Lean mass, grip strength, and hospital‐associated disability among older adults in Health ABC

Abstract Background Half of all physical disability, including activity of daily living (ADL) disability, among older adults occurs in the setting of hospitalization. This study examines whether appendicular lean mass (ALM) and grip strength, which are commonly included in various definitions of sarcopenia, are associated with development of hospital-associated ADL disability in older adults in the Health ABC Study. Methods Individuals hospitalized during the first 5 years of follow-up (n=1,724) were analyzed. ALM to body mass index (BMI) ratio (ALMBMI), by dual energy x-ray absorptiometry (DXA), and grip strength, by hand-held dynamometery, were assessed annually. Development of new ADL disability was assessed at the time of the next annual assessment after hospitalization. Separate regression analyses modeled the association of pre-hospitalization ALMBMI or grip strength with death before the next scheduled annual assessment. Next, among those who survived to the next annual assessment, separate regression analyses modeled the association of ALMBMI or grip strength with development of ADL disability. Results Each standard deviation decrement in pre-hospitalization grip strength was associated with an adjusted 1.80 odds of new ADL disability at follow-up (95% CI: 1.18, 2.74). Low, compared to not low, grip strength (per FNIH definition) was associated with an adjusted 2.36 odds of ADL disability at follow-up (95% CI: 1.12, 4.97). ALM measures were not associated with development of hospital-associated ADL disability. ALM and grip strength measures were not associated with death. Conclusions Pre-hospitalization lower grip strength may be an important risk factor for ADL disability among older adult survivors of hospitalization.

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Physical Activity in Aging Population

European Journal of Interdisciplinary Studies ◽

10.26417/ejis.v5i3.p74-80 ◽

2019 ◽

Vol 5 (3) ◽

pp. 74

Author(s):

Rezarta Stena ◽

Klara Hysenaj ◽

Mitilda Gugu Karoli ◽

Armelda Teta ◽

Gjergji Doka

Keyword(s):

Physical Activity ◽

Older Adults ◽

Heart Rate ◽

Pain Intensity ◽

Range Of Motion ◽

Training Program ◽

Grip Strength ◽

Upper Limb ◽

Hand Grip ◽

Trunk Flexibility

It is known that worldwide populations are aging, and also that physical activity can play an important role in minimizing impairments characteristic of old age. Adopting a more active lifestyle and doing regular physical activity, including aerobic and resistance exercises, daily walking etc. have been demonstrated to improve cardiovascular, respiratory, and musculoskeletal parameters in older adults. We assessed a potential participant from Elbasan (Albania), 67 years, for eligibility to participate in a 5 month training program. The subject gave written informed consent before inclusion.The following parameters were measured at the beginning (baseline) and end of the training period: BMI, body fat percentage, hand grip strength, lower/upper limb and trunk flexibility and range of motion, heart rate, balance, pain intensity, as well as VO2 max, directly and/or an estimate using the Rockport fitness test estimate. An initial evaluation was carried out just before starting the training (baseline). A second evaluation was made 5 months after starting the program of physical exercise (post training). Each evaluation included the recording of health related events, such as any changes in previous symptoms, as well as measurements of balance, flexibility, body composition, coordination, muscle strength, and aerobic capacity, to detect any changes that might have been induced specifically by physical activity. The subject’s attendance and participation in the program was also recorded. Range of motion for each part evaluated (trunk, hip, cervical region and shoulder) is improved about 15-20° degree. BMI, hand grip strength, lower/upper limb and trunk flexibility, heart rate, balance, pain intensity, VO2 max are also improved after training program. Following a training program or a regular physical activity in older adults minimise impairments characteristics in this age and cardiovascular, respiratory, and musculoskeletal parameters. According to the low importance shown in my country for the physical activity in older adults, I want to emphasize the importance of state structures involvement and the sensibilization of this group of age to stimulate an actively participation in physical training programs followed by professionals for bests life parameters. A higher investment for this age group, building as many facilities as possible for activation and spending quality free time, hiring more physiotherapists in nursing homes will increase life motivation and improve the quality and the parameters of living.

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Faculty Opinions recommendation of Efficacy of whey protein supplementation on resistance exercise-induced changes in lean mass, muscle strength, and physical function in mobility-limited older adults.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717968146.793467953 ◽

2012 ◽

Author(s):

Thomas Lang

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Resistance Exercise ◽

Physical Function ◽

Whey Protein ◽

Lean Mass ◽

Protein Supplementation ◽

Exercise Induced ◽

Induced Changes

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Multidimensional Sleep Health and Physical Functioning in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1382 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 428-428

Author(s):

Caitlan Tighe ◽

Ryan Brindle ◽

Sarah Stahl ◽

Meredith Wallace ◽

Adam Bramoweth ◽

...

