Prevalence of low muscle mass and associated factors in community-dwelling older adults in Singapore

AbstractThe population is rapidly aging worldwide, and there is an age-related decline in muscle mass. Therefore, it is important to examine the prevalence and associated factors of low appendicular skeletal muscle mass index (ASMI) in older adults. The objectives of this cross-sectional study were (i) to determine the prevalence of low ASMI (ASM/height2) and (ii) to identify factors associated with low ASMI. This study included 1211 community-dwelling adults aged ≥ 65 years. Low ASMI was defined as < 7.0 kg/m2 in males and < 5.7 kg/m2 in females (bioelectrical impedance analysis). Gender-specific cut-off values of calf circumference for low ASMI were determined. The prevalence of low ASMI in the overall cohort was 59.9%, i.e., 57.0% among males and 61.8% among females, with no significant difference between genders (P = 0.1068). The prevalence of low ASMI was 81.3% in individuals at risk of malnutrition compared to 20.6% in their counterparts with normal nutritional status (P < 0.0001). Participants with low ASMI were older, had lower physical activity scores, and greater likelihood of hospitalization in prior 6 months compared with normal ASMI (all P < 0.0001). Low ASMI was associated with risk of malnutrition (odds ratio: 3.58 for medium risk, odds ratio: 12.50 for high risk), older age, smoking, drinking, smaller calf circumference, and lower bone mass (all P ≤ 0.0328). Cut-off values of calf circumference for low ASMI for males was 33.4 cm and for females was 32.2 cm. In conclusion, we found that low ASMI was highly prevalent among community-dwelling older adults at risk of malnutrition. Other significant factors associated with low ASMI were age, smoking, drinking, calf circumference, and bone mass. Screening community-dwelling older adults for risk of malnutrition can prevent or delay onset of low ASMI.

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Impact of Malnutrition on Low Muscle Mass in Community-Dwelling Older People in Singapore: Findings from the SHIELD study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_080 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 80-80

Author(s):

Siew Ling Tey ◽

Samuel Teong Huang Chew ◽

Yatin Berde ◽

Geraldine Baggs ◽

Choon How How ◽

...

Keyword(s):

At Risk ◽

Nutritional Status ◽

Bone Mass ◽

Older People ◽

Muscle Mass ◽

Community Dwelling ◽

Risk Category ◽

Calf Circumference ◽

Factors Associated ◽

Community Dwelling Older People

Abstract Objectives Malnutrition contributes to loss of muscle mass. There is limited information on the prevalence of low muscle mass in community-dwelling older people who are (not) at risk of malnutrition. Factors associated with muscle mass are also not well characterized. This cross-sectional study aimed to determine the prevalence of low appendicular skeletal muscle mass index (ASMI; ASM/height2) in older people with normal nutritional status (Malnutrition Universal Screening Tool, MUST risk category = low) and those at risk of malnutrition (MUST risk category = medium or high), and to determine factors associated with ASMI. Methods Strengthening Health In ELDerly through nutrition (SHIELD) is a study involving 1211 (400 with normal nutritional status and 811 at risk of malnutrition) community-dwelling older people aged ≥65 years in Singapore. Low ASMI was determined by bioelectrical impedance analysis (Asian Working Group for Sarcopenia, 2014). Results One in five (20.6%) nourished participants had low ASMI vs. four in five (81.3%) participants at risk of malnutrition had low ASMI (P < 0.0001). Older people with low ASMI were more likely to be admitted to the hospital, had longer length of stay, 25-hydroxyvitamin D deficiency, and lower education level, compared to those with normal ASMI (all P ≤ 0.0472). In the multiple linear regression model, age (coefficient, b = −0.013 kg/m2; P < 0.001), gender (female: b = −0.963 kg/m2; P < 0.001), calf circumference (b = 0.042 kg/m2; P < 0.001), bone mass (b = 0.593 kg/m2; P < 0.001), BMI (b = 0.129 kg/m2; P < 0.001), and Physical Activity Scale for the Elderly (PASE) score (b = 0.001 kg/m2; P = 0.048) were associated with ASMI. Conclusions Community-dwelling older people at risk of malnutrition had four-fold greater risk of having low ASMI as compared to nourished counterparts. Increasing age was associated with lower ASMI, whereas calf circumference, bone mass, BMI, PASE score, and being male were positively associated with ASMI. These findings highlight the importance of screening for low muscle mass and maintaining muscle health as part of the overall malnutrition management in this population group. Funding Sources The Economic Development Board of Singapore, Abbott Nutrition, and Changi General Hospital funded this study.

