Malnutrition in Relation to Muscle Mass, Muscle Quality, and Muscle Strength in Hospitalized Older Adults

Abstract Obesity is associated with increased muscle mass and muscle strength. Methods taking into account the total body mass to reveal obese older individuals at increased risk of functional impairment are needed. Therefore, we aimed to detect methods to identify obese older adults at increased risk of functional impairment. Home-dwelling older adults (n 417, ≥ 70 years of age) were included in this cross-sectional study. Sex-specific cut-off points for two obesity phenotypes (waist circumference (WC) and body fat mass (FM %)) were used to divide women and men into obese and non-obese groups, and within-sex comparisons were performed. Obese women and men, classified by both phenotypes, had similar absolute handgrip strength (HGS) but lower relative HGS (HGS/total body mass) (P < 0·001) than non-obese women and men, respectively. Women with increased WC and FM %, and men with increased WC had higher appendicular skeletal muscle mass (P < 0·001), lower muscle quality (HGS/upper appendicular muscle mass) (P < 0·001), and spent longer time on the stair climb test and the repeated sit-to-stand test (P < 0·05) than non-obese women and men, respectively. Absolute muscle strength was not able to discriminate between obese and non-obese older adults. However, relative muscle strength in particular, but also muscle quality and physical performance tests, where the total body mass was taken into account or served as an extra load, identified obese older adults at increased risk of functional impairment. Prospective studies are needed to determine clinically relevant cut-off points for relative HGS in particular.

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Body composition associations with muscle strength in older adults living in Auckland, New Zealand

PLoS ONE ◽

10.1371/journal.pone.0250439 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0250439

Author(s):

Anne N. Hiol ◽

Pamela R. von Hurst ◽

Cathryn A. Conlon ◽

Owen Mugridge ◽

Kathryn L. Beck

Keyword(s):

Older Adults ◽

Body Composition ◽

Muscle Strength ◽

Grip Strength ◽

Muscle Mass ◽

Body Fat ◽

Muscle Quality ◽

Body Fat Percentage ◽

Fat Percentage ◽

Cross Sectional

Background Aging is associated with decreases in muscle strength and simultaneous changes in body composition, including decreases in muscle mass, muscle quality and increases in adiposity. Methods Adults (n = 369; 236 females) aged 65–74 years living independently were recruited from the cross-sectional Researching Eating Activity and Cognitive Health (REACH) study. Body fat percentage and appendicular skeletal muscle mass (ASM) (sum of lean mass in the arms and legs) were assessed using Dual-energy X-ray Absorptiometry (Hologic, QDR Discovery A). The ASM index was calculated by ASM (kilograms) divided by height (meters) squared. Isometric grip strength was measured using a hand grip strength dynamometer (JAMAR HAND). Results Linear regression analyses revealed that muscle strength was positively associated with the ASM index (R2 = 0.431, p < 0.001). When exploring associations between muscle strength and muscle mass according to obesity classifications (obesity ≥30% males; ≥40% females), muscle mass was a significant predictor of muscle strength in non-obese participants. However, in participants with obesity, muscle mass was no longer a significant predictor of muscle strength. Conclusions Body fat percentage should be considered when measuring associations between muscle mass and muscle strength in older adults.

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A rapid point-of-care ultrasound marker for muscle mass and muscle strength in older adults

Age and Ageing ◽

10.1093/ageing/afaa163 ◽

2020 ◽

Author(s):

