Muscle Strength, Physical Activity, and Functional Limitations in Older Adults with Central Obesity

Background.Obesity and muscle weakness are independently associated with increased risk of physical and functional impairment in older adults. It is unknown whether physical activity (PA) and muscle strength combined provide added protection against functional impairment. This study examines the association between muscle strength, PA, and functional outcomes in older adults with central obesity.Methods.Prevalence and odds of physical (PL), ADL, and IADL limitation were calculated for 6,388 community dwelling adults aged ≥ 60 with central obesity. Individuals were stratified by sex-specific hand grip tertiles and PA. Logistic models were adjusted for age, education, comorbidities, and body-mass index and weighted.Results.Overall prevalence of PL and ADL and IADL limitations were progressively lower by grip category. Within grip categories, prevalence was lower for individuals who were active than those who were inactive. Adjusted models showed significantly lower odds of PL OR 0.42 [0.31, 0.56]; ADL OR 0.60 [0.43, 0.84], and IADL OR 0.46[0.35, 0.61] for those in the highest grip strength category as compared to those in the lowest grip category.Conclusion.Improving grip strength in obese elders who are not able to engage in traditional exercise is important for reducing odds of physical and functional impairment.

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Relationship Between Physical Activity and Function With Quality of Life in Community-Living Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.613 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 189-189

Author(s):

Milan Chang ◽

Olof Geirsdottir ◽

Inga Thorsdottir ◽

Palmi Jonsson ◽

Alfons Ramel ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Older Adults ◽

Muscle Strength ◽

Physical Function ◽

Grip Strength ◽

Community Dwelling ◽

Walking Distance ◽

Community Dwelling Older Adults

Abstract Background: Quality of life (QOL) is a multidimensional concept which is often used as an evaluation of a person‘s health and psychological status. Increasing longevity can be associated with better QOL as long as older adults are independent in daily life. The aim of the study was to examine the associations of QOL with muscle strength and physical function among community-dwelling older adults. Methods: The current cross-sectional study had 225 participants (73.7±5.7yrs, 58.2% female) living in Reykjavik, Iceland. QOL measured using the 36-item short-form survey (SF-36). Covariates were anthropometrics, muscle strength, physical function including timed up and go test (TUG), and 6-minute walking distance (6MWD), physical activity per week (PA). Linear regression analysis was used to examine the association of QOL with physical function. Results: The mean QOL score for the study population was 54.9±6.13. The analysis was adjusted for age and gender, body mass index, height, and PA. We found that QOL was associated with better grip strength (B=1.4, P<0.0001), 6MWD (B=0.03, P<0.0001), slower TUG (B=-0.9, P<0.0001), and higher PA (B=0.03 m, P=0.039). However, QOL was not associated with quadriceps leg strength. Conclusion: The study suggests that QOL was associated with better physical function including grip strength, walking ability and the level of PA among community-dwelling older adults in Iceland.

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Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137067 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7067

Author(s):

Esther García-Esquinas ◽

Rosario Ortolá ◽

Iago Gine-Vázquez ◽

José A. Carnicero ◽

Asier Mañas ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Older Adults ◽

Social Isolation ◽

Community Dwelling ◽

Housing Conditions ◽

Older Individuals ◽

Lifestyle Risk Factors ◽

Increased Risk ◽

Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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Vascular lesions and functional limitations among older adults: does depression make a difference?

International Psychogeriatrics ◽

10.1017/s1041610214000829 ◽

2014 ◽

Vol 26 (9) ◽

pp. 1501-1509 ◽

Cited By ~ 5

Author(s):

Celia F. Hybels ◽

Carl F. Pieper ◽

Lawrence R. Landerman ◽

Martha E. Payne ◽

David C. Steffens

Keyword(s):

Risk Factors ◽

Older Adults ◽

White Matter ◽

Functional Impairment ◽

Functional Limitations ◽

Late Life ◽

Cognitive Status ◽

Cerebral White Matter ◽

Late Life Depression ◽

Increased Risk

ABSTRACTBackground:The association between disability and depression is complex, with disability well established as a correlate and consequence of late life depression. Studies in community samples report that greater volumes of cerebral white matter hyperintensities (WMHs) seen on brain imaging are linked with functional impairment. These vascular changes are also associated with late life depression, but it is not known if depression is a modifier in the relationship between cerebrovascular changes and functional impairment.Methods:The study sample was 237 older adults diagnosed with major depression and 140 never depressed comparison adults, with both groups assessed at study enrollment. The dependent variable was the number of limitations in basic activities of daily living (ADL), instrumental ADLs, and mobility tasks. The independent variable was the total volume of cerebral white matter lesions or hyperintensities assessed though magnetic resonance imaging.Results:In analyses controlling for age, sex, race, high blood pressure, and cognitive status, a greater volume of WMH was positively associated with the total number of functional limitations as well as the number of mobility limitations among those older adults with late life depression but not among those never depressed, suggesting the association between WMH volume and functional status differs in the presence of late life depression.Conclusions:These findings suggest older patients with both depression and vascular risk factors may be at an increased risk for functional decline, and may benefit from management of both cerebrovascular risk factors and depression.

