Community-dwelling Elderly Subjects Research Articles

Comparing the Effects of Multicomponent and Concurrent Exercise Protocols on Muscle Strength in Older Adults.

This study aimed to compare the effects of a multicomponent exercise program and a concurrent exercise program on muscle strength in community-dwelling elderly subjects. Participants (n = 35; male = 17; female = 18; Mage = 69.17, SD = 5.01 years) were screened and included in the study. Among them, 19 individuals were assigned to the multicomponent group, while 16 were assigned to the concurrent group. The results of the repeated-measures ANOVA revealed significant main effects for the group factor (F(1,15) = 66.59, p < 0.001, η2 = 0.81) and the group*time factor (F(1,15) = 16.95, p < 0.001, η2 = 0.53) for the 30-second chair test. Furthermore, significant main effects were observed only for the group factor (F(1,15) = 19.28, p < 0.001, η2 = 0.56) for the 30-second arm curl. Regarding the Timed Up and Go test, significant main effects were found for the group factor (F(1,15) = 35.56, p < 0.001, η2 = 0.70) and the group*time factor (F(1,15) = 11.68, p < 0.001, η2 = 0.43). Lastly, significant main effects were observed for the group*time factor (F(1,15) = 5.19, p = 0.038, η2 = 0.25) for handgrip strength. The multicomponent exercise group displayed a greater mean increase compared to the concurrent exercise group. While both the multicomponent and the concurrent exercise programs were effective in improving muscle strength in community-dwelling older adults, the multicomponent exercise group exhibited superior outcomes compared to the concurrent exercise group across the physical fitness measures. These findings suggest that a multicomponent exercise program may be more beneficial for enhancing muscle strength in this population.

Different effects of chronic omeprazole use on osteoporotic fractures rate in the elderly.

To investigate the potential association of chronic use of omeprazole with the occurrence of osteoporotic fractures (OF) in community-dwelling elderly subjects. The cohort consisted of community-dwelling residents aged >65 years registered with a large health maintenance organization in Israel between January 2002 and December 2016. Data were retrospectively collected from the electronic medical files on demographics, parameters known to be associated with OF, diagnoses of osteoporotic hip, wrist, and vertebral fractures, and chronic use of omeprazole (>11 prescriptions/year). Time to OF/death/end of study was calculated from the beginning of the study (2002). The risk of fractures in the chronic users of omeprazole was analyzed by multivariate Cox proportional hazard regression model. In total, 46 805 subjects were included (41% men), mean age 83.4±6.4 years, of whom 10 272 (21.9%) were chronic users of omeprazole. During 14 years of follow-up, OF were diagnosed in 414 (4.0%) omeprazole users and 1007 (2.8%) omeprazole nonusers (p < 0.001). In a Cox regression model adjusted for age and gender only, chronic use of omeprazole was associated with a 16% excess of OF. However, when parameters known to be associated with OF were entered into the multivariate Cox regression model, chronic use of omeprazole was not found to be an independent risk factor for OF, either overall (adjusted hazard ratio = 0.965, 95% confidence interval 0.86-1.08, P = .55) or specifically, in the ≥85 years age group (adjusted hazard ration = 0.780, 95% confidence interval 0.635-0.958, P < .05) in which an inverse correlation between omeprazole use and OF, was demonstrated. Chronic use of omeprazole was not associated with the occurrence of OF in elders.

Association of Hyper-Low-Density Lipoprotein and Hypo-High-Density Lipoprotein Cholesterolemia with Low Saliva Flow Rates in Japanese Community-Dwelling Elders.

