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Suliman ME, Ryu K, Qureshi AR, Li X, Avesani CM, Barany P, Heimbürger O, Stenvinkel P, Lindholm B. Handgrip strength and mortality in a cohort of kidney failure patients: Comparative analysis of different normalization methods. Nutrition 2024; 125:112470. [PMID: 38788512 DOI: 10.1016/j.nut.2024.112470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/01/2024] [Accepted: 04/14/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVES Reduced handgrip strength (HGS) is associated with adverse clinical outcomes. We analyzed and compared associations of HGS with mortality risk in dialysis patients, using different normalization methods of HGS. METHODS HGS and clinical and laboratory parameters were measured in a cohort of 446 incident dialysis patients (median age 56 y, 62% men). The area under the receiver operating characteristic curve (AUROC) was used to compare different normalization methods of HGS as predictors of mortality: absolute HGS in kilograms; HGS normalized to height, weight, or body mass index; and HGS of a reference population of sex-matched controls (percentage of the mean HGS value [HGS%]). Multivariate linear regression analysis was used to assess HGS predictors. Competing risk regression analysis was used to evaluate 5-year all-cause mortality risk. Differences in survival time between HGS% tertiles were quantitated by analyzing the restricted mean survival time. RESULTS The AUROC for HGS% was higher than the AUROCs for absolute or normalized HGS values. Compared with the high HGS% tertile, low HGS% (subdistribution hazard ratio [sHR] = 2.36; 95% CI, 1.19-3.70) and middle HGS% (sHR = 1.79; 95% CI, 1.12-2.74) tertiles were independently associated with higher all-cause mortality and those with high HGS% tertile survived on average 7.95 mo (95% CI, 3.61-12.28) and 18.99 mo (95% CI, 14.42-23.57) longer compared with middle and low HGS% tertile, respectively. CONCLUSIONS HGS% was a strong predictor of all-cause mortality risk in incident dialysis patients and a better discriminator of survival than absolute HGS or HGS normalized to body size dimensions.
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Affiliation(s)
- Mohamed E Suliman
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Kakei Ryu
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Abdul Rashid Qureshi
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Xiejia Li
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Carla Maria Avesani
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Peter Barany
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Olof Heimbürger
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Lindholm
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
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Kemala Sari N, Stepvia S, Ilyas MF. The Association between Anthropometric Measurements and Body Composition with Hand Grip Strength among the Elderly Population in Indonesia. J Clin Med 2024; 13:4697. [PMID: 39200839 PMCID: PMC11355069 DOI: 10.3390/jcm13164697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/08/2024] [Accepted: 08/08/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Hand grip strength (HGS) is a crucial measure for evaluating muscle function and general physical ability, and it may be associated with several diseases. Previous studies have demonstrated inconsistent associations between anthropometric measurement and body composition with HGS. This study aims to investigate the association between anthropometric measurement and body composition with HGS in the elderly population residing in Indonesia. Methods: This is a cross-sectional study on older adults aged between 60 and 82 years who live in the community. Anthropometric parameters assessed in this study comprised the body mass index (BMI), mid-upper arm circumference (MUAC), calf circumference (CC), and waist circumference (WC). Subsequently, body composition measurements, including fat mass (FM), fat-free mass (FFM), muscle mass (MM), skeletal muscle mass (SMM), and the appendicular skeletal mass index (ASMI), were assessed using a body composition analyzer. Last, the measurement of HGS was conducted using a hand dynamometer. Results: A total of 109 participants were involved in this study. Our study demonstrates a significant association between anthropometric parameters, namely CC and HGS. Subsequently, several body composition parameters, including FFM, SMM, ASMI, and MM in the four extremities, are also significantly associated with HGS. However, in a multivariate analysis, only CC and FFM were able to significantly predict HGS. Conclusions: Improving CC and maintaining FFM may enhance muscle strength in older adults. This suggests that targeted exercise and nutrition programs could increase muscle mass and strength, thereby mitigating age-related decline and improving quality of life.
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Affiliation(s)
- Nina Kemala Sari
- Geriatric Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Stepvia Stepvia
- Geriatric Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
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Taylor KA, Carroll MK, Short SA, Goode AP. Identifying characteristics and clinical conditions associated with hand grip strength in adults: the Project Baseline Health Study. Sci Rep 2024; 14:8937. [PMID: 38637523 PMCID: PMC11026445 DOI: 10.1038/s41598-024-55978-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/29/2024] [Indexed: 04/20/2024] Open
Abstract
Low hand grip strength (HGS) is associated with several conditions, but its value outside of the older adult population is unclear. We sought to identify the most salient factors associated with HGS from an extensive list of candidate variables while stratifying by age and sex. We used data from the initial visit from the Project Baseline Health Study (N = 2502) which captured detailed demographic, occupational, social, lifestyle, and clinical data. We applied MI-LASSO using group methods to determine variables most associated with HGS out of 175 candidate variables. We performed analyses separately for sex and age (< 65 vs. ≥ 65 years). Race was associated with HGS to varying degrees across groups. Osteoporosis and osteopenia were negatively associated with HGS in female study participants. Immune cell counts were negatively associated with HGS for male participants ≥ 65 (neutrophils) and female participants (≥ 65, monocytes; < 65, lymphocytes). Most findings were age and/or sex group-specific; few were common across all groups. Several of the variables associated with HGS in each group were novel, while others corroborate previous research. Our results support HGS as a useful indicator of a variety of clinical characteristics; however, its utility varies by age and sex.
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Affiliation(s)
- Kenneth A Taylor
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
| | | | | | - Adam P Goode
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
- Duke University School of Medicine, Population Health Sciences, Durham, NC, USA
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Sileikiene L, Tamosiunas A, Luksiene D, Radisauskas R, Kranciukaite-Butylkiniene D, Bobak M. Longitudinal association of grip strength with cardiovascular and all-cause mortality in older urban Lithuanian population. BMC Public Health 2024; 24:1040. [PMID: 38622618 PMCID: PMC11017659 DOI: 10.1186/s12889-024-18506-w] [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: 09/01/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Ageing populations experience greater risks associated with health and survival. It increases the relevance of identifying variables associated with mortality. Grip strength (GS) has been identified as an important biomarker for all cause and cardiovascular mortality, however, its prognostic value has not been studied in Lithuania. The aim of the present study is to evaluate the relationship of GS to vital status in a representative sample of the Lithuanian 45-72-year-old urban population during the period of 12 years of follow-up and to explore associations of GS with all-cause mortality and mortality from cardiovascular diseases (CVD). METHODS Within the framework of the international study Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) 7,115 men and women 45-72 years of age were examined in the baseline survey (2006 to 2008). Data from the Official Lithuanian Mortality Register were used to evaluate CVD and all-cause mortality from follow-up till 2020. Cox proportional hazards regression was used, and four models for all-cause and CVD mortality were assessed. RESULTS The mean GS was significantly higher among survivors' men and women as compared to individuals deceased from CVD and other causes of death. In survivor men and women groups, minimal values of GS in all terciles were higher as compared to all three deceased groups. In both men and women groups, the lowest GS (1st tercile) was associated with a significantly higher risk of all-cause and CVD mortality as compared to the highest levels of GS (3rd tercile) in three Cox regression models. In both men and women were found to have a 1.34- and 1.35-fold higher risk of all-cause mortality, respectively, at lower GS, but no significant difference in the risk of CVD mortality. When GS was treated in all models as decrement per 1 kg and decrement per 1 SD, in both men and women, the risk of all-cause mortality significantly increased with decreasing of GS. CONCLUSIONS The mean GS was significantly higher among survivors' men and women as compared to deceased from CVD and other causes of death. Risk of all-cause mortality significantly increased with decreasing of GS.