Keyword(s):

Older Adults ◽

Lower Extremity ◽

Grip Strength ◽

Physical Functioning ◽

Gait Speed ◽

The United States ◽

Depression Symptoms ◽

Sleep Health ◽

Lower Extremity Strength ◽

Sleep Parameters

Abstract Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.

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165 Sex differences in the relationship between self-reported sleep quality and frailty in South Florida older adult outpatients

SLEEP ◽

10.1093/sleep/zsab072.164 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A67-A67

Author(s):

Sonya Kaur ◽

Katalina McInerney ◽

Mitchell Slugh ◽

Annelly Bure ◽

Marina Sarno ◽

...

Keyword(s):

Older Adults ◽

Sex Differences ◽

Sleep Quality ◽

Grip Strength ◽

Brain Research ◽

Functional Independence ◽

South Florida ◽

Left Hand ◽

Depression Status ◽

The Relationship

Abstract Introduction Frailty, a multidimensional construct of decreased reserve is an important predictor of functional independence and quality of life in older adults. There is a growing body of evidence highlighting reduced sleep efficiency and sleep duration predicts frailty in older adults. However, the sex differences in these relationships have been understudied. Methods 253 participants (163) ranging in age from 50-92 years (mean= 67.59 years, S.D.= 9.22 years), underwent frailty assessment and completed the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical moderation was assessed using nonparametric bootstrapping. All models statistically controlled for age, education and depression status. Results Higher scores on the PSQI predicted higher levels of fatigue (β=1.87, 95% CI= 0.48-3.27) and higher grip strength with the left hand (β= 0.81, 95% CI= 0.85-1.53). These relationships were significantly moderated by sex (β=-0.77, p=0.05 & β=-0.52, p=0.01). Specifically, high scores on the PSQI predicted more fatigue stronger grip strength in men (β=1.11, 95% CI=0.41-1.81) and weaker grip strength in women (β=-0.25, 95% CI=-0.51--0.02). There was no association between scores on the ESS and any of the frailty measures. Conclusion The relationships between PSQI scores and measures of fatigue and grip strength were statistically moderated by sex. These differences are not explained by sex differences in overall sleep quality or baseline frailty. This is consistent with the literature emphasizing sex differences in the effects of risk/lifestyle factors. It is possible that the relationship between sleep quality and frailty is altered by additional hormonal factors and warrant further investigation. Support (if any) This research was supported by the Evelyn F. McKnight Brain Research Foundation

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Type 2 Diabetes Reduces the Muscle Anabolic Effect of Resistance Exercise Training in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1706 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 529-529

Author(s):

Amanda Randolph ◽

Tatiana Moro ◽

Adetutu Odejimi ◽

Blake Rasmussen ◽

Elena Volpi

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Muscle Strength ◽

Exercise Training ◽

Resistance Exercise ◽

Lean Mass ◽

Synthesis Rate ◽

Resistance Exercise Training ◽

Appendicular Lean Mass

Abstract Type 2 Diabetes Mellitus (T2DM) accelerates the incidence and increases the prevalence of sarcopenia in older adults. This suggests an urgent need for identifying effective sarcopenia treatments for older adults with T2DM. It is unknown whether traditional approaches, such as progressive resistance exercise training (PRET), can effectively counteract sarcopenia in older patients with T2DM. To test the efficacy of PRET for the treatment of sarcopenia in older adults with T2DM, 30 subjects (15 T2DM and 15 age- and sex- matched controls) underwent metabolic testing with muscle biopsies before and after a 13-week full-body PRET program. Primary outcome measures included changes in appendicular lean mass, muscle strength, and mixed muscle fractional synthesis rate (FSR). Before PRET, BMI-adjusted appendicular lean mass was significantly lower in the T2DM group (0.7095±0.0381 versus 0.8151±0.0439, p<0.0001). As a result of PRET, appendicular lean mass adjusted for BMI and muscle strength increased significantly in both groups, but to a lesser extent for the T2DM group (p=0.0009) . Preliminary results for FSR (n=25) indicate that subjects with T2DM had lower basal FSR prior to PRET (p=0.0197) . Basal FSR increased significantly in the control group after PRET (p=0.0196), while it did not change in the T2DM group (p=0.3537). These results suggest that in older adults the positive effect of PRET on muscle anabolism and strength is reduced by T2DM . Thus, older adults with T2DM may require more intensive, multimodal and targeted sarcopenia treatment. Funded by NIH R01AG049611 and P30AG024832.

