Long-term determinants of muscle strength decline: prospective evidence from the 22-year mini-Finland follow-up survey

Association of a healthy ageing index with health-related outcomes in a multi-ethnic cohort from Singapore

BACKGROUND

The global population is ageing rapidly and it is important to promote healthy ageing. The Healthy Ageing Index (HAI) is a comprehensive measure of health, but there is limited research on its association with other age-related outcomes. The management of an aging population necessitates considerations even among generally healthy adults, as age-related diseases often remain unaccounted for until later stages of life. This study explores the association of risk factors with HAI and its association with peripheral artery disease (PAD), muscle strength, health-related quality of life (HRQoL), and psychological distress in the Singapore Multi-Ethnic Cohort study.

METHODS

This cross-sectional study involved 1909 participants (median (Q1, Q3) age: 53 (48, 60) years and 59.3% females) from Singapore Multi-Ethnic Cohort study. The risk factors of HAI included age, gender, ethnicity, education level, smoking, alcohol consumption, employment, BMI and past medical histories. PAD was assessed using ankle-brachial index (ABI), handgrip strength (HGS), HRQoL with the EQ-5D-5 L questionnaire and psychological distress via the Kessler Psychological Distress Scale (K10). HAI components were assessed using relevant marker tests.

RESULTS

Older age, Malay and Indian ethnicities, unemployment, high BMI and histories of CHD, hypercholesterolaemia, tumours and TIA/stroke were associated with lower HAI scores indicative of poorer health. Higher HAI scores were associated with females and higher education levels. Lower HAI scores were significantly associated with low ABI, high K10 scores, mobility and anxiety/depression dimensions of EQ-5D-5 L.

CONCLUSION

The most important factors associated with HAI were age, sex, ethnicity, education, unemployment, BMI and a history of health conditions. Lower HAI scores were significantly associated with PAD, lower HRQoL and psychological distress. Thus, the HAI demonstrates promise as an evaluation method for assessing PAD, overall muscle strength and HRQoL in a population-based setting.

Hand grip strength as a proposed new vital sign of health: a narrative review of evidences

Hand grip strength (HGS) serves as a fundamental metric in assessing muscle function and overall physical capability and is particularly relevant to the ageing population. HGS holds an important connection to the concept of sarcopenia, which encompasses the age-related decline in muscle mass, strength, and function. It has also been reported to indicate the health of an individual. We reviewed the interplay between HGS and various health parameters, including morbidity and mortality, by carrying out a literature search on PubMed, Scopus and Google Scholar between 10 and 30 August 2023, to identify the relevant papers on the relationship between health and HGS. We used several keywords like 'hand grip strength', 'muscle strength, 'sarcopenia', 'osteosarcopenia', 'health biomarker', 'osteoporosis', and 'frailty', to derive the appropriate literature for this review. This review has shown that the HGS can be measured reliably with a hand-held dynamometer. The cut-off values are different in various populations. It is lower in Asians, women, less educated and privileged, and those involved in sedentary work. Several diseases have shown a correlation with low HGS, e.g., Type 2 diabetes, cardiovascular disease, stroke, chronic kidney and liver disease, some cancers, sarcopenia and fragility fractures. The low HSG is also associated with increased hospitalization, nutritional status, overall mortality and quality of life. We believe that there is adequate evidence to show that HGS stands as an important biomarker of health. Its utility extends to the identification of diverse health issues and its potential as a new vital sign throughout the lifespan.

Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis

The purpose of this study was to examine (a) the socioeconomic status (SES)-related inequalities associated with handgrip strength (HGS); and (b) the extent to which several demographic, health, and behavioral factors contributed to such SES disparities in HGS among older adults in India. Data were drawn from the 2017-2018 wave 1 of the Longitudinal Ageing Study of India (LASI). The study sample included 27,707 older adults (13,199 men and 14,508 women) aged 60 years and older. HGS was assessed using a handheld Smedley's Hand Dynamometer with a cut-off of 19.5 kg for men and 12.5 kg for women. Bivariate analysis showed the weighted percentage distribution of weak HGS across respondent characteristics. Multivariate logistic regression assessed factors linked to weak HGS. The concentration curve and index (CCI) was used to determine the inequalities in the prevalence of weak HGS by wealth index scores. Wagstaff's decomposition approach was used to test the contribution of each explanatory variable to weak HGS. Around 9% of older adults in this study reported a weak HGS. It was significantly higher among those aged 80 or older (19.21%) and males (15.55%). Weak HGS was concentrated among older adults from poor SES (CCI: 0.05, p < 0.001). A higher percentage of wealth-based inequality in weak HGS was explained by being underweight (38.83%), belonging to the richest wealth quintile (27.95%), and having a higher subjective social status (32.20%). Moreover, about 23.29% of the inequality in weak HGS was explained by Western region and 22.54% by female gender. Additionally, having a secondary level of education explained a higher percentage (22.09%) of inequality, followed by current working status (- 20.68%). Rural residence (13.08%), limitations in instrumental activities of daily living (IADL) (12.21%), and engagement in yoga-related activities (11.55%) explained a higher percentage of wealth-based inequalities. The findings provide evidence of significant SES-related inequalities in HGS and the contribution of various demographic, health, and behavioral factors to such inequality. As such, public health policies and programs focusing on reducing the burden of disability must consider the contribution of social and economic equity to the preservation of muscle strength among older adults.

Exploring Handgrip Strength as a Cross-cultural Correlate of Body Composition and Upper Body Strength in Older Adults from Costa Rica and Kansas

Sarcopenia and disability in older adults are often characterized by body composition measurements; however, the gold standard of body composition measurement, dual-energy X-ray absorptiometry (DEXA), is expensive to acquire and maintain, making its use in low and middle income countries (LMIC) it out-of-reach in developing nations. Because these LMIC will bear a disproportionate amount of chronic disease burden due to global aging trends, it is important that reliable, low-cost surrogates need to be developed. Handgrip strength (HGS) is a reliable measure of disability in older adults but has not been used widely in diverse populations. This study compared HGS to multiple measurements of body composition in older adults from the US (Kansas) and a middle-income country (Costa Rica) to test if HGS is a cross-culturally appropriate predictive measure that yields reliable estimates across developed and developing nations. Percent body fat (%BF), lean tissue mass index (LTMI), appendicular lean soft tissue index (ALSTI), body fat mass index (BFMI), bone mineral density (BMD), and HGS were measured in older Costa Ricans (n = 78) and Kansans (n = 100). HGS predicted lean arm mass with equal accuracy for both samples (p ≤ 0.05 for all groups), indicating that it is a reliable, low-cost and widely available estimate of upper body lean muscle mass. Older adults from Costa Rica showed different body composition overall and HGS than controls from Kansas. Handgrip operates equivalently in the US and Mesoamerica and is a valid estimate of lean arm muscle mass as derived by the more expensive DEXA.

Glycerol induced paraspinal muscle degeneration leads to hyper-kyphotic spinal deformity in wild-type mice

Degenerative spinal disorders, including kyphotic deformity, are associated with a range of degenerative characteristics of the paraspinal musculature. It has therefore been hypothesized that paraspinal muscular dysfunction is a causative factor for degenerative spinal deformity; however, experimental studies demonstrating causative relationships are lacking. Male and female mice received either glycerol or saline injections bilaterally along the length of the paraspinal muscles at four timepoints, each separated by 2 weeks. Immediately after sacrifice, micro-CT was performed to measure spinal deformity; paraspinal muscle biopsies were taken to measure active, passive and structural properties; and lumbar spines were fixed for analysis of intervertebral disc (IVD) degeneration. Glycerol-injected mice demonstrated clear signs of paraspinal muscle degeneration and dysfunction: significantly (p < 0.01) greater collagen content, lower density, lower absolute active force, greater passive stiffness compared to saline-injected mice. Further, glycerol-injected mice exhibited spinal deformity: significantly (p < 0.01) greater kyphotic angle than saline-injected mice. Glycerol-injected mice also demonstrated a significantly (p < 0.01) greater IVD degenerative score (although mild) at the upper-most lumbar level compared to saline-injected mice. These findings provide direct evidence that combined morphological (fibrosis) and functional (actively weaker and passively stiffer) alterations to the paraspinal muscles can lead to negative changes and deformity within the thoracolumbar spine.

Sex-specific associations of single metal and metal mixture with handgrip strength: a cross-sectional study among Chinese adults

Metallic elements are ubiquitous in the natural environment and always collaborate to affect human health. The relationship of handgrip strength, a marker of functional ability or disability, with metal co-exposure remains vague. In this study, we aimed to investigate the effect of metal co-exposure on sex-specific handgrip strength. A total of 3594 participants (2296 men and 1298 women) aged 21 to 79 years recruited from Tongji Hospital were included in the present study. Urinary concentrations of 21 metals were measured by inductively coupled plasma mass spectrometer (ICP-MS). We used linear regression, restricted cubic spline (RCS) model, and weighted quantile sum (WQS) regression to evaluate the association of single metal as well as metal mixture with handgrip strength. After adjusting for important confounding factors, the results of linear regression showed that vanadium (V), zinc (Zn), arsenic (As), rubidium (Rb), cadmium (Cd), thallium (Tl), and uranium (U) were adversely associated with handgrip strength in men. The results of RCS showed a non-linear association between selenium (Se), silver (Ag), and nickel (Ni) with handgrip strength in women. The results of WQS regression revealed that metal co-exposure was inversely related to handgrip strength for men (β = -0.65, 95% CI: -0.98, -0.32). Cd was the critical metal in men (weighted 0.33). In conclusion, co-exposure to a higher level of metals is associated with lower handgrip strength, especially among men, and Cd may contribute most to the conjunct risk.

