The importance of weak physical performance in older adults for the development of musculoskeletal pain that interferes with normal life. A prospective cohort study

2019 ◽  
Vol 19 (4) ◽  
pp. 789-796
Author(s):  
Stina Lilje ◽  
Johan Sanmartin Berglund ◽  
Peter Anderberg ◽  
Lina Palmlöf ◽  
Eva Skillgate
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Grip Strength ◽  
Physical Performance ◽  
Musculoskeletal Pain ◽  
National Study ◽  
Risk Of Falling ◽  
Normal Life ◽  
Sit To Stand ◽  
Proprioceptive Function

Abstract Background and aims There are associations between pain, comorbidity and risk of falling, and falling increases the risk of mortality in older persons, but few studies have investigated the development of pain as a result of impaired physical function. The aim of this study was to examine possible associations between weak physical performance and the development of musculoskeletal pain that interferes with normal life in a sample of older adults. The sample derived from a national, longitudinal multicenter study; the Swedish National Study on Ageing and Care; SNAC-B. Methods The participants (n = 490) were between 60 and 78 years at the baseline examinations. Three variables were chosen for the exposure physical function, from the baseline examinations; One Leg Stand, Grip strength and Sit-to-Stand. The outcome musculoskeletal pain that interferes with normal life was measured using EQ5D and SF-12 6 years later, and logistic regression was used to investigate possible associations between the exposures and the outcome. Results Maximum grip strength (Grippit) was inversely associated with musculoskeletal pain that interferes with normal life (OR 2.31; 95% CI 1.15–4.61), and One-Leg Stand and Sit-to-Stand were not associated with the development of pain (OR 1.30; 95% CI 0.64–2.64) and (OR 0.91; 95% CI 0.45–1.86), respectively. Conclusions Weak grip strength was inversely associated with the development of musculoskeletal pain that interferes with normal life in older adults. Implications Impaired proprioceptive function, strength and mobility in elderly with pain have been found in earlier research. Since pain increases the risk of falling, it is important to investigate if it may develop as a function of an impaired physical function. The results of the present study could be of importance for future prevention programs aiming to protect elderly from falling.

Physical Performance Predictors for Incident Dementia Among Japanese Community-Dwelling Older Adults

2019 ◽  
Vol 99 (9) ◽  
pp. 1132-1140
Author(s):  
Takehiko Doi ◽  
Kota Tsutsumimoto ◽  
Sho Nakakubo ◽  
Min-Ji Kim ◽  
Satoshi Kurita ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Grip Strength ◽  
Physical Performance ◽  
Performance Level ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Community Dwelling Older Adults

Abstract Background Evaluating physical performance could facilitate dementia risk assessment. However, findings differ regarding which type of physical performance best predicts dementia. Objective The objective of this study was to examine the association between physical performance and incidence of dementia in Japanese community-dwelling older adults. Design This was a prospective study of community-dwelling older adults. Methods Of 14,313 invited individuals who were ≥ 65 years old, 5104 agreed to participate from 2011 to 2012, and 4086 (52% women; mean age = 72.0 years) met the criteria. Baseline assessments of the following physical performance indicators were obtained: grip strength, the Five-Times Sit-to-Stand Test, and the Timed “Up & Go” Test. The physical performance level in each test was categorized as C1 (highest), C2 (middle–high), C3 (middle–low), or C4 (lowest) on the basis of sex-stratified quartile values. Incident dementia status was obtained from medical records that were updated monthly. Results During follow-up (mean duration = 42.9 months), there were 243 incident cases of dementia (5.9%). Log-rank test results indicated that a lower physical performance level constituted a significant risk factor for dementia. After adjustment for covariates, Cox proportional hazards models (reference: highest physical performance level [C1]) demonstrated that the Five-Times Sit-to-Stand Test in the group with the lowest physical performance level (hazard ratio = 1.69; 95% CI = 1.10–2.59) was significantly associated with a risk of dementia. Likewise, the Timed “Up & Go” Test in the group with the lowest physical performance level (hazard ratio = 1.54; 95% CI = 1.01–2.35) was significantly associated with a risk of dementia. However, grip strength was not significantly associated with a risk of dementia. Limitations This study was limited by the use of medical record data. Conclusions A lower mobility-related physical performance level was associated with dementia risk. Dementia risk assessment should include an adequate evaluation of physical function.

