Physical Functional Assessment in Older Adults

2020 ◽  
pp. 1-9
Author(s):  
E. Patrizio ◽  
R. Calvani ◽  
E. Marzetti ◽  
M. Cesari
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Performance ◽  
Handgrip Strength ◽  
Objective Assessment ◽  
Multiple Chronic Conditions ◽  
Physical Domain ◽  
Walk Test ◽  
Predictive Capacity ◽  
Timed Up And Go

The evaluation of the physical domain represents a critical part of the assessment of the older person, both in the clinical as well as the research setting. To measure physical function, clinicians and researchers have traditionally relied on instruments focusing on the capacity of the individual to accomplish specific functional tasks (e.g., the Activities of Daily Living [ADL] or the Instrumental ADL scales). However, a growing number of physical performance and muscle strength tests has been developed in parallel over the past three decades. These measures are specifically designed to: 1) provide objective results (not surprisingly, they are frequently timed tests) taken in standardized conditions, whereas the traditional physical function scales are generally self- or proxy-reported measures; 2) be more sensitive to changes; 3) capture the real biology of the function through the assessment of standardized tasks mirroring specific functional subdomains; and 4) mirror the quality of specific mechanisms underlying more complex and multidomain functions. Among the most commonly used instruments, the usual gait speed test, the Short Physical Performance Battery, the handgrip strength, the Timed Up-and-Go test, the 6-minute walk test, and the 400-meter walk test are widely adopted by clinicians and researchers. The clinical and research importance of all these instruments has been demonstrated by their predictive capacity for negative health-related outcomes (i.e., hospitalization, falls, institutionalization, disability, mortality). Moreover, they have shown to be associated with subclinical and clinical conditions that are also not directly related to the physical domain (e.g., inflammation, oxidative stress, overall mortality). For this reason, they have been repeatedly indicated as markers of wellbeing linked to the burden of multiple chronic conditions rather than mere parameters of mobility or strength. In this work protocols of the main tests for the objective assessment of physical function in older adults are presented.

scholarly journals Inappropriate medications and physical function: a systematic review

2021 ◽  
Vol 12 ◽  
pp. 204209862110303
Author(s):  
Elizabeth Manias ◽  
Md Zunayed Kabir ◽  
Andrea B. Maier
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Performance ◽  
Inappropriate Medication ◽  
Functional Independence ◽  
Potentially Inappropriate Medications ◽  
Timed Up And Go ◽  
Risk Of Falls ◽  
Prescribing Omissions ◽  
Inappropriate Medications

Background and aims: Inappropriate medication prescription is highly prevalent in older adults and is associated with adverse health outcomes. The aim of this study was to examine the associations between potentially inappropriate medications (PIMS) and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: A systematic search was completed using the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE and COCHRANE. Results were extracted from the included studies. Results: In total, 55 studies reported on 2,767,594 participants with a mean age of 77.1 years (63.5% women). Study designs comprised 26 retrospective cohort studies, 21 prospective cohort studies and 8 cross-sectional studies. Inappropriate medications in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), impaired activities of daily living (ADL; 8 out of 10 studies) and impaired instrumental ADL (IADL) score (4 out of 6 studies). Five out of seven studies also showed that PIMs were associated with poorer physical performance comprising the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many medication classes were implicated as PIMs in falls, fractures and impairment in physical performance including antipsychotic, sedative, anti-anxiety, anticholinergic, antidiabetic, opioid and antihypertensive medications. For patients not receiving musculoskeletal medications, such as calcium, vitamin D and bisphosphonates, older adults were found to be at risk of a hospital admission for a fall or fracture. Conclusion: Inappropriate medication prescriptions are associated with impaired physical function across longitudinal and cross-sectional studies in older adults situated in diverse settings. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions. Plain language summary Inappropriate medications and physical function Background and aims: The use of inappropriate medications is very common in older adults and is associated with harmful health problems. The aim was to examine associations between potentially inappropriate medications and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: Library databases were examined for possible studies to include and a systematic search was completed. Relevant information was obtained from the included studies. Results: In total, 55 studies reported on 2,767,594 participants who were an average age of 77.1 years and about 6 out of 10 were women. A variety of different study designs were used. Inappropriate medication prescriptions in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), problems with activities of daily living (ADL), such as eating, bathing, dressing, grooming, walking and toileting (8 out of 10 studies) and problems with instrumental ADL such as managing medications, house cleaning and shopping (4 out of 6 studies). Five out of seven studies also showed that inappropriate medications were associated with poorer physical performance involving the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many types of medication classes were shown to be associated with a risk of falls, fractures and problems with physical performance. Omitted medications were also associated with falls and fractures. Conclusion: Inappropriate medication prescriptions are associated with problems relating to physical function. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions.