Kenneth M Madden ◽

Boris Feldman ◽

Shane Arishenkoff ◽

Graydon S Meneilly

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Grip Strength ◽

Muscle Mass ◽

Gait Speed ◽

Point Of Care ◽

Geriatric Medicine ◽

Muscle Thickness ◽

Muscle Quality ◽

Point Of Care Ultrasound

Abstract Background/Objectives Sarcopenia is defined as the gradual age-associated loss of both muscle quantity and strength in older adults, and is associated with increased mortality, falls, fractures and hospitalisations. Current sarcopenia criteria use dual-energy X-ray absorptiometry (DXA) measures of muscle mass, a test that cannot be performed at the bedside, unlike point-of-care ultrasound (PoCUS). We examined the association between ultrasonic measures of muscle thickness (MT, vastus medialis muscle thickness) and measures of muscle quantity and strength in older adults. Methods A total of 150 older adults (age ≥ 65; mean age 80.0 ± 0.5 years, 66 women, 84 men) were recruited sequentially from geriatric medicine clinics. Each subject had lean body mass (LBM, by bioimpedance assay), grip strength, mid-arm biceps circumference (MABC), gait speed and MT measured. All initial models were adjusted for biological sex. Results In our final parsimonious models, MT showed a strong significant correlation with all measures of muscle mass, including LBM (Standardised β = 0.204 ± 0.058, R2 = 0.577, P < 0.001) and MABC (Standardised β = 0.141 ± 0.067, R2 = 0.417, P = 0.038). With respect to measures of muscle quality, there was a strong significant correlation with grip strength (Standardised β = 0.118 ± 0.115, R2 = 0.511, P < 0.001) but not with subject performance (gait speed). Conclusions MT showed strong correlations with both measures of muscle mass (LBM and MABC) and with muscle strength (grip strength). Although more work needs to be done, PoCUS shows potential as a screening tool for sarcopenia in older adults.

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Longitudinal Changes in Muscle Mass, Muscle Strength, and Physical Performance in Acutely Hospitalized Older Adults

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.12.006 ◽

2021 ◽

Author(s):

Jesse J. Aarden ◽

Esmee M. Reijnierse ◽

Marike van der Schaaf ◽

Martin van der Esch ◽

Lucienne A. Reichardt ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance ◽

Longitudinal Changes ◽

Hospitalized Older Adults

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ESTIMATION OF APPENDICULAR MUSCLE MASS IN HOSPITALIZED OLDER ADULTS USING BIOELECTRICAL IMPEDANCE

Innovation in Aging ◽

10.1093/geroni/igx004.455 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 109-109

Author(s):

R.R. Deer ◽

L. Akhverdiyeva ◽

E. Volpi

Keyword(s):

Older Adults ◽

Muscle Mass ◽

Bioelectrical Impedance ◽

Hospitalized Older Adults ◽

Appendicular Muscle Mass

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Muscle strength: A better index of low physical performance than muscle mass in older adults

Geriatrics and Gerontology International ◽

10.1111/ggi.12514 ◽

2015 ◽

Vol 16 (5) ◽

pp. 577-585 ◽

Cited By ~ 26

Author(s):

Yeo Hyung Kim ◽

Kwang-Il Kim ◽

Nam-Jong Paik ◽

Ki-Woong Kim ◽

Hak Chul Jang ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Physical Performance

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Prevalence of sarcopenia in community-dwelling older adults using the definition of the European Working Group on Sarcopenia in Older People 2: findings from the Korean Frailty and Aging Cohort Study

Age and Ageing ◽

10.1093/ageing/afz091 ◽

2019 ◽

Vol 48 (6) ◽

pp. 910-916 ◽

Cited By ~ 22

Author(s):

Miji Kim ◽

Chang Won Won

Keyword(s):