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Affiliation(s)
- Lolita Sileikiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Abdonas Tamosiunas
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Luksiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ricardas Radisauskas
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Martin Bobak
- Institute of Epidemiology and Health Care, University College London, London, UK
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Zhang S, Otsuka R, Tange C, Nishita Y, Shimokata H, Satake S, Arai H. Implication of grip strength assessment for the management of body weight in disability prevention in older adults. J Cachexia Sarcopenia Muscle 2024; 15:208-219. [PMID: 38086773 PMCID: PMC10834323 DOI: 10.1002/jcsm.13396] [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: 04/21/2023] [Revised: 09/10/2023] [Accepted: 11/02/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Although body mass index (BMI) and grip strength (GS) are both predictors of disability, their joint effect on predicting incident disability remains uncertain. We examined whether the effect of BMI on incident disability can be modulated by GS in community-dwelling older people in Japan. METHODS A total of 1486 community-dwellers in Japan (731 men and 755 women, aged 65-82 years) who participated in the 2nd to 7th waves of the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) project, were followed up to 20 years. Twelve subgroups were created according to the intersections of GS (sex-specific tertiles: low, intermediate, and high) and BMI (underweight 1, <18.5; underweight 2, 18.5-<21.5; normal, 21.5-<25.0; and overweight/obese, ≥25.0 kg/m2 ). Incident disability was defined as requiring care need level 1 or higher, as per the long-term care insurance system in Japan. The hazard ratios (HR) and corresponding 95% confidence intervals (CI) of incident disability (the 'high GS-normal BMI' subgroup was used as the reference) were calculated using a multivariable-adjusted Cox proportional hazards model. The model was adjusted for baseline characteristics on sex, participation wave, smoking, depressive symptoms, total physical activity, disease history, education level, residential status, and energy intake. RESULTS Compared with that for participants in the 'high GS-normal BMI' group, the risk of incident disability was higher for participants in the 'low GS-normal BMI', 'low GS-overweight/obese', 'intermediate GS-underweight 1' and 'intermediate GS-overweight/obese' groups. The multivariable-adjusted HR (95% CI) were 1.72 (1.27-2.32, P value<0.001), 1.81 (1.27-2.58, P value = 0.001), 2.42 (1.35-4.32, P value = 0.003) and 1.53 (1.06-2.20, P value = 0.023), respectively. The results did not change substantially when participants with disability occurring within 1 and 2 years of follow-up were excluded, or when the competing events were death without incident disability or dementia. CONCLUSIONS The joint effect of BMI and GS was more pronounced in those of normal weight or overweight/obese status and low GS, along with underweight or overweight/obese status and intermediate GS in predicting disability. The lack of observed joint effect for those underweight with low GS was likely due to insufficient sample size. GS consideration is necessary for weight management in older adults, and interventions for individuals who are underweight or overweight/obese with adequate GS need not be prioritized for disability prevention.
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Affiliation(s)
- Shu Zhang
- Department of Epidemiology of AgingResearch Institute, National Center for Geriatrics and GerontologyObuJapan
| | - Rei Otsuka
- Department of Epidemiology of AgingResearch Institute, National Center for Geriatrics and GerontologyObuJapan
| | - Chikako Tange
- Department of Epidemiology of AgingResearch Institute, National Center for Geriatrics and GerontologyObuJapan
| | - Yukiko Nishita
- Department of Epidemiology of AgingResearch Institute, National Center for Geriatrics and GerontologyObuJapan
| | - Hiroshi Shimokata
- Department of Epidemiology of AgingResearch Institute, National Center for Geriatrics and GerontologyObuJapan
- Graduate School of Nutritional SciencesNagoya University of Arts and SciencesNisshinJapan
| | - Shosuke Satake
- Department of Frailty ResearchResearch Institute, National Center for Geriatrics and GerontologyObuJapan
- Department of Geriatric MedicineHospital, National Center for Geriatrics and GerontologyObuJapan
| | - Hidenori Arai
- National Center for Geriatrics and GerontologyObuJapan
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McGrath R, Tomkinson GR, Hamm JM, Juhl K, Knoll K, Parker K, Smith AE, Rhee Y. The Role of Different Weakness Cut-Points for Future Cognitive Impairment in Older Americans. J Am Med Dir Assoc 2023; 24:1936-1941.e2. [PMID: 37634549 PMCID: PMC10840802 DOI: 10.1016/j.jamda.2023.07.021] [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: 05/12/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES New absolute and normalized handgrip strength (HGS) cut-points may not yield similar predictive value for cognitive performance. We sought to determine the associations of (1) each absolute and normalized weakness cut-point, and (2) compounding weakness on future cognitive impairment in older Americans. DESIGN Longitudinal panel. SETTING AND PARTICIPANTS The analytic sample included 11,116 participants aged ≥65 years from the 2006 to 2018 waves of the Health and Retirement Study. Participants from the Health and Retirement Study completed detailed interviews that included physical measures and core interviews. METHODS The modified Telephone Interview of Cognitive Status assessed cognitive function and persons scoring <11 were classified as having a cognitive impairment. A handgrip dynamometer measured HGS. Men were considered weak if their HGS was <35.5 kg (absolute), <0.45 kg/kg (body mass normalized), or <1.05 kg (body mass index normalized), whereas women were classified as weak if their HGS was <20.0 kg, <0.337 kg/kg, or <0.79 kg. Compounding weakness included those below 1, 2, or all 3 cut-points. Generalized estimating equations quantified the associations. RESULTS Persons considered weak under the absolute cut-point had 1.62 (95% CI 1.34-1.96) greater odds for future cognitive impairment, but no significant associations were observed for those classified as weak under the body mass [odds ratio (OR) 1.12, CI 0.91-1.36] and body mass index normalized (OR 1.17, CI 0.95-1.43) cut-points. Older Americans below all 3 weakness cut-points had 1.47 (CI 1.15-1.88) greater odds for future cognitive impairment, but no significant associations were found for persons classified as weak under 1 (OR 1.08, CI 0.83-1.42) or 2 (OR 1.19, CI 0.91-1.55) cut-points. CONCLUSIONS AND IMPLICATIONS Our findings suggest that each weakness cut-point has differential prognostic value for future cognitive impairment, and aggregating weakness cut-points may improve their predictive utility. Consideration should be given to how weakness categories are uniquely linked to cognitive function.
