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Chen Y, Ma L, Han Z, Xiong P. The global burden of disease attributable to high body mass index in 204 countries and territories: Findings from 1990 to 2019 and predictions to 2035. Diabetes Obes Metab 2024; 26:3998-4010. [PMID: 38957939 DOI: 10.1111/dom.15748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Abstract
AIM Our study aims to provide an updated estimate of age- and sex-specific deaths and disability-adjusted life years (DALYs) associated with high body mass index (BMI) from 1990 to 2019 at the global, regional and national levels, and to forecast the global burden of disease attributed to high BMI from 2020 to 2035. METHODS We used the data for the number of deaths, DALYs, age-standardized rate (per 100 000 population), percentage change and population attributable fraction from the Global Burden of Disease Study 2019 (GBD 2019) to examine the disease burden attributable to high BMI. We further applied an autoregressive integrated moving average (ARIMA) model to predict the disease burden for the period 2020-2035. RESULTS From 1990 to 2019, the deaths and DALYs attributable to high BMI increased by 148% and 155.86% for men, and by 111.67% and 121.78% for women, respectively. In 2019, high BMI directly accounted for 8.52% [95% uncertainty intervals (UI) 0.05, 0.12] of all-cause deaths and 5.89% (95% UI 0.04, 0.08) of global DALYs. The highest death rates were observed in men aged 65-69 and women aged 75-79. The highest DALY rates were observed in the age group of 60-64 for both sexes. In 2019, the highest age-standardized deaths and DALY rates were observed in the Central Asia region [163.15 (95% UI 107.72, 223.58) per 100 000 people] and the Oceania region [4643.33 (95% UI 2835.66, 6902.6) per 100 000 people], respectively. Fiji [319.08 (95% UI 213.77, 444.96) per 100 000 people] and Kiribati [10 000.58 (95% UI 6266.55, 14159.2) per 100 000 people] had the highest age-standardized deaths and DALY rates, respectively. In 2019, the highest age-standardized rates of high BMI-related deaths and DALYs were observed in the middle-high socio-demographic index quintile and in the middle socio-demographic index quintile. The age-standardized deaths and DALY rates attributable to high BMI are projected to increase in both sexes from 2020 to 2035. The death rates are projected to rise from 62.79 to 64.31 per 100 000 people, while the DALY rates are projected to rise from 1946 to 2099.54 per 100 000 people. CONCLUSIONS High BMIs significantly contribute to the global disease burden. The projected rise in deaths and DALY rates attributable to high BMI by 2035 highlights the critical need to address the impact of obesity on public health. Our study provides policymakers with up-to-date and comprehensive information.
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Affiliation(s)
- Yuhan Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Li Ma
- Biomedical Innovation and Entrepreneurship Laboratory, Jinan University, Guangzhou, China
| | - Zhigang Han
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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Ghorbanzadeh A, Abud A, Liedl D, Rooke T, Wennberg P, Wysokinski W, McBane R, Houghton DE. Reduced calf muscle pump function is not explained by handgrip strength measurements. J Vasc Surg Venous Lymphat Disord 2024; 12:101869. [PMID: 38460817 DOI: 10.1016/j.jvsv.2024.101869] [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: 11/17/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE Reduced calf muscle pump function (CPF) is an independent risk factor for venous thromboembolism and mortality. We aimed to evaluate the relationship between handgrip strength (HGS) and CPF. METHODS Patients referred to the Gonda Vascular Laboratory for noninvasive venous studies were identified and consented. Patients underwent standard venous air plethysmography protocol. CPF (ejection fraction) was measured in each lower extremity of ambulatory patients by comparing refill volume after ankle flexes and passive refill volumes. The cutoff for reduced CPF (rCPF) was defined as an ejection fraction of <45%. Maximum HGS bilaterally was obtained (three trials per hand) using a dynamometer. HGS and CPF were compared (right hand to calf, left hand to calf) and the correlation between the measures was evaluated. RESULTS 115 patients (mean age, 59.2 ± 17.4 years; 67 females, mean body mass index, 30.83 ± 6.46) were consented and assessed for HGS and CPF. rCPF was observed in 53 right legs (46%) and 67 left legs (58%). CPF was reduced bilaterally in 45 (39%) and unilaterally in 30 (26%) patients. HGS was reduced bilaterally in 74 (64.3%), unilaterally in 23 (20%), and normal in 18 (15.7%) patients. Comparing each hand/calf pair, no significant correlations were seen between HGS and CPF. The Spearman's rank correlation coefficients test yielded values of 0.16 for the right side and 0.10 for the left side. CONCLUSIONS There is no significant correlation between HGS and CPF, demonstrating that HGS measurements are not an acceptable surrogate for rCPF, indicating different pathophysiological mechanisms for each process.
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Affiliation(s)
- Atefeh Ghorbanzadeh
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Abdi Abud
- University of Missouri-Columbia School of Medicine, Columbia, MO
| | - David Liedl
- Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Thom Rooke
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Paul Wennberg
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Waldemar Wysokinski
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Robert McBane
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN
| | - Damon E Houghton
- Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, MN; Gonda Vascular Center, Mayo Clinic, Rochester, MN; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN.
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Zevallos A, Pajuelo-Vásquez R, Camacho-Caballero K, Corcuera-Ciudad R, Goicochea-Romero P, Gutiérrez-Baca W, Chambergo-Michilot D, Parodi JF, Runzer-Colmenares FM. Evaluation of Factors Influencing Handgrip Strength Asymmetry in Older Peruvian Adults. Ann Geriatr Med Res 2024; 28:184-191. [PMID: 38486469 PMCID: PMC11217652 DOI: 10.4235/agmr.23.0194] [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: 11/24/2023] [Revised: 03/02/2024] [Accepted: 03/12/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults. METHODS We used a database of the Peruvian Naval Medical Center "Cirujano Santiago Távara" located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand. RESULTS From a total of 1,468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (adjusted prevalence ratio [aPR]=1.08; 95% confidence interval [CI], 1.01-1.15), falls risk (aPR = 1.08; 95% CI, 1.02-1.16), and an altered Lawton index (aPR=0.92; 95% CI, 0.84-0.99) were associated with HGS asymmetry. CONCLUSION Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly.
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Affiliation(s)
- Alba Zevallos
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Renzo Pajuelo-Vásquez
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Kiara Camacho-Caballero
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Rodrigo Corcuera-Ciudad
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Paola Goicochea-Romero
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Wendy Gutiérrez-Baca
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Diego Chambergo-Michilot
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - José F. Parodi
- Centro de Investigación del Envejecimiento (CIEN), Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú
| | - Fernando M. Runzer-Colmenares
- CHANGE Research Working Group, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
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Fuentes-Abolafio IJ, Ricci M, Bernal-López MR, Gómez-Huelgas R, Cuesta-Vargas AI, Pérez-Belmonte LM. Relationship between quadriceps femoris echotexture biomarkers and muscle strength and physical function in older adults with heart failure with preserved ejection fraction. Exp Gerontol 2024; 190:112412. [PMID: 38570057 DOI: 10.1016/j.exger.2024.112412] [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: 02/08/2024] [Revised: 03/19/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Muscle wasting is pronounced in patients with heart failure with preserved ejection fraction (HFpEF). The quadriceps femoris echotexture biomarkers assessed by ultrasound (US) have not been studied in these patients. OBJECTIVE To describe echotexture biomarkers assessed by the US and to assess their relationship with sex, age, body mass index (BMI), self-reported outcomes, muscle strength and physical function in older adults with HFpEF. METHODS A cross-sectional study was conducted. Patients 70 years and older with HFpEF were included. The sex, age, BMI, and self-reported outcomes were collected. The US assessed muscle and subcutaneous fat tissue contrast, correlation, energy, homogeneity, and entropy at rest and maximal voluntary isometrical contraction (MVIC). The six-minute walk test (6MWT), the short physical performance battery (SPPB), the timed up and go test (TUG), the usual pace gait speed test (UGS), and the fast pace gait speed test (FGS) were used to assess physical function. The five-repetitions sit-to-stand test (5-STS) was performed to assess muscle strength. Bivariant Pearson correlations and subsequent multivariate linear regression analyses were conducted. RESULTS Seventy-two older adults with HFpEF [81.06 years, 29.13 BMI, and 55.60% females] were recruited. In women, relaxed and MVIC muscle energy and entropy explained 35.40% of the TUG variance; relaxed muscle entropy and MVIC muscle energy shared 24.00% of the UGS variance; relaxed and MVIC muscle entropy, MVIC muscle contrast and MVIC muscle energy explained 32.60% of the FGS variance, adjusted all the models by age and BMI. CONCLUSIONS Echotexture biomarkers are related to women's muscle strength and physical function, especially muscle energy, contrast, and entropy. Echotexture biomarkers assessed by the US could facilitate the management of older adults with HFpEF, monitor its progression and assess the effectiveness of treatments on the musculoskeletal structure. TRIAL REGISTRATION NCT03909919. April 10, 2019. Retrospectively registered.
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Affiliation(s)
- Iván José Fuentes-Abolafio
- Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Málaga, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma‑Bionand, Málaga, Spain
| | - Michele Ricci
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - María Rosa Bernal-López
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma‑Bionand, Málaga, Spain; Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain; CIBER Fisio-patología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Ricardo Gómez-Huelgas
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma‑Bionand, Málaga, Spain; Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain; CIBER Fisio-patología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Ignacio Cuesta-Vargas
- Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Málaga, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma‑Bionand, Málaga, Spain; School of Clinical Sciences, Faculty of Health at the Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Luis Miguel Pérez-Belmonte
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Bionand)), IBIMA Plataforma‑Bionand, Málaga, Spain; Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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Sullivan BP, Collins BC, McMillin SL, Toussaint E, Stein CZ, Spangenburg EE, Lowe DA. Ablation of skeletal muscle estrogen receptor alpha impairs contractility in male mice. J Appl Physiol (1985) 2024; 136:764-773. [PMID: 38328824 DOI: 10.1152/japplphysiol.00714.2023] [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: 10/04/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/09/2024] Open
Abstract
Estradiol and estrogen receptor α (ERα) have been shown to be important for the maintenance of skeletal muscle strength in females; however, little is known about the roles of estradiol and ERα in male muscle. The purpose of this study was to determine if skeletal muscle ERα is required for optimal contractility in male mice. We hypothesize that reduced ERα in skeletal muscle impairs contractility in male mice. Skeletal muscle-specific knockout (skmERαKO) male mice exhibited reduced strength across multiple muscles and several contractile parameters related to force generation and kinetics compared with wild-type littermates (skmERαWT). Isolated EDL muscle-specific isometric tetanic force, peak twitch force, peak concentric and peak eccentric forces, as well as the maximal rates of force development and relaxation were 11%-21% lower in skmERαKO compared with skmERαWT mice. In contrast, isolated soleus muscles from skmERαKO mice were not affected. In vivo peak torque of the anterior crural muscles was 20% lower in skmERαKO compared with skmERαWT mice. Muscle masses, contractile protein contents, fiber types, phosphorylation of the myosin regulatory light chain, and caffeine-elicited force did not differ between muscles of skmERαKO and skmERαWT mice, suggesting that strength deficits were not due to size, composition, or calcium release components of muscle contraction. These results indicate that in male mice, reduced skeletal muscle ERα blunts contractility to a magnitude similar to that previously reported in females; however, the mechanism may be sexually dimorphic.NEW & NOTEWORTHY We comprehensively measured in vitro and in vivo contractility of leg muscles with reduced estrogen receptor α (ERα) in male mice and reported that force generation and contraction kinetics are impaired. In contrast to findings in females, phosphorylation of myosin regulatory light chain cannot account for low force production in male skeletal muscle ERα knockout mice. These results indicate that ERα is required for optimal contractility in males and females but via sexually dimorphic means.
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Affiliation(s)
- Brian P Sullivan
- Division of Physical Therapy and Rehabilitation Science, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Brittany C Collins
- Division of Physical Therapy and Rehabilitation Science, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Shawna L McMillin
- Division of Physical Therapy and Rehabilitation Science, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Elise Toussaint
- Division of Physical Therapy and Rehabilitation Science, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Clara Z Stein
- Division of Physical Therapy and Rehabilitation Science, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Espen E Spangenburg
- Department of Physiology, Brody School of Medicine, East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States
| | - Dawn A Lowe
- Division of Physical Therapy and Rehabilitation Science, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
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Baxter BA, Baross AW, Ryan DJ, Wright BH, Kay AD. The acute and repeated bout effects of multi-joint eccentric exercise on physical function and balance in older adults. Eur J Appl Physiol 2023; 123:2131-2143. [PMID: 37217609 PMCID: PMC10492690 DOI: 10.1007/s00421-023-05226-z] [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: 11/18/2022] [Accepted: 05/10/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE Eccentric muscle actions generate high levels of force at a low metabolic cost, making them a suitable training modality to combat age-related neuromuscular decline. The temporary muscle soreness associated with high intensity eccentric contractions may explain their limited use in clinical exercise prescription, however any discomfort is often alleviated after the initial bout (repeated bout effect). Therefore, the aims of the present study were to examine the acute and repeated bout effects of eccentric contractions on neuromuscular factors associated with the risk of falling in older adults. METHODS Balance, functional ability [timed up-and-go and sit-to-stand], and lower-limb maximal and explosive strength were measured in 13 participants (67.6 ± 4.9 year) pre- and post-eccentric exercise (0, 24, 48, and 72 hr) in Bout 1 and 14 days later in Bout 2. The eccentric exercise intervention was performed on an isokinetic unilateral stepper ergometer at 50% of maximal eccentric strength at 18 step‧min-1 per limb for 7 min (126 steps per limb). Two-way repeated measures ANOVAs were conducted to identify any significant effects (P ≤ 0.05). RESULTS Eccentric strength significantly decreased (- 13%) in Bout 1 at 24 hr post-exercise; no significant reduction was observed at any other time-point after Bout 1. No significant reductions occurred in static balance or functional ability at any time-point in either bout. CONCLUSION Submaximal multi-joint eccentric exercise results in minimal disruption to neuromuscular function associated with falls in older adults after the initial bout.
