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Qian S, Wen Q, Huang T, Chen J, Feng X. Dynapenic abdominal obesity and incident functional disability: Results from a nationwide longitudinal study of middle-aged and older adults in China. Arch Gerontol Geriatr 2024; 123:105434. [PMID: 38583265 DOI: 10.1016/j.archger.2024.105434] [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: 11/09/2023] [Revised: 03/24/2024] [Accepted: 04/01/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND There is little epidemiological evidence on the relationship of dynapenic abdominal obesity (DAO) and the development of functional disability, particularly in Asian populations. We aimed to investigate the association of DAO with new-onset functional disability in Chinese adults. METHODS A total of 7881 participants aged ≥45 years from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015 were included in the study. Dynapenia and abdominal obesity were respectively defined based on handgrip strength (<28 kg for male and <18 kg for female) and waist circumference (≥ 90 cm for male and ≥85 cm for female). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). Functional status was assessed by basic activities of daily living (BADL) or instrumental activities of daily living (IADL). Logistic regression model was used to explore the longitudinal association between dynapenic abdominal obesity and incident functional disability. RESULTS After a 4-year follow-up, 1153 (14.6 %) developed BADL disability and 1335 (16.9 %) developed IADL disability. The multivariable-adjusted odds ratios (95 % CIs) for the D/AO versus ND/NAO were 2.21 (1.61-3.03) for BADL disability, and 1.68 (1.23-2.30) for IADL disability. In addition, DAO was associated with an increased risk for functional dependency severity (odds ratio, 2.08 [95 % CI, 1.57-2.75]). CONCLUSIONS DAO was significantly associated with greater risk of functional disability among Chinese middle-aged and older adults. Our findings indicated that interventions targeted DAO might be effective in the primary prevention of functional disability.
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Affiliation(s)
- Sifan Qian
- Department of Public Health, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China
| | - Qiuqing Wen
- Department of Public Health, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China
| | - Tiansheng Huang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Neurology, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China.
| | - Xiaobin Feng
- Department of Traditional Chinese Medicine, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China.
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Cochar-Soares N, de Oliveira DC, Luiz MM, Aliberti MJR, Suemoto CK, Steptoe A, de Oliveira C, Alexandre T. Sex Differences in the Trajectories of Cognitive Decline and Affected Cognitive Domains Among Older Adults With Controlled and Uncontrolled Glycemia. J Gerontol A Biol Sci Med Sci 2024; 79:glae136. [PMID: 38775400 PMCID: PMC11181940 DOI: 10.1093/gerona/glae136] [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: 11/21/2023] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND We aimed to analyze the trajectories of cognitive decline as a function of the presence of type 2 diabetes and glycemic control in analyzes stratified by sex in an 8-year follow-up period. METHODS A total of 1 752 men and 2 232 women aged ≥50 years who participated in the English Longitudinal Study of Ageing (ELSA), conducted from 2004 to 2012, were analyzed. The outcomes of interest were performance on the cognitive domains of memory, executive function, and temporal orientation as well as the global cognition score. Cognitive performance was standardized in z-scores in strata based on schooling and age. The participants were classified as without diabetes, with controlled glycemia, and with uncontrolled glycemia, according to medical diagnosis, glucose-lowering medications use and HbA1c levels. Generalized linear mixed models controlled by sociodemographic, behavioral, and health-related characteristics were used for the trajectory analyses. RESULTS No differences in z-scores were found for global cognition or cognitive domains based on diabetes classification in men and women at baseline. More than 8 years of follow up, women with uncontrolled glycemia had a greater decline in z-scores for global cognition (-0.037 SD/year [95% CI: -0.073; -0.001]) and executive function (-0.049 SD/year [95% CI: -0.092; -0.007]) compared with those without diabetes. No significant difference in trajectories of global cognition or any cognitive domain was found in men as a function of diabetes classification. CONCLUSIONS Women with uncontrolled glycemia are at greater risk of a decline in global cognition and executive function than those without diabetes.
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Affiliation(s)
| | - Dayane C de Oliveira
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Mariane M Luiz
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Márlon J R Aliberti
- Laboratory of Medical Research in Aging (LIM-66), Servico de Geriatria, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Claudia K Suemoto
- Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Andrew Steptoe
- Department of Behavioral Science and Health, University College London, London, UK
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago S Alexandre
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
- Department of Epidemiology and Public Health, University College London, London, UK
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Vasilopoulos T, Drozda D, Vincent HK. Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index. Arch Gerontol Geriatr 2024; 120:105339. [PMID: 38340391 DOI: 10.1016/j.archger.2024.105339] [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: 09/17/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931-1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0-5 scale) and Large Muscle Function (0-4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P= 0.577), Large Muscle Function (P= 0.511), ADLs (P= 0.600), and IADLs (P= 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age.
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Affiliation(s)
- Terrie Vasilopoulos
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA; Department of Orthopaedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL 32611, USA.
| | - David Drozda
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
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Zhu S, Kong X, Han F, Tian H, Sun S, Sun Y, Feng W, Wu Y. Association between social isolation and depression: Evidence from longitudinal and Mendelian randomization analyses. J Affect Disord 2024; 350:182-187. [PMID: 38220103 DOI: 10.1016/j.jad.2024.01.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/11/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Increasing evidence shows that social isolation and depression are likely to interact with each other, yet the direction and causality of the association are not clear. This study aims to examine the possible reciprocity in the relationship between social isolation and depression. METHODS This study fitted a cross-lagged panel model (CLPM) by using data from the English Longitudinal Study of Aging (ELSA, 2014-2019, n = 6787) to examine the temporal relationship between social isolation and depressive symptoms in older adults. We then conducted two-sample bidirectional Mendelian randomization (MR) analyses by using independent genetic variants associated with multiple social isolation phenotypes (n = 448,858-487,647) and with depression (n = 215,644-2,113,907) as genetic instruments from genome-wide association studies to assess the causality between social isolation and onset of depression. RESULTS The CLPM in the ELSA cohort showed a significant and positive lagged effect of social isolation on depressive symptoms (β = 0.037, P < .001). The reverse cross-lagged path from depressive symptoms to social isolation was also statistically significant (β = 0.039, P < .001). In two-sample bidirectional MR, the genetically predicted loneliness and social isolation combined phenotype (LNL-ISO) was positively associated with occurrence of depression (OR = 1.88, 95 % CI: 1.41-2.50, P < .001), vice versa (OR = 1.16, 95 % CI:1.13-1.20, P < .001). LIMITATIONS The self-report nature of the assessments and missing data are study limitations. CONCLUSIONS These findings suggest a bidirectional relationship between social isolation and depression. It is important to develop interventions that highlight the reciprocal consequences of improving either mental health or social connection in older adults.
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Affiliation(s)
- Shuai Zhu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Xiangjie Kong
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Fulei Han
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Huimin Tian
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Shuqin Sun
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wenjing Feng
- Department of Geriatrics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China.
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Sun B, Wang J, Wang Y, Xiao W, Liu Y, Wang Y, Chen Y, Lu W. Associations of Dynapenic Abdominal Obesity and Frailty Progression: Evidence from Two Nationwide Cohorts. Nutrients 2024; 16:518. [PMID: 38398843 PMCID: PMC10892768 DOI: 10.3390/nu16040518] [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: 01/03/2024] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
The associations of dynapenic abdominal obesity and transitions with frailty progression remain unclear among middle-aged and older adults. We included 6937 participants from the China Health and Retirement Longitudinal Study (CHARLS) and 3735 from the English Longitudinal Study of Aging (ELSA). Participants were divided into non-dynapenia and non-abdominal obesity (ND/NAO), abdominal obesity alone (AO), dynapenia alone (D), and dynapenic abdominal obesity (D/AO). Frailty status was assessed by the frailty index (FI), and a linear mixed-effect model was employed to analyze the associations of D, AO, D/AO, and transitions with frailty progression. Participants with AO, D, and D/AO had increased FI progression compared with ND/NAO in both cohorts. D/AO possessed the greatest additional annual FI increase of 0.383 (95% CI: 0.152 to 0.614), followed by D and AO in the CHARLS. Participants with D in the ELSA had the greatest magnitude of accelerated FI progression. Participants who transitioned from ND/NAO to D and from AO to D/AO presented accelerated FI progression in the CHARLS and ELSA. In conclusion, dynapenic abdominal obesity, especially for D/AO and D, presented accelerated frailty progression. Our findings highlighted the essential intervention targets of dynapenia and abdominal obesity for the prevention of frailty progression.
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Affiliation(s)
| | | | | | | | | | | | | | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (B.S.); (J.W.); (Y.W.); (W.X.); (Y.L.); (Y.W.); (Y.C.)