Association of sarcopenia and systolic blood pressure with mortality: A 5-year longitudinal study

PURPOSE

Whether the combination of sarcopenia and systolic blood pressure (SBP) changes the risk of all-cause mortality is unknown. Thus, this study aimed to examine the association between sarcopenia and SBP in community-dwelling older adults and determine whether this association changes the mortality risk.

METHODS

Older adults aged ≥65 years participated in the baseline assessment. The participants were classified into six groups according to a combination of the presence or absence of sarcopenia (sarcopenia, non-sarcopenia) and SBP (low SBP, ≤119 mmHg; normal SBP, 120-139 mmHg; high SBP, ≥140 mmHg). The participants were followed for the occurrence of death for 5 years after baseline assessment. Muscle mass, grip strength, and walking speed as indicators of sarcopenia, SBP, and all-cause mortality data for 5 years from baseline assessment were evaluated.

RESULTS

This study included 13,569 community-dwelling older adults. During the 5-year follow-up period, 830 participants (6.6%) died. In the Cox proportional hazards models, the risk of all-cause mortality was higher in other non-sarcopenia groups than in the non-sarcopenia/normal SBP group. In particular, those with sarcopenia had a higher mortality risk.

CONCLUSIONS

Low or high SBP increased the mortality risk in community-dwelling older adults. In those with sarcopenia, low or high SBP was associated with an even higher mortality risk. Older adults with sarcopenia and low/high blood pressure should be monitored as a population at a higher mortality risk.

SARcopenia Assessment in Hypertension: The SARAH Study

OBJECTIVES

The aims of the study were to investigate the relationship between sarcopenia and renin-angiotensin system-related disorders and to explore the effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on muscle mass/function and physical performance.

DESIGN

This multicenter, cross-sectional study was performed using ISarcoPRM algorithm for the diagnosis of sarcopenia.

RESULTS

Of the 2613 participants (mean age = 61.0 ± 9.5 yrs), 1775 (67.9%) were hypertensive. All sarcopenia-related parameters (except chair stand test in males) were worse in hypertensive group than in normotensive group (all P < 0.05). When clinical/potential confounders were adjusted, hypertension was found to be an independent predictor of sarcopenia in males (odds ratio = 2.403 [95% confidence interval = 1.514-3.813]) and females (odds ratio = 1.906 [95% confidence interval = 1.328-2.734], both P < 0.001). After adjusting for confounding factors, we found that all sarcopenia-related parameters (except grip strength and chair stand test in males) were independently/negatively related to hypertension (all P < 0.05). In females, angiotensin-converting enzyme inhibitors users had higher grip strength and chair stand test performance values but had lower anterior thigh muscle thickness and gait speed values, as compared with those using angiotensin II receptor blockers (all P < 0.05).

CONCLUSIONS

Hypertension was associated with increased risk of sarcopenia at least 2 times. Among antihypertensives, while angiotensin-converting enzyme inhibitors had higher muscle function values, angiotensin II receptor blockers had higher muscle mass and physical performance values only in females.

Nationwide handgrip strength values and factors associated with muscle weakness in older adults: findings from the Brazilian Longitudinal Study of Aging (ELSI-Brazil)

BACKGROUND

Handgrip strength (HGS) is a simple, quick, inexpensive, and highly reliable method for the assessment of muscle strength in clinical practice and epidemiological studies. This study aimed at describing the HGS values by age group and sex in Brazilians aged 50 years and over, determining age group- and sex-specific cutoff points for muscle weakness, and investigating sociodemographic and anthropometric variables associated with muscle weakness for each sex.

METHODS

Data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed. HGS was measured in the dominant hand using a hydraulic hand dynamometer. Fractional polynomial regression models were fitted to estimate the percentiles (P5, P10, P20, P25, P50, P75, P90, and P95) of HGS by age group and sex. The P20 of the maximum HGS by age group and sex was used to define muscle weakness. Associations between sociodemographic (racial self-classification, place of residence, schooling, and monthly household income per capita in tertiles) and anthropometric variables (body mass index and waist circumference) and muscle weakness, by sex, were evaluated using logistic regression.

RESULTS

The analytical sample included 7905 participants (63.1 ± 9.1 years; 60% women). HGS reduced with increasing age in both sexes. Men presented higher HGS than women in all age groups. The cutoff points for muscle weakness ranged from 28 to 15 kg for men and from 17 to 9 kg for women. In the adjusted analyses, low schooling (0-4 years) was positively associated with muscle weakness in both sexes (in men, odds ratio (OR) 2.45, 95% confidence interval (CI) 1.46-4.12; in women, OR 1.90, 95%CI 1.18-3.06). Low and middle monthly household income per capita also had a positive association with muscle weakness among women (OR 1.78, 95%CI 1.37-2.32; OR 1.32, 95%CI 1.01-1.73, respectively). Overweight had a negative association with muscle weakness among men (OR 0.66, 95%CI 0.52-0.83), and obesity was inversely associated with muscle weakness in both sexes (in men, OR 0.49, 95%CI 0.31-0.78; in women, OR 0.69, 95%CI 0.52-0.92).

CONCLUSIONS

This study provides HGS values and cutoff points for muscle weakness by age group and sex from a nationally representative sample of older Brazilian adults. The variables associated with muscle weakness slightly differed between men and women. HGS values and cutoff points generated can be used as benchmarks in clinical settings and foster future epidemiological research.

Association of dietary and lifestyle inflammation scores with muscle strength and muscle endurance among Tehranian adults

Diet and lifestyle as modifiable factors play an effective role in muscle strength and muscle endurance. In addition, inflammatory reactions may have an association with the etiology of a a lower muscle strength and muscle endurance. We aimed to investigate the association of dietary and lifestyle inflammation scores (DLIS) with muscle strength and muscle endurance in a sample of Iranian adults. In this cross-sectional study, 270 adults aged 20 to 59 years (55.9% female) were selected. The dietary intakes were collected using a 168-item semi-quantitative food frequency questionnaire. The DLIS was calculated using the dietary inflammatory score (DIS), and lifestyle inflammatory score (LIS). Muscle endurance and muscle strength were measured by a digital-handgrip-dynamometer. Multivariate adjusted means for muscle strength and endurance across quartiles of the DIS, LIS, and DLIS were determined by the ANCOVA test. Multiple linear regression analysis was used to evaluate the association between inflammation scores (i.e., DIS, LIS, and DLIS), and muscle strength, muscle endurance. The DLIS ranged between -2.94 and 3.09. The adjusted P-value of muscle strength of the right hand (MSR) along quartiles of DIS was significantly lower (P = 0.024). MSR (β: -1.19; P-value: 0.020) and mean muscle strength (MMS) (β: -0.95; P-value: 0.047) had significant association with DIS. MSR (β: -0.85; P-value: 0.050) had a marginally significant association with DLIS. Overall, we found that a high adherence to a pro-inflammatory diet might be associated to a lower muscle strength. However, a lifestyle with greater inflammatory potential was not related to any components of muscle endurance. Further studies with prospective designs are needed to confirm the present findings in further details.

Secondhand Tobacco Smoke and Functional Impairments in Older Adults Living in the Community

BACKGROUND/AIM

There has been no comprehensive examination of the potential association of SHS with broad functional limitation assessment in older adults, where functional limitations are burdensome and challenging.

METHODS

We examined 2258 community-dwelling non-smoking older adults from the Seniors-Enrica-2-cohort. At baseline (2017) and follow-up (2019) grip strength was measured with a Jamar dynamometer, lower-extremity performance with the Short Physical Performance Battery (SPPB), overall physical function using the physical component summary (PCS) of the Spanish version of the SF-12, frailty with a Deficits Accumulation Index (DAI), and mobility limitations with the Rosow-Breslau scale. Baseline exposure to SHS was assessed by serum cotinine, and past exposure was self-reported. Cross-sectional analyses were performed using linear and logistic regression models, whereas functional performance changes were examined using repeated measures models with robust SE estimates.

RESULTS

Overall, the median (IQR) serum cotinine concentration was 0.079 (0.035-0.175) ng/ml, with 20 participants presenting concentrations ≥3 ng/ml. Compared to the unexposed, fully-adjusted models showed that the highest exposure group (≥0.239 ng/ml) presented lower grip strength (mean difference: -1.05 kg; 95% CI = -1.80, -0.31) and higher DAI scores (1.52; 95% CI = 0.38, 2.66) at baseline. Similarly, in models of self-reported past exposure, never-smokers who had lived with ≥2 smokers or been exposed to higher SHS cumulative doses showed lower baseline SPPB values, higher DAI scores, and higher prevalence of mobility limitations. In prospective analyses, those in the highest quartile of baseline cotinine presented harmful SPPB [-0.24 (-0.46, -0.02)] and DAI [1.28 (0.00, 2.55)] changes, and higher risk of mobility limitations [hazard ratio: 1.64; 95% CI = 1.01, 2.68] than the unexposed.

CONCLUSIONS

SHS exposure over the life-course and during old age may accelerate functional decline.