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Affiliation(s)
- Brett A Baxter
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northampton, NN1 5PH, UK.
| | - Anthony W Baross
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northampton, NN1 5PH, UK
| | - Declan J Ryan
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northampton, NN1 5PH, UK
| | - Ben H Wright
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northampton, NN1 5PH, UK
| | - Anthony D Kay
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northampton, NN1 5PH, UK
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Baker JF, Katz P, Weber DR, Gould P, George MD, Long J, Zemel BS, Giles JT. Adipocytokines and Associations With Abnormal Body Composition in Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2023; 75:616-624. [PMID: 34558809 PMCID: PMC8942864 DOI: 10.1002/acr.24790] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/07/2021] [Accepted: 09/21/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We determined associations between adipokines and abnormal body composition in patients with rheumatoid arthritis (RA). METHODS Combining data from three RA cohorts, whole-body dual-energy absorptiometry measures of appendicular lean mass and fat mass indices were converted to age-, sex-, and race- and ethnicity-specific Z scores. Lean mass relative to fat mass was determined based on prior methods. Independent associations between body composition profiles and circulating levels of adiponectin, leptin, and fibroblast growth factor (FGF)-21 were assessed using linear and logistic regression models adjusting for demographic characteristics and study cohort. We also determined the improvement in the area under the curve (AUC) for prediction of low lean mass when adipokines were added to predictive models that included clinical factors such as demographic characteristics, study, and body mass index (BMI). RESULTS Among 419 participants, older age was associated with higher levels of all adipokines, whereas higher C-reactive protein level was associated with lower adiponectin levels and higher FGF-21 levels. Greater fat mass was strongly associated with lower adiponectin levels and higher leptin and FGF-21 levels. Higher levels of adiponectin, leptin, and FGF-21 were independently associated with low lean mass. The addition of adiponectin and leptin levels to regression models improved prediction of low lean mass when combined with demographic characteristics, study, and BMI (AUC 0.75 vs. 0.66). CONCLUSION Adipokines are associated with both excess adiposity and low lean mass in patients with RA. Improvements in the prediction of body composition abnormalities suggest that laboratory screening could help identify patients with altered body composition who may be at greater risk of adverse outcomes.
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Affiliation(s)
- Joshua F. Baker
- Philadelphia VA Medical Center, Philadelphia, PA, USA
- University of Pennsylvania School of Medicine, Philadelphia, PA
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | - Patricia Katz
- University of California San Francisco, San Francisco, CA, USA
| | - David R. Weber
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Patrick Gould
- University of Pennsylvania School of Medicine, Philadelphia, PA
| | | | - Jin Long
- Stanford University, Palo Alto, CA, USA
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Fuentes-Abolafio IJ, Bernal-López MR, Gómez-Huelgas R, Ricci M, Cuesta-Vargas AI, Pérez-Belmonte LM. Relationship between quadriceps femoris muscle architecture and muscle strength and physical function in older adults with heart failure with preserved ejection fraction. Sci Rep 2022; 12:21660. [PMID: 36522418 PMCID: PMC9755120 DOI: 10.1038/s41598-022-26064-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Heart failure (HF)-related factors potentially lead to sarcopenia. Ultrasound (US) assessment has all the advantages of being used in clinical practice to assess muscle architecture. This study aimed to assess the relationship between the quadriceps femoris (QF) muscle architecture with the gender, age, body mass index (BMI), muscle strength and physical function in older adults with HF with preserved ejection fraction (HFpEF) as well as to assess the difference in these relationships between the two genders. Patients 70 years and older with HFpEF were included. The gender, age and BMI were collected. The QF muscle thickness, the QF muscle echo-intensity, the subcutaneous fat tissue thickness (FT) and the subcutaneous fat tissue echo-intensity were assessed by the US. The six-minute walk test, the short physical performance battery (SPPB), the timed up and go test (TUG), and the gait speed test (UGS) were used to assess physical function. The five-repetitions sit-to-stand test (5-STS) was performed to assess muscle strength. Bivariant Pearson correlations and subsequent multivariate linear regression analysis were conducted. Seventy older adults with HFpEF [81.00 (5.97) years] were recruited. The FT showed a correlation between poor and moderate muscle strength and physical function in women with HFpEF. The FT explained 24.5% of the 5-STS variance, 32.4% of the SPPB variance, 31.5% of the TUG variance, 28.6% of the UGS variance, and 21.4% of the FGS variance in women. The US assessment could allow clinicians to assess muscle architecture biomarkers related to muscle strength and physical function in older adults with HFpEF.Trial registration NCT03909919. April 10, 2019. Retrospectively registered.
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Affiliation(s)
- Iván J. Fuentes-Abolafio
- grid.10215.370000 0001 2298 7828Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Peñalosa, 3, 29071 Málaga, España ,grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España
| | - M. Rosa Bernal-López
- grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España ,grid.413448.e0000 0000 9314 1427CIBER Fisio-Patología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, España
| | - Ricardo Gómez-Huelgas
- grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España ,grid.413448.e0000 0000 9314 1427CIBER Fisio-Patología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, España
| | - Michele Ricci
- grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio I. Cuesta-Vargas
- grid.10215.370000 0001 2298 7828Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, C/Arquitecto Peñalosa, 3, 29071 Málaga, España ,grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.1024.70000000089150953School of Clinical Sciences, Faculty of Health at the Queensland University of Technology, Brisbane, QLD Australia
| | - Luis M. Pérez-Belmonte
- grid.452525.1Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, España ,grid.411457.2Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España ,grid.10215.370000 0001 2298 7828Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias (CIMES), Universidad de Málaga (UMA), Campus de Excelencia Internacional (CEI) Andalucía Tech, Málaga, España ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
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Chung CM, Shin S, Lee Y, Lee DY. Determination of the Predictors with the Greatest Influence on Walking in the Elderly. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1640. [PMID: 36422178 PMCID: PMC9693411 DOI: 10.3390/medicina58111640] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 08/26/2023]
Abstract
Background and Objectives: Previous studies have revealed that independent variables (lower extremity strength, postural control ability, and body composition) influence gait performance and variability, but the difference in the relative influence between these variables is unclear. Hence, this study determines the variable that is the most influential predictor of gait performance and variability among potential independent variables in the elderly. Materials and Methods: Seventy-eight subjects aged ≥60 years participated. For each subject, the gait variables and lower extremity muscle strength were measured using an accelerometer worn on both feet during a 6-minute walk and a manual force sensor, respectively. The static balance ability was measured through two force plates, and the body composition was measured by applying bioelectrical impedance analysis. Linear regression analyses were performed stepwise to determine whether these variables affect gait performance and variability. Results: After adjusting for sex and gait performance, the ankle strength, body fat mass, mean velocity in the medial-lateral direction, ankle plantar flexion strength, and girth were predictors of gait speed dorsiflexion, gait performance, swing width of the gait performance, walking speed, and gait variability, respectively. Conclusions: Overall, gait performance in the elderly is related to muscle strength, postural control, and body composition in a complex manner, but gait variability appears to be more closely related to ankle muscle strength. This study provides further evidence that muscle strength is important in motor function and stability.
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Affiliation(s)
- Chul-Min Chung
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Yungon Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Do-Youn Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
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10
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Changes in body composition in the year following critical illness: A case-control study. J Crit Care 2022; 71:154043. [DOI: 10.1016/j.jcrc.2022.154043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/23/2022] [Accepted: 04/04/2022] [Indexed: 11/17/2022]
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11
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Tou NX, Wee SL, Pang BWJ, Lau LK, Jabbar KA, Seah WT, Chen KK, Ng TP. Association of fat mass index versus appendicular lean mass index with physical function – The Yishun Study. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Štefan L, Neljak B, Petrić V, Kasović M, Vespalec T. Normative Data for Musculoskeletal Fitness in 13,217 Children and Adolescents: The Croatian Fitness (CROFIT) Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:528-536. [PMID: 34663188 DOI: 10.1080/02701367.2021.1873903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/05/2021] [Indexed: 06/13/2023]
Abstract
Purpose: The main purpose of the study was to establish normative data for health-related musculoskeletal fitness. Method: We recruited 13,217 children and adolescents aged 11-18 years (6,181 boys and 7,036 girls; 57% of girls). To evaluate musculoskeletal fitness, the following field tests were applied: standing broad jump (cm), sprint 20 m (sec), medicine-ball throw (dm), sit-ups in one minute (#), sit-ups in one minute (short, #), and squats in one minute (#). Curves for the 10th, 20th, 30th, 40th, 50th (median), 60th, 70th, 80th, and 90th percentiles were calculated using the Lambda (L), Mu (M), and Sigma (S) method. The LMS method assumes that the data can be normalized by using a power transformation and removing the skewness. Results: Median scores for standing broad jump, sprint 20 m, medicine-ball throw, sit-ups in one minute, sit-ups in one minute (short) and squats in one minute were 185.00 cm, 3.66 sec, 80.00 dm, 46.00 x, 56.00 x and 49 x in boys and 160.00 cm, 4.01 sec, 60.00 dm, 40.00 x, 49.00 and 43 x in girls. Effect sizes (ES) showed that boys performed better in all physical fitness tests (ES = 0.50-1.05), compared to girls. In general, age-related physical fitness changes showed the plateau between ages 15 and 16 in boys, while in girls, the plateau was reached at the age of 14. Conclusions: This study shows standards for musculoskeletal tests in youth.
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Effects of Internet-Based Nutrition and Exercise Interventions on the Prevention and Treatment of Sarcopenia in the Elderly. Nutrients 2022; 14:nu14122458. [PMID: 35745187 PMCID: PMC9229368 DOI: 10.3390/nu14122458] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/02/2022] [Accepted: 06/12/2022] [Indexed: 12/12/2022] Open
Abstract
Effective nutrition and exercise interventions may improve sarcopenia in the elderly. The purpose of our study was to investigate the effectiveness of Internet-based nutrition and exercise interventions in the elderly with sarcopenia. Participants were divided into 4 groups: control, nutrition, exercise, and comprehensive (nutrition plus exercise) groups; there was at least 50 participants in each group. Our trial lasted 12 weeks. We conducted dietary and exercise interventions through an app and collected feedback from the participants every three weeks. Information on the diet, skeletal muscle mass, and muscle function was collected before and after the interventions. The comprehensive group had higher high-quality protein intake than the control (p = 0.017) and exercise (p = 0.012) groups. After the interventions, we obtained differences in skeletal muscle mass, skeletal muscle mass/height2, skeletal muscle mass/weight, muscle mass/BMI, and skeletal muscle mass/body fat percentage (p < 0.05). Changes in average daily energy and total daily protein intakes were not significantly different; however, there was an overall improvement in the intervention groups relative to baseline data. There were no changes in the average daily time of moderate physical activity. The Internet was an effective tool of nutrition intervention in the elderly with sarcopenia. The Internet-based nutrition intervention improved high-quality protein intake and skeletal muscle mass in the elderly with sarcopenia.
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14
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Chen L, Wu L, Li Q, Hu Y, Ma H, Lin H, Gao X. Hyperuricemia Associated with Low Skeletal Muscle in the Middle-Aged and Elderly Population in China. Exp Clin Endocrinol Diabetes 2022; 130:546-553. [PMID: 35609819 DOI: 10.1055/a-1785-3729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous studies have presented inconsistent results on the relationship between serum uric acid and skeletal muscle mass (SMM). We aimed to explore whether a higher serum uric acid level was associated with low SMM in the Chinese population. METHODS We performed a cross-sectional analysis of 6595 subjects aged 45 years or older. They were tested for fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, uric acid, blood urea nitrogen, creatinine, and estimated glomerular filtration rate. SMM was accessed by dual-energy x-ray absorptiometry using two approaches: weight-adjusted appendicular skeletal muscle mass (ASM)% and ASM/BMI (body mass index (kg/m2)). Low SMM was defined as a cut-off point of ASM/BMI<0.789 for men and<0.512 for women. RESULTS Compared with their normal group, patients with hyperuricemia had lower ASM% (29.33±2.33 vs 30.03±2.34 for males and 24.71±1.99 vs 25.19±2.07 for females, P<0.01) and ASM/BMI (0.83±0.10 vs 0.85±0.10 for male and 0.60±0.07 vs 0.62±0.07 for female), with a higher prevalence of the associated low SMM in both sexes (35.2 vs 26.5% for male and 10.5 vs 5.9% for female, P<0.01). Pearson analysis showed that ASM% and ASM/BMI were negatively correlated with SUA (male: ASM/BMI, r=-0.097, ASM%, r=-0.146; female: ASM/BMI, r=-0.151, ASM%, r=-0.157; all P<0.001). Logistic regression analysis showed a positive association of hyperuricemia with adjusted risk of low SMM association. CONCLUSIONS In a middle-aged and elderly Chinese population, hyperuricemia is independently and positively associated with low SMM and can vary by age and gender.