scholarly journals Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Xianyang Sherman Yee ◽  
Yee Sien Ng ◽  
John Carson Allen ◽  
Aisyah Latib ◽  
Ee Ling Tay ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Gait Speed ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Sit To Stand ◽  
Fitness Measures ◽  
Community Dwelling Older Adults

Abstract Background The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants – Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) – with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults. Methods This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance. Results Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST, r = 0.290; 5TSTS, r = − 0.242; both p< 0.01), and stronger correlations with gait speed (30CST, r = 0.517; 5TSTS, r = − 0.533; both p< 0.01), endurance (30CST, r = 0.558; 5TSTS, r = − 0.531; both p < 0.01) and dynamic balance (30CST, r = − 0.501; 5TSTS, r = 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%; p = 0.276). When both measures are used, prevalence is significantly higher (42.0%; p = 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%; p< 0.05). Conclusion In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.

scholarly journals The effects of the body mass index on the physical function and the quality of life in the elderly

2020 ◽  
Vol Supplement 1 (1) ◽  
pp. 55-62
Author(s):  
RAZIYE ŞAVKIN ◽  
GÖKHAN BAYRAK ◽  
NIHAL BÜKER
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Body Mass Index ◽  
Physical Health ◽  
Physical Function ◽  
Grip Strength ◽  
Physical Performance ◽  
The Elderly ◽  
The Body

Background: As in all age groups, the prevalence of overweight and obesity is gradually increasing in the elderly. The aim of this study is to examine the effect of the body mass index (BMI) on the physical function and the overall quality of life in the elderly. Materials and methods: 265 community-dwelling older adults (131 women and 134 men) were included. BMI, grip strength (hand-held dynamometer), physical performance (Short Physical Performance Battery, SPPB) and overall quality of life (WHOQOL-BREF) were assessed. Results: 265 older adults were divided into three groups: normal (n=66), overweight (n=116), obese (n=83). SPPS and WHOQOL-BREF psychological health scores of the normal group were statistically significantly higher than in the obese group (p≤0.005). The WHOQOL-BREF physical health score of the normal and the overweight groups was significantly higher than in the obese group (p≤0.005). Grip strength, SPPB and WHOQOL-BREF physical health scores of older men in all groups were better than in women (p≤0.005). Conclusions: BMI negatively affects the physical function, physical health and the psychological domain of the quality of life in the elderly. In order to avoid or limit the effects of disability secondary to obesity and promote healthy ageing, the elderly should be encouraged to increase their physical activity and maintain healthy weight.

Stand Up Now: A Sedentary Behavior Intervention in Older Adults of Moderate to Low Physical Function

2020 ◽  
pp. 1-13
Author(s):  
Katie Thralls Butte ◽  
Susan S. Levy
Keyword(s):  
Older Adults ◽  
Sedentary Behavior ◽  
Physical Function ◽  
Physical Performance ◽  
Mixed Models ◽  
Sedentary Time ◽  
Health Coaching ◽  
Behavior Intervention ◽  
Sit To Stand ◽  
Over Time

Objectives: To examine the efficacy of an the intervention Stand Up Now (SUN) to reduce sedentary behavior (SB) and improve physical function and mobility. Methods: SUN included two groups: (a) focused on reducing total SB (SUNSL) and (b) focused on increasing sit-to-stand (STS) transitions (SUNSTS). The participants (N = 71; Mage = 87 ± 7 years) had 12 weekly health coaching sessions. SB, physical function, and mobility were measured at the baseline, 6, and 12 weeks via the activPAL, Short Physical Performance Battery, and the 8-foot up and go, respectively. Linear mixed models examined the outcome variables over time. Results: Both groups decreased sedentary time (1.3 ± 0.3 hr, p < .001), increased standing time (0.5 ± 0.2 hr, p < .02), and improved physical function (1.5 ± 0.4 points, p < .001) from the baseline to 6 weeks, and they maintained it at 12 weeks. SUNSTS increased STS transitions (5.4 ± 4.1, p < .001), while SUNSL had no changes (0.5 ± 3.1, p > .9). There were no changes in mobility for either group (0.5 ± 1.5 s, p > .05). Discussion: SUN demonstrates the efficacy to improve SB and physical function in older adults.

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.