IMPLICATIONS

This manuscript provides a comprehensive examination of the relationship between secondhand smoke exposure and a broad range of functional limitations in older adults. Results show that: (i) non-smokers who had been exposed to higher cumulative doses of SHS in adulthood show worse physical function than non-exposed. (ii) Exposure to SHS during old age, as measured with cotinine concentrations, is associated with accelerated short-term functional declines. (iii) The effects of SHS are stronger among older adults with chronic morbidities. (iv) Results suggest that more efforts are needed to protect older adults from passive smoking, especially to those with chronic conditions because of their potential greater vulnerability to the effects of SHS.

The Prevalence of Sarcopenia among Hunan Province Community-Dwelling Adults Aged 60 Years and Older and Its Relationship with Lifestyle: Diagnostic Criteria from the Asian Working Group for Sarcopenia 2019 Update

Background and Objectives: This study aims to detect the prevalence of sarcopenia in community-dwelling older adults in Hunan Province, discuss factors related to lifestyle, and provide a reliable basis for the prevention and treatment of sarcopenia. Materials and Methods: In this study, a total of 1040 community-dwelling adults ≥ 60 years were examined for sarcopenia using a cluster stratified random sampling method, which was defined using the diagnostic criteria recommended by the Asian Working Group for Sarcopenia (AWGS) from September 2019 to March 2020. Multivariate logistic regression analysis was applied to determine the correlation between sarcopenia and smoking, drinking, nutritional status, physical activity, and sleep quality. Results: A total of 27.1% of the older adults were diagnosed with sarcopenia, with rates of 26.2% in men and 25.2% in women. Multiple logistic regression showed that advanced age (OR = 2.480, 95% CI: 1.730, 3.553), the risk of malnutrition (OR = 2.085, 95% CI: 1.440, 3.019), and malnutrition (OR = 1.212, 95% CI: 0.304, 4.834) were risk factors for sarcopenia. No falls in the previous year (OR = 0.616, 95% CI: 1.885, 1.209), normal weight (OR = 0.228, 95% CI: 0.109, 0.475), overweight (OR = 0.030, 95% CI: 0.013, 0.069), moderate physical activity (OR = 0.593, 95% CI: 0.377, 0.933), or high physical activity (OR = 0.417, 95% CI: 0.230, 0.755) were identified as protective factors for sarcopenia. Conclusions: The prevalence of sarcopenia was high among older adults in the community in Hunan Province. In addition, we found that lifestyle is an important factor in sarcopenia.

Grip Strength Trajectories and Cognition in English and Chilean Older Adults: A Cross-Cohort Study

Growing evidence about the link between cognitive and physical decline suggests the early changes in physical functioning as a potential biomarker for cognitive impairment. Thus, we compared grip-strength trajectories over 12-16 years in three groups classified according to their cognitive status (two stable patterns, normal and impaired cognitive performance, and a declining pattern) in two representative UK and Chilean older adult samples. The samples consisted of 7069 UK (ELSA) and 1363 Chilean participants (ALEXANDROS). Linear Mixed models were performed. Adjustments included socio-demographics and health variables. The Declined and Impaired group had significantly lower grip-strength at baseline when compared to the Non-Impaired. In ELSA, the Declined and Impaired showed a faster decline in their grip strength compared to the Non-Impaired group but differences disappeared in the fully adjusted models. In ALEXANDROS, the differences were only found between the Declined and Non-Impaired and they were partially attenuated by covariates. Our study provides robust evidence of the association between grip strength and cognitive performance and how socio-economic factors might be key to understanding this association and their variability across countries. This has implications for future epidemiological research, as hand-grip strength measurements have the potential to be used as an indicator of cognitive performance.

Association between sarcopenia and respiratory function in elderly orthopedic outpatients

The relationship between sarcopenia and respiratory function has not been investigated in elderly Japanese orthopedic outpatients. This study aimed to assess the relationship between sarcopenia and respiratory function in elderly orthopedic outpatients in Japan. Elderly outpatients (n = 102; aged ≥65 years) with orthopedic diseases were enrolled in the study. Muscle mass was measured using the bioelectrical impedance analysis. Grip strength and walking speed were measured (2 trials). The respiratory function (e.g., percent vital capacity [VC] and percent forced expiratory volume in 1 second) was also measured. The association between sarcopenia and respiratory function was assessed using logistic regression analysis, adjusting for sex, comorbidities, and smoking status. The mean ages for men and women were 77.7 ± 8.3 and 76.5 ± 6.8 years, respectively, and the overall prevalence of sarcopenia was 25.5% (30.0% and 24.4% in men and women, respectively). The study demonstrated that low respiratory function, which was represented by decreased percent VC, was associated with sarcopenia in outpatients visiting an orthopedic department (odds ratio, 1.73; 95% confidence interval: 1.02-2.97). Sarcopenia was significantly associated with a lower percentage of VC in orthopedic outpatients after adjustment for sex, comorbidity, and smoking. Further studies are needed to determine the causality.

Homing in on cognition with cross-sectional analysis of sarcopenia-related measurements: the SARCOG study

BACKGROUND

Cognitive impairment may cause significant decline in muscle function and physical performance via affecting the neuromotor control.

AIM

To investigate the relationship between cognition and sarcopenia-related parameters in middle-aged and older adults.

METHODS

Demographic data and comorbidities of adults ≥ 45-year-old were noted. The Mini-Mental State Examination (MMSE) was used to evaluate global cognitive function. Sonographic anterior midthigh muscle thickness, handgrip strength, chair stand test (CST) and gait speed were measured. The diagnosis of sarcopenia was established if low muscle mass was combined with low muscle function. Dynapenia was defined as low grip strength or increased CST duration.

RESULTS

Among 1542 subjects (477 M, 1065 F), sarcopenia and dynapenia were detected in 22.6 and 17.2% of males, and 17.2 and 25.3% of females, respectively. Sarcopenic patients were older and had higher body mass index, higher frequencies of hypertension, diabetes mellitus and obesity. They had lower muscle thickness, grip strength in males only, CST performance in females only and gait speed than the other groups (all p < 0.05). Sarcopenic and dynapenic patients had similar MMSE scores which were lower than those of normal subjects (both p < 0.001). After adjusting for confounding factors, MMSE values were positively related with grip strength in females only, CST performance and gait speed (all p < 0.001); but not with muscle thickness in either gender.

CONCLUSION

Cognitive impairment may unfavorably affect muscle function and physical performance, but not muscle mass. Accordingly, its prompt management can help to decrease patient morbidity and mortality.

Relationship Between Age-Related Changes in Skeletal Muscle Mass and Physical Function: A Cross-Sectional Study of an Elderly Japanese Population

Skeletal muscle mass and muscle strength are positively correlated, but the relationship between grip strength and global muscle strength is controversial. This study aimed to clarify the changes in site-specific skeletal muscle mass by age group and determine the relationship between site-specific, age-related changes in skeletal muscle mass and physical function in community-dwelling elderly people in Japan. The participants were divided into age groups of five-year intervals (65-69 years, 70-74 years, 75-79 years, and ≥80 years) and were also categorized by sex. The skeletal muscle mass of the upper limbs, lower limbs, and trunk was measured using multifrequency bioelectrical impedance analyzers (InBody 430 (Biospace Co., Ltd., Seoul, Korea) and InBody 470 (InBody Japan Inc., Tokyo, Japan)). For physical function assessment, we measured grip strength, quadriceps strength, sit-up count, sit-and-reach distance, and standing time on one leg with eyes open and performed the timed up and go (TUG) test. The results showed that skeletal muscle mass decreased with age regardless of sex at all measured sites. Furthermore, a partial correlation analysis adjusted for age, physical constitution, and the presence/absence of exercise habits revealed that the highest correlation was between skeletal muscle mass in all sites and grip strength. Thus, monitoring grip strength may be used as a representative of systemic skeletal mass even in Japanese people.

Handgrip Strength-Related Factors in a Colombian Hypertensive Population: A Cross-Sectional Study

(1) Background: This study determined the factors associated with manual grip strength in people with high blood pressure (HBP); (2) Methods: 219 subjects participated in this cross-sectional study, which evaluated muscle strength (manual dynamometer), sociodemographic factors, clinical characteristics, level of physical activity (International Physical Activity Questionnaire-IPAQ score), and depression (Zung's Depression Self-Rating Scale); (3) Results: The bivariate analysis found that handgrip strength in people with HPB was associated with sex (p = 0.000), age (p = 0.000), ethnicity (p = 0.019), smoking habits (p = 0.037), alcohol consumption (p = 0.004), diastolic blood pressure (p = 0.012), weight (p = 0.000), height (p = 0.000), measurement of waist circumference (p = 0.002), depression (p = 0.041), and IPAQ score (p = 0.000). Regardless of being male or female, handgrip strength was associated with age (p = 0.009), IPAQ (p = 0.000), weight (p = 0.038), height (p = 0.000), DPB units (p = 0.043), and depression (p = 0.020). The multivariate generalized linear gamma regression model showed that the coefficient with the greatest weight, regardless of sex, was age (p = 0.043), level of physical activity (24% more at high level than at low level, p = 0.031), and depression (moderate/severe depression level) associated with lower handgrip strength (p = 0.025); (4) Conclusions: Handgrip strength showed an association with level of physical activity, age, and level of depression in a middle-aged population with HBP.