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Affiliation(s)
- Lingyan Chen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Li Wu
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China
| | - Qian Li
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China
| | - Yu Hu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Hui Ma
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Huandong Lin
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China.,Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Xin Gao
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China.,Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
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15
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Bårdstu HB, Andersen V, Fimland MS, Raastad T, Saeterbakken AH. Muscle Strength Is Associated With Physical Function in Community-Dwelling Older Adults Receiving Home Care. A Cross-Sectional Study. Front Public Health 2022; 10:856632. [PMID: 35548065 PMCID: PMC9081336 DOI: 10.3389/fpubh.2022.856632] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Higher maximal- and explosive strength is associated with better physical function among older adults. Although the relationship between isometric maximal strength and physical function has been examined, few studies have included measures of isometric rate of force development (RFD) as a measure of explosive strength. Furthermore, little is known about the oldest old (>80 years), especially individuals who receive home care and use mobility devices. Therefore, the aim of this study was to examine the association between maximal- and explosive muscle strength with physical function in community-dwelling older adults receiving home care. Methods An exploratory cross-sectional analysis including 107 (63 females and 43 males) community-dwelling older adults [median age 86 (interquartile range 80–90) years] receiving home care was conducted. Physical function was measured with five times sit-to-stand (5TSTS), timed 8-feet-up-and-go (TUG-8ft), preferred-, and maximal gait speed. Maximal strength was assessed as maximal isometric voluntary contraction (MVC) and explosive strength as RFD of the knee extensors. We used linear regression to examine the associations, with physical function as dependent variables and muscle strength (MVC and RFD) as independent variables. Results MVC was significantly associated with 5TSST [standardized regression coefficient β = −0.26 95% CI (−0.45, −0.06)], TUG-8ft [−0.6 (−0.54, −0.17)], preferred gait speed [0.39 (0.22, 0.57)], and maximal gait speed [0.45 (0.27, 0.62)]. RFD was significantly associated with 5TSST [−0.35 (−0.54, −0.17)], TUG-8ft [−0.43 (−0.60, −0.27)], preferred gait speed [0.40 (0.22, 0.57)], and maximal gait speed [0.48 (0.31, 0.66)]. Conclusions Higher maximal- and explosive muscle strength was associated with better physical function in older adults receiving home care. Thus, maintaining and/or improving muscle strength is important for perseverance of physical function into old age and should be a priority.
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Affiliation(s)
- Hilde Bremseth Bårdstu
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- *Correspondence: Hilde Bremseth Bårdstu ;
| | - Vidar Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Atle Hole Saeterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
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16
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Zhao X, Yu J, Hu F, Chen S, Liu N. Association of body mass index and waist circumference with falls in Chinese older adults. Geriatr Nurs 2022; 44:245-250. [DOI: 10.1016/j.gerinurse.2022.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/12/2022]
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17
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Muscle Quality of Knee Extensors Based on Several Types of Force in Multiple Sclerosis Patients with Varying Degrees of Disability. Medicina (B Aires) 2022; 58:medicina58020316. [PMID: 35208639 PMCID: PMC8879596 DOI: 10.3390/medicina58020316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 01/02/2023] Open
Abstract
Background and Objectives: Multiple sclerosis (MS) tends to affect muscle performance, mainly in the lower extremities. The degree of disability is associated with the loss of strength and muscle mass, to varying extents. Muscle quality (MQ) expresses the amount of force produced relative to the activated muscle mass. The purpose of this study was to compare the MQ of the knee extensors in the main manifestations of strength (isometric, dynamic strength, and power) among patients with differing degrees of neurological disability and evolutionary forms of the disease. We also establish reference values for MQ in MS patients (pwMS). Materials and Methods: In total, 250 pwMS were evaluated according to the Expanded Disability Status Scale (EDSS). The maximum dynamic and isometric forces and muscle power manifested a load of 60% of the maximum dynamics of the knee extensors. The lean mass of the thigh and hip was determined by densitometry, and the MQ was calculated for the three types of force evaluated. Results: The pwMS with relapsing remitting MS (RRMS) presented isometric MQ values that were 15.8% better than those of pwMS with primary progressive MS (PPMS) and 13.8% better than those of pwMS with secondary progressive MS (SPMS). For pwMS with SPMS, the dynamic MQ was 16.7% worse than that of patients with RRMS, while the power MQ was 29.5% worse. By degree of disability (<4 >7.5 EDSS score), patients with better MQ had mild EDSS scores, and patients with severe EDSS scores had 24.8%, 25.9%, and 40.3% worse isometric, dynamic, and power MQ scores, respectively, than those with RRMS. Based on these results, reference values for MQ in pwMS were established. Conclusions: The pwMS with different types of MS do not show differences in lean mass or strength but do show differences in MQ. In pwMS with different EDSS grades, there are no differences in lean mass, but there are differences in strength based on MQ, especially power MQ.
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18
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Comparison of methods to identify individuals with obesity at increased risk of functional impairment among a population of home-dwelling older adults. Br J Nutr 2021; 128:1064-1071. [PMID: 34749837 DOI: 10.1017/s0007114521004128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity is associated with increased muscle mass and muscle strength. Methods taking into account the total body mass to reveal obese older individuals at increased risk of functional impairment are needed. Therefore, we aimed to detect methods to identify obese older adults at increased risk of functional impairment. Home-dwelling older adults (n 417, ≥ 70 years of age) were included in this cross-sectional study. Sex-specific cut-off points for two obesity phenotypes (waist circumference (WC) and body fat mass (FM %)) were used to divide women and men into obese and non-obese groups, and within-sex comparisons were performed. Obese women and men, classified by both phenotypes, had similar absolute handgrip strength (HGS) but lower relative HGS (HGS/total body mass) (P < 0·001) than non-obese women and men, respectively. Women with increased WC and FM %, and men with increased WC had higher appendicular skeletal muscle mass (P < 0·001), lower muscle quality (HGS/upper appendicular muscle mass) (P < 0·001), and spent longer time on the stair climb test and the repeated sit-to-stand test (P < 0·05) than non-obese women and men, respectively. Absolute muscle strength was not able to discriminate between obese and non-obese older adults. However, relative muscle strength in particular, but also muscle quality and physical performance tests, where the total body mass was taken into account or served as an extra load, identified obese older adults at increased risk of functional impairment. Prospective studies are needed to determine clinically relevant cut-off points for relative HGS in particular.
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19
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Fernandes DPDS, Juvanhol LL, Lozano M, Ribeiro AQ. Calf circumference is an independent predictor of mortality in older adults: An approach with generalized additive models. Nutr Clin Pract 2021; 37:1190-1198. [PMID: 34648208 DOI: 10.1002/ncp.10780] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND There is a wide variation in the cutoff points of body mass index (BMI) and calf circumference (CC) , and it is necessary to assess their adequacy in predicting mortality, especially in the older adults in the community. This study aimed to investigate the association of low muscle mass and underweight with mortality in older adults, comparing different cutoff points. METHODS This was a prospective study that included 796 older adults, not institutionalized, from a Brazilian city. Generalized additive models (GAMs) were used to identify cutoff points for CC and BMI, which were compared with values available in the literature. Survival analysis using Cox regression models was used to assess the independent association between these nutrition indicators and mortality. RESULTS Over the 9 years of follow-up, 197 deaths (24.7%) occurred. Cutoff points established for CC and BMI as predictors of mortality were, respectively, <34.5 cm and <24.5. In the adjusted Cox models, older adults with a BMI <18.5 showed a significant increase in the risk of death (hazard ratio [HR], 2.57; 95% CI, 1.23-5.35). Higher mortality was observed among older adults with CC <34.5 cm (HR, 1.72; 95% CI, 1.27-2.33) and CC <31 cm (HR, 2.11; 95% CI, 1.44-3.10). CONCLUSION CC was an independent predictor of mortality, and the cutoff point identified by GAMs was higher than recommended by literature (31 cm). This study suggests a review of cutoff points for CC currently adopted to assess low muscle mass in older adults.
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Affiliation(s)
| | | | - Manuel Lozano
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, University of Valencia, Valencia, Spain
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20
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Baker JF, Giles JT, Weber D, George MD, Leonard MB, Zemel BS, Long J, Katz P. Sarcopenic Obesity in Rheumatoid Arthritis: Prevalence and Impact on Physical Functioning. Rheumatology (Oxford) 2021; 61:2285-2294. [PMID: 34559201 DOI: 10.1093/rheumatology/keab710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 09/07/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE We determined the prevalence of sarcopenic obesity in patients with rheumatoid arthritis (RA) using multiple methods and assessed associations with physical functioning. METHODS This study evaluated data from three RA cohorts. Whole-body dual-energy absorptiometry (DXA) measures of appendicular lean mass index (ALMI, kg/m2) and fat mass index (FMI) were converted to age, sex, and race-specific Z-Scores and categorized using a recently validated method and compared it to a widely-used existing method. The prevalence of body composition abnormalities in RA was compared with two reference populations. In the RA cohorts, associations between body composition and change in the Health Assessment Questionnaire (HAQ) and the Short Physical Performance Battery (SPPB) in follow-up were assessed using linear and logistic regression, adjusting for age, sex, race, and study. RESULTS The prevalence of low lean mass and sarcopenic obesity were higher in patients with RA (14.2; 12.6%, respectively) compared with the reference population cohorts (7-10%; 4-4.5%, respectively, all p< 0.05). There was only moderate agreement among methods of sarcopenic obesity categorization (Kappa 0.45). The recently validated method categorized fewer subjects as obese, and many of these were categorized as low lean mass only. Low lean mass, obesity, and sarcopenic obesity were each associated with higher HAQ and lower SPPB at baseline and numerically greater worsening. CONCLUSION RA patients had higher rates of low lean mass and sarcopenic obesity than the general population. The recently validated methods characterized body composition changes differently from traditional methods and were more strongly associated with physical function.
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Affiliation(s)
- Joshua F Baker
- Philadelphia VA Medical Center, Philadelphia, PA, USA.,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | | | - David Weber
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael D George
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mary B Leonard
- Stanford University School of Medicine, Stanford, CA, USA
| | - Babette S Zemel
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jin Long
- Stanford University School of Medicine, Stanford, CA, USA
| | - Patricia Katz
- University of California San Francisco, San Francisco, CA, USA
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21
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Coyle PC, Knox PJ, Pohlig RT, Pugliese JM, Sions JM, Hicks GE. Hip Range of Motion and Strength Predict 12-Month Physical Function Outcomes in Older Adults With Chronic Low Back Pain: The Delaware Spine Studies. ACR Open Rheumatol 2021; 3:850-859. [PMID: 34524738 PMCID: PMC8672177 DOI: 10.1002/acr2.11342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The objective of this study was to investigate whether poor hip range of motion (ROM) and strength predict 12‐month physical function decline among older adults with chronic low back pain (LBP) and whether hip osteoarthritis modifies those relationships. Methods At baseline, passive ROM and strength measurements were taken for hip flexion, extension, abduction, adduction, internal rotation, and external rotation; ultrasound images and self‐reported symptoms were used to evaluate hip osteoarthritis presence (eg, osteophytes and hip pain). At baseline and 12 months, performance‐based (repeated chair rise, self‐selected gait speed, 6‐minute walk test [6MWT]) and self‐reported (Quebec LBP Disability Questionnaire, Late‐Life Function & Disability Instrument [LLFDI] basic and advanced lower extremity scales) physical function outcomes were assessed. Regression models were constructed for each outcome predicted by baseline hip ROM and strength measures, with adjustment for potential covariates. To avoid collinearity, hip ROM and strength measures with the strongest unadjusted correlations were included in final models. The hip osteoarthritis presence by hip ROM/strength interaction was also explored. Results Hip abduction strength predicted repeated chair rise (β = −0.297, P < 0.001), gait speed (β = 0.160, P = 0.003), 6MWT (β = 0.159, P ≤ 0.001), Quebec LBP Disability Questionnaire (β = −0.152, P = 0.003), and LLFDI basic lower extremity scale (β = 0.171, P = 0.005) outcomes. Regarding hip ROM, extension predicted repeated chair rise (β = −0.110, P = 0.043) and LLFDI advanced lower extremity scale (β = 0.090, P = 0.007) outcomes, external rotation predicted gait speed (β = 0.122, P = 0.004) outcomes, and abduction predicted LLFDI basic lower extremity scale (β = 0.114, P = 0.026) outcomes. The hip osteoarthritis interaction was not significant for any model. Conclusion Reduced hip strength and ROM predict physical function decline; hip osteoarthritis presence may not modify these relationships.