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Smith L, López Sánchez GF, Tully MA, Veronese N, Soysal P, Yon DK, Pizzol D, López-Gil JF, Barnet Y, Butler L, Shin JI, Koyanagi A. Sex differences in the association between dynapenic abdominal obesity and onset of disability in activities of daily living among adults aged ≥50 years: A prospective analysis of the Irish Longitudinal Study on Ageing. Maturitas 2023; 176:107763. [PMID: 37393660 DOI: 10.1016/j.maturitas.2023.04.006] [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: 01/04/2023] [Revised: 03/18/2023] [Accepted: 04/14/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Sex differences in the longitudinal relationship between dynapenic abdominal obesity, i.e., impairment in muscle strength and high waist circumference, and disability in activities of daily living have not been investigated to date. Therefore, we aimed to examine sex differences in the longitudinal association between dynapenic abdominal obesity at baseline and the onset of disability in activities of daily living during a four-year follow-up period among Irish adults aged ≥50 years. METHODS Data from Wave 1 (2009-2011) and Wave 3 (2014-2015) of the Irish Longitudinal Study on Ageing survey were analyzed. Dynapenia was defined as handgrip strength of <26 kg for men and <16 kg for women. Abdominal obesity was defined as waist circumference of >88 cm for women and >102 cm for men. Dynapenic abdominal obesity was defined as having both dynapenia and abdominal obesity. Disability was defined as having difficulty with at least one of six activities of daily living (dressing, walking, bathing, eating, getting in or out of bed, using the toilet). Multivariable logistic regression was conducted to assess associations. RESULTS Data on 4471 individuals aged ≥50 years and free of disability at baseline were analyzed [mean (SD) age 62.3 (8.6) years; 48.3 % males]. In the overall sample, compared to no dynapenia and no abdominal obesity, dynapenic abdominal obesity was associated with 2.15 (95%CI = 1.17-3.93) times higher odds for incident disability at 4-year follow-up. This association was significant among men (OR = 3.78; 95%CI = 1.70-8.38) but not among women (OR = 1.34; 95%CI = 0.60-2.98). CONCLUSIONS Interventions to prevent or address dynapenic abdominal obesity may aid in the prevention of disability, especially among men.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireleand, UK.
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra, IdiSNA, Pamplona, Spain; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA; One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Yvonne Barnet
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain.
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de Paiva Souza L, Martins CA, Cattafesta M, Theodoro Dos Santos-Neto E, Salaroli LB. Waist-to-height ratio and dynapenic abdominal obesity in users of hemodialysis services. Nutr Metab Cardiovasc Dis 2023; 33:1583-1590. [PMID: 37344283 DOI: 10.1016/j.numecd.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/23/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND AND AIMS Abdominal obesity and decreased muscle strength are risk factors for individuals on hemodialysis. Thus, the combination of these two factors known as dynapenic abdominal obesity acts as an important marker of the nutritional status of this population. Therefore, the objective of the work was to investigate the association between abdominal obesity, dynapenia, and sociodemographic, clinical, and nutritional factors in individuals with chronic kidney disease undergoing hemodialysis. METHODS AND RESULTS Cross-sectional study with 940 individuals undergoing hemodialysis in southeastern Brazil. Dynapenic abdominal obesity was defined by the combination of the presence of abdominal obesity, indicated by the waist-to-height ratio, and the reduction in muscle strength, measured by handgrip strength. Binary logistic regression was performed to calculate the odds ratio (OR) and the respective confidence intervals (95% CI). Dynapenic abdominal obesity was present in 45.42% of the study population. We found that being 18-59 years (OR: 3.17; 95% CI 2.35-4.28; p < 0.001) and being overweight (OR: 2.58; 95% CI 1.92-3.47; p < 0.001) increased the chances for the presence of dynapenic abdominal obesity; however, the habit of consuming meals away from home (OR: 0.63; 95% CI 0.47-0.85; p = 0.003) and having preserved behavioral adductor muscle thickness (OR: 0.52; 95% CI 0.38-0.71; p < 0.001) are considered protective factors. CONCLUSION Dynapenic abdominal obesity, present in individuals on hemodialysis, may represent a valid nutritional tool for assessing cardiovascular risk and mortality in this population, in order to implement the most effective preventive and/or therapeutic intervention possible.
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Affiliation(s)
| | - Cleodice Alves Martins
- Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Brazil.
| | - Monica Cattafesta
- Graduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
| | - Edson Theodoro Dos Santos-Neto
- Graduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
| | - Luciane Bresciani Salaroli
- Graduate Program in Collective Health and Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Brazil.
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Kim NY, Choi YA. Obesity Impairs Functional Recovery of Older Stroke Patients with Possible Sarcopenia: A Retrospective Cohort Study. J Clin Med 2023; 12:jcm12113676. [PMID: 37297871 DOI: 10.3390/jcm12113676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
The functional prognosis of older patients with coexisting obesity and possible sarcopenia remains uncertain following acute stroke. This study aimed to determine whether coexisting obesity independently affects activities of daily living (ADL) and balance ability at discharge in older patients with possible sarcopenia admitted to a stroke rehabilitation ward. A total of 111 patients aged 65 years or older with possible sarcopenia were included, of whom 36 (32.4%) had coexisting obesity. Possible sarcopenia was diagnosed based on low handgrip strength without reduced muscle mass, while obesity was determined by body fat percentage (≥25% for men, ≥30% for women). Multivariate linear regression analysis revealed that compared to patients without obesity, patients with obesity had a higher likelihood of poorer ADL (b = -0.169; p = 0.02) and balance ability (b = -0.14; p = 0.04) performance at discharge following a 4-week period of inpatient rehabilitation. These findings suggest that obesity may be a modifiable risk factor in the rehabilitation of older patients with possible sarcopenia and should be considered in the assessment of decreased muscle strength.
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Affiliation(s)
- Na Young Kim
- Department of Rehabilitation Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Republic of Korea
| | - Young-Ah Choi
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Ramírez PC, de Oliveira DC, de Oliveira Máximo R, de Souza AF, Luiz MM, Delinocente MLB, Steptoe A, de Oliveira C, da Silva Alexandre T. Is dynapenic abdominal obesity a risk factor for cardiovascular mortality? A competing risk analysis. Age Ageing 2023; 52:6966518. [PMID: 36626317 PMCID: PMC9831270 DOI: 10.1093/ageing/afac301] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/17/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Dynapenic abdominal obesity has been shown as a risk factor for all-cause mortality in older adults. However, there is no evidence on the association between this condition and cardiovascular mortality. OBJECTIVE We aimed to investigate whether dynapenic abdominal obesity is associated with cardiovascular mortality in individuals aged 50 and older. METHODS A longitudinal study with an 8-year follow-up was conducted involving 7,030 participants of the English Longitudinal Study of Ageing study. Abdominal obesity and dynapenia were respectively defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). The outcome was cardiovascular mortality. The Fine-Grey regression model was used to estimate the risk of cardiovascular mortality as a function of abdominal obesity and dynapenia status in the presence of competing events controlled by socio-demographic, behavioural and clinical variables. RESULTS The risk of cardiovascular mortality was significantly higher in individuals with D/AO compared with ND/NAO (SHR 1.85; 95% CI: 1.15-2.97). D/NAO was also associated with cardiovascular mortality (SHR: 1.62; 95% CI: 1.08-2.44). CONCLUSION Dynapenic abdominal obesity is associated with cardiovascular mortality, with a larger effect size compared to dynapenia alone in individuals older than 50 years. Thus, prevention strategies and clinical interventions that enable mitigating the harmful effects of these conditions should be adopted to diminish such risk.
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Affiliation(s)
- Paula Camila Ramírez
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil,Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Dayane Capra de Oliveira
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Aline Fernanda de Souza
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Mariane Marques Luiz
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Address correspondence to: Tiago da Silva Alexandre, Departamento de Gerontologia, Universidade Federal de São Carlos, Rodovia Washington Luís, km 235, SP-310. CEP 13565-905, São Carlos, Brazil. E-mail: ;
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Silva RR, Galvão LL, Meneguci J, Santos DDAT, Virtuoso Júnior JS, Tribess S. Dynapenia in all-cause mortality and its relationship with sedentary behavior in community-dwelling older adults. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:253-259. [PMID: 36600974 PMCID: PMC9806709 DOI: 10.1016/j.smhs.2022.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 01/07/2023] Open
Abstract
The aim of the present study was to investigate the relationship of dynapenia combined with sedentary behavior (SB) on the risk of mortality in older adults living in a Brazilian community. A total of 322 participants aged ≥ 60 years from the ELSIA (Longitudinal Study of Elderly Health in Alcobaça) prospective cohort were included. Dynapenia was diagnosed when the handgrip strength was < 27 kg for men and < 16 kg for women. The exposure time to SB was assessed considering the total time spent sitting during one day in the week and one day on the weekend. When combined with dynapenia, we derived the construction of four groups: best behavior (absence of dynapenia and low SB), intermediate behavior (absence of dynapenia and high SB; presence of dynapenia and low SB) and worst behavior (presence of dynapenia and high SB). Mortality was assessed by the follow-up time until death and/or censorship. During the 5-year follow-up of the study, 55 participants progressed to death. In the adjusted models, the dynapenia and the time spent exposed to SB were analyzed in a combined way, the older adults with worse behavior (high SB and dynapenia) had higher risk ratios for mortality (hazard ratio 2.46; 95% confidence interval 1.01-5.97) than the best behavior group. Older adults with dynapenia are at greater risk for all-cause mortality, which is aggravated by the addition of longer exposure to SB.
