Associations between daily physical activity, handgrip strength, muscle mass, physical performance and quality of life in prefrail and frail community-dwelling older adults.

Sandra Haider,Eva Luger,Christian Lackinger,Ali Kapan,Thomas E Dorner,Karin E Schindler,Sylvia Titze

doi:10.1007/s11136-016-1349-8

Abstract

PurposeThe aim of this study was to examine the associations between daily physical activity (DPA), handgrip strength, appendicular skeletal muscle mass (ASMM) and physical performance (balance, gait speed, chair stands) with quality of life in prefrail and frail community-dwelling older adults.MethodsPrefrail and frail individuals were included, as determined by SHARE-FI. Quality of life (QoL) was measured with WHOQOL-BREF and WHOQOL-OLD, DPA with PASE, handgrip strength with a dynamometer, ASMM with bioelectrical impedance analysis and physical performance with the SPPB test. Linear regression models adjusted for sex and age were developed: In model 1, the associations between each independent variable and QoL were assessed separately; in model 2, all the independent variables were included simultaneously.ResultsEighty-three participants with a mean age of 83 (SD: 8) years were analysed. Model 1: DPA (ß = 0.315), handgrip strength (ß = 0.292) and balance (ß = 0.178) were significantly associated with ‘overall QoL’. Balance was related to the QoL domains of ‘physical health’ (ß = 0.371), ‘psychological health’ (ß = 0.236), ‘environment’ (ß = 0.253), ‘autonomy’ (ß = 0.276) and ‘social participation’ (ß = 0.518). Gait speed (ß = 0.381) and chair stands (ß = 0.282) were associated with ‘social participation’ only. ASMM was not related to QoL. Model 2: independent variables explained ‘overall QoL’ (R 2 = 0.309), ‘physical health’ (R 2 = 0.200), ‘autonomy’ (R 2 = 0.247) and ‘social participation’ (R 2 = 0.356), among which balance was the strongest indicator.ConclusionASMM did not play a role in the QoL context of the prefrail and frail older adults, whereas balance and DPA were relevant. These parameters were particularly associated with ‘social participation’ and ‘autonomy’.

Highlights

In community-dwelling older adults, the geriatric syndrome of frailty is common [1]
Purpose The aim of this study was to examine the associations between daily physical activity (DPA), handgrip strength, appendicular skeletal muscle mass (ASMM) and physical performance with quality of life in prefrail and frail community-dwelling older adults
Using Cronbach’s alpha, the internal consistency was determined for each single domain: ‘overall Quality of life (QoL)’ (a = 0.662), ‘physical health’ (a = 0.673), ‘psychological health’ (a = 0.658), ‘social relationships’ (a = 0.580), ‘environment’ (a = 0.624), ‘sensory ability’ (a = 0.919), ‘autonomy’ (a = 0.640), ‘past, present and future activities’ (a = 0.636) and ‘social participation’ (a = 0.491)

Summary

Introduction

In community-dwelling older adults, the geriatric syndrome of frailty is common [1]. Frailty is defined as a state of high vulnerability and is caused by malnutrition, chronic inflammation and sarcopenia [2], which is a progressive loss of muscle mass in combination with a decrease in muscle strength or physical performance [3].The consequences of frailty are adverse health outcomes such as disability, dependency, hospitalisation and need for long-term care [2]. When compared to robust community-dwelling persons, frail adults demonstrate significantly lower quality of life (QoL) [4,5,6,7]. There is evidence that low daily physical activity (DPA) is associated with poor QoL in older adults [9, 10]. Previous studies of frail persons have demonstrated that muscle strength, as represented by handgrip strength [3], plays an important role regarding QoL [6, 7, 11]. Gobbens et al [7] revealed that, in addition to handgrip strength, difficulties in maintaining balance and difficulties in walking are associated with poor QoL in frail adults living in nursing homes

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