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Alcazar J, Alegre LM, Van Roie E, Magalhães JP, Nielsen BR, González‐Gross M, Júdice PB, Casajús JA, Delecluse C, Sardinha LB, Suetta C, Ara I. Relative sit-to-stand power: aging trajectories, functionally relevant cut-off points, and normative data in a large European cohort. J Cachexia Sarcopenia Muscle 2021; 12:921-932. [PMID: 34216098 PMCID: PMC8350203 DOI: 10.1002/jcsm.12737] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/13/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A validated, standardized, and feasible test to assess muscle power in older adults has recently been reported: the sit-to-stand (STS) muscle power test. This investigation aimed to assess the relationship between relative STS power and age and to provide normative data, cut-off points, and minimal clinically important differences (MCID) for STS power measures in older women and men. METHODS A total of 9320 older adults (6161 women and 3159 men) aged 60-103 years and 586 young and middle-aged adults (318 women and 268 men) aged 20-60 years were included in this cross-sectional study. Relative (normalized to body mass), allometric (normalized to height squared), and specific (normalized to legs muscle mass) muscle power values were assessed by the 30 s STS power test. Body composition was evaluated by dual energy X-ray absorptiometry and bioelectrical impedance analysis, and legs skeletal muscle index (SMI; normalized to height squared) was calculated. Habitual and maximal gait speed, timed up-and-go test, and 6 min walking distance were collected as physical performance measures, and participants were classified into two groups: well-functioning and mobility-limited older adults. RESULTS Relative STS power was found to decrease between 30-50 years (-0.05 W·kg-1 ·year-1 ; P > 0.05), 50-80 years (-0.10 to -0.13 W·kg-1 ·year-1 ; P < 0.001), and above 80 years (-0.07 to -0.08 W·kg-1 ·year-1 ; P < 0.001). A total of 1129 older women (18%) and 510 older men (16%) presented mobility limitations. Mobility-limited older adults were older and exhibited lower relative, allometric, and specific power; higher body mass index (BMI) and legs SMI (both only in women); and lower legs SMI (only in men) than their well-functioning counterparts (all P < 0.05). Normative data and cut-off points for relative, allometric, and specific STS power and for BMI and legs SMI were reported. Low relative STS power occurred below 2.1 W·kg-1 in women (area under the curve, AUC, [95% confidence interval, CI] = 0.85 [0.84-0.87]) and below 2.6 W·kg-1 in men (AUC [95% CI] = 0.89 [0.87-0.91]). The age-adjusted odds ratios [95% CI] for mobility limitations in older women and men with low relative STS power were 10.6 [9.0-12.6] and 14.1 [10.9-18.2], respectively. MCID values for relative STS power were 0.33 W·kg-1 in women and 0.42 W·kg-1 in men. CONCLUSIONS Relative STS power decreased significantly after the age of 50 years and was negatively and strongly associated with mobility limitations. Our study provides normative data, functionally relevant cut-off points, and MCID values for STS power for their use in daily clinical practice.
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Affiliation(s)
- Julian Alcazar
- GENUD Toledo Research GroupUniversidad de Castilla‐La ManchaToledoSpain
- CIBER of Frailty and Healthy Aging (CIBERFES)MadridSpain
- Geriatric Research Unit, Geriatric DepartmentBispebjerg‐Frederiksberg University HospitalCopenhagenDenmark
| | - Luis M. Alegre
- GENUD Toledo Research GroupUniversidad de Castilla‐La ManchaToledoSpain
- CIBER of Frailty and Healthy Aging (CIBERFES)MadridSpain
| | - Evelien Van Roie
- Department of Movement Sciences, Physical Activity, Sports and Health Research GroupKU LeuvenLeuvenBelgium
| | - João P. Magalhães
- Exercise and Health Laboratory, CIPER, Facultade de Motricidade HumanaUniversidade de LisboaLisbonPortugal
| | - Barbara R. Nielsen
- Department of Internal Medicine, Geriatric DivisionAmager and Hvidovre Hospital, GlostrupCopenhagenDenmark
| | - Marcela González‐Gross
- ImFine Research Group, Departamento de Salud y Rendimiento Humano, Facultad de Ciencias de la Actividad Física y del DeporteUniversidad Politécnica de MadridMadridSpain
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN)MadridSpain
| | - Pedro B. Júdice
- Exercise and Health Laboratory, CIPER, Facultade de Motricidade HumanaUniversidade de LisboaLisbonPortugal
| | - Jose A. Casajús
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN)MadridSpain
- Growth, Exercise, Nutrition, and Development Research GroupUniversity of ZaragozaZaragozaSpain
| | - Christophe Delecluse
- Department of Movement Sciences, Physical Activity, Sports and Health Research GroupKU LeuvenLeuvenBelgium
| | - Luis B. Sardinha
- Exercise and Health Laboratory, CIPER, Facultade de Motricidade HumanaUniversidade de LisboaLisbonPortugal
| | - Charlotte Suetta
- Geriatric Research Unit, Geriatric DepartmentBispebjerg‐Frederiksberg University HospitalCopenhagenDenmark
- Department of Clinical Physiology, Nuclear Medicine & PET, Righospitalet‐GlostrupCopenhagen University HospitalCopenhagenDenmark
- Geriatric Research Unit, Department of Internal MedicineHerlev‐Gentofte University HospitalHerlevDenmark
| | - Ignacio Ara
- GENUD Toledo Research GroupUniversidad de Castilla‐La ManchaToledoSpain
- CIBER of Frailty and Healthy Aging (CIBERFES)MadridSpain
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Koeppel M, Mathis K, Schmitz KH, Wiskemann J. Muscle hypertrophy in cancer patients and survivors via strength training. A meta-analysis and meta-regression. Crit Rev Oncol Hematol 2021; 163:103371. [PMID: 34062243 DOI: 10.1016/j.critrevonc.2021.103371] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Muscle wasting has a negative effect on treatment toxicity and cancer prognosis. Resistance training appears to be a promising approach to counteract the loss of muscle mass. METHODS Pubmed, Cochrane Library, SportDiscus and CINAHL. Randomized controlled resistance training trials with cancer survivros where eligible if lean body mass (LBM) or muscle mass were assessed. RESULTS A total of 34 trials were included into the primary analysis. Compared to the control individuals, the intervention groups show a superiority in LBM of 0.85 kg (95 % CI = 0.26-1.43, p = .004). Isolated, the participants in the intervention groups show an increase in LBM of 0.51 kg (95 % CI = -0.05-1.06, p = .072); the control groups displayed a decrease of -0.59 kg (95 % CI= -1.04 to 0.06, p = .078). Supervision displayed an mediating role. CONCLUSIONS Resistance training can counteract the loss of muscle mass in cancer patients. Especially in a supervised setting.
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Affiliation(s)
- Maximilian Koeppel
- Institute of Sports and Sport Science, Heidelberg University, Im Neuenheimer Feld 700, 69120, Heidelberg, Germany; Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases Heidelberg (NCT Heidelberg) and Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany; Penn State College of Medicine, University Drive 500, 17033, Hershey, PA, USA
| | - Katlynn Mathis
- Penn State College of Medicine, University Drive 500, 17033, Hershey, PA, USA; Harrisburg Area Community College, Bldg. YL150, 17401, YORK, PA, USA
| | - Kathryn H Schmitz
- Penn State College of Medicine, University Drive 500, 17033, Hershey, PA, USA
| | - Joachim Wiskemann
- Penn State College of Medicine, University Drive 500, 17033, Hershey, PA, USA; Harrisburg Area Community College, Bldg. YL150, 17401, YORK, PA, USA.
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Cunha PM, Tomeleri CM, Nascimento MA, Mayhew JL, Fungari E, Cyrino LT, Barbosa DS, Venturini D, Cyrino ES. Comparision of Low and High Volume of Resistance Training on Body Fat and Blood Biomarkers in Untrained Older Women: A Randomized Clinical Trial. J Strength Cond Res 2021; 35:1-8. [PMID: 31306389 DOI: 10.1519/jsc.0000000000003245] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Cunha, PM, Tomeleri, CM, Nascimento, MA, Mayhew, JL, Fungari, E, Cyrino, LT, Barbosa, DS, Venturini, D, and Cyrino, ES. Comparision of low and high volume of resistance training on body fat and blood biomarkers in untrained older women: a randomized clinical trial. J Strength Cond Res 35(1): 1-8, 2021-The purpose of this study was to compare the effects of resistance training (RT) performed with 2 different volumes on body fat and blood biomarkers in untrained older women. Sixty-five physically independent older women (≥60 years) were randomly assigned to one of 3 groups: low-volume (LV) training group, high-volume (HV) training group, and a control group. Both training groups performed RT for 12 weeks, using 8 exercises of 10-15 repetitions maximum for each exercise. The low-volume group performed only a single set per exercise, whereas the HV group performed 3 sets. Anthropometric, body fat (%), trunk fat, triglycerides (TG), total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol, very LDL-c (VLDL-c), glucose (GLU), C-reactive protein (CRP), and composite Z-score were measured. The HV group obtained greater improvements compared with the LV group (p < 0.05) for TG (LV = -10.5% vs. HV = -16.6%), VLDL-c (LV = -6.5% vs. HV = -14.8%), GLU (LV = -4.7% vs. HV = -11.1%), CRP (LV = -13.2% vs. HV = -30.8%), % body fat (LV = -2.4% vs. HV = -6.1%), and composite Z-score (LV = -0.13 ± 0.30 vs. HV = -0.57 ± 0.29). Trunk fat was reduced (p < 0.05) only in the HV group (-6.8%). We conclude that RT performed in higher volume seems to be the most appropriate strategy to reduce body fat (%), trunk fat, improve blood biomarkers, and reduce composite Z-score in older women.
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Affiliation(s)
- Paolo M Cunha
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Puerto Rico, Brazil
| | - Crisieli M Tomeleri
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Puerto Rico, Brazil
| | - Matheus A Nascimento
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Puerto Rico, Brazil.,Paraná State University-UNESPAR, Paranavaí, Puerto Rico, Brazil
| | - Jerry L Mayhew
- Exercise Science Program, Truman State University, Kirksville, Missouri; and
| | - Edilaine Fungari
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Puerto Rico, Brazil
| | - Letícia T Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Puerto Rico, Brazil
| | - Décio S Barbosa
- Clinical Analyses Laboratory, Londrina State University, Londrina, Brazil
| | - Danielle Venturini
- Clinical Analyses Laboratory, Londrina State University, Londrina, Brazil
| | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Puerto Rico, Brazil
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Rostron ZP, Green RA, Kingsley M, Zacharias A. Associations Between Measures of Physical Activity and Muscle Size and Strength: A Systematic Review. Arch Rehabil Res Clin Transl 2021; 3:100124. [PMID: 34179760 PMCID: PMC8211997 DOI: 10.1016/j.arrct.2021.100124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective To determine whether physical activity is associated with lower limb muscle size and strength within the general population. Data Sources Six databases were systematically searched from inception using 3 main constructs: lower extremity, muscle volume, and muscle strength. Study Selection Studies that measured physical activity (using either objective or subjective measurements), lower limb muscle size, and strength were included. Available discrete group data were standardized using previously published age- and sex-specific normative values prior to analysis. Data Extraction The final analysis included 47 studies from an initial yield of 5402 studies. Standardized scores for outcome measures were calculated for 97 discrete groups. Data Synthesis As anticipated, lower limb muscle size was positively correlated with lower limb muscle strength (r=0.26, P<.01; n=4812). Objectively measured physical activity (ie, accelerometry, pedometry) (n=1944) was positively correlated with both lower limb muscle size (r=0.30, P<.01; n=1626) and lower limb strength (r=0.24, P<.01; n=1869). However, subjectively measured physical activity (ie, questionnaires) (n=3949) was negatively associated with lower limb muscle size (r=–0.59, P<.01; n=3243) and lower limb muscle strength (r=–0.48, P<. 01; n=3882). Conclusions This review identified that objective measures of physical activity are moderately associated with lower limb muscle size and muscle strength and can, therefore, be used to predict muscle changes within the lower limbs associated with exercise-based rehabilitation programs.
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Affiliation(s)
- Zachary P. Rostron
- Department of Pharmacy and Biomedical Sciences, College of Science, Health and Engineering, La Trobe University, Bendigo, Victoria, Australia
- Corresponding author Zachary P. Rostron, MExPhys, Department of Pharmacy and Biomedical Sciences, College of Science, Health and Engineering, La Trobe University, PO Box 199, Edwards Rd, Flora Hill, Bendigo, VIC 3552, Australia.
| | - Rodney A. Green
- Department of Pharmacy and Biomedical Sciences, College of Science, Health and Engineering, La Trobe University, Bendigo, Victoria, Australia
| | - Michael Kingsley
- Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
- Holsworth Research Initiative, College of Science, Health and Engineering, La Trobe University, Bendigo, Victoria, Australia
| | - Anita Zacharias
- Department of Pharmacy and Biomedical Sciences, College of Science, Health and Engineering, La Trobe University, Bendigo, Victoria, Australia
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Life course socioeconomic position and body composition in adulthood: a systematic review and narrative synthesis. Int J Obes (Lond) 2021; 45:2300-2315. [PMID: 34316000 PMCID: PMC8528709 DOI: 10.1038/s41366-021-00898-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 05/24/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Multiple systematic reviews have investigated the relation between socioeconomic position (SEP) and body mass index (BMI) throughout the life course. However, BMI does not capture quantity and distribution of fat and muscle, which are better indicators of obesity than BMI, and have been independently linked to adverse health outcomes. Less is known about the relation between SEP and body composition, and the literature has not been reviewed. We therefore systematically reviewed the literature on the association between life course SEP and body composition in adulthood. METHODS A protocol was registered on PROSPERO (CRD42019119937), and the review followed PRISMA guidelines. An electronic search of three databases (MEDLINE, Embase Classic + Embase and SPORTDiscus) was conducted. Original studies in the English language were included that examine the association between any recognised measure of SEP at any age and body composition (fat mass, fat-free mass, ratio and distribution) in adulthood, measured using a direct technique, i.e., not an anthropometric measure. A narrative synthesis was conducted. RESULTS A total of 47 papers were included in the final review, none were from low-income countries (LICs). Greater advantage in childhood and adulthood was associated with lower fat levels in high-income countries (HICs). Associations in the opposite direction were found exclusively in middle-income countries (MICs). No studies in MICs reported associations for childhood SEP. For measures of lean mass, the majority of papers reported no association, or greater advantage in adulthood associated with higher lean mass, with little variation between HICs and MICs. Associations in HICs are more often observed in women than men. CONCLUSION The results indicate that fat measures follow similar patterns to those seen for BMI, and that women in HICs are more likely to experience inequalities in both fat and lean measures. Further research in LICs and MICs is needed.
