Synergistic associations of visual and self-reported hearing acuity with low handgrip strength in older adults: a population-based cross-sectional study

Association between hearing loss and physical performance in patients on maintenance hemodialysis

BACKGROUND

The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD.

METHODS

This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed.

RESULTS

Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = -0.356, p < 0.001 and r = -0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73-1.81), 1.69 (1.07-2.70), and 2.87 (1.69-4.88) (p for trend = 0.005).

CONCLUSION

Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.

Association between Locomotive Syndrome and Hearing Loss in Community-Dwelling Adults

The relationship between hearing and motor function as a function of aging is unclear. Therefore, we aimed to clarify the relationship between age-related hearing loss and locomotive syndrome. In total, 240 participants aged ≥40 years, whose hearing acuity and motor function had been measured, were included in this study. Patients with a hearing acuity of <35 dB and ≥35 dB were categorized into normal and low hearing acuity groups, respectively. Motor function was compared according to sex between the groups. Among men, those in the low hearing acuity group (51/100) were older, had a significantly slower walking speed, and had a higher prevalence of locomotive syndrome than those in the normal group. Among women, those in the low hearing group (14/140) were older and had a significantly slower gait speed than those in the normal group. The multivariate analysis showed that, in the low hearing acuity group, age and gait speed were risk factors in men, while age was the only risk factor in women. In conclusion, hearing loss was associated with walking speed. The association between hearing loss and locomotive syndrome was observed only in men. In the multivariate analysis, hearing loss was associated with walking speed only in men.

Association of smartphone use with abnormal social jetlag among adolescents in Korea before and after COVID-19

PURPOSE

This study aimed to use social jetlag to determine how smartphone overuse by adolescents before and after the COVID-19 pandemic might be associated with their circadian rhythm.

METHODS

We used 2017 and 2020 Korea Youth Risk Behavior web-based Survey data and conducted a survey analysis on 100,976 adolescents. The dependent variable was abnormal social jetlag. Based on the times recorded by the survey, we calculated the weekday midpoint and weekend sleep time. The main independent variable was smartphone usage time (<2h/day, 2-3.9 h/day, 4-5.9 h/day, and ≥ 6 h/day). Multiple logistic regression and relative excess risk due to interaction (RERI) were performed.

RESULTS

Abnormal social jetlag was most prevalent in male and female adolescents who used smartphones ≥ 6 h/day (adjusted odds ratio [AOR] = 2.60, 95 % confidence interval [CI] = 2.47-2.74). The longer the smartphone usage time, the higher the association with abnormal social jetlag. This association was more prominent in female adolescents. The additive interaction between longer smartphone usage time and post-COVID-19 year was statistically significant (total: RERI = 0.92, 95 % CI = 0.90-0.95; males: RERI = 0.83, 95 % CI = 0.80-0.87; females: RERI = 1.13, 95 % CI = 1.08-1.18).

CONCLUSION

Our results clearly indicated that increased smartphone usage time tended to result in greater social jetlag, an association that was more pronounced in female. Moreover, the COVID-19 pandemic significantly strengthened this relationship. Further research is needed regarding the proper use of smartphones to ensure good sleep-in adolescents after the COVID-19 pandemic.

Longitudinal grip strength is associated with susceptibility to the Sound Induced Flash Illusion in older adults

The precision of temporal multisensory integration is associated with specific aspects of physical functioning in ageing, including gait speed and incidents of falling. However, it is unknown if such an association exists between multisensory integration and grip strength, an important index of frailty and brain health and predictor of disease and mortality in older adults. Here, we investigated whether temporal multisensory integration is associated with longitudinal (eight-year) grip strength trajectories in a large sample of 2,061 older adults (mean age = 64.42 years, SD = 7.20; 52% female) drawn from The Irish Longitudinal Study on Ageing (TILDA). Grip strength (kg) for the dominant hand was assessed with a hand-held dynamometer across four testing waves. Longitudinal k-means clustering was applied to these data separately for sex (male, female) and age group (50-64, 65-74, 75+ years). At wave 3, older adults participated in the Sound Induced Flash Illusion (SIFI), a measure of the precision of temporal audio-visual integration, which included three audio-visual stimulus onset asynchronies (SOAs): 70, 150 and 230 ms. Results showed that older adults with a relatively lower (i.e., weaker) grip strength were more susceptible to the SIFI at the longer SOAs compared to those with a relatively higher (i.e., stronger) grip strength (p <.001). These novel findings suggest that older adults with relatively weaker grip strength exhibit an expanded temporal binding window for audio-visual events, possibly reflecting a reduction in the integrity of the central nervous system.

