scholarly journals O05 How does radiographic knee OA impact musculoskeletal aging in midlife? Findings from the Hertfordshire Cohort study

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Nicholas R Fuggle ◽  
Michael Clynes ◽  
Faidra Laskou ◽  
Karen Jameson ◽  
Cyrus Cooper ◽  
...  

Abstract Background With an aging population, the burden of musculoskeletal aging in joints, bones and muscles carries with it significant morbidity. Osteoarthritis (OA) is the most common joint condition, and can be defined clinically or radiologically. Musculoskeletal aging in bone and muscle can be assessed through change in body composition, grip strength and physical performance. The aim of this study was to investigate whether a diagnosis of radiological knee OA impacted involution in muscle or bone in the midlife in a group of community-dwelling older adults in the UK. Methods Our study comprised 220 members of the Hertfordshire Cohort Study (118 males and 102 females), a group of community dwelling older adults in the United Kingdom. Knee radiographs were performed at baseline (1999-2003), with osteoarthritis defined as a Kellgren and Lawrence score ≥2. At baseline and follow-up (2017) questionnaires assessed physical activity and lifestyle factors; JAMAR dynamometry was performed to assess grip strength; 8 foot walk test was performed to assess gait speed and DXA was performed to assess bone mineral density at the hips and body composition. Linear regression was performed to analyse associations in males and females, before and after adjustment for follow-up time, lifestyle factors (including smoking, alcohol consumption, social class, calcium intake and physical activity), anthropometric measures (BMI) and HRT use and age at menopause in women. The development of hand osteoarthritis was adjusted for grip strength outcomes. Results The mean age of participants at baseline was 65.0 years. Median follow-up was 16.7 years (range 15.0-18.4 years). Knee osteoarthritis was present in 75 (34%) participants. Radiographic knee osteoarthritis status at baseline was significantly associated with grip strength (β=-3.2kg, -5.3 to -1.1, p < 0.01) at follow-up in females but not in males (β=-2.9, -5.8 to 0.1, p = 0.06). No significant associations between radiographic osteoarthritis status at baseline and other measures of sarcopenia (gait speed or lean mass) or bone mineral density were found in either sex. Conclusion Our findings demonstrate that the presence of knee osteoarthritis in midlife can have a substantial bearing on grip strength in women over 15 years later independent of the presence of hand osteoarthritis. Grip strength has been shown to correlate closely with lower limb strength and so the demonstrated association between grip strength and knee osteoarthritis is representative of a global weakness resulting from the disease. Reduction in grip strength has been associated with an increased risk of morbidity including falls and fractures. Thus, in order to countermand this association, it may be that concerted interventions (including physical therapy, strengthening and surgical intervention) should be recommended for those with knee osteoarthritis at this stage in the lifecourse. Of course, these findings require replication and validation in other cohorts. Disclosures N.R. Fuggle None. M. Clynes None. F. Laskou None. K. Jameson None. C. Cooper None. E. Dennison None.

2021 ◽  
Vol 12 ◽  
pp. 215013272110477
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Denisse A. Rumbea ◽  
Pedro Pérez ◽  
Bettsy Y. Recalde ◽  
...  

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.


2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
S E R Lim ◽  
N J Cox ◽  
H C Roberts

Abstract Introduction Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status.


2004 ◽  
Vol 1 (4) ◽  
pp. 321-330 ◽  
Author(s):  
Jennifer M. Hootman ◽  
Shannon FitzGerald ◽  
Carol A. Macera ◽  
Steven N. Blair

Purpose:The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).Methods:Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.Results:Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip or knee OA. A similar, nonsignificant trend was noted among men. Moderate isotonic leg press strength was protective for hip or knee osteoarthritis among men only.Conclusions:These results suggest that quadriceps weakness is an independent and modifiable risk factor for lower extremity OA, particularly among women.


10.2196/15168 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e15168
Author(s):  
Claudia R Pischke ◽  
Claudia Voelcker-Rehage ◽  
Manuela Peters ◽  
Tiara Ratz ◽  
Hermann Pohlabeln ◽  
...  

Background Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. Objective We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. Methods Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants’ intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. Results The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. Conclusions Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. Trial Registration German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m International Registered Report Identifier (IRRID) DERR1-10.2196/15168


2019 ◽  
Author(s):  
Claudia R Pischke ◽  
Claudia Voelcker-Rehage ◽  
Manuela Peters ◽  
Tiara Ratz ◽  
Hermann Pohlabeln ◽  
...  