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Affiliation(s)
- Rizia Rocha Silva
- Research Center on Physical Activity, Health and Aging, Department of Sport Sciences, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Lucas Lima Galvão
- Research Center on Physical Activity, Health and Aging, Department of Sport Sciences, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Joilson Meneguci
- Research Center on Physical Activity, Health and Aging, Department of Sport Sciences, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | - Jair Sindra Virtuoso Júnior
- Research Center on Physical Activity, Health and Aging, Department of Sport Sciences, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Sheilla Tribess
- Research Center on Physical Activity, Health and Aging, Department of Sport Sciences, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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Faure M, Decavèle M, Morawiec E, Dres M, Gatulle N, Mayaux J, Stefanescu F, Caliez J, Similowski T, Delemazure J, Demoule A. Specialized Weaning Unit in the Trajectory of SARS-CoV-2 ARDS: Influence of Limb Muscle Strength on Decannulation and Rehabilitation. Respir Care 2022; 67:967-975. [PMID: 35640998 PMCID: PMC9994145 DOI: 10.4187/respcare.09602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Patients with ARDS due to COVID-19 may require tracheostomy and transfer to a weaning center. To date, data on the outcome of these patients are scarce. The objectives of this study were to determine the factors associated with time to decannulation and limb-muscle strength recovery. METHODS This was an observational retrospective study of subjects with COVID-19-related ARDS requiring tracheostomy after prolonged ventilation, who were subsequently transferred to a weaning center from April 4, 2020-May 30, 2020. RESULTS Forty-three subjects were included. Median age (interquartile range) was 61 (48-66) y; 81% were men, and median body mass index (BMI) was 30 (26-35) kg/m2. Tracheostomy was performed after a median of 19 (12-27) d of mechanical ventilation, and the median ICU length of stay prior to transfer to the weaning center was 30 (21-46) d. On admission to the weaning center, the median Medical Research Council (MRC) score was 36 (27-44). Time to decannulation was 9 (7-18) d after admission to the weaning center. The only factor independently associated with early decannulation was the MRC score on admission to the weaning center (odds ratio 1.16 [95% CI 1.06-1.31], P = .005). Two factors were independently associated with MRC gain ≥ 10: BMI (odds ratio 0.88 [95% CI 0.76-0.99], P = .045) and MRC on admission (odds ratio 0.91 [95% CI 0.82-0.98], P = .03. Three months after admission to the weaning center, 40 subjects (93%) were weaned from mechanical ventilation and 36 (84%) had returned home. CONCLUSIONS MRC score at weaning center admission predicted both early decannulation and limb-muscle strength recovery.
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Affiliation(s)
- Morgane Faure
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France
| | - Maxens Decavèle
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France; and Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.
| | - Elise Morawiec
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France
| | - Martin Dres
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France; and Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Nicolas Gatulle
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France
| | - Julien Mayaux
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France
| | - François Stefanescu
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France
| | - Julien Caliez
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; and APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Département R3S (Respiration, Réanimation, Réhabilitation respiratoire, Sommeil), Paris, France
| | - Julie Delemazure
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France
| | - Alexandre Demoule
- APHP-6 Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive - Réanimation (Département R3S), Paris, France; and Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
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12
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Spexoto MCB, Ramírez PC, de Oliveira Máximo R, Steptoe A, de Oliveira C, Alexandre TDS. European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) criteria or slowness: which is the best predictor of mortality risk in older adults? Age Ageing 2022; 51:6649128. [PMID: 35906934 PMCID: PMC9338689 DOI: 10.1093/ageing/afac164] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Indexed: 01/11/2023] Open
Abstract
Objectives to analyse the accuracy of grip strength and gait speed in identifying mortality; to compare the association between mortality and sarcopenia defined by the EWGSOP1 and EWGSOP2 using the best cut-off found in the present study and those recommended in the literature and to test whether slowness is better than these two definitions to identify the risk of death in older adults. Methods a longitudinal study was conducted involving 6,182 individuals aged 60 or older who participated in the English Longitudinal Study of Ageing. Sarcopenia was defined based on the EWGSOP1 and EWGSOP2 using different cut-off for low muscle strength (LMS). Mortality was analysed in a 14-year follow-up. Results compared with the LMS definitions in the literature (<32, <30, <27 and < 26 kg for men; <21, <20 and < 16 kg for women), the cut-off of <36 kg for men (sensitivity = 58.59%, specificity = 72.96%, area under the curve [AUC] = 0.66) and < 23 kg for women (sensitivity = 68.90%, specificity = 59.03%, AUC = 0.64) as well as a low gait speed (LGS) ≤0.8 m/s (sensitivity = 53.72%, specificity = 74.02%, AUC = 0.64) demonstrated the best accuracy for mortality. Using the cut-off found in the present study, probable sarcopenia [HR = 1.30 (95%CI: 1.16–1.46)], sarcopenia [HR = 1.48 (95%CI: 1.24–1.78)] and severe sarcopenia [HR = 1.78 (95%CI: 1.49–2.12)] according to EWGSOP2 were better predictors of mortality risk than EWGSOP1. LGS ≤0.8 m/s was a better mortality risk predictor only when LMS was defined by low cut-off. Conclusions using LMS <36 kg for men and < 23 kg for women and LGS ≤ 0.8 m/s, EWGSOP2 was the best predictor for mortality risk in older adults.
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Affiliation(s)
- Maria Claudia Bernardes Spexoto
- Food, Nutrition and Health Postgraduate Program, Federal University of Grande Dourados, Dourados, Brazil.,Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Paula Camila Ramírez
- Escuela de Fisioterapia, Universidad Industrial de Santander, Bucaramanga, Colombia.,Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil.,Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil.,Department of Epidemiology and Public Health, University College London, London, UK.,Department of Gerontology, Federal University of Sao Carlos, Sao Carlos, Brazil
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13
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Gender and physical frailty modify the association between abdominal obesity and functional disability in older adults. Aging Clin Exp Res 2022; 34:2013-2021. [PMID: 35752721 DOI: 10.1007/s40520-022-02167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/26/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Abdominal obesity is associated with functional disability in older adults. AIM We evaluated whether this association was modified by gender and/or physical frailty. METHODS We used cross-sectional data from 12,583 participants in the third follow-up of the population-based Singapore Chinese Health Study, when participants had mean age of 74 years (range 63-97). Abdominal obesity was defined using waist circumference, physical frailty was established using the modified Cardiovascular Health Study phenotype, and functional disability was determined by the Lawton Instrumental Activities of Daily Living Scale. We used logistic regression models to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between abdominal obesity and disability. RESULTS Abdominal obesity was associated with increased likelihood of functional disability, and this association was stronger in women than in men [OR (95% CI): 1.27 (1.11-1.46) vs. 1.08 (0.93-1.25); P for interaction < 0.001]. Furthermore, there was a significantly stronger association between abdominal obesity and functional disability in participants who were physically frail compared to those who were not [OR (95% CI): 1.57 (1.19-2.08) vs. 1.11 (0.99-1.23); P for interaction = 0.003], and this phenomenon was observed in both genders. When compared to participants who were neither abdominally obese nor physically frail, participants who were both abdominally obese and physically frail had a synergistically increased risk of functional disability [OR (95% CI): 3.61 (3.03-4.30)]. CONCLUSIONS Women with abdominal obesity had higher risk of functional disability compared to men, and older adults who were both abdominally obese and physically frail had a synergistically increased risk of disability.
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Marcangeli V, Youssef L, Dulac M, Carvalho LP, Hajj-Boutros G, Reynaud O, Guegan B, Buckinx F, Gaudreau P, Morais JA, Mauriège P, Noirez P, Aubertin-Leheudre M, Gouspillou G. Impact of high-intensity interval training with or without l-citrulline on physical performance, skeletal muscle, and adipose tissue in obese older adults. J Cachexia Sarcopenia Muscle 2022; 13:1526-1540. [PMID: 35257499 PMCID: PMC9178162 DOI: 10.1002/jcsm.12955] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/17/2022] [Accepted: 02/01/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Aging is associated with a progressive decline in skeletal muscle mass and strength as well as an increase in adiposity. These changes may have devastating impact on the quality of life of older adults. Mitochondrial dysfunctions have been implicated in aging-related and obesity-related deterioration of muscle function. Impairments in mitochondrial quality control processes (biogenesis, fusion, fission, and mitophagy) may underlie this accumulation of mitochondrial dysfunction. High-intensity interval training (HIIT) was shown to improve muscle and mitochondrial function in healthy young and old adults and to improve body composition in obese older adults. Recent studies also positioned citrulline (CIT) supplementation as a promising intervention to counter obesity-related and aging-related muscle dysfunction. In the present study, our objectives were to assess whether HIIT, alone or with CIT, improves muscle function, functional capacities, adipose tissue gene expression, and mitochondrial quality control processes in obese older adults. METHODS Eighty-one-old and obese participants underwent a 12 week HIIT with or without CIT on an elliptical trainer [HIIT-CIT: 20 men/25 women, 67.2 ± 5.0 years; HIIT-placebo (PLA): 18 men/18 women, 68.1 ± 4.1 years]. Handgrip and quadriceps strength, lower limb muscle power, body composition, waist circumference, and functional capacities were assessed pre and post intervention. Vastus lateralis muscle biopsies were performed in a subset of participants to quantify markers of mitochondrial content (TOM20 and OXPHOS subunits), biogenesis (TFAM), fusion (MFN1&2, OPA1), fission (DRP1), and mitophagy (Parkin). Subcutaneous abdominal adipose tissue biopsies were also performed to assess the expression of genes involved in lipid metabolism. RESULTS HIIT-PLA and HIIT-CIT displayed improvements in functional capacities (P < 0.05), total (mean ± SD: HIIT-PLA: +1.27 ± 3.19%, HIIT-CIT: +1.05 ± 2.91%, P < 0.05) and leg lean mass (HIIT-PLA: +1.62 ± 3.85%, HIIT-CIT: +1.28 ± 4.82%, P < 0.05), waist circumference (HIIT-PLA: -2.2 ± 2.9 cm, HIIT-CIT: -2.6 ± 2.5 cm, P < 0.05), and muscle power (HIIT-PLA: +15.81 ± 18.02%, HIIT-CIT: +14.62 ± 20.02%, P < 0.05). Only HIIT-CIT decreased fat mass (-1.04 ± 2.42%, P < 0.05) and increased handgrip and quadriceps strength (+4.28 ± 9.36% and +10.32 ± 14.38%, respectively, P < 0.05). Both groups increased markers of muscle mitochondrial content, mitochondrial fusion, and mitophagy (P < 0.05). Only HIIT-CIT decreased the expression of the lipid droplet-associated protein CIDEA (P < 0.001). CONCLUSIONS High-intensity interval training is effective in improving functional capacities, lean mass, muscle power, and waist circumference in obese older adults. HIIT also increases markers of mitochondrial biogenesis, mitochondrial fusion, and mitophagy. Importantly, adding CIT to HIIT results in a greater increase in muscle strength and a significant decrease in fat mass. The present study therefore positions HIIT combined with CIT as an effective intervention to improve the health status of obese older adults.