Physical function and all-cause mortality in older adults diagnosed with cancer: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Yasmin Ezzatvar ◽  
Robinson Ramírez-Vélez ◽  
Mikel L Sáez de Asteasu ◽  
Nicolás Martínez-Velilla ◽  
Fabricio Zambom-Ferraresi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Physical Function ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Timed Up And Go ◽  
Hazard Ratios ◽  
Inverse Variance ◽  
All Cause Mortality ◽  
Prospective Association

Abstract Background Physical function is an independent predictor of numerous chronic diseases, but its association with all-cause mortality in older adults diagnosed with cancer has received little attention. Objective The aim of this study was to conduct a systematic review and meta-analysis on the prospective association between physical function and all-cause mortality in older adults diagnosed with cancer. Methods Two authors systematically searched MEDLINE, EMBASE, and SportsDiscus databases. Prospective studies reporting associations of baseline physical function with all-cause mortality in patients aged 60 years or older diagnosed with any type of cancer were included. Hazard Ratios (HR) with associated 95% confidence intervals (CI) were extracted from studies for all-cause mortality and pooled HRs were then calculated using the random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman adjustment. Results Data from 25 studies with 8,109 adults diagnosed with cancer aged ≥60 years were included in the study. Higher levels of physical function (short physical performance battery, HR=0.44 95% CI, 0.29–0.67; I 2=16.0%; timed up and go, HR=0.40 95% CI, 0.31–0.53; I 2=61.9%; gait speed, HR=0.41 95% CI, 0.17–0.96; I 2=73.3%; handgrip strength: HR=0.61 95% CI, 0.43–0.85, I 2=85.6%; and overall, HR=0.45 95% CI, 0.35–0.57; I 2=88.6%) were associated with a lower risk of all-cause mortality compared to lower levels of functionality. Neither age at baseline nor length of follow-up had a significant effect on the HR estimates for lower all-cause mortality risk. Conclusion Physical function may exert an independent protective effect on all-cause mortality in older adults diagnosed with cancer.

scholarly journals PHYSICAL FUNCTION AND BODY COMPOSITION AS NUTRITIONAL OUTCOMES: ASSESSMENT APPROACHES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S392-S392
Author(s):  
Connie W Bales ◽  
Kathryn N Porter Starr ◽  
Marshall Miller
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
Physical Function ◽  
Physical Performance ◽  
Performance Test ◽  
Handgrip Strength ◽  
Muscle Quality ◽  
Physical Performance Test ◽  
Nutritional Interventions ◽  
Obesity Interventions

Abstract Nutritional status is a strong determinant of both body composition and physical function (PF), parameters that are closely interrelated but rarely evaluated in the clinical setting due to cost, access, and lack of agreement on best approaches in older adults. Recent evidence that changes in muscle mass do not closely correspond to changes in muscle function will be reviewed in the context of our studies of higher protein obesity interventions. PF assessments, including indices for older adults (Short Physical Performance Battery and Physical Performance Test), as well as specific tests like gait speed and handgrip strength, will be explained as nutrition outcomes and in relation to body composition from air displacement (BodPod) and dual energy x-ray absorptiometry (DXA). These results, along with new studies of muscle quality, will bring a better understanding of the complexity of responses to nutritional interventions designed to optimize body mass and composition in older adults.

scholarly journals Anthropometric, physical function and general health markers of Masters athletes: a cross-sectional study

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3768 ◽  
Author(s):  
Samantha Fien ◽  
Mike Climstein ◽  
Clodagh Quilter ◽  
Georgina Buckley ◽  
Timothy Henwood ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Function ◽  
Muscle Mass ◽  
Physical Performance ◽  
General Health ◽  
Handgrip Strength ◽  
Middle Aged ◽  
Male And Female ◽  
Masters Athletes

