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

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.

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

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.

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

PLoS ONE ◽  
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.

scholarly journals Intracellular Water Content in Lean Mass as an Indicator of Muscle Quality in an Older Obese Population

2020 ◽  
Vol 9 (5) ◽  
pp. 1580
Author(s):  
Mateu Serra-Prat ◽  
Isabel Lorenzo ◽  
Mònica Papiol ◽  
Elisabet Palomera ◽  
Maria Bartolomé ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Water Content ◽  
Muscle Mass ◽  
Lean Mass ◽  
Gait Speed ◽  
Bioelectrical Impedance ◽  
Intracellular Water ◽  
Muscle Quality ◽  
Timed Up And Go ◽  
Cross Sectional

Background: In aged populations, muscle strength depends more on muscle quality than on muscle quantity, while all three are criteria for the diagnosis of sarcopenia. Intracellular water content (ICW) in lean mass (LM) has been proposed as an indicator of muscle quality related to muscle strength in older people. Objectives: To evaluate the relationship between the ICW/LM ratio, muscle strength and indicators of functional performance in obese older adults, and to assess the value of the ICW/LM ratio as an indicator of muscle quality. Methodology: Design: cross-sectional study. Population: persons aged 65–75 years with a body mass index of 30–39 kg/m2. ICW and LM were estimated by bioelectrical impedance. Hand grip, gait speed, unipedal stance test, timed up-and-go (TUG) test, Barthel score and frailty (Fried criteria) were assessed. Sarcopenia was established according to EWGSOP2 criteria. Results: Recruited were 305 subjects (66% women), mean age 68 years. The ICW/LM ratio correlated with the TUG test, gait speed and grip strength, and was also associated with sex, the unipedal stance test and frailty. Independently of age, sex and muscle mass, the ICW/LM ratio was related with gait speed, the TUG test and unipedal stance capacity. One person (0.3%) had sarcopenia defined as low muscle strength and low muscle mass, while 25 people (8.2%) had sarcopenia defined as low muscle strength and poor muscle quality (ICW/LM). With this last definition, sarcopenia was related to frailty, gait speed and the TUG test. Conclusions: ICW content in LM could be a useful muscle quality indicator for defining sarcopenia. However, more studies are required to confirm our findings for other populations.

scholarly journals Comparison of methods to identify individuals with obesity at increased risk of functional impairment among a population of home-dwelling older adults

2021 ◽  
pp. 1-8
Author(s):  
Anne Lene Nordengen ◽  
Linn Kristin Lie Øyri ◽  
Stine Marie Ulven ◽  
Truls Raastad ◽  
Kirsten Bjørklund Holven ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Body Mass ◽  
Functional Impairment ◽  
Muscle Quality ◽  
Obese Women ◽  
Total Body Mass ◽  
Increased Risk ◽  
Total Body

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.

scholarly journals Decreased Muscle Strength and Quality in Diabetes-Related Dementia

2017 ◽  
Vol 7 (3) ◽  
pp. 454-462 ◽  
Author(s):  
Akito Tsugawa ◽  
Yusuke Ogawa ◽  
Naoto Takenoshita ◽  
Yoshitsugu Kaneko ◽  
Hirokuni Hatanaka ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Muscle Mass ◽  
Gait Speed ◽  
Knee Extension ◽  
Upper Extremities ◽  
Muscle Quality ◽  
Type 2 Dm ◽  
Male Subjects ◽  
Skeletal Muscle Strength

Background/Aims: Diabetes-related dementia (DrD), a dementia subgroup associated with specific diabetes mellitus (DM)-related metabolic abnormalities, is clinically and pathophysiologically different from Alzheimer disease (AD) and vascular dementia. We determined whether skeletal muscle strength, quality, and mass decrease in individuals with DrD. Methods: We evaluated grip and knee extension strength, muscle mass, and gait speed in 106 patients with probable AD and without type 2 DM (AD[–DM] group), 74 patients with probable AD and with DM (AD[+DM] group), and 36 patients with DrD (DrD group). Muscle quality was defined as the ratio of muscle strength to muscle mass. Results: Both female and male subjects with DrD showed significantly decreased muscle strength and quality in the upper extremities compared with the subjects with AD[–DM] or AD[+DM]. Female subjects with DrD showed significantly decreased muscle quality in the lower extremities compared with the subjects with AD[–DM]. Both female and male subjects with DrD had a significantly lower gait speed compared with the subjects with AD[–DM]. However, there were no significant differences in muscle mass and the prevalence of sarcopenia between the groups. Conclusion: Subjects with DrD showed decreased muscle strength and quality, but not muscle mass, and had a low gait speed.

Associations of Sleep Quality with Gait Speed and Falls in Older Adults: The Mediating Effect of Muscle Strength and the Gender Difference

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Li Zhang ◽  
Shuqin Liu ◽  
Yujie Li ◽  
Suyun Li ◽  
Yili Wu
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Sleep Quality ◽  
Grip Strength ◽  
Gait Speed ◽  
Mediating Effect ◽  
Self Report ◽  
Mediating Effects ◽  
Walking Test ◽  
Falls In Older Adults

