Physical Performance Predictors for Incident Dementia Among Japanese Community-Dwelling Older Adults

2019 ◽  
Vol 99 (9) ◽  
pp. 1132-1140
Author(s):  
Takehiko Doi ◽  
Kota Tsutsumimoto ◽  
Sho Nakakubo ◽  
Min-Ji Kim ◽  
Satoshi Kurita ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Grip Strength ◽  
Physical Performance ◽  
Performance Level ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Community Dwelling Older Adults

Abstract Background Evaluating physical performance could facilitate dementia risk assessment. However, findings differ regarding which type of physical performance best predicts dementia. Objective The objective of this study was to examine the association between physical performance and incidence of dementia in Japanese community-dwelling older adults. Design This was a prospective study of community-dwelling older adults. Methods Of 14,313 invited individuals who were ≥ 65 years old, 5104 agreed to participate from 2011 to 2012, and 4086 (52% women; mean age = 72.0 years) met the criteria. Baseline assessments of the following physical performance indicators were obtained: grip strength, the Five-Times Sit-to-Stand Test, and the Timed “Up & Go” Test. The physical performance level in each test was categorized as C1 (highest), C2 (middle–high), C3 (middle–low), or C4 (lowest) on the basis of sex-stratified quartile values. Incident dementia status was obtained from medical records that were updated monthly. Results During follow-up (mean duration = 42.9 months), there were 243 incident cases of dementia (5.9%). Log-rank test results indicated that a lower physical performance level constituted a significant risk factor for dementia. After adjustment for covariates, Cox proportional hazards models (reference: highest physical performance level [C1]) demonstrated that the Five-Times Sit-to-Stand Test in the group with the lowest physical performance level (hazard ratio = 1.69; 95% CI = 1.10–2.59) was significantly associated with a risk of dementia. Likewise, the Timed “Up & Go” Test in the group with the lowest physical performance level (hazard ratio = 1.54; 95% CI = 1.01–2.35) was significantly associated with a risk of dementia. However, grip strength was not significantly associated with a risk of dementia. Limitations This study was limited by the use of medical record data. Conclusions A lower mobility-related physical performance level was associated with dementia risk. Dementia risk assessment should include an adequate evaluation of physical function.

scholarly journals Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Xianyang Sherman Yee ◽  
Yee Sien Ng ◽  
John Carson Allen ◽  
Aisyah Latib ◽  
Ee Ling Tay ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Gait Speed ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Fitness Measures ◽  
Community Dwelling Older Adults

Abstract Background The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants – Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) – with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults. Methods This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance. Results Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST, r = 0.290; 5TSTS, r = − 0.242; both p< 0.01), and stronger correlations with gait speed (30CST, r = 0.517; 5TSTS, r = − 0.533; both p< 0.01), endurance (30CST, r = 0.558; 5TSTS, r = − 0.531; both p < 0.01) and dynamic balance (30CST, r = − 0.501; 5TSTS, r = 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%; p = 0.276). When both measures are used, prevalence is significantly higher (42.0%; p = 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%; p< 0.05). Conclusion In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.

Prospective associations of plasma growth differentiation factor 15 with physical performance and cognitive functions in older adults

2022 ◽  
Author(s):  
Lingxiao He ◽  
Philipe de Souto Barreto ◽  
Juan Luis Sánchez Sánchez ◽  
Yves Rolland ◽  
Sophie Guyonnet ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Physical Performance ◽  
Cognitive Functions ◽  
Community Dwelling ◽  
Cognitive Score ◽  
Growth Differentiation Factor 15 ◽  
Clinically Significant ◽  
One Year ◽  
Community Dwelling Older Adults

