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

2012 ◽  
Vol 92 (9) ◽  
pp. 1148-1159 ◽  
Author(s):  
Moshe Marko ◽  
Christopher G. Neville ◽  
Mark A. Prince ◽  
Lori L. Ploutz-Snyder

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.

Author(s):  
Monica R Perracini ◽  
Mateus Mello ◽  
Roberta de Oliveira Máximo ◽  
Tereza L Bilton ◽  
Eduardo Ferriolli ◽  
...  

Abstract Background The Short Physical Performance Battery (SPPB) is widely used to predict negative health-related outcomes in older adults. However, the cutoff point for the detection of the frailty syndrome is not yet conclusive. Objective The aim of this study was to determine the diagnostic value of the SPPB for detecting frailty in community-dwelling older adults. Design This was a population-based cross-sectional study focusing on households in urban areas. A total of 744 people who were 65 years old or older participated in this study. Methods Frailty was determined by the presence of 3 or more of the following components: unintentional weight loss, self-reported fatigue, weakness, low level of physical activity, and slowness. Diagnostic accuracy measures of the SPPB cutoff points were calculated for the identification of frailty (individuals who were frail) and the frailty process (individuals who were considered to be prefrail and frail). Receiver operating characteristic curves were constructed. Odds ratios for frailty and the frailty process and respective CIs were calculated on the basis of the best cutoff points. A bootstrap analysis was conducted to confirm the internal validity of the findings. Results The best cutoff point for the determination of frailty was ≤8 points (sensitivity = 79.7%; specificity = 73.8%; Youden J statistic = 0.58; positive likelihood ratio = 3.05; area under the curve = 0.85). The best cutoff point for the determination of the frailty process was ≤10 points (sensitivity = 75.5%; specificity = 52.8%; Youden J statistic = 0.28; positive likelihood ratio = 1.59; area under the curve = 0.76). The adjusted odds of being frail and being in the frailty process were 7.44 (95% CI = 3.90–14.19) and 2.33 (95% CI = 1.65–3.30), respectively. Limitations The external validation using separate data was not performed and the cross-sectional design does not allow SPPB predictive capacity to be established. Conclusions The SPPB might be used as a screening tool to detect frailty syndrome in community-dwelling older adults, but the cutoff points should be tested in another sample as a further validation step.


2021 ◽  
Vol 15 ◽  
Author(s):  
Juliana Fonseca Nogueira Alves ◽  
Bruno Remígio Cavalcante ◽  
Amanda de Araújo Valença ◽  
Igor Rafael Campos ◽  
Milena Lucilla Lácio Tomaz ◽  
...  

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.


2022 ◽  
Author(s):  
Yoshihiko Ishihara ◽  
Hayao Ozaki ◽  
Takashi Nakagata ◽  
Toshinori Yoshihara ◽  
Toshiharu Natsume ◽  
...  

Abstract Background: Locomotive syndrome (LS) is associated with weakness and loss of function in the musculoskeletal organs. To evaluate the association between LS and daily physical activities (PA) in community-dwelling older adults using a three-axis accelerometer. Methods: This cross-sectional study included healthy 80 older adults (40 men and 40 women; age: 60-79 years). Three functional tests, the two-step test, the stand-up test, and the 25-question geriatric locomotive function scale (GLFS) were used to assess the risk of LS. Maximal isometric muscle strengths of the knee extensors were examined, and the weight bearing index (knee extension strength/body weight) was calculated. Habitual daily PA was evaluated using a three-axis wrist accelerometer. Results: Of the 80 participants, 41 (51.3%) fulfilled the diagnostic criteria for LS (including a two-step test score < 1.3, difficulty with one-leg standing from 40 cm in the stand-up test, and a 25-question GLFS score ≥ 7) We found that step count and time spent performing moderate to vigorous PA (MVPA) were significantly higher in women participants without LS compared to those with LS (p = 0.01); no significant difference was found in men. Logistic regression analyses indicated a longer time spent performing MVPA (> 47.26 min/day) was associated with a lower risk of LS compared to only performing for 21.11 min/day. Conclusions: Our data showed that daily MVPA using a three-axis accelerometer was associated with LS in community-dwelling older adult women, but not in men.


Author(s):  
Tran Dai Tri Han ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Vo Nu Hong Duc ◽  
Thang Van Vo

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francisco Félix Caballero ◽  
Ellen A. Struijk ◽  
Alberto Lana ◽  
Antonio Buño ◽  
Fernando Rodríguez-Artalejo ◽  
...  

AbstractElevated concentrations of acylcarnitines have been associated with higher risk of obesity, type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the association between L-carnitine and acylcarnitine profiles, and 2-year risk of incident lower-extremity functional impairment (LEFI). This case–control study is nested in the Seniors-ENRICA cohort of community-dwelling older adults, which included 43 incident cases of LEFI and 86 age- and sex- matched controls. LEFI was assessed with the Short Physical Performance Battery. Plasma L-carnitine and 28 acylcarnitine species were measured. After adjusting for potential confounders, medium-chain acylcarnitines levels were associated with 2-year incidence of LEFI [odds ratio per 1-SD increase: 1.69; 95% confidence interval: 1.08, 2.64; p = 0.02]. Similar results were observed for long-chain acylcarnitines [odds ratio per 1-SD increase: 1.70; 95% confidence interval: 1.03, 2.80; p = 0.04]. Stratified analyses showed a stronger association between medium- and long-chain acylcarnitines and incidence of LEFI among those with body mass index and energy intake below the median value. In conclusion, higher plasma concentrations of medium- and long-chain acylcarnitines were associated with higher risk of LEFI. Given the role of these molecules on mitochondrial transport of fatty acids, our results suggest that bioenergetics dysbalance contributes to LEFI.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2151
Author(s):  
Berna Rahi ◽  
Hermine Pellay ◽  
Virginie Chuy ◽  
Catherine Helmer ◽  
Cecilia Samieri ◽  
...  

Dairy products (DP) are part of a food group that may contribute to the prevention of physical frailty. We aimed to investigate DP exposure, including total DP, milk, fresh DP and cheese, and their cross-sectional and prospective associations with physical frailty in community-dwelling older adults. The cross-sectional analysis was carried out on 1490 participants from the Three-City Bordeaux cohort. The 10-year frailty risk was examined in 823 initially non-frail participants. A food frequency questionnaire was used to assess DP exposure. Physical frailty was defined as the presence of at least 3 out of 5 criteria of the frailty phenotype: weight loss, exhaustion, slowness, weakness, and low physical activity. Among others, diet quality and protein intake were considered as confounders. The baseline mean age of participants was 74.1 y and 61% were females. Frailty prevalence and incidence were 4.2% and 18.2%, respectively. No significant associations were observed between consumption of total DP or DP sub-types and frailty prevalence or incidence (OR = 1.40, 95%CI 0.65–3.01 and OR = 1.75, 95%CI 0.42–1.32, for a total DP consumption >4 times/d, respectively). Despite the absence of beneficial associations of higher DP consumption on frailty, older adults are encouraged to follow the national recommendations regarding DP.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 291
Author(s):  
Tatsuro Inoue ◽  
Keisuke Maeda ◽  
Ayano Nagano ◽  
Akio Shimizu ◽  
Junko Ueshima ◽  
...  

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.


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