Knee extension strength and handgrip strength are important predictors of Timed Up and Go test performance among community-dwelling elderly women: a cross-sectional study

BACKGROUND

Handgrip and knee extension strengths have each been used to characterize disability. However, it has been reported that the association between handgrip and knee extension strengths is weak.

OBJECTIVE

To evaluate the influence of knee extensor and handgrip muscle strength on Timed Up and Go (TUG) test results among elderly women with worse (≥ 10 seconds) and better (< 10 seconds) performance, after controlling for confounders.

DATA AND SETTING

Cross-sectional study on a sample selected according to convenience, carried out in a federal public institution of higher education.

METHODS

Assessment of handgrip was carried out using the Jamar dynamometer (Lafayette Instrument Company, Inc., Lafayette, United States). Knee extensor muscle performance was measured using an isokinetic dynamometer (Biodex System 3 Pro; Biodex Medical Systems, Inc., United States), The confounding factors were education, age, comorbidities, body mass index and Geriatric Depression Scale and Human Activity Profile scores. Functional performance was assessed through the TUG test. A backward linear regression model was used.

RESULTS

127 elderly women performed the TUG test in more than 10 seconds and 93 in less than 10 seconds. However, regardless of test performance, handgrip strength and knee extension strength comprised the reduced final model.

CONCLUSIONS

Knee extension strength and handgrip strength might be particularly useful indicators for measuring disability.

Biopsychosocial factors associated with disability in older adults with acute low back pain: BACE-Brasil study

This cross-sectional study evaluated the association of biopsychosocial factors with disability in older adults with a new episode of acute low back pain. Older patients with a new episode of acute low back pain were included and those with cognitive alterations and severe motor impairment were excluded. Disability was assessed using the Roland Morris Disability Questionnaire. The biopsychosocial factors (clinical, functional, health status, psychological and social variables) were evaluated by a structured multidimensional questionnaire and physical examination. A multivariate linear regression was used to analyze data with a statistical significance of 0.05. A total of 386 older individuals with a mean age of 71.6 (± 4.2) years and disability of 13.7 (± 5.7) points were enrolled. Our regression analyses identified that worse physical and mental health (assessed through SF-36), low falls self-efficacy, trouble sleeping due to pain, worse kinesiophobia levels, higher body mass indexes, lumbar morning stiffness, increased pain intensity, female gender and worse functional mobility were significantly associated with baseline disability (p < 0.05). Low back pain-related disability is significantly associated with worse biopsychosocial health conditions in older adults.

Handgrip strength is associated with, but poorly predicts, disability in older women with acute low back pain: A 12-month follow-up study

BACKGROUND

Older women with low back pain (LBP) constitute a special subpopulation at risk of severe and permanent disability. It is important to identify factors limiting functionality in this population in order to reduce costs and improve both prevention and intervention. Handgrip strength (HGS) is a biomarker of aging associated with several adverse health outcomes, but long-term associations with disability in older patients with LBP are not known.

OBJECTIVE

To examine whether HGS predicts disability in older women with acute low back pain (LBP).

METHODS

Longitudinal analyses were conducted with a sample of 135 older women from the international multicenter study Back Complaints in the Elders (BACE-Brazil). Women aged 60 years and over with a new episode of acute LBP were included. HGS was assessed with Jamar^® dynamometer, and disability was assessed using the Roland Morris questionnaire and gait speed test. Variables were assessed at baseline and at 12-month follow-up. Linear regression models explored associations between HGS and disability measures.

RESULTS

Significant association was found between HGS at baseline and gait speed at 12-month follow-up (r=-0.24; p=0.004). A multivariable-adjusted model showed that this association was independent of age, body mass index, and pain intensity (adjusted R²=0.13; p<0.001). A final prediction model showed an incremental difference of only 2.1% in gait speed after inclusion of HGS as an independent variable. No association was found between HGS and score on the Roland Morris questionnaire.

CONCLUSION

Caution is needed regarding the use of HGS as a predictive measure of disability in older women with acute LBP. Changes in gait speed were very small and unlikely to be of clinical relevance.

Brain-derived neurotrophic factor plasma levels are increased in older women after an acute episode of low back pain

BACKGROUND

Low back pain (LBP) is a growing public health problem in old age, and it is associated with disabling pain and depressive disorders. We compared brain-derived neurotrophic factor (BDNF) plasma levels, a key neurotrophin in pain modulation, between older women after an acute episode of LBP and age-matched pain-free controls, and investigated potential differences in BDNF levels between controls and LBP subgroups based on pain severity, presence of depressive symptoms and use of analgesic and antidepressant drugs.