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Comparison of methods to identify individuals with obesity at increased risk of functional impairment among a population of home-dwelling older adults

British Journal Of Nutrition ◽

10.1017/s0007114521004128 ◽

2021 ◽

pp. 1-8

Author(s):

Anne Lene Nordengen ◽

Linn Kristin Lie Øyri ◽

Stine Marie Ulven ◽

Truls Raastad ◽

Kirsten Bjørklund Holven ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Muscle Mass ◽

Body Mass ◽

Functional Impairment ◽

Muscle Quality ◽

Obese Women ◽

Total Body Mass ◽

Increased Risk ◽

Total Body

Abstract Obesity is associated with increased muscle mass and muscle strength. Methods taking into account the total body mass to reveal obese older individuals at increased risk of functional impairment are needed. Therefore, we aimed to detect methods to identify obese older adults at increased risk of functional impairment. Home-dwelling older adults (n 417, ≥ 70 years of age) were included in this cross-sectional study. Sex-specific cut-off points for two obesity phenotypes (waist circumference (WC) and body fat mass (FM %)) were used to divide women and men into obese and non-obese groups, and within-sex comparisons were performed. Obese women and men, classified by both phenotypes, had similar absolute handgrip strength (HGS) but lower relative HGS (HGS/total body mass) (P < 0·001) than non-obese women and men, respectively. Women with increased WC and FM %, and men with increased WC had higher appendicular skeletal muscle mass (P < 0·001), lower muscle quality (HGS/upper appendicular muscle mass) (P < 0·001), and spent longer time on the stair climb test and the repeated sit-to-stand test (P < 0·05) than non-obese women and men, respectively. Absolute muscle strength was not able to discriminate between obese and non-obese older adults. However, relative muscle strength in particular, but also muscle quality and physical performance tests, where the total body mass was taken into account or served as an extra load, identified obese older adults at increased risk of functional impairment. Prospective studies are needed to determine clinically relevant cut-off points for relative HGS in particular.

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Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis

Journal of Medical Internet Research ◽

10.2196/14343 ◽

2019 ◽

Vol 21 (11) ◽

pp. e14343 ◽

Cited By ~ 10

Author(s):

Dharani Yerrakalva ◽

Dhrupadh Yerrakalva ◽

Samantha Hajna ◽

Simon Griffin

Keyword(s):

Physical Activity ◽

Older Adults ◽

Mobile Health ◽

Sedentary Time ◽

Meta Analysis ◽

Statistical Significance ◽

Functional Decline ◽

Risk Of Bias ◽

Community Dwelling ◽

Increased Risk

Background High sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of chronic diseases, functional decline, and premature mortality. Mobile health (mHealth) apps, apps that run on mobile platforms, may help promote active living. Objective We aimed to quantify the effect of mHealth app interventions on sedentary time, PA, and fitness in older adults. Methods We systematically searched five electronic databases for trials investigating the effects of mHealth app interventions on sedentary time, PA, and fitness among community-dwelling older adults aged 55 years and older. We calculated pooled standardized mean differences (SMDs) in these outcomes between the intervention and control groups after the intervention period. We performed a Cochrane risk of bias assessment and Grading of Recommendations, Assessment, Development, and Evaluation certainty assessment. Results Overall, six trials (486 participants, 66.7% [324/486] women; age mean 68 [SD 6] years) were included (five of these trials were included in the meta-analysis). mHealth app interventions may be associated with decreases in sedentary time (SMD=−0.49; 95% CI −1.02 to 0.03), increases in PA (506 steps/day; 95% CI −80 to 1092), and increases in fitness (SMD=0.31; 95% CI −0.09 to 0.70) in trials of 3 months or shorter and with increases in PA (753 steps/day; 95% CI −147 to 1652) in trials of 6 months or longer. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time and low for fitness. Conclusions mHealth app interventions have the potential to promote changes in sedentary time and PA over the short term, but the results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.

