scholarly journals Body Weight, BMI, Percent Fat and Associations with Mortality and Incident Mobility Limitation in Older Men

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 53
Author(s):  
Peggy M. Cawthon ◽  
Stephanie L. Harrison ◽  
Tara Rogers-Soeder ◽  
Katey Webber ◽  
Satya Jonnalagadda ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Proportional Hazards ◽  
Older Men ◽  
Community Dwelling ◽  
Mobility Limitation ◽  
Mobility Limitations ◽  
Single Measure ◽  
Risk Of Mortality ◽  
Log Linear ◽  
Difficulty Walking

How different measures of adiposity are similarly or differentially related to mobility limitation and mortality is not clear. In total, 5849 community-dwelling men aged ≥65 years (mean age: 72 years) were followed mortality over 10 years and self-reported mobility limitations (any difficulty walking 2–3 blocks or with climbing 10 steps) at six contacts over 14 years. Baseline measures of adiposity included weight, BMI and percent fat by DXA. Appendicular lean mass (ALM, by DXA) was analyzed as ALM/ht2. Proportional hazards models estimated the risk of mortality, and repeated measures generalized estimating equations estimated the likelihood of mobility limitation. Over 10 years, 27.9% of men died; over 14 years, 48.0% of men reported at least one mobility limitation. We observed U-shaped relationships between weight, BMI, percent fat and ALM/ht2 with mortality. There was a clear log-linear relationship between weight, BMI and percent fat with incident mobility limitation, with higher values associated with a greater likelihood of mobility limitation. In contrast, there was a U-shaped relationship between ALM/ht2 and incident mobility limitation. These observational data suggest that no single measure of adiposity or body composition reflects both the lowest risk of mortality and the lowest likelihood for developing mobility limitation in older men.

scholarly journals Body Weight, BMI, Percent Fat, Lean Mass and Their Long-Term Associations with Mortality and Incident Mobility Limitation

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1422-1422
Author(s):  
Satya Jonnalagadda ◽  
Stephanie Harrison ◽  
Tara Rogers-Soeder ◽  
Katey Webber ◽  
Suzette Pereria ◽  
...  
Keyword(s):  
Lean Mass ◽  
Repeated Measures ◽  
Proportional Hazards ◽  
Community Dwelling ◽  
Mobility Limitation ◽  
Mobility Limitations ◽  
Funding Sources ◽  
Risk Of Mortality ◽  
Log Linear

Abstract Objectives Adiposity is often approximated by body mass index (BMI), weight, and % fat from dual energy x-ray absorptiometry (DXA). We aimed to describe how different measures of adiposity and body composition are similarly or differentially related to mobility limitation and mortality. Methods Older community-dwelling men aged ≥65 yrs were followed for 10 years for mortality (N = 5849) and at six study contacts over 14 year for self-reported mobility limitations (any difficulty walking 2–3 blocks or with climbing 10 steps, N = 5841). Baseline measures of adiposity included weight, BMI, % fat by DXA. Appendicular lean mass (ALM, by DXA) was analyzed as ALM/ht2. Proportional hazards models estimated the risk of mortality and repeated measures generalized estimating equations estimated the likelihood of mobility limitation. Adiposity and ALM/ht2 measures were analyzed as quintiles and with splines. Results Over 10 years, 27.9% of men died; over 14 years, 48.0% of men reported at least one mobility limitation. We observed U-shaped relationships between weight, BMI, % fat and ALM/ht2 with mortality. There was a log-linear relationship between weight, BMI and % fat with incident mobility limitation, with higher values associated with greater likelihood of mobility limitation: for those with the lowest values of each of these metrics (quintile 1), the likelihood of mobility limitation was 1.6 to 3.5 times greater than those with the highest values for these metrics (quintile 5, P < .001 for all). In contrast, there was a U-shaped relationship between ALM/ht2 and incident mobility limitation. Conclusions These observational data suggest that there is not a single weight, BMI or % fat value that can represent both the lowest risk of mortality and also the lowest likelihood for developing mobility limitation over time in older men. Funding Sources National Institute on Aging and Abbott Nutrition.

scholarly journals Estimated GFR and Mortality in Older Men: Are All eGFR Formulae Equal?