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Affiliation(s)
- Ryan McGrath
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND, USA; Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA; Fargo VA Healthcare System, Fargo, ND, USA; Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA; Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Jeremy M Hamm
- Department of Psychology, North Dakota State University, Fargo, ND, USA
| | - Kirsten Juhl
- Department of Internal Medicine, University of North Dakota, Grand Forks, ND, USA; Sanford Health, Fargo, ND, USA
| | - Kelly Knoll
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND, USA; Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Kelly Parker
- Department of Psychology, North Dakota State University, Fargo, ND, USA
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Yeong Rhee
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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McGrath R, Jurivich DA, Christensen BK, Choi BJ, Langford M, Rhee Y, Tomkinson GR, Hackney KJ. Examining the role of different weakness categories for mobility and future falls in older Americans. Aging Clin Exp Res 2023; 35:2491-2498. [PMID: 37535311 PMCID: PMC10877671 DOI: 10.1007/s40520-023-02516-6] [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: 06/10/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Recently developed absolute and body size normalized handgrip strength (HGS) cut-points could be used individually and collectively to predict mobility problems and falls. AIMS We examined the associations of (1) each absolute and normalized weakness cut-point, (2) collective weakness categories, and (3) changes in weakness status on future falls in older Americans. METHODS The analytic sample included 11,675 participants from the 2006-2018 waves of the Health and Retirement Study. Falls were self-reported. Men were classified as weak if their HGS was < 35.5-kg (absolute), < 0.45 kg/kg (body mass normalized), or < 1.05 kg/kg/m2 (body mass index normalized). While, women were considered weak if their HGS was < 20.0-kg, < 0.337 kg/kg, or < 0.79 kg/kg/m2. Collective weakness categorized those below 1, 2, or all 3 cut-points. The collective weakness categories were also used to observe changes in weakness status over time. RESULTS Older Americans below each absolute and normalized cut-point had greater odds for future falls: 1.23 (95% confidence interval (CI): 1.15-1.32) for absolute weakness, 1.20 (CI 1.11-1.29) for body mass index normalized weakness, and 1.26 (CI 1.17-1.34) for body mass normalized weakness. Persons below 1, 2, or all 3 weakness cut-points had 1.17 (CI 1.07-1.27), 1.29 (CI 1.18-1.40), and 1.36 (CI 1.24-1.48) greater odds for future falls, respectively. Those in some changing weakness categories had greater odds for future falls: 1.26 (CI 1.08-1.48) for persistent and 1.31 (CI 1.11-1.55) for progressive. DISCUSSION Collectively using these weakness cut-points may improve their predictive value. CONCLUSION We recommend HGS be evaluated in mobility and fall risk assessments.
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Affiliation(s)
- Ryan McGrath
- Healthy Aging North Dakota (HAND), North Dakota State University, 1805 NDSU Research Park Dr. N., Fargo, ND, 58102, USA.
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA.
- Fargo VA Healthcare System, Fargo, ND, USA.
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA.
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia.
| | - Donald A Jurivich
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
| | - Bryan K Christensen
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Bong-Jin Choi
- Department of Statistics, North Dakota State University, Fargo, ND, USA
- Department of Public Health, North Dakota State University, Fargo, ND, USA
| | - Matthew Langford
- Healthy Aging North Dakota (HAND), North Dakota State University, 1805 NDSU Research Park Dr. N., Fargo, ND, 58102, USA
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Yeong Rhee
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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Heyn PC, Tagawa A, Pan Z, Reistetter T, Ng TKS, Lewis M, Carollo JJ. The association between isometric strength and cognitive function in adults with cerebral palsy. Front Med (Lausanne) 2023; 10:1080022. [PMID: 37181370 PMCID: PMC10170265 DOI: 10.3389/fmed.2023.1080022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Background The literature supports quantifying the maximum force/tension generated by one's forearm muscles such as the hand grip strength (HGS) to screen for physical and cognitive frailty in older adults. Thus, we postulate that individuals with cerebral palsy (CP), who are at higher risk for premature aging, could benefit from tools that objectively measure muscle strength as a functional biomarker to detect frailty and cognitive decline. This study assesses the clinical relevancy of the former and quantifies isometric muscle strength to determine its association with cognitive function in adults with CP. Methods Ambulatory adults with CP were identified from a patient registry and were enrolled into this study. Peak rate of force development (RFD) and maximum voluntary isometric contraction of the quadriceps were measured using a commercial isokinetic machine, while HGS was collected with a clinical dynamometer. Dominant and non-dominant side were identified. Standardized cognitive assessments, including the Wechsler Memory and Adult Intelligence Scales IV, Short Test of Mental Status, and the Patient-Reported Outcomes Measurement Information System (PROMIS®) were used to evaluate cognitive function. Results A total of 57 participants (32 females; mean age 24.3 [SD 5.3]; GMFCS levels I-IV) were included in the analysis. Although dominant and non-dominant RFD and HGS measures were associated with cognitive function, non-dominant peak RFD showed the strongest associations with cognitive function. Conclusion RFD capacity may reflect age-related neural and physical health and could be a better health indicator than HGS in the CP population.
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Affiliation(s)
- Patricia C. Heyn
- Center for Optimal Aging (COA), Marymount University, Arlington, VA, United States
- Physical Medicine & Rehabilitation Department, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Alex Tagawa
- Center for Gait and Movement Analysis (CGMA), Children’s Hospital Colorado, Aurora, CO, United States
- Musculoskeletal Research Center (MRC), Orthopedics Institute, Children’s Hospital Colorado, Aurora, CO, United States
| | - Zhaoxing Pan
- Center for Gait and Movement Analysis (CGMA), Children’s Hospital Colorado, Aurora, CO, United States
- Musculoskeletal Research Center (MRC), Orthopedics Institute, Children’s Hospital Colorado, Aurora, CO, United States
| | - Timothy Reistetter
- University of Texas Health Science Center San Antonio, San Antonio, TX, United States
| | - Ted Kheng Siang Ng
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Meredith Lewis
- Center for Gait and Movement Analysis (CGMA), Children’s Hospital Colorado, Aurora, CO, United States
- Musculoskeletal Research Center (MRC), Orthopedics Institute, Children’s Hospital Colorado, Aurora, CO, United States
| | - James J. Carollo
- Physical Medicine & Rehabilitation Department, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Center for Gait and Movement Analysis (CGMA), Children’s Hospital Colorado, Aurora, CO, United States
- Musculoskeletal Research Center (MRC), Orthopedics Institute, Children’s Hospital Colorado, Aurora, CO, United States
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Kasović M, Sagat P, Kalčik Z, Štefan L, Hubinák A, Krška P. Allometric normalization of handgrip strength in older adults: Which body size parameter is the most appropriate? BMC Sports Sci Med Rehabil 2023; 15:18. [PMID: 36755305 PMCID: PMC9907875 DOI: 10.1186/s13102-023-00628-0] [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: 12/02/2022] [Accepted: 02/03/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Although absolute handgrip strength has been associated with health-related outcomes in older adults, little evidence has been provided regarding its adjustment by a variety of body size dimensions. Therefore, the main purpose of the study was to establish the most appropriate normalization of handgrip strength by different body size parameters in a large sample of noninstitutionalized older adults. METHODS In this cross-sectional study, we enrolled 643 men and women aged > 60, who were part of the rehabilitation center facility program. Handgrip strength was objectively measured using a Jamar Plus* + Digital Hand Dynamometer. Body size parameters included body weight and height, body mass index, waist circumference, waist-to-height ratio, fat mass and fat-free mass. The most appropriate parameter associated with handgrip strength was identified using allometry. RESULTS Findings showed that the most appropriate body size parameter for handgrip strength normalization was height (allometric exponent: 0.85), compared to fat-free mass (0.26) and body mass (0.12). Other body size variables were not significantly associated with handgrip strength and were omitted from further analyses. The correlations between normalized handgrip strength were significant when handgrip strength was normalized by body mass and fat-free mass, while no significant correlations were found, when handgrip strength was normalized by body height. CONCLUSION Based on the study results, body height seems to be the best body size parameter for handgrip strength normalization in older adults, omitting the influence of body size on strength performance. If handgrip strength is measured, body height may help normalize strength for large-scale research.
