Life-space Mobility in Older Men: The Role of Perceived Physical and Mental Fatigability

Abstract Background Physical performance and fatigue can limit mobility within the larger environment (life-space mobility). It is unknown whether perceived fatigability, self-reported fatigue anchored to activity intensity and duration, is independently associated with life-space. Methods We assessed this cross-sectionally in Visit 4 (2014–2016) of the Osteoporotic Fractures in Men Study (MrOS; N = 1 672, Age: Mean = 84.2 ± 4.0 years). The Pittsburgh Fatigability Scale (PFS, range: 0–50; higher = greater fatigability) measured physical (Mean = 16.1 ± 9.4) and mental fatigability (Mean = 7.5 ± 7.9). Life Space Assessment scores incorporated level, frequency, and assistance used for life-space mobility (range: 0–120, higher = greater life-space mobility; life-space constriction: inability to leave neighborhood without assistance). Separate multiple linear and logistic regressions for physical and mental fatigability were sequentially adjusted for demographic, health/lifestyle, and performance measures. Results The mean life-space mobility score was 84.6 ± 21.8, and 18% (n = 296) of men had life-space constriction. Higher physical and mental fatigability were both associated with lower life-space mobility in models adjusted for health and lifestyle factors (Physical PFS: B = −2.37, 95% confidence interval [CI]: [−3.39, −1.35]; Mental PFS: B = −1.79, 95% CI: [−2.73, −0.84]). Men with higher fatigability also had increased risk of life-space constriction (Physical PFS: OR = 1.59, 95% CI: [1.32, 1.92]; Mental PFS: OR = 1.25, 95% CI: [1.08, 1.46]). Associations were larger in magnitude for physical versus mental fatigability. Adjusting for physical performance measures more strongly attenuated associations for physical compared to mental fatigability. Conclusions Fatigability is linked with real-world mobility in older men, independent of their physical health. This association may be driven by separate physical and cognitive mechanisms worth examining further in longitudinal studies.

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Associations Between Perceived Physical and Mental Fatigability and Life Space Mobility in Older Men: The MrOS Study

Innovation in Aging ◽

10.1093/geroni/igab046.2156 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 565-565

Author(s):

Andrea Rosso ◽

Theresa Gmelin ◽

Yujia (Susanna) Qiao ◽

Michelle Carlson ◽

Peggy Cawthon ◽

...

Keyword(s):

Physical Health ◽

Physical Performance ◽

Real World ◽

Osteoporotic Fractures ◽

Older Men ◽

Life Space ◽

Assessment Scores ◽

Activity Intensity

Abstract Physical performance and fatigue can limit mobility within the larger environment (life-space mobility). It is unknown whether perceived fatigability, fatigue anchored to activity intensity and duration, is independently associated with life-space. We assessed this cross-sectionally in the Osteoporotic Fractures in Men Study (MrOS; N=1,681, Meanage=85±4.1). The Pittsburgh Fatigability Scale (PFS, range: 0-50) measured physical (Mean=16.2±9.5) and mental fatigability (Mean=7.5±8.0). Life Space Assessment scores (range: 0-120, higher=greater life-space) incorporated level, frequency, and assistance used for life-space mobility (Mean=84.3±22.0). Compared to the lowest fatigability strata (Physical: PFS 0-4; Mental: PFS 0-3, modeled separately), men in the two highest physical strata (PFS 20-24: B=-4.10±1.67; PFS≥25: B=-6.23±1.72; p’s≤.05) and men in the three highest mental strata reported significantly lower life-space mobility (PFS 13-15: B=-3.42±1.74; PFS 16-19: B=-5.38±1.83; PFS≥20: B=-7.96±1.66, p’s≤.05), adjusted for physical performance and health covariates. Our results provide evidence linking fatigability and real-world mobility, independent of physical health, in older men.

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64 Association between Risk of Osteoporotic Fractures with Spinal Morphology, Muscle Strength and Physical Performance

Age and Ageing ◽

10.1093/ageing/afz164.64 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Siew Kuan Chua ◽

Devinder ◽

KA Singh ◽

Bala S Rajaratnam ◽

Sabarul Afian Mokhtar ◽

...

Keyword(s):