BACKGROUND Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. OBJECTIVE We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. METHODS Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants’ intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. RESULTS The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. CONCLUSIONS Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. CLINICALTRIAL German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15168


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S483-S484
Author(s):  
Milan Chang ◽  
Alfons Ramel ◽  
Palmi V Jonsson ◽  
Inga Thorsdottir ◽  
Olof Geirsdottir

Abstract Background: Decline in both physical function and cognition among older adults has been associated with increased risk of dementia. Physical activity (PA) is beneficial for the improvement of both physical and cognitive function. The purpose of the study was to investigate the association between baseline physical function and cognitive function after 12 weeks of resistance training among older adults. Methods: Two hundred and thirty-seven community-dwelling older adults (N=237, 73.7±5.7 years, 58.2% female) participated in a 12-week resistance exercise program (3 times/week; 3 sets, 6-8 repetitions at 75-80% of the 1-repetition maximum), designed to increase strength and muscle mass of major muscle groups. Body composition, physical activity status, grip strength, cardiovascular risk factors, 6 minutes walking distance (6MWD), and Mini-Mental State Examination (MMSE) were measured at baseline and endpoint. The linear regression model was used to examine the association. Results: Mean MMSE score was 27.5±2.1 at baseline and 28.1±2.2 after the exercise intervention. After the intervention, 57 declined, 55 remained the same, and 120 have improved in MMSE scores. We found that the MMSE score after the intervention was significantly associated with baseline grip strength (beta=.03, P<.05) among healthy older adults, after adjusting basic characteristics, cardiovascular risk factors and mobility at baseline. Conclusion: Our study found that baseline grip strength was strongly associated with cognitive function after the 12 weeks of resistance training. Muscle power, such as grip strength may play an important role in the effect of exercise intervention on cognition even among healthy independent older adults.


2019 ◽  
Vol 5 ◽  
pp. 233372141988069
Author(s):  
Walter E. Palmer ◽  
Vicki S. Mercer

Objective: To (a) evaluate effects of the Matter of Balance (MOB) program on self-reported physical activity (PA) in older adults as measured by the program’s activity (MOB-PA) measure and the Rapid Assessment of Physical Activity, Part 1 (RAPA1) and (b) for a separate Community cohort, explore correlations between MOB-PA and RAPA1 scores and step counts obtained using accelerometry. Methods: Community-dwelling older adults recruited from upcoming MOB classes and from in-person contacts comprised MOB ( N = 56) and Community ( N = 23) cohorts, respectively. For the MOB cohort, paired t tests were computed for baseline and follow-up MOB-PA and RAPA1 scores. For the Community cohort, Pearson’s correlations between self-reported PA and step counter measures were calculated. Results: Self-reported PA did not change following MOB participation. The MOB-PA had substantial ceiling effects, which weakened relationships with step counter data. Discussion: No evidence was found that MOB participation increased PA. The MOB-PA may not be appropriate for measuring activity levels.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Faidra Laskou ◽  
Karen Jameson ◽  
Elaine Dennison

Abstract Background/Aims  Frailty is associated with a range of adverse health outcomes, including falls and fractures. Previous work in a Japanese cohort found that the presence of both osteoporosis (OP) and sarcopenia (SP) increased the risk of frailty compared to the presence of OP or SP alone. We examined these relationships in a comparable cohort of community dwelling older people in the UK. Methods  Our study comprised of 432 participants (216 men and 216 women) of the UK the Hertfordshire Cohort Study (HCS). Participants were assessed at baseline and followed up 5 years later with questionnaires, clinical examination, measures of physical performance and grip strength. Proximal femur bone mineral density (BMD) values were determined using dual-energy X-ray absorptiometry. OP was defined at BMD T- scores < = -2.5 at the femoral neck or use of anti-osteoporosis medication. Cut-offs for low grip strength; <30kg for men and <20kg for women and ALM index < =7.23kg/m2 for men, < =5.67kg/m2 for women, were used to define SP. Frailty was defined using the Fried definition. Logistic regressions were performed to analyse associations of OP/SP as explanatory variables for frailty. Results  The mean (SD) age of participants was 75.7 (2.6) years. At baseline, the prevalence of frailty and pre-frailty was 12.2% (men, 8%, women, 16.3 %), and 57% (men, 55.7%; women, 58.2%) respectively. Individuals living with frailty were older, tended to drink less alcohol, have lower physical activity, lower walking speed and grip strength (P < 0.001). They were more likely to be female compared to non-frail subjects (P = 0.007). Co-existence of SP, OP and frailty was observed in 0.6% of the population; 0.6% had SP and frailty; 1.6% had OP and frailty and 1.6% of the study population had SP and OP. 71.8% did not have SP, OP or frailty at baseline. SP was significantly associated with frailty at baseline (p < 0.001). The cumulative incidence of frailty during the 5-year period was 2.47% /year (2.13%/year in men, 2.89%/year in women) and that of SP was 2.14%/year (2.84% in men, 1.35%/year in women). The presence of OP at baseline was a significant predictive factor for the occurrence of frailty at follow-up (odds ratio [OR], 3.04; 95% confidence interval [95% CI], 1.11,8.38; P = 0.031), while the risk of developing frailty was also increased in those participants who were both osteoporotic and sarcopenic at baseline; though this was not significant (OR; 10.08, 95% CI,0.55,186.08; P = 0.12). Conclusion  Our findings demonstrate that the presence of OP is a significant predictive factor for developing frailty and might be used as a trigger for appropriate interventions to reduce or reverse its development in older adults. Our findings are in accordance with the previous reports in Asian populations and warrant further investigation in other national cohorts. Disclosure  F. Laskou: None. K. Jameson: None. E. Dennison: None.


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