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Affiliation(s)
- Mario Kasović
- grid.4808.40000 0001 0657 4636Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10 000 Zagreb, Croatia ,grid.10267.320000 0001 2194 0956Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Peter Sagat
- grid.443351.40000 0004 0367 6372Albert Einstein, Bc., Prince Sultan University, Sport Sciences and Diagnostics Research Group, GSD-HPE Department, Riyadh, Saudi Arabia
| | | | - Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10 000, Zagreb, Croatia. .,Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic. .,Recruitment and Examination (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic.
| | - Andrej Hubinák
- grid.445184.80000 0004 0400 2732Department of Physical Education and Sport, Faculty of Education, Catholic University in Ružomberok, Ružomberok, Slovakia
| | - Peter Krška
- grid.445184.80000 0004 0400 2732Department of Physical Education and Sport, Faculty of Education, Catholic University in Ružomberok, Ružomberok, Slovakia
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10
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Peterson MD, Collins S, Meier HC, Brahmsteadt A, Faul JD. Grip strength is inversely associated with DNA methylation age acceleration. J Cachexia Sarcopenia Muscle 2023; 14:108-115. [PMID: 36353822 PMCID: PMC9891916 DOI: 10.1002/jcsm.13110] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/06/2022] [Accepted: 09/26/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is a large body of evidence linking muscular weakness, as determined by low grip strength, to a host of negative ageing-related health outcomes. Given these links, grip strength has been labelled a 'biomarker of aging'; and yet, the pathways connecting grip strength to negative health consequences are unclear. The objective of this study was to determine whether grip strength was associated with measures of DNA methylation (DNAm) age acceleration. METHODS Middle age and older adults from the 2006 to 2008 waves of the Health and Retirement Study with 8-10 years of follow-up were included. Cross-sectional and longitudinal regression modelling was performed to examine the association between normalized grip strength (NGS) and three measures of DNAm age acceleration, adjusting for cell composition, sociodemographic variables and smoking. Longitudinal modelling was also completed to examine the association between change in absolute grip strength and DNAm age acceleration. The three DNAm clocks used for estimating age acceleration include the established DunedinPoAm, PhenoAge and GrimAge clocks. RESULTS There was a robust and independent cross-sectional association between NGS and DNAm age acceleration for men using the DunedinPoAm (β: -0.36; P < 0.001), PhenoAge (β: -8.27; P = 0.01) and GrimAge (β: -4.56; P = 0.01) clocks and for women using the DunedinPoAm (β: -0.36; P < 0.001) and GrimAge (β: -4.46; P = 0.01) clocks. There was also an independent longitudinal association between baseline NGS and DNAm age acceleration for men (β: -0.26; P < 0.001) and women (β: -0.36; P < 0.001) using the DunedinPoAm clock and for women only using the PhenoAge (β: -8.20; P < 0.001) and GrimAge (β: -5.91; P < 0.001) clocks. Longitudinal modelling revealed a robust association between change in grip strength from wave 1 to wave 3 was independently associated with PhenoAgeAA (β: -0.13; 95% CI: -0.23, -0.03) and GrimAgeAA (β: -0.07; 95% CI: -0.14, -0.01) in men only (both P < 0.05). CONCLUSIONS Our findings provide some initial evidence of age acceleration among men and women with lower NGS and loss of strength over time. Future research is needed to understand the extent to which DNAm age mediates the association between grip strength and chronic disease, disability and mortality.
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Affiliation(s)
- Mark D. Peterson
- Department of Physical Medicine and RehabilitationUniversity of MichiganAnn ArborMIUSA
- Michigan Institute for Health Policy and Innovation (IHPI)Ann ArborMIUSA
- Michigan Center on the Demography of Aging (MiCDA)Ann ArborMIUSA
| | - Stacey Collins
- Survey Research Center, Institute for Social ResearchUniversity of MichiganAnn ArborMIUSA
| | - Helen C.S. Meier
- Michigan Center on the Demography of Aging (MiCDA)Ann ArborMIUSA
- Survey Research Center, Institute for Social ResearchUniversity of MichiganAnn ArborMIUSA
| | - Alexander Brahmsteadt
- Department of Physical Medicine and RehabilitationUniversity of MichiganAnn ArborMIUSA
| | - Jessica D. Faul
- Michigan Center on the Demography of Aging (MiCDA)Ann ArborMIUSA
- Survey Research Center, Institute for Social ResearchUniversity of MichiganAnn ArborMIUSA
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11
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Hetherington-Rauth M, Magalhães JP, Alcazar J, Rosa GB, Correia IR, Ara I, Sardinha LB. Relative Sit-to-Stand Muscle Power Predicts an Older Adult's Physical Independence at Age of 90 Yrs Beyond That of Relative Handgrip Strength, Physical Activity, and Sedentary Time: A Cross-sectional Analysis. Am J Phys Med Rehabil 2022; 101:995-1000. [PMID: 35034060 DOI: 10.1097/phm.0000000000001945] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Muscle power is important for an older adult's physical independence and can be easily estimated using the sit-to-stand test. This investigation aimed to assess whether muscle power estimated using the sit-to-stand test could identify older adults at risk of losing physical independence beyond handgrip strength, physical activity, and sedentary time and to develop minimal sit-to-stand power thresholds. DESIGN Physical independence was assessed cross-sectionally in older adults using a composite physical function questionnaire. Muscle power was calculated using the 30-sec sit-to-stand test. Muscle strength was determined using a handgrip dynamometer. Physical activity and sedentary time were assessed by accelerometry. Multiple logistic regression was used to assess the independent association between sit-to-stand power and projected physical independence ( n = 737). Receiver operator characteristic curves were used to develop sit-to-stand power cut points ( N = 1748). RESULTS Sit-to-stand power proved to be the best predictor of physical independence in later life regardless of handgrip strength, physical activity, and sedentary time (standardized B = 0.45, -0.02, 0.12, -0.28, respectively). Sex- and age-specific cutoffs for sit-to-stand power had good discriminatory ability (area under the curve = 0.75-0.78 [women], 0.76-0.82 [men]). CONCLUSIONS Sit-to-stand power can be used as a simple and practical screening tool to assess an older adult's future physical independence.
