26 Initial Orthostatic Hypotension in Older Persons: Results from the Malaysian Elders Longitudinal Research Study

Abstract Objectives Initial orthostatic hypotension (IOH) is defined as a reduction in systolic or diastolic blood pressure (1) of 40 mmHg or 20 mmHg or greater within 15 seconds of standing. However, little is known about the characteristics of individuals with IOH and its relevance in the older population. The present study aimed to determine factors associated with IOH and classical orthostatic hypotension (COH) and their relationship with physical, functional and cognitive performance. Design Cross-sectional observational study. Setting and Participants Individuals aged ≥55 years were recruited through the Malaysian Elders Longitudinal Research (MELoR) study and continuous non-invasive BP was monitored over five minutes of supine rest and three minutes of standing. Measures Physical performance was measured using timed up and go, functional reach (FR), hand grip (HG) and Lawton’s functional ability scale; cognition was measured with Montreal Cognitive Assessment (MoCA). BP response to standing was categorized as non-OH, COH, IOH or COH and IOH Results 1245 participants were recruited, 623 (50%) had COH, 165 (13%) had IOH and 145 (12%) met the criteria for COH and IOH. COH was associated with increasing age, hypertension, transient ischemic attacks, diabetes mellitus, anti-hypertensive medications and reduced functional reach compared to individuals without COH. IOH was associated with younger age, normo-tension, and the absence of cerebrovascular disease or diabetes. Individuals with IOH had significantly better TUG, FR and HG scores compared to individuals without IOH. Conclusions This study suggests that IOH is associated with better physical performance. Further research is now required to fully elucidate the clinical relevance of IOH and its relationship to COH, as well as determine appropriate clinical cut-offs.

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67 Determine Risk of Fall in Medical Ward: An Exploratory Study

Age and Ageing ◽

10.1093/ageing/afz164.67 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Julaida Embong ◽

L K Lee ◽

M A Nawawi ◽

R M Razali ◽

E C M Chong ◽

...

Keyword(s):

Cross Sectional Study ◽

Medical Ward ◽

Sectional Study ◽

Timed Up And Go ◽

Cross Sectional ◽

Osteoarthritic Knee ◽

Functional Reach ◽

Hand Grip ◽

Significant Difference ◽

Risk Of Fall

Abstract Introduction Patient fall is very common in hospital. It is the biggest reason of hospitalization, morbidity and mortality. However there were few evidence on risk of fall. Thus, the aim of this study was to determine risk of fall and factor associated. Method A Cross-sectional study has been carried out from 3 January until 7 June 2019. A total number of 151 subject were recruited from selected medical ward. Data on Socio-demographic, medication, medical related history, vision and hearing impairment were collected. The outcome measures used were Hand Grip Strength, Timed Up and Go (TUG), and Berg Balance Score (BBS). Result There were significant difference between risk of fall with balance (p=0.00), right and left grip strengths (p=0.004&0.001), osteoarthritic Knee (p=0.006) and Functional reach (p=0.000). Conclusion The results show greater risk of fall associated with balance, grip strengths, osteoarthritic knee and Functional reach.

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Malnutrition is associated with dynamic physical performance

Aging Clinical and Experimental Research ◽

10.1007/s40520-019-01295-3 ◽

2019 ◽

Vol 32 (6) ◽

pp. 1085-1092 ◽

Cited By ~ 5

Author(s):

Keenan A. Ramsey ◽

Carel G. M. Meskers ◽

Marijke C. Trappenburg ◽

Sjors Verlaan ◽

Esmee M. Reijnierse ◽

...

Keyword(s):

Physical Performance ◽

Muscle Power ◽

Nutritional Assessment ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Timed Up And Go ◽