Abstract Background Growth differentiation factor 15 (GDF15) has been associated with several age-related disorders, but its associations with functional abilities in community-dwelling older adults are not well studied. Methods The study was a secondary analysis on 1096 community-dwelling older adults (aged 69 to 94 years) recruited from the Multidomain Alzheimer’s Preventive Trial. Plasma GDF15 was measured one year after participants’ enrolment. Annual data of physical performance (grip strength and short physical performance battery [SPPB]) and global cognitive functions (mini-mental state examination [MMSE] and a composite cognitive score) were measured for four years. Adjusted mixed-effects linear models were performed for cross-sectional and longitudinal association analyses. Results A higher GDF15 was cross-sectionally associated with a weaker grip strength (β = -1.1E-03, 95%CI [-2.0E-03, -1.5E-04]), a lower SPPB score (β = -3.1E-04, 95%CI [-5.4E-04, -9.0E-05]) and worse cognitive functions (β = -2.4E-04, 95%CI [-3.3E-04, -1.6E-04] for composite cognitive score; β = -4.0E-04, 95%CI [-6.4E-04, -1.6E-04] for MMSE). Participants with higher GDF15 demonstrated greater longitudinal declines in SPPB (β = -1.0E-04, 95%CI [-1.7E-04, -2.0E-05]) and composite cognitive score (β = -2.0E-05, 95%CI [-4.0E-05, -3.6E-06]). The optimal initial GDF15 cutoff values for identifying participants with minimal clinically significant decline after one year were 2189 pg/mL for SPPB (AUC: 0.580) and 2330 pg/mL for composite cognitive score (AUC: 0.587). Conclusions Plasma GDF15 is cross-sectionally and longitudinally associated with lower-limb physical performance and global cognitive function in older adults. Circulating GDF15 alone has limited capacity of discriminating older adults who will develop clinically significant functional declines.

scholarly journals Relationship Between Tooth Loss and Sarcopenia in Chinese Suburban Community-dwelling Older Adults

2021 ◽  
Author(s):  
Feng Wang ◽  
Jingru Wang ◽  
Peipei Han ◽  
Yuewen Liu ◽  
Weibo Ma ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Grip Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Tooth Loss ◽  
Walking Speed ◽  
Community Dwelling ◽  
Suburban Community ◽  
Community Dwelling Older Adults

Abstract Background: Both sarcopenia and loss of teeth are associated with aging. The purpose of this study was to investigate potential relationships between tooth loss and sarcopenia and components of sarcopenia, including declining muscle mass, muscle strength, and physical performance, in Chinese suburban community-dwelling older adults.Methods: The subjects were 1494 people over 60 years of age (average age: 71.64 ± 5.97 years；men, n=609) from Chongming District of Shanghai and Hangu District of Tianjin. The Asian Working Group for Sarcopenia (AWGS) criteria were used to define sarcopenia. The three basic diagnostic components of sarcopenia (muscle mass, muscle strength, and physical performance) were assessed using a bioelectrical impedance analyzer, a grip strength test, and a four-meter walk test, respectively. The subjects were divided into groups depending on self-reported loss of teeth. Results: After adjusting for confounding variables, we found no correlation between tooth loss and sarcopenia or muscle mass. However, the walking speed of female participants with at least 10 teeth lost was 0.059 m/s slower than that of participants with fewer than 10 teeth lost (P＜0.001), and grip strength was 1.577 kg lower among male participants with at least 10 teeth lost than among males with fewer than 10 teeth lost (P =0.023).Conclusion: Our results suggest that tooth loss is negatively correlated with muscle strength in males and average walking speed in females. These results are consistent with the importance of good oral hygiene in preventing declines of physical performance in older adults.

scholarly journals SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuen Yee Lee ◽  
Pei Ling Choo ◽  
Benedict Wei Jun Pang ◽  
Lay Khoon Lau ◽  
Khalid Abdul Jabbar ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Reference Values ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Appropriate Treatment ◽  
Sum Score ◽  
The Mean ◽  
And Performance ◽  
Community Dwelling Older Adults