Muscle Strength ◽

Fracture Risk ◽

Physical Performance ◽

Tracking System ◽

Osteoporotic Fractures ◽

Limited Information ◽

Functional Impairments ◽

Mineral Density ◽

Increased Risk ◽

Study Results

Abstract Osteoporotic related fractures (OF) are associated with functional impairments and declined quality of life. Low bone mineral density is one of the main risk factor for OF. However, there is limited information regarding the association of spinal morphology, muscle strength and physical performance with OF. The aim of the study was to examine association between risk of osteoporotic fractures with spinal morphology (thoracolumbar curvature and back extensors muscle strength), muscle strength and physical performance. 105 adults aged 50 years and above (69.3+ 8.5 years) were recruited for this cross-sectional study from a spine orthopaedic clinic. Thoracolumbar curvature, back extensors (BEMS) and handgrip (HGS) muscle strength were measured using an electromagnetic tracking system, a load-cell system and hand-held dynamometer respectively. Physical performance was assessed using Short Physical Performance Battery (SPPB). Participants were categorised for major osteoporotic fracture risk (major OF) with cut-point 10% using fracture risk calculator (FRAX®) with BMD. Student t-test analysis demonstrated that there is a significant (p<0.05) difference between participants with low risk and moderate to high risk of major OF for BEMS, HGS, and SPPB. Adjusted logistic models (forward and backward), showed that lower HGS and physical performance were associated with increased risk of major OF (HGS: OR = 0.18 [95% CI, 0.07–0.48]; SPPB: OR = 0.32[95% CI, 0.13–0.80]). Our study results suggest that declined muscle strength and physical performance is associated with higher risk of OF. It is important to promote optimum muscle strength and physical performance among older adults in the prevention of OF.

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Incident Fall Risk and Physical Activity and Physical Performance among Older Men: The Osteoporotic Fractures in Men Study

American Journal of Epidemiology ◽

10.1093/aje/kwk050 ◽

2007 ◽

Vol 165 (6) ◽

pp. 696-703 ◽

Cited By ~ 132

Author(s):

B. K. S. Chan ◽

L. M. Marshall ◽

K. M. Winters ◽

K. A. Faulkner ◽

A. V. Schwartz ◽

...

Keyword(s):

Physical Activity ◽

Physical Performance ◽

Fall Risk ◽

Osteoporotic Fractures ◽

Older Men

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Reference Values and Correlations for Multiple Physical Performance Measures: A Cross-Sectional Study among Independently Mobile Older Men in Japan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072305 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2305

Author(s):

Yoshinori Ishii ◽

Hideo Noguchi ◽

Junko Sato ◽

Hana Ishii ◽

Ryo Ishii ◽

...

Keyword(s):

Life Expectancy ◽

Physical Performance ◽

Performance Measures ◽

Reference Values ◽

Older Men ◽

Reference Ranges ◽

Care Providers ◽

Total Life Expectancy ◽

Functional Reach Test ◽

Balance Ability

Purpose: Japan is one of few countries with a male life expectancy over 80 years. The gap between the healthy life span and the total life expectancy is large, highlighting the importance of maintaining physical performance. The present study aims to establish reference values for multiple physical performance measures among high-functioning oldest-old Japanese men and to investigate the correlations among these measurements to understand how these variables are related. Methods: This study was conducted with 120 Japanese males aged 80 years or older who were able to walk independently. Seven measures of physical performance were assessed: handgrip strength, quadriceps strength, static balance ability (one-legged stance), dynamic balance ability (Functional Reach Test; FRT), walking ability (5-m walking time test), combined movement ability (Timed Up & Go test), and bone quality. Cognitive function was also measured (Mini-Mental State Examination; MMSE). Results: Specific reference values are reported for each physical performance measurement explored in this study. Only six participants were classified as cognitively impaired, and 16 had mild cognitive impairment. There were significant correlations of varying levels among all of the measures of physical performance. Age was significantly correlated with all performance measures except FRT, and there was no correlation between age and MMSE. MMSE was weakly correlated with FRT and unrelated to the other performance measures. Conclusions: The reference ranges can be used by older men who have not yet reached 80 years and their health care providers as physical performance targets to facilitate the maintenance of independent mobility in later life.

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The Relationships Between Physical Performance, Activity Levels, and Falls in Older Men

The Journals of Gerontology Series A ◽

10.1093/gerona/gly248 ◽

2018 ◽

Vol 74 (9) ◽

pp. 1475-1483 ◽

Cited By ~ 2

Author(s):

Eric S Orwoll ◽

Nora F Fino ◽

Thomas M Gill ◽

Jane A Cauley ◽

Elsa S Strotmeyer ◽

...

Keyword(s):

High Activity ◽

Physical Performance ◽

Gait Speed ◽

Fall Risk ◽

High Performance ◽

Older Men ◽

Community Dwelling ◽

Low Performance ◽

And Performance ◽

Low Activity

Abstract Background Physical performance and activity have both been linked to fall risk, but the way they are jointly associated with falls is unclear. We investigated how these two factors are related to incident falls in older men. Methods In 2,741 men (78.8 ± 5 years), we evaluated the associations between activity and physical performance and how they jointly contributed to incident falls. Activity was assessed by accelerometry. Physical performance was measured by gait speed, dynamic balance (narrow walk), chair stand time, grip strength, and leg power. Falls were ascertained by tri-annual questionnaires. Results Men were grouped into four categories based on activity and performance levels. The greatest number of falls (36%–43%) and the highest fall rate (4.7–5.4/y among those who fell) (depending on the performance test) occurred in men with low activity/low performance, but most falls (57%–64%) and relatively high fall rates (3.0–4.35/y) occurred in the other groups (low activity/high performance, high activity/high performance and high activity/low performance; 70% of men were in these groups). There were interactions between activity, performance (gait speed, narrow walk), and incident falls (p = .001–.02); predicted falls per year were highest in men with low activity/low performance, but there was also a peak of predicted falls in those with high activity. Conclusions In community-dwelling older men, many falls occur in those with the lowest activity/worst physical performance but fall risk is also substantial with better activity and performance. Activity/physical performance assessments may improve identification of older men at risk of falls, and allow individualized approaches to prevention.