2016 ◽  
Vol 43 (5) ◽  
pp. 325-333 ◽  
Author(s):  
Muna T. Canales ◽  
Terri Blackwell ◽  
Areef Ishani ◽  
Brent C. Taylor ◽  
Allyson Hart ◽  
...  
Keyword(s):  
Older Adults ◽  
Cystatin C ◽  
Proportional Hazards ◽  
Older Men ◽  
Cardiovascular Death ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Sleep Study ◽  
Disease Epidemiology ◽  
Net Reclassification Improvement

Background: Recently, the first estimated glomerular filtration rate (eGFR) formula specifically developed for community-dwelling older adults, the Berlin Initiative Study Equation 2 (BIS2), was reported. To date, however, no study has examined the performance of the BIS2 to predict death in older adults as compared to equations used clinically and in research. Methods: We prospectively followed 2,994 community-dwelling men (age 76.4 ± 5.6) enrolled in the MrOS Sleep Study. We calculated baseline eGFR from serum creatinine and cystatin-C using the BIS2, Chronic Kidney Disease Epidemiology (CKD-EPIcr,cysc), CKD-EPIcysc and CKD-EPIcr equations. Analyses included Cox-proportional hazards regression and net reclassification improvement (NRI) for the outcomes of all-cause and cardiovascular death. Results: Follow-up time was 7.3 ± 1.9 years. By BIS2, 42 and 11% had eGFR <60 and <45, respectively, compared to CKD-EPIcr (23 and 6%), CKD-EPIcysc (36 and 13%) and CKD-EPIcr,cysc (28 and 8%). BIS2 eGFR <45 was associated with twofold higher rate of all-cause mortality when compared to eGFR ≥75 after multivariate adjustment (HR 2.1, 95% CI 1.5-2.8). Results were similar for CKD-EPIcr,cysc <45 (HR 2.1, 95% CI 1.6-2.7) and CKD-EPIcysc <45 (HR 2.1, 95% CI 1.7-2.7) and weaker for CKD-EPIcr <45 (HR 1.5, 95% CI 1.2-2.0). In NRI analyses, when compared to CKD-EPIcr,cysc, both BIS2 and CKD-EPIcr equations more often misclassified participants with respect to mortality. We found similar results for cardiovascular death. Conclusion: The BIS2 did not outperform and the CKD-EPIcr was inferior to the cystatin C-based CKD-EPI equations to predict death in this cohort of older men. Thus, the cystatin C-based CKD-EPI equations are the formulae of choice to predict death in community-dwelling older men.

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&lt;.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.

scholarly journals Free Testosterone Levels Are Associated with Mobility Limitation and Physical Performance in Community-Dwelling Men: The Framingham Offspring Study

2010 ◽  
Vol 95 (6) ◽  
pp. 2790-2799 ◽  
Author(s):  
Joanne B. Krasnoff ◽  
Shehzad Basaria ◽  
Michael J. Pencina ◽  
Guneet K. Jasuja ◽  
Ramachandran S. Vasan ◽  
...  
Keyword(s):  
Physical Performance ◽  
Lower Risk ◽  
Walking Speed ◽  
Free Testosterone ◽  
Older Men ◽  
Subjective Health ◽  
Community Dwelling ◽  
Mobility Limitation ◽  
Longitudinal Analyses ◽  
Cross Sectional