Comparison of the Relationship between Visual Acuity and Motor Function in Non-Elderly and Elderly Adults

This study aimed to clarify the relationship between visual acuity and motor function in younger and elderly participants and to compare differences between non-elderly and elderly participants. In total, 295 participants who underwent visual and motor functional examinations were included; participants with visual acuity ≥0.7 were assigned to the normal group (N group) and those with visual acuity ≤0.7 were assigned to the low-visual-acuity group (L group). Motor function was compared between the N and L groups; the analysis was performed by grouping participants into those aged >65 years (elderly) and those aged <65 years (non-elderly). The non-elderly group (average age, 55.6 ± 6.7 years) had 105 and 35 participants in the N and L groups, respectively. Back muscle strength was significantly lower in the L group than in the N group. The elderly group (average age, 71.1 ± 5.1 years) had 102 and 53 participants in the N and L groups, respectively. Gait speed was significantly lower in the L group than in the N group. These results reveal differences in the relationship between vision and motor function in non-elderly and elderly adults and indicate that poor vision is associated with lower back-muscle strength and walking speed in younger and elderly participants, respectively.

Association of Dual Sensory Impairment with Declining Physical Function in Community-Dwelling Older Adults

Few studies have investigated whether dual sensory impairment (DSI) adversely affects the deterioration of physical function in older adults compared to single sensory impairment (SSI, visual or auditory). We studied the association between DSI and declining physical function by analyzing the data of 2780 Korean community-dwelling adults aged 70-84 years. Sensory impairment was assessed through pure tone audiometry and visual acuity testing. Muscle strength (handgrip strength) and physical performance (timed up and go test and short physical performance battery (SPPB)) were evaluated. In the cross-sectional analysis, DSI was associated with higher odds of having low muscle strength (odds ratio (OR), 1.78; 95% confidence interval (CI), 1.27-2.48) and poor physical performance (SPPB: OR, 2.04; 95% CI, 1.38-3.00) than SSI. Among all sensory impairment groups in the longitudinal analysis, DSI at baseline increased the risk of deteriorating physical performance during the follow-up period (OR, 1.94; 95% CI, 1.31-2.88; p < 0.01) the most. DSI showed a more severe adverse effect on the decline in physical function among community-dwelling older adults than SSI. More comprehensive care is needed to prevent the deterioration of physical function in older adults due to DSI.

Association between Intrinsic Capacity and Sarcopenia in Hospitalized Older Patients

OBJECTIVES

This study aimed to clarify the association between intrinsic capacity (IC) and sarcopenia in hospitalized older patients.

DESIGN

A cross-sectional study.

SETTING

Hospital-based.

PARTICIPANTS

This study included 381 inpatients aged ≥ 60 years (225 men and 156 women).

MEASUREMENTS

IC was evaluated in five domains defined by the World Health Organization: cognition (Mini-Mental State Examination), locomotion (Short Physical Performance Battery test), vitality (Short-Form Mini Nutritional Assessment), sensory (self-reported hearing and vision) and psychological (5-item Geriatric Depression Scale) capacities. IC composite score (0-5) was calculated based on five domains, with lower scores representing greater IC. Sarcopenia was defined in accordance with the criteria recommended by the Asian Working Group for Sarcopenia (AWGS) 2019. Multiple linear and logistic regressions were performed to explore the associations between IC composite score and IC domains with sarcopenia and its defining components.

RESULTS

The mean age of 381 patients included was 81.95±8.42 years. Of them, 128 (33.6%) patients had sarcopenia. The median IC composite score was 1 (1, 2). Cognition, locomotion, vitality, sensory and psychological capacities were impaired in 22.6%, 63.5%, 18.9%, 27.3% and 11.3% of patients. Multiple linear regression analyses showed that favorable IC domain scores in cognition, locomotion and vitality were associated with a stronger handgrip strength. A higher vitality score was associated with a greater appendicular skeletal muscle mass index (ASMI), and a higher locomotion score was associated with a greater gait speed. The multiple logistic regression analysis showed that only vitality impairment was associated with sarcopenia. A higher IC composite score was associated with higher risks of sarcopenia, as well as low ASMI, handgrip strength and gait speed.