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Prospective associations of plasma growth differentiation factor 15 with physical performance and cognitive functions in older adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glac020 ◽

2022 ◽

Author(s):

Lingxiao He ◽

Philipe de Souto Barreto ◽

Juan Luis Sánchez Sánchez ◽

Yves Rolland ◽

Sophie Guyonnet ◽

...

Keyword(s):

Older Adults ◽

Grip Strength ◽

Physical Performance ◽

Cognitive Functions ◽

Community Dwelling ◽

Cognitive Score ◽

Growth Differentiation Factor 15 ◽

Clinically Significant ◽

One Year ◽

Community Dwelling Older Adults

Abstract Background Growth differentiation factor 15 (GDF15) has been associated with several age-related disorders, but its associations with functional abilities in community-dwelling older adults are not well studied. Methods The study was a secondary analysis on 1096 community-dwelling older adults (aged 69 to 94 years) recruited from the Multidomain Alzheimer’s Preventive Trial. Plasma GDF15 was measured one year after participants’ enrolment. Annual data of physical performance (grip strength and short physical performance battery [SPPB]) and global cognitive functions (mini-mental state examination [MMSE] and a composite cognitive score) were measured for four years. Adjusted mixed-effects linear models were performed for cross-sectional and longitudinal association analyses. Results A higher GDF15 was cross-sectionally associated with a weaker grip strength (β = -1.1E-03, 95%CI [-2.0E-03, -1.5E-04]), a lower SPPB score (β = -3.1E-04, 95%CI [-5.4E-04, -9.0E-05]) and worse cognitive functions (β = -2.4E-04, 95%CI [-3.3E-04, -1.6E-04] for composite cognitive score; β = -4.0E-04, 95%CI [-6.4E-04, -1.6E-04] for MMSE). Participants with higher GDF15 demonstrated greater longitudinal declines in SPPB (β = -1.0E-04, 95%CI [-1.7E-04, -2.0E-05]) and composite cognitive score (β = -2.0E-05, 95%CI [-4.0E-05, -3.6E-06]). The optimal initial GDF15 cutoff values for identifying participants with minimal clinically significant decline after one year were 2189 pg/mL for SPPB (AUC: 0.580) and 2330 pg/mL for composite cognitive score (AUC: 0.587). Conclusions Plasma GDF15 is cross-sectionally and longitudinally associated with lower-limb physical performance and global cognitive function in older adults. Circulating GDF15 alone has limited capacity of discriminating older adults who will develop clinically significant functional declines.

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Whey protein and vitamin D supplementation in institutionalized older adults: A randomized trial

Nutrition and Health ◽

10.1177/02601060211060665 ◽

2021 ◽

pp. 026010602110606

Author(s):

Tamy Colonetti ◽

Antônio Jose Grande ◽

Franciani Rodrigues da Rocha ◽

Eduardo Ronconi Dondossola ◽

Lisiane Tuon ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Body Composition ◽

Resistance Training ◽

Whey Protein ◽

Muscle Mass ◽

Lean Mass ◽

Vitamin D Supplementation ◽

Relative Index ◽

And Control

Background: The increase in life expectancy and in the number of individuals over 60 years old brings new demands to health professionals and services based on the physiological changes that occur in this population. The aging process results in changes in body composition, increasing body fat and reducing muscle mass, in addition to a reduction in bone mass. Aim: The aim of this study was to examine the effect of whey protein and vitamin D supplementation on body composition and skeletal muscle in older adults living in long-term care facilities. Methods: This study is a double-blind randomized controlled trial. Thirty older adults (>60 years old) were randomized and allocated in three groups: group receiving resistance training and supplementation receiving resistance training, whey protein and vitamin D; group received resistance and placebo training receiving resistance training and placebo, and control group without any intervention. Body composition was measured by dual-energy X-ray absorptiometry at baseline, 12 weeks, and 24 weeks. Results: The mean age was 74.87 (± 8.14) years. A significant difference ( p = 0.042) was observed between the group receiving resistance training and supplementation and control groups in relation to lean mass increase (kg) at 24 weeks. After 24 weeks of intervention, there was a significant increase in Relative index of muscle mass for the two groups that underwent resistance training, group received resistance and placebo training ( p = 0.042) and group receiving resistance training and supplementation ( p = 0.045), in relation to the control. Conclusion: Combined supplementation of whey protein and vitamin D with resistance training can significantly improve lean mass, total mass, and relative index of muscle mass in institutionalized older adults.

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