Abstract Context: Mobility limitation is associated with increased morbidity and mortality. The relationship between circulating testosterone and mobility limitation and physical performance is incompletely understood. Objective: Our objective was to examine cross-sectional and prospective relations between baseline sex hormones and mobility limitations and physical performance in community-dwelling older men. Design, Setting, and Participants: We conducted cross-sectional and longitudinal analyses of 1445 men (mean age 61.0 ± 9.5 yr) who attended Framingham Offspring Study examinations 7 and 8 (mean 6.6 yr apart). Total testosterone (TT) was measured by liquid chromatography tandem mass spectrometry at examination 7. Cross-sectional and longitudinal analyses of mobility limitation and physical performance were performed with continuous (per sd) and dichotomized [low TT and free testosterone (FT) and high SHBG vs. normal] hormone levels. Main Outcome Measures: Self-reported mobility limitation, subjective health, usual walking speed, and grip strength were assessed at examinations 7 and 8. Short physical performance battery was performed at examination 7. Results: Higher continuous FT was positively associated with short physical performance battery score (β = 0.13; P = 0.008), usual walking speed (β = 0.02; P = 0.048), and lower risk of poor subjective health [odds ratio (OR) = 0.72; P = 0.01]. In prospective analysis, 1 sd increase in baseline FT was associated with lower risk of developing mobility limitation (OR = 0.78; 95% confidence interval = 0.62–0.97) and progression of mobility limitation (OR = 0.75; 95% confidence interval = 0.60–0.93). Men with low baseline FT had 57% higher odds of reporting incident mobility limitation (P = 0.03) and 68% higher odds of worsening of mobility limitation (P = 0.007). Conclusions: Lower levels of baseline FT are associated with a greater risk of incident or worsening mobility limitation in community-dwelling older men. Whether this risk can be reduced with testosterone therapy needs to be determined by randomized trials.

Correlates of limitations in activities of daily living and mobility among community-dwelling older Singaporeans

2010 ◽  
Vol 31 (4) ◽  
pp. 663-682 ◽  
Author(s):  
ANGELIQUE CHAN ◽  
CHETNA MALHOTRA ◽  
TRULS ØSTBYE
Keyword(s):  
Activities Of Daily Living ◽  
Low Income ◽  
Daily Living ◽  
Significant Risk ◽  
Community Dwelling ◽  
Mobility Limitation ◽  
Activity Limitations ◽  
Mobility Limitations ◽  
Use Of Services ◽  
Weighted Prevalence

ABSTRACTMost research on activity limitations has focused on the association between chronic health conditions and activity limitations and given little attention to their social and financial implications. In this paper, we study the correlates of limitations in the activities of daily living (ADL) and mobility among older Singaporeans (aged 55 or more years), based on the ‘disability frameworks’ or pathways proposed by Nagi, Verbrugge and the International Classification of Functioning, Disability and Health. Data from the 2005 National Survey of Senior Citizens in Singapore was used. The weighted prevalence of ADL and mobility limitations was calculated, overall and in subgroups. Logistic regression models were used to assess predictors of ADL and mobility limitations and variation in involvement with family, society, work, use of services and perceived financial adequacy, by ADL and mobility status was studied. We found the overall weighted prevalence of ADL and mobility limitation to be 5 and 8 per cent, respectively. Significant risk factors for ADL and mobility limitation were being older (aged 75 or more years), widowed, having diabetes, joint/bone problems, stroke, cancer and low income. Individuals with ADL and mobility limitations had lower involvement with family, society and work, and perceived financial adequacy, while use of services was higher. The findings underline the importance of improving elderly services for sustained integration of disabled elderly within the community.

Motives for and Barriers to Physical Activity among Older Adults with Mobility Limitations

2007 ◽  
Vol 15 (1) ◽  
pp. 90-102 ◽  
Author(s):  
Minna Rasinaho ◽  
Mirja Hirvensalo ◽  
Raija Leinonen ◽  
Taru Lintunen ◽  
Taina Rantanen
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Exercise ◽  
Community Dwelling ◽  
Mobility Limitation ◽  
Mobility Limitations ◽  
Negative Experiences ◽  
Limited Mobility ◽  
Barriers To Exercise ◽  
Positive Experiences

The purpose of this study was to investigate what older adults with severe, moderate, or no mobility limitation consider motives for and barriers to engaging in physical exercise. Community-dwelling adults (N = 645) age 75–81 years completed a questionnaire about their motives for and barriers to physical exercise and answered interview questions on mobility limitation. Those with severely limited mobility more often reported poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise than did those with no mobility limitation. They also accentuated disease management as a motive for exercise, whereas those with no or moderate mobility limitation emphasized health promotion and positive experiences related to exercise. Information about differences in motives for and barriers to exercise among people with and without mobility limitation helps tailor support systems that support engagement in physical activity among older adults.

Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Comparison Group ◽  
Care Delivery ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Positive Effects ◽  
Repeated Measures Design ◽  
Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

scholarly journals Factors associated to functioning and health in relation to home rehabilitation in Sweden: a non-randomized pre-post intervention study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anette Johansson ◽  
Marie Ernsth Bravell ◽  
Eleonor I. Fransson ◽  
Sofi Fristedt
Keyword(s):  
Repeated Measures ◽  
Linear Models ◽  
Medical Condition ◽  
Rehabilitation Program ◽  
Community Dwelling ◽  
Rehabilitation Service ◽  
Post Intervention ◽  
Factors Associated ◽  
Rehabilitation Outcomes ◽  
Self Rated Health

Abstract Background Home rehabilitation is a growing rehabilitation service in many countries, but scientific knowledge of its components and outcomes is still limited. The aim of this study was to investigate; 1) which changes in functioning and self-rated health could be identified in relation to a home rehabilitation program in a population of community-dwelling citizens, and 2) how socio-demographic factors, health conditions and home rehabilitation interventions were associated to change in functioning and self-rated health after the home rehabilitation program. Method The sample consisted of participants in a municipal home rehabilitation project in Sweden and consisted of 165 community-dwelling citizens. General Linear Models (ANOVA repeated measures) was used for identifying changes in rehabilitation outcomes. Logistic regressions analysis was used to investigate associations between rehabilitation outcomes and potential factors associated to outcome. Result Overall improvements in functioning and self-rated health were found after the home rehabilitation program. Higher frequencies of training sessions with occupational therapists, length of home rehabilitation, and orthopaedic conditions of upper extremities and spine as the main health condition, were associated with rehabilitation outcomes. Conclusion The result indicates that the duration of home rehabilitation interventions and intensity of occupational therapy, as well as the main medical condition may have an impact on the outcomes of home rehabilitation and needs to be considered when planning such programs. However, more research is needed to guide practice and policymaking.

scholarly journals Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis

Gerontology ◽  
2021 ◽  
pp. 1-16
Author(s):  
Jane Xu ◽  
Ching S. Wan ◽  
Kiriakos Ktoris ◽  
Esmee M. Reijnierse ◽  
Andrea B. Maier
Keyword(s):  
Systematic Review ◽  
Working Group ◽  
Meta Analysis ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Risk Of Mortality ◽  
European Working ◽  
Subgroup Analyses ◽  
Meta Analyses

<b><i>Background:</i></b> Sarcopenia can predispose individuals to falls, fractures, hospitalization, and mortality. The prevalence of sarcopenia depends on the population studied and the definition used for the diagnosis. <b><i>Objective:</i></b> This systematic review and meta-analysis aimed to investigate the association between sarcopenia and mortality and if it is dependent on the population and sarcopenia definition. <b><i>Methods:</i></b> A systematic search was conducted in MEDLINE, EMBASE, and Cochrane from 1 January 2010 to 6 April 2020 for articles relating to sarcopenia and mortality. Articles were included if they met the following criteria – cohorts with a mean or median age ≥18 years and either of the following sarcopenia definitions: Asian Working Group for Sarcopenia (AWGS and AWGS2019), European Working Group on Sarcopenia in Older People (EWGSOP and EWGSOP2), Foundation for the National Institutes of Health (FNIH), International Working Group for Sarcopenia (IWGS), or Sarcopenia Definition and Outcomes Consortium (SDOC). Hazard ratios (HR) and odds ratios (OR) were pooled separately in meta-analyses using a random-effects model, stratified by population (community-dwelling adults, outpatients, inpatients, and nursing home residents). Subgroup analyses were performed for sarcopenia definition and follow-up period. <b><i>Results:</i></b> Out of 3,025 articles, 57 articles were included in the systematic review and 56 in the meta-analysis (42,108 participants, mean age of 49.4 ± 11.7 to 86.6 ± 1.0 years, 40.3% females). Overall, sarcopenia was associated with a significantly higher risk of mortality (HR: 2.00 [95% CI: 1.71, 2.34]; OR: 2.35 [95% CI: 1.64, 3.37]), which was independent of population, sarcopenia definition, and follow-up period in subgroup analyses. <b><i>Conclusions:</i></b> Sarcopenia is associated with a significantly higher risk of mortality, independent of population and sarcopenia definition, which highlights the need for screening and early diagnosis in all populations.

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