CONCLUSION

This study indicated that a more serious impairment of IC was associated with a greater risk of sarcopenia. Vitality was the domain most strongly associated with sarcopenia. IC may be employed to detect and manage sarcopenia.

A genetic correlation and bivariate genome-wide association study of grip strength and depression

Grip strength is an important biomarker reflecting muscle strength, and depression is a psychiatric disorder all over the world. Several studies found a significant inverse association between grip strength and depression, and there is also evidence for common physiological mechanisms between them. We used twin data from Qingdao, China to calculate genetic correlations, and we performed a bivariate GWAS to explore potential SNPs, genes, and pathways in common between grip strength and depression. 139 pairs of Dizygotic twins were used for bivariate GWAS. VEAGSE2 and PASCAL software were used for gene-based analysis and pathway enrichment analysis, respectively. And the resulting SNPs were subjected to eQTL analysis and pleiotropy analysis. The genetic correlation coefficient between grip strength and depression was -0.41 (-0.96, -0.15). In SNP-based analysis, 7 SNPs exceeded the genome-wide significance level (P<5×10-8) and a total of 336 SNPs reached the level of suggestive significance (P<1×10-5). Gene-based analysis and pathway-based analysis identified genes and pathways related to muscle strength and the nervous system. The results of eQTL analysis were mainly enriched in tissues such as the brain, thyroid, and skeletal muscle. Pleiotropy analysis shows that 9 of the 15 top SNPs were associated with both grip strength and depression. In conclusion, this bivariate GWAS identified potentially common pleiotropic SNPs, genes, and pathways in grip strength and depression.

Hearing loss and physical function in the general population: A cross-sectional study

OBJECTIVE

Hearing loss is a major public health concern. Higher physical function may be related to the maintenance of hearing acuity. Therefore, this study examined the association between hearing loss and physical function in the general population.

METHODS

This cross-sectional study was conducted with health checkup participants who underwent pure-tone audiometry at a regional health care center in Japan. Information for physical function included handgrip strength, vital capacity (VC), and forced expiratory volume in one second (FEV1). A hearing threshold of >30 dB at 1 kHz and/or >40 dB at 4 kHz in either ear was identified as hearing loss. The characteristics of the subjects were examined with stratification by sex and age group. Multivariable logistic regression analysis was performed to examine the association between hearing loss and physical function with adjustments for age, body mass index and current smoking.

RESULTS

Among the 4766 study subjects, 56.5% were male. The mean age was 47.7 years (SD: 13.8 years; range: 20-86 years), and the prevalence of hearing loss was 12.8% based on the definition stated above. For females, handgrip strength, VC, and FEV1 showed significant negative associations with hearing loss (multivariable-adjusted OR [95% CI] = 0.691 [0.560-0.852], 0.542 [0.307-0.959], and 0.370 [0.183-0.747], respectively). These associations were not found in males.

CONCLUSIONS

Higher physical function was associated with a lower prevalence of hearing loss among females. This study suggests that it is important to maintain physical function for hearing loss in females. Further studies are required to investigate sex differences in the relationship between physical function and hearing loss in the general population.

The potential of assessment based on the WHO framework of intrinsic capacity in fragility fracture prevention

The risk of falls associated with population ageing and the burden of chronic diseases increase the risk of fragility fractures. Globally, a large increase in the numbers of people sustaining fragility fractures is predicted. The management of highly vulnerable older persons who present and/or are at risk of fragility fractures is challenging given their clinical complexity and the fragmentation of the healthcare services. Fragility fractures frequently result in reduced functional ability and quality of life. Therefore, it is essential to implement person-centered models of care to address the individual's priorities and needs. In this context, the multidimensional construct of intrinsic capacity, composed of the critical functions on which the individual's functional ability rely, becomes of particular interest.In this article, the potential of current models to meet the global challenge is considered, particularly where healthcare systems are less integrated and poorly structured. It then describes how assessment of intrinsic capacity might provide the clinician with a holistic picture of an older individual's reserves before and after a fragility fracture and the implications of implementing this approach based on the construct of intrinsic capacity in healthcare systems, in both well-developed and low-resourced settings. It suggests that optimization of intrinsic capacity and functional ability is a credible conceptual model and might support a generally feasible approach to primary and secondary fracture prevention in older people.