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Affiliation(s)
- Megan Hetherington-Rauth
- From the Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada-Dafundo, Portugal (MH-R, JPM, GBR, IRC, LBS); GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain (JA, IA); and CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain (JA, IA)
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12
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Haapala HJ, Schmidt M, Lin P, Kamdar N, Mahmoudi E, Peterson MD. Musculoskeletal Morbidity Among Adults Living With Spina Bifida and Cerebral Palsy. Top Spinal Cord Inj Rehabil 2022; 28:73-84. [PMID: 36017121 DOI: 10.46292/sci21-00078] [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: 11/19/2022]
Abstract
Background Individuals living with cerebral palsy (CP) or spina bifida (SB) are at heightened risk for chronic health conditions that may develop or be influenced by the impairment and/or the process of aging. Objectives The objective of this study was to compare the incidence of and adjusted hazards for musculoskeletal (MSK) morbidities among adults living with and without CP or SB. Methods A retrospective, longitudinal cohort study was conducted among adults living with (n = 15,302) CP or SB and without (n = 1,935,480) CP or SB. Incidence estimates of common MSK morbidities were compared at 4 years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident MSK morbidities. The analyses were performed in 2019 to 2020. Results Adults living with CP or SB had a higher 4-year incidence of any MSK morbidity (55.3% vs. 39.0%) as compared to adults without CP or SB, and differences were to a clinically meaningful extent. Fully adjusted survival models demonstrated that adults with CP or SB had a greater hazard for all MSK disorders; this ranged from hazard ratio (HR) 1.40 (95% CI, 1.33 to 1.48) for myalgia to HR 3.23 (95% CI, 3.09 to 3.38) for sarcopenia and weakness. Conclusion Adults with CP or SB have a significantly higher incidence of and risk for common MSK morbidities as compared to adults without CP or SB. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce risk of MSK disease onset/progression in these higher risk populations.
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Affiliation(s)
- Heidi J Haapala
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Mary Schmidt
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Paul Lin
- Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Neil Kamdar
- Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,Department of Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Elham Mahmoudi
- Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
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13
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Guo Y, Piasecki J, Swiecicka A, Ireland A, Phillips BE, Atherton PJ, Stashuk D, Rutter MK, McPhee JS, Piasecki M. Circulating testosterone and dehydroepiandrosterone are associated with individual motor unit features in untrained and highly active older men. GeroScience 2022; 44:1215-1228. [PMID: 34862585 PMCID: PMC9213614 DOI: 10.1007/s11357-021-00482-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/28/2021] [Indexed: 10/31/2022] Open
Abstract
Long-term exercise training has been considered as an effective strategy to counteract age-related hormonal declines and minimise muscle atrophy. However, human data relating circulating hormone levels with motor nerve function are scant. The aims of the study were to explore associations between circulating sex hormone levels and motor unit (MU) characteristics in older men, including masters athletes competing in endurance and power events. Forty-three older men (mean ± SD age: 69.9 ± 4.6 years) were studied based on competitive status. The serum concentrations of dehydroepiandrosterone (DHEA), total testosterone (T) and estradiol were quantified using liquid chromatography mass spectrometry. Intramuscular electromyographic signals were recorded from vastus lateralis (VL) during 25% of maximum voluntary isometric contractions and processed to extract MU firing rate (FR), and motor unit potential (MUP) features. After adjusting for athletic status, MU FR was positively associated with DHEA levels (p = 0.019). Higher testosterone and estradiol were associated with lower MUP complexity; these relationships remained significant after adjusting for athletic status (p = 0.006 and p = 0.019, respectively). Circulating DHEA was positively associated with MU firing rate in these older men. Higher testosterone levels were associated with reduced MUP complexity, indicating reduced electrophysiological temporal dispersion, which is related to decreased differences in conduction times along axonal branches and/or MU fibres. Although evident in males only, this work highlights the potential of hormone administration as a therapeutic interventional strategy specifically targeting human motor units in older age.
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Affiliation(s)
- Yuxiao Guo
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jessica Piasecki
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, UK
| | - Agnieszka Swiecicka
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - Alex Ireland
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Bethan E. Phillips
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
| | - Philip J. Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
| | - Daniel Stashuk
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON Canada
| | - Martin K. Rutter
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Jamie S. McPhee
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Mathew Piasecki
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
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14
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Nevill AM, Tomkinson GR, Lang JJ, Wutz W, Myers TD. How Should Adult Handgrip Strength Be Normalized? Allometry Reveals New Insights and Associated Reference Curves. Med Sci Sports Exerc 2022; 54:162-168. [PMID: 34431826 DOI: 10.1249/mss.0000000000002771] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Handgrip strength (HGS) is an important indicator of health. Because HGS is strongly associated with body size, most investigators normalize HGS for some measure of body size as a more sensitive indicator of strength within a population. We aimed to 1) identify the optimal body size dimension to remove (normalize) HGS for differences in body size among adults and 2) generate norm-referenced centiles for HGS using the identified body size dimension. METHODS Data were from the National Health and Nutrition Examination Survey, a representative sample of the US noninstitutionalized civilian population. Exclusions resulted in a final sample of 8690 adults 20 yr and older. HGS was measured using handheld dynamometry. Body size dimensions included body mass, height, and waist circumference. The most appropriate dimension(s) associated with HGS is identified using allometry. We fitted centile curves for normalized HGS using the generalized additive model for location, scale, and shape. RESULTS Findings suggest that neither body mass nor body mass index is appropriate to normalize HGS. Incorporating all three body size dimensions of body mass, height, and waist circumference, or the reduced subsets of body mass and height, or height alone, suggests that the most appropriate normalizing (body size) dimension associated with HGS should be a cross-sectional or surface area measure of an individual's body size (i.e., L2, where L is a linear dimension of body size). Given that height was also identified as the signally best body size dimension associated with HGS, we recommend HGS be normalized by height2 (i.e., HGS/HT2). Centile curves for HGS/HT2 by age group and gender were therefore provided. CONCLUSIONS Scaling adult HGS by height2 may help normalize strength for population-based research.