Once the general decline in muscle mass, muscle strength and physical performance falls below specific thresholds, the middle aged or older adult will be diagnosed as having sarcopenia (a loss of skeletal muscle mass and strength). Sarcopenia contributes to a range of adverse events in older age including disability, hospitalisation, institutionalisation and falls. One potentially relevant but understudied population for sarcopenia researchers would be Masters athletes. Masters sport is becoming more common as it allows athletes (typically 40 years and older) the opportunity to participate in individual and/or team sports against individuals of similar age. This study examined a variety of measures of anthropometric, physical function and general health markers in the male and female Masters athletes who competed at the 2014 Pan Pacific Masters Games held on the Gold Coast, Australia. Bioelectrical impedance analysis was used to collect body fat percentage, fat mass and fat-free mass; with body mass, height, body mass index (BMI) and sarcopenic status also recorded. Physical function was quantified by handgrip strength and habitual walking speed; with general health described by the number of chronic diseases and prescribed medications. Between group analyses utilised ANOVA and Tukey’s post-hoc tests to examine the effect of age group (40–49, 50–59, 60–69 and >70 years old) on the outcome measures for the entire sample as well as the male and female sub-groups. A total of 156 athletes (78 male, 78 female; mean 55.7 years) provided informed consent to participate in this study. These athletes possessed substantially better anthropometric, physical function and general health characteristics than the literature for their less physically active age-matched peers. No Masters athletes were categorised as being sarcopenic, although one participant had below normal physical performance and six participants had below normal muscle strength. In contrast, significant age-related reductions in handgrip strength and increases in the number of chronic diseases and prescribed medications were observed for the overall cohort as well as the male and female sub-groups. Nevertheless, even those aged over 70 years only averaged one chronic disease and one prescribed medication. These results may suggest that participation in Masters sport helps to maintain anthropometry, physical function and general health in middle-aged and older adults. However, it is also possible that only healthier middle-aged and older adults with favourable body composition and physical function may be able to participate in Masters sport. Future research should therefore utilise longitudinal research designs to determine the health and functional benefits of Master sports participation for middle-aged and older adults.

scholarly journals Changes in Physical and Oral Function after a Long-Term Care Prevention Program in Community-Dwelling Japanese Older Adults: A 12-Month Follow-Up Study

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 719
Author(s):  
Yoshimi Iwao-Kawamura ◽  
Hideo Shigeishi ◽  
Shino Uchida ◽  
Shirou Kawano ◽  
Tomoko Maehara ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Health Program ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Term Care ◽  
Oral Function ◽  
Nutritional Guidance ◽  
Japanese Older Adults

Background: The aim of this prospective cohort study was to clarify changes in physical and oral function in older adults after completing a 3-month health program combining physical and oral exercise, oral health instruction, and nutritional guidance. Methods: Subjects were 34 women aged at least 70 years (mean age 79.2 years) in Bungotakada City, Oita Prefecture, Japan. Physical and oral function was investigated on the first day (baseline), at the end of the program, and 6 and 12 months after completing the health program. Physical function was measured using handgrip strength test, timed up and go (TUG) test and one-leg standing time test. Oral diadochokinesis test and repetitive saliva swallowing test (RSST) were employed to assess oral function. Results: TUG scores were significantly lower at 6 and 12 months than at baseline in participants aged ≥70 and <80 years. The repetition rate of the monosyllables /pa/, /ta/, and /ka/ was improved at the end of program in participants aged ≥70 and <80 years and increased to more than 6 times/second at 12 months. Conclusions: Our 3-month health program maintained improvements in oral and physical function in older women 1 year after completing the program.

scholarly journals Associations of sarcopenia components with physical activity and nutrition in Australian older adults performing exercise training

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ewelina Akehurst ◽  
David Scott ◽  
Juan Peña Rodriguez ◽  
Carol Alonso Gonzalez ◽  
Jasmaine Murphy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Muscle Mass ◽  
Physical Performance ◽  
Gait Speed ◽  
Protein Intake ◽  
Handgrip Strength ◽  
The Elderly ◽  
Community Dwelling ◽  
Timed Up And Go

Abstract Background The risk of progressive declines in skeletal muscle mass and strength, termed sarcopenia, increases with age, physical inactivity and poor diet. The purpose of this study was to explore and compare associations of sarcopenia components with self-reported physical activity and nutrition in older adults participating in resistance training at Helsinki University Research [HUR] and conventional gyms for over a year, once a week, on average. Methods The study looked at differences between HUR (n = 3) and conventional (n = 1) gyms. Muscle strength (via handgrip strength and chair stands), appendicular lean mass (ALM; via dual energy X-ray absorptiometry) and physical performance (via gait speed over a 4-m distance, short physical performance battery, timed up and go and 400-m walk tests) were evaluated in 80 community-dwelling older adults (mean ± SD 76.5 ± 6.5 years). Pearson correlations explored associations for sarcopenia components with self-reported physical activity (via Physical Activity Scale for the Elderly [PASE]) and nutrition (via Australian Eating Survey). Results No differences in PASE and the Australian Recommended Food Score (ARFS) were observed between HUR and conventional gyms, however HUR gym participants had a significantly higher self-reported protein intake (108 ± 39 g vs 88 ± 27 g; p = 0.029) and a trend to have higher energy intake (9698 ± 3006 kJ vs 8266 ± 2904 kJ; p = 0.055). In both gym groups, gait speed was positively associated with self-reported physical activity (r = 0.275; p = 0.039 and r = 0.423; p = 0.044 for HUR and conventional gyms, respectively). ALM was positively associated with protein (p = 0.047, r = 0.418) and energy (p = 0.038, r = 0.435) intake in the conventional gym group. Similar associations were observed for ALM/h2 in the HUR group. None of the sarcopenia components were associated with ARFS in either gym group. Conclusion Older adults attending HUR and conventional gyms had similar self-reported function and nutrition (but not protein intake). Inadequate physical activity was associated with low gait speed and inadequate nutrition and low protein ingestion associated with low lean mas, even in older adults participating in exercise programs. Optimal physical activity and nutrition are important for maintaining muscle mass and function in older adults.