Relation of incident chronic disease with changes in muscle function, mobility, and self-reported health: Results from the Health and Retirement Study

The primary objective was to learn the extent that muscle function, mobility, and self-reported health decline following incident diabetes, stroke, lung problem, and heart problems. A secondary objective was to measure subsequent recovery following the incident events. A longitudinal panel study of the natural history of four major chronic diseases using the Health and Retirement Study, a nationally representative sample of adults over age 50 years. People first interviewed from 1998-2004 were followed across five biannual exams. The study included 5,665 participants who reported not having diabetes, stroke, lung problems, and heart problems at their baseline interview. Their mean age was 57.3 years (SD = 6.0). They were followed for an average of 4.3 biannual interviews. Declines and subsequent recovery in self-reported health, muscle function, and mobility were examined graphically and modeled using negative binomial regression. The study also measured the incidence rates and prevalence of single and multiple chronic diseases across the follow-up years.Self-reported health and muscle function declined significantly following incident stroke, heart problems, lung problems, and multiple chronic diseases. Mobility declined significantly except following incident diabetes. Self-reported health improved following incident multiple chronic conditions, but recovery was limited compared to initial decline. Population prevalence after five follow-up waves reached 9.0% for diabetes, 8.1% for heart problems, 3.4% for lung disease, 2.1% for stroke, and 5.2% for multiple chronic diseases. Significant declines in self-reported health, muscle function, and mobility occurred within two years of chronic disease incidence with only limited subsequent recovery. Incurring a second chronic disease further increased the declines. Early intervention following incident chronic disease seems warranted to prevent declines in strength, mobility, and perceptions of health.

Is lifestyle change around retirement associated with better physical performance in older age?: insights from a longitudinal cohort

A growing evidence base links individual lifestyle factors to physical performance in older age, but much less is known about their combined effects, or the impact of lifestyle change. In a group of 937 participants from the MRC National Survey of Health and Development, we examined their number of lifestyle risk factors at 53 and 60-64 years in relation to their physical performance at 60-64, and the change in number of risk factors between these ages in relation to change in physical performance. At both assessments, information about lifestyle (physical activity, smoking, diet) was obtained via self-reports and height and weight were measured. Each participant's number of lifestyle risk factors out of: obesity (body mass index ≥ 30 kg/m2); inactivity (no leisure time physical activity over previous month); current smoking; poor diet (diet quality score in bottom quarter of distribution) was determined at both ages. Physical performance: measured grip strength, chair rise and standing balance times at both ages and conditional change (independent of baseline) in physical performance outcomes from 53 to 60-64 were assessed. There were some changes in the pattern of lifestyle risk factors between assessments: 227 (24%) participants had fewer risk factors by age 60-64; 249 (27%) had more. Reductions in risk factors were associated with better physical performance at 60-64 and smaller declines over time (all p < 0.05); these associations were robust to adjustment. Strategies to support reduction in number of lifestyle risk factors around typical retirement age may have beneficial effects on physical performance in early older age.

SUPPLEMENTARY INFORMATION

The online version of this article (10.1007/s10433-021-00607-9) contains supplementary material, which is available to authorized users.

Long-term conditions, multimorbidity, lifestyle factors and change in grip strength over 9 years of follow-up: Findings from 44,315 UK biobank participants

Background

Weak grip strength is associated with a range of adverse health outcomes and an accelerated decline in grip strength confers an even greater risk. The factors associated with change in grip strength in mid-life remain to be fully determined.

Methods

We used data from 44,315 UK Biobank participants who had grip strength measured at baseline (2006-10) and a subsequent visit approximately nine years later. At baseline, participants’ long-term conditions (LTCs) were categorised against a hierarchy, with multimorbidity characterised by the number of LTC categories. Lifestyle factors were assessed. Change in grip strength was grouped into four patterns: decline, stable low, stable high or reference (no change or increase) and used as the outcome in multinomial logistic regression.

Results

Most LTC categories were associated with adverse patterns of change in grip strength (stable low and/or decline): for example, musculoskeletal/trauma conditions were associated with an increased risk of the stable low pattern (Relative Risk Ratio [RRR] = 1.63; 95% confidence interval [CI]: 1.49-1.79). Multimorbidity and lifestyle factors had independent associations with grip strength change. Those with 3+ categories of LTCs were more likely to experience decline in grip strength (RRR = 1.18; 95% CI: 1.08-1.28) compared to those with none. Low physical activity was associated with adverse patterns of grip strength, while raised body mass index (BMI) had divergent associations.

Conclusions

Individuals living with multimorbidity and those with lifestyle risk factors such as low physical activity are at increased risk of low muscle strength and the loss of strength over time.

Handgrip strength, dynapenia, and related factors in postmenopausal women

OBJECTIVE

This study aimed to evaluate the prevalence of dynapenia and factors related to low dominant handgrip strength (HGS) in postmenopausal women.

METHODS

A cross-sectional study was performed on 249 postmenopausal women aged 50 to 84 years. The following variables were recorded: age, age at menopause, smoking status, and the HGS measured with a digital dynamometer, body mass index, and adiposity assessed by bioelectric impedance. The physical activity level was evaluated by using the International Physical Activity Questionnaire. Bone mineral density was reported as T-scores, and blood biochemical parameters (calcium, phosphorus, vitamin D, and parathormone levels) were measured.

RESULTS

31.3% of women had dynapenia, and those aged ≥65 years had lower HGS (P < 0.001). Age at menopause was also associated with HGS, with those with menopause < 51 showing lower HGS (P = 0.005). Likewise, fat content ≥ 40%, and osteopenia/osteoporosis were also related to lower strength (P < 0.001). There was no statistically significant difference among HGS with respect to body mass index, smoking status, and plasma levels of vitamin D. A logistic regression model with lower Akaine Information Criterion showed that for every year in age and for each 1% of adiposity, women were more likely to have dynapenia with odd ratio (OR): 1.09; 95% and confidence interval (CI): 1.04 to 1.14 and OR: 1.06; 95% CI: 1.00 to 1.13, respectively. Conversely, women with higher femoral neck T-score were less likely to have dynapenia (OR: 0.53; 95% CI: 0.35-0.78).

CONCLUSIONS

HGS was associated with age at menopause, bone mineral density, and adiposity adjusted by age. The age and adiposity were significantly associated with a higher risk of dynapenia, whereas women with higher femoral neck T-score were less likely to have dynapenia.

Musculoskeletal Changes Across the Lifespan: Nutrition and the Life-Course Approach to Prevention

Aging is characterized by the progressive decline of muscle mass and function, the so-called sarcopenia. Also bone loss is widespread among older people. Sarcopenia and osteopenia/osteoporosis are associated with several adverse outcomes including falls, risk of fractures, functional decline, frailty, and mortality. Recently, the life-course approach to prevent or delay functional decline has become very popular. Regarding musculoskeletal health, there is suggestive evidence that acting during critical or sensitive periods of life in which each person build-up its biological reserves may influence the rate of functional decline in the later stages of life. A life-course approach to musculoskeletal health should take place during early life when plasticity allows more easily the attainment of the peak of the musculoskeletal system driven by environmental stimuli. The rate of the subsequent decline will depend on the peak previously reached. Nutrition and physical exercise are important environmental factors that can influence musculoskeletal development by favoring and maintaining peak bone and muscle mass and strength. Here we provide an overview of body composition changes occurring across the lifespan and strategies based on nutrition and physical exercise to support musculoskeletal health as well as minimizing losses during older life.

Usefulness of Relative Handgrip Strength as a Simple Indicator of Cardiovascular Risk in Middle-Aged Koreans

BACKGROUND

Reduced muscular strength, measured by handgrip strength, has been associated with increased risk for cardiovascular disease (CVD) and mortality. However, the prognostic significance of handgrip strength has been less well-studied in the middle-aged Korean population. This study determined whether handgrip strength predicted 10-year CVD risk in this population and whether there is a sex-specific difference.

METHODS

The data were derived from the 2015 Korean National Health and Nutrition Examination Survey that included total of 2776 participants aged 40-69 years without prior history of CVD (men: 1184; women: 1592). Isometric relative handgrip strength was calculated by dividing absolute handgrip strength by body mass index. Participants were classified into three groups by their 10-year Framingham cardiovascular risk score: low (<10%), intermediate (10-19%), and high (≥20%).

RESULTS

In men, relative handgrip strength was higher in the absence of hypertension, dyslipidemia, and diabetes compared with in the presence of these CVD risk factors. In women, a higher relative handgrip strength was observed in the absence of hypertension and dyslipidemia but not in the absence of diabetes compared with their counterparts. Advanced age was inversely associated with relative handgrip strength for both sexes. Multivariate logistic regression analysis demonstrated that an increased relative handgrip strength was a significant and independent predictor of low 10-year CVD risk among middle-aged women (odds ratio range 0.09-0.49, p < 0.001), but not among men.

CONCLUSIONS

Handgrip strength is a simple and effective screening tool for risk stratification for CVD in middle-aged Korean women.