Cross Sectional ◽

Static Performance ◽

Z Scores ◽

Individual Measure

Abstract Background Malnutrition and poor physical performance are both conditions that increase in prevalence with age; however, their interrelation in a clinically relevant population has not been thoroughly studied. Aims This study aimed to determine the strength of the association between malnutrition and measures of both static and dynamic physical performance in a cohort of geriatric outpatients. Methods This cross-sectional study included 286 older adults (mean age 81.8, SD 7.2 years, and 40.6% male) who were referred to geriatric outpatient mobility clinics. The presence of malnutrition was determined using the Short Nutritional Assessment Questionnaire (SNAQ, cut-off ≥ 2 points). Measures of dynamic physical performance included timed up and go (TUG), 4-m walk test, and chair stand test (CST). Static performance encompassed balance tests and hand grip strength (HGS). Physical performance was standardized into sex-specific Z-scores. The association between malnutrition and each individual measure of physical performance was assessed using linear regression analysis. Results 19.9% of the cohort was identified as malnourished. Malnutrition was most strongly associated with CST and gait speed; less strong but significant associations were found between malnutrition and TUG. There was no significant association between malnutrition and HGS or balance. Discussion Physical performance was associated with malnutrition, specifically, dynamic rather than static measures. This may reflect muscle power being more impacted by nutritional status than muscle strength; however, this needs to be further addressed. Conclusions Malnutrition is associated with dynamic physical performance in geriatric outpatients, which should inform diagnosis and treatment/prevention strategies.

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RISING FROM THE FLOOR IN PERSONS WITH PARKINSON’S DISEASE

Innovation in Aging ◽

10.1093/geroni/igz038.1768 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S474-S475

Author(s):

Dennis W Klima ◽

Jeremy Stewart ◽

Frank Freijomil ◽

Mary DiBartolo

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Performance ◽

Performance Measure ◽

Community Dwelling ◽

Gait Velocity ◽

Performance Tests ◽

Motor Patterns ◽

Timed Up And Go ◽

Cross Sectional

Abstract While considerable research has targeted gait, balance and preventing falls in individuals with Parkinson’s disease (PD), less in known about the ability to rise from the floor in this population. The aims of this study were to 1) Examine the relationship between locomotion and physical performance tests and the timed supine to stand performance measure and to 2) Identify both the time required and predominant motor patterns utilized by persons with PD to complete to floor rise transition. A cross-sectional design was utilized. Twenty community-dwelling older adults with PD (mean age 74.8+/-9.5 years; 13 men) performed a standardized floor rise test and locomotion tests in a structured task circuit. Subject demographic and anthropometric data were also collected. Statistical analyses included descriptive statistics and Pearson Product Moment correlations. Fifteen subjects (75%) demonstrated the crouch kneel pattern and fourteen (70%) used an all-4’s strategy to rise to stand. The mean time to rise from the floor was 14.9 (+/- 7.6) seconds and slower than published norms for persons without PD. Nine subjects required the use of a chair to perform floor recovery. Supine to stand performance time was significantly correlated with the: Dynamic Gait Index (r= - 0.66; p<0.002), Five Times Sit to Stand Test (r=0.78; p<0.001), Timed Up and Go Test (r=0.74; p<0.001), and gait velocity (r= -0.77; p<0.001). Rising from the floor demonstrates concurrent validity with locomotion and physical performance tests. Floor recovery techniques can be incorporated in fall prevention initiatives in conjunction with PD symptom management.

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50 Sociodemographic, Physical Performance and Fear of Falls Profile of Older Adult Fallers and Non Fallers: A Preliminary Study

Age and Ageing ◽

10.1093/ageing/afz164.50 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Azianah Ibrahim ◽

Nur Aimuni Abu Hassan ◽

Halizahanim Hassan

Keyword(s):

Older Adults ◽

Older Adult ◽

Physical Performance ◽

Cross Sectional Study ◽

Falls Prevention ◽

Timed Up And Go ◽

Cross Sectional ◽

Sit To Stand ◽

Management Plans ◽

Fear Of Falls

Abstract Introduction It is important to identify older adult fallers in order to implement early prevention management also prevent recurrent falls. This study aimed to explore the profiles of older adult fallers and non-fallers in regards to socio-demographic, physical performance, fear of falls that includes the activities that were feared in regard to falls. Analysis Descriptive and mean comparison test. Methodology Participants for this study were recruited among individuals aged 60 years and above, able to walk 3m, able to stand independently for longer than 1min and able to comprehend and follow instructions. Exclusion criteria include recent vertebral or lower limb fracture (less than 6months), unstable angina, unable to follow command and severe hearing and vision impairment. Design: Cross-sectional study. Results A number of 27 older adults were screened for falls. Based on Timed Up and Go test (cut off 11.18s), 8 (29.6%) of them were identified as fallers. Fallers were majority females (10, 37%), had visual impairment (4,14.8%), older (77.4±2.9years versus 68.4±5.7years) and had slightly higher in fear of falls score (13.2±5.5 versus 12.0±7.0). In view of physical performance, fallers were slower in Timed Up and Go test (13.6±2.4 versus 9.1±1.4), weaker in hand grip strength (14.3±2.5kg versus 21.5±19.3kg) and weaker in sit-to-stand performance (13.3±2.7s versus 10.7±2.7s). Age (p<0.05) and sit-to-stand performance (p<0.05) significantly differed between fallers and non-fallers. Among seven activities assessed using short Falls Efficacy Scale-International, non-fallers were found to have more fear during various activities compared to fallers. Implication Exploration of falls risk profiles in older adults will hopefully allow better understanding and further improvement in developing falls prevention management plans.

