scholarly journals SINGLE PHYSICAL PERFORMANCE MEASURES CANNOT IDENTIFY GERIATRIC OUTPATIENTS WITH SARCOPENIA

2018 ◽  
pp. 1-6
Author(s):  
S.M.L.M. Looijaard ◽  
S.J. Oudbier ◽  
E.M. Reijnierse ◽  
G.J. Blauw ◽  
C.G.M. Meskers ◽  
...  

Background: Sarcopenia is highly prevalent in the older population and is associated with several adverse health outcomes. Equipment to measure muscle mass and muscle strength to diagnose sarcopenia is often unavailable in clinical practice due to the related expenses while an easy physical performance measure to identify individuals who could potentially have sarcopenia is lacking. Objectives: This study aimed to assess the association between physical performance measures and definitions of sarcopenia in a clinically relevant population of geriatric outpatients. Design, setting and participants: A cross-sectional study was conducted, consisting of 140 community-dwelling older adults that were referred to a geriatric outpatient clinic. No exclusion criteria were applied. Measurements: Physical performance measures included balance tests (side-by-side, semi-tandem and tandem test with eyes open and -closed), four-meter walk test, timed up and go test, chair stand test, handgrip strength and two subjective questions on mobility. Direct segmental multi-frequency bioelectrical impedance analysis was used to measure muscle mass. Five commonly used definitions of sarcopenia were applied. Diagnostic accuracy was determined by sensitivity, specificity and area under the curve.Results: Physical performance measures, i.e. side-by-side test, tandem test, chair stand test and handgrip strength, were associated with at least one definition of sarcopenia. Diagnostic accuracy of these physical performance measures was poor. Conclusions: Single physical performance measures could not identify older individuals with sarcopenia, according to five different definitions of sarcopenia.

2020 ◽  
Vol 63 (10) ◽  
pp. 633-641
Author(s):  
Chang Won Won

With aging, there is a loss of skeletal muscle mass and function, which leads to an increased risk of falls, fractures, long-term institutional care, cardiovascular and metabolic diseases, and even mortality. Sarcopenia has been defined as a condition characterized by low muscle mass together with low muscle strength and/or low muscle performance. In 2019, the Asian Working Group for Sarcopenia (AWGS) published a consensus paper on the diagnosis and treatment of sarcopenia. The AWGS 2019 guideline, in particular, presented strategies for case-finding and assessment, which could aid in the diagnosis of possible sarcopenia in primary care settings. AWGS 2019 proposed an algorithm that recommends calf circumference measurement (cut-off <34 cm in men, <33 cm in women) or the SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, falls) questionnaire (cut-off ≥4), followed by handgrip strength measurement (cut-off <28 kg in men, <18 kg in women) or the 5-time chair stand test (≥12 seconds). Finally, “possible sarcopenia” is defined by either low muscle strength (handgrip strength) or low physical performance (5-time chair stand test). This paper will address the way in which sarcopenic patients can be identified and assessed practically in primary care settings.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kenichi Kono ◽  
Yoshifumi Moriyama ◽  
Hiroki Yabe ◽  
Ayaka Hara ◽  
Takeki Ishida ◽  
...  

Abstract Background The first objective of this study was to determine the relationship between muscle strength or physical performance and mortality, and the second objective was to show the relationship of Geriatric Nutritional Risk Index (GNRI) to muscle strength and physical performance decline. Methods We examined handgrip, the 5-times chair stand test, and GNRI in 635 maintenance hemodialysis patients and followed up for 72 months. Predictors for all-cause death were examined using Kaplan-Meier analysis and Cox proportional analysis. The relationship between possible sarcopenia and nutritional disorder (GNRI) was constructed receiver operating characteristic (ROC) curve. We used the Youden index to determine the optimal cutoff points for GNRI. Results The multivariate Cox proportional hazard analysis revealed that the GNRI did not show any significance, although handgrip (HR 3.61, 95% CI 1.70–7.68, p < 0.001) and the 5-times chair stand test (HR 1.71 95% CI 1.01–2.90, p = 0.045) were significant predictors for mortality. On the evaluation of possible sarcopenia by handgrip strength, the area under curve (AUC) on ROC curve analysis were 0.68 (95% CI 0.64–0.72), and 5-chair stand, the AUC on ROC were 0.55 (95% CI 0.51–0.60). The cut-off value for the GNRI discriminating those at possible sarcopenia by handgrip strength based on the Youden index was 91.5. Conclusions Our study suggests that the handgrip strength test of the AWGS 2019 sarcopenia consensus was a simple and useful tool to predict mortality in chronic hemodialysis patients. Furthermore, GNRI assessment can be a useful tool for screening before assessing possible sarcopenia when it is difficult to perform SARC-F to all patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Theng Choon Ooi ◽  
Devinder Kaur Ajit Singh ◽  
Suzana Shahar ◽  
Nor Fadilah Rajab ◽  
Divya Vanoh ◽  
...  