Grip strength performance from 9431 participants of the GenoFit study: normative data and associated factors

Weak grip strength is a strong predictor of multiple adverse health outcomes and an integral diagnostic component of sarcopenia. However, the limited availability of normative data for certain populations impedes the interpretation of grip performance across adulthood. This study aimed to establish normative data and low grip strength thresholds in a large adult population, and to examine associations between grip strength and clinically relevant health variables. A total of 9431 adults aged between 18 and 92 years participated in this study (mean age: 44.8 ± 13.4 years; 57% females). Grip strength, body composition, and cardiorespiratory (CR) fitness were assessed using hand dynamometry, dual-energy x-ray absorptiometry and physical work capacity tests, respectively. Low grip strength was established according to criteria of the European Working Group on Sarcopenia in Older People. Normative data and t-scores, stratified by sex and age groups, are presented. Grip performance was associated with lean mass, skeletal muscle index (SMI), fat mass, CR fitness, bone mineral density (BMD), android/gynoid ratio, disease prevalence and physical activity levels (all p < 0.001) after controlling for multiple potential confounders. Individuals with weak grip strength had lower lean mass, SMI, CR fitness (all p < 0.001) and BMD (p = 0.001), and higher disease prevalence (p < 0.001), compared to healthy controls, although sex-specific differences were observed. Grip strength has practical screening utility across a range of health domains. The normative data and grip strength thresholds established in this study can guide the clinical interpretation of grip performance and facilitate timely therapeutic strategies targeting sarcopenia.

Adult obesity and mid-life physical functioning in two British birth cohorts: investigating the mediating role of physical inactivity

Background

Associations between obesity and physical inactivity are bi-directional. Both are associated with physical functioning (PF, ability to perform physical tasks of daily living) but whether obesity influences PF via inactivity is unknown. We investigated whether mid-adult obesity trajectories were associated with subsequent PF and mediated by inactivity.

Methods

Body mass index (BMI; kg/m²) and inactivity were recorded at: 36, 43, 53 and 60–64 years in the 1946 Medical Research Council (MRC) National Survey of Health and Development (1946-NSHD; n = 2427), and at 33, 42 and 50 years in the 1958 National Child Development Study (1958-NCDS; n = 8674). Poor PF was defined as the lowest (gender and cohort-specific) 10% on the Short-form 36 Physical Component Summary subscale at 60–64 years (1946-NSHD) and 50 years (1958-NCDS). Estimated randomized-interventional-analogue natural direct (rNDE) and indirect (rNIE) effects of obesity trajectories on PF via inactivity are expressed as risk ratios [overall total effect (rTE) is rNDE multiplied by rNIE].

Results

In both cohorts, most individuals (∼68%) were never obese in adulthood, 16–30% became obese and ≤11% were always obese. In 1946-NSHD, rTE of incident obesity at 43 years (vs never) on poor PF was 2.32 (1.13, 3.51); at 53 years it was 1.53 (0.91, 2.15). rNIEs via inactivity were 1.02 (0.97, 1.07) and 1.02 (0.99, 1.04), respectively. Estimated rTE of persistent obesity from 36 years was 2.91 (1.14, 4.69), with rNIE of 1.03 (0.96, 1.10). In 1958-NCDS, patterns of association were similar, albeit weaker.

Conclusions

Longer duration of obesity was associated with increased risk of poor PF. Inactivity played a small mediating role. Findings reinforce the importance of preventing and delaying obesity onset to protect against poor PF.

Impact of dietary protein intake on the incidence of low muscle strength in middle-aged and older adults

BACKGROUND

A reduction in skeletal muscle strength is a prognostic indicator of negative consequences, such as physical disability, frailty, and mortality in older adults. Studies investigating associations between the risk of reduction in skeletal muscle strength and the amount of dietary protein which is a factor influenced muscle health are scarce, particularly in Asian populations. Therefore, we investigated the association between the amount and change in daily protein intake and the prospective risk of developing low skeletal muscle strength in middle-aged and older adults.

METHODS

This study used data from the Korean Genome and Epidemiology Study as an ongoing population-based cohort study of adults aged 40 years and over. The amount of daily protein consumed was assessed using a semi-quantitative food frequency questionnaire. Low skeletal muscle strength was measured with a handgrip strength dynamometer.

RESULTS

In total, 32,458 adults (11,358 males and 21,100 females) were evaluated. The amount of daily dietary protein consumed was not associated with the risk of low muscle strength over the 4-year follow-up period after adjusting for covariates. No associations between low muscle strength events according to the change in the amount of protein consumed from the baseline to the follow-up surveys were identified.

CONCLUSIONS

The amount of and change in dietary protein consumed were not associated with developing low muscle strength in middle-aged and older adults. Further studies with a focus on physical activity-protein intake interactions and specific conditions, such as mobility-limited adults or hospitalized patients, are warranted to clarify the relationship between protein intake status and the incidence of low skeletal muscle strength.

Mortality of Japanese Olympic athletes in 1964 Tokyo Olympic Games

Objectives

To compare the mortality of Japanese athletes in the 1964 Tokyo Olympic Games with that of the Japanese population, and to elucidate factors associated with their mortality.

Methods

We obtained from the Japan Sport Association study subjects’ biographical information, information on lifestyles and medical data. Missing data were obtained from online databases. Standardised mortality ratio (SMR) was calculated to compare athletes’ mortality with the Japanese population. Cox proportional hazards model was applied to estimate the HR for each category of body mass index (BMI), smoking history and handgrip strength. This analysis was limited to male athletes due to the small number of female athletes.

Results

Among 342 (283 men, 59 women) athletes, deaths were confirmed for 70 (64 men, 6 women) athletes between September 1964 and December 2017. Total person years was 15 974.8, and the SMR was 0.64 (95% CI 0.50 to 0.81). Multivariate analysis performed on 181 male athletes. Mortality was significantly higher for BMI≥25 kg/m² than for 21–23 kg/m² (HR: 3.03, 95% CI 1.01 to 9.07). We found no statistically significant associations between smoking history and mortality; the HR (95% CI) for occasional and daily smokers were 0.82 (0.26 to 2.57) and 1.30 (0.55 to 3.03) compared with never smokers. We also found no statistically significant associations between handgrip strength and mortality (P for trend: 0.51).

Conclusion

Japanese athletes in the 1964 Tokyo Olympic Games lived longer than the Japanese population. BMI≥25 kg/m² was associated with higher mortality, but smoking history and handgrip strength were not associated with mortality.

Sarcopenia: prevalence, associated factors, and the risk of mortality and disability in Japanese older adults

BACKGROUND

There is limited evidence on sarcopenia in Asian populations. This study aimed to clarify the prevalence, associated factors, and the magnitude of association with mortality and incident disability for sarcopenia and combinations of its components among Japanese community-dwelling older adults.

METHODS

We conducted a 5.8 year prospective study of 1851 Japanese residents aged 65 years or older (50.5% women; mean age 72.0 ± 5.9) who participated in health check-ups. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 algorithm. Appendicular lean mass index (ALMI) was measured using direct segmental multi-frequency bioelectrical impedance analysis. A Cox proportional hazards regression model was used to identify associations of sarcopenia and the combinations of its components with all-cause mortality and incident disability.

RESULTS

The prevalence of sarcopenia was 11.5% (105/917) in men and 16.7% (156/934) in women. Significant sarcopenia-related factors other than ageing were hypoalbuminaemia, cognitive impairment, low activity, and recent hospitalization (all P-values <0.05) among men and cognitive impairment (P = 0.004) and depressed mood (P < 0.001) among women. Individuals with sarcopenia had higher risks of mortality [hazard ratios (95% confidence interval): 2.0 (1.2-3.5) in men and 2.3 (1.1-4.9) in women] and incident disability [1.6 (1.0-2.7) in men and 1.7 (1.1-2.7) in women]. Compared with the individuals without any sarcopenia components, those having low grip strength and/or slow gait speed without low ALMI tended to have an increased risk of disability [1.4 (1.0-2.0), P = 0.087], but not mortality [1.3 (0.8-2.2)]. We did not find increased risks of these outcomes in participants having low ALMI in the absence of low grip strength and slow gait speed [1.2 (0.8-1.9) for mortality and 0.9 (0.6-1.3) for incident disability].

CONCLUSIONS

Japanese older men and women meeting Asian criteria of sarcopenia had increased risks of all-cause mortality and disability. There were no significant increased risks of death or incident disability for both participants with muscle weakness and/or low performance without low muscle mass and those with low muscle mass with neither muscle weakness nor low performance. Further studies are needed to examine the interaction between muscle loss, muscle weakness, and low performance for adverse health-related outcomes.

Circulating MicroRNA-486 and MicroRNA-146a serve as potential biomarkers of sarcopenia in the older adults

Background

Age-related sarcopenia meaningfully increases the risks of functional limitations and mortality in the older adults. Although circulating microRNAs (c-miRNAs) are associated with aging-related cellular senescence and inflammation, the relationships between c-miRNAs and sarcopenia in the older adults remain unclear. This study investigates whether circulating myo-miRNAs and inflammation-related miRNAs are associated with sarcopenia in the older adults.

Methods

This investigation recruited 77 eligible subjects (41 males and 36 females) from 597 community-dwelling older adults, and then divided them into normal (n = 24), dynapenic (loss of muscular function without mass, n = 35), and sarcopenic groups (loss of muscular function with mass, n = 18). Moreover, myo- (c-miRNA-133a and c-miRNA-486) and inflammation- (c-miRNA-21 and c-miRNA-146a) related miRNAs, as well as, inflammatory-related cytokine and peroxide levels in plasma were determined using quantitative polymerase chain reaction and ELISA, respectively.

Results

Sarcopenic group exhibited lesser skeletal muscle mass index (SMI), handgrip strength, and gait speed, as well as, lower c-miR-486 and c-miR-146a levels, compared to those of normal and dynapenic groups. Moreover, c-miR-486 level was positively related to SMI (r = 0.334, P = 0.003), whereas c-miR-146a level was positively associated with SMI (r = 0.240, P = 0.035) and handgrip strength (r = 0.253, P = 0.027). In the receiver operating characteristic analysis for predicting sarcopenia, the area under the curve in c-miR-486 was 0.708 (95% confidence interval: 0.561–0.855, P = 0.008) and c-miR-146a was 0.676 (95% CI: 0.551–0.801, P = 0.024). However, no significant relationships were observed between SMI/handgrip strength/gait speed and plasma myeloperoxidase/interleukin-1훽/interleukin-6 levels.