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Affiliation(s)
- Vincent Marcangeli
- Département des sciences biologiques, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Groupe de recherche en Activité Physique Adaptée, Montréal, Québec, Canada
| | | | - Maude Dulac
- Département des sciences biologiques, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Groupe de recherche en Activité Physique Adaptée, Montréal, Québec, Canada
| | - Livia P Carvalho
- École de Réadaptation, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Centre de Recherche sur le Vieillissement du Centre intégré universitaire de santé et services sociaux de l'Estrie-CHUS, Sherbrooke, Québec, Canada
| | - Guy Hajj-Boutros
- Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Groupe de recherche en Activité Physique Adaptée, Montréal, Québec, Canada.,Department of Medicine, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Olivier Reynaud
- Département des sciences biologiques, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Groupe de recherche en Activité Physique Adaptée, Montréal, Québec, Canada
| | | | - Fanny Buckinx
- Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Pierrette Gaudreau
- Département de Médecine de l'Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Université de Montréal, Montréal, Québec, Canada
| | - José A Morais
- Department of Medicine, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Pascale Mauriège
- Département de kinésiologie, Université Laval, Québec, Québec, Canada
| | - Philippe Noirez
- Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,INSERM U1124, Université de Paris, Paris, France.,UFR STAPS, Université de Reims Champagne Ardenne, Reims, France
| | - Mylène Aubertin-Leheudre
- Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Groupe de recherche en Activité Physique Adaptée, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Gilles Gouspillou
- Département des sciences de l'activité physique, Faculté des Sciences, UQAM, Montréal, Québec, Canada.,Groupe de recherche en Activité Physique Adaptée, Montréal, Québec, Canada.,Department of Medicine, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
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15
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Lv D, Shen S, Chen X. Association Between Dynapenic Abdominal Obesity and Fall Risk in Older Adults. Clin Interv Aging 2022; 17:439-445. [PMID: 35418747 PMCID: PMC9001023 DOI: 10.2147/cia.s347053] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background In recent years, dynapenic abdominal obesity has received more and more attention. This article aimed to explore the relationship between dynapenic abdominal obesity and fall risk in older adults. Methods In this cross-sectional study, according to waist circumference (≥90 cm for men and ≥85 cm for women) and handgrip strength (<28 kg for men and <18 kg for women), 551 older adults were divided into four groups: dynapenic abdominal obese (D/AO), dynapenic nonabdominal obese (D/NAO), nondynapenic abdominal obese (ND/AO) and nondynapenic nonabdominal obese (ND/NAO). Fall risk was measured by the Tinetti performance-oriented mobility assessment (POMA). Binary logistic regression was used to explore the relationship between D/AO and fall risk. Results D/AO was related to POMA score (odds ratio [OR]=3.39; 95% confidence interval [CI]: 1.47–7.81; P=0.004) after adjusting the confounding variables. However, D/NAO (OR=1.51; 95% CI:0.69–3.32; P=0.302) and ND/AO (OR=1.48; 95% CI:0.74–2.99; P=0.272) were not associated with POMA score. Conclusion This study suggests that older adults with D/AO have a higher risk of falls. Therefore, it is necessary to strengthen the attention to D/AO and relevant interventions should be implemented.
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Affiliation(s)
- Danmei Lv
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, 310013, People’s Republic of China
| | - Shanshan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, 310013, People’s Republic of China
| | - Xujiao Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, 310013, People’s Republic of China
- Correspondence: Xujiao Chen, Department of Geriatrics, Zhejiang Hospital, Lingyin Road #12, Hangzhou, 310013, People’s Republic of China, Email
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16
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Perera RS, Chen L, Ferreira ML, Arden NK, Radojčić MR, Kluzek S. Age- and sex-specific effects of obesity, metabolic syndrome and its components on back pain: The English Longitudinal Study of Ageing. Joint Bone Spine 2022; 89:105366. [DOI: 10.1016/j.jbspin.2022.105366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
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17
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Araújo FCD, Silva KSD, Ohara DG, Matos AP, Pinto ACPN, Pegorari MS. Prevalence of and risk factors for dynapenic abdominal obesity in community-dwelling older adults: a cross-sectional study. CIENCIA & SAUDE COLETIVA 2022; 27:761-769. [DOI: 10.1590/1413-81232022272.01122021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/02/2021] [Indexed: 11/21/2022] Open
Abstract
Abstract This article aims to identify the prevalence of and factors associated with dynapenic abdominal obesity (DAO) in older adults in a city in the northern region of Brazil. A cross-sectional study was conducted with 382 community-dwelling older adults in Macapa, Amapa, Brazil. Socioeconomic, clinical, and health information were collected using a structured form. DAO was defined as a combination of dynapenia (handgrip strength of < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). Descriptive and inferential analyses were performed using chi-squared tests, Student’s t-tests, and a Poisson regression. The prevalence of DAO was 10.73%. In the preliminary bivariate analysis, the variables of age range, marital status, number of diseases, functional disability for basic and instrumental activities of daily living, gait speed, and level of physical activity met the established criterion. The final model indicated that only gait speed was a predictor of DAO in older adults. DAO affects nearly 11% of community-dwelling older adults from northern Brazil; gait speed was a predictor of DAO and could be a useful tool for managing and monitoring this population’s health.
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18
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Máximo RDO, de Oliveira DC, Ramirez PC, Luiz MM, de Souza AF, Delinocente MLB, Steptoe A, de Oliveira C, Alexandre TDS. Combination of dynapenia and abdominal obesity affects long-term physical performance trajectories in older adults: sex differences. Am J Clin Nutr 2022; 115:1290-1299. [PMID: 35102379 PMCID: PMC9071386 DOI: 10.1093/ajcn/nqac023] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/24/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is little epidemiological evidence of sex differences in the association between dynapenic abdominal obesity and the decline in physical performance in older adults. OBJECTIVES The aims of the present study were to investigate whether the decline in physical performance is worse in individuals with dynapenic abdominal obesity and whether there are sex differences in this association. METHODS Of 6183 individuals aged ≥60 y from the English Longitudinal Study of Ageing, 2308 participants with missing data were excluded. Therefore, a longitudinal analysis was conducted with 3875 older adults. Abdominal obesity was determined based on waist circumference (>102 cm for males, and >88 cm for females), and dynapenia was based on grip strength (<26 kg for males, <16 kg for female). The sample was divided into 4 groups: nondynapenic/nonabdominal obesity (ND/NAO), nondynapenic/abdominal obesity (ND/AO), dynapenic/nonabdominal obesity (D/NAO), and dynapenic/abdominal obesity (D/AO). Decline in physical performance in an 8-y follow-up period was analyzed using generalized linear mixed models. RESULTS At baseline, both male (-1.11 points; 95% CI: -1.58, -0.65 points; P < 0.001) and female (-1.39 points; 95% CI: -1.76, -1.02 points; P < 0.001) with D/AO had worse performances on the Short Physical Performance Battery (SPPB) than their counterparts in the ND/NAO group. Over the 8-y follow-up, males with D/AO had a faster rate of decline in the SPPB performance compared with males in the ND/NAO group (-0.11 points/y; 95% CI: -0.21, -0.01 points; P = 0.03). CONCLUSIONS D/AO is associated with a stronger decline in physical performance in males but not in females. The identification and management of dynapenic abdominal obesity could be essential to avoiding the first signs of functional impairment in older males.
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Affiliation(s)
- Roberta de Oliveira Máximo
- Postgraduate Program in Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Dayane Capra de Oliveira
- Postgraduate Program in Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Paula Camila Ramirez
- Postgraduate Program in Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Mariane Marques Luiz
- Postgraduate Program in Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Aline Fernanda de Souza
- Postgraduate Program in Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Ohara DG, Moreira YP, Silva CFR, Matos AP, Gama TO, Jamami M, Pinto ACPN, Pegorari MS. Impaired pulmonary function is associated with dynapenia, but not with abdominal obesity and dynapenic abdominal obesity in older adults. Eur Geriatr Med 2021; 13:475-482. [PMID: 34550559 DOI: 10.1007/s41999-021-00560-x] [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: 02/17/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE No studies have previously analyzed the association between dynapenic abdominal obesity (DAO) and pulmonary function in older adults. The aim of this study was to analyze whether there is an association between pulmonary function and abdominal obesity, dynapenia, and DAO in community-dwelling older adults. METHODS A cross-sectional study was conducted with community-dwelling older adults (n = 383) of Macapá, Amapá, Brazil. Pulmonary function variables were evaluated with spirometry; and DAO was evaluated with the combination of dynapenia and abdominal obesity. Cutoff points for handgrip strength, 26 kg force for men and 16 kg force for women, were used to detect dynapenia; and cutoff points of abdominal circumference of > 102 cm for men and > 88 cm for women were used to identify abdominal obesity. RESULTS Most of the studied pulmonary function variables (obtained values and obtained versus predicted values) were associated with abdominal obesity, dynapenia, and DAO. However, in the adjusted model, there was an association of FVC (β = - 0.163; p < 0.001), FEV1 (β = - 0.119; p = 0.006), and PEF (β = - 0.110; p = 0.017) only with dynapenia. CONCLUSIONS Older adults with abdominal obesity, dynapenia, and DAO presented impaired pulmonary function when compared to those without these conditions. Most of the pulmonary function variables were associated with abdominal obesity, dynapenia, and DAO conditions. However, in the adjusted model, there was an association of reduced FVC, FEV1, and PEF values only with dynapenia.
