Cutpoints for Low Appendicular Lean Mass That Identify Older Adults With Clinically Significant Weakness

Abstract Type 2 Diabetes Mellitus (T2DM) accelerates the incidence and increases the prevalence of sarcopenia in older adults. This suggests an urgent need for identifying effective sarcopenia treatments for older adults with T2DM. It is unknown whether traditional approaches, such as progressive resistance exercise training (PRET), can effectively counteract sarcopenia in older patients with T2DM. To test the efficacy of PRET for the treatment of sarcopenia in older adults with T2DM, 30 subjects (15 T2DM and 15 age- and sex- matched controls) underwent metabolic testing with muscle biopsies before and after a 13-week full-body PRET program. Primary outcome measures included changes in appendicular lean mass, muscle strength, and mixed muscle fractional synthesis rate (FSR). Before PRET, BMI-adjusted appendicular lean mass was significantly lower in the T2DM group (0.7095±0.0381 versus 0.8151±0.0439, p<0.0001). As a result of PRET, appendicular lean mass adjusted for BMI and muscle strength increased significantly in both groups, but to a lesser extent for the T2DM group (p=0.0009) . Preliminary results for FSR (n=25) indicate that subjects with T2DM had lower basal FSR prior to PRET (p=0.0197) . Basal FSR increased significantly in the control group after PRET (p=0.0196), while it did not change in the T2DM group (p=0.3537). These results suggest that in older adults the positive effect of PRET on muscle anabolism and strength is reduced by T2DM . Thus, older adults with T2DM may require more intensive, multimodal and targeted sarcopenia treatment. Funded by NIH R01AG049611 and P30AG024832.

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Appendicular Lean Mass, Grip Strength, and the Development of Knee Osteoarthritis and Knee Pain Among Older Adults

ACR Open Rheumatology ◽

10.1002/acr2.11302 ◽

2021 ◽

Author(s):

James S. Andrews ◽

Laura S. Gold ◽

Michael Nevitt ◽

Patrick J. Heagerty ◽

Peggy M. Cawthon

Keyword(s):

Older Adults ◽

Knee Osteoarthritis ◽

Grip Strength ◽

Knee Pain ◽

Lean Mass ◽

Appendicular Lean Mass

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Appendicular Lean Mass, Grip Strength, and the Development of Hospital-Associated Activities of Daily Living Disability among Older Adults in the Health ABC Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glab332 ◽

2021 ◽

Author(s):

James S Andrews ◽

Laura S Gold ◽

May J Reed ◽

Jose M Garcia ◽

Robyn L McClelland ◽

...

Keyword(s):

Older Adults ◽

Grip Strength ◽

Lean Mass ◽

Daily Living ◽

Adult Survivors ◽

Regression Analyses ◽

Appendicular Lean Mass ◽

Adl Disability ◽

Separate Regression

Abstract Background Half of all physical disability, including activity of daily living (ADL) disability, among older adults occurs in the setting of hospitalization. This study examines whether appendicular lean mass (ALM) and grip strength, which are commonly included in various definitions of sarcopenia, are associated with development of hospital-associated ADL disability in older adults in the Health ABC Study. Methods Individuals hospitalized during the first 5 years of follow-up (n=1,724) were analyzed. ALM to body mass index (BMI) ratio (ALMBMI), by dual energy x-ray absorptiometry (DXA), and grip strength, by hand-held dynamometery, were assessed annually. Development of new ADL disability was assessed at the time of the next annual assessment after hospitalization. Separate regression analyses modeled the association of pre-hospitalization ALMBMI or grip strength with death before the next scheduled annual assessment. Next, among those who survived to the next annual assessment, separate regression analyses modeled the association of ALMBMI or grip strength with development of ADL disability. Results Each standard deviation decrement in pre-hospitalization grip strength was associated with an adjusted 1.80 odds of new ADL disability at follow-up (95% CI: 1.18, 2.74). Low, compared to not low, grip strength (per FNIH definition) was associated with an adjusted 2.36 odds of ADL disability at follow-up (95% CI: 1.12, 4.97). ALM measures were not associated with development of hospital-associated ADL disability. ALM and grip strength measures were not associated with death. Conclusions Pre-hospitalization lower grip strength may be an important risk factor for ADL disability among older adult survivors of hospitalization.

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Correlation of Jumping Power with Commonly Used Muscle Function Tests and DXA Appendicular Lean Mass in Older Adults.

Journal of Clinical Densitometry ◽

10.1016/j.jocd.2011.02.049 ◽

2011 ◽

Vol 14 (2) ◽

pp. 167

Author(s):

Bjoern Buehring ◽

Ellen Fidler ◽

Jessie Libber ◽

Mary Checovich ◽

Diane Krueger ◽

...