Abstract Background The Short Physical Performance Battery (SPPB) is an established test of physical performance. We provide reference values for SPPB and determine SPPB performance and cut-offs in assessing sarcopenia for Asian community-dwelling older adults. Methods Five hundred thirty-eight (57.8% women) community-dwelling adults aged 21–90 years were recruited. SPPB and its subtest scores and timings (8 ft. gait speed (GS), five-times repeated chair sit-to-stand (STS) and balance) were determined. Appendicular lean mass divided by height-squared, muscle strength (handgrip) and physical performance (6 m GS, STS and SPPB) were assessed to define sarcopenia for various Asian criteria. Area under the ROC curve (AUC) was used to assess performance of SPPB and subtests in discriminating sarcopenia in adults aged ≥60 years. Optimal SPPB and GS subtest cut-offs for each sarcopenia criterion were determined by maximizing sensitivity and specificity. Results The mean SPPB score was 11.6(SD 1.1) in men and 11.5(SD1.2) in women. Majority of participants(≥50%) aged 21–80 years achieved the maximum SPPB score. SPPB total and subtest scores generally decreased with age (all p < 0.001), but did not differ between sex. Among older adults (≥60 years), SPPB and GS subtest had varied performance in assessing sarcopenia (AUC 0.54–0.64 and 0.51–0.72, respectively), and moderate-to-excellent performance in assessing severe sarcopenia (AUC 0.69–0.98 and 0.75–0.95, respectively), depending on sarcopenia definitions. The optimal cut-offs for discriminating sarcopenia in both sexes were SPPB ≤11points and GS subtest ≤1.0 m/s. The most common optimal cut-offs for discriminating severe sarcopenia according to various definitions were SPPB ≤11points in both sexes, and GS ≤0.9 m/s in men and ≤ 1.0 m/s in women. Conclusions Population-specific normative SPPB values are important for use in diagnostic criteria and to interpret results of studies evaluating and establishing appropriate treatment goals. Performance on the SPPB should be reported in terms of the total sum score and registered time to complete the repeated-chair STS and 8-ft walk tests. The performance of GS subtest was comparable to SPPB and could be a useful, simple and accessible screening tool for discriminating severe sarcopenia in community-dwelling older adults.

scholarly journals Relationship Between Tooth Loss and Sarcopenia in Chinese Suburban Community-Dwelling Older Adults

2021 ◽  
Author(s):  
Feng Wang ◽  
Jingru Wang ◽  
Peipei Han ◽  
Yuewen Liu ◽  
Weibo Ma ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Grip Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Tooth Loss ◽  
Walking Speed ◽  
Community Dwelling ◽  
Suburban Community ◽  
Community Dwelling Older Adults

Abstract Background: Both sarcopenia and loss of teeth are associated with aging. The purpose of this study was to investigate potential relationships between tooth loss and sarcopenia and components of sarcopenia, including declining muscle mass, muscle strength, and physical performance, in Chinese suburban community-dwelling older adults.Methods: The subjects were 1494 people over 60 years of age (average age: 71.64 ± 5.97 years；men, n=609) from Chongming District of Shanghai and Hangu District of Tianjin. The Asian Working Group for Sarcopenia (AWGS) criteria were used to define sarcopenia. The three basic diagnostic components of sarcopenia (muscle mass, muscle strength, and physical performance) were assessed using a bioelectrical impedance analyzer, a grip strength test, and a four-meter walk test, respectively. The subjects were divided into groups depending on self-reported loss of teeth. Results: After adjusting for confounding variables, we found no correlation between tooth loss and sarcopenia or muscle mass. However, the walking speed of female participants with at least 10 teeth lost was 0.059 m/s slower than that of participants with fewer than 10 teeth lost (P＜0.001), and grip strength was 1.577 kg lower among male participants with at least 10 teeth lost than among males with fewer than 10 teeth lost (P =0.023).Conclusion: Our results suggest that tooth loss is negatively correlated with muscle strength in males and average walking speed in females. These results are consistent with the importance of good oral hygiene in preventing declines of physical performance in older adults.

scholarly journals SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun Study

2021 ◽  
Author(s):  
Shuen Yee Lee ◽  
Pei Ling Choo ◽  
Benedict Wei Jun Pang ◽  
Lay Khoon Lau ◽  
Khalid Abdul Jabbar ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Reference Values ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Appropriate Treatment ◽  
Sum Score ◽  
The Mean ◽  
And Performance ◽  
Community Dwelling Older Adults

