scholarly journals Motor function is the primary driver of the associations of sarcopenia and physical frailty with adverse health outcomes in community-dwelling older adults

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245680
Author(s):  
Aron S. Buchman ◽  
Sue E. Leurgans ◽  
Tianhao Wang ◽  
Michal Schnaider-Beeri ◽  
Puja Agarwal ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Muscle Mass ◽  
Motor Function ◽  
Proportional Hazards ◽  
Community Dwelling ◽  
Physical Frailty ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Primary Driver ◽  
Community Dwelling Older Adults

Background This study tested the hypothesis that sarcopenia and its constituent components, reduced lean muscle mass and impaired motor function, are associated with reduced survival and increased risk of incident disabilities. Methods 1466 community-dwelling older adults underwent assessment of muscle mass with bioelectrical impedance analysis (BIA), grip strength, gait speed and other components of physical frailty and annual self-report assessments of disability. We used Cox proportional hazards models that controlled for age, sex, race, education and height to examine the associations of a continuous sarcopenia metric with the hazard of death and incident disabilities. Results Mean baseline age was about 80 years old and follow-up was 5.5 years. In a proportional hazards model controlling for age, sex, race, education and baseline sarcopenia, each 1-SD higher score on a continuous sarcopenia scale was associated with lower hazards of death (HR 0.70, 95%CI [0.62, 0.78]), incident IADL (HR 0.80,95%CI [0.70, 0.93]), incident ADL disability (HR 0.80 95%CI [71, 91]) and incident mobility disability (HR 0.81, 95%CI [0.70, 0.93]). Further analyses suggest that grip strength and gait speed rather than muscle mass drive the associations with all four adverse health outcomes. Similar findings were observed when controlling for additional measures used to assess physical frailty including BMI, fatigue and physical activity. Conclusions Motor function is the primary driver of the associations of sarcopenia and physical frailty with diverse adverse health outcomes. Further work is needed to identify other facets of muscle structure and motor function which together can identify adults at risk for specific adverse health outcomes.

scholarly journals Brain Magnetic Susceptibility is Associated With Slower Gait in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 878-878
Author(s):  
Victoria Poole ◽  
Robert Dawe ◽  
Sue Luergans ◽  
David Bennett ◽  
Aron Buchman ◽  
...  
Keyword(s):  
Older Adults ◽  
Magnetic Susceptibility ◽  
Health Outcomes ◽  
Gait Speed ◽  
Right Hemisphere ◽  
Community Dwelling ◽  
Gaussian Kernel ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Community Dwelling Older Adults

Abstract Age-related slowing of gait is exceedingly common and a robust predictor of various adverse health outcomes in older age. Prior neuroimaging studies have documented diverse non-specific structural brain abnormalities which are related to slow gait; however, the extent to which quantitative susceptibility mapping (QSM), which measures regional magnetic susceptibility in the brain, associates with gait speed remains unexplored. In the current study, 415 non-demented community-dwelling older adults (91 males; 81+/- 7 years) underwent an MRI (Siemens 3T TIM Trio) and in-home motor assessment. Gait speed was measured and averaged across 2 timed 8-ft walks. MR-acquired QSM data were pre-processed, registered to ICBM template, and spatially smoothed with a 5mm FWHM Gaussian kernel. When these maps entered group-level GLMs, voxel-wise associations with gait speed were of interest, after adjusting for demographics. We observed very strong negative associations between gait speed and magnetic susceptibility, such that those with slower gait had higher susceptibility in bilateral inferior frontal, superior temporal, and angular gyri (corrected p<.0005). Robust associations were also observed in the middle frontal, precentral, and postcentral gyri of the right hemisphere. These novel findings suggest that reduced myelination or increased iron accumulation in these brain regions may contribute to impaired gait. Future work will need to determine to what extent these cross-sectional QSM metrics are independent predictors of incident adverse health outcomes when controlling for other common brain imaging abnormalities observed in older adults.

scholarly journals The Prevalence of Back and Leg Pain and the Cross-Sectional Association with Adverse Health Outcomes in Community Dwelling Older Adults in England

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Esther Williamson ◽  
Maria T. Sanchez-Santos ◽  
Alana Morris ◽  
Angela Garrett ◽  
Oliver Conway ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Community Dwelling ◽  
Leg Pain ◽  
Cross Sectional ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
The Cross ◽  
Community Dwelling Older Adults

scholarly journals Living Arrangement Modifies the Associations of Loneliness with Adverse Health Outcomes in Older Adults: Evidence From the CLHLS

2021 ◽  
Author(s):  
Kai Wei ◽  
Yong Liu ◽  
Junjie Yang ◽  
Nannan Gu ◽  
Xinyi Cao ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Living Alone ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Physical Functions ◽  
Community Dwelling Older Adults

Abstract Background: Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements.Methods: In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 16255 community-dwelling older adults (≥65 years) were recruited. Living arrangements and feelings of loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The associations of loneliness with adverse health outcomes accroding to different living arrangements were estimated using logistic regression or Cox proportional hazards regression models. Interactions between living arrangement and loneliness on adverse health outcomes were also investigated.Results: Older adults who were lonely (47.8% of those living alone and 25% of those living with others) had higher prevalence of cognitive impairment, frailty and 3-year mortality than older adults without loneliness, especially among those who lived with others (OR=1.31, 95% CI=1.15-1.51; OR=1.42, 95% CI=1.26-1.60; HR=1.16, 95% CI=1.07-1.26, respecitvely). In contrast, among the living alone older adults, loneliness was only associated with higher prevalence of frailty (OR=1.41, 95% CI=1.06-1.88). Living arrangement modified the associations of loneliness with prevalent cognitive impairment and mortality (P values for interactions=0.006 and 0.015, respectively).Conclusions: Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population to reduce adverse health outcomes.