Keyword(s):

Older Adults ◽

Lean Mass ◽

Muscle Function ◽

Appendicular Lean Mass ◽

Function Tests

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Appendicular lean mass and mortality among prefrail and frail older adults

The journal of nutrition health & aging ◽

10.1007/s12603-016-0753-7 ◽

2016 ◽

Vol 21 (3) ◽

pp. 342-345 ◽

Cited By ~ 10

Author(s):

Justin C. Brown ◽

M. O. Harhay ◽

M. N. Harhay

Keyword(s):

Older Adults ◽

Lean Mass ◽

Frail Older Adults ◽

Appendicular Lean Mass

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Assessment of appendicular lean mass for diagnosis of sarcopenia in older adults: Bio-electrical impedance analysis versus dual-energy x-ray absorptiometry

Clinical Nutrition ◽

10.1016/j.clnu.2018.06.1392 ◽

2018 ◽

Vol 37 ◽

pp. S102

Author(s):

A.M. Verreijen ◽

J. van den Helder ◽

C. van Dronkelaar ◽

R.G. Memelink ◽

M.F. Engberink ◽

...

Keyword(s):

Older Adults ◽

Lean Mass ◽

Electrical Impedance ◽

Impedance Analysis ◽

Dual Energy ◽

X Ray ◽

Appendicular Lean Mass

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The Roles of Body Composition and Specific Strength in the Relationship Between Race and Physical Performance in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glz103 ◽

2019 ◽

Vol 75 (4) ◽

pp. 784-791 ◽

Cited By ~ 1

Author(s):

Nancy Chiles Shaffer ◽

Eleanor M Simonsick ◽

Roland J Thorpe ◽

Stephanie A Studenski

Keyword(s):

Older Adults ◽

Body Composition ◽

High Education ◽

Racial Differences ◽

Physical Performance ◽

Lean Mass ◽

Gait Speed ◽

Cross Sectional ◽

Specific Strength ◽

Appendicular Lean Mass

Abstract Background Socioeconomics may explain black–white differences in physical performance; few studies examine racial differences among socioeconomically similar groups. Performance is also affected by body composition and specific strength, which differ by race. We assessed whether racial differences in physical performance exist among older adults with high education and similar income and whether body composition and specific strength attenuate observed differences. Methods Cross-sectional analysis of 536 men (18% black) and 576 women (28% black) aged more than 60 years from the Baltimore Longitudinal Study of Aging. Body composition was evaluated using dual-energy x-ray absorptiometry. Specific strength was assessed by quadricep peak torque divided by height-normalized thigh cross-sectional area and grip strength divided by body mass index-normalized appendicular lean mass. Physical performance was assessed using usual gait speed and fast 400 m walk time. Sex-stratified linear regression models, adjusted for age, height, education, and recent income, determined whether body composition or specific strength attenuated associations between race and physical performance. Results Blacks were younger, with higher weight and appendicular lean mass. Black women had higher percent fat and specific strength. In both sexes, blacks had poorer physical performance after adjustment for socioeconomic factors. In women, neither body composition nor specific strength altered the association with gait speed. In men, neither body composition nor specific strength attenuated racial differences in either performance measure. Conclusions Poorer physical performance among black compared to white older adults persists among persons with high education and similar income and cannot generally be attributed to differences in body composition or specific strength.

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Dietary Protein and Change in Appendicular Lean Mass in Older Adults: The Health ABC Study

The FASEB Journal ◽

10.1096/fasebj.20.4.a555 ◽

2006 ◽

Vol 20 (4) ◽

Author(s):

Denise Houston ◽

Barbara Nicklas ◽

Tamara Harris ◽

Frances Tylavsky ◽

Anne Newman ◽

...

Keyword(s):

Older Adults ◽

Lean Mass ◽

Dietary Protein ◽

Appendicular Lean Mass

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Appendicular Lean Mass Loss Does Not Impact Physical Performance Change During Caloric Restriction in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.301 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 80-80

Author(s):

Daniel Beavers ◽

Ryan Miller ◽

Kristen Beavers ◽

Barbara Nicklas

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Caloric Restriction ◽

Physical Performance ◽

Lean Mass ◽

Controlled Trials ◽

Randomized Controlled ◽

Performance Change ◽

Appendicular Lean Mass ◽

Sit To Stand

Abstract Data from 11 six-month randomized controlled trials were pooled, with 902 participants randomized to caloric restriction (CR; n=762) or Non-CR (n=140) to determine if CR-induced appendicular lean mass (ALM) loss was associated with change in physical performance among older adults. After adjusting for age, sex, race, body mass index, exercise assignment and baseline value of the outcome, CR had significant ALM loss [-0.77 kg (95% CI: -0.89, -0.65)], while Non-CR had ALM gain [+0.28 kg (0.08, 0.49)]; p<0.001. Both groups experienced similar improvements in the Short Physical Performance Battery (SPPB) score [CR: +0.45 (0.35, 0.55) vs Non-CR: +0.50 (0.30, 0.69); p=0.63] and sit-to-stand time [CR: -1.42 s (-1.81, -1.03) vs Non-CR: -1.85 s (-2.49, -1.21); p=0.19]. Change in SPPB score and sit-to-stand time was not associated with change in ALM (both p>0.15). In spite of significant ALM loss, CR resulted in overall improvements in physical performance in older adults.

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