Abstract Background: The Short Physical Performance Battery (SPPB) is an established test of physical performance. We provide reference values for SPPB and determine SPPB performance and cut-offs in assessing sarcopenia for Asian community-dwelling older adults.Methods: 538 (57.8% women) community-dwelling adults aged 21–90 years were recruited. SPPB and its subtest scores and timings (8ft gait speed (GS), five-times repeated chair sit-to-stand (STS) and balance) were determined. Appendicular lean mass divided by height-squared, muscle strength (handgrip) and physical performance (6m GS, STS and SPPB) were assessed to define sarcopenia for various Asian criteria. Area under the ROC curve (AUC) was used to assess performance of SPPB and subtests in discriminating sarcopenia in adults aged ≥60 years. Optimal SPPB and GS subtest cut-offs for each sarcopenia criterion were determined by maximizing sensitivity and specificity. Results: The mean SPPB score was 11.6(SD 1.1) in men and 11.5(SD1.2) in women. Majority of participants(≥50%) aged 21–80 years achieved the maximum SPPB score. SPPB total and subtest scores generally decreased with age (all p<0.001), but did not differ between sex. Among older adults (≥60 years), SPPB and GS subtest had varied performance in assessing sarcopenia (AUC 0.54–0.64 and 0.51–0.72, respectively), and moderate-to-excellent performance in assessing severe sarcopenia (AUC 0.69–0.98 and 0.75–0.95, respectively), depending on sarcopenia definitions. The optimal cut-offs for discriminating sarcopenia in both sexes were SPPB ≤11points and GS subtest ≤1.0m/s. The most common optimal cut-offs for discriminating severe sarcopenia according to various definitions were SPPB ≤11points in both sexes, and GS ≤0.9m/s in men and ≤1.0m/s in women.Conclusions: Population-specific normative SPPB values are important for use in diagnostic criteria and to interpret results of studies evaluating and establishing appropriate treatment goals. Performance on the SPPB should be reported in terms of the total sum score and registered time to complete the repeated-chair STS and 8-ft walk tests. The performance of GS subtest was comparable to SPPB and could be a useful, simple and accessible screening tool for discriminating severe sarcopenia in community-dwelling older adults.

Does physical performance and muscle strength predict future personal and nursing care services in community-dwelling older adults aged 75+?

2021 ◽  
pp. 140349482097909
Author(s):  
Jonathan Vaarst ◽  
Eleanor Boyle ◽  
Sonja Vestergaard ◽  
Lars G. Hvid ◽  
Elsa S. Strotmeyer ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Grip Strength ◽  
Physical Performance ◽  
Nursing Care ◽  
Community Dwelling ◽  
Short Physical Performance Battery ◽  
Home Nursing ◽  
Home Nursing Care ◽  
Community Dwelling Older Adults

Aim: The objective of this study was to investigate if grip strength or the short physical performance battery could predict the rate of receiving two different types of home care services: (a) personal care and (b) home nursing care for community-dwelling older adults aged 75+ years. Methods: A secondary data analysis of a prospective cohort study including 323 community-dwelling older adults. Measures of grip strength and the short physical performance battery were incorporated in a nationally regulated preventive home visit programme. Referral to personal and home nursing care were obtained from an administrative database with an average follow-up of 4.1 years. The rate of receiving the individual home care services and the study measures were determined using multivariable Cox proportional hazards models controlling for a priori selected covariates (age, sex, living status, obesity, smoking and prior use of home care). Results: The mean age was 81.7 years with 58.8% being women. The rate of receiving personal care differed between the short physical performance battery groups but not between the grip strength groups after adjusting for all covariates with hazard ratios (95% confidence intervals) of 1.90 (1.29–2.81) and 1.41 (0.95–2.08), respectively. The rate of receiving home nursing care differed between both the short physical performance battery and grip strength groups after adjusting for all covariates with hazard ratios of 2.03 (1.41–2.94) and 1.48 (1.01–2.16), respectively. Conclusions: The short physical performance battery was associated with the rate of receiving both personal care and home nursing care. The short physical performance battery can be used to predict home care needs of community-dwelling older adults aged 75+ years.

scholarly journals SPPB reference values and performance in assessing sarcopenia in community-dwelling Singaporeans – Yishun Study

2021 ◽  
Author(s):  
Shuen Yee Lee ◽  
Pei Ling Choo ◽  
Benedict Wei Jun Pang ◽  
Lay Khoon Lau ◽  
Khalid Abdul Jabbar ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Reference Values ◽  
Community Dwelling ◽  
Excellent Performance ◽  
Sit To Stand ◽  
Appropriate Treatment ◽  
Sum Score ◽  
And Performance ◽  
Community Dwelling Older Adults

