Creatinine to cystatin C ratio, a biomarker of sarcopenia measures and falls risk in community-dwelling older women

2021 ◽  
Author(s):  
Marc Sim ◽  
Jack Dalla Via ◽  
David Scott ◽  
Wai H Lim ◽  
Jonathan M Hodgson ◽  
...  
Keyword(s):  
Grip Strength ◽  
Older Women ◽  
Cystatin C ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Hand Grip ◽  
Diet And Exercise ◽  
Risk Of Falls ◽  
Adjusted Model ◽  
Multivariable Adjusted Model

Abstract Background The ratio of creatinine to cystatin C (Cr:Cyc) has been proposed as a biomarker of sarcopenia, as greater Cr:Cyc is typically associated with greater muscle mass. We examined the relationship between Cr:Cyc with individual sarcopenia measures, 5 y self-reported falls and 12 y fall-related hospitalizations in a prospective cohort study of 1,118 community-dwelling older women (mean age 75.2 ± 2.7 y). Methods Serum Cr:Cyc, hand grip strength and timed-up-and-go (TUG) performance were assessed at baseline (1998), while dual-energy X-ray absorptiometry (DXA) derived ALM/Height (m) 2 was obtained in a subset of women at baseline and 1 year (n=334). Incident 5 y self-reported falls and 12-year falls-related hospitalizations were considered. Results In a multivariable-adjusted model, women with the lowest Cr:Cyc (Quartile [Q] 1) had 5% (1.0 kg) weaker grip strength, as well as 3.7% (0.22 kg/m 2) and 5.5% (0.031) lower ALM adjusted for height 2 or BMI, respectively, compared to women in Q4 (all p<0.05). 329 women reported an incident fall over 5 years, and 326 fall-related hospitalizations were recorded over 12 years. Women in Q1 of Cr:Cyc had a greater relative hazard for a fall over 5 years (HR 1.50 95%CI 1.11-2.01) and fall-related hospitalization over 12 years (HR 1.53 95%CI 1.13-2.07) compared to Q4 in the multivariable-adjusted model. Conclusion These findings support further investigation into the use of Cr:Cyc as a muscle biomarker to help clinicians identify individuals at risk of falls for early inclusion into evidence-based primary prevention programs targeting improvements to diet and exercise.

scholarly journals Components of physical fitness as prognostic factors for falls in elderly female exercise practitioners: a longitudinal study

2020 ◽  
Vol 33 ◽  
Author(s):  
Giovana Zarpellon Mazo ◽  
Raquel Ester Lima ◽  
Pedro Silvelo Franco ◽  
Leonardo Hoffmann ◽  
Enaiane Cristina Menezes
Keyword(s):  
Physical Fitness ◽  
Grip Strength ◽  
Older Women ◽  
Lower Limb ◽  
Hand Grip Strength ◽  
Left Hand ◽  
Elderly Female ◽  
Hand Grip ◽  
Risk Of Falls ◽  
Falls In Elderly

Abstract Introduction: Physical exercise is used as a strategy for the prevention of falls because it improves the physical fitness of older adults. Objective: To determine which components of physical fitness are predictors of falls in elderly female exercise practitioners. Method: Longitudinal, descriptive, comparative study. The components of physical fitness (upper and lower limb strength and flexibility, agility, aerobic endurance, and hand grip strength) and the occurrence or not of falls in the last 12 months were analyzed in 80 older women practitioners of exercise from 2013 to 2016. Descriptive analysis, ROC curve attributing cut-off points, and binary logistic regression for the prediction of falls were used. Results: The mean age of the participants was 67.46 years (SD=7.65). Over the years, a significant difference between elderly fallers and non-fallers was observed for right hand grip strength (2013 and 2015), left hand grip strength (2014 and 2015), lower limb flexibility (2013, 2014 and 2015), agility (2015), and aerobic endurance (2015). In adjusted analysis, older women with poor lower limb flexibility in 2013 had a higher risk of falls in 2016 (OR=4.98; 95%CI 1.12 - 22.1). Older women with poor flexibility in 2015 also had a higher risk of falls (OR= 6.08; 95%CI 1.06 - 34.67). Conclusion: Poor performance in the lower limb flexibility, right and left hand grip strength, agility and aerobic endurance tests was associated with falls and these components are predictors of future falls in elderly exercise practitioners.

scholarly journals Higher Levels of Physical Fitness Are Associated with Lower Peak Plantar Pressures in Older Women

2020 ◽  
Vol 12 (10) ◽  
pp. 4119
Author(s):  
Lovro Štefan ◽  
Mario Kasović ◽  
Martin Zvonař
Keyword(s):  
Older Adults ◽  
Physical Fitness ◽  
Older Women ◽  
Plantar Pressure ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Plantar Pressures ◽  
Risk Of Falls ◽  
Fitness Levels