scholarly journals Duration or Timing? What is the Optimal Core for Older Adults to Engage in Moderate-to-vigorous Physical Activity to Prevent Disability?

2020 ◽  
Author(s):  
Ting-Fu Lai ◽  
Yung Liao ◽  
Chien-Yu Lin ◽  
Wan-Chi Huang ◽  
Ming-Chun Hsueh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Function ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Vigorous Physical Activity ◽  
Total Duration ◽  
Functional Mobility ◽  
Linear Regression Models ◽  
Timed Up And Go

Abstract Background The positive association between the total duration of physical activity and performances of physical function may vary at different times of the day as circadian rhythm regulates individuals in response to external stimulations. We aimed to examine the association of timing-specific and overall moderate-to-vigorous physical activity (MVPA) with performances of physical function in older adults. Methods A cross-sectional analysis was conducted among 118 older adults (mean age = 70.0 ± 5.0 years). We assessed and identified timing-specific (morning: 06:01-12:00; afternoon: 12:01-18:00; evening: 18:01-24:00) and overall MVPA using a triaxial accelerometer. Different measures of physical function were evaluated including handgrip strength (by grip dynamometer), gait speed (five-meter walk test), basic functional mobility (timed up and go test), and lower limb strength (five times sit-to-stand test). Multivariate linear regression models adjusting for covariates were used to investigate the associations. Results Participants spent 0.4 hours in MVPA per day on average, half the time spent during the morning (47.7%), followed by during the afternoon (29.9%) and evening (21.6%). The time spent on overall MVPA was generally associated with better physical function performances. There was statistical evidence for the percentages of MVPA engagement during the morning ( B = 0.214, 95% confidence interval [CI] 0.001 to 0.428) and afternoon ( B = -0.273, 95% CI -0.518 to -0.027) associated with basic functional mobility but with contrary directions; the percentage of MVPA engagement during the evening was associated with less time spent in gait speed performance ( B = -0.237, 95% CI -0.468 to -0.006). Conclusions Our findings inform implications that the overall MVPA engagement was more important than timing-specific MVPA to older adults’ physical function performances. Strategies for accumulating time of MVPA is more practical and effective than encouraging to engage MVPA in specific timing for the enhancement of functional ability and therefore prevent disability among older adults.

scholarly journals Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

2021 ◽  
Author(s):  
Linda Elizabeth Villagomez Fuentes ◽  
Engi Abdel–Hady Algharably ◽  
Sarah Toepfer ◽  
Maximilian König ◽  
Ilja Demuth ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Physical Function ◽  
Kidney Function ◽  
Association Studies ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Digit Symbol Substitution Test ◽  
Genome Wide Association Studies ◽  
Timed Up And Go

AbstractIn genome-wide association studies, genetic variants in the UMOD gene associate with kidney function, blood pressure (BP), and hypertension. Elevated BP is linked to kidney function and impaired cognitive as well as physical performance in later life. We investigated the association between UMOD rs4293393–A > G and kidney function, BP, cognitive and physical function in the Berlin Aging Study II (BASE–II). Data of 1556 older BASE–II participants (mean age 68.2 ± 3.7 years) were analyzed. BP was determined by standardized automated measurements, estimated glomerular filtration rate (eGFR) by CKD Epidemiology Collaboration creatinine equation. Cognitive function was assessed by Mini-Mental State Examination and Digit Symbol Substitution Test, while physical function by Handgrip Strength and Timed Up and Go-Test. Association analyses were performed by covariance and logistic regression models adjusting for sex. G–allele carriers at UMOD rs4293393 exhibited significantly higher eGFR values compared to non–carriers (AA, 76.4 ml/min/1.73 m², CI: 75.7–77.2 vs. AG, 78.4 ml/min/1.73 m², CI: 77.3–79.5 vs. GG, 78.5 ml/min/1.73 m², CI: 75.4–81.7; P = 0.010), and a lower risk of eGFR < 60 mL/min/1.73 m2 (AG, OR: 0.63, CI: 0.41–0.97, P = 0.033). However, UMOD rs4293393 genotypes were not associated with BP, diagnosis of hypertension or cognitive and physical function parameters. Our data corroborate previous findings on the association of UMOD rs4293393-G with better kidney function in older adults. However, no association between UMOD and BP or physical and cognitive parameters in these community-dwelling older adults was detected.