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Affiliation(s)
- Alan M Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall Campus, Walsall, UNITED KINGDOM
| | | | | | - Wyatt Wutz
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND
| | - Tony D Myers
- Sport and Health, Newman University, Birmingham, UNITED KINGDOM
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15
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Predictors of Falls in Patients with Degenerative Cervical Myelopathy: A Prospective Multi-institutional Study. Spine (Phila Pa 1976) 2021; 46:1007-1013. [PMID: 33496544 DOI: 10.1097/brs.0000000000003958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective multicenter study. OBJECTIVES The purpose of this study was to characterize a population of patients with degenerative cervical myelopathy (DCM) combined with a history of falling, and to identify the predictors associated with those falls. SUMMARY OF BACKGROUND DATA Falls among patients with DCM are common and can lead to the worsening of neurological symptoms. However, there are no prospective studies that have investigated the risk factors for falls in these patients. METHODS We prospectively enrolled patients scheduled for surgery for DCM and evaluated the significance of various preoperative measures for predicting falls. We then examined the correlation between the number of falls and the preoperative factors. Lastly, we performed stepwise logistic regression analysis to assess the concurrent effects of various factors on the occurrence of falls. RESULTS Among the 135 patients analyzed, 64 experienced one or more falls from the time of enrollment to 1 year postoperatively. Univariate analysis showed that the preoperative potassium and albumin levels, handgrip strength, and the Japanese Orthopaedic Association score for the assessment of cervical myelopathy (C-JOA score) were lower and Nurick grade was higher in the fallers group. Serum potassium level, handgrip strength, C-JOA score, Nurick grade, European Quality of Life-5 Dimensions (EQ-5D) score, t1 pelvic angle, and sagittal vertical axis had weak correlations with the number of falls. The fallers group had a lower C-JOA and EQ-5D scores and a lower recovery rate at one year postoperatively. Stepwise multiple logistic regression analysis identified preoperative potassium level and handgrip strength as the independent preoperative predictors for falling. CONCLUSION We identified preoperative lower serum potassium level and weaker handgrip strength as significant predictors of falls in patients with DCM. Therefore, DCM patients with these risk factors should be cautious about falls and might be candidates for immediate surgical intervention.Level of Evidence: 3.
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16
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Fan B, Mohammed A, Huang Y, Luo H, Zhang H, Tao S, Xu W, Liu Q, He T, Jin H, Sun M, Sun M, Yun Z, Zhao R, Wu G, Li X. Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment. Front Oncol 2021; 11:633462. [PMID: 34350107 PMCID: PMC8327774 DOI: 10.3389/fonc.2021.633462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/30/2021] [Indexed: 12/03/2022] Open
Abstract
Aspirin, widely used to prevent cardiovascular disease, had been linked to the incidence of bladder cancer (BCa). Existing studies focusing on Chinese populations are relatively rare, especially for Northeast China. Meanwhile, relevant studies on the effects of aspirin on the occurrence or prognosis of BCa are inconsistent or even controversial. First, in the case control study, logistic regression analysis was used to investigate the association between aspirin intake and risk of BCa including 1121 patients with BCa and the 2242 controls. Subsequently, Kaplan-Meier curve and Cox regression analyses were applied to explore the association between aspirin intake and clinicopathological factors which may predict overall survival (OS) and recurrence-free survival (RFS) of BCa patients. Finally, we quantificationally combined the results with those from the published literature evaluating aspirin intake and its effects on the occurrence, outcome of surgery and prognosis of BCa by meta-analysis up to May 1, 2021.Our case-control study demonstrated that the regular use of aspirin was not associated with a reduced incidence of BCa (P=0.175). Stratified analyses of sex showed that aspirin intake did not lead to a lower risk of BCa in female patients (P=0.063). However, the male population who regularly took aspirin had a lower incidence of BCa (OR=0.748, 95% CI= 0.584-0.958, P=0.021). Subgroup analyses stratified by smoking found a significant reduction in the risk of BCa in current smokers with aspirin intake (OR=0.522, 95% CI=0.342-0.797, P=0.002). In terms of prognosis of BCa, patients with a history of aspirin intake did not had a markedly longer OS or RFS than those with no history of aspirin intake by Kaplan-Meier curves. Stratified analysis by sex showed no correlation between aspirin intake and the recurrence or survival of BCa for either male or female patients. However, in people younger than 68, aspirin intake seemed to have prolonged effects for overall survival (HR=3.876; 95% CI=1.326-11.325, P=0.019). Then, we performed a meta-analysis and the combined results from 19 articles and our study involving more than 39524 BCa cases indicated that aspirin intake was not associated with the occurrence of BCa (P=0.671). Subgroup analysis by whether regular use of aspirin, by the mean duration of use of aspirin, by sex, by smoking exposure, by research region and by study type also supported the above results. In terms of the impact of aspirin intake on the prognosis of patients with BCa, 11 articles and our study involving 8825 BCa cases were eligible. The combined results showed that patients with aspirin intake did not have significantly influence on survival, recurrence, progression and metastasis than those without aspirin intake. On the whole, both our retrospective study and literature meta-analysis suggested a lack of a strong relevant association between the use of aspirin and the incidence or prognosis of BCa. Thus, additional long-term follow-up prospective research is warranted to clarify the association of aspirin with BCa incidence and prognosis.
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Affiliation(s)
- Bo Fan
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Alradhi Mohammed
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yuanbin Huang
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hong Luo
- Clinical Medicine, Dalian Medical University, Dalian, China
| | - Hongxian Zhang
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shenghua Tao
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Weijiao Xu
- Clinical Medicine, Dalian Medical University, Dalian, China
| | - Qian Liu
- Medical Imaging, Dalian Medical University, Dalian, China
| | - Tao He
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Huidan Jin
- Department of Anaesthesiology, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Mengfan Sun
- Department of Pharmacy, Zhongshan College of Dalian Medical University, Dalian, China
| | - Man Sun
- Clinical Medicine, Dalian Medical University, Dalian, China
| | - Zhifei Yun
- Clinical Medicine, Dalian Medical University, Dalian, China
| | - Rui Zhao
- Department of Pharmacy, Zhongshan College of Dalian Medical University, Dalian, China
| | - Guoyu Wu
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiancheng Li
- Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
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17
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Tsai SH, Cheng HC, Liu HW. Effects of volume-matched resistance training with different loads on glycemic control, inflammation, and body composition in prediabetic older adults. Appl Physiol Nutr Metab 2021; 46:1400-1406. [PMID: 34265211 DOI: 10.1139/apnm-2021-0355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of the investigation was to examine the influence of resistance training (RT) with equal volume and varying load on glycemic control, inflammation, and body composition in non-obese prediabetic older adults. Non-obese older adults with prediabetes were randomized into two groups - high-load (80% 1RM) and low-load (40% of 1RM) RT (n=12/group), both with the same training volume. Oral glucose tolerance test (OGTT) and blood samples were collected at baseline and again after 10 weeks of RT. Fasting plasma glucose (103.8 vs. 99.9 mg/dL) and the area under the curve (AUC) of OGTT (0-30min) decreased significantly in older adults with prediabetes after 10-weeks of volume-matched RT (p < 0.05). Serum levels of MCP-1 (138.7 vs. 98.5 pg/mL) and TNF-α (1.8 vs. 1.3 pg/mL) showed significant decrease after 10-weeks of high-load RT (p < 0.05). There were no changes in IL-10, IL-6, and CRP levels in both groups. Leptin showed significant decrease after 10-weeks of low-load RT (p < 0.05). Changes in fasting glucose and AUC of OGTT (0-120 min) were positively correlated with changes in MCP-1 and TNF-α (p < 0.05). Lean body mass (39.6 vs. 40.3 kg) increased significantly after 10-weeks of volume-matched RT (p < 0.05). Results indicate that equal-volume RT at different loads is beneficial to glycemic control and muscle growth, and high-load RT shows more prominent anti-inflammatory effects. Novelty: ●Short-term high-load resistance training can help older adults bring their blood sugar level back to normal. ●High-load resistance training attenuates aging-associated chronic inflammation.