Impact of Caregiver Burden on Adverse Health Outcomes in Community-Dwelling Dependent Older Care Recipients

2011 ◽  
Vol 19 (4) ◽  
pp. 382-391 ◽  
Author(s):  
Masafumi Kuzuya ◽  
Hiromi Enoki ◽  
Jun Hasegawa ◽  
Sachiko Izawa ◽  
Yoshihisa Hirakawa ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Caregiver Burden ◽  
Community Dwelling ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Care Recipients

scholarly journals Social Frailty Is Independently Associated with Mood, Nutrition, Physical Performance, and Physical Activity: Insights from a Theory-Guided Approach

2020 ◽  
Vol 17 (12) ◽  
pp. 4239 ◽  
Author(s):  
Kalene Pek ◽  
Justin Chew ◽  
Jun Pei Lim ◽  
Suzanne Yew ◽  
Cai Ning Tan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Health Outcomes ◽  
Physical Performance ◽  
Community Dwelling ◽  
Physical Frailty ◽  
Life Space ◽  
Independent Association ◽  
Community Dwelling Older Adults ◽  
Significant Covariates

Notwithstanding the increasing body of evidence that links social determinants to health outcomes, social frailty is arguably the least explored among the various dimensions of frailty. Using available items from previous studies to derive a social frailty scale as guided by the Bunt social frailty theoretical framework, we aimed to examine the association of social frailty, independently of physical frailty, with salient outcomes of mood, nutrition, physical performance, physical activity, and life–space mobility. We studied 229 community-dwelling older adults (mean age 67.22 years; 72.6% females) who were non-frail (defined by the FRAIL criteria). Using exploratory factor analysis, the resultant 8-item Social Frailty Scale (SFS-8) yielded a three-factor structure comprising social resources, social activities and financial resource, and social need fulfilment (score range: 0–8 points). Social non-frailty (SNF), social pre-frailty (SPF), and social frailty (SF) were defined based on optimal cutoffs, with corresponding prevalence of 63.8%, 28.8%, and 7.4%, respectively. In logistic regression adjusted for significant covariates and physical frailty (Modified Fried criteria), there is an association of SPF with poor physical performance and low physical activity (odds ratio, OR range: 3.10 to 6.22), and SF with depressive symptoms, malnutrition risk, poor physical performance, and low physical activity (OR range: 3.58 to 13.97) compared to SNF. There was no significant association of SPF or SF with life–space mobility. In summary, through a theory-guided approach, our study demonstrates the independent association of social frailty with a comprehensive range of intermediary health outcomes in more robust older adults. A holistic preventative approach to frailty should include upstream interventions that target social frailty to address social gradient and inequalities.

scholarly journals THE ASSOCIATION BETWEEN D3CR MUSCLE MASS AND MORTALITY IN COMMUNITY-DWELLING OLDER MEN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S84-S84 ◽  
Author(s):  
Peggy M Cawthon ◽  
Terri Blackwell ◽  
Steven R Cummings ◽  
Eric S Orwoll ◽  
Kate A Duchowny ◽  
...  
Keyword(s):  
Risk Factor ◽  
Muscle Mass ◽  
Proportional Hazards ◽  
Smoking Status ◽  
Older Men ◽  
Community Dwelling ◽  
Adverse Health Outcomes ◽  
Injurious Falls ◽  
Clinical Center ◽  
Mortality Outcome

Abstract We have shown that men with low muscle mass assessed by D3Cr (deuterated creatine) dilution are more likely to have worse physical performance and incident fractures, injurious falls and disability. However, the relation between D3Cr muscle mass and mortality is unknown. With data from Year 14 Visit of the MrOS study (N=1400, mean age 84.2 yrs), proportional hazards models estimated the risk of mortality (hazard ratio and 95% CI) by quartiles of D3Cr muscle mass (standardized to body mass); we calculated p for trend across quartiles. Models were adjusted for age, race, clinical center, alcohol use, smoking status, comorbidities, activity, percent fat, exhaustion, and cognitive function. Cause of death was centrally adjudicated. Over 3.3±0.8 years of follow-up, 197 (14.1%) men died. Men in the lowest quartile of D3Cr muscle mass/wgt were 2.8-fold more likely to die than men in the highest quartile (HR: 2.8, 95% CI: 1.6, 4.9; p for trend<.001). The HRs for each cause-specific mortality outcome were of similar magnitude to the HR for overall mortality: cancer death (HR, Q1 vs Q4: 2.2, 95% CI: 0.7, 7.1; p trend =0.140); CVD death (HR, Q1 vs Q4: 3.7, 95% CI: 1.3, 10.5; p trend =0.008); or non-cancer non-CVD death (HR, Q1 vs Q4: 2.4, 95% CI: 1.0, 5.6; p trend=0.019). We conclude that low muscle mass assessed by D3Cr dilution is a strong risk factor for mortality in older men, providing additional evidence that low muscle mass is an important risk factor for adverse health outcomes.

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