METHODS

A total of 221 participants (154 with LBP and 67 pain-free) were studied. A comprehensive assessment of sociodemographic and clinical variables was conducted including pain severity (11-point NRS), depressive symptoms (GDS-15), age, body mass index, physical activity and total number of comorbidities and medications in use.

RESULTS

BDNF levels in LBP group were significantly higher than controls (7515.9±3021.2; Md=7116.0 vs 6331.8±3364.0; Md=5897.5pg/mL, P=0.005). LBP subgroups exhibited higher BDNF levels than controls, regardless of pain severity, presence of depressive symptoms and use of analgesic drugs. BDNF levels were significantly higher in LBP subgroup without use of antidepressant drugs compared to both controls and LBP subgroup with use of antidepressant drugs.

DISCUSSION

This study provides evidence that older women with acute low back pain exhibit higher BDNF plasma levels compared to pain-free controls. Subgroup comparisons suggest that use of pain-relief drugs may influence BDNF levels. The study results offer a novel target for research on mechanisms of back pain in older adults.

ADAPTAÇÃO TRANSCULTURAL E CONFIABILIDADE DO ACTIVE AUSTRALIA QUESTIONNAIRE PARA IDOSOS

RESUMO Introdução: A atividade física é um importante parâmetro a ser quantificado em idosos. São necessários instrumentos de medida confiáveis para avaliar e elaborar metas de intervenções terapêuticas efetivas e verificar a evolução do paciente. Objetivo: Adaptar transculturalmente e determinar a confiabilidade teste-reteste e interexaminadores do Active Australia Questionnaire em idosos da comunidade. Métodos: A adaptação transcultural foi realizada de acordo com os critérios propostos por Guillemin e Beaton, a saber, tradução, retrotradução, síntese das traduções, apresentação ao comitê de especialistas e aplicação da versão pré-final para testar o questionário. Para a confiabilidade teste-reteste foi dado um intervalo de quatro horas para as coletas e um intervalo de seis horas para a análise interexaminador, após o reteste. Foram consideradas as informações de atividade física nos últimos sete dias. A caracterização da amostra foi feita pela análise descritiva. Para a análise da confiabilidade utilizou-se o coeficiente de correlação intraclasse (CCI). Participaram do estudo 22 idosos (72,5 ± 5,3 anos) e com 7,6 ± 3,9 anos de escolaridade. Resultados: A confiabilidade teste-reteste foi CCI = 0,97 e interexaminadores CCI = 0,82. Conclusão: O instrumento mostrou-se semântica e linguisticamente adequado e confiável, para avaliar o nível de atividade física em idosos na comunidade.

Psychometric properties of the Brazilian version of the Pain Catastrophizing Scale for acute low back pain

Measurement instruments of pain catastrophizing for middle-aged and elderly individuals are needed to understand its impact on low back pain. The goals were to cross-culturally adapt the Pain Catastrophizing Scale, assess the construct validity through Rasch analysis, and verify reliability and convergent validity of pain catastrophizing with psychosocial factors. 131 individuals aged 55 years and older with acute low back pain were interviewed . The intra-rater reliability was Kp = 0.80 and interrater Kp = 0.75. The Rasch analysis found adequate reliability coefficients (0.95 for items and 0.90 for individuals ). The separation index for the elderly was 2.95 and 4.59 items. Of the 13 items, one did not fit the model, which was justified in the sample evaluated. The pain catastrophizing correlated with most psychosocial factors. The instrument proved to be clinically useful. Subsequent studies should carry out the same analysis in different populations.

Prevalência de sarcopenia em idosos: resultados de estudos transversais amplos em diferentes países