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Association of Plasma Carotenoid and Malondialdehyde Levels with Physical Performance in Korean Adolescents

10.21203/rs.3.rs-1080957/v1 ◽

2021 ◽

Author(s):

Heeyeon Joo ◽

Jiyoung Hwang ◽

Jiyeon Kim ◽

Hyesook Kim ◽

Oran Kwon

Keyword(s):

Grip Strength ◽

Physical Performance ◽

Maximal Oxygen Consumption ◽

Multiple Linear Regression Model ◽

Cross Sectional Study ◽

Hand Grip Strength ◽

Photodiode Array Detection ◽

Cross Sectional ◽

Korean Adolescents ◽

Hand Grip

Abstract Background Increased oxidative stress has been shown to lead to muscle damage and reduced physical performance. The antioxidant mechanism is most likely to reduce these relationships, but in the context of the action of carotenoids, more research is needed. This cross-sectional study aims to investigate whether carotenoids modify the association between plasma malondialdehyde (MDA) and physical performance in Korean adolescents. Methods The study sample consisted of 381 participants (164 boys, 217 girls) aged 13−18, who participated in the 2018 National Fitness Award Project. We quantified α-carotene, β-carotene, β-cryptoxanthin, lutein, zeaxanthin, lycopene, and MDA levels in plasma using HPLC with photodiode array detection. Physical performance was measured by determining the absolute and relative hand grip strength, 20-m progressive aerobic cardiovascular endurance run, estimated maximal oxygen consumption, curl-up, and sit-and-reach. Results In boys, the multiple linear regression model adjusted for age, BMI, smoking, drinking, and physical activity showed that the MDA level was negatively associated with absolute hand grip strength; this association was observed only in groups with α-carotene, β-cryptoxanthin, zeaxanthin, and total carotenoid values below the median. Conclusion These results suggest that carotenoids may act as an effect modifier of the association between MDA and physical performance in Korean male adolescents.

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P1586SARCOPENIA IN HEMODIALYSIS PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1586 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Armando Luis Negri ◽

Ruben Abdala ◽

Elisa Del Valle ◽

Pablo Bridoux ◽

Luciana Gonzalez Paganti ◽

...

Keyword(s):

Grip Strength ◽

Muscle Mass ◽

Physical Performance ◽

Significant Proportion ◽

Cross Sectional Study ◽

Dialysis Patients ◽

Cross Sectional ◽

Hand Grip ◽

Hand Dynamometer ◽

And Function

Abstract Background and Aims Sarcopenia is the loss of skeletal muscle mass and function that occurs with aging. These modifications lead to greater morbidity and mortality as a result of falls, hospitalization, depression and dependence among others. Chronic Kidney disease (CKD) and hemodialysis (HD) produce a favorable environment for the development of sarcopenia. Objective: to study the prevalence of sarcopenia and its different components (muscle mass, strength and physical performance) using EWGSOP 2018 proposed criteria. Method cross-sectional study evaluating 100 adult HD patients. We evaluated: Grip strength (GS) with Jamar Hydraulic Hand Dynamometer (three determinations in the arm without fistula); Appendicular lean mass (ALM) by DXA (GE LUNAR Prodigy Advance) and physical performance: Gait-speed (Time needed to perform a 4-meter walk on a flat surface) and the sit-stand test Results 58 males (M) and 42 females (F). Mean age for M was 54.3 years and 58 years for F. The prevalence of sarcopenia was 18% in the whole group, 10% in M and 20% in F. In M 33% had low GS and 26% low ALM. In M GS correlated with ALM, Albumin and weight p<0.05 (R 2 0.41); ALM correlated with weight r 0.75, height r 0.64 and GS r 0.46 (p<0.05). In F, 27% had low GS, 54% low ALM, and 17% poor physical performance. In F, GS correlated positively with ALM; ALM correlated positively with: weight r 0.78, height r 0.66, GS r 0.59 and sit-stand r 0.40 (p<0.5). Patients with lower grip strength had a higher prevalence of falls in the last year (40% two or more falls) p=0.03. Conclusion A significant proportion of dialysis patients had sarcopenia. Low hand grip strength was associated with a higher prevalence of falls. Recognizing sarcopenia in dialysis patients would allow us to develop strategies to prevent falls and other complications.