Abstract Background Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. Methods Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. Results Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04–2.36), being single (OR: 5.31; 95 % CI: 3.36–37.48), having history of fall (OR: 1.86; 95 % CI: 1.19–2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02–1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45–5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12–34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01–1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77–0.97) appeared as recurrent falls predictors. Conclusions Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.


2016 ◽  
Vol 31 (5) ◽  
pp. 759-763
Author(s):  
Masayuki SOUMA ◽  
Shin MURATA ◽  
Hiroaki IWASE ◽  
Jun MURATA ◽  
Kenji KAMIJOU ◽  
...  

2019 ◽  
Vol 26 (11) ◽  
pp. 1-12 ◽  
Author(s):  
Carine Lumi ◽  
Fabrício Edler Macagnan ◽  
Adriana Kessler ◽  
Priscila De Toni ◽  
Adriana Maisonnave Raffone

Background/Aims The negative impact caused by haematopoietic stem cell transplantation still requires further investigation. This study aims to investigate the effects of this procedure on skeletal muscle strength, functional performance and fatigue sensation in the hospitalisation phase. Methods This prospective cohort study aimed to assess physical performance by measuring ventilatory muscle strength, peripheral muscle strength and fatigue in patients who underwent haematopoietic stem cell transplantation. Results The sample consisted of 30 patients of both sexes (63% men) with a mean age of 48.6 ± 13.2 years. Maximal inspiratory pressure and expiratory pressure decreased by 19% and 16%, respectively (P<0.001). There was a 16% reduction in handgrip strength in the second assessment (P<0.001), as well as a reduction of 30.6% in the 30-Second Chair Stand Test (P<0.001). The fatigue test score increased exponentially (60%) (P<0.001). Individuals with worse results in the 30-Second Chair Stand Test remained hospitalised for a longer period than those with better results (P=0.024). Conclusions This study concluded that after the transplantation of haematopoietic stem cells there was a relevant reduction in the results of the applied tests, as well as an increase in fatigue.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Heewon Jung ◽  
Jae-Young Lim ◽  
Jihong Park

Abstract Background Short physical performance battery (SPPB) is a well-accepted clinical test to assess vulnerability in older adults. We aimed to develop and validate a multi-sensor based kiosk (e-SPPB kiosk) which can perform automated measurement for SPPB. Methods The e-SPPB kiosk was developed to measure 3 components of SPPB of standing balance, gait speed, and chair stand test with embedded sensors and algorithms. Feasibility and reliability of the e-SPPB kiosk was assessed with the manually measured SPPB (m-SPPB) by a physical therapist in participants aged 65 or older recruited from the outpatient rehabilitation clinic of the Seoul National University Bundang Hospital, Seongnam, Korea, from November 2018 to April 2019. Results In 34 participants with mean age of 73.6 (standard deviation [SD] 5.4), mean of e-SPPB total score was 10.1 (SD 2.2) and mean of m-SPPB total score was 10.2 (SD 2.3). Concordance between e-SPPB and m-SPPB total score was 0.94 (P&lt;0.001) and agreement by Kappa was 0.65 (P&lt;0.001). Agreements for components of e-SPPB and m-SPPB were 0.68 (P&lt;0.001), 0.73 (P&lt;0.001), 0.92 (P&lt;0.001) for standing balance, gait speed and chair stand test, respectively. Conclusion In older adults, physical performance measured by the e-SPPB kiosk correlated to m-SPPB measured by a single physical therapist. In multicenter studies for older people with physical performance as an outcome or selection criterion, e-SPPB kiosk can be used to reduce possible inter-rater variabilities of SPPB.


Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 146
Author(s):  
Akio Goda ◽  
Shin Murata ◽  
Hideki Nakano ◽  
Hina Matsuda ◽  
Kana Yokoe ◽  
...  