scholarly journals Moderate-to-vigorous physical activity duration is more important than timing for physical function in older adults

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ting-Fu Lai ◽  
Yung Liao ◽  
Chien-Yu Lin ◽  
Wan-Chi Huang ◽  
Ming-Chun Hsueh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Function ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Vigorous Physical Activity ◽  
Total Duration ◽  
Functional Mobility ◽  
Linear Regression Models ◽  
Timed Up And Go

AbstractThe positive association between the total duration of physical activity and performances of physical function may vary at different times of the day as circadian rhythm regulates individuals in response to external stimulations. We aimed to examine the association of timing-specific and overall moderate-to-vigorous physical activity (MVPA) with performances of physical function in older adults. A cross-sectional analysis was conducted among 118 older adults (mean age = 70.0 ± 5.0 years). We assessed and identified timing-specific (morning: 06:01–12:00; afternoon: 12:01–18:00; evening: 18:01–24:00) and overall MVPA using a triaxial accelerometer. Different measures of physical function were evaluated including handgrip strength (by grip dynamometer), gait speed (5-m walk test), basic functional mobility (timed up and go test), and lower limb strength (five times sit-to-stand test). Multivariate linear regression models adjusting for covariates were used to investigate the associations. Participants spent 25.0 (± 26.2) minutes in MVPA per day on average, half the time spent during the morning (47.7%), followed by during the afternoon (29.9%) and evening (21.6%). The time spent on overall MVPA was generally associated with better physical function performances. There was statistical evidence for the percentages of MVPA engagement during the morning [B = 0.214, 95% confidence interval (CI) 0.001 to 0.428] and afternoon (B = − 0.273, 95% CI − 0.518 to − 0.027) associated with basic functional mobility but with contrary directions; the percentage of MVPA engagement during the evening was associated with less time spent in gait speed performance (B = − 0.237, 95% CI − 0.468 to − 0.006). Our findings inform implications that the overall MVPA engagement was more important than timing-specific MVPA to older adults’ physical function performances. Strategies for accumulating time of MVPA is more practical and effective than encouraging to engage MVPA in specific timing for the enhancement of functional ability and therefore prevent disability among older adults.

Efficacy of an Exercise and Nutritional Supplement Program on Physical Performance and Nutritional Status in Older Adults With Mobility Limitations Residing at Senior Living Facilities

2017 ◽  
Vol 25 (3) ◽  
pp. 453-463 ◽  
Author(s):  
Michael P. Corcoran ◽  
Miriam E. Nelson ◽  
Jennifer M. Sacheck ◽  
Kieran F. Reid ◽  
Dylan Kirn ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Physical Function ◽  
Physical Performance ◽  
Handgrip Strength ◽  
Cluster Randomized Trial ◽  
Nutritional Supplement ◽  
Activity Level ◽  
Mobility Limitations ◽  
Hydroxyvitamin D

This cluster-randomized trial was designed to determine the efficacy of a 6-month exercise-nutritional supplement program (ENP) on physical function and nutritional status for older adults and the feasibility of implementing this program in a senior living setting. Twenty senior-living facilities were randomized to either a 3 day per week group-based ENP led by a trained facility staff member or a health education program (SAP). Participants (N = 121) completed a short physical performance battery, 400-m walk, handgrip strength test, and mini-nutrition assessment. 25-hydroxyvitamin D [25(OH)D], insulin-like growth-factor 1 (IGF-1), and activity level were also measured. The ENP did not significantly improve physical function or nutritional status compared with the SAP. Compared with baseline, participants in the ENP engaged in 39 min less physical activity per week at 6 months. Several facility characteristics hindered implementation of the ENP. This study highlights the complexity of implementing an evidence-based program in a field setting.

Sign in / Sign up

Export Citation Format

Share Document