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PREVALENCE AND CHARACTERISTICS ASSOCIATED WITH ALCOHOL USE AND ALCOHOL RELATED PROBLEMS IN COMMUNITY DWELLING OLDER ADULTS

Journal of Aging Research and Lifestyle ◽

10.14283/jarcp.2019.6 ◽

2019 ◽

pp. 1-11

Author(s):

Y. van Gils ◽

E. Franck ◽

S.J.P. van Alphen ◽

E. Dierckx

Keyword(s):

Older Adults ◽

At Risk ◽

Alcohol Use ◽

Binge Drinking ◽

Associated Factors ◽

Alcohol Problems ◽

Hazardous Drinking ◽

Community Dwelling ◽

Community Dwelling Older Adults ◽

Alcohol Related Problems

Objective: This study examine the prevalence, characteristics and associated factors of alcohol use and alcohol related problems among Belgian community dwelling older adults. Design: Retrospective cross-sectional study by extensive examination survey. Setting: The participants were questioned in their homes or in community centres. Participants: Overall, 1,366 adults ≥65 years participated in this study. Method: Information about self-reported alcohol use during the past year, Health Related Quality of Life (HRQL) and alcohol related problems was gathered with respectively the AUDIT, SF36 and MAST-G. Results: Of the total sample, 84.4% reported alcohol consumption. Using the NIAAA guidelines, the overall prevalence for at risk drinking was 26.6% and for binge drinking 14.8%, both risky alcohol patterns. Logistic regression analyses were performed on the drinking sample to determine the predictors associated with at risk drinking, binge drinking and hazardous drinking. Being male, a smoker of former smoker and living alone were associated with at risk drinking. Being male, being aged 65-74 years, being a smoker, reporting polypharmacy, MCS and having recent loss experience were associated with binge drinking. More than 25% of respondents were classified as hazardous drinking (score ≥5 on MAST-G). Associated factors with hazardous drinking were being male, having a family history of alcohol problems, PCS and MCS. Conclusions: The prevalence rates for at risk alcohol patterns and alcohol related problems were higher than in previous studies. As older adults are more vulnerable to the adverse consequences of alcohol use, awareness about alcohol use should be raised among older adults, as well as amongst health care givers and researchers.

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Prevalence of frailty and associated factors among community-dwelling older adults after total hip arthroplasty

Hip International ◽

10.1177/11207000211048180 ◽

2021 ◽

pp. 112070002110481

Author(s):

Kazunari Ninomiya ◽

Naonobu Takahira ◽

Takashi Ikeda ◽

Koji Suzuki ◽

Ryoji Sato ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Associated Factors ◽

Multinomial Logistic Regression ◽

Knee Extensor ◽

Community Dwelling ◽

Calf Circumference ◽

Hip Abductor ◽

Knee Extensor Muscle Strength ◽

Community Dwelling Older Adults

Objective: To evaluate the prevalence of frailty and associated factors among community-dwelling older adults who have undergone total hip arthroplasty (THA). Materials and methods: This study, which employed a cross-sectional, observational design, was conducted between April and November 2020. The participants were older adults (⩾65 years) who had undergone primary THA at the study hospital. Based on Fried’s modified phenotype, frailty was stratified into 3 degrees according to the presence of 3 or more of the following components: weight loss, weakness, exhaustion, low activity level, and slow walking speed. Multinomial logistic regression was used to analyse the associations of frailty with its potential risk factors. Results: The data of 518 participants were analysed. The overall prevalence of frailty and prefrailty was 11.4% and 51.0%, respectively. The multinomial logistic regression analysis showed that calf circumference (odds ratio [OR] 0.716, 95% confidence interval [CI], 0.611–0.839; p < 0.001), fall history (OR 2.435, 95% CI, 1.114–5.322; p = 0.026), hip abductor muscle strength (OR 0.962, 95% CI, 0.938–0.987; p = 0.003), knee extensor muscle strength (OR 0.980, 95% CI, 0.964–0.996; p = 0.013), and Timed Up and Go test (TUG) performance (OR 1.802, 95% CI, 1.458–2.228; p < 0.001) were associated with frailty. Conclusions: Frailty was highly prevalent in community-dwelling older adults after THA. Further, its potential associations with calf circumference, hip abductor and knee extensor muscle strength, TUG performance, and fall history highlight the significance of these factors for interventions.