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Association Of Physical Performance Measures With Bone Dimensions And Volumetric Density In Older Men

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000354264.20400.8b ◽

2009 ◽

Vol 41 ◽

pp. 14

Author(s):

Julie M. Cousins ◽

Moira A. Petit ◽

Brent C. Taylor ◽

Misti Paudel ◽

Julie M. Hughes ◽

...

Keyword(s):

Physical Performance ◽

Performance Measures ◽

Older Men ◽

Volumetric Density ◽

Bone Dimensions

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The Utility of Parent Report in the Assessment of Working Memory among Childhood Brain Tumor Survivors

Journal of the International Neuropsychological Society ◽

10.1017/s1355617712001567 ◽

2013 ◽

Vol 19 (4) ◽

pp. 380-389 ◽

Cited By ~ 21

Author(s):

Robyn A. Howarth ◽

Jason M. Ashford ◽

Thomas E. Merchant ◽

Robert J. Ogg ◽

Victor Santana ◽

...

Keyword(s):

Working Memory ◽

Brain Tumor ◽

Performance Measures ◽

Digit Span ◽

Parent Report ◽

Childhood Brain Tumor ◽

Conformal Radiation Therapy ◽

Search Tasks ◽

Increased Risk ◽

And Performance

AbstractChildhood brain tumor survivors are at increased risk for neurocognitive impairments, including working memory (WM) problems. WM is typically assessed using performance measures. Little is known about the value of parent ratings for identifying WM difficulties, the relationship between rater and performance measures, or predictors of parent-reported WM problems in this population. Accordingly, the current study examined the utility of parent report in detecting WM difficulties among childhood brain tumor survivors treated with conformal radiation therapy (n = 50) relative to siblings (n = 40) and solid tumor survivors not receiving central nervous system-directed therapy (n = 40). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants were administered WM measures (digit span, self-ordered search tasks). Findings revealed parents rated brain tumor survivors as having significantly more WM problems (p < .01) compared to controls. However, the BRIEF-WM scale demonstrated poor sensitivity and specificity for detecting performance-based problems. Significant, albeit modest, correlations were found between the BRIEF-WM scale and performance measures (r = −.24–.22; p < .05) for the combined group. Age at testing, socioeconomic status, and IQ were significant predictors of parent reported WM problems. Rater and performance measures offer complimentary yet different information in assessing WM, which reiterates the importance of using both within the context of clinical assessment. (JINS, 2013, 19, 1–10)

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The Importance of Muscle Versus Fat Mass in Sarcopenic Obesity: A Re-evaluation Using D3-Creatine Muscle Mass Versus DXA Lean Mass Measurements

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa064 ◽

2020 ◽

Vol 75 (7) ◽

pp. 1362-1368 ◽

Cited By ~ 3

Author(s):

Eric S Orwoll ◽

Katherine E Peters ◽

Marc Hellerstein ◽

Steven R Cummings ◽

William J Evans ◽

...

Keyword(s):

Muscle Mass ◽

Physical Performance ◽

Fat Mass ◽

Lean Mass ◽

Older Men ◽

Adverse Outcomes ◽

Negative Effects ◽

Adverse Health Outcomes ◽

Injurious Falls ◽

Increased Risk

Abstract Background The combination of sarcopenia and obesity has been associated with physical impairment in older people. However, previous research has relied on assessments of lean mass as a surrogate for muscle mass. We postulate that inaccurate measures of muscle mass may have obscured the role of obesity in sarcopenia and related outcomes. Our aim was to clarify the interactions of muscle and fat with physical performance and adverse outcomes using an accurate measure of muscle mass. Methods In a longitudinal study of >1,300 older men (mean age 84 years), we compared a direct measurement of muscle mass (D3 creatine dilution; D3Cr) with an approximation of muscle mass (appendicular lean mass [ALM] by dual-energy x-ray absorptiometry [DXA]) and their associations with measures of physical performance (gait speed, chair stand time) and adverse outcomes (incident injurious falls and mobility problems). We measured percent fat mass by DXA. Results Low D3Cr muscle mass was strongly associated with decreased performance and increased risk of adverse outcomes. Increased fat mass had little association after accounting for D3Cr muscle mass. In contrast, DXA ALM was minimally associated with performance or adverse outcomes, and fatness remained associated with both outcomes after accounting for DXA ALM. Conclusions When an accurate assessment of muscle mass (rather than lean mass) is used, reduced muscle mass is highly associated with important outcomes and the negative effects of adiposity are minimal, suggesting that obesity has little relevance for the understanding of important adverse health outcomes of sarcopenia in older men.

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