Introduction The associations of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein (HDL-C) with reduced saliva flow rates have not been previously reported. Objective The present study aimed to assess the association of cholesterolemia with reduced saliva flow rates in community-dwelling elderly subjects. Methods The present study analyzed 342 participants (170 males and 172 females aged between 78 and 79 years old). Unstimulated salivary flow rate (USFR) was assessed using a cotton roll method. Low-USFR was defined as 0.10 g/30 seconds. Stimulated salivary flow rate (SSFR) was assessed by having the participants chew tasteless gum for 3 minutes. Low-SSFR was defined as 1.0 mL/minute. Blood samples were collected for the measurement of LDL-C, HDL-C, rheumatoid factor, hemoglobin A1c, and creatinine. To assess depression, the General Health Questionnaire 30 was used. A standardized questionnaire was completed, covering the current and previous medications of the participants and smoking status. We stratified the serum LDL-C levels of the participants as normal, moderate or severe hyper-LDL cholesterolemia and serum HDL-C levels as normal or hypo-HDL cholesterolemia. Multivariate logistic regression models were established and low-USFR or low-SSFR were set as dependent variables in the aforementioned models. Results After controlling for the effects of the other variables, the odds ratios (ORs) (95% confidence intervals [CIs]) for low-USFR were 2.25 (1.10-4.61) for moderate and 5.69 (1.55-20.8) for severe hyper-LDL cholesterolemia, while that of hypo-HDL cholesterolemia was 3.40 (1.33-8.69). Severe hyper-LDL cholesterolemia was also associated with low-SSFR with an OR of 3.89 (1.39-10.88). Conclusion Elderly patients with cholesterolemia have a risk of reduced salivary flow rate.

Associations of Walking Activity With Hypertensive Mediated Organ Damage in Community-Dwelling Elderly Chinese: The Northern Shanghai Study.

Background: Walking, as the most common campaign in older people, is recommended to improve their cardiovascular health. However, the direct association between weekly walking activity and asymptomatic hypertensive mediated organ damage (HMOD) remains unclear.Methods: 2,830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from 2014 to 2018. Weekly walking activity was assessed by International Physical Activity Questionnaires (IPAQ). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity, creatinine clearance rate, urinary albumin–creatinine ratio, carotid-femoral pulse wave velocity (cf-PWV), carotid intima–media thickness (CIMT), arterial plaque, and ankle-brachial index (ABI), were all evaluated.Results: 1,862 (65.8%) participants with weekly walking activity showed lower CIMT, lower cf-PWV, fewer abnormal ABI, and lower prevalence of hypertension and coronary heart disease (p < 0.05). Walking activity was negatively correlated with age and smokers (correlation coefficient: −0.066, −0.042; both p < 0.05). After adjusting for cardiovascular risk factors and concomitant diseases, walking activity was significantly associated with better indicator of most vascular HMOD in multivariate logistic regressions, including arterial stiffness [odds ratio (OR) = 0.75, p = 0.01], increased CIMT (OR = 0.70, p = 0.03), and peripheral artery disease (OR = 0.72, p = 0.005), but not cardiac or renal HMOD. Subgroup analysis further showed that walking duration ≥1 h/day was significantly associated with decreased risk of most vascular HMOD after adjustment for confounders and moderate-to-vigorous physical activity based on IPAQ (all p < 0.05).Conclusions: In the community-dwelling elderly Chinese, there was a significant negative association of weekly walking activity with vascular HMOD, but not cardiac or renal HMOD. Increased daily walking duration, but not walking frequency, was significantly associated with improved vascular HMOD. Hence, increasing daily walking duration seems to encourage a healthy lifestyle in terms of vascular protection.Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT02368938.

Is there a Difference between the Timed Up and Go Test and Physical Function due to the Difference in Perception of Slip?

The purpose of this study was to examine whether there are differences in the timed up and go (TUG) test results and physical functions due to the differences in slip recognition when performing TUG on wood flooring. The study consisted of 30 community-dwelling elderly subjects, aging over 65 years old. The differences in the perception of floor slippage before and after TUG were as follows: (1) slippery-slipped group (S-S group), (2) slippery-not slipped group (S-N group), and (3) not slippery-not slipped group (N-N group). The modified falls efficacy scale, grip strength, knee extension strength, one-leg standing time, functional reach test, Trail Making Test (TMT), two-step test were used in this study. The results showed no statistically significant difference in TUG test. However, statistically significant difference was observed in TMT between the S-S and N-N groups (p = 0.019, r = 0.51, respectively) and between the S-S and S-N groups (p = 0.003, r = 0.65, respectively). It was found that there was no statistically significant difference in TUG results due to the recognition differences of slippage. However, it was suggested that the subject who reported a history of slippage had a high attention function and could pay attention to the floor environment.

Characterization of Lenticulostriate Arteries and Its Associations With Vascular Risk Factors in Community-Dwelling Elderly.