Conclusions

Myo-miRNA (c-miR-486) and inflammation-related miRNA (c-miR-146a) are superior to inflammatory peroxide/cytokines in plasma for serving as critical biomarkers of age-related sarcopenia.

Muscle mass and aerobic capacity in older women: Impact of regular exercise at middle age

BACKGROUND

The impact of regular exercise habits at middle-age on muscle mass and function at old age remains inconclusive. While regular exercise likely represents a primary source of health-enhancing physical activity (PA), the physical demand of occupation needs to be considered. Additionally, PA level at old age should be taken into account in order to elucidate true associations between past exercise behaviors and muscle mass and function at old age. Therefore, the aim of the study was to examine the impact of regular exercise habits during middle age years on muscle mass and physical function at old age, while considering occupation and objectively assessed PA level at old age.

METHODS

Self-reported leisure-time PA during middle age years [35-65 years] and present accelerometer-derived PA level were assessed in a population of community-dwelling older women (65-70 years; n = 112). Participants who accumulated at least 600 MET-min of PA per week during middle age years were classified as physically active. Skeletal muscle mass index (SMI), aerobic fitness and maximal isometric arm and leg strength were determined. Analyses of differences in muscle mass and physical function between physically active and inactive at middle age were adjusted by present PA, adiposity level, and the physical demand of former occupation (sedentary vs manual).

RESULTS

Participants accumulating at least 600 MET-min of exercise-related activities during middle-age years had higher aerobic fitness (P < 0.01) and SMI (P < 0.05) at old age compared to their less active peers. Notably, these beneficial impacts were driven by exercise habits during late middle-age period [50 to 65 years], and remained significant after further adjustment by the physical demand of former occupation and present PA behavior at old age. Finally, middle-age engagement in exercise-related activities had no influence on maximal arm and leg isometric strength at old age.

CONCLUSION

Our findings highlight the importance of engaging in regular PA of at least moderate intensity during middle age years in order to promote benefits at the level of muscle mass and aerobic fitness. This clearly supports the potential of PA in delaying aerobic capacity impairment and the occurrence of clinically manifest sarcopenia at old age.

Glucose regulation and grip strength in adults: Findings from the Helsinki Birth Cohort Study

AIM

This study aimed to assess the association between grip strength and glucose regulation in a cross-sectional setting.

METHODS

Using data from the Helsinki Birth Cohort Study, 924 men and 953 women were studied at a mean age of 61.6 years. Grip strength was assessed in the dominant hand using a Newtest Grip Force dynamometer. A standard 2-h 75 g oral glucose tolerance test (OGTT) was used to define glucose regulation. The participants were classified into four groups: normoglycaemia, prediabetes (impaired fasting glucose or impaired glucose tolerance), newly diagnosed diabetes and previously known diabetes. The association between grip strength and glucose regulation was assessed using multiple linear regression models.

RESULTS

Prediabetes was diagnosed in 32.2% and diabetes in 8.4% using the OGTT. A total of 7.8% of the individuals had previously known diabetes. Compared to individuals with normoglycaemia, grip strength was lower for those with newly diagnosed diabetes (-1.8 kg, 95% CI -3.2 to -0.5) as well as those with previously known diabetes (-1.8 kg, 95% CI -3.2 to -0.4) after adjusting for covariates (age, sex, body mass index, physical activity, education and smoking). No difference in grip strength was found when comparing those with prediabetes and normoglycaemia.

CONCLUSION

In adults, grip strength was lower among those with known and newly diagnosed diabetes compared to those with normoglycaemia. Together with previous findings on associations between grip strength and chronic diseases, these results support the use of grip strength as an overall health marker in adults.

Cigarette Smoking Is Associated With Lower Quadriceps Cross-sectional Area and Attenuation in Older Adults

INTRODUCTION

In addition to well-established links with cardiovascular and respiratory diseases, cigarette smoking may affect skeletal muscle; however, associations with quadriceps atrophy, density, and function are unknown. This study explored the associations of current and former smoking with quadriceps muscle area and attenuation as well as muscle force (assessed as knee extension peak torque) and rate of torque development-a measure of muscle power in older adults.

METHODS

Data from 4469 older adults, aged 66-95 years at baseline in the Age, Gene/Environment Susceptibility-Reykjavik Study with measurements of thigh computed tomography, isometric knee extension testing, self-reported smoking history, and potential covariates were analyzed.

RESULTS

Sex differences were observed in these data; therefore, our final analyses are stratified by sex. In men, both former smokers and current smokers had lower muscle area (with β= -0.10, 95% confidence interval [CI] = -0.17 to -0.03 and β = -0.19, 95% CI = -0.33 to -0.05, respectively) and lower muscle attenuation (ie, higher fat infiltration, β = -0.08, 95% CI = -0.16 to -0.01 and β = -0.17, 95% CI = -0.34 to -0.01, respectively) when compared with never smokers. Smoking status was not associated with male peak torque or rate of torque development. In women, current smoking was associated with lower muscle attenuation (β = -0.24, 95% CI = -0.34 to -0.13) compared to never smoking. Among female smokers (current and former), muscle attenuation and peak torque were lower with increasing pack-years.

CONCLUSIONS

Results suggest that cigarette smoking is related to multiple muscle properties at older age and that these relationships may be different among men and women.

IMPLICATIONS

This article presents novel data, as it examined for the first time the relationship between smoking and computed tomography-derived quadriceps muscle size (cross-sectional area) and attenuation. This study suggests that current cigarette smoking is related to higher muscle fat infiltration, which may have significant health implications for the older population, because of its known association with poor physical function, falls, and hip fractures.

Perfil de força de preensão manual em pacientes idosos com câncer de próstata

Objetivo: analisar o perfil de Força de Preensão Manual em pacientes idosos com câncer de próstata, atendidos em instituição hospitalar filantrópica do Recife.Métodos: estudo transversal com análise de dados secundários, coletados no Ambulatório de Oncogeriatria do Instituto de Medicina Integral Professor Fernando Figueira, utilizando uma amostra por conveniência com uma amostragem de 72 idosos. A análise estatística foi realizada utilizando o programa estatístico STATA 12. O teste de Kolmogorov-Smirnov foi aplicado a variáveis numéricas para se determinar a normalidade da amostra. Em caso de não normalidade, foi utilizado o teste de Mann-Whitney. Adotou-se o nível de significância de 0,05%.Resultados: observou-se uma Força de Preensão Manual reduzida nos pacientes com estadiamento de uma doença mais avançada quando comparado a outros estágios mais localizados ou clinicamente melhores (estadiamento I: 27,78 vs. estadiamento IV: 27,20 no braço dominante (p=0, 340)/ estadiamento I: 27,33 vs. estadiamento IV: 24,13 no braço não dominante) sendo esse resultado melhor reproduzido na mão não dominante (p=0,090). Por meio da análise das comorbidades (hipertensão, diabetes, cardiomiopatia e osteoartrite) em relação à mão dominante e não dominante, não foram verificadas diferenças significativas na Força de Preensão Manual na presença ou ausência das comorbidades analisadas tanto na mão dominante quanto da não dominante (p=0,189 vs.p=0,437).Conclusões: o estudo trouxe subsídios relevantes sobre a importância da Força de Preensão Manual como um importante parâmetro geral para força e um indicativo de saúde, principalmente quando analisados em idosos com câncer, onde afeta significativamente sua função física e neuromuscular, incluindo atrofia muscular, diminuição da força muscular e diminuição do desempenho funcional em atividades diárias, comprometendo significativamente a qualidade de vida e seu prognóstico.

Influences of Neck and/or Wrist Pain on Hand Grip Strength of Industrial Quality Proofing Workers

Background

The aim of this study was to analyze the interaction between neck and/or wrist pain and hand grip strength (HGS) and to investigate factors (age, sex, neck disorders, and carpal tunnel syndrome) influencing the HGS of industrial quality proofing workers (N = 145).

Methods

Standardized questionnaires [Neck Disability Index (NDI), Boston Carpal Tunnel Questionnaire] were used to evaluate existing neck and/or wrist pain. HGS measurements were performed in different wrist positions.

Results

Significant differences between participants with and without neck pain were found in different wrist positions, in neutral wrist position right [without neck pain (n = 48) 46.34 (43.39 - 49.30); with neck pain (n = 97) 38.46 (36.20 - 40.72), F _(1,144)  = 16.82, p < 0.001, ŋ _p ² = 0.11] and left [without neck pain 44.06 (41.19 - 46.94); with neck pain 37.36 (35.13 - 39.58), F _(1,144)  = 12.70, p < 0.001, ŋ _p ² = 0.08]. A significant difference between participants with and without wrist pain was found for neutral wrist position right [without wrist pain (n = 105) 42.53 (40.37 - 44.70); with wrist pain (n = 40) 37.24 (33.56 - 40.91), F _(1,144)  = 6.41, p = 0.01, ŋ _p ² = 0.04]. Regression analysis showed significant results especially for steps two (age and weight, NDI) and three (age and weight, NDI, Boston Carpal Tunnel Questionnaire) for neutral position right (R² = 0.355, R² = 0.357, respectively).

