Abstract
ObjectiveThis study aimed to explore the relationship between dependence in Activities of Daily Living and muscle strength, muscle morphology and physical function in older nursing home residents, taking possible confounders into consideration.MethodsA total of 30 nursing home residents (age, 85.6±7.1 years) were included in this observational cross-sectional study. Performance of basic Activities of Daily Living (ADL) was assessed with the Resident Assessment Instrument and categorized as either independent or dependent. Isometric grip, quadriceps and elbow-flexor strength were determined by hand-dynamometry, muscle thickness and echo intensity by B-mode ultrasonography, a sit-to-stand task by using a stop watch and physical activity by the German-Physical-Activity Questionnaire. Degree of frailty was evaluated according to Fried’s frailty criteria, whereas cognition, depression, incontinence, pain and falls were part of the Resident Assessment Instrument.ResultsDependence in Activities of Daily Living was negatively correlated with physical activity (rs = -0.44, p = .015), handgrip (rs = -0.38, p = .038), elbow-flexor (rs = -0.42, p = .032) and quadriceps strength (rs = -0.67, p < .001), analysed by Spearman’s correlation. Chronic diseases (rs = -0.41, p = .027) and incontinence (rs = -0.39, p = .037) were positively correlated with ADL while the other variables were not related. Only quadriceps strength remained significant with logistic regression (Wald(1) = 4.7, p = .03), when chronic diseases, quadriceps and handgrip strength were considered (R2 .79). 11 kg was the best fitting value in this sample to predict performance in Activities of Daily Living, evaluated with Receiver-Operating Characteristic analysis, with a sensitivity of 100% and a specificity of 79%.Conclusion and implicationQuadriceps strength had a positive independent relationship with performance in ADL in the nursing home residents studied. Although a large prospective study is needed to verify the results, maintaining quadriceps strength above 11 kg may be helpful in retaining independence in this cohort.
Highlights
In 2017, 15.7% of the Swiss population aged 80 years and over were institutionalized [1]
Dependence in Activities of Daily Living was negatively correlated with physical activity, handgrip, elbow-flexor and quadriceps strength, analysed by Spearman’s correlation
We aimed to investigate whether muscle structure, strength, function or physical activity were predictive variables of dependence in activities of daily living (ADL) in nursing home residents, when accounting for cognition, depression, falls, incontinence, chronic disease, sedative medication and pain
Summary
In 2017, 15.7% of the Swiss population aged 80 years and over were institutionalized [1]. In 30–50% of these people, dependence increases within the first 18 months of institutionalization due to further functional decline [6, 7], which adversely affects quality of life [8] and health care costs [7]. The ability of nursing home residents to perform ADL independently is associated with multiple factors, both modifiable and non-modifiable, but is mainly dependent on age, chronic disease and disability, with the latter factor being the most discriminant predictor [9]. Muscle strength is reduced by up to 50% in people aged 80 years and over [11], with highest rates of loss in physically inactive individuals [12, 13] that are institutionalized in nursing homes [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