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Prevalence of Sarcopenia Employing Population-Specific Cut-Points: Cross-Sectional Data from the Geelong Osteoporosis Study, Australia

Journal of Clinical Medicine ◽

10.3390/jcm10020343 ◽

2021 ◽

Vol 10 (2) ◽

pp. 343

Author(s):

Sophia X. Sui ◽

Kara L. Holloway-Kew ◽

Natalie K. Hyde ◽

Lana J. Williams ◽

Monica C. Tembo ◽

...

Keyword(s):

Physical Performance ◽

Handgrip Strength ◽

Whole Body ◽

Australian Population ◽

Timed Up And Go ◽

Cross Sectional ◽

Cut Points ◽

European Working ◽

Prevalence Estimates ◽

Geelong Osteoporosis Study

Background: Prevalence estimates for sarcopenia vary depending on the ascertainment criteria and thresholds applied. We aimed to estimate the prevalence of sarcopenia using two international definitions but employing Australian population-specific cut-points. Methods: Participants (n = 665; 323 women) aged 60–96 years old were from the Geelong Osteoporosis Study. Handgrip strength (HGS) was measured by dynamometers and appendicular lean mass (ALM) by whole-body dual-energy X-ray absorptiometry. Physical performance was assessed using gait speed (GS, men only) and/or the timed up-and-go (TUG) test. Using cut-points equivalent to two standard deviations (SDs) below the mean young reference range from the same population and recommendations from the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was identified by low ALM/height2 (<5.30 kg for women; <6.94 kg for men) + low HGS (<16 kg women; <31 kg men); low ALM/height2 + slow TUG (>9.3 s); low ALM/height2 + slow GS (<0.8 m/s). For the Foundation for the National Institutes of Health (FNIH) equivalent, sarcopenia was identified as low ALM/BMI (<0.512 m2 women, <0.827 m2 men) + low HGS (<16 kg women, <31 kg men). Receiver Operating Characteristic curves were also applied to determine optimal cut-points for ALM/BMI (<0.579 m2 women, <0.913 m2 men) that discriminated poor physical performance. Prevalence estimates were standardized to the Australian population and compared to estimates using international thresholds. Results: Using population-specific cut-points and low ALM/height2 + HGS, point-estimates for sarcopenia prevalence were 0.9% for women and 2.9% for men. Using ALM/height2 + TUG, prevalence was 2.5% for women and 4.1% for men, and using ALM/height2 + GS, sarcopenia was identified for 1.6% of men. Using ALM/BMI + HGS, prevalence estimates were 5.5–10.4% for women and 11.6–18.4% for men. Conclusions: This study highlights the range of prevalence estimates that result from employing different criteria for sarcopenia. While population-specific criteria could be pertinent for some populations, a consensus is needed to identify which deficits in skeletal muscle health are important for establishing an operational definition for sarcopenia.

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Social Participation’s Association with Falls and Frailty in Malaysia: A Cross-Sectional Study

Journal of Frailty & Aging ◽

10.14283/jfa.2021.31 ◽

2021 ◽

pp. 1-7

Author(s):

S. Risbridger ◽

R. Walker ◽

W.K. Gray ◽

S.B. Kamaruzzaman ◽

C. Ai-Vyrn ◽

...

Keyword(s):

Social Isolation ◽

Social Participation ◽

Longitudinal Research ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Community Activities ◽