Lenticulostriate arteries (LSAs) supply blood to important subcortical areas and are, therefore, essential for maintaining the optimal functioning of the brain’s most metabolically active nuclei. Past studies have demonstrated the potential for quantifying the morphology of LSAs as biomarkers of vascular fragility or underlying arteriopathies. Thus, the current study aims to evaluate the morphological features of LSAs, their potential value in cerebrovascular risk stratification, and their concordance with other vascular risk factors in community-dwelling elderly people. A total of 125 community-dwelling elderly subjects who underwent a brain MRI scan were selected from our prospectively collected imaging database. The morphological measures of LSAs were calculated on the vascular skeletons obtained by manual tracing, and the number of LSAs was counted. Additionally, imaging biomarkers of small vessel disease were evaluated, and the diameters of major cerebral arteries were measured. The effects of vascular risk factors on LSA morphometry, as well as the relationship between LSA measures and other imaging biomarkers, were investigated. We found that smokers had shorter (p = 0.04) and straighter LSAs (p < 0.01) compared to nonsmokers, and the presence of hypertension is associated with less tortuous LSAs (p = 0.03) in community-dwelling elderly. Moreover, the middle cerebral artery diameter was positively correlated with LSA count (r = 0.278, p = 0.025) and vessel tortuosity (r = 0.257, p = 0.04). The posterior cerebral artery diameter was positively correlated with vessel tortuosity and vessel length. Considering the scarcity of noninvasive methods for measuring small artery abnormalities in the brain, the LSA morphological measures may provide valuable information to better understand cerebral small vessel degeneration during aging.

BENEFICIAL EFFECTS OF WEEKLY WALKING ACTIVITY ON HYPERTENSIVE MEDIATED ORGAN DAMAGE IN THE COMMUNITY-DWELLING ELDERLY CHINESE: THE NORTHERN SHANGHAI STUDY

Objective: To investigate the effects of weekly walking activity on the asymptomatic hypertensive mediated organ damage (HMOD) remains unclear. Design and method: 2830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from June 2014 to June 2018. Weekly walking activity was evaluated by standard questionnaire based on the International Physical Activity Questionnaires-short form (including walking duration per time and walking days per week). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index (LVMI), peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid intima-media thickness (CIMT), arterial plaque, creatinine clearance rate (CCR), urinary albumin-creatinine ratio (UACR), carotid-femoral pulse wave velocity (cf-PWV) and ankle-brachial index (ABI), were all evaluated. Results: There were 1862 (65.8%) participants enrolled in weekly walking activity, with 56.8 ± 36.8 min/day and a median of 6.71 days/week walking. Young elderly, fewer smokers, lower CIMT, lower cf-PWV, fewer abnormal ABI, lower prevalence of hypertension and coronary heart disease were observed in walking activity group (P &lt; 0.05). Similarly, Pearson's correlation analysis revealed that weekly walking activity was significantly correlated with elderly (age 70 years or more) and smoker (both P &lt; 0.05). To further investigate the association of weekly walking activity with HMOD, logistic regression analysis was conducted. Interestingly, weekly walking activity was only significantly associated with peripheral artery diseases (P &lt; 0.05), together with cardiovascular risk factors. Subsequently, subgroup analysis about weekly walking activity was performed and the results revealed that only walking duration more than 30 min per time was related to arterial plaque (OR: 1.048, 95% CI: 1.002–1.095, P = 0.038). Conclusions: Taken together, in the community-dwelling elderly Chinese, weekly walking activity played a protective role in HMOD, especially vascular HMOD, regardless of walking duration per time and walking days per week.

The Mini Sarcopenia Risk Assessment (MSRA) Questionnaire score as a predictor of skeletal muscle mass loss.