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Affiliation(s)
- Daniela G Ohara
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Yasmin P Moreira
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Caroline F R Silva
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Areolino P Matos
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Tatiana O Gama
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Maurício Jamami
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Carolina P N Pinto
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Maycon S Pegorari
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil.
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de Oliveira Máximo R, de Oliveira DC, Ramírez PC, Luiz MM, de Souza AF, Delinocente MLB, Steptoe A, de Oliveira C, da Silva Alexandre T. Dynapenia, abdominal obesity or both: which accelerates the gait speed decline most? Age Ageing 2021; 50:1616-1625. [PMID: 34087934 PMCID: PMC8437070 DOI: 10.1093/ageing/afab093] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 03/15/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE to investigate whether the combination of dynapenia and abdominal obesity is worse than these two conditions separately regarding gait speed decline over time. METHODS a longitudinal study was conducted involving 2,294 individuals aged 60 years or older free of mobility limitation at baseline (gait speed >0.8 m/s) who participated in the English Longitudinal Study of Ageing. Dynapenia was determined as a grip strength <26 kg for men and <16 kg for women. Abdominal obesity was determined as a waist circumference >102 cm for men and >88 cm for women. The participants were divided into four groups: non-dynapenic/non-abdominal obese (ND/NAO); only abdominal obese (AO); only dynapenic (D) and dynapenic/abdominal obese (D/AO). Generalised linear mixed models were used to analyse gait speed decline (m/s) as a function of dynapenia and abdominal obesity status over an 8-year follow-up period. RESULTS over time, only the D/AO individuals had a greater gait speed decline (-0.013 m/s per year, 95% CI: -0.024 to -0.002; P < 0.05) compared to ND/NAO individuals. Neither dynapenia nor abdominal obesity only was associated with gait speed decline. CONCLUSION dynapenic abdominal obesity is associated with accelerated gait speed decline and is, therefore, an important modifiable condition that should be addressed in clinical practice through aerobic and strength training for the prevention of physical disability in older adults.
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Affiliation(s)
| | | | - Paula Camila Ramírez
- Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
- Escuela de Fisioterapia, Universidad Industrial de Santander, Colômbia
| | - Mariane Marques Luiz
- Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | | | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Tiago da Silva Alexandre
- Physical Therapy Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
- Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
- Department of Epidemiology and Public Health, University College London, London, UK
- Department of Gerontology, Federal University of Sao Carlos, Sao Carlos, Brazil
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21
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Gandham A, Mesinovic J, Jansons P, Zengin A, Bonham MP, Ebeling PR, Scott D. Falls, fractures, and areal bone mineral density in older adults with sarcopenic obesity: A systematic review and meta-analysis. Obes Rev 2021; 22:e13187. [PMID: 33491333 DOI: 10.1111/obr.13187] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 12/23/2022]
Abstract
Sarcopenia and obesity are common conditions in older adults that may have differing effects on falls and fracture risk. This systematic review and meta-analysis aimed to determine whether older adults with sarcopenic obesity have increased risk of falls and fractures or lower bone mass compared with older adults with sarcopenia, obesity, or neither condition. Twenty-six studies (n = 37,124) were included in the systematic review and 17 (n = 31,540) were included in the meta-analysis. Older adults with sarcopenic obesity had lower femoral neck areal bone mineral density (aBMD) compared with those with obesity alone but had higher femoral neck aBMD compared with counterparts with sarcopenia alone (both P < 0.05). Older adults with sarcopenic obesity had higher nonvertebral fracture rates (incidence rate ratio: 1.88; 95% confidence intervals: 1.09, 3.23; based on two studies), compared with those with sarcopenia alone, and also had higher falls risk compared with controls (risk ratio: 1.30; 95% confidence intervals: 1.10, 1.54) and obesity alone (risk ratio: 1.17; 95% confidence intervals: 1.01, 1.36). In conclusion, this systematic review and meta-analysis has demonstrated that older adults with sarcopenic obesity are at increased risk of adverse musculoskeletal outcomes compared with individuals with obesity, sarcopenia, or neither condition. These data support the need for developing interventions to improve bone health and physical function in this population.
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Affiliation(s)
- Anoohya Gandham
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Paul Jansons
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, The University of Melbourne, St Albans, Victoria, Australia
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Steptoe A, Di Gessa G. Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study. LANCET PUBLIC HEALTH 2021; 6:e365-e373. [PMID: 33894138 PMCID: PMC8517412 DOI: 10.1016/s2468-2667(21)00069-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 01/31/2023]
Abstract
Background The COVID-19 pandemic has affected mental health, psychological wellbeing, and social interactions. People with physical disabilities might be particularly likely to be negatively affected, but evidence is scarce. Our aim was to evaluate the emotional and social experience of older people with physical disabilities during the early months of the COVID-19 pandemic in England. Methods In this longitudinal cohort study, we analysed data from the English Longitudinal Study of Ageing collected in 2018–19 and June–July, 2020, from participants aged 52 years and older and living in England. Physical disability was defined as impairment in basic and instrumental activities of daily living (ADL) and impaired mobility. Depression, anxiety, loneliness, quality of life, sleep quality, and amount of real-time and written social contact were assessed online or by computer-assisted telephone interviews. Comparisons of experiences during the COVID-19 pandemic of people with and without a physical disability were adjusted statistically for pre-pandemic outcome measures, age, sex, wealth, ethnicity, presence of a spouse or partner, number of people in the household, and chronic pain. All participants with full data available for both surveys were included in the analyses. Findings Between June 3 and July 26, 2020, 5820 participants responded, 4887 of whom had full data available for both the pre-pandemic measures and the COVID-19 survey and were included in the analysis. During the COVID-19 pandemic, significantly more people with ADL impairment had clinically significant symptoms of depression (odds ratio 1·78 [95% CI 1·44–2·19]; p<0·0001), anxiety (2·23 [1·72–2·89]; p<0·0001), and loneliness (1·52 [1·26–1·84]; p<0·0001) than people without ADL impairment. Significantly more people with ADL impairment also had impaired sleep quality (1·44 [1·20–1·72]; p<0·0001) and poor quality of life than people without ADL impairment. The results were similar when disability was defined by impaired mobility. People with ADL impairment had less frequent real-time contact (0·70 [0·55–0·89]; p=0·0037) and written social contact (0·54 [0·45–0·64]; p<0·0001) with family than people without ADL impairment. Results for social contact were similar when disability was defined by impaired mobility. Interpretation People with physical disability might be at particular risk for emotional distress, poor quality of life, and low wellbeing during the COVID-19 pandemic, highlighting the need for additional support and targeted mental health services. Funding Economic and Social Research Council/UK Research and Innovation, National Institute on Aging, National Institute for Health Research.
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Affiliation(s)
- Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK.
| | - Giorgio Di Gessa
- Department of Epidemiology and Public Health, University College London, London, UK
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23
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Tavares Milhem Ygnatios N, de Oliveira C, Vaz de Melo Mambrini J, Bof de Andrade F, Lima-Costa MF, Lustosa Torres J. Differences in disability and nutritional status among older Brazilian and English adults: the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and English Longitudinal Study of Aging (ELSA) cohorts. Am J Clin Nutr 2021; 114:422-428. [PMID: 33831943 PMCID: PMC8436132 DOI: 10.1093/ajcn/nqab060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/16/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Brazil and England are 2 countries at different stages in their demographic, epidemiological, and nutritional transitions and with distinct socioeconomic and politic contexts, but with similar universal health systems. We aimed to examine disability and its association with objective anthropometric indicators of nutritional status, including BMI, waist circumference, and waist-to-height ratio, comparing older Brazilian and English adults. METHODS We used cross-sectional data from 2 nationally representative aging studies. For Brazil, we included 9412 participants who participated in the baseline (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The English data were from 8024 participants of the wave 6 (2012-2013) of the English Longitudinal Study of Aging (ELSA). Disability was defined as difficulty to perform at least 1 activity of daily living. We used logistic regression models to examine the association between anthropometric indicators and disability, adjusted for sociodemographic and health-related characteristics, considering the interaction term between each anthropometric indicator and country. RESULTS All health-related characteristics were worse in Brazil than England, although the prevalence of disability was similar among Brazilian (17.85%) and English (16.27%) older adults. Fully adjusted models showed statistically significant interaction terms between country and anthropometric indicators. The strength of the associations in Brazil was weaker compared with England. All anthropometric indicators were positively associated with disability: elevated BMI, in Brazil (OR: 1.27; 95% CI: 1.06, 1.51) and in England (OR: 1.80; 95% CI: 1.51, 2.14); elevated waist circumference, in Brazil (OR: 1.21; 95% CI: 1.02, 1.44) and in England (OR: 1.90; 95% CI: 1.51, 2.37); and elevated waist-to-height ratio, in Brazil (OR: 1.20; 95% CI: 0.96, 1.52) and in England (OR: 1.83; 95% CI: 1.37, 2.44). CONCLUSIONS Elevated BMI and waist circumference increased the odds of disability in both populations. However, these associations were stronger in England than in Brazil.
