Composite variable of lower extremity muscle strength and balance ability for evaluating risks of mobility limitation and falls in community-dwelling older adults

Objective: Declines in physical and cognitive functioning often co-exist through aging. Gait-related parameters have been related to cognitive function, although it is unclear whether other measures of physical functioning are similarly related to cognition. Here, we analyzed the relationship between physical functioning with cognition in older adults. Methods: In total, 116 participants were included (M age = 69 years, SD = 6; 71% women). We quantified cognitive functioning using the Montreal Cognitive Assessment (MoCA) and executive functioning tasks (Digit Span Forward minus Backward and verbal fluency tests). Physical function measures included gait speed, Short-physical Performance Battery (SPPB), five-times Sit-to-Stand Test, the Timed Up and Go (TUG) test, the Six-minute Walk Test (6MWT), and lower extremity muscle strength. We used multiple linear regression analyses to explore the association between cognitive measures and each measure of physical functioning, adjusting for age, sex, education, and RCT. Results: We observed a positive association between muscle strength and the MoCA (b = 0.84, SE = 0.40, 95%CI 0.05–1.64) after controlling for covariates. Significant associations were also found between the five-times-sit-to-stand test (b = -0.63, SE = 0.26, 95%CI -1.15–-0.12), TUG (b = -1.13, SE = 0.57, 95%CI -2.26–-0.01), 6MWT (b = 0.04, SE = 0.02, 95%CI 0.01–0.07), and lower extremity muscle strength (b = 1.92, SE = 0.93, 95%CI 0.09–3.77) with the FAS verbal fluency test, and between the TUG (b = -0.62, SE = 0.24, 95%CI -1.11–-0.14) with animal naming. Conclusion: In community-dwelling older adults, higher levels of muscle strength, dynamic balance and cardiorespiratory fitness were positively related with global cognition and executive control measures.

Download Full-text

Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00260-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Chisato Hayashi ◽

Soshiro Ogata ◽

Tadashi Okano ◽

Hiromitsu Toyoda ◽

Sonoe Mashino

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Exercise ◽

Lower Extremity ◽

Physical Function ◽

Community Dwelling ◽

Group Exercise ◽

Community Based ◽

Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

Download Full-text

Lower-Extremity Force Decrements Identify Early Mobility Decline Among Community-Dwelling Older Adults

Physical Therapy ◽

10.2522/ptj.20110239 ◽

2012 ◽

Vol 92 (9) ◽

pp. 1148-1159 ◽

Cited By ~ 13

Author(s):

Moshe Marko ◽

Christopher G. Neville ◽

Mark A. Prince ◽

Lori L. Ploutz-Snyder

Keyword(s):

Older Adults ◽

Confidence Interval ◽

Lower Extremity ◽

Likelihood Ratio ◽

Community Dwelling ◽

Knee Extensors ◽

Cross Sectional ◽

Lower Extremity Muscle ◽

Cutoff Points ◽

Community Dwelling Older Adults

BackgroundMany apparently independent older adults modify daily tasks. Task modifications strongly predict future mobility disability. Clinically intuitive, easily measured “biomarkers” associated with task modifications would offer quantifiable treatment targets for prevention of age-related functional limitations.ObjectiveThe objective of the study was to examine lower-extremity muscle strength deficits and functionally relevant cutoff points associated with daily task modifications in community dwelling older adults living independently.DesignThis was a cross-sectional observational study.MethodsFifty-three participants (mean age=76.4 years, SD=5.2) were tested for task modifications and leg strength. Task modifications were assessed using a previously described tool (summary task modification score). Twenty-six of the participants were classified as task modifiers (TM group), and 27 participants were classified as non–task modifiers (NTM group). A net antigravity leg force in the sagittal plane (NETforce) was calculated by summing the normalized isometric and isokinetic torques from the hip extensors, knee extensors, and ankle plantar flexors.ResultsCompared with the NTM group, the TM group exhibited 30.0% and 33.5% reduction in lower-extremity isometric and isokinetic NETforces, respectively. Isometric and isokinetic NETforce cutoff points for task modifications were ≤4.24 and 2.77 N·m/kg body weight, respectively. The isometric and isokinetic models both yielded sensitivity and specificity values of 74.1% and 80.8%, respectively (positive likelihood ratio=3.852, 95% confidence interval=1.699–8.735; negative likelihood ratio=0.321, 95% confidence interval=0.167–0.618). Isometric and isokinetic NETforces were significantly associated with task modifications (odds ratio=2.50 and 2.42, respectively).LimitationsThe cross-sectional design of this study does not allow for a test of causal relationships. This study used a modest yet adequate sample size that may limit generalization of the results.ConclusionsIsometric and isokinetic NETforce cutoff points provide quantifiable biomarkers that discriminate community-dwelling older adults who modify daily tasks from those who do not.