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Affiliation(s)
- Shun-Hsi Tsai
- National Taiwan Normal University, 34879, Department of Physical Education, Taipei, Taiwan;
| | - Hao-Chien Cheng
- National Taiwan Normal University, 34879, Department of Physical Education, Taipei, Taiwan;
| | - Hung-Wen Liu
- National Taiwan Normal University, 34879, Department of Physical Education, Taipei, Taiwan, 106;
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18
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Peterson MD, Casten K, Collins S, Hassan H, García-Hermoso A, Faul J. Muscle weakness is a prognostic indicator of disability and chronic disease multimorbidity. Exp Gerontol 2021; 152:111462. [PMID: 34224846 DOI: 10.1016/j.exger.2021.111462] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/09/2021] [Accepted: 06/25/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The objective of this study was to use nationally-representative data on Americans greater than 50 years of age to determine the association between grip strength and inflammation as independent predictors of incident disability, chronic multimorbidity and dementia. METHODS Middle age and older adults (n = 12,618) from the 2006-2008 waves of the Health and Retirement Study with 8-years of follow-up were included. Longitudinal modeling was performed to examine the association between baseline grip strength (normalized to body mass: NGS) and high sensitivity C-reactive protein (hs-CRP) (≥3.0 mg/L) with incident physical disabilities (i.e., ≥2 limitations to activities of daily living), chronic multimorbidity (≥2 of chronic conditions), and dementia. RESULTS The odds of incident disability were 1.25 (95% CI: 1.20-1.30) and 1.31 (95% CI: 1.26-1.36) for men and women respectively, for each 0.05-unit lower NGS. The odds of incident chronic multimorbidity were 1.14 (95% CI: 1.08-1.20) and 1.14 (95% CI: 1.07-1.21) for men and women respectively for each 0.05-unit lower NGS. The odds of incident dementia were 1.10 for men (95% CI: 1.02-1.20) for each 0.05-unit lower NGS, but there was no significant association for women. Elevated hs-CRP was only associated with chronic multimorbidity among men (OR = 1.29; 95% CI: 1.00-1.73) and women (OR = 1.60; 95% CI: 1.26-2.02). CONCLUSIONS Our findings indicate a robust inverse association between NGS and disability and chronic, multimorbidity in older men and women, and dementia in men. Elevated hs-CRP was only associated with chronic multimorbidity in men and women. Healthcare providers should implement measures of grip strength in routine health assessments and discuss the potential dangers of weakness as well as interventions to improve strength with their patients.
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Affiliation(s)
- Mark D Peterson
- Department of Physical Medicine & Rehabilitation, University of Michigan, United States of America; Michigan Center on the Demography of Aging (MiCDA), United States of America; Michigan Institute for Health Policy and Innovation (IHPI), United States of America.
| | - Kimberly Casten
- Department of Physical Medicine & Rehabilitation, University of Michigan, United States of America
| | - Stacey Collins
- Institute for Social Research, University of Michigan, United States of America
| | - Halimah Hassan
- Institute for Social Research, University of Michigan, United States of America
| | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Jessica Faul
- Institute for Social Research, University of Michigan, United States of America
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Nakano J, Fukushima T, Tanaka T, Fu JB, Morishita S. Physical function predicts mortality in patients with cancer: a systematic review and meta-analysis of observational studies. Support Care Cancer 2021; 29:5623-5634. [PMID: 33770257 DOI: 10.1007/s00520-021-06171-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/18/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE This systematic review and meta-analysis aimed to determine whether physical function can predict mortality in patients with cancer. METHODS Literature searches were conducted in Web of Science, CINAHL, the Cochrane Library, ProQuest, PEDro, and PubMed for articles published before September 2020. Four review authors retrieved studies using predetermined eligibility criteria and conducted quality assessment and data extraction. RESULTS A total of 1356 titles and abstracts were screened; ultimately, 26 studies were determined to be suitable for meta-analysis. Grip strength was significantly associated with mortality risk in patients with cancer (hazard ratio [HR] = 1.15, P = 0.005). Gait speed was also associated with mortality risk (HR = 1.58, P = 0.0004). In grip strength and gait speed, the subgroup comprised of patients with cancer aged ≥ 80 years had a higher effect size than that of patients aged < 80 years. The short physical performance battery measurement was markedly associated with mortality risk, showing the largest effect size (HR = 2.37, P < 0.00001). The 6-min walking test distance was significantly associated with mortality risk (HR = 1.55, P = 0.001). The timed up and go test was significantly associated with mortality risk with a high effect size (HR = 2.66, P < 0.00001). CONCLUSION This systematic review and meta-analysis demonstrated that physical function predicted mortality in patients with cancer. Furthermore, physical function outcomes in patients aged 80 years and above reflected a higher mortality.
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Affiliation(s)
- Jiro Nakano
- Department of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Takuya Fukushima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Jack B Fu
- Department of Palliative, Rehabilitation & Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shinichiro Morishita
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.
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20
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A new easily accessible and practical method for dynapenia screening: blink rate. Ir J Med Sci 2021; 190:1619-1623. [PMID: 33449323 DOI: 10.1007/s11845-020-02454-6] [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: 09/17/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The methods used in the diagnosis and screening of sarcopenia are not available everywhere. There is a need for more practical tests that can be used especially in the first step. AIMS We aimed to investigate the usability of blink rate as an alternative test for dynapenia screening. METHODS A total of 355 patients ≥ 65 years of age (254 (71.50%) female and 101 (28.50%) male) who were admitted to geriatric outpatient clinic were included in this prospective cross-sectional study. RESULTS Blink rate was positively correlated with grip strength and negatively correlated with SARC-F. Also, it was found that the blink rate was associated with dynapenia independent of other factors. The optimal cut-off value of 15 s blink rate to predict dynapenia was measured as ≤ 40.5, with 70.3% sensitivity and 43.3% specificity. CONCLUSION Our study indicated the relationship between blink rate with dynapenia and grip strength. Especially in patients with limited mobilization and where it is not possible to reach the hand dynamometer to measure grip strength, the blink rate can be used as an alternative test to detect dynapenia.
