueh Chou
- Aging and Health Research Center, National Yang Ming University.,Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Taichung, Taiwan
| | - Liang-Yu Chen
- Aging and Health Research Center, National Yang Ming University.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital
| | - Kuei-Yu Wang
- JiaLi Veterans Home, Veterans Affairs Council, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital
| | - Yu-Te Lin
- Aging and Health Research Center, National Yang Ming University.,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital
| | - Ching-Hui Loh
- Department of Healthcare and Medical care, Veterans Affairs Council, Taiwan
| |
Collapse
|
32
|
Combining Activity-Related Behaviors and Attributes Improves Prediction of Health Status in NHANES. J Phys Act Health 2017; 14:626-635. [PMID: 28422582 DOI: 10.1123/jpah.2016-0419] [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] [Indexed: 11/18/2022]
Abstract
BACKGROUND This paper tested whether a physical activity index (PAI) that integrates PA-related behaviors (ie, moderate-to-vigorous physical activity [MVPA] and TV viewing) and performance measures (ie, cardiorespiratory fitness and muscle strength) improves prediction of health status. METHODS Participants were a nationally representative sample of US adults from 2011 to 2012 NHANES. Dependent variables (self-reported health status, multimorbidity, functional limitations, and metabolic syndrome) were dichotomized. Wald-F tests tested whether the model with all PAI components had statistically significantly higher area under the curve (AUC) values than the models with behavior or performance scores alone, adjusting for covariates and complex survey design. RESULTS The AUC (95% CI) for PAI in relation to health status was 0.72 (0.68, 0.76), and PAI-AUC for multimorbidity was 0.72 (0.69, 0.75), which were significantly higher than the behavior or performance scores alone. For functional limitations, the PAI AUC was 0.71 (0.67, 0.74), significantly higher than performance, but not behavior scores, while the PAI AUC for metabolic syndrome was 0.69 (0.66, 0.73), higher than behavior but not performance scores. CONCLUSIONS These results provide empirical support that an integrated PAI may improve prediction of health and disease. Future research should examine the clinical utility of a PAI and verify these findings in prospective studies.
Collapse
|
33
|
Intramuscular Adipose Tissue and the Functional Components of Sarcopenia in Hospitalized Geriatric Patients. Geriatrics (Basel) 2017; 2:geriatrics2010011. [PMID: 31011021 PMCID: PMC6371171 DOI: 10.3390/geriatrics2010011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 12/25/2022] Open
Abstract
Intramuscular adipose tissue (IMAT) could be an important missing value in the assessment of sarcopenia. This study tries to determine the relation between IMAT, muscle strength, functionality and mortality. In addition, the relation with nutritional status is screened. For six months, all patients admitted to the University Geriatric Center of Antwerp were evaluated for strength (hand grip), functionality (short physical performance battery—SPPB) and nutritional status. After one year, patients/relatives were contacted to obtain a current health status (mortality). A total of 303 patients were included at a mean age of 83.0 ± 6.4 years. The mean percentage of IMAT was 29.2% ± 13.0% (range 3.2%–86.2%). There was a negative correlation between IMAT and both grip strength and SPPB. SPPB was positively correlated with both grip strength and muscle mass. There was a positive correlation between IMAT and mortality. There was a negative correlation between grip strength, SPPB and mortality. IMAT did not have a clear relation with nutritional status. IMAT should be addressed in the work-up of sarcopenia, as it is correlated with muscle strength, functionality and mortality. In this cohort of hospitalized geriatric patients, there is a mean of about one-third of measured muscle volume that appears to be adipose tissue.
Collapse
|