Previous studies showed a strong relationship between reduction of appendicular muscle mass and worsening disability; hence, accuracy in assessing muscle mass is considered a key feature for a sarcopenia screening tool. The aim of the study was to evaluate if the 7 items of Mini Sarcopenia Risk Assessment (MSRA) questionnaire predict muscle mass loss in a population of community-dwelling elderly subjects over a 5.5-y follow-up. The study included 159 subjects, 92 women and 67 men aged 71.5 ± 2.2years and with mean body mass index of 26.7 ± 4.0kg/m2. Appendicular skeletal muscle mass (ASMM) as measured with Dual-Energy X-ray absorptiometry (DXA), was obtained at baseline and after 2 and 5.5years of follow-up where the skeletal muscle index (SMI) was calculated. A significant reduction of ASMM and SMI was observed at two and 5.5years of follow-up, in both, men and women. Repeated-measures analysis of variance (ANOVA) found a significant time effect on ASMM for both subjects with MSRA > 30 and ≤ 30 (P < 0.01 and P < 0.001). The group × time interaction was significant (P < 0.001), after even considering separately subjects with normal muscle mass and low muscle mass at baseline (P < 0.05 and P = 0.005). Similar results were obtained for SMI. Considering only the subjects with normal SMI at baseline, subjects with MSRA questionnaire ≤ 30 showed 5.7 (95% CI 1.73-19.03) higher risk of exceeding the low muscle mass threshold. In a population of community-dwelling elderly men and women, MSRA score of 30 is predictive of a steeper decline in ASMM and SMI and of a higher risk of exceeding the low muscle mass EWGSOP threshold.

The impact of an 8-week Pilates-based physical training program on functional mobility: data from a septuagenarian group

Abstract Study aim: This study aimed to evaluate the effects of a Pilates-based training program on functional mobility and strength in community-dwelling adults over 70 years old. Material and methods: Twenty community-dwelling elderly subjects were recruited and randomly assigned to control (C = 10) or Pilates training (PT = 10) groups for 8 weeks (2 times/week). Anthropometric, strength, cardiorespiratory fitness, functional mobility, and static and dynamic balance parameters were assessed before and after the intervention. Results: The PT group had higher values of lower limb strength (p = 0.013 d = 0.56) and 6-minute walking test distance (p = 0.04; d = 0.45) than the C group. The PT group also had differences in one leg stance duration and decrease in the Timed Up and Go test. We also observed a positive correlation between muscle strength and cardiorespiratory fitness (p &lt; 0.01, r = 0.62), cardiorespiratory fitness and one leg stance, eyes closed, right and left leg (p = 0.04, r = 0.45; p = 0.05, r = 0.45, respectively). Conclusions: Eight weeks of Pilates-based physical training induced improvements in skeletal muscle strength and functional mobility of community-dwelling septuagenarians.

Relationship between handgrip strength and albuminuria in community-dwelling elderly Japanese subjects: the Shika Study

Purpose This study aimed to investigate the association between handgrip strength (HGS) and albuminuria in the general population of Japan as per sex and age. Methods This population-based, cross-sectional study enrolled 916 Japanese participants aged ≥40 years. Albuminuria was measured and expressed as the urinary albumin-to-creatinine ratio (UACR). Biochemical, nutritional, and anthropometric profiles as well as HGS were measured using standardised protocols. Results Four hundred and thirty-two (47%) of the study participants were men, and 484 were women, with respective mean ages of 62 ± 11 years and 63 ± 11 years. HGS, older age, high body mass index, presence of hypertension or diabetes, and a decreased estimated glomerular filtration rate were correlated with the log-transformed UACR in subjects of both sexes. Multivariate linear regression analysis showed that HGS was independently associated with the log UACR in both, men [beta coefficient −0.43; 95% confidence interval (CI) −0.73, −0.13] and women (beta coefficient −0.50; 95% CI −0.90, −0.10) aged ≥65 years; however, a similar association was not observed in younger participants. Conclusion Low HGS was associated with albuminuria in older men and women in Japan.

Association of Asymptomatic Diastolic Dysfunction Assessed by Left Atrial Strain With Incident Heart Failure