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Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.14343 ◽

2019 ◽

Author(s):

Dharani Yerrakalva ◽

Dhrupadh Yerrakalva ◽

Samantha Hajna ◽

Simon Griffin

Keyword(s):

Physical Activity ◽

Older Adults ◽

Mobile Health ◽

Sedentary Time ◽

Meta Analysis ◽

Statistical Significance ◽

Functional Decline ◽

Risk Of Bias ◽

Community Dwelling ◽

Increased Risk

BACKGROUND High sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of chronic diseases, functional decline, and premature mortality. Mobile health (mHealth) apps, apps that run on mobile platforms, may help promote active living. OBJECTIVE We aimed to quantify the effect of mHealth app interventions on sedentary time, PA, and fitness in older adults. METHODS We systematically searched five electronic databases for trials investigating the effects of mHealth app interventions on sedentary time, PA, and fitness among community-dwelling older adults aged 55 years and older. We calculated pooled standardized mean differences (SMDs) in these outcomes between the intervention and control groups after the intervention period. We performed a Cochrane risk of bias assessment and Grading of Recommendations, Assessment, Development, and Evaluation certainty assessment. RESULTS Overall, six trials (486 participants, 66.7% [324/486] women; age mean 68 [SD 6] years) were included (five of these trials were included in the meta-analysis). mHealth app interventions may be associated with decreases in sedentary time (SMD=−0.49; 95% CI −1.02 to 0.03), increases in PA (506 steps/day; 95% CI −80 to 1092), and increases in fitness (SMD=0.31; 95% CI −0.09 to 0.70) in trials of 3 months or shorter and with increases in PA (753 steps/day; 95% CI −147 to 1652) in trials of 6 months or longer. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time and low for fitness. CONCLUSIONS mHealth app interventions have the potential to promote changes in sedentary time and PA over the short term, but the results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.

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90 The Effectiveness of Volunteer-Led Physical Activity Interventions in Improving Health Outcomes for Community-Dwelling Older People: A Systematic Review

Age and Ageing ◽

10.1093/ageing/afz194.01 ◽

2020 ◽

Vol 49 (Supplement_1) ◽

pp. i30-i32

Author(s):

S E R Lim ◽

N J Cox ◽

H C Roberts

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Older Adults ◽

Older People ◽

Health Outcomes ◽

Grip Strength ◽

Community Dwelling ◽

Frailty Status ◽

Community Dwelling Older People ◽

Community Dwelling Older Adults

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.

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ASSOCIATION BETWEEN GRIP STRENGTH AND COGNITIVE FUNCTION AMONG COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1797 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S483-S484

Author(s):

Milan Chang ◽

Alfons Ramel ◽

Palmi V Jonsson ◽

Inga Thorsdottir ◽

Olof Geirsdottir

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Older Adults ◽

Cardiovascular Risk ◽

Cognitive Function ◽

Grip Strength ◽

Exercise Intervention ◽

Mmse Score ◽

Community Dwelling ◽

Community Dwelling Older Adults

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.

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Association of Water Intake with Hand Grip Strength in Community-Dwelling Older Adults

Nutrients ◽

10.3390/nu13061756 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1756

Author(s):

Hyeonmok Kim ◽

Sun Hee Beom ◽

Tae Ho Kim ◽

Beom-Jun Kim

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Grip Strength ◽

Water Intake ◽

Population Based ◽

Hand Grip Strength ◽

Community Dwelling ◽

Cross Sectional ◽

Hand Grip ◽

The Difference

Although recent clinical studies have suggested that water intake enhances muscle mass, its impact on muscle strength remain unclear, especially in older adults. This cross-sectional, population-based study using a representative sample of Koreans investigated the relationship of water intake with hand grip strength (HGS) in 4443 older adults, including 2090 men aged ≥50 years and 2253 postmenopausal women. A digital grip strength dynamometer was used for HGS assessment. Low muscle strength was defined by the Korean-specific HGS cut-off value and adequate water intake was defined according to the Korean dietary reference intakes. In an unadjusted model, water intake was significantly higher in men and women without than with low muscle strength (both p < 0.001), but this difference disappeared after adjustment for confounding variables in both men (p = 0.050) and women (p = 0.245). Similarly, the correlation between water intake and HGS, the difference in HGS depending on adequate water intake status, and the risk of low muscle strength depending on water intake quartile were significant only in the unadjusted model. These data indicate that factors such as age, body size, and resistance exercise contribute to improvements in HGS in older adults, whereas water intake may not.

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