Conclusion

Neck pain has an impact on HGS but should be evaluated in consideration of age and sex.

Trajectories of Handgrip Strength and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging

BACKGROUND

Handgrip strength (HGS) is a good predictor of adverse health outcomes in later life. This prospective study aimed to investigate whether HGS trajectory patterns were associated with all-cause mortality among older adults in Korea.

METHODS

This study used the database of the 2006-2016 Korean Longitudinal Study of Aging. Study participants included 3,069 adults aged ≥65 years without a previous history of cancer. The trajectory model was developed to identify different homogeneous trajectory patterns of HGS according to study period. Cox proportional hazards models were then applied to investigate the association between HGS and all-cause mortality.

RESULTS

The survival probability according to HGS during the follow-up period decreased as base HGS weakened. We identified four distinct trajectory groups of HGS among men and three among women. The risk of mortality increased as the HGS of both males and females decreased. Compared with the highest HGS group, the adjusted hazard ratios for all-cause mortality of the lowest, lower-mid, and upper-mid HGS groups among males were 3.46 (95% confidence interval [CI], 2.17-6.69), 2.26 (95% CI, 1.47-3.48), and 1.58 (95% CI, 1.07-2.32). Those of the low and mid HGS groups among females were 2.69 (95% CI, 1.39-5.21) and 1.97 (95% CI, 1.05-3.69).

CONCLUSION

The faster HGS declined over time, the greater the all-cause mortality risk increased compared with the slowly decreasing or maintained HGS groups among men and women. HGS measurement among older adults will be helpful in assessing their health statuses and pre-assessing disease-associated morbidity.

Does Abdominal Obesity Accelerate Muscle Strength Decline in Older Adults? Evidence From the English Longitudinal Study of Ageing

Background

Cross-sectional evidence has shown an association between abdominal obesity and lower muscle strength in older adults. However, no longitudinal findings have confirmed this association. In addition, the impact of abdominal fat on the reduction in muscle strength is not yet fully understood.

Methods

We investigated the longitudinal associations between abdominal obesity and handgrip strength in 5,181 older adults from the English Longitudinal Study of Ageing over 8 years of follow-up. Muscular strength was measured using a manual dynamometer. Abdominal obesity was defined as a waist circumference >102 cm for men and >88 cm for women. Generalized linear mixed models were adjusted by measures of socioeconomic status, health conditions, lifestyle, cognition, depressive symptoms, biomarkers, and disability.

Results

At baseline, the mean age of participants was 65.8 years and their mean waist circumference and body mass index (BMI) were 95 cm and 27.7 kg/m², respectively. Fully adjusted models showed that abdominal obese men and women had stronger muscle strength at baseline. The decline over time in muscle strength was accelerated in abdominal obese men (−0.12 kg/year, 95% confidence interval: −0.24 to −0.01) compared with nonabdominal obese. This association was not found in women. Comparative analyses showed that overweight men according to their BMI were not at greater risk of muscle strength decline. However, these men were at risk based on their waist circumference.

Conclusions

Abdominal obesity is associated with accelerated muscle strength decline in men.

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

Here we sought to clarify the prognostic impact of sarcopenia-related markers (grip strength (GS), muscle mass using bioimpedance analysis and patient quality of life as assessed by the 36-Item Short-Form Health Survey (SF36)) in patients with chronic liver diseases (CLDs, n = 411; 160 liver cirrhosis patients; median age, 64 years) on the incidence of composite hepatic events (CHEs). A GS decrease was defined as <26 kg in men and <18 kg in women, while a skeletal muscle mass index (SMI) decrease was defined as <7.0 kg/m² in men and <5.7 kg/m² in women based on the current guidelines. The physical and metal component summary scores on the SF36 were also included into the analysis. Sixty-two patients (15.1%) had the first incidence of CHEs. The three-year cumulative incidence rates of CHEs in patients with GS decrease or non-decrease were 24.51% and 12.44% (p = 0.0057). The three-year cumulative incidence rates of CHEs in patients with an SMI decrease or non-decrease were 19.65% and 12.99% (p = 0.0982). Multivariate analysis revealed that GS decrease (p = 0.0350) and prothrombin time (p = 0.0293) were significantly associated with the incidence of CHEs. In conclusion, GS can be an independent predictor for CHE development in patients with CLDs.

Normative data and associated factors of hand grip strength among elderly individuals: The Yilan Study, Taiwan

Weak grip strength is associated with subsequent mortality in elderly populations. The normative data and associated factors of HGS in community-dwelling elderly Taiwanese populations require further evaluation. From February 2012 until the end of 2016, all residents of Yilan City, Taiwan aged 65 years or older were randomly selected for a population-based community health survey. A total of 2,470 older adults were enrolled in this study. The relationships between HGS and various anthropometric and sociodemographic correlates were examined. The results showed that HGS was higher in men than in women. The mean HGS exhibited a decreasing trend with advanced age in both men and women. HGS was significantly associated with height, weight, and exercise habits. The physical as well as the mental component summary measures of health-related quality of life (HRQoL) were positively associated with HGS. After HRQoL was integrated into the regression model, female sex, age, waist circumference, and diabetes mellitus were significantly negatively associated with HGS. In conclusion, HGS significantly decreased with advanced age. among community-dwelling Taiwanese elderly people, Various factors had different effects on HGS.

Association between omega-3 fatty acids intake and muscle strength in older adults: A study from National Health and Nutrition Examination Survey (NHANES) 1999-2002

BACKGROUND

Muscle strength is a predictor of mortality in older adults and some dietary components are associated with this variable; however, little is known about the association between omega-3 fatty acids (ω-3) intake and strength in older adults.

OBJECTIVE

To assess whether ω-3 intake is associated with muscle strength in individuals over 50 years. We also aimed to evaluate whether an isocaloric substitution of dietary fatty acids types by ω-3 intake could be associated with muscle strength.

METHODS

This study included older adults aged from 50 to 85 y, from National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. A total of 2141 individuals (1119 men and 1022 women) were evaluated and provided complete and reliable dietary intake and isokinetic strength of the knee extensors (peak force) data. Linear regression analysis was conducted without (Model 1) and with adjustments (Model 2). Isocaloric substitution analysis was performed to evaluate whether the substitution of polyunsaturated (excluding ω-3), monounsaturated, saturated fats and ω-6 by consumption of ω-3 is associated with strength.

RESULTS

Total ω-3, docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and alpha-linolenic acid (ALA) intakes were positively associated with peak force in men (Model 1). However, after the adjustments for confounders (Model 2), only total ω-3 intake remained significant. Ω-3 intake was not associated with strength in women. The isocaloric substitution of saturated, polyunsaturated, monounsaturated fats and ω-6 by ω-3 was not associated with peak force.

CONCLUSION

The intake of total ω-3 was positively associated with muscle strength in older men, but not in older women. In addition, the substitution of other fatty acids by ω-3 intake was not associated with strength.

The role of mouse models in colorectal cancer research-The need and the importance of the orthotopic models

Colorectal cancer is a worldwide health burden, with high incidence and mortality, especially in the advanced stages of the disease. Preclinical models are very important and valuable to discover and validate early and specific biomarkers as well as new therapeutic targets. In order to accomplish that, the animal models must replicate the clinical evolution of the disease in all of its phases. In this article, we review the existent mouse models, with their strengths and weaknesses in the replication of human cancer disease progression, with major focus on orthotopic models.

Reference values for handgrip strength: data from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study

BACKGROUND

although handgrip strength (HGS) is considered an excellent predictor of morbidity and mortality, there are few reference data available, especially across life from young to old populations.

OBJECTIVE

to investigate the reference values and determinants for HGS in a large Chinese adult population.

DESIGN

this cross-sectional study used data from the Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study ranging from 2013 to 2017.

SETTING AND SUBJECTS

in total, 37,707 Chinese adults aged 18-93 years with measures of HGS were included.

METHODS

HGS was measured using a handheld digital dynamometer. The percentile distribution of HGS, as well as mean (standard deviation) values of HGS, was calculated according to sex and age categories. The Pearson's or Spearman's correlation coefficient and multiple linear regression were also used.

RESULTS

the peak mean value of HGS was 45.2 ± 6.88 kg in men and 26.8 ± 4.65 kg in women. Different reference values for each sex and age category are present. The prevalence of low HGS was 7.69% in men and 6.46% in women. Multiple regression analysis showed that almost 72.5% of HGS variability can be explained by sex, age, height and weight.

CONCLUSIONS

the HGS reached peak at 40 years old, maintained or slightly lowered between ages 40 and50 and then start an accelerated decline after 50 years old. Reference values of HGS should be stratified by sex and age group. HGS variability can be largely explained by sex, age, height and weight.

Age-specific differences in the time-frequency representation of surface electromyographic data recorded during a submaximal cyclic back extension exercise: a promising biomarker to detect early signs of sarcopenia

PURPOSE

Motivated by the goal of developing new methods to detect early signs of sarcopenia, we investigated if surface electromyographic (SEMG) data recorded during the performance of cyclic, submaximal back extensions are marked by age-specific differences in their time and frequency characteristics. Furthermore, day-to-day retest reliability of the EMG measures was examined.