ObjectivesThis study is to establish the association of left atrial reservoir strain (LARS) with incident heart failure (HF), and the impact of substituting LARS for left atrial (LA) volume index (LAVI) in diastolic assessment. BackgroundLARS measures passive LA stretch and is a sensitive marker of left ventricular diastolic dysfunction (DD). The potential contribution of LARS to diastolic assessment is unclear. MethodsBaseline clinical and echocardiographic assessments were obtained in 758 asymptomatic, community-dwelling elderly subjects (age 70 [interquartile range: 67 to 74] years, 53% women) with nonischemic HF risk factors. LARS-defined DD (LARS-DD) was assessed by speckle-tracking echocardiography, and grades were assigned as normal (>35%), grade 1 (25% to 35%) and grade 2 (≤24%). DD grade using current recommendations was compared with grading using LARS <24% in place of LAVI >34 ml/m2. Patients were followed for up to 2 years for incident HF. ResultsLA strain analysis was feasible in 738 (97%) patients; average LARS was 39% (range 34% to 43%). Incident HF was associated with LARS-DD grade; 8 (36%) of those had grade 2+, 14 (10%) had grade 1, and 39 (9%) had normal function (p < 0.001). LARS-DD grade 2+ predicted incident HF after adjustment for clinical and echocardiographic markers (adjusted hazard ratio: 2.5; 95% confidence interval: 1.02 to 6.3; p = 0.049); there was no significant HF risk associated with LARS-DD grade 1. Dichotomized abnormal LARS <24% had an adjusted hazard ratio of 2.9 (95% confidence interval: 1.25 to 6.79; p = 0.013). Substituting LARS for LAVI provided a 75% reduction in indeterminate diastolic function; all were recategorized as normal. There was no increased risk associated normal diastolic function by this grading compared to conventional grading (C-statistic = 0.76 for both models). ConclusionsLARS-DD grade 2+ is associated with incident HF in the elderly, independent of LAVI. The substitution of LARS for LAVI reduces the number of indeterminate cases without impacting prognosis in normal diastolic function and grade 1 DD.

Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India

ObjectivesThere is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence...

Association between sarcopenia and atherosclerosis in elderly patients with ischemic heart disease.

Compared to the general population, elderly patients with cardiovascular disease have a higher prevalence of sarcopenia, and it shows an association with increased mortality risk. Although several studies have indicated that atherosclerosis may cause sarcopenia in community dwelling elderly subjects, the association between sarcopenia and atherosclerosis is not clear in patients with ischemic heart disease (IHD). The present study was performed to examine the association between muscle function and atherosclerosis in elderly patients with IHD. We reviewed the findings of 321 consecutive patients ≥ 65years old with IHD. Three measures of muscle function were examined, i.e., gait speed, quadriceps isometric strength, and handgrip strength, just before hospital discharge. In addition, we measured intima-media thickness (IMT) as a parameter of arteriosclerosis. To investigate the association between sarcopenia and atherosclerosis, patients were divided into Group H (high), Group M (middle), and Group L (low) according to the tertiles of muscle function, and IMT was compared between the three groups. In addition, we considered the association between IMT thickening and muscle function. The mean age of the study population was 74.1 ± 6.0years and 73.2% of the patients were men. IMT was compared between groups stratified according to gait speed and quadriceps isometric strength, and the results indicated that IMT was significantly lower in Group H than in Groups L and M (p < 0.05). In addition, gait speed and quadriceps isometric strength were associated with IMT thickening (p < 0.05). Parameters reflecting muscle function of the lower limbs are associated with atherosclerosis in patients with IHD.

"Active Guide" Brochure Reduces Sedentary Behavior of Elderly People: A Randomized Controlled Trial.

The aim of this study was to examine in a randomized controlled trial how much the sedentary behavior (sitting time) of community-dwelling elderly Japanese subjects decreased as a result of using the "Active Guide" brochure published by the Ministry of Health, Labour and Welfare (2013) and additional documents related to the benefits of reducing sedentary behavior. A total of 86 elderly people who participated in health-club activities for one year were randomly allocated to two groups. Subjects in the intervention group received explanations of the importance of physical activity using the "Active Guide" brochure (n=42) and additional documents, while subjects in the control group did not (n=44). Physical activity was measured using a triaxial accelerometer for two weeks at baseline and again after one year. After one year of intervention, the difference in the sedentary behavior rate from baseline was -2.2% for the intervention group (n=40) and +2.5% for controls (n=40) (Welch's t-test, p=0.007). Use of the "Active Guide" brochure and additional documents may reduce the sedentary behavior of community dwelling elderly people in Japan.