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Wu PY, Huang KS, Chen KM, Chou CP, Tu YK. Exercise, Nutrition, and Combined Exercise and Nutrition in Older Adults with Sarcopenia: A Systematic Review and Network Meta-analysis. Maturitas 2020; 145:38-48. [PMID: 33541561 DOI: 10.1016/j.maturitas.2020.12.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/07/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
It is unclear whether the combined effects of exercise and nutrition are better than those of exercise alone or nutrition alone in older adults with sarcopenia. This paper assesses the comparative effects of exercise, nutrition, and the combination of exercise and nutrition on muscle mass, muscle strength, and physical performance in older adults with sarcopenia. In this systematic review and network meta-analysis, 11 electronic databases were searched up to November 2020. Inclusion criteria were: (1) adults aged 65 years and older with sarcopenia; (2) interventions of exercise, nutrition, or the combination of both; (3) the outcomes include at least one of the following: muscle mass, muscle strength (hand grip and knee extension strength), or physical performance (gait speed and dynamic balance); and (4) randomized control trials. For each outcome measurement, a network meta-analysis was conducted to determine the direct and indirect effects of each intervention compared with each of the other interventions. A total of 26 studies were included in the network meta-analysis. Compared with the control group, exercise alone and the combination of exercise and nutrition significantly increased handgrip strength (1.12 kg, 95% CI: 0.12, 2.11; 2.03 kg, 95% CI: 1.10, 2.97) and improved dynamic balance (-1.76 seconds, 95% CI: -2.24, -1.28; -1.02 seconds, 95% CI: -1.64, -0.39). Both exercise alone and the combination of exercise and nutrition have beneficial effects on muscle strength and physical performance in older adults with sarcopenia.
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Affiliation(s)
- Pei-Yu Wu
- Center for Long-Term Care Research, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708, Taiwan.
| | - Kun-Siang Huang
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan; College of Medicine, Chang Gung University, Taiwan.
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1(st)Rd., Sanmin District, Kaohsiung, 80708, Taiwan; Center for Long-Term Care Research, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
| | - Chia-Pei Chou
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan; College of Medicine, Chang Gung University, Taiwan
| | - Yu-Kang Tu
- College of Public Health, National Taiwan University, 17 Xu-Zhou Rd., Zhongzheng District, Taipei, 10055, Taiwan; Department of Medical Research, National Taiwan University Hospital, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taiwan.
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Gittings PM, Wand BM, Hince DA, Grisbrook TL, Wood FM, Edgar DW. The efficacy of resistance training in addition to usual care for adults with acute burn injury: A randomised controlled trial. Burns 2020; 47:84-100. [PMID: 33280953 DOI: 10.1016/j.burns.2020.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/13/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. Data analysis was an available cases analysis with no data imputed. Regression analyses were used for all longitudinal outcome data and between-group comparisons were used for descriptive analyses. Forty-eight patients were randomised resistance training (RTG) (n=23) or control group (CG) (n=25). The RTG demonstrated improved outcomes for the functional domain of the Burn Specific Health Scale-Brief (p=0.017) and the Quick Disability of Arm Shoulder and Hand (p<0.001). Between group differences were seen for C-reactive protein and retinol binding protein (p=0.001). Total quality of life scores, lower limb disability, muscle strength and volume were not seen to be different between groups (p>0.05). Resistance training in addition to usual rehabilitation therapy showed evidence of improving functional outcomes, particularly in upper limb burn injuries. Additionally, resistance training commenced acutely after a burn injury was not seen to be harmful to patients.
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Affiliation(s)
- Paul M Gittings
- State Adult Burns Service, South Metropolitan Area Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; School of Physiotherapy, University of Notre Dame Australia, Fremantle, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia.
| | - Benedict M Wand
- School of Physiotherapy, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Dana A Hince
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Tiffany L Grisbrook
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
| | - Fiona M Wood
- State Adult Burns Service, South Metropolitan Area Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia; Burn Injury Research Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Dale W Edgar
- State Adult Burns Service, South Metropolitan Area Health Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia; Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia; Burn Injury Research Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia; Burn Injury Research Node, Institute of Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Koohsari MJ, McCormack GR, Nakaya T, Shibata A, Ishii K, Yasunaga A, Liao Y, Oka K. Walking-friendly built environments and objectively measured physical function in older adults. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:651-656. [PMID: 33308816 PMCID: PMC7749248 DOI: 10.1016/j.jshs.2020.02.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/22/2019] [Accepted: 12/12/2019] [Indexed: 06/12/2023]
Abstract
BACKGROUND Few studies have examined the associations between urban design attributes and older adults' physical function. Especially, it is not well known how built-environment attributes may influence physical function in Asian cities. The aim of this study was to examine associations between objectively measured environmental attributes of walkability and objectively assessed physical function in a sample of Japanese older adults. METHODS Cross-sectional data collected in 2013 from 314 older residents (aged 65-84 years) living in Japan were used. Physical function was estimated from objectively measured upper- and lower-body function, mobility, and balance by a trained research team member. A comprehensive list of built-environment attributes, including population density, availability of destinations, intersection density, and distance to the nearest public transport station, were objectively calculated. Walk Score as a composite measure of neighborhood walkability was also obtained. RESULTS Among men, higher population density, availability of destinations, and intersection density were significantly associated with better physical function performance (1-legged stance with eyes open). Higher Walk Score was also marginally associated with better physical function performance (1-legged stance with eyes open). None of the environmental attributes were associated with physical function in elderly women. CONCLUSION Our findings indicate that environmental attributes of walkability are associated with the physical function of elderly men in the context of Asia. Walking-friendly neighborhoods can not only promote older adults' active behaviors but can also support their physical function.
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Affiliation(s)
- Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan; Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia.
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada; Faculty of Kinesiology, University of Calgary, Calgary, Alberta T2N 4Z6, Canada; School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta T2N 4Z6, Canada
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai 980-0845, Japan
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Akitomo Yasunaga
- Faculty of Liberal Arts and Sciences, Bunka Gakuen University, Tokyo 151-8523, Japan
| | - Yung Liao
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
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Anton SD, Cruz-Almeida Y, Singh A, Alpert J, Bensadon B, Cabrera M, Clark DJ, Ebner NC, Esser KA, Fillingim RB, Goicolea SM, Han SM, Kallas H, Johnson A, Leeuwenburgh C, Liu AC, Manini TM, Marsiske M, Moore F, Qiu P, Mankowski RT, Mardini M, McLaren C, Ranka S, Rashidi P, Saini S, Sibille KT, Someya S, Wohlgemuth S, Tucker C, Xiao R, Pahor M. Innovations in Geroscience to enhance mobility in older adults. Exp Gerontol 2020; 142:111123. [PMID: 33191210 PMCID: PMC7581361 DOI: 10.1016/j.exger.2020.111123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
Aging is the primary risk factor for functional decline; thus, understanding and preventing disability among older adults has emerged as an important public health challenge of the 21st century. The science of gerontology - or geroscience - has the practical purpose of "adding life to the years." The overall goal of geroscience is to increase healthspan, which refers to extending the portion of the lifespan in which the individual experiences enjoyment, satisfaction, and wellness. An important facet of this goal is preserving mobility, defined as the ability to move independently. Despite this clear purpose, this has proven to be a challenging endeavor as mobility and function in later life are influenced by a complex interaction of factors across multiple domains. Moreover, findings over the past decade have highlighted the complexity of walking and how targeting multiple systems, including the brain and sensory organs, as well as the environment in which a person lives, can have a dramatic effect on an older person's mobility and function. For these reasons, behavioral interventions that incorporate complex walking tasks and other activities of daily living appear to be especially helpful for improving mobility function. Other pharmaceutical interventions, such as oxytocin, and complementary and alternative interventions, such as massage therapy, may enhance physical function both through direct effects on biological mechanisms related to mobility, as well as indirectly through modulation of cognitive and socioemotional processes. Thus, the purpose of the present review is to describe evolving interventional approaches to enhance mobility and maintain healthspan in the growing population of older adults in the United States and countries throughout the world. Such interventions are likely to be greatly assisted by technological advances and the widespread adoption of virtual communications during and after the COVID-19 era.
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Affiliation(s)
- Stephen D Anton
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Yenisel Cruz-Almeida
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Arashdeep Singh
- University of Florida, Department of Pharmacodynamics, College of Pharmacy, 1345 Center Drive, Gainesville, FL 32610, United States.
| | - Jordan Alpert
- University of Florida, College of Journalism and Communications, Gainesville, FL 32610, United States.
| | - Benjamin Bensadon
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Melanie Cabrera
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - David J Clark
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Natalie C Ebner
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Karyn A Esser
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Roger B Fillingim
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Soamy Montesino Goicolea
- University of Florida, Department of Community Dentistry and Behavioral Science, 1329 SW Archer Road, Gainesville, FL 32610, United States.
| | - Sung Min Han
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Henrique Kallas
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Alisa Johnson
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christiaan Leeuwenburgh
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Andrew C Liu
- University of Florida, Department of Physiology and Functional Genomics, 1345 Center Drive, Gainesville, FL, United States.
| | - Todd M Manini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Michael Marsiske
- University of Florida, Department of Clinical & Health Psychology, 1225 Center Drive, Gainesville, FL 32610, United States.
| | - Frederick Moore
- University of Florida, Department of Surgery, Gainesville, FL 32610, United States.
| | - Peihua Qiu
- University of Florida, Department of Biostatistics, Gainesville, FL 32611, United States.
| | - Robert T Mankowski
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Mamoun Mardini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Christian McLaren
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Sanjay Ranka
- University of Florida, Department of Computer & Information Science & Engineering, Gainesville, FL 32611, United States.
| | - Parisa Rashidi
- University of Florida, Department of Biomedical Engineering. P.O. Box 116131. Gainesville, FL 32610, United States.
| | - Sunil Saini
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Kimberly T Sibille
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Shinichi Someya
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Stephanie Wohlgemuth
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Carolyn Tucker
- University of Florida, Department of Psychology, 945 Center Drive, Gainesville, FL 32611, United States.
| | - Rui Xiao
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
| | - Marco Pahor
- University of Florida, Department of Aging and Geriatric Research, 2004 Mowry Road, Gainesville, FL 32611, United States.
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Percent body fat, but not lean mass, is associated with objectively measured physical function in middle-aged women. Maturitas 2020; 142:11-16. [PMID: 33158482 DOI: 10.1016/j.maturitas.2020.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 06/02/2020] [Accepted: 06/09/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The relationship between components of body composition and physical function is not well characterized among middle-aged women. This cross-sectional study examined the strength of the associations between lean mass and percent fat and physical function in middle-aged women. STUDY DESIGN Body composition, physical function and physical activity were objectively measured in 80 women (mean age 52.58 ± 6.10 years; range = 40-63 years). MAIN OUTCOME MEASURES Adiposity (%Fat) and lean mass were measured via dual-energy x-ray absorptiometry. Steps/day and minutes of low-, moderate- and vigorous-intensity physical activity were assessed via accelerometer. Physical function was measured via a seated transfer task, 30-second chair stand, a six-minute walk task, 8-foot timed up and go, and a lift and carry task. RESULTS When controlling for steps/day, measures of lean mass were related to performance on the seated transfer task (r = .25) and 30-second chair stand (-.26) (both p > 0.05), while %Fat was related to performance on the seated transfer task (r = .53), 8-foot timed up and go (r = .32), 30-second chair stand (r = -.35), and six-minute walk (r = -.48; all p ≤ 0.05). Linear regression analyses revealed: (1) age, steps/day, and %Fat were independently related to performance on the seated transfer task and 30-second chair stand (both p ≤ 0.05), (2) %Fat was associated with six-minute walk and 8-foot up-and-go performance (p ≤ 0.01); none of the variables included were associated with lift and carry. CONCLUSIONS Adiposity but not lean mass was associated with objectively measured physical function in middle-aged women. Interventions that focus on reducing body fat may be an effective method for improving functional performance among women in this age group.