METHODS

A total of 86 healthy volunteers used a back dynamometer to perform a series of three maximal voluntary contractions (MVC) consisting of isometric back extensions, followed by an isometric back extension at 80% MVC, and finally 25 slow cyclic back extensions at 50% MVC. SEMG data was recorded bilaterally at L1, L2, and L5 from the iliocostalis lumborum, longissimus, and multifidus muscles, respectively. Tests were repeated two days and six weeks later. A linear mixed-effects model with fixed effects "age, sex, test number" and the random effect "person" was performed to investigate age-specific differences in both the initial value and the time-course (as defined by the slope of the regression line) of the root mean square (RMS-SEMG) values and instantaneous median frequency (IMDF-SEMG) values calculated separately for the shortening and lengthening phases of the exercise cycles. Generalizability Theory was used to examine reliability of the EMG measures.

RESULTS

Back extensor strength was comparable in younger and older adults. The initial value of RMS-SEMG and IMDF-SEMG as well as the RMS-SEMG time-course did not significantly differ between the two age groups. Conversely, the IMDF-SEMG time-course showed more rapid changes in younger than in older individuals. Absolute and relative reliability of the SEMG time-frequency representations were comparable in older and younger individuals with good to excellent relative reliability but variable absolute reliability levels.

CONCLUSIONS

The IMDF-SEMG time-course derived from submaximal, cyclic back extension exercises performed at moderate effort showed significant differences in younger vs. older adults even though back extension strength was found to be comparable in the two age groups. We conclude that the SEMG method proposed in this study has great potential to be used as a biomarker to detect early signs of sarcopenic back muscle function.

Exposure to secondhand tobacco smoke is associated with reduced muscle strength in US adults

Secondhand tobacco smoke (SHS) exposure is a well-established risk factor for several diseases in adults. Despite the evidence that active tobacco smoke is harmful for the muscles, the association between SHS and muscle strength is still uncertain.We analyzed data from 5390 nonsmoking U.S. adults aged >30 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Exposure to SHS was assessed with serum cotinine concentrations. Grip strength was measured using a Takei digital handgrip dynamometer, and combined grip strength was calculated as the sum of the largest reading from each hand. Median (interquartile range) serum cotinine and grip strength were 0.015 ng/mL (IQR 0.011-0.36) and 65.5 kg (IQR 53.4-86.4), respectively. After adjusting for sociodemographic, anthropometric, health-related behavioral, and clinical risk factors, the highest (0.047-9.9 ng/mL) vs lowest (≤0.011 ng/mL) quartile of serum cotinine was associated with a reduction in combined grip strength of 1.41 kg (95%CI: -2.58, -0.24), p-trend=0.02. These results were consistent across socio-demographic and clinical subgroups. In the US nonsmoking adult population, even low levels of exposure to passive smoking were associated with decreased grip strength. Despite great achievements in tobacco control, extending public health interventions to reduce SHS exposure is still needed.

Handgrip Strength and Pulmonary Disease in the Elderly: What is the Link?

Societies in developed countries are aging at an unprecedented rate. Considering that aging is the most significant risk factor for many chronic lung diseases (CLDs), understanding this process may facilitate the development of new interventionist approaches. Skeletal muscle dysfunction is a serious problem in older adults with CLDs, reducing their quality of life and survival. In this study, we reviewed the possible links between handgrip strength (HGS)—a simple, noninvasive, low-cost measure of muscle function—and CLDs in the elderly. Different mechanisms appear to be involved in this association, including systemic inflammation, chronic hypoxemia, physical inactivity, malnutrition, and corticosteroid use. Respiratory and peripheral myopathy, associated with muscle atrophy and a shift in muscle fiber type, also seem to be major etiological contributors to CLDs. Moreover, sarcopenic obesity, which occurs in older adults with CLDs, impairs common inflammatory pathways that can potentiate each other and further accelerate the functional decline of HGS. Our findings support the concept that the systemic effects of CLDs may be determined by HGS, and HGS is a relevant measurement that should be considered in the clinical assessment of the elderly with CLDs. These reasons make HGS a useful practical tool for indirectly evaluating functional status in the elderly. At present, early muscle reconditioning and optimal nutrition appear to be the most effective approaches to reduce the impact of CLDs and low muscle strength on the quality of life of these individuals. Nonetheless, larger in-depth studies are needed to evaluate the link between HGS and CLDs.

Higher Diet Quality is Associated with Lower Odds of Low Hand Grip Strength in the Korean Elderly Population

Single nutrients or food groups have been associated with physical performance. However, little is known about the association of overall diet quality with hand grip strength (HGS), a predictive parameter in the prognosis of chronic disease morbidity and mortality, or quality of life. This study examined the association between HGS and three indices-the Korean Healthy Eating Index (KHEI), the Alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH)-using data obtained on Korean elderly persons aged ≥65 years (n = 3675) from a nationally representative database. The cross-sectional data was collected as part of the Korea National Health and Nutrition Examination Survey (KNHANES, 2014-2016). Dietary intake data from the 24-h recall method were used to calculate diet quality scores. The cutoff value for low HGS was defined as the value corresponding to the lowest 20th percentile of HGS of the study population (men, 28.6 kg; women, 16.5 kg). Higher index scores for diet quality were associated with 32%-53% lower odds of low HGS. Better overall diet quality may be associated with higher HGS in the elderly Korean population.

Developmental factors associated with decline in grip strength from midlife to old age: a British birth cohort study

OBJECTIVES

To test whether developmental factors are associated with grip strength trajectories between 53 and 69 years, and operate independently or on the same pathway/s as adult factors.

DESIGN

British birth cohort study.

SETTING

England, Scotland and Wales.

PARTICIPANTS

3058 men and women.

MAIN OUTCOME MEASURES

Grip strength (kg) at ages 53, 60-64 and 69 were analysed using multilevel models to estimate associations with developmental factors (birth weight, growth parameters, motor and cognitive development) and father's social class, and investigate adult factors that could explain observed associations, testing for age and sex interactions.

RESULTS

In men, heavier birth weight, beginning to walk 'on time', later puberty and greater weight 0-26 years and in women, heavier birth weight and earlier age at first standing were independently associated with stronger grip but not with its decline. The slower decline in grip strength (by 0.07 kg/year, 95% CI 0.02 to 0.11 per 1 SD, p=0.003) in men of higher cognitive ability was attenuated by adjusting for adult verbal memory.

CONCLUSIONS

Patterns of growth and motor development have persisting associations with grip strength between midlife and old age. The strengthening associations with cognition suggest that, at older ages, grip strength increasingly reflects neural ageing processes. Interventions across life that promote muscle development or maintain muscle strength should increase the chance of an independent old age.

Risk factors associated with low handgrip strength in the older Korean population

Hand grip strength (HGS) is a means to assess health status and physical abilities indirectly. Various factors are known to be related to HGS, but data on the factors influencing HGS in the Korean population are lacking. Recently, the Korea National Health and Nutrition Examination Survey (KNHANES) conducted by the Korea Centers for Disease Control and Prevention surveyed social status, nutrition, physical status, and other medical history including HGS. This study aimed to investigate the social, physical, and individual health behavior factors associated with low HGS in the elderly Korean population. This population-based cross-sectional study was based on the 2014-2016 KNHANES. Community-dwelling Korean elderly (aged ≥65 years) were included in this survey. The relationship between HGS and socioeconomic status, nutrition, exercise, and other clinical characteristics were analyzed using multivariate logistic regression. The sample size was 3,634 (weighted: 6,006,406). Elderly men and women with low HGS showed lower body mass index, reduced physical activity and lower education level. Among elderly men, excessive carbohydrate and inadequate protein intake were observed in the low HGS group. Meanwhile, older women who did not drink alcohol and had diabetes were at higher risk of low HGS. In conclusion, various physical, nutritional, socioeconomic and comorbidity statuses were seemed to be the factors associated with HGS in Korean elderly. However, further cohort or case-control study will be necessary to determine the causal relationship of those factors and HGS.

Impact of obesity and physical inactivity on the long-term change in grip strength among middle-aged and older European adults

BACKGROUND

Grip strength is a well-established predictor of various chronic conditions and all-cause mortality. Body weight and physical activity (PA) are considered potential determinants of muscle strength. This study aimed to investigate gender-specific associations of baseline obesity and physical inactivity with long-term changes in grip strength among middle-aged and older European adults.

METHODS

Data from the Survey of Health, Ageing and Retirement in Europe 2004-2015 which was conducted in 12 countries were analysed. Grip strength was repeatedly measured at five follow-up visits with average 2-year intervals. Obesity and physical inactivity at baseline were primary exposures. Generalised estimated equations stratified by gender were fitted.

RESULTS

This study included 8616 males and 10 088 females with a median follow-up of 9.42 years. Significant interactions between obesity and time with grip strength were identified in both males (χ² _interaction=16.65, p = 0.002) and females (χ² _interaction=10.80, p = 0.029). No significant interaction between physical inactivity and time with grip strength was identified in males (χ² _interaction=9.42, p = 0.051) or females (χ² _interaction=5.62, p = 0.230). Those who were less physically active at baseline had weaker grip strength from the beginning at baseline (β = -2.753, p < 0.001 for males and β = -1.529, p < 0.001 for females) to Visit 6 (β = -2.794, p < 0.001 for males and β = -1.550, p < 0.001 for females). Further combined analysis suggested a trend that exposure to both obesity and physical inactivity was related to the fastest decline rate of grip strength.

CONCLUSIONS

This study provides the additional evidence that PA and obesity prevention earlier in life play an important role in maintaining grip strength during ageing.