ResumoA sarcopenia caracteriza-se pela perda generalizada e progressiva da força e massa muscular esquelética com o envelhecimento. Com o aumento da população idosa em ritmo acelerado em todo o mundo, torna-se necessário o maior entendimento dos fenômenos associados ao processo de envelhecimento. Portanto, descrever a frequência e distribuição desses fenômenos, tal como a sarcopenia, é um passo fundamental para se conhecer os componentes atrelados a sua ocorrência e promover a assistência à saúde direcionada ao idoso. O objetivo desta revisão de literatura foi apresentar a síntese dos resultados de estudos epidemiológicos de base populacional sobre a prevalência de sarcopenia em idosos da comunidade, mostrando também as características sociodemográficas das populações estudadas e a diferença dos resultados entre os sexos. Os resultados de seis estudos transversais, entre os anos 2002 e 2014, provenientes dos seguintes países: Estados Unidos, Reino Unido, Brasil, Japão, Coreia do Sul e Taiwan, foram apresentados. Verificou-se neles que a sarcopenia tem alta prevalência na população a partir dos 60 anos de idade, em ambos os sexos, sendo mais alta nas mulheres em cinco dos seis trabalhos. O Japão foi o país que apresentou as maiores taxas de prevalência, seguido pelo Brasil. A sarcopenia aumentou com a idade em todos os estudos e esteve associada com várias adversidades. A dificuldade em se estabelecer uma avaliação padronizada para sarcopenia, sobretudo pelas peculiaridades de cada população, constitui um importante fator a ser analisado na leitura de estudos de prevalência sobre essa síndrome.

TNF-α, IL6, and IL10 polymorphisms and the effect of physical exercise on inflammatory parameters and physical performance in elderly women

High levels of inflammatory mediators are associated with reduced physical capabilities and muscle function in the elderly. Single nucleotide polymorphisms (SNPs) may affect the expression and synthesis of these molecules, thus influencing the intensity of the inflammatory response and susceptibility to certain diseases. Physical exercise may attenuate age-related chronic inflammation and improve physical performance. This study evaluated the interaction between the SNP rs1800629 in TNF-α, rs1800795 in IL6, and rs1800896 in IL10 and the effect of physical exercise on physical performance and inflammation in elderly women. There was a significant interaction between rs1800629 and the effect of exercise on physical performance and between the combined 3-SNP genotype and changes in physical performance in response to exercise. These SNPs did not influence the effect of exercise on inflammatory parameters. Elderly women with a combination of genotypes associated with an anti-inflammatory profile (low TNF-α and IL-6 production, high IL-10 production) showed better physical performance independent of exercise modality, evidence of an interactive influence of genetic and environmental factors on improving physical performance in elderly women.

Desempenho muscular, dor, rigidez e funcionalidade de idosas com osteoartrite de joelho

OBJETIVO: Verificar a correlação do desempenho dos músculos do joelho e os domínios dor, rigidez e funcionalidade do Questionário Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) de idosas com osteoartrite de joelho (OA). MÉTODOS: Estudo transversal observacional com uma amostra de 80 idosas (71,2 ± 5,3 anos) com diagnóstico clínico de OA de joelho. Força, resistência e equilíbrio musculares foram avaliados por meio do dinamômetro isocinético Biodex System 3 Pro, nas velocidades angulares de 60º/s e 180º/s; a funcionalidade, presença de dor e rigidez foram avaliadas pelo questionário WOMAC. A correlação entre as variáveis foi analisada pelo teste de Spearman. RESULTADOS: Houve correlação inversa significativa da força e resistência musculares do quadríceps (QUA) e isquiossurais (IQS) nas velocidades de 60º/s e 180°/s, respectivamente, e da relação de equilíbrio muscular IQS/QUA a 180°/s com todos os domínios do WOMAC (p<0.05). CONCLUSÕES: A redução da força e da resistência e a presença de desequilíbrio dos músculos do joelho correlacionaram-se inversamente com todos os domínios do WOMAC, apontando para a necessidade de intervenções que envolvam um trabalho de fortalecimento, resistência e equilíbrio muscular de extensores e flexores de joelho, visando a redução do impacto da OA na dor, rigidez e funcionalidade do idoso. Nivel de Evidência I, Estudos diagnósticos, Investigação de um exame para diagnóstico.

Interleukin-6 plasma levels and socioeconomic status in Brazilian elderly community-dwelling women

Aging is related to a chronic increase in inflammatory cytokines. Adverse socioeconomic conditions are associated with increased plasma levels of these molecules, especially interleukin (IL)-6. Considering the differential profile of elderly Brazilians regarding their socioeconomic and cultural aspects, the objectives of this study were: to assess the correlation and differences between levels of IL-6 and socioeconomic status (education and income) in elderly women. IL-6 levels were measured using ELISA. The Spearman test was used to determine the correlation between IL-6 and socioeconomic status, and the Kruskal-Wallis and Mann-Whitney tests for cytokine level differences across education and income. IL-6 showed a significant inverse correlation with education (r = -0.205, p = 0.014) and income (r = -0.185, p = 0.028). Differences in IL-6 levels were registered across the education variables. The results corroborate evidence that low socioeconomic status is related to higher IL-6 plasma levels in elderly women.