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Affiliation(s)
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Santos EPRD, Silva CFR, Ohara DG, Matos AP, Pinto ACPN, Pegorari MS. Short Physical Performance Battery (SPPB) score as a discriminator of dynapenic abdominal obesity among community-dwelling older adults. Geriatr Nurs 2021; 42:467-472. [PMID: 33714904 DOI: 10.1016/j.gerinurse.2021.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/25/2022]
Abstract
The aim of this study is to verify the utility of using physical performance to discriminate the presence of dynapenic abdominal obesity (DAO) in older adults. This cross-sectional study was conducted with 382 community-dwelling older adults. DAO was identified when dynapenia (cut-off points of <26 kilogram-force [kgf] for men and <16 kgf for women) was detected together with abdominal obesity (waist circumference >102 cm for men and >88 cm for women). Physical performance was assessed with the Short Physical Performance Battery (SPPB). SPPB scores and DAO were inversely associated even after adjustment (OR: 0.69; 95%CI: 0.58-0.83). Cut-off points of ≤9 for SPPB scores were the most efficient for discriminating the presence of DAO in both men (AUC= 0.836; 95%CI: 0.76-0.89; sensitivity: 90.91% and specificity: 60.33%) and women (AUC= 0.677; 95%CI: 0.62-0.73; sensitivity: 73.33% and specificity: 40.91%). Physical performance assessed with SPPB can discriminate DAO and be useful for the timely identification and management of this condition in older adults.
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Affiliation(s)
- Elane Priscila Rosa Dos Santos
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Juscelino Kubitschek Road, Km - 02, Jardim Marco Zero, CEP 68903-419 Macapá, Amapá, Brazil
| | - Caroline Fátima Ribeiro Silva
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Juscelino Kubitschek Road, Km - 02, Jardim Marco Zero, CEP 68903-419 Macapá, Amapá, Brazil
| | - Daniela Gonçalves Ohara
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Juscelino Kubitschek Road, Km - 02, Jardim Marco Zero, CEP 68903-419 Macapá, Amapá, Brazil
| | - Areolino Pena Matos
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Juscelino Kubitschek Road, Km - 02, Jardim Marco Zero, CEP 68903-419 Macapá, Amapá, Brazil
| | - Ana Carolina Pereira Nunes Pinto
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Juscelino Kubitschek Road, Km - 02, Jardim Marco Zero, CEP 68903-419 Macapá, Amapá, Brazil
| | - Maycon Sousa Pegorari
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Juscelino Kubitschek Road, Km - 02, Jardim Marco Zero, CEP 68903-419 Macapá, Amapá, Brazil.
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Xiao J, Shi Z, Fang Y. Association Between Disability Trajectory and Health Care Service Utilization Among Older Adults in China. J Am Med Dir Assoc 2021; 22:2169-2176.e4. [PMID: 33577828 DOI: 10.1016/j.jamda.2020.12.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/21/2020] [Accepted: 12/25/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to identify the heterogeneous disability trajectories among older Chinese adults and examine the association between disability trajectories and health care service utilization. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS A community-based study including older adults aged ≥65 years from the Chinese Longitudinal Healthy Longevity Survey. METHODS Disability was assessed by the difficulties in activities of daily living and instrumental activities of daily living between 2002 and 2018. Health care utilization was measured by the expenditures on outpatient and inpatient services in 2018. Growth mixture modeling was conducted to estimate heterogeneous disability trajectories. A 2-part model was used to analyze the association of disability trajectories and health care utilization. Covariates were included based on Andersen's behavioral model. RESULTS Three classes of disability trajectories were identified: the progressive (7.9%), late-onset (13.7%), and normal classes (78.4%). Older adults who followed the late-onset trajectory of disability were more likely to use inpatient services compared with the normal class (odds ratio = 1.47, P < .010), after controlling potential confounders. Compared with the normal class, the progressive class on average spent US$145.94 more annually (45.2% higher) on outpatient services (P < .010) and $738.99 more annually (72.6% higher) on inpatient services (P < .001); the late-onset class reported higher annual expenditures on outpatient and inpatient services of $215.94 (66.9% higher) and $1405.00 (138.0% higher), respectively (all P < .001). CONCLUSIONS AND IMPLICATIONS Heterogeneous disability trajectories exhibited distinct health care service utilization patterns among older Chinese adults. Older adults affected by late-onset disability incurred the highest health care needs. These findings provide valuable policy-relevant evidence for reducing health care burden among older adults.
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Affiliation(s)
- Jian Xiao
- School of Public Health, Xiamen University, Xiamen, China
| | - Zaixing Shi
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China.
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Corrêa HDL, Rosa TDS, Dutra MT, Sales MM, Noll M, Deus LA, Reis AL, de Araújo TB, Neves RVP, Gadelha AB. Association between dynapenic abdominal obesity and inflammatory profile in diabetic older community-dwelling patients with end-stage renal disease. Exp Gerontol 2021; 146:111243. [PMID: 33460716 DOI: 10.1016/j.exger.2021.111243] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obesity and poor strength impose higher risk factor for end-stage renal disease (ESRD) patients. It is expected that the combination of both conditions might be critically associated with the inflammatory profile in this population, especially in community-dwelling elderly. So, diagnosis of dynapenic obesity and inflammation is an important tool in the management of chronic kidney disease patients at imminent risk of hospitalization. PURPOSE To investigate the association between dynapenic abdominal obesity and inflammatory markers in community-swelling elderly with ESRD. METHODS Two hundred and forty-seven community-dwelling older patients (66.74 ± 3.20 years; n = 150, 60.73%, males) undergoing maintenance phase hemodialysis volunteered for this study. The study sample was categorized into four groups according to handgrip strength and waist circumference as follows: control, dynapenia (low strength alone), abdominal obesity (high waist circumference alone), and dynapenic obesity (D/AO) (the combination of low strength and high waist circumference). Blood samples were collected for tumor necrosis factor alpha (TNF-α), interleukin (IL)- 6 and IL- 10. Results were considered significant at P < 0.05. RESULTS Proportions for control, abdominal obesity, dynapenic, and D/AO were 38.5%, 15.8%, 25.9%, and 19.8%, respectively. Higher concentrations of TNF-α were found in the D/AO group (P < 0.0001). This group also displayed lower levels of IL-10 (P < 0.0001). Further, the D/AO traits were strongly associated with TNF-α and IL-10 (P < 0.0001). CONCLUSION The closely relation between D/AO and inflammatory profile provides evidence that the pooled information of low muscle strength and abdominal obesity may be clinically relevant for the management of ESRD patients.
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Affiliation(s)
- Hugo de Luca Corrêa
- Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil.
| | - Thiago Dos Santos Rosa
- Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil
| | | | - Marcelo Magalhães Sales
- Graduate Program in Human Movement and Rehabilitation of University Center of Anápolis, Anápolis, Brazil; State University of Goiás, Quirinópolis, Brazil
| | - Matias Noll
- Federal Institute of Education, Science and Technology Goiano, Ceres, Goiás, Brazil
| | - Lysleine Alves Deus
- Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil
| | - Andrea Lucena Reis
- Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil
| | - Thaís Branquinho de Araújo
- Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil; Clinic Renal Fisio, Brasilia, Distrito Federal, Brazil
| | | | - André Bonadias Gadelha
- Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil; Seção de Educação Física, Colégio Militar de Brasília, Asa Norte, Brasília, DF, Brazil
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Assumpção DD, Francisco PMSB, Borim FSA, Yassuda MS, Neri AL. Which anthropometric measures best identify excess weight in older adults? GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES: To estimate the prevalence of and factors associated with excess weight in older adults according to body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WtHR), as well as to measure the differences between the prevalences estimated by WC and WtHR in relation to BMI. METHODS: This cross-sectional study was conducted in 2016 – 2017 with 549 older adults (72–102 years) from Campinas and Ermelino Matarazzo, two cities in the state of São Paulo, Brazil. Excess weight was defined according to cut-off points established for older adults. Multiple Poisson regression analysis was performed. RESULTS: The overweight/obesity prevalences were 47.36% (BMI), 61.38% (WC) and 65.57% (WtHR), being higher in women and in those with hypertension, diabetes, polypharmacy, and normal calf circumference. They were also higher in the youngest age strata (BMI and WC), in those with arthritis/rheumatism (BMI), and in those with slow gait (WtHR). The estimated overweight/obesity prevalences according to WC and WtHR were 29.00% and 38.00% higher, respectively, than BMI. In the multiple model, there was a higher prevalence of adiposity among diabetics and those with normal calf circumference. CONCLUSIONS: Measures of abdominal adiposity provided a better diagnosis of excess weight. We recommended that health professionals consider using WtHR in anthropometric assessment of older adults, especially regarding adiposity.
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Schuldt RF, Felix HC, Bradway CK. The impact of severe obesity on home health care agency admission: An organizational perspective. Home Health Care Serv Q 2020; 40:27-38. [PMID: 33327895 DOI: 10.1080/01621424.2020.1856747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Home health care is a growing treatment option for older adults who wish to remain in their homes and communities. However, the growing number of older adults with severe obesity presents a challenge for home health professionals. This study utilizes survey data from 128 home health care agencies in Arkansas and Pennsylvania to explore home health care agencies' decision-making in admitting patients with severe obesity. The responding agencies indicated that concerns about adequate staffing levels were the primary barriers to entry for severe obesity patients. Existing research on the intersection of obesity and home health care is sparse, and this study adds an organizational perspective to the scant literature on the topic. Additional research on this topic is advised to accommodate the expected growth in home health care utilization and rising obesity rates among older adults.