Relationships between Physical Activity, Sleeping Time, and Psychological Distress in Community-Dwelling Elderly Japanese

Background and objectives: It is well-known that lifestyle is closely associated with psychological distress in many elderly subjects. However, the effect of intervention with physical activity and/or sleeping on psychological distress has not been fully discussed. The purpose of this cross-sectional study was to investigate the relationships between physical activity, sleeping time, and psychological distress in community-dwelling elderly Japanese subjects. Materials and Methods: A total of 108 elderly Japanese (31 men and 77 women) subjects were enrolled in this cross-sectional study. Psychological distress was evaluated using the K6 questionnaire. Physical activity, including sedentary behavior, was measured using a tri-accelerometer. Sleeping time was evaluated using a self-reported questionnaire. Results: The median of the K6 scores was 1.0 (0–18), and the sedentary behavior (%) and walking time (minutes/day) were 57.2 ± 10.7 and 80.7 (17.9–222.4), respectively. Sleeping time was negatively correlated with psychological distress. In addition, multiple linear regression showed that walking time and sleeping time were important factors for psychological distress, even after adjusting for confounding factors. Conclusions: These results suggest that increased walking time and sleeping time may be beneficial for reducing psychological distress in community-dwelling elderly Japanese subjects.

Functional capacity, renal function and vitamin D in community-dwelling oldest old.

The aim of this study was to evaluate the association between the decline in estimated glomerular filtration rate (eGFR) and serum 25(OH)D with the physical and mental functional capacity of elderly individuals aged 80years or older. We evaluated the functional capacity in its multidomain aspects: Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Mental State Mini-Exam (MMSE), Verbal Fluency Test (VF), handgrip strength and time to sit and rise from a chair five times, combined creatinine and cystatin C-based eGFR and 25(OH)D levels in 205 independent asymptomatic and community-dwelling elderly subjects in a cross-sectional study. Every 1year of life, there was reduction of about 10% chance of adequate performance in functional capacity. Each 1ml/min/m2 in eGFR was associated with 2% better chance of adequate performance in the IADL. We found no association between eGFR and cognition. Serum 25(OH)D between 15.00 and 22.29ng/ml increased the chance of better performance in VF, IADL, handgrip strength and sit and rise from the chair compared to the lower level of serum vitamin D. Decreased renal function associated with age compromises the ability to perform activities for independent life in the community, but we did not observe influence in specific domains of cognition and physical performance. Low serum level of 25(OH)D appears to be a marker of greater risk of functional decline than eGFR measurement in independent oldest old dwelling in the community.

Sarcopenia and quality of life: the validated Hungarian translation of the Sarcopenia Quality of Life (SarQoL) questionnaire

Sarcopenia, or age-related muscle loss, is emerging as a serious public health concern. Due to the impaired physical performance associated with sarcopenia, a reduced quality of life (QoL) has been evidenced in the affected individuals. Generic instruments, such as Rand Corporation Short Form 36 (SF-36) or the European Quality of Life (EuroQoL-5D) questionnaires do not accurately assess the impact of sarcopenia on QoL. SarQoL (Sarcopenia Quality of Life) questionnaire, was the first disease-specific questionnaire addressing the quality of life in patients with sarcopenia and has been recently designed for providing a global assessment of the quality of life in community-dwelling elderly subjects aged 65 years and older. Our aim was the development of a valid Hungarian version of the original SarQoL, through the translation, cultural adaptation and content validation of the original questionnaire. We followed the recommended process, the international protocol of translation in five steps: two initial translations, synthesis of the two translations, backward translation, expert committee to compare translations with the original questionnaire and pretest. The pretest process involved 20 subjects (10 clinically sarcopenic and 10 non-sarcopenic with different educational and socioeconomic backgrounds) who were asked to complete the questionnaire. Feedbacks were requested from all subjects regarding the comprehensibility of questions or difficulties in completing the test. Using the recommended best practice protocol for translation, the pre-final version is comparable with the original instrument in terms of content and accuracy. After the content validation with clinically sarcopenic persons it should be a useful tool to assess the quality of life of people with sarcopenia among elderly Hungarian patients. Orv Hetil. 2018; 159(36): 1483-1486.

Dysmobility syndrome is associated with prevalent morphometric vertebral fracture in older adults: the Korean Urban-Rural Elderly (KURE) study.