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Sanz-Requena R, Martínez-Arnau FM, Pablos-Monzó A, Flor-Rufino C, Barrachina-Igual J, García-Martí G, Martí-Bonmatí L, Pérez-Ros P. The Role of Imaging Biomarkers in the Assessment of Sarcopenia. Diagnostics (Basel) 2020; 10:diagnostics10080534. [PMID: 32751452 PMCID: PMC7460125 DOI: 10.3390/diagnostics10080534] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/14/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The diagnosis of sarcopenia through clinical assessment has some limitations. The literature advises studies that include objective markers along with clinical assessment in order to improve the sensitivity and specificity of current diagnostic criteria. The decrease of muscle quality precedes the loss of quantity, so we studied the role magnetic resonance imaging biomarkers as indicators of the quantity and quality of muscle in sarcopenia patients. METHODS a cross-sectional analysis was performed to analyze what MR-derived imaging parameters correlate better with sarcopenia diagnostic criteria in women of 70 years of age and over (independent walking and community-dwelling women who were sarcopenic in accordance with EWGSOP criteria with muscle mass adjusted to Spanish population were chosen). RESULTS The study included 26 women; 81 ± 8 years old. A strong correlation was obtained between cineanthropometric variables (BMI; thigh perimeter and fat mass) and imaging biomarkers (muscle/fat ratio, fatty infiltration, muscle T2*, water diffusion coefficient, and proton density fat fraction) with coefficients around 0.7 (absolute value). CONCLUSIONS Knowing the correlation of clinical parameters and imaging-derived muscle quality indicators can help to identify older women at risk of developing sarcopenia at an early stage. This may allow taking preventive actions to decrease disability, morbidity, and mortality in sarcopenia patients.
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Affiliation(s)
- Roberto Sanz-Requena
- Radiology Department, Hospital Quironsalud Valencia, 46010 Valencia, Spain; (R.S.-R.); (G.G.-M.); (L.M.-B.)
| | - Francisco Miguel Martínez-Arnau
- Department of Physiotherapy, Universitat de Valencia, 46010 Valencia, Spain;
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain
- Correspondence: ; Tel.: +34-963-983853 (ext. 51227)
| | - Ana Pablos-Monzó
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Mártir, 46900 Valencia, Spain;
| | | | | | - Gracián García-Martí
- Radiology Department, Hospital Quironsalud Valencia, 46010 Valencia, Spain; (R.S.-R.); (G.G.-M.); (L.M.-B.)
| | - Luis Martí-Bonmatí
- Radiology Department, Hospital Quironsalud Valencia, 46010 Valencia, Spain; (R.S.-R.); (G.G.-M.); (L.M.-B.)
| | - Pilar Pérez-Ros
- Nursing Department, Universidad Católica de Valencia San Vicente Mártir, 46007 Valencia, Spain;
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Haynes EMK, Neubauer NA, Cornett KMD, O'Connor BP, Jones GR, Jakobi JM. Age and sex-related decline of muscle strength across the adult lifespan: a scoping review of aggregated data. Appl Physiol Nutr Metab 2020; 45:1185-1196. [PMID: 32598857 DOI: 10.1139/apnm-2020-0081] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Muscle strength is sex-related and declines with advancing age; yet, a comprehensive comparative evaluation of age-related strength loss in human females and males has not been undertaken. To do so, segmented piecewise regression analysis was performed on aggregated data from studies published from 1990 to 2018 and are available in CINAHL, EMBASE, MEDLINE, and PsycINFO databases. The search identified 5613 articles that were reviewed for physical assessment results stratified by sex and age. Maximal isometric and isokinetic 60°·s-1 knee extension (KE) and knee flexion (KF) contractions from 57 studies and 15 283 subjects (N = 7918 females) had sufficient data reported on females and males for meaningful statistical evaluation to be undertaken. The analysis revealed that isometric KE and KF strength undergo similar rapid declines in both sexes late in the sixth decade of life. Yet, there is an abrupt age-related decline in KE 60°·s-1 peak torque earlier in females (aged 41.8 years) than males (aged 66.7 years). In the assessment of KF peak torque, an age-related acceleration in strength loss was only identified in males (aged 49.3 years). The results suggest that age-related isometric strength loss is similar between sexes while the characteristics of KE and KF peak torque decline are sex-related, which likely explains the differential rate of age-related functional decline. Novelty Inclusion of muscle strength and torque of KE and KF data from >15 000 subjects. Isometric KE and KF strength loss are similar between sexes. Isokinetic 60°·s-1 KE torque decline accelerates 25 years earlier in females and female age-related KF peak torque decline does not accelerate with age.
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Affiliation(s)
- E M K Haynes
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - N A Neubauer
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - K M D Cornett
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - B P O'Connor
- Psychology, School of Arts and Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - G R Jones
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - J M Jakobi
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
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Maciel Batista M, da Silva DSG, Bento PCB. Effects of Blood Flow Restriction Training on Strength, Muscle Mass and Physical Function in Older Individuals - Systematic Review and Meta-Analysis. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1769796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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35
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Baker JF, Long J, Leonard MB, Harris T, Delmonico MJ, Santanasto A, Satterfield S, Zemel B, Weber DR. Estimation of Skeletal Muscle Mass Relative to Adiposity Improves Prediction of Physical Performance and Incident Disability. J Gerontol A Biol Sci Med Sci 2019; 73:946-952. [PMID: 28958026 DOI: 10.1093/gerona/glx064] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/29/2017] [Indexed: 12/21/2022] Open
Abstract
Purpose We assessed the discrimination of lean mass estimates that have been adjusted for adiposity for physical functioning deficits and prediction of incident disability. Methods Included were 2,846 participants from the Health, Aging and Body Composition Study with available whole-body dual energy absorptiometry measures of appendicular lean mass index (ALMI, kg/m2) and fat mass index (FMI, kg/m2). Age-, sex-, and race-specific Z-Scores and T-Scores were determined by comparison to published reference ranges. ALMI values were adjusted for FMI (ALMIFMI) using a novel published method. Sex-stratified analyses assessed associations between lean mass estimates and the physical performance score, ability to complete a 400-meter walk, grip strength, and incident disability. Dichotomized definitions of low lean for age and sarcopenia were examined and their performance compared to the ALM-to-BMI ratio. Results Compared to ALMI T-Scores and Z-Scores, the ALMIFMI scores demonstrated stronger associations with physical functioning, and were similarly associated with grip strength. Greater FMI Z-Scores and T-Scores were associated with poor physical functioning and incident disability. Definitions of low lean for age and sarcopenia using ALMIFMI (compared to ALMI) better discriminated those with poor physical functioning and a greater risk of incident disability. The ALM-to-BMI ratio was modestly associated with grip strength and physical performance, but was not associated with completion of the 400-meter walk or incident disability, independent of adiposity and height. Conclusion Estimation of skeletal muscle mass relative to adiposity improves correlations with physical performance and prediction of incident disability suggesting it is an informative outcome for clinical studies.
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Affiliation(s)
- Joshua F Baker
- Division of Rheumatology, Philadelphia Veterans Affairs Medical Center, Pennsylvania.,School of Medicine, University of Pennsylvania, Philadelphia.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia
| | - Jin Long
- Department of Pediatrics and Medicine, Stanford University, California
| | - Mary B Leonard
- Department of Pediatrics and Medicine, Stanford University, California
| | - Tamara Harris
- Laboratory of Epidemiology and Population Sciences, National Institute of Aging, Bethesda, Maryland
| | - Matthew J Delmonico
- Department of Kinesiology, University of Rhode Island, Kingston.,Health Science Center, University of Tennessee, Memphis
| | - Adam Santanasto
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Suzanne Satterfield
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Pennsylvania
| | - Babette Zemel
- Department of Kinesiology, University of Rhode Island, Kingston
| | - David R Weber
- Health Science Center, University of Tennessee, Memphis.,Division of Endocrinology and Diabetes, Golisano Children's Hospital, University of Rochester, New York
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36
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Current Concepts in Healthy Aging and Physical Activity: A Viewpoint. J Aging Phys Act 2019; 27:755-761. [PMID: 30747553 DOI: 10.1123/japa.2018-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Physical activity plays an important role for achieving healthy aging by promoting independence and increasing the quality of life. However, current guidelines for physical activity in older adults may be difficult to achieve in an older population. Indeed, there is evidence to suggest that increasing exercise intensity in older adults may be associated with greater reductions in the risk of cardiovascular disease and mortality. Therefore, the idea prescribing high-intensity exercise protocols such as high-intensity interval training and high-intensity resistance training becomes an intriguing strategy for healthy aging. Collectively, the literature review in this viewpoint will briefly focus on summarizing alternative/novel time-efficient approaches in physical activity toward healthy aging. Our goal is to hopefully open a discussion on possibly revising the current physical activity guidelines in older adults.
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Comparison between eccentric and concentric resistance exercise training without equipment for changes in muscle strength and functional fitness of older adults. Eur J Appl Physiol 2019; 119:1581-1590. [PMID: 31055678 DOI: 10.1007/s00421-019-04147-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/20/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE The present study tested the hypothesis that resistance exercise training focusing on eccentric muscle contractions would improve muscle strength and functional physical fitness more than concentric contraction-focused resistance training in older adults. METHODS Healthy older adults (65-84 years) were placed into eccentric (ECC; n = 9) or concentric training group (CON; n = 8). They performed 4-6 basic manual resistance exercises focusing on either eccentric or concentric muscle contractions once at a community centre and at least twice at home a week for 8 weeks. Muscle thickness of the quadriceps femoris (MT), knee extensor maximal voluntary isometric contraction strength (MVC), 30-second chair stand (CS), 3-metre timed up and go (TUG), 2-minute step (2MS), sit and reach (SR), and static balance with eyes open and closed (Bal-EC) were assessed before and 7 days after the last community centre session. RESULTS Changes in MT (ECC: 21.6 ± 9.2% vs CON: 6.7 ± 7.1%), MVC (38.3 ± 22.6% vs 8.2 ± 8.4%), CS (51.0 ± 21.7% vs 34.6 ± 28.3%), TUG (16.7 ± 9.9% vs 6.3 ± 7.7%), 2MS (9.9 ± 6.0% vs 6.0 ± 7.3%) and Bal-EC (35.1 ± 6.7% vs 8.8 ± 16.2%) from baseline were greater (P < 0.05) for the ECC than the CON group. CONCLUSION These results show that the eccentric manual resistance exercise training was more effective for improving lower limb strength, mobility, and postural stability of older adults when compared with the concentric training. This suggests the significance of emphasising eccentric muscle contractions in movements to maintain and improve physical function.
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Lees MJ, Wilson OJ, Hind K, Ispoglou T. Muscle quality as a complementary prognostic tool in conjunction with sarcopenia assessment in younger and older individuals. Eur J Appl Physiol 2019; 119:1171-1181. [PMID: 30806780 PMCID: PMC6469623 DOI: 10.1007/s00421-019-04107-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/20/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE This pilot study investigated differences in lean tissue mass, muscle strength, muscle quality (strength per unit of muscle mass; MQ), and functional performance in healthy younger and older individuals. The most robust predictors of appendicular lean mass (ALM) were then determined in each group. METHODS Fifty younger (18-45 years) and 50 older (60-80 years) participants completed tests of upper and lower body strength alongside body composition by dual-energy X-ray absorptiometry from which upper- and lower-body MQ were estimated. Available cut-points for older people were used to determine low upper-body MQ in both groups. Low lower-body MQ was determined as at least two standard deviations below the mean of the younger group. Functional performance was assessed by gait speed. Sarcopenia was identified using two established definitions. RESULTS Upper and lower body strength, ALM, lower-body MQ and gait speed were significantly higher in the younger group (all p < 0.002). Sarcopenia was identified in 2-4% of the older group. Low upper-body MQ was evident in 32% and 42% of the younger and older group, respectively. Low lower-body MQ was observed in 4% of younger participants, and 50% of older participants. In both groups, the most robust predictors of ALM were upper and lower body strength (young R2 = 0.74, 0.82; older R2 = 0.68, 0.72). CONCLUSIONS Low MQ despite low prevalence rates of sarcopenia in both groups suggests a need for age-specific MQ cut-points. Muscle quality assessments might be useful complementary prognostic tools alongside existing sarcopenia definitions.
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Affiliation(s)
- Matthew J Lees
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK.
| | - Oliver J Wilson
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK
| | - Karen Hind
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Theocharis Ispoglou
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK
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39
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Waters DL, Qualls CR, Cesari M, Rolland Y, Vlietstra L, Vellas B. Relationship of Incident Falls with Balance Deficits and Body Composition in Male and Female Community-Dwelling Elders. J Nutr Health Aging 2019; 23:9-13. [PMID: 30569062 DOI: 10.1007/s12603-018-1087-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Sarcopenia and obesity are reported risk factors for falls, although the data are not consistent and most studies do not make sex comparisons. We investigated whether falls were associated with balance, gait, and body composition, and whether these relationships are sex-specific. DESIGN Secondary analysis of 4-year follow-up data from of the New Mexico Aging Process Study. SETTING Albuquerque, New Mexico. PARTICIPANTS 307 participants (M, n=122, 75.8 yr. SD5.5; F, n=183, 74.6yr SD6.1). MEASUREMENTS Gait and balance were assessed annually using the Tinetti test. Lean body mass (LBM), appendicular skeletal muscle mass (ASM), fat free mass (FFM), total fat mass (FM) were assessed annually by DXA. Falls were assessed using bimonthly falls calendars. Hazard ratios (HR) for 2-point worsening in gait and balance score and falls were calculated by Cox proportional hazard for men and women. RESULTS Baseline balance deficits, and not body composition, represented the strongest predictor of falls. For the total balance score, the variables with significant sex interactions were ASM (Male-HR 1.02 95%CI 0.60-1.73; Female-HR 1.92 95%CI 1.05-3.52, p=0.03) and FFM (Male-HR 1.04 95%CI 0.64-1.70; Female-HR 1.91 95%CI 1.12-3.24, p=0.04), after adjustment for age, sarcopenia and physical activity. The body composition relationship with balance deficits was U-shaped with the strongest predictors being low LBM in males and high FM in females. CONCLUSIONS Specific body composition components and balance deficits are risk factors for falls following sex-specific patterns. Sex differences need to be explored and considered in interventions for worsening balance and falls prevention.