Download Full-text

Differences in lower limb muscle strength and balance ability between sarcopenia stages depend on sex in community-dwelling older adults

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-01952-6 ◽

2021 ◽

Author(s):

Takehiro Kato ◽

Tome Ikezoe ◽

Yasuharu Tabara ◽

Fumihiko Matsuda ◽

Tadao Tsuboyama ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Lower Limb ◽

Community Dwelling ◽

Lower Limb Muscle ◽

Limb Muscle ◽

Balance Ability ◽

Community Dwelling Older Adults

Download Full-text

124 Core Stability is Involved in the Fall Risk of Older Adults

Age and Ageing ◽

10.1093/ageing/afz164.124 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv28-iv33

Author(s):

Tagashira Satoshi ◽

Takashima Atsushi ◽

Shintani Takeshi

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Lower Extremity ◽

Fall Prevention ◽

Fall Risk ◽

Community Dwelling ◽

Core Stability ◽

Step Test ◽

The Core ◽

Lower Extremity Muscle

Abstract Background Fall prevention in older adults is an important task. Lower extremity function is a main focus in fall prevention. There are few previous studies focusing on core stability. The purpose of this study was to investigate the relationship between fall risk and core stability. Methods The study participants were 33 community-dwelling older adults (mean age: 65±17 years old; 5 men, 28 women). The fall risk was assessed using the Fall Risk Index-21 (FRI-21). Core stability measured the retention time of Side Bridge (SB) and Front Bridge (FB). Secondary outcome measures included lower extremity muscle strength (knee extension, hip abduction) and physical function (two-step test). Statistical analysis investigated the correlation between the measurement items. Results We found a significant negative correlation between FRI-21 and SB (r = -0.51, p<0.01) and FRI-21 and FB (r = -0.47, p<0.01). We also found a correlation between FRI-21 and the two-step test (r = -0.40, p<0.05). There was no significant correlation between FRI-21 and lower extremity muscle strength. Discussion FRI and Core stability showed moderate correlation. It suggests that the core and hip muscle functions involved in posture retention are involved with fall. Conclusion The risk of falls in older adults was related to core stability. If the core stability of older adults improves, it may help to reduce the risk of falling. Therefore, it is useful to consider core stability in the assessment of fall risk.

Download Full-text

Effectiveness of Community-Delivered Functional Power Training Program for Frail and Pre-frail Community-Dwelling Older Adults: a Randomized Controlled Study

Prevention Science ◽

10.1007/s11121-021-01221-y ◽

2021 ◽

Author(s):

Nien Xiang Tou ◽

Shiou-Liang Wee ◽

Wei Ting Seah ◽

Daniella Hui Min Ng ◽

Benedict Wei Jun Pang ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Controlled Trial ◽

Community Dwelling ◽

Controlled Study ◽

Power Training ◽

Frail Older Adults ◽

Frailty Status ◽

Randomized Controlled ◽

Community Dwelling Older Adults

AbstractTranslation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.

Download Full-text

Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽

10.3390/nu13020407 ◽

2021 ◽

Vol 13 (2) ◽

pp. 407

Author(s):

Laetitia Lengelé ◽

Olivier Bruyère ◽

Charlotte Beaudart ◽

Jean-Yves Reginster ◽

Médéa Locquet

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Performance ◽

Community Dwelling ◽

Timed Up And Go ◽

P Values ◽

Student’S T ◽

The Impact ◽

Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

Download Full-text