Abstract

Skeletal muscle function deficits associated with advancing age are due to several physiological and morphological changes including loss of muscle size and quality (conceptualized as a reduction in the intrinsic force-generating capacity of a muscle when adjusted for muscle size). Several factors can contribute to loss of muscle quality, including denervation, excitation-contraction uncoupling, increased fibrosis, and myosteatosis (excessive levels of inter- and intramuscular adipose tissue and intramyocellular lipids). These factors also adversely affect metabolic function. There is a major unmet need for tools to rapidly and easily assess muscle mass and quality in clinical settings with minimal patient and provider burden. Herein, we discuss the potential for electrical impedance myography (EIM) as a tool to evaluate muscle mass and quality in older adults. EIM applies weak, non-detectible (e.g., 400 μA), mutifrequency (e.g., 1 kHz–1 MHz) electrical currents to a muscle (or muscle group) through two excitation electrodes, and resulting voltages are measured via two sense electrodes. Measurements are fast (~5 s/muscle), simple to perform, and unaffected by factors such as hydration that may affect other simple measures of muscle status. After nearly 2 decades of study, EIM has been shown to reflect muscle health status, including the presence of atrophy, fibrosis, and fatty infiltration, in a variety of conditions (e.g., developmental growth and maturation, conditioning/deconditioning, and obesity) and neuromuscular diseases states [e.g., amyotrophic lateral sclerosis (ALS) and muscular dystrophies]. In this article, we describe prior work and current evidence of EIM’s potential utility as a measure of muscle health in aging and geriatric medicine.

Highlights

  • By 2050, the world’s population aged 60 years and older is expected to total 2 billion (22% of the total population), up from 900 million (12% of the total population) in 2015 (U.N., 2017)

  • To further expand on the data supporting the potential utility for electrical impedance myography (EIM) to detect age-related skeletal muscle function deficits, in Figure 6, we present original data from young (6 months; n = 8) and old (26 months; n = 7) F344 rats

  • We are advocating for more attention and research be devoted to examining the potential for EIM to be used to assess skeletal muscle health in aging

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Summary

INTRODUCTION

By 2050, the world’s population aged 60 years and older (the World Health Organization’s cut-off point for an older adult) is expected to total 2 billion (22% of the total population), up from 900 million (12% of the total population) in 2015 (U.N., 2017). This literature base includes studies comparing EIM to muscle histology (Jafarpoor et al, 2013; Arnold et al, 2017; Kapur et al, 2018a,b; Mortreux et al, 2019; Pandeya et al, 2021), theoretical studies assessing current flow (Wang et al, 2011; Pacheck et al, 2016; Kwon et al, 2019), and clinical studies showing EIM’s sensitivity to disease progression and loss of muscle function (Esper et al, 2006; Garmirian et al, 2009; Li et al, 2015; Rutkove et al, 2017; Shefner et al, 2018; Roy et al, 2020) While these investigations are from a relatively small group of investigators and have involved seriously debilitating neuromuscular conditions, they underscore the potential utility of EIM in disorders that impact muscle health, such as age-related skeletal muscle function deficits. These EIM parameters were associated with measures of muscle mass (Figures 6C,D), muscle strength (Figures 6E,F), and muscle contractility (Figures 6G,H)

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