Abstract
ObjectiveTo assess the association between muscle parameters (mass, strength, physical performance) and activities of daily living (ADL), quality of life (QoL), and health care costs.DesignCross-sectional Maastricht Sarcopenia Study (MaSS).SettingCommunity-dwelling, assisted-living, residential living facility.Participants227 adults aged 65 and older.MeasurementsMuscle mass, hand grip strength and physical performance were assessed by bio-electrical impedance, JAMAR dynamometer and the Short Physical Performance Battery, respectively. Health outcomes were measured by the Groningen Activity Restriction Scale (disability in ADL) and the EQ-5D-5L (QoL). Health care costs were calculated based on health care use in the past three months.ResultsMuscle strength and physical performance showed a strong correlation with ADL, QoL, and health care costs (P<.01); for muscle mass no significant correlations were observed. Regression analyses showed that higher gait speed (OR 0.06, 95%CI 0.01-0.55) was associated with a lower probability of ADL disability. Furthermore, slower chair stand (OR 1.23, 95%CI 1.08-1.42), and more comorbidities (OR 1.58, 95%CI 1.23-2.02) were explanatory factors for higher ADL disability. Explanatory factors for QoL and costs were: more disability in ADL (OR 1.26, 95%CI 1.12-1.41 for QoL; B = 0.09, P<.01 for costs) and more comorbidities (OR 1.44, 95%CI 1.14-1.82 for QoL; B = 0.35, P<.01 for costs).ConclusionLower gait speed and chair stand were potential drivers of disability in ADL. Disability in ADL and comorbidities were associated with QoL and health care costs in community-dwelling older adults. Improving physical performance may be a valuable target for future intervention and research to impact health burden and costs.
Highlights
After 30 years of age, the balance between muscle growth and break down shifts more to degeneration, leading to a net loss of muscle mass and concurrent loss of muscle strength
Improving physical performance may be a valuable target for future intervention and research to impact health burden and costs
Muscle mass did not differ between care groups, but strength and physical performance were better in the no care group compared with the home care and residential living group
Summary
After 30 years of age, the balance between muscle growth and break down shifts more to degeneration, leading to a net loss of muscle mass and concurrent loss of muscle strength. Previous studies on the association between muscle parameters [1,2,3,4] or sarcopenia [5,6,7,8] and QoL, disability in activities of daily living (ADL) and health care utilization show inconsistent results. Muscle mass, muscle strength, and physical performance have their own distinct effect on health and economic outcomes [2,3,4,5, 9]. In contrast to the study of Cawthon et al [5], Bianchi et al [10] did find an association between sarcopenia defined by the EWGSOP and disability, hospitalization and mortality
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