Studies involving the 30 s chair-stand test (CS-30) have shown that subjects’ movements can vary during the test, and that these variations may follow several patterns. The present study aimed to define these different patterns and their respective incidences among a population of community-dwelling older adults in Japan. We also investigated, among the patterns identified, potential associations with physical and mental characteristics. The study population comprised 202 community-dwelling older adults. Subjects were classified into four groups based on how their CS-30 performance (defined through sit–stand–sit cycle count) changed over three successive 10 s segments: “steady-goers,” “fluctuators,” “decelerators,” and “accelerators.” Several other measures were also evaluated, including sit-up count, knee-extension strength, toe-grip strength, and Mini-Mental State Examination score. We found that steady-goers and decelerators comprised 70% of the sample. Fluctuators and steady-goers showed comparable physical function. Decelerators exhibited significant correlations between CS-30 score (total cycles) and tasks involving persistence and repetitive actions (p < 0.05). In addition, accelerators showed significantly stronger knee extension than steady-goers (p < 0.01). Differences in temporal patterns of CS-30 performance corresponded to differences in certain dimensions of physical and mental function. Our findings may be useful for planning and evaluating intervention programs aimed at long-term-care prevention among community-dwelling older adults.


2020 ◽  
Vol 75 (10) ◽  
pp. 1951-1959
Author(s):  
Trynke Hoekstra ◽  
Anna Galina Maria Rojer ◽  
Natasja M van Schoor ◽  
Andrea Britta Maier ◽  
Mirjam Pijnappels

Abstract Background Physical performance is an important factor for successful aging. This study aimed to identify distinct trajectories of multiple physical performance measures over 9 years in individuals aged 60–70 years and to evaluate their characteristics and the overlap between measures. Methods Four physical performance measures were assessed in 440 participants of the Longitudinal Aging Study Amsterdam: tandem stand, gait speed, chair stand, and handgrip strength. Gender-specific latent class models were conducted to obtain distinct trajectories and their degree of overlap. Results Mean age at baseline was 67.9 (SD 1.7) years for males and 68.0 (SD 1.7) years for females. The optimal number of trajectories differed across measures. For tandem stand, no distinct trajectories were found (all 179 males, 198 females). For gait speed, three trajectories were identified, dependent on baseline speed: high-stable (47 males, 27 females), intermediate-stable (132 males, 130 females), and low-declining performance (6 males, 48 females). Two trajectories were identified for the chair stand: a stable (168 males, 150 females) and declining trajectory (10 males, 38 females). For handgrip strength, three declining trajectories were identified differing in baseline performance: high (55 males, 75 females), intermediate (111 males, 118 females), and low (17 males, 10 females). Overall, 11.9% of males and 5.7% of females were classified in similar trajectories across measures. Conclusions Trajectories of physical performance were heterogeneous, but showed similar patterns for males and females. Little overlap between measures was shown, suggesting different mechanisms for decline. This study emphasizes the use of multiple domains to assess physical performance.


GeroScience ◽  
2020 ◽  
Author(s):  
Angelo Di Iorio ◽  
Roberto Paganelli ◽  
Michele Abate ◽  
Giovanni Barassi ◽  
Alex Ireland ◽  
...  

AbstractThyroid hormones (THs) play a crucial role in the homeostasis of muscle function, such as myogenesis and energy metabolism, suggesting that the thyroid may be also involved in the entropic processes of muscle aging. The aim of the present study is to evaluate the effect of TH signaling on physical performance, muscle mass, and strength in a cohort of community-dwelling oldest-old subjects (> 90 years). The study population was selected in a rural area of central Italy (Mugello, Tuscany), and the design was cross-sectional. Four hundred seventy-five subjects (130 males and 345 females) were enrolled, representing about 65% of all the nonagenarians living in the Mugello area. After adjusting for multiple confounding factors (sex, age, diabetes, and levothyroxine administration), the lowest quartile of FT3/FT4 ratio distribution showed lower physical performance compared to the other quartiles (β ± SE: − 0.49 ± 0.12; p < 0.001), whereas the highest quartile of FT3/FT4 ratio was associated with higher skeletal muscle index (β ± SE: 1.11 ± 0.42; p = 0.009). In addition, the lowest quartile of FT4 showed a statistically significant higher handgrip strength (β ± SE: 1.78 ± 0.68; p = 0.009) compared to all other quartiles. This study demonstrates that nonagenarians with higher FT3/FT4 ratios had better preserved muscle function, therefore successfully overcoming the imbalance of homeostatic and entropic processes involved in muscle aging. However, we could not establish a cause-effect relationship due to the cross-sectional design of the study.


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