Abstract Background: The Short Physical Performance Battery (SPPB) is an established test of physical performance. We provide reference values for SPPB and determine SPPB performance and cut-offs in assessing sarcopenia for Asian community-dwelling older adults.Methods: 538 (57.8% women) community-dwelling adults aged 21–90 years were recruited. SPPB and its subtest scores and timings (8ft gait speed (GS), five-times repeated chair sit-to-stand (STS) and balance) were determined. Appendicular lean mass divided by height-squared, muscle strength (handgrip) and physical performance (6m GS, STS and SPPB) were assessed to define sarcopenia for various Asian criteria. Area under the ROC curve (AUC) was used to assess performance of SPPB and subtests in discriminating sarcopenia. Optimal SPPB and GS subtest cut-offs for each sarcopenia criterion were determined by maximizing sensitivity and specificity.Results: The mean SPPB score was 11.6(SD 1.1) in men and 11.5(SD1.2) in women. Majority of participants(≥50%) aged 21–80 years achieved the maximum SPPB score. SPPB total and subtest scores generally decreased with age (all p<0.001), but did not differ between sex. SPPB was limited in assessing sarcopenia (AUC 0.56–0.64) but had moderate-to-excellent performance in assessing severe sarcopenia (AUC 0.69–0.98), with optimal cut-off of ≤11points. SPPB GS subtest had moderate-to-excellent performance in assessing sarcopenia (AUC 0.62–0.72) and severe sarcopenia (AUC 0.81–0.95). The optimal GS cut-off for sarcopenia was 1.0m/s.Conclusions: Population-specific normative SPPB values are important for use in diagnostic criteria and to interpret results of studies evaluating and establishing appropriate treatment goals. Performance on the SPPB should be reported in terms of the total sum score and registered time to complete the repeated-chair STS and 8-ft walk tests. An SPPB cut-off of ≤11points was optimal in assessing sarcopenia. GS subtest could be an independent criterion for discriminating sarcopenia in community-dwelling older adults.

scholarly journals Dual Decline in Gait and Cognition Is Associated With Future Dementia: Evidence for a Phenotype

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 264-264
Author(s):  
Manuel Montero Odasso ◽  
Mark Speechley ◽  
Richard Camicioli ◽  
Nellie Kamkar ◽  
Qu Tian ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Regression Models ◽  
Community Dwelling ◽  
Hierarchical Regression ◽  
Chi Square ◽  
Cox Models ◽  
Incident Dementia ◽  
Risk Of Progression ◽  
Community Dwelling Older Adults

Abstract BACKGROUND: The concurrent decline in gait speed and cognition are associated with future dementia. However, the clinical profile of those who present with dual-decline has not yet been described. We aimed to describe the phenotype and risk for incident dementia of individuals who present a dual-decline in comparison with non dual-decliners. METHODS: Prospective cohort of community-dwelling older adults free of dementia at baseline. We evaluated participants’ gait speed, cognition, medical status, functionality, incidence of adverse events, and dementia biannually over 7 years. Gait speed was assessed with a 6-meter electronic-walkway, and global cognition was assessed using the MoCA test. We compared characteristics between dual-decliners and non dual-decliners using t-test, Chi-square, and hierarchical regression models. We estimated incident dementia using Cox models. RESULTS: Among 144 participants (mean age 74.23 ± 6.72 years, 54% women), 17% progressed to dementia. Dual-decliners had a three-fold risk (HR: 3.12, 95%CI:1.23-7.93, p=0.017) of progression to dementia compared with non dual-decliners. Dual-decliners were significantly older with a higher prevalence of hypertension and dyslipidemia (p=0.002). Hierarchical regression models show that age and sex alone explained 3% of the variation in the dual-decliners group, while adding hypertension and dyslipidemia increased the explained variation to 8% and 10 %, respectively. The risk of becoming a dual-decliner was 4-fold if hypertension was present. CONCLUSION: Older adults with concurrent decline in gait speed and cognition represent a group at the highest risk of progression to dementia. These dual-decliners have a distinct phenotype with a higher prevalence of hypertension, a potentially treatable condition.

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