Association between Ambient Fine Particulate Matter and Physical Functioning in Middle-aged and Older Chinese Adults: A Nationwide Longitudinal Study

Author(s):  
Huiyu Wang ◽  
Hengyi Liu ◽  
Fuyu Guo ◽  
Jiajianghui Li ◽  
Pengfei Li ◽  
...  

Abstract Background Exposure to air pollution is associated with several chronic diseases and subclinical processes that could subsequently contribute to physical disability. However, whether and to what extent air pollution exposure is associated with objective measures of physical functioning remains understudied. Methods We used longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) and included 10,823 participants who were surveyed at least twice. Annual average exposure to fine particulate matter (PM2.5) was assessed using a state-of-the-art estimator. Physical functioning was assessed with four objective tests covering hand-grip strength, balance, repeated chair stands, and gait speed. Mixed-effects models with participants as a random term were used to estimate associations with multiple adjustments. Results We found a significant and robust association between exposure to increased PM2.5 and the reduction in hand-grip strength and balance ability. Each 10-μg/m 3 increase in annual averaged concentrations of PM2.5 was associated with a 220-g (95% confidence interval [CI]: 127, 312 g) reduction in hand-grip strength per 60 kg of body weight and a 5% risk (95% CI: 2, 7) of reduced balance ability. The estimated effect of each 10-μg/m 3 increase in PM2.5 on hand-grip strength and balance ability was equivalent to the effect of aging [1.12 (95% CI: 0.76, 1.48) and 0.98 (95% CI: 0.50, 1.50) years, respectively]. Conclusions PM2.5 may be differentially associated with various dimensions of physical functioning. Improving air quality can prevent physical disability.

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Joanna Sophia Jacoline Vinke ◽  
Hanneke Wouters ◽  
Adriaan Post ◽  
Suzanne Stam ◽  
Rianne M. Douwes ◽  
...  

Abstract Background and Aims Post-transplant anemia is highly prevalent in kidney transplant recipients (KTRs). It is known that anemia impairs health-related quality of life, especially physical functioning. Although surmised, data about the latter are scarce. Hence, we aimed to investigate the association between anemia and muscle mass and muscle strength in KTRs. Method We used the TransplantLines Biobank and Cohort study, a prospective cohort study among all types of solid organ transplant recipients. For the current study, we used stable KTRs with a functional graft for more than 1 year post transplantation and with data available on hemoglobin levels and muscle mass (n=824). Muscle mass was assessed using 24-hour urinary creatinine excretion. Muscle strength was determined by means of hand grip strength using a dynamometer. Hand grip strength was tested three times with 30 seconds recovery time between attempts. For current analyses, the mean overall hand grip strength was calculated. Anemia was defined as hemoglobin <12 g/dL for women and <13 g/dL for men, according to WHO definitions. We used multivariable linear regression analyses to assess associations between anemia and muscle mass and strength. Results We included 824 KTRs (age 56±13 years, 60% males), with a mean hemoglobin of 13.5±1.8 g/dL. Anemia was present in 28% (n=277) of KTRs. Serum hemoglobin was associated with creatinine excretion, independent of age, sex, eGFR, BMI, hs-CRP, smoking status, alcohol use, and the use of RAAS-inhibitors, calcineurin inhibitors, proliferation inhibitors, or prednisolone (β=0.13, P<0.001). Similarly, the presence of anemia was independently associated with a lower creatinine excretion (β=-0.09, P=0.002). In line with creatinine excretion, hemoglobin levels (β=0.15, P<0.001) and the presence of anemia (β=-0.09, P=0.002) were also associated with handgrip strength independent of potential confounders. Conclusion Low hemoglobin levels and anemia are both strongly associated with lower muscle mass and muscle strength in KTRs, likely impairing physical functioning. Future research is needed to address whether correction of anemia improves physical performance in KTRs.


2002 ◽  
Vol 23 (2) ◽  
pp. 110-122 ◽  
Author(s):  
Henrik Frederiksen ◽  
David Gaist ◽  
Hans Christian Petersen ◽  
Jacob Hjelmborg ◽  
Matt McGue ◽  
...  

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3363
Author(s):  
Kristian Kirkelund Bentsen ◽  
Olfred Hansen ◽  
Jesper Ryg ◽  
Ann-Kristine Weber Giger ◽  
Stefan Starup Jeppesen

The Geriatric 8 (G-8) is a known predictor of overall survival (OS) in older cancer patients, but is mainly based on nutritional aspects. This study aimed to assess if the G-8 combined with a hand-grip strength test (HGST) in patients with NSCLC treated with stereotactic body radiotherapy can predict long-term OS better than the G-8 alone. A total of 46 SBRT-treated patients with NSCLC of stage T1-T2N0M0 were included. Patients were divided into three groups: fit (normal G-8 and HGST), vulnerable (abnormal G-8 or HGST), or frail (abnormal G-8 and HGST). Statistically significant differences were found in 4-year OS between the fit, vulnerable, and frail groups (70% vs. 46% vs. 25%, p = 0.04), as well as between the normal and abnormal G-8 groups (69% vs. 39%, p = 0.02). In a multivariable analysis of OS, being vulnerable with a hazard ratio (HR) of 2.03 or frail with an HR of 3.80 indicated poorer OS, but this did not reach statistical significance. This study suggests that there might be a benefit of adding a physical test to the G-8 for more precisely predicting overall survival in SBRT-treated patients with localized NSCLC. However, this should be confirmed in a larger study population.


Hand ◽  
2021 ◽  
pp. 155894472110172
Author(s):  
Kaisa Jokinen ◽  
Arja Häkkinen ◽  
Toni Luokkala ◽  
Teemu Karjalainen

Background Modern multistrand repairs can withstand forces present in active flexion exercises, and this may improve the outcomes of flexor tendon repairs. We developed a simple home-based exercise regimen with free wrist and intrinsic minus splint aimed at facilitating the gliding of the flexor tendons and compared the outcomes with the modified Kleinert regimen used previously in the same institution. Methods We searched the hospital database to identify flexor tendon repair performed before and after the new regimen was implemented and invited all patients to participate. The primary outcome was total active range of motion, and secondary outcomes were Disabilities of Arm, Shoulder, and Hand; grip strength; globally perceived function; and the quality of life. Results The active range of motion was comparable between the groups (mean difference = 14; 95% confidence interval [CI], −8 to 36; P = .22). Disabilities of Arm, Shoulder, and Hand; grip strength; global perceived function; and health-related quality of life were also comparable between the groups. There was 1 (5.3%) rupture in the modified Kleinert group and 4 (15.4%) in the early active motion group (relative risk = 0.3; 95% CI, 0.04-2.5; P = .3). Conclusions Increasing active gliding with a free wrist and intrinsic minus splint did not improve the clinical outcomes after flexor tendon injury at a mean of 38-month follow-up.


Sign in / Sign up

Export Citation Format

Share Document