Older Adults ◽

Cohort Study ◽

Muscle Strength ◽

Older People ◽

Muscle Mass ◽

Working Group ◽

Community Dwelling ◽

European Working ◽

Definition Of ◽

Community Dwelling Older Adults

Abstract Background in October 2018, the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) updated their original definition of sarcopenia to reflect the scientific and clinical evidence that has accumulated over the last decade. Objective to determine the prevalence of sarcopenia in a large group of community-dwelling older adults using the EWGSOP2 definition and algorithm. Design a cross-sectional study. Setting the nationwide Korean Frailty and Aging Cohort Study (KFACS). Subjects a total of 2,099 ambulatory community-dwelling older adults, aged 70–84 years (mean age, 75.9 ± 4.0 years; 49.8% women) who were enrolled in the KFACS. Methods physical function was assessed by handgrip strength, usual gait speed, the five-times-sit-to-stand test, the timed up-and-go test, and the Short Physical Performance Battery. Appendicular skeletal muscle mass (ASM) was measured by dual-energy X-ray absorptiometry. Results according to the criteria of the EWGSOP2, the sarcopenia indicators of combined low muscle strength and low muscle quantity were present in 4.6–14.5% of men and 6.7–14.4% of women. The severe sarcopenia indicators of combined low muscle strength, low muscle quantity and low physical performance were present in 0.3–2.2% of men and 0.2–6.2% of women. Using the clinical algorithm with SARC-F as a screening tool, the prevalence of probable sarcopenia (2.2%), confirmed sarcopenia (1.4%) and severe sarcopenia (0.8%) was low. Conclusions the prevalence of sarcopenia among community-dwelling older individuals varied depending on which components of the revised EWGSOP2 definition were used, such as the tools used to measure muscle strength and the ASM indicators for low muscle mass.

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Lower limb muscle mass is associated with insulin resistance more than lower limb muscle strength in non‐diabetic older adults

Geriatrics and Gerontology International ◽

10.1111/ggi.13805 ◽

2019 ◽

Vol 19 (12) ◽

pp. 1254-1259

Author(s):

Toshiaki Seko ◽

Hiroshi Akasaka ◽

Masayuki Koyama ◽

Nobuaki Himuro ◽

Shigeyuki Saitoh ◽

...

Keyword(s):

Insulin Resistance ◽

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Lower Limb ◽

Lower Limb Muscle ◽

Limb Muscle

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Effects of vibration therapy on muscle mass, muscle strength and physical function in older adults with sarcopenia: a systematic review and meta-analysis

European Review of Aging and Physical Activity ◽

10.1186/s11556-020-00247-5 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Shuang Wu ◽

Hong-Ting Ning ◽

Su-Mei Xiao ◽

Ming-Yue Hu ◽

Xin-Yin Wu ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Muscle Strength ◽

Physical Function ◽

Muscle Mass ◽

Meta Analysis ◽

Whole Body Vibration ◽

Whole Body ◽

Local Vibration ◽

Vibration Therapy

Abstract Background Sarcopenia, a progressive loss of muscle mass and function with advancing age, is a prevalent condition among older adults. As most older people are too frail to do intensive exercise and vibration therapy has low risk and ease of participation, it may be more readily accepted by elderly individuals. However, it remains unclear whether vibration therapy would be effective among older adults with sarcopenia. This systematic review and meta-analysis examined the effect of vibration therapy including local vibration therapy and whole-body vibration therapy, for enhancing muscle mass, muscle strength and physical function in older people with sarcopenia. Methods A systematic literature search was conducted in March 2019 in the following 5 electronic databases: PubMed, CINAHL, Embase, PEDro, and the Cochrane Central Register of Controlled Trials, with no restriction of language or the year of publication. Randomized controlled trials and quasi-experimental studies examining effects of vibration therapy on muscle mass, muscle strength or physical function in older adults with sarcopenia were included in this systematic review. Two reviewers independently assessed the methodological quality of the selected studies. Results Of the 1972 identified studies, seven publications from six studies involving 223 participants were included in this systematic review. Five of them conducted whole-body vibration therapy, while two conducted local vibration therapy. A meta-analysis of randomized controlled studies indicated that muscle strength significantly increased after whole-body vibration therapy (SMD 0.69, 95% CI 0.28 to 1.11, I2 = 0%, P = 0.001) and local vibration therapy (SMD 3.78, 95% CI 2.29 to 5.28, P < 0.001). Physical performance measured by the sit-to-stand test and the timed-up-and-go test were significantly improved after the intervention (SMD -0.79, 95% CI − 1.21 to − 0.37, I2 = 0%, P < 0.001) and SMD -0.83, 95% CI − 1.56 to − 0.11, I2 = 64%, P = 0.02, respectively). Conclusion Vibration therapy could be a prospective strategy for improving muscle strength and physical performance in older adults with sarcopenia. However, due to the limited number of the included studies, caution is needed when interpreting these results. More well-designed, large sample size studies should be conducted to further explore and validate the benefits of vibration therapy for this population.

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