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21
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Lo CJ, Ko YS, Chang SW, Tang HY, Huang CY, Huang YC, Ho HY, Lin CM, Cheng ML. Metabolic signatures of muscle mass loss in an elderly Taiwanese population. Aging (Albany NY) 2020; 13:944-956. [PMID: 33410783 PMCID: PMC7834982 DOI: 10.18632/aging.202209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 10/05/2020] [Indexed: 12/25/2022]
Abstract
To identify the association between metabolites and muscle mass in 305 elderly Taiwanese subjects, we conducted a multivariate analysis of 153 plasma samples. Based on appendicular skeletal muscle mass index (ASMI) quartiles, female and male participants were divided into four groups. Quartile 4 (Men: 5.67±0.35, Women: 4.70±0.32 Kg/m2) and quartile 1 (Men: 7.60±0.29, Women: 6.56±0.53 Kg/m2) represented low muscle mass and control groups, respectively. After multivariable adjustment, except for physical function, we found that blood urea nitrogen, creatinine, and age were associated with ASMI in men. However, only triglyceride level was related to ASMI in women. The multiple logistic regression models were used to analyze in each baseline characteristic and metabolite concentration. After the adjustment, we identify amino acid-related metabolites and show that glutamate levels in women and alpha-aminoadipate, Dopa, and citrulline/ornithine levels in men are gender-specific metabolic signatures of muscle mass loss.
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Affiliation(s)
- Chi-Jen Lo
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
| | - Yu-Shien Ko
- Division of Cardiology, Chang Gung Memorial Hospital, Taipei 105, Taiwan.,College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Su-Wei Chang
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan 333, Taiwan
| | - Hsiang-Yu Tang
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
| | - Cheng-Yu Huang
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
| | - Yu-Chen Huang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.,Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Hung-Yao Ho
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan.,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.,Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Chih-Ming Lin
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.,Division of Internal Medicine, Chang Gung Memorial Hospital, Taipei 105, Taiwan.,Department of Health Management, Chang Gung Health and Culture Village, Taoyuan 333, Taiwan
| | - Mei-Ling Cheng
- Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan.,Clinical Metabolomics Core Laboratory, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.,Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
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22
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Liu HW, Cheng HC, Tsai SH, Sun WH. Effect of Progressive Resistance Training on Circulating Adipogenesis-, Myogenesis-, and Inflammation-Related microRNAs in Healthy Older Adults: An Exploratory Study. Gerontology 2020; 66:562-570. [PMID: 33022678 DOI: 10.1159/000510148] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/14/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Functional and physiological adaptations induced by resistance training have been extensively studied in older adults. However, microRNA (miRNA) as the novel regulator in protective effects remains poorly understood. OBJECTIVE The purpose of an exploratory study was to analyze the response of a panel of circulating miRNAs to adaptations mediated by resistance training. METHODS Ten healthy older adults (age: 67.6 ± 2.2 years, 7 women and 3 men) without previous experience in resistance training were recruited. Blood samples were collected at baseline and after a 12-week resistance training. Next-generation sequencing was used to determine circulating miRNA responses to chronic resistance training. RESULTS After the 12-week training, physical functions including grip strength, lower body strength and endurance, and walking capacity were improved in the older adults, while the serum levels of leptin (from 18.1 ± 20.0 to 14.9 ± 17.6 ng/mL, p = 0.029) and tumor necrosis factor alpha (TNFα; from 4.4 ± 0.6 to 4.0 ± 0.6 pg/mL, p < 0.001) were significantly decreased. In addition, adipogenesis-related miRNAs (miR-103a-3p, -103b, -143-5p, -146b-3p, -146b-5p, -17-5p, -181a-2-3p, -181b-5p, -199a-5p, -204-3p, and -378c), anti-adipogenesis-related miRNAs (miR-155-3p, -448, and -363-3p), myogenesis-related miRNAs (miR-125b-1-3p, -128-3p, -133a-3p, 155-3p, -181a-2-3p, -181b-5p, -199a-5p, -223-3p, and -499a-5p), and inflammation-related miRNAs (miR-146b-3p, -146b-5p, -155-3p, -181a-2-3p, and -181b-5p) were changed significantly in the older adults after training (fold change >2, p < 0.05). The log2 fold change of miRNA-125-1-3p was inversely correlated with delta walking time (R = -0.685, p = 0.029) and change in insulin-like growth factor 1 (R = -0.644, p = 0.044). CONCLUSIONS Our results can help explain the link between specific circulating miRNAs and beneficial effects of resistance training on functional and physiological adaptations in older adults.
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Affiliation(s)
- Hung-Wen Liu
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan,
| | - Hao-Chien Cheng
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Shun-Hsi Tsai
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Wen-Hsien Sun
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
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Reduced Handgrip Strength in Hospital Admission Predicts Prolonged Hospital Stay and Death but Is Not Accurate to Identify Malnutrition: A Longitudinal Study of Reduced Handgrip Strength in Hospitalized Patients. JPEN J Parenter Enteral Nutr 2020; 45:1016-1022. [DOI: 10.1002/jpen.1976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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24
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Bohannon RW. Grip Strength: An Indispensable Biomarker For Older Adults. Clin Interv Aging 2019; 14:1681-1691. [PMID: 31631989 PMCID: PMC6778477 DOI: 10.2147/cia.s194543] [Citation(s) in RCA: 406] [Impact Index Per Article: 81.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/13/2019] [Indexed: 12/20/2022] Open
Abstract
Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator of concurrent overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multimorbidity, and quality of life. Evidence is also provided for a predictive link between grip strength and all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. Consequently, the routine use of grip strength can be recommended as a stand-alone measurement or as a component of a small battery of measurements for identifying older adults at risk of poor health status.
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Affiliation(s)
- Richard W Bohannon
- Department of Physical Therapy, Campbell University, Lillington, NC, USA
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25
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Smith L, Yang L, Hamer M. Handgrip strength, inflammatory markers, and mortality. Scand J Med Sci Sports 2019; 29:1190-1196. [PMID: 30972827 DOI: 10.1111/sms.13433] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/22/2019] [Accepted: 04/04/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate the extent to which inflammatory markers explain the association between handgrip strength and mortality. METHODS Analyses of data from The English Longitudinal Study of Ageing. Handgrip strength and inflammatory marker data (C-reactive protein and fibrinogen) were collected at baseline (2004/5) and inflammatory marker data at follow-up (2012/13). Participant data were linked with death records. General linear models were used to explore associations between handgrip strength and inflammatory markers at follow-up. Cox proportional hazards regression models were used to examine associations between grip strength and risk of death. Models were estimated with the covariates age, sex, wealth, physical activity, smoking, depressive symptoms, long-standing illness, and adiposity. RESULTS The sample comprised of 5,240 participants (mean age 65.9 (SD 9.4) years; 53.8% female). Over an average 9.7 ± 1.4 years follow-up, there were 650 deaths. Inverse associations were evident between handgrip strength and change in inflammatory markers in women only. There was an association between grip strength and lower risk of mortality in women (hazard ratio = 0.85; 95% CI, 0.74, 0.98) after adjusting for age and wealth. The association was attenuated after adjustment for clinical and behavioral risk factors (0.92; 0.79, 1.07), and further attenuated after adjusting for inflammatory markers (0.95; 0.82, 1.11). CONCLUSION Higher grip strength is associated with lower levels of inflammation at 8-year follow-up, and inflammatory markers partly explained the association between handgrip strength and mortality.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Lin Yang
- Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - Mark Hamer
- School Sport, Exercise Health Sciences, Loughborough University, Loughborough, UK
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