Prospective associations of plasma growth differentiation factor 15 with physical performance and cognitive functions in older adults

2022 ◽  
Author(s):  
Lingxiao He ◽  
Philipe de Souto Barreto ◽  
Juan Luis Sánchez Sánchez ◽  
Yves Rolland ◽  
Sophie Guyonnet ◽  
...  
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Physical Performance ◽  
Cognitive Functions ◽  
Community Dwelling ◽  
Cognitive Score ◽  
Growth Differentiation Factor 15 ◽  
Clinically Significant ◽  
One Year ◽  
Community Dwelling Older Adults

Abstract Background Growth differentiation factor 15 (GDF15) has been associated with several age-related disorders, but its associations with functional abilities in community-dwelling older adults are not well studied. Methods The study was a secondary analysis on 1096 community-dwelling older adults (aged 69 to 94 years) recruited from the Multidomain Alzheimer’s Preventive Trial. Plasma GDF15 was measured one year after participants’ enrolment. Annual data of physical performance (grip strength and short physical performance battery [SPPB]) and global cognitive functions (mini-mental state examination [MMSE] and a composite cognitive score) were measured for four years. Adjusted mixed-effects linear models were performed for cross-sectional and longitudinal association analyses. Results A higher GDF15 was cross-sectionally associated with a weaker grip strength (β = -1.1E-03, 95%CI [-2.0E-03, -1.5E-04]), a lower SPPB score (β = -3.1E-04, 95%CI [-5.4E-04, -9.0E-05]) and worse cognitive functions (β = -2.4E-04, 95%CI [-3.3E-04, -1.6E-04] for composite cognitive score; β = -4.0E-04, 95%CI [-6.4E-04, -1.6E-04] for MMSE). Participants with higher GDF15 demonstrated greater longitudinal declines in SPPB (β = -1.0E-04, 95%CI [-1.7E-04, -2.0E-05]) and composite cognitive score (β = -2.0E-05, 95%CI [-4.0E-05, -3.6E-06]). The optimal initial GDF15 cutoff values for identifying participants with minimal clinically significant decline after one year were 2189 pg/mL for SPPB (AUC: 0.580) and 2330 pg/mL for composite cognitive score (AUC: 0.587). Conclusions Plasma GDF15 is cross-sectionally and longitudinally associated with lower-limb physical performance and global cognitive function in older adults. Circulating GDF15 alone has limited capacity of discriminating older adults who will develop clinically significant functional declines.

scholarly journals Associating Gait Phase and Physical Fitness with Global Cognitive Function in the Aged

2020 ◽  
Vol 17 (13) ◽  
pp. 4786
Author(s):  
Byungjoo Noh ◽  
Changhong Youm ◽  
Myeounggon Lee ◽  
Hwayoung Park
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Physical Fitness ◽  
Grip Strength ◽  
Stance Phase ◽  
Strong Dependence ◽  
Sit To Stand ◽  
Global Cognitive Function ◽  
Age Related ◽  
Type Data

This study aimed to identify classifier variables by considering both gait and physical fitness for identifying adults aged over 75 years and global cognitive function declines in older adults. The participants included 735 adults aged 65–89 years who were asked to walk at three different speeds (slower, preferred, and faster) while wearing inertial measurement units embedded in shoe-type data loggers and to perform nine physical fitness tests. The variability in the stance phase as well as the strength, balance, and functional endurance showed a strong dependence on the age being over 75 years. The cognitive function was evaluated by the Mini-Mental State Examination; a longer stance phase at a slower walking speed and decreased grip strength and five times sit-to-stand were associated with cognitive function. These findings may be useful for determining the decline in physical performance of older adults. A longer stance phase and decreased grip strength and five times sit-to-stand may be factors that help distinguish declines in cognitive function from normal age-related declines.

scholarly journals Cross-Sectional Examination of Musculoskeletal Pain and Physical Function in a Racially and Socioeconomically Diverse Sample of Adults

2020 ◽  
Author(s):  
Angie L Sardina ◽  
Alyssa A Gamaldo ◽  
Ross Andel ◽  
Shanthi Johnson ◽  
Tamara A Baker ◽  
...  
Keyword(s):  
Physical Function ◽  
Physical Performance ◽  
Musculoskeletal Pain ◽  
Performance Measures ◽  
Healthy Aging ◽  
Functional Limitation ◽  
Future Research ◽  
Middle Aged ◽  
Cross Sectional ◽  
Middle Aged Adults