Little is known about how physical fitness is associated with peak plantar pressures in older adults. Therefore, the main purpose of the study was to explore whether higher physical fitness levels were associated with lower peak plantar pressures in a sample of community-dwelling older adults. In this cross-sectional study, we recruited 120 older women aged ≥60 years. To assess the level of peak plantar pressure, we used a Zebris plantar pressure platform. To estimate the level of physical fitness, a senior fitness test battery was used. To calculate the associations between the level of physical fitness and peak plantar pressures beneath the different foot regions (forefoot, midfoot and hindfoot), we used generalized estimating equations with a linear regression model. In unadjusted models, higher physical fitness levels were associated with lower peak plantar pressures. When we adjusted for chronological age, the risk of falls and the presence of foot pain, higher physical fitness levels remained associated with lower peak plantar pressures. Our study shows that higher levels of physical fitness are associated with lower peak plantar pressures, even after adjusting for several potential covariates.

scholarly journals Differences in sarcopenia prevalence between upper-body and lower-body based EWGSOP2 muscle strength criteria: the Tromsø study 2015–2016

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jonas Johansson ◽  
Bjørn Heine Strand ◽  
Bente Morseth ◽  
Laila Arnesdatter Hopstock ◽  
Sameline Grimsgaard
Keyword(s):  
Waist Circumference ◽  
Grip Strength ◽  
Body Height ◽  
Community Dwelling ◽  
Upper Body ◽  
Linear Regression Models ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Chair Stand ◽  
European Working

Abstract Background The European Working Group on Sarcopenia in Older People (EWGSOP2) recommends grip strength and chair stand tests to be used as primary defining measures. It is unclear how either test affects prevalence estimates. Methods This cross-sectional study involved 3498 community-dwelling participants (40–84 years) from the 7th Tromsø Study survey (2015–2016). We used grip strength, five-repetition chair stands, four-meter Walk Speed Test, Timed-Up-and-Go (TUG) and Dual-Energy X-ray Absorptiometry measurements. Data were analyzed using multiple linear regression models and ROC-curves. Results Probable and confirmed sarcopenia prevalence was 1.3 and 4.4% based on grip strength and chair stands, respectively. There was very low agreement between grip strength and chair stand cut-offs (κ = 0.07), with only 4.3% of participants defined as having probable sarcopenia overlapping in the two criteria. Participants with grip strength-based sarcopenia had lower mean height, weight, waist circumference, and appendicular lean mass relative to body height (ALMheight2) than non-sarcopenic participants (all p < 0.001), after adjusting for multiple covariates. Conversely, participants with chair stand-based sarcopenia had similar height, higher weight, waist circumference and body fat% compared to non-sarcopenic participants (all p < 0.05). Area-under-curves (AUCs) for TUG-time were significantly larger when using chair stand instead of grip strength cut-offs (0.86, 95% CI 0.84–0.89 vs. 0.75, 95% CI 0.69–0.83). Conclusions Using chair stands instead of grip strength more than doubled probable sarcopenia prevalence across all ages. The two measures defined individuals of contradictory anthropometrics, body composition, and dissimilar physical function to have probable sarcopenia. Researchers should further evaluate the consequences of using different strength measures in the EWGSOP2 definition to classify sarcopenia.

scholarly journals The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Robbert J. J. Gobbens ◽  
Marcel A. L. M. van Assen
Keyword(s):  
Physical Activity ◽  
Grip Strength ◽  
Gait Speed ◽  
Response Rate ◽  
Hand Grip Strength ◽  
Community Dwelling ◽  
Physical Frailty ◽  
Activity Restriction ◽  
Hand Grip ◽  
Iadl Disability

Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N=264, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability.

scholarly journals Comparison of static balance and mobility between nursing home residents and community-dwelling elderly.

2020 ◽  
pp. 1-6
Author(s):  
Livia Marcondes Faber ◽  
Lara Alves Moreira ◽  
Marcos Eduardo Scheicher
Keyword(s):  
Nursing Home ◽  
Linear Regression Analysis ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Coefficient Of Determination ◽  
Static Balance ◽  
Index Number ◽  
Community Group ◽  
Timed Up And Go ◽  
Risk Of Falls

