Abstract
BackgroundIdentification of simple screening tools for detecting lower skeletal muscle mass may be beneficial for planning effective interventions in the elderly.AimsWe aimed to (1) establish a threshold for one-leg standing balance test (OLST) time for low muscle mass, and (2) test the ability of that threshold to assess muscular impairments in a poor balance group.MethodsEyes-open OLST (maximum duration 30 s) was performed with right and left legs in 291 women (age 71 ± 6 years). OLST time was calculated as the sum of the OLST time of right and left legs. Fat-free mass (FFM), skeletal muscle mass (SMM), fat mass, biceps brachii and vastus lateralis sizes; handgrip strength (HGS), elbow flexion maximum torque (MVCEF) and knee extension maximum torque (MVCKE) were measured. Muscle quality was calculated as MVCKE/FFM and physical activity was assessed by questionnaire. Low muscle mass was defined as SMMrelative of 22.1%, a previously established threshold for pre-sarcopenia.ResultsThe OLST threshold time to detect low muscle mass was 55 s (sensitivity: 0.63; specificity: 0.60). The poor balance group (OLST < 55 s) had higher fat mass (3.0%, p < 0.001), larger VL thickness (5.1%, p = 0.016), and lower HGS (− 10.2%, p < 0.001), MVCEF (− 8.2%, p = 0.003), MVCKE (− 9.5%, p = 0.012), MVCKE/FFM (− 11.0%, p = 0.004) and physical activity (− 8.0%, p = 0.024) compared to the normal balance group. While after adjusting age, the differences exist for HGS, fat mass and VL thickness only.DiscussionAn OLST threshold of 55 s calculated as the summed score from both legs discriminated pre-sarcopenic characteristics among active, community-dwelling older women with limited potential (sensitivity 0.63, specificity 0.60).ConclusionOLST, which can be performed easily in community settings without the need for more complex muscle mass measurement, may help identify women at risk of developing sarcopenia.
Highlights
Sarcopenia is characterized by loss of skeletal muscle mass and muscle strength that contributes to a decline in physical performance with ageing [1]
one-leg standing balance test (OLST) time was lower in older age groups, such that the 80 + years group only achieved 29% of OLST time achieved by the 60–64 years group (Fig. 1)
The current study identified an OLST time threshold for low muscle mass risk in healthy elderly women and tested the potential of this derived OLST threshold to distinguish pre-sarcopenic characteristics in the poor balance group
Summary
Sarcopenia is characterized by loss of skeletal muscle mass and muscle strength that contributes to a decline in physical performance with ageing [1]. A simple screening tool that could be conducted with minimal equipment could help to identify those elderly individuals with low muscle mass, who are at risk of sarcopenia and subsequent frailty and loss of independence. One would expect interventions to be more effective at pre-sarcopenic levels of muscle mass than at the accepted thresholds for developed sarcopenia as limitations in a physical function may prevent meaningful improvements to the above functional impairment thresholds. An alternative and more accessible screening assessment for low muscle mass in the elderly, that could be adopted in populations living independently is the static one-leg standing balance test (OLST). Discussion An OLST threshold of 55 s calculated as the summed score from both legs discriminated pre-sarcopenic characteristics among active, community-dwelling older women with limited potential (sensitivity 0.63, specificity 0.60). Conclusion OLST, which can be performed in community settings without the need for more complex muscle mass measurement, may help identify women at risk of developing sarcopenia
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