Abstract Background Musculoskeletal pain alters physiological function, which may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for musculoskeletal pain and report functional limitations similar to older adults. However, few studies have examined the relationships between musculoskeletal pain and physical function, using objective performance measures in a sample of racially and socioeconomically diverse adults. Thus, this study examined musculoskeletal pain in relation to physical function in middle-aged (30–64 years) White and Black adults and investigated whether the relationship varied by sociodemographic characteristics. Methods This cross-sectional examination incorporated data from the Healthy Aging in Neighborhoods of Diversity across the Life-Span Study. Participants (n = 875) completed measures of musculoskeletal pain and objective measures of physical performance (ie, lower and upper body strength, balance, and gait abnormalities). Physical performance measures were standardized to derive a global measure of physical function as the dependent variable. Results Approximately, 59% of participants identified at least 1 pain sites (n = 518). Multivariable regression analyses identified significant relationships between greater musculoskeletal pain and poorer physical function (β = −0.07, p = .031), in mid midlife (β = −0.04, p = .041; age 40–54) and late midlife (β = −0.05, p = .027; age 55–64). Conclusions This study observed that musculoskeletal pain was associated with poorer physical function within a diverse group of middle-aged adults. Future research should longitudinally explore whether chronic musculoskeletal pain identified at younger ages is associated with greater risk for functional limitation and dependence in later life.

Global cognition predicts the incidence of poor physical performance among older adults: A cross‐national study

2020 ◽  
Vol 20 (3) ◽  
pp. 218-222 ◽  
Author(s):  
Alexandra Dansereau ◽  
Susan W Hunter ◽  
Fernando Gomez ◽  
Jack M Guralnik ◽  
Vincent G DePaul ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
National Study ◽  
Global Cognition ◽  
Cross National Study ◽  
Cross National

scholarly journals Comparison of difficulty with activities of daily living in elderly adults undergoing hemodialysis and community-dwelling individuals: a cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Toshiki Kutsuna ◽  
Yusuke Isobe ◽  
Takaaki Watanabe ◽  
Yusuke Matsunaga ◽  
Satomi Kusaka ◽  
...  
Keyword(s):  
Physical Function ◽  
Grip Strength ◽  
Gait Speed ◽  
Community Dwelling ◽  
Test Time ◽  
Control Group ◽  
Elderly Adults ◽  
Sit To Stand ◽  
Difficulty Score ◽  
Usual Gait Speed

Abstract Background Elderly adults undergoing hemodialysis (HD) have multiple comorbidities, physical frailty, and functional dependence with activities of daily living (ADL). ADL difficulty is an early predictor of ADL dependency in community-dwelling elderly adults. However, the characteristics of ADL difficulty in patients undergoing HD have not yet been reported. The present study aimed to examine the current status and characteristics of physical function and ADL difficulty in ambulatory elderly patients undergoing HD. Methods In all, 136 elderly outpatients undergoing HD and 40 community-dwelling controls participated in the present study. The characteristics, physical function (SARC-F score, grip strength, five-times sit-to-stand test time, usual gait speed, maximum gait speed, and short physical performance battery score), and scores from the ADL difficulty questionnaires [difficulty related to upper limb (U/L) and lower limb (L/L) functions] were compared between the HD and control groups. Multiple regression analysis was performed to examine whether the characteristics of physical function were able to discriminate ADL difficulty in the HD group. Results The HD group had a significantly greater SARC-F score, lower grip strength, longer five-times sit-to-stand test time, slower usual gait speed, slower maximum gait speed, lower short physical performance battery score, and lower U/L and L/L ADL difficulty scores compared to the control group (all P < 0.001). The distribution of U/L and L/L ADL difficulty scores showed a wider variation in the HD group than in the control group. The U/L ADL difficulty score was independently associated with the SARC-F score (β = −0.52, P < 0.001) and grip strength (β = 0.21, P = 0.02). The L/L ADL difficulty score was independently associated with the SARC-F score (β = −0.56, P < 0.001) and usual gait speed (β = 0.35, P < 0.001). Conclusions The elderly HD group had a poorer physical function and experienced stronger ADL difficulty than the control group. There was an association between ADL difficulty and sarcopenia or poor physical function among patients undergoing HD. These findings provide useful data for effective clinical management to prevent decline of ADL in ambulatory elderly patients undergoing HD.

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