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Affiliation(s)
- Robert F Schuldt
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock, Arkansas, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences , Little Rock, Arkansas, USA
| | - Christine K Bradway
- Biobehavioral Health Sciences Department, University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania, USA
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Kuzuya M. Nutritional status related to poor health outcomes in older people: Which is better, obese or lean? Geriatr Gerontol Int 2020; 21:5-13. [PMID: 33200583 DOI: 10.1111/ggi.14088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 12/30/2022]
Abstract
Good nutritional status is crucial for maintaining growth and health in all stages of life. However, the relationship between nutritional status and health and the effect on various health-related outcomes differ, depending on the life stage. Many adverse outcomes in older adults, directly linked to different nutritional status, are not present in middle-aged adults, and their ideal nutritional status may differ. This article will review the optimal nutritional status, mainly evaluated by anthropometric measurements such as body mass index, for older adults from various perspectives. Overall, in older adults low body mass index is at higher risk of health problems such as mortality and difficulties in physical functioning compared with middle-aged adults, reducing the risk of health problems for overweight and (abdominal) obesity. Overweight may be more beneficial than lower level of normal weight in older-old and vulnerable older people. While, with or without obesity, skeletal muscle loss or weakness as well as unintentional weight loss induces health problems in older adults. The impact of metabolic syndrome on the prognosis of older adults is clearly reduced compared with middle-aged adults, requiring a shift in medical attention in older adults from metabolic syndrome to frailty. There are still many unclear points regarding the optimal nutritional status of older people, and further research is needed to support healthy longevity. Geriatr Gerontol Int 2021; 21: 5-13.
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Affiliation(s)
- Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
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Prognostic utility of dynapenia in patients with cardiovascular disease. Clin Nutr 2020; 40:2210-2218. [PMID: 33873266 DOI: 10.1016/j.clnu.2020.09.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/05/2020] [Accepted: 09/29/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dynapenia, defined as age-associated loss of skeletal muscle strength, is associated with increased mortality rate, poor activities of daily living, and reduced quality of life. Therefore, dynapenia appears to be a better independent predictor of mortality than sarcopenia in the elderly. However, the prognostic utility of dynapenia in patients with cardiovascular disease (CVD) is not clear. This study was performed to examine the prognostic utility of dynapenia defined by the criteria of Manini et al. in patients with CVD. METHODS The findings of 4192 consecutive patients ≥30 years old (median [interquartile range (IQR)] age 69 [60-76] years, 2874 males) with CVD were reviewed. Grip strength and quadriceps isometric strength (QIS) were measured just before hospital discharge, and low grip strength (<26 kg in males and <18 kg in females), low QIS (<45.0% body mass [BM] and <35.0% BM in males and females, respectively) were considered to indicate dynapenia. The endpoint was all-cause mortality. RESULTS A total of 507 deaths occurred during follow-up (median 2.0 years, IQR 0.8-4.4 years). The overall prevalence of dynapenia was 33.6% and increased with age (p for trend < 0.01). Females showed a significantly higher prevalence rate of dynapenia than males (43.3% vs. 29.2%, respectively; p < 0.01). Patients with dynapenia showed higher all-cause mortality rate than non-dynapenia patients (adjusted hazard ratio: 1.84; 95% confidence interval: 1.51-2.23; p < 0.01). CONCLUSIONS Dynapenia has a high prevalence among patients with CVD and is associated with increased mortality rate.
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Luiz MM, Máximo R, Oliveira DC, Ramírez PC, de Souza AF, Delinocente MLB, Steptoe A, de Oliveira C, Alexandre T. Association of Serum 25-Hydroxyvitamin D Deficiency with Risk of Incidence of Disability in Basic Activities of Daily Living in Adults >50 Years of Age. J Nutr 2020; 150:2977-2984. [PMID: 32937653 PMCID: PMC7675030 DOI: 10.1093/jn/nxaa258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/01/2020] [Accepted: 08/04/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Vitamin D deficiency compromises muscle function and is related to the etiology of several clinical conditions that can contribute to the development of disability. However, there are few epidemiological studies investigating the association between vitamin D deficiency and the incidence of disability. OBJECTIVES We aimed to assess whether vitamin D deficiency is associated with the incidence of disability in basic activities of daily living (BADL) and to verify whether there are sex differences in this association. METHODS A 4-y follow-up study was conducted involving individuals aged 50 y or older who participated in ELSA (English Longitudinal Study of Ageing). The sample consisted of 4814 participants free of disability at baseline according to the modified Katz Index. Vitamin D was assessed by serum 25-hydroxyvitamin D [25(OH)D] concentrations and the participants were classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L), or deficient (≤30 nmol/L). Sociodemographic, behavioral, and clinical characteristics were also investigated. BADL were re-evaluated after 2 and 4 y of follow-up. The report of any difficulty to perform ≥1 BADL was considered as an incident case of disability. Poisson models stratified by sex and controlled for sociodemographic, behavioral, and clinical characteristics were carried out. RESULTS After 4-y follow-up, deficient serum 25(OH)D was a risk factor for the incidence of BADL disability in both women (IRR: 1.53; 95% CI: 1.16, 2.03) and men (IRR: 1.44; 95% CI: 1.02, 2.02). However, insufficient serum 25(OH)D was not a risk factor for the incidence of BADL disability in either men or women. CONCLUSIONS Independently of sex, deficient serum 25(OH)D concentrations were associated with increased risk of incidence of BADL disability in adults >50 y old and should be an additional target of clinical strategies to prevent disability in these populations.
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Affiliation(s)
- Mariane M Luiz
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Roberta Máximo
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Dayane C Oliveira
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Paula C Ramírez
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil,School of Physical Therapy, Santander Industrial University, Bucaramanga, Colombia
| | - Aline F de Souza
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Maicon L B Delinocente
- Postgraduate Program in Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Gadelha AB, Neri SGR, Vainshelboim B, Ferreira AP, Lima RM. Dynapenic abdominal obesity and the incidence of falls in older women: a prospective study. Aging Clin Exp Res 2020; 32:1263-1270. [PMID: 31489597 DOI: 10.1007/s40520-019-01318-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/10/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dynapenic abdominal obesity (D/AO) has been associated with negative outcomes in older people, including trait of falls. AIMS To assess the association between D/AO and the incidence of falls over 18 months in older community-dwelling women. METHODS A total of 201 older women (67.97 ± 6.02 years; 27.70 kg/m2) underwent waist circumference measurement, and had handgrip strength assessed using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength, while abdominal obesity was considered as a waist circumference > 88 cm. D/AO was the combination of both aforementioned criteria. Volunteers were classified into four groups: normal, abdominal obesity, dynapenic, and D/AO. Participants were then tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and multivariable Cox proportional regressions were conducted. RESULTS The overall incidence of falls over the follow-up was 27.5%; and for normal, dynapenic, abdominal obesity, and D/AO were 14.7%, 17.2%, 27.5%, and 40.4% (X2 = 8.341; P = 0.039), respectively. D/AO was associated with a higher risk of falls (hazard ratio: 3.595 [95% CI: 1.317-9.815], even after adjustments for age, body mass index, physical activity level, regular use of medications, peripheral sensation, chronic diseases, and history of lower-limbs pain. CONCLUSIONS D/AO is more closely related to falls than either dynapenia or abdominal obesity alone, and is independently associated with an increased incidence of falls in older women. These results provide support for the concept that the combined evaluation of muscle strength and central obesity may be clinically relevant in this population.
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Affiliation(s)
- André Bonadias Gadelha
- Department of Physical Education and Sports, Federal Institute of Education, Science and Technology Goiano, Rod. Geraldo Silva Nascimento, Km-2,5, Zona Rural, Urutaí, Goiás, 75790-000, Brazil.
| | - Silvia G R Neri
- Faculdade de Educação Física, University of Brasília, Campus Darcy Ribeiro, Asa Norte, Brasília, 70910-900, Distrito Federal, Brazil
| | - Baruch Vainshelboim
- Master of Cancer Care Program, School of Health Sciences, Saint Francis University, Loretto, PA, USA
| | | | - Ricardo M Lima
- Faculdade de Educação Física, University of Brasília, Campus Darcy Ribeiro, Asa Norte, Brasília, 70910-900, Distrito Federal, Brazil
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Obesity, dynapenia, and their combination: Implications for bone mineral density in Brazilian adults-the Pró-Saúde study. Nutrition 2020; 81:110898. [PMID: 32739661 DOI: 10.1016/j.nut.2020.110898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/07/2020] [Accepted: 05/16/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study aimed to evaluate bone mineral density (BMD) in the presence or absence of dynapenia or obesity in Brazilian adults. METHODS This is a cross-sectional study conducted in 502 adults (age: 33-81 y; 51% women) participating in the Pró-Saúde study, a cohort of civil servants at the university campuses in Rio de Janeiro, Brazil. Body composition and BMD were determined by dual energy x-ray absorptiometry. Handgrip strength was measured using a dynamometer. According to measures of handgrip strength (≤19 kg for women; ≤32 kg for men) and fat mass (>30% for men; >40% for women), participants were classified into four groups: non-obese non-dynapenic, obese non-dynapenic, non-obese dynapenic, and obese dynapenic. The association between BMD at each specific bone site and obesity, dynapenia, and their interaction was evaluated using a general linear model. RESULTS The prevalence of dynapenic obesity was 14% in men and 15.2% in women. Dynapenia alone was not associated with BMD at any site in either men nor women. Obesity and dynapenia interacted to influence BMD in women (P < 0.05). Total body, lumbar spine, and femoral neck BMD were higher by 6.3%, 9.3%, and 10.4%, respectively, in dynapenic obese women compared with their non-obese counterparts (P < 0.05). In men, obesity, dynapenia, and their combination were not associated with BMD at any site. CONCLUSIONS Our results suggest that dynapenia, obesity, and their combination may affect BMD in a sex-dependent manner. In the presence of dynapenia, fat mass appears to exert a protective effect on BMD in women, but not in men.