Background: Postural control is considered to be a complex motor skill derived from the interaction of multiple sensorimotor processes. Objectives: To compare the static balance and mobility of nursing home residents with community-dwelling elderly and verify which confounders imply in a worse postural balance on nursing home residents. Methods: Were included elderly aged 60 and more, both sexes, living at nursing homes (NHs) and at the community. The static balance was evaluated by a force platform and the mobility by the Timed Up and Go test (TUG). The confounders available were length of institutionalization, age, gender, body mass index, number of falls and number of medication. Comparisons were made by unpaired t-tests and by the Mann-Whitney test. The risk of falls was evaluated by Fisher’s Exact Test. Pearson or Spearman correlation analysis was performed to identify the independent variables with a significant relationship with the dependent variables. The simple linear regression analysis and R2 was analyzed to ascertain the coefficient of determination of the percentage variation. A value of p≤0.05 was considered significant. Results: 21 nursing home residents and 21 community-dwelling elderly were included. The NHs residents presented significantly higher values of COP oscillation than the community group (total displacement: p=0.0002; mean velocity: p=0.001, 95% ellipse area: p=0,04, and standard deviation in the frontal plane: p=0.01). The NHs group presented longer time to perform the TUG test than the community group (17.28±4.5 s and 13.21±3.9 s, p=0.002). Was observed that the number of medications showed a significant correlation with the TUG (r=0.52; p=0.01), and none variable showed correlation with the static balance. Conclusion: The results showed that the nursing home residents with a normal cognitive condition had greater center of gravity oscillation, worse mobility, and higher risk of falls than community elders. In addition, it was found that in nursing home residents, the ingestion of five or more drugs had relation with mobility.

scholarly journals Combined Chair-Based Exercises Improve Functional Fitness, Mental Well-Being, Salivary Steroid Balance, and Anti-microbial Activity in Pre-frail Older Women

2021 ◽  
Vol 12 ◽  
Author(s):  
Guilherme Eustáquio Furtado ◽  
Rubens Vinícius Letieri ◽  
Adriana Silva-Caldo ◽  
Joice C. S. Trombeta ◽  
Clara Monteiro ◽  
...  
Keyword(s):  
Mental Health ◽  
Grip Strength ◽  
Older Women ◽  
Steroid Hormones ◽  
Gait Speed ◽  
Well Being ◽  
Hand Grip Strength ◽  
Functional Fitness ◽  
Hand Grip ◽  
Mental Well Being

IntroductionRegular exercise has long been shown to positively impact the immune system responsiveness and improve mental well-being (MWB). However, the putative links between biomarkers of mental health and immune efficiency in exercising subjects have been scarcely investigated. The aim of this study was to verify the effect of a 14-week combined chair-based exercise program (CEP) on salivary steroid hormones and anti-microbial proteins, functional fitness, and MWB indexes in pre-frail older women.MethodsThe participant women (82.8 4.6 years old; n = 32) were randomly divided into the exercising group (CEP, n = 17) and the non-exercising control group (CG, n = 15). The pre/post assessment included: (1) salivary anti-microbial proteins lysozyme; (Lys) and immunoglobulin-A (IgA); (2) salivary steroid hormones of testosterone (TT) and cortisol (COR); (3) functional fitness (gait speed, hand grip strength, and static balance); (4) MWB questionnaires (happiness, depression state, satisfaction with life, and stress).ResultsSignificant differences with large Cohen’s (d) effect sizes were found on increased salivary TT (p &lt; 0.05; d = 0.60) after exercise intervention. The results revealed a decrease in IgA levels after CEP (p &lt; 0.01, d = 0.30). The increase in subjective happiness levels (p &lt; 0.05, d = 0.30) and decrease of stress perception (p &lt; 0.01, d = 2.60) and depressive state (p &lt; 0.05, d = 0.30) were found after intervention in the CEP group. Robust statistical differences in gait speed (p &lt; 0.05; d = 0.60) and balance tests (p &lt; 0.05; d = 0.80) were also found in the CEP group. In control, COR increased moderately (p &lt; 0.05; d = 0.65) while no changes were found for the other indicators. Correlation analyses showed inter-dependence between pre–post variations of MWB, biochemical indexes, and fitness function (e.g., COR inverse correlation with hand grip strength and balance tests).ConclusionThe CEP program was able to improve functional-fitness performance, decrease feelings of stress, and increase happiness. The CEP also induced clinically relevant hormonal and immune responses, which suggests that chair exercises that combine muscular strength, balance, and gait speed training are promising interventions to improve physical and mental health of older pre-frail adults.

scholarly journals Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

2020 ◽  
Author(s):  
Yuki Kusagawa ◽  
Toshiyuki Kurihara ◽  
Aiko Imai ◽  
Sumiaki Maeo ◽  
Takashi Sugiyama ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Older Women ◽  
Walking Speed ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Chair Stand ◽  
Foot Posture ◽  
Toe Flexor Strength ◽  
Flexor Strength

Abstract Background: Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women. Methods: Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-second chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group. Results: TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = -0.32, p = 0.07) and supinated (r = -0.56, p = 0.08) groups, and positively correlate with 30-second chair stand score in the pronated group (r = 0.31, p = 0.08). Conclusions: The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.

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