Dysmobility syndrome was coined to indicate patients with impaired musculoskeletal health. Data on the association of dysmobility syndrome with prevalent morphometric vertebral fracture (VF) in elderly persons are limited. A total of 1369 community-dwelling elderly subjects (mean age 71.6years; women 66%) were analyzed. Dysmobility syndrome was defined as ≥ 3 components among falls, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go performance. VF was defined as a ≥ 25% reduction in the height of vertebral bodies in plain radiographs. Modified cutpoints of each component at which elevate the odds of fracture were investigated using receiver-operating characteristics analysis. Net reclassification improvement (NRI) and integrated discrimination index (IDI) were calculated to assess additive discriminatory value of dysmobility syndrome over FRAX. The prevalence of VF and any fracture composite of VF and non-VF was 16% and 25%, respectively, increasing according to number of dysmobility components (from 0 to 5; VF 10-35%; any fracture 16-45%). Dysmobility syndrome was associated with elevated odds of VF (adjusted OR [aOR] 1.52, 95% CI 1.08-2.15) or any fracture (aOR 1.46, 95% CI 1.07-1.98) but no longer with non-VF (aOR 1.31, 95% CI 0.86-1.98) in multivariate model, whereas modified definition showed robust association with non-VF (aOR 1.79, 95% CI 1.23-2.60). Dysmobility syndrome improved discrimination for prevalent fracture when added to FRAX (NRI 0.25, 95% CI 0.13-0.37; IDI 0.020, 95% CI 0.014-0.026). Dysmobility syndrome was associated with elevated odds of morphometric VF in community-dwelling older adults, independent of age and covariates.

Lower Urinary Tract Symptoms in Subjects with Subclinical Cerebral White Matter Lesions

Aim We assessed the impact of cerebral white matter lesions (WMLs) on lower urinary tract symptoms in subjects with normal neurological and cognitive function. Methods A cohort of community-dwelling subjects aged ≥65 years were recruited to undergo MRI brain assessment. WMLs were graded using the Fazekas scale from 0 to 3. A separate telephone interview was carried out to assess the urinary symptoms in these subjects using the questionnaire Overactive Bladder-Validated 8-Question Awareness Tool (OAB-V8). Results 800 community-dwelling elderly subjects were recruited to undergo MRI brain. In this cohort, 431 subjects responded to the telephone interview concerning their urinary symptoms. Among the respondents, 21.1% did not exhibit any WML on their MRI brain. Most of the subjects (52.6%) exhibited grade 1 WML. On logistic regression, age was found to be positively correlated with the Fazekas score (correlation coefficient 0.203, p ≤ 0.01). Using a cutoff of 8 on OAB-V8, 22% of the respondents experienced OAB. Presence of WML, hypertension, or diabetes mellitus was not found to be correlated with storage urinary symptoms or OAB-V8 total score. Multiple logistic regression analysis did not show the presence of WML to be associated with the diagnosis of OAB (adjusted OR 1.13, 95% CI 0.65–1.96, p=0.659). Conclusions WML is associated with age and is common in the elderly population. Mild WML is subclinical, with no obvious neurological and urinary symptoms. Our cohort did not demonstrate a relationship between WML and lower urinary tract symptoms.

Effect of Squat Exercises on Lung Function in Elderly Women with Sarcopenia.

We explored whether a mechanically-assisted squat exercise improved muscle mass, muscle function, and pulmonary function in elderly women with or without sarcopenia. In total, 76 community-dwelling elderly subjects (>60 years of age) were screened. We ultimately included 30 subjects who completed more than 80% of the six-week course of mechanically-assisted squat exercises (three days per week, 30 min per day). We measured body composition, lung function, knee extensor strength, hand grip strength, and the 3-min walk distance (3MWD) before and after the exercise program. Subjects with sarcopenia had poor hand grip strength and knee extensor strength, and a slow walking speed. Their lung function parameters, including forced vital capacity (FVC), was lower than those of the controls. After six weeks of squat exercises, the hand grip strength, knee extensor strength, and 3MWD increased significantly in both groups. Appendicular skeletal muscle mass and leg lean mass were increased in subjects without sarcopenia. The FVC (L) increased significantly only in the sarcopenia group (p = 0.019). The mechanically-assisted squat exercise program increased muscle function and lung function, including FVC, in patients with sarcopenia. Muscle mass increased in subjects without sarcopenia.