Hand Grip ◽

Increased Risk ◽

History Of

Background: The global population is ageing rapidly, with the most dramatic increases in developing countries like Malaysia. Older people are at increased risk of multimorbidity, frailty and falls. Objectives: In this study we aimed to determine the relationship between social participation, frailty and falls in Malaysia. Design, Setting, and Participants: This was a cross-sectional study of individuals aged 55 years and above selected from the electoral rolls of three Klang Valley parliamentary constituencies through stratified random sampling. They were invited to take part in a questionnaire and physical assessment as part of the Malaysian Elders Longitudinal Research (MELoR) study. Measurements: Fallers were individuals who had fallen in the previous year. Frailty was defined as meeting ≥3 of: low body mass index, reduced cognition, low physical activity, low hand-grip strength, and slow walking speed. Social participation was determined from employment status, social network, and community activity. Binomial logistic regression multivariant analysis was performed to identify links between the measures of social participation and falls and frailty. Results: The mean age of the 1383 participants was 68.5 years, with 57.1% female. Within the population, 22.9% were fallers and 9.3% were frail. Social isolation (OR= 2.119; 95% CI=1.351-3.324), and non-engagement in community activities (OR=2.548; 95% CI=1.107-5.865) were associated with increased frailty. Falls increased with social isolation (OR=1.327; 95% CI=1.004-1.754). Conclusions: Previous studies have shown social participation to be linked to frailty and falls risk, and social isolation to be a predictor of falls. In this study frailty was associated with all three social participation measures and history of falls was associated with social isolation.

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Orthostatic blood pressure recovery patterns in suspected syncope in the emergency department

Emergency Medicine Journal ◽

10.1136/emermed-2017-207207 ◽

2018 ◽

Vol 35 (4) ◽

pp. 226-230 ◽

Cited By ~ 2

Author(s):

Veera K van Wijnen ◽

Dik Ten Hove ◽

Reinold O B Gans ◽

Wybe Nieuwland ◽

Arie M van Roon ◽

...

Keyword(s):

Orthostatic Hypotension ◽

Tertiary Care ◽

Final Diagnosis ◽

Non Invasive ◽

Arterial Pressure Measurement ◽

Unexplained Syncope ◽

Initial Orthostatic Hypotension ◽

Routine Assessment ◽

Worse Prognosis

IntroductionOrthostasis is a frequent trigger for (pre)syncope but some forms of orthostatic (pre)syncope have a worse prognosis than others. Routine assessment of orthostatic BP in the ED can detect classic orthostatic hypotension, but often misses these other forms of orthostatic (pre)syncope. This study aimed to determine the frequency of abnormal orthostatic BP recovery patterns in patients with (pre)syncope by using continuous non-invasive BP monitoring.MethodsWe performed a prospective cohort study in suspected patients with (pre)syncope in the ED of a tertiary care teaching hospital between January and August 2014. Orthostatic BP was measured during the active lying-to-standing test with Nexfin, a continuous non-invasive finger arterial pressure measurement device. Orthostatic BP recovery patterns were defined as normal BP recovery, initial orthostatic hypotension, delayed BP recovery, classic orthostatic hypotension and reflex-mediated hypotension.ResultsOf 116 patients recruited, measurements in 111 patients (age 63 years, 51% male) were suitable for analysis. Classic orthostatic hypotension was the most prevalent abnormal BP pattern (19%), but only half of the patients received a final diagnosis of orthostatic hypotension. Initial orthostatic hypotension and delayed BP recovery were present in 20% of the patients with (pre)syncope of whom 45% were diagnosed as unexplained syncope. Reflex-mediated hypotension was present in 4% of the patients.ConclusionContinuous non-invasive BP measurement can potentially identify more specific and concerning causes of orthostatic (pre)syncope. Correct classification is important because of different short-term and long-term clinical implications.

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Correlation between Cognitive Function and Physical Performance in Community-Dwelling Older Adults

Althea Medical Journal ◽

10.15850/amj.v8n2.2145 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Amanda Risviandari ◽

Rensa Rensa

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Physical Performance ◽

Rank Correlation ◽

Cross Sectional Study ◽

Community Dwelling ◽

Timed Up And Go ◽

Cross Sectional ◽

Spearman’S Rank Correlation ◽

Community Dwelling Older Adults

Background: One of the health problems often found among older adults in Indonesia is cognitive impairment, resulting in difficulties daily life and a significant decrease in functional status. This study aimed to determine the correlation between cognitive function and physical performance in community-dwelling older adults.Methods: This was a cross-sectional study conducted from October–November 2019. Samples were collected from North Jakarta through consecutive sampling (n=38). Cognitive function was measured using the Mini-Mental State Examination (MMSE) and the physical performance was measured using the Timed Up and Go Test (TUG) method. The statistical test applied in this study was Spearman’s rank correlation (p<0.05). Results: The majority of the subjects in this study were mostly female young older adults with the most received ≥12 years of education. The results for both MMSE and TUG were normal. There was a negative correlation between MMSE and TUG scores (r= -0.357, p=0.028).Conclusions: There is a weak but significant correlation between cognitive function and physical performance in community-dwelling older adults. A further study exploring cognitive dysfunction and physical performance in older adults is needed.

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