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Affiliation(s)
- D L Waters
- Debra Waters, Department of Medicine / School of Physiotherapy, University of Otago PO Box 56, Dunedin 9054, New Zealand, , +64 3 479 7222
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Neves T, Fett CA, Ferriolli E, Crespilho Souza MG, dos Reis Filho AD, Martin Lopes MB, Carraro Martins NM, Rezende Fett WC. Correlation between muscle mass, nutritional status and physical performance of elderly people. Osteoporos Sarcopenia 2018; 4:145-149. [PMID: 30775558 PMCID: PMC6372823 DOI: 10.1016/j.afos.2018.11.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/05/2018] [Accepted: 11/11/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study evaluated the relationship between the skeletal muscle mass (SMM), obtained by predictive equations, and the body composition, nutritional aspects, functionality and physical performance in elderly people. METHODS The sample consisted of adults aged 65 years or over from the cross-sectional study of the Brazilian Elderly Frailty Study Network, in Cuiabá, Mato Grosso State, Brazil. The anthropometric parameters, instrumental activities of daily living (IADL), Short Physical Performance Battery (SPPB), and handgrip strength (HGS) were evaluated. The SMM was estimated by 2 predictive anthropometric equations. RESULTS Both SMM equations correlated with age, anthropometric indices, SPPB, IADL, and HGS. However, only HGS and neck circumference strongly correlated in both equations, being higher in SMM II. CONCLUSIONS It seems that both equations are sensitive to obtain the SMM, contributing to the diagnosis of sarcopenia, nutritional status, and a physical performance condition.
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Affiliation(s)
- Thiago Neves
- Department of Physical Education, University of the State of Mato Grosso, Diamantino, MT, Brazil
| | - Carlos Alexandre Fett
- Department of Physical Education, Nucleus of Studies in Physical Fitness, Computers, Metabolism, and Sports and Health, Federal University of Mato Grosso, Cuiabá, MT, Brazil
| | - Eduardo Ferriolli
- Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Milene Giovana Crespilho Souza
- Department of Physical Education, Nucleus of Studies in Physical Fitness, Computers, Metabolism, and Sports and Health, Federal University of Mato Grosso, Cuiabá, MT, Brazil
| | | | | | - Neusa Maria Carraro Martins
- Department of Physical Education, Nucleus of Studies in Physical Fitness, Computers, Metabolism, and Sports and Health, Federal University of Mato Grosso, Cuiabá, MT, Brazil
| | - Waléria Christiane Rezende Fett
- Department of Physical Education, Nucleus of Studies in Physical Fitness, Computers, Metabolism, and Sports and Health, Federal University of Mato Grosso, Cuiabá, MT, Brazil
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Liao Y, Hsu HH, Shibata A, Ishii K, Koohsari MJ, Oka K. Associations of total amount and patterns of objectively measured sedentary behavior with performance-based physical function. Prev Med Rep 2018; 12:128-134. [PMID: 30234001 PMCID: PMC6139483 DOI: 10.1016/j.pmedr.2018.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/11/2018] [Accepted: 09/09/2018] [Indexed: 12/25/2022] Open
Abstract
Although greater sedentary time has been found to be associated with negative health impacts, little is known whether the specific pattern of sedentary behavior (i.e. sedentary bouts, breaks and durations) are associated with physical function among older adults. The present study examined the associations between objectively measured sedentary behavior and physical function among older Japanese adults. A total of 174 male and 107 female community-dwelling older Japanese adults aged 65–84 years (mean age: 74.5 ± 5.2 years) were recruited. Sedentary behavior and physical activity were assessed using a triaxial accelerometer. Physical function was measured through hand grip strength, eye-open one leg standing, 5-m walking, and timed up and go tests. Forced-entry multiple linear regression models adjusted for potential confounders were performed. After adjustment, total daily sedentary time and duration of prolonged sedentary bouts (both ≥ 30 min) were positively associated with time spent on the 5-m walking stage and timed up and go tests in older women; however, no significant associations were observed in older men or the whole sample. This paper highlights the importance of developing sedentary behavior change strategies for interventions aiming to improve mobility in in older women. Further evidence from a prospective study is required to establish directions of causality between sedentary behavior and mobility. This study used triaxial accelerometers and standardized physical fitness tests. Total daily sedentary time was negatively associated with mobility in older women. Duration of prolonged sedentary bouts was negatively related to mobility in older women.
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Affiliation(s)
- Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei, Taiwan.,Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima Tokorozawa, Saitama 359-1192, Japan
| | - Hsiu-Hua Hsu
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima Tokorozawa, Saitama 359-1192, Japan
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1 Otsuka Bunkyo, Tokyo 112-0012, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima Tokorozawa, Saitama 359-1192, Japan
| | - Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima Tokorozawa, Saitama 359-1192, Japan.,Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, Victoria 3004, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000, Australia
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima Tokorozawa, Saitama 359-1192, Japan
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Straight CR, Berg AC, Reed RA, Johnson MA, Evans EM. Reduced body weight or increased muscle quality: Which is more important for improving physical function following exercise and weight loss in overweight and obese older women? Exp Gerontol 2018; 108:159-165. [PMID: 29679690 DOI: 10.1016/j.exger.2018.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/06/2018] [Accepted: 04/16/2018] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to examine the relative contributions of changes in muscle quality and body composition to changes in lower-extremity physical function (LEPF) following a 6-month exercise and weight loss intervention in overweight and obese older women. Thirty-eight overweight and obese (BMI = 30.0 ± 4.4 kg/m2) older (age = 69.3 ± 4.1 y) women completed 6 months of multicomponent exercise (cardiorespiratory, resistance, balance and flexibility training) and weight loss (hypocaloric diet that reduced energy intake by ~500 kcal/d). Body composition was measured via dual-energy X-ray absorptiometry and muscle quality (N-m/kg) was defined as maximal concentric isokinetic knee torque divided by upper-leg lean mass. The standardized scores of four objective measures of physical function were summed to yield a composite LEPF Z-score. At 6 months, there were significant reductions in body weight (-9.6 ± 3.5%, p < 0.01), absolute fat mass (-6.8 ± 2.4 kg, p < 0.01) and relative adiposity (-4.9 ± 2.1%, p < 0.01). There were also improvements in both muscle quality (+1.6 ± 1.8 N-m/kg, p < 0.01) and individual measures of LEPF (11-57%, p < 0.01). Multivariate linear regression indicated that increased muscle quality was the strongest independent predictor of an improvement in LEPF Z-score (standardized β = 0.64, p < 0.01) and explained 34% of the variance. A reduction in body weight also predicted an improvement in LEPF, independent of the change in muscle quality. In conclusion, muscle quality can be increased in the presence of clinically meaningful weight loss, and is the primary determinant of improved physical function in overweight/obese older women.
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Affiliation(s)
- Chad R Straight
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA.
| | - Alison C Berg
- Department of Foods and Nutrition, University of Georgia, 300 Carlton Street, Athens, GA 30602, USA.
| | - Rachelle A Reed
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA.
| | - Mary Ann Johnson
- Department of Foods and Nutrition, University of Georgia, 115 DW Brooks Dr., Athens, GA 30602, USA.
| | - Ellen M Evans
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA.
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Oh SL, Yoon SH, Lim JY. Age- and sex-related differences in myosin heavy chain isoforms and muscle strength, function, and quality: a cross sectional study. J Exerc Nutrition Biochem 2018; 22:43-50. [PMID: 30149426 PMCID: PMC6058071 DOI: 10.20463/jenb.2018.0016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 06/28/2018] [Indexed: 11/22/2022] Open
Abstract
[Purpose] Declining muscle strength and function are hallmarks of the aging process. This study aimed to determine sex-related differences in myosin heavy chain (MHC) isoforms and muscle mass, strength, and quality with aging. [Methods] This cross-sectional study recruited 53 healthy participants (32 men, 21 women) aged 20–85 years who were divided into four groups: young men (n=17, YM, 29.23±4.51), older men (n=15, OM, 71.87±3.42), young women (n=11, YW, 29.64±4.88), and older women (n=10, OW, 68.1±1.91). Body composition and muscle strength and quality were analyzed. Muscle specimens were obtained from the vastus lateralis in all participants to analyze the type of MHC isoforms. [Results] Men showed a greater age-related decline in skeletal muscle mass (18.6%, p<0.01), lean body mass (10.1%, p<0.05), grip strength (35.3%, p<0.001), isometric strength (29.6%, p<0.001), isotonic power (42.5%, p<0.001), isokinetic strength (up to 44.3%, p<0.001), and muscle quality (up to 24.8%, p<0.01). In contrast, women had significantly lower isometric strength (24.2%, p<0.05), isotonic power (36.5%, p<0.01), and upper-body muscle quality (24.7%, p<0.001) with aging. In addition, the proportion of MHC IIa was significantly lower in OM (p<0.05) and OW (p<0.05) than in YM and YW, respectively. However, the proportion of MHC I was significantly higher in OM (p<0.01) than in YM but was high in both YW and OW. MHC I and MHC IIa negatively and positively correlated, respectively, with muscle strength and function. [Conclusion] These results indicate the existence of sex-related differences in muscle mass, strength, and quality and MHC isoform composition with increasing age. The effects on muscle strength and function with aging were significant in men, but not in women. Higher and lower proportions of MHC I and MHC IIa fibers, respectively, were inversely associated with muscle strength and quality. In particular, Korean YW showed lower muscle strength and quality, and the proportion of MHC isoforms was similar to that in the muscles of OW.
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Kim S, Kim M, Lee Y, Kim B, Yoon TY, Won CW. Calf Circumference as a Simple Screening Marker for Diagnosing Sarcopenia in Older Korean Adults: the Korean Frailty and Aging Cohort Study (KFACS). J Korean Med Sci 2018; 33:e151. [PMID: 29760608 PMCID: PMC5944215 DOI: 10.3346/jkms.2018.33.e151] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 03/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The purpose of this study was to explore the optimal cut-off point of calf circumference (CC) as a simple proxy marker of appendicular skeletal muscle mass (ASM) and sarcopenia in the Korean elderly and to test the criterion-related validity of CC by analyzing its relationships with the physical function. METHODS The participants were 657 adults aged 70 to 84 years who had completed both dual energy X-ray absorptiometry (DXA) and physical function test in the first baseline year of the Korean Frailty and Aging Cohort Study. RESULTS ASM and skeletal muscle mass index (SMI) were correlated positively with CC (male, ASM, r = 0.55 and SMI, r = 0.54; female, ASM, r = 0.55 and SMI, r = 0.42; all P < 0.001). Testing the validity of CC as a proxy marker for low muscle mass, an area under the curve (AUC) of 0.81 for males and 0.72 for females were found and their optimal cut-off values of CC were 35 cm for males and 33 cm for females. In addition, CC-based low muscle groups were correlated with physical functions even after adjusting for age and body mass index. Also, the cut-off value of CC for sarcopenia was 32 cm (AUC; male, 0.82 and female, 0.72). CONCLUSION The optimal cut-off values of CC for low MM are 35 cm for males and 33 cm for females. Lower CC based on these cut-off values is related with poor physical function. CC may be also a good indicator of sarcopenia in Korean elderly.
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Affiliation(s)
- Sunyoung Kim
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine/East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - ByungSung Kim
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Tai Young Yoon
- Department of Preventive Medicine and Public Health, Kyung Hee University School of Medicine, Seoul, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
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45
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Collins BC, Mader TL, Cabelka CA, Iñigo MR, Spangenburg EE, Lowe DA. Deletion of estrogen receptor α in skeletal muscle results in impaired contractility in female mice. J Appl Physiol (1985) 2018; 124:980-992. [PMID: 29345963 DOI: 10.1152/japplphysiol.00864.2017] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Estradiol deficiency in females can result in skeletal muscle strength loss, and treatment with estradiol mitigates the loss. There are three primary estrogen receptors (ERs), and estradiol elicits effects through these receptors in various tissues. Ubiquitous ERα-knockout mice exhibit numerous biological disorders, but little is known regarding the specific role of ERα in skeletal muscle contractile function. The purpose of this study was to determine the impact of skeletal muscle-specific ERα deletion on contractile function, hypothesizing that ERα is a main receptor through which estradiol affects muscle strength in females. Deletion of ERα specifically in skeletal muscle (skmERαKO) did not affect body mass compared with wild-type littermates (skmERαWT) until 26 wk of age, at which time body mass of skmERαKO mice began to increase disproportionally. Overall, skmERαKO mice had low strength demonstrated in multiple muscles and by several contractile parameters. Isolated extensor digitorum longus muscles from skmERαKO mice produced 16% less eccentric and 16-26% less submaximal and maximal isometric force, and isolated soleus muscles were more fatigable, with impaired force recovery relative to skmERαWT mice. In vivo maximal torque productions by plantarflexors and dorsiflexors were 16% and 12% lower in skmERαKO than skmERαWT mice, and skmERαKO muscles had low phosphorylation of myosin regulatory light chain. Plantarflexors also generated 21-32% less power, submaximal isometric and peak concentric torques. Data support the hypothesis that ablation of ERα in skeletal muscle results in muscle weakness, suggesting that the beneficial effects of estradiol on muscle strength are receptor mediated through ERα. NEW & NOTEWORTHY We comprehensively measured in vitro and in vivo skeletal muscle contractility in female estrogen receptor α (ERα) skeletal muscle-specific knockout mice and report that force generation is impaired across multiple parameters. These results support the hypothesis that a primary mechanism through which estradiol elicits its effects on strength is mediated by ERα. Evidence is presented that estradiol signaling through ERα appears to modulate force at the molecular level via posttranslational modifications of myosin regulatory light chain.