<b><i>Introduction:</i></b> Although previous studies have reported the significant associations of sleep quality with gait speed and falls, the mechanisms underlying these associations are unclear. We aimed to examine the gender-specific associations of sleep quality with gait speed and falls among older adults and to explore the possible mediating effect of muscle strength on these relationships. <b><i>Methods:</i></b> Data were taken from wave 6 (2012–2013) of the English Longitudinal Study of Aging (ELSA), including 7,664 participants aged 60 years and older. Sleep quality and falls were assessed by self-report. Gait speed was measured by the “timed walking test” and then adjusted by height. As an indicator of overall muscle strength, grip strength was measured by using the Smedley dynamometer. Baron and Kenny’s causal steps and the Karlson/Holm/Breen method were used to examine the mediating effect. <b><i>Results:</i></b> Higher sleep quality was associated with the higher level of gait speed (β = 0.008, <i>p</i> = 0.031 in men; β = 0.008, <i>p</i> = 0.017 in women) and with lower prevalence of falls (OR = 0.878, 95% CI: 0.773, 0.998 in men; OR = 0.874, 95% CI: 0.792, 0.965 in women). Grip strength mediated these associations in men but not in women, and the mediating effects of grip strength can explain 23.74 and 11.01% of the total effect of sleep quality on gait speed and falls, respectively. <b><i>Conclusion:</i></b> Our findings help explain the mechanism underlying the associations of sleep quality with gait speed and falls. Effort to maintain the mobility of the older men should focus on improving both sleep quality and muscle strength.

scholarly journals Suggested Assessments for Sarcopenia in Patients With Stroke Who Can Walk Independently

2020 ◽  
Vol 44 (1) ◽  
pp. 20-37 ◽  
Author(s):  
Ho Joong Jung ◽  
Yong Min Lee ◽  
Minsun Kim ◽  
Kyeong Eun Uhm ◽  
Jongmin Lee
Keyword(s):  
Muscle Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Gait Speed ◽  
Tibialis Anterior ◽  
Muscle Thickness ◽  
Medial Gastrocnemius ◽  
Stroke Severity ◽  
Skeletal Muscle Index ◽  
Sum Score

Objective To investigate variables for assessment of stroke-related sarcopenia that are alternative options to the current assessment for sarcopenia, which focuses on age-related sarcopenia and also has limitations in addressing sarcopenia due to weakness resulting from stroke.Methods Forty patients (17 men, 23 women; mean age, 66.9±15.4 years) with first-ever stroke who can walk independently were included. Muscle mass was determined by measuring ultrasonographic muscle thickness of vastus intermedius, rectus femoris, tibialis anterior, medial gastrocnemius, and biceps brachii muscles in addition to using the skeletal muscle index (SMI) with bioelectrical impedance analysis. Muscle strength was assessed with the Medical Research Council (MRC) sum score as well as handgrip (HG) strength. Physical performance was measured by the Berg Balance Scale (BBS) along with 4-meter gait speed (4MGS). Correlations between each assessment in the three categories were analyzed and adjusted by stroke severity, comorbidity, and nutritional status.Results For muscle mass, SMI showed the highest correlation with the tibialis anterior muscle (r=0.783, p<0.001) among the other muscles. Regarding muscle strength, the MRC sum score correlated with the HG (r=0.660, p<0.001). For physical performance, the BBS correlated with the 4MGS (r=0.834, p<0.001). The same result was obtained after adjusting for factors of stroke severity, comorbidity, and nutritional status.Conclusion These results suggest that ultrasonographic muscle thickness of the tibialis anterior, the MRC sum score, and BBS might be alternatives to SMI, HG, and usual gait speed for sarcopenia in stroke patients.

scholarly journals Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Xianyang Sherman Yee ◽  
Yee Sien Ng ◽  
John Carson Allen ◽  
Aisyah Latib ◽  
Ee Ling Tay ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Gait Speed ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Fitness Measures ◽  
Community Dwelling Older Adults

Abstract Background The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants – Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) – with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults. Methods This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance. Results Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST, r = 0.290; 5TSTS, r = − 0.242; both p< 0.01), and stronger correlations with gait speed (30CST, r = 0.517; 5TSTS, r = − 0.533; both p< 0.01), endurance (30CST, r = 0.558; 5TSTS, r = − 0.531; both p < 0.01) and dynamic balance (30CST, r = − 0.501; 5TSTS, r = 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%; p = 0.276). When both measures are used, prevalence is significantly higher (42.0%; p = 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%; p< 0.05). Conclusion In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.

scholarly journals Relationship Between Tooth Loss and Sarcopenia in Chinese Suburban Community-dwelling Older Adults

2021 ◽  
Author(s):  
Feng Wang ◽  
Jingru Wang ◽  
Peipei Han ◽  
Yuewen Liu ◽  
Weibo Ma ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Grip Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Tooth Loss ◽  
Walking Speed ◽  
Community Dwelling ◽  
Suburban Community ◽  
Community Dwelling Older Adults

Abstract Background: Both sarcopenia and loss of teeth are associated with aging. The purpose of this study was to investigate potential relationships between tooth loss and sarcopenia and components of sarcopenia, including declining muscle mass, muscle strength, and physical performance, in Chinese suburban community-dwelling older adults.Methods: The subjects were 1494 people over 60 years of age (average age: 71.64 ± 5.97 years；men, n=609) from Chongming District of Shanghai and Hangu District of Tianjin. The Asian Working Group for Sarcopenia (AWGS) criteria were used to define sarcopenia. The three basic diagnostic components of sarcopenia (muscle mass, muscle strength, and physical performance) were assessed using a bioelectrical impedance analyzer, a grip strength test, and a four-meter walk test, respectively. The subjects were divided into groups depending on self-reported loss of teeth. Results: After adjusting for confounding variables, we found no correlation between tooth loss and sarcopenia or muscle mass. However, the walking speed of female participants with at least 10 teeth lost was 0.059 m/s slower than that of participants with fewer than 10 teeth lost (P＜0.001), and grip strength was 1.577 kg lower among male participants with at least 10 teeth lost than among males with fewer than 10 teeth lost (P =0.023).Conclusion: Our results suggest that tooth loss is negatively correlated with muscle strength in males and average walking speed in females. These results are consistent with the importance of good oral hygiene in preventing declines of physical performance in older adults.

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