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Sarcopenia risk and associated factors among Chinese community-dwelling older adults living alone

Scientific Reports ◽

10.1038/s41598-021-01614-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Li Cheng ◽

Janet W. H. Sit ◽

Helen Y. L. Chan ◽

Kai Chow Choi ◽

Regina K. Y. Cheung ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

At Risk ◽

High Risk ◽

Physical Activity Level ◽

Associated Factors ◽

Community Dwelling ◽

Activity Level ◽

Living Alone ◽

Community Dwelling Older Adults

AbstractSarcopenia, defined as a progressive loss of muscle mass and reduced muscle strength and functional capacity, is common among older adults. This study aimed to assess the proportion of people at risk of sarcopenia and probable sarcopenia among Chinese community-dwelling older adults living alone and to identify the associated factors. A total of 390 older adults were included in this study. Sarcopenia and probable sarcopenia were defined according to the criteria of the Asian Working Group for Sarcopenia 2019. Data on socio-demographic characteristics, health status, health behaviours and lifestyle characteristics, nutritional status, physical activity level, and depressive symptoms were collected. The association between these characteristics and sarcopenia risk was analysed using a multivariate ordinal logistic regression. The proportion of subjects at risk of sarcopenia and probable sarcopenia was found to be 57.7% and 30%, respectively. Older age, being malnourished and being at risk of malnutrition were significantly associated with sarcopenia risk. Being educated to secondary level or above, being overweight or obese and higher physical activity level were associated with decreased sarcopenia risk. Our results showed that older adults living alone were at high risk of developing sarcopenia and probable sarcopenia. These results emphasise the urgent need to initiate aggressive screening and holistic lifestyle therapeutic intervention strategies for this high-risk population.

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Bedside Ultrasound Measures of Muscle Mass and Frailty Measures in Community-Dwelling Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.861 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 269-269

Author(s):

Kenneth Madden ◽

Boris Feldman ◽

Shane Arishenkoff ◽

Graydon Meneilly

Keyword(s):

Older Adults ◽

Muscle Mass ◽

Frailty Index ◽

Geriatric Medicine ◽

Muscle Thickness ◽

Vancouver General Hospital ◽

Community Dwelling ◽

Point Of Care Ultrasound ◽

Clinical Frailty Scale ◽

Community Dwelling Older Adults

Abstract The age-associated loss of muscle mass and strength in older adults is called sarcopenia, and it is associated with increased rates of falls, fractures, hospitalizations and death. Sarcopenia is one of the most common physical etiologies for increased frailty in older adults, and some recent work has suggested the use of Point-of care ultrasound (PoCUS) measures as a potential measure of muscle mass. The objective of this study was to examine the association of PoCUS measures of muscle thickness (MT) with measures of frailty in community-dwelling older adults. We recruited 150 older adults (age >= 65; mean age 80.0±0.5 years, 66 women, 84 men) sequentially from 5 geriatric medicine clinics (Vancouver General Hospital). We measured lean muscle mass (LMM, by bioimpedance assay) and an ultrasonic measure of muscle quantity (MT, vastus medialis muscle thickness) in all subjects, as well as two outcome measures of frailty (FFI, Fried Frailty Index; RCFS, Rockwood Clinical Frailty Scale). In our models, MT showed an inverse correlation with the FFI (Standardized β=-0.2320±0.107, p=0.032) but no significant correlation with the RCFS (Standardized β = -0.025±0.086, p=0.776). LMM showed no significant association with either FFI (Standardized β=-0.232±0.120, p=0.055) or RCFS (Standardized β = -0.043±0.119, p=0.719). Our findings indicate that PoCUS measures show potential as a way to screen for physical manifestations of frailty and might be superior to other bedside methods such as bioimpedance assay. However, PoCUS measures of muscle thickness will likely miss patients showing frailty in the much broader context captured by the RCFS.

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Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

Innovation in Aging ◽

10.1093/geroni/igaa057.2380 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 683-683

Author(s):

Asa Inagaki ◽

Ayumi Igarashi ◽

Maiko Noguchi-Watanabe ◽

Mariko Sakka ◽

Chie Fukui ◽

...

Keyword(s):

Older Adults ◽

Online Survey ◽

Physical Restraint ◽

Community Dwelling ◽

Physical Restraints ◽

Care Nurse ◽

Factors Associated ◽

Home Care Nurse ◽

Community Dwelling Older Adults ◽

At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

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