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Affiliation(s)
- Brittany C Collins
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota , Minneapolis, Minnesota
| | - Tara L Mader
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota , Minneapolis, Minnesota
| | - Christine A Cabelka
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota , Minneapolis, Minnesota
| | - Melissa R Iñigo
- East Carolina Diabetes and Obesity Institute, Department of Physiology, Brody School of Medicine, East Carolina University , Greenville, North Carolina
| | - Espen E Spangenburg
- East Carolina Diabetes and Obesity Institute, Department of Physiology, Brody School of Medicine, East Carolina University , Greenville, North Carolina
| | - Dawn A Lowe
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation Medicine, Medical School, University of Minnesota , Minneapolis, Minnesota
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Age-related reduction in single muscle fiber calcium sensitivity is associated with decreased muscle power in men and women. Exp Gerontol 2017; 102:84-92. [PMID: 29247790 DOI: 10.1016/j.exger.2017.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/17/2017] [Accepted: 12/11/2017] [Indexed: 01/06/2023]
Abstract
Age-related declines in human skeletal muscle performance may be caused, in part, by decreased responsivity of muscle fibers to calcium (Ca2+). This study examined the contractile properties of single vastus lateralis muscle fibers with various myosin heavy chain (MHC) isoforms (I, I/IIA, IIA and IIAX) across a range of Ca2+ concentrations in 11 young (24.1±1.1years) and 10 older (68.8±0.8years) men and women. The normalized pCa-force curve shifted rightward with age, leading to decreased activation threshold (pCa10) and/or Ca2+ sensitivity (pCa50) for all MHC isoforms examined. In older adults, the slope of the pCa-force curve was unchanged in MHC I-containing fibers (I, I/IIA), but was steeper in MHC II-containing fibers (IIA, IIAX), indicating greater cooperativity compared to young adults. At sub-maximal [Ca2+], specific force was reduced in MHC I-containing fibers, but was minimally decreased in MHC IIA fibers as older adults produced greater specific forces at high [Ca2+] in these fibers. Lessor pCa50 in MHC I fibers independently predicted reduced isokinetic knee extensor power across a range of contractile velocities, suggesting that the Ca2+ response of slow-twitch fibers contributes to whole muscle dysfunction. Our findings show that aging attenuates Ca2+ responsiveness across fiber types and that these cellular alterations may lead to age-related reductions in whole muscle power output.
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Baker JF, Giles JT, Weber D, Leonard MB, Zemel BS, Long J, Ibrahim S, Katz PP. Assessment of muscle mass relative to fat mass and associations with physical functioning in rheumatoid arthritis. Rheumatology (Oxford) 2017; 56:981-988. [PMID: 28340012 DOI: 10.1093/rheumatology/kex020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To determine whether a novel measure of appendicular lean mass relative to fat mass is associated with physical functioning in RA. Methods In a cross-sectional design, three independent RA cohorts were retrospectively analysed. Whole-body DXA measures of appendicular lean mass index (ALMI, kg/m 2 ) and fat mass index (FMI, kg/m 2 ) were converted to age, sex and race-specific Z-scores using published National Health and Nutrition Examination Survey reference ranges. Adiposity-adjusted ALMI Z-scores (ALMI FMI ) were determined using a published method to adjust for normal associations between ALMI and FMI Z-scores. Associations between ALMI Z-scores, ALMI FMI Z-scores and physical functioning were assessed after adjusting for age, sex and study. Functional outcomes assessed included the HAQ, Valued Life Activities assessment and Short Physical Performance Battery. Low lean for age was defined as a Z-score of -1 or less. Results Our sample consisted of 442 patients with RA. The combined cohort had a mean ALMI Z-score of - 0.51 (1.08) and a mean ALMI FMI Z-score of - 0.58 (1.53), suggesting muscle mass deficits compared with a nationally representative sample. Greater ALMI FMI Z-scores demonstrated stronger associations with better functional outcomes compared with ALMI Z-scores. Associations were not attenuated with adjustment for systemic inflammation or pain. The FMI Z-score was independently associated with physical functioning, with a stronger association seen among patients with greater FMI Z-score. Adiposity-adjusted definitions of low lean mass more clearly identified those with functional impairment. Conclusion Estimates of appendicular lean mass that are adjusted for adiposity demonstrate stronger positive associations with functional outcomes compared with unadjusted estimates.
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Affiliation(s)
- Joshua F Baker
- Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center.,Division of Rheumatology.,Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
| | - Jon T Giles
- Division of Rheumatology, Columbia University, New York, NY
| | - David Weber
- Department of Pediatrics, Stanford University, Palo Alto, CA
| | - Mary B Leonard
- Department of Pediatrics, University of Rochester, Rochester, NY
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia
| | - Jin Long
- Department of Pediatrics, University of Rochester, Rochester, NY
| | - Said Ibrahim
- Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA
| | - Patricia P Katz
- Division of Rheumatology, University of California San Francisco, San Francisco, CA, USA
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Fabbri E, Chiles Shaffer N, Gonzalez-Freire M, Shardell MD, Zoli M, Studenski SA, Ferrucci L. Early body composition, but not body mass, is associated with future accelerated decline in muscle quality. J Cachexia Sarcopenia Muscle 2017; 8:490-499. [PMID: 28198113 PMCID: PMC5476863 DOI: 10.1002/jcsm.12183] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 08/26/2016] [Accepted: 12/28/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Muscle quality (MQ) or strength-to-mass ratio declines with aging, but the rate of MQ change with aging is highly heterogeneous across individuals. The identification of risk factors for accelerated MQ decline may offer clues to identity the underpinning physiological mechanisms and indicate targets for prevention and treatment. Using data from the Baltimore Longitudinal Study of Aging, we tested whether measures of body mass and body composition are associated with differential rates of changes in MQ with aging. METHODS Participants included 511 men and women, aged 50 years or older, followed for an average of 4 years (range: 1-8). MQ was operationalized as ratio between knee-extension isokinetic strength and CT-thigh muscle cross-sectional area. Predictors included body mass and body composition measures: weight (kg), body mass index (BMI, kg/m2 ), dual-energy x-ray absorptiometry-measured total body fat mass (TFM, kg) and lean mass (TLM, kg), and body fatness (TFM/weight). Covariates were baseline age, sex, race, and body height. RESULTS Muscle quality showed a significant linear decline over the time of the follow up (average rate of decline 0.02 Nm/cm2 per year, P < .001). Independent of covariates, neither baseline body weight (P = .756) nor BMI (P = .777) was predictive of longitudinal rate of decline in MQ. Instead, higher TFM and lower TLM at baseline predicted steeper longitudinal decline in MQ (P = .036 and P < .001, respectively). In particular, participants with both high TFM and low TLM at baseline experienced the most dramatic decline compared with those with low TFM and high TLM (about 3% per year vs. 0.5% per year, respectively). Participants in the higher tertile of baseline body fatness presented a significantly faster decline of MQ than the rest of the population (P = .021). Similar results were observed when body mass, TFM, and TLM were modeled as time-dependent predictors. CONCLUSIONS Body composition, but not weight nor BMI, is associated with future MQ decline, suggesting that preventive strategies aimed at maintaining good MQ with aging should specifically target body composition features.
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Affiliation(s)
- Elisa Fabbri
- Longitudinal Study Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD, 21224-6825, USA.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Nancy Chiles Shaffer
- Longitudinal Study Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD, 21224-6825, USA
| | - Marta Gonzalez-Freire
- Longitudinal Study Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD, 21224-6825, USA
| | - Michelle D Shardell
- Longitudinal Study Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD, 21224-6825, USA
| | - Marco Zoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stephanie A Studenski
- Longitudinal Study Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD, 21224-6825, USA
| | - Luigi Ferrucci
- Longitudinal Study Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD, 21224-6825, USA
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Bochkezanian V, Newton RU, Trajano GS, Vieira A, Pulverenti TS, Blazevich AJ. Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on the decline and recovery of muscle force. BMC Neurol 2017; 17:82. [PMID: 28464800 PMCID: PMC5414318 DOI: 10.1186/s12883-017-0862-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/22/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) is commonly used to activate skeletal muscles and reverse muscle atrophy in clinical populations. Clinical recommendations for NMES suggest the use of short pulse widths (100-200 μs) and low-to-moderate pulse frequencies (30-50 Hz). However, this type of NMES causes rapid muscle fatigue due to the (non-physiological) high stimulation intensities and non-orderly recruitment of motor units. The use of both wide pulse widths (1000 μs) and tendon vibration might optimize motor unit activation through spinal reflex pathways and thus delay the onset of muscle fatigue, increasing muscle force and mass. Thus, the objective of this study was to examine the acute effects of patellar tendon vibration superimposed onto wide-pulse width (1000 μs) knee extensor electrical stimulation (NMES, 30 Hz) on peak muscle force, total impulse before "muscle fatigue", and the post-exercise recovery of muscle function. METHODS Tendon vibration (Vib), NMES (STIM) or NMES superimposed onto vibration (STIM + Vib) were applied in separate sessions to 16 healthy adults. Total torque-time integral (TTI), maximal voluntary contraction torque (MVIC) and indirect measures of muscle damage were tested before, immediately after, 1 h and 48 h after each stimulus. RESULTS TTI increased (145.0 ± 127.7%) in STIM only for "positive responders" to the tendon vibration (8/16 subjects), but decreased in "negative responders" (-43.5 ± 25.7%). MVIC (-8.7%) and rectus femoris electromyography (RF EMG) (-16.7%) decreased after STIM (group effect) for at least 1 h, but not after STIM + Vib. No changes were detected in indirect markers of muscle damage in any condition. CONCLUSIONS Tendon vibration superimposed onto wide-pulse width NMES increased TTI only in 8 of 16 subjects, but reduced voluntary force loss (fatigue) ubiquitously. Negative responders to tendon vibration may derive greater benefit from wide-pulse width NMES alone.
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Affiliation(s)
- Vanesa Bochkezanian
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia. .,Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia.,Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia.,UQ Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | | | - Timothy S Pulverenti
- Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Anthony J Blazevich
- Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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50
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Lo YTC, Wahlqvist ML, Huang YC, Chuang SY, Wang CF, Lee MS. Medical costs of a low skeletal muscle mass are modulated by dietary diversity and physical activity in community-dwelling older Taiwanese: a longitudinal study. Int J Behav Nutr Phys Act 2017; 14:31. [PMID: 28288651 PMCID: PMC5348879 DOI: 10.1186/s12966-017-0487-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 03/05/2017] [Indexed: 12/15/2022] Open
Abstract
Background Age-related loss of skeletal muscle mass (SMM) and function (sarcopenia) are associated with poor health outcomes and an economic burden on health care services. An appropriate diet and physical activity have been proposed for prevention and treatment of sarcopenia. Nevertheless, the effects on medical service utilization and costs remain unclear. This study determined the effects of SMM in conjunction with diet quality and physical activity on medical service utilization and expenditure in community-dwelling older Taiwanese. Methods In total, 1337 participants from the Elderly Nutrition and Health Survey in Taiwan (1999–2000) were enrolled. An SMM index [SMMI, calculated by dividing SMM (kg) by height (m2)] was used as the marker of sarcopenia. Participants with the lowest SMMI quartiles (<11.4 kg/m2 for men and 8.50 kg/m2 for women) comprised the high-risk group, and the remainder comprised the low-risk group. Dietary information (dietary diversity: low and high) and physical activity (low and moderate) were obtained at baseline. Annual medical service utilization and expenditure were calculated from National Health Insurance claims until December 31, 2006. Generalized linear models were used to determine the association between the SMMI and annual medical service utilization and costs in conjunction with dietary diversity or physical activity. Results After 8 follow-up years, regardless of gender, participants in the high-risk group reported significantly more hospitalization (days and expenditure) and total medical expenditure. Participants in the high-risk group who had low dietary diversity made fewer annual outpatient (14%), preventive care (19%), and dental (40%) visits, but exhibited longer hospitalization (102%) than did those who had a low SMMI and high dietary diversity. Similar patterns were observed in the corresponding medical expenditures. The findings were similar when considering physical activity. Being in the low-risk group in conjunction with having high dietary diversity or more physical activity was associated with the lowest annual adjusted mean hospitalization days with expenditure, and also total expenditure. Conclusions A lower SMMI was associated with more hospitalization days and costs. However, high dietary diversity and more physical activity can attenuate the effects of lower SMMI on medical service utilization and expenditure.
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Affiliation(s)
- Yuan-Ting C Lo
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China
| | - Mark L Wahlqvist
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China.,Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan, Republic of China.,Monash Asia Institute, Monash University, Caulfield East, PO Box 197, Melbourne, VIC, 3145, Australia
| | - Yi-Chen Huang
- Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China
| | - Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan, Republic of China
| | - Chi-Fen Wang
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China. .,Monash Asia Institute, Monash University, Caulfield East, PO Box 197, Melbourne, VIC, 3145, Australia. .,Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China.
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