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Nebuloni CC, Máximo RDO, de Oliveira C, Alexandre TDS. Uncontrolled Diabetes as an Associated Factor with Dynapenia in Adults Aged 50 Years or Older: Sex Differences. J Gerontol A Biol Sci Med Sci 2020; 75:1191-1197. [PMID: 31665234 PMCID: PMC7243578 DOI: 10.1093/gerona/glz257] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Indexed: 12/25/2022] Open
Abstract
Background Epidemiological studies demonstrate an association between diabetes and low neuromuscular strength (NMS). However, none have grouped participants into nondiabetics (ND), undiagnosed diabetics (UDD), controlled diabetics (CD), and uncontrolled diabetics (UCD) or investigated what glycated hemoglobin levels (HbA1c) are associated with low NMS (dynapenia) by sex. Methods We analyzed the association between UDD, CD, and UCD and dynapenia, the extent to which the different groupings of these individuals modifies this association and the association between HbA1c levels and NMS, by sex, in a cross-sectional study involving 5,290 participants ≥50 years from the ELSA study. In the first two analyses, logistic regression models were used with dynapenia (grip strength <26 kg in men and <16 kg in women) as outcome and diabetes (ND, UDD, CD, and UCD) as exposure. Next, linear regression was performed with grip strength as the outcome, and the participants were classified based on HbA1c level as exposure. The models were adjusted by sociodemographic, behavioral, and clinical characteristics. Results Compared to ND, only UCD was associated with dynapenia (men OR = 2.37 95% CI 1.36–4.14; women OR = 1.67 95% CI 1.01–2.79). This association was less clear, particularly in women, when CD and UCD groups were merged. HbA1c ≥6.5% in men and ≥8.0% in women were associated with lower NMS. Conclusions UCD increases the chance of dynapenia in both sexes. The different groupings based on diabetes status modify the association between UCD and dynapenia. The threshold of HbA1c associated with reduced NMS is lower in men compared to women.
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Affiliation(s)
- Clarice Cavalero Nebuloni
- Gerontology Graduate Program, Federal University of Sao Carlos, Brazil.,Geriatrics and Gerontology Sector, Federal University of Sao Paulo, Brazil
| | | | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, UK
| | - Tiago da Silva Alexandre
- Gerontology Graduate Program, Federal University of Sao Carlos, Brazil.,Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, SP, Brazil.,Department of Epidemiology and Public Health, University College London, UK.,Gerontology Department, Federal University of Sao Carlos, Brazil
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Valenzuela PL, Maffiuletti NA, Tringali G, De Col A, Sartorio A. Obesity-associated poor muscle quality: prevalence and association with age, sex, and body mass index. BMC Musculoskelet Disord 2020; 21:200. [PMID: 32234006 PMCID: PMC7110672 DOI: 10.1186/s12891-020-03228-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 03/20/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Muscle quality (i.e., the expression of muscle function per unit of muscle mass) has been proposed as a clinically-relevant measure to detect individuals at risk of functional incapacity. Individuals with obesity might be at an increased risk of having poor muscle quality. Thus, we aimed to analyze the prevalence of poor muscle quality in obese individuals, to determine associated variables, and to provide normative values for this population. METHODS 203 individuals with obesity (103 women, age: 18-75 years, body mass index (BMI): 35-64 kg·m- 2) participated in this cross-sectional study. Their muscle strength (handgrip dynamometry), muscle power (sit-to-stand test) and muscle mass (bioelectrical impedance analysis) were measured, and muscle quality (strength/power to muscle mass ratio) was compared with reference values obtained in young healthy individuals. Muscle quality was individually categorized as normal, low or poor based on specific muscle strength and power (i.e., strength and power per unit of muscle mass, respectively). Sex and age-specific normative values of specific muscle strength and power were computed for the whole cohort. RESULTS Age and being a woman were inversely associated with specific muscle strength, with age being also inversely associated with specific muscle power. A small proportion of participants (6%) presented with an impaired (i.e., low/poor) specific muscle power while most of them (96%) had impaired specific muscle strength. Eventually, 84% of the participants were deemed to have poor muscle quality. Being a woman (odds ratio [OR]: 18.09, 95% confidence intervals [CI]: 4.07-80.38), age (OR: 1.06, 95%CI: 1.03-1.10) and BMI (OR: 1.22, 95%CI: 1.07-1.38) were independently associated with a higher risk of poor muscle quality in adjusted analyses. CONCLUSIONS These findings show a high prevalence of poor muscle quality among individuals with obesity, with age, sex and BMI being independent predictors.
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Affiliation(s)
- Pedro L Valenzuela
- Department of Systems Biology, School of Medicine, University of Alcalá, Ctra Barcelona, Km, 33 600 28871, Alcalá de Henares, Spain.
| | | | - Gabriella Tringali
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research, Verbania, Piancavallo (VB), Italy
| | - Alessandra De Col
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research, Verbania, Piancavallo (VB), Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research, Verbania, Piancavallo (VB), Italy.,Istituto Auxologico Italiano, IRCCS, Division of Metabolic Diseases and Auxology , Verbania, Piancavallo (VB), Italy
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Birth weight associated with dual energy X-ray absorptiometry-determined muscle-bone unit in young healthy women from the Nutritionists' Health Study. J Dev Orig Health Dis 2020; 12:42-49. [PMID: 31902386 DOI: 10.1017/s2040174419000874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Muscle and bone have been considered a functional unit that grows together early in life, deteriorates with aging, and can cause osteosarcopenia. Due to its importance in public health, detecting risk factors in early life is desirable. This study examined whether birth weight (BW) was associated with muscle-bone unit using dual energy X-ray absorptiometry (DXA) parameters in young women from the Nutritionists' Health Study (NutriHS), a cohort study of undergraduates and Nutrition graduates. This cross-sectional analysis included 170 young healthy women who answered early life events-questionnaire, and had anthropometric, muscle tests and DXA-determined body composition and bone densitometry (iDXA-Lunar®). A blood sample was obtained for a subsample of 148 participants. Appendicular skeletal muscle mass index (ASMI) was calculated. BW was categorized in quartiles (BWq) and variables of interest compared by ANOVA. Associations of BWq with calf circumference (CC), handgrip, muscle performance tests, ASMI, bone mineral density and content (BMD and BMC), and plasma glucose, lipids, insulin, and 25-hydroxyvitamin D were performed using multiple linear regression and directed acyclic graph-recommended adjustments. Mean values of age, body mass index, and BW were 23.0 years (20.0-28.0), 22.9 ± 2.9 kg/m2, and 3199 ± 424 g, respectively. Comparing variables across BWq, significant differences in CC, handgrip, ASMI, and total body BMC were detected. Regression models adjusted for confounders showed associations of BWq with CC (β = 0.72, p = 0.005), handgrip (β = 1.53, p = 0.001), ASMI (β = 0.16, p = 0.022), total body BMC (β = 64.8, p = 0.005), total femur BMC (β = 0.70, p = 0.041), total body BMD (β = 0.02, p = 0.043), and lumbar spine BMD (β = 0.03, p = 0.028). We conclude that BW is associated with muscle-bone unit using DXA-parameters in Brazilian young healthy women from the NutriHS, suggesting a role for intrauterine environment for musculoskeletal health.
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Buckinx F, Gouspillou G, Carvalho LP, Marcangeli V, El Hajj Boutros G, Dulac M, Noirez P, Morais JA, Gaudreau P, Aubertin-Leheudre M. Effect of High-Intensity Interval Training Combined with L-Citrulline Supplementation on Functional Capacities and Muscle Function in Dynapenic-Obese Older Adults. J Clin Med 2018; 7:jcm7120561. [PMID: 30562948 PMCID: PMC6306942 DOI: 10.3390/jcm7120561] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/16/2022] Open
Abstract
Background: To compare the effects of high-intensity interval training (HIIT) alone vs. HIIT combined with L-citrulline (CIT) supplementation on functional capacity and muscle function in dynapenic-obese elderly. Methods: A total of 56 obese (fat mass: men > 25%, women > 35%) and dynapenic (grip strength/body weight: women < 0.44, men < 0.61) subjects were recruited and divided in two groups: HIIT+CIT (n = 26; age: 6 5 ± four years) vs. HIIT+Placebo (PLA, n = 30; age: 68 ± four years). Participants followed a 12-week HIIT using an elliptical trainer. Participants took a single and isocaloric 10 g-dose of CIT or PLA every day. Body composition; functional and aerobic capacities; absolute or relative upper and lower limbs muscle strength, muscle power; and energy balance were measured pre and post intervention. Results: Both groups significantly improved functional capacity and muscle function. However, HIIT+CIT demonstrated greater improvements in fast-paced Timed Up & Go (p = 0.04) and upper limbs muscle strength (absolute and relative) (p = 0.05) than HIIT+Placebo. Conclusion: CIT supplementation when combined with HIIT seems to induce greater improvements in upper limbs muscle strength and walking speed in dynapenic-obese elderly. Further studies are needed to confirm our results, to elucidate the mechanisms underlying the beneficial effects of CIT and to define the long-term impact of CIT/HIIT.
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Affiliation(s)
- Fanny Buckinx
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Gilles Gouspillou
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Livia P Carvalho
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Vincent Marcangeli
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Guy El Hajj Boutros
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Maude Dulac
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
| | - Philippe Noirez
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Institut de Recherche bioMédicale et d'Épidémiologie du Sport (IRMES), Université Paris Descartes, Sorbonne Paris Cité, 75012 Paris, France.
| | - José A Morais
- Division of Geriatric Medicine, McGill University Health Centre (MUHC), McGill University, Montréal, QC H3A 1A1, Canada.
| | - Pierette Gaudreau
- Département de Médecine de l'Université de Montréal, Centre de Recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Université de Montréal, Montréal, QC H2X 3E4, Canada.
| | - Mylène Aubertin-Leheudre
- Département des Sciences de l'activité physique, Groupe de Recherche en Activité Physique Adaptée (GRAPA), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W6, Canada.
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