Grip Strength Test Research Articles

The acceptability, practicality, implementation and efficacy of a physical and social activity intervention 'BreatheHappy' for people with long-term respiratory conditions: A feasibility study.

This study aimed to determine the feasibility of a group-based pilot programme of low-to-moderate physical activity training, education and social activities, by investigating acceptability, practicality, implementation and efficacy testing. We offer suggestions on programme adaptions for future study. People with a range of chronic respiratory diseases were invited to participate in a pilot 12week group activity programme. Activities included outdoor walking, tai-chi, education and a range of social activities. Acceptability was determined by participant experiences determined during interviews. Practicality was determined by programme and outcome measure completion, cost and adverse events. Implementation was determined according to whether the programme ran as planned. Efficacy was determined by statistical analyses of outcomes including hand grip strength, timed up and go test, COPD Helplessness Index, COPD Assessment Test, and measures of physical activity via accelerometry. Thematic analysis indicated that the "BreatheHappy" programme was acceptable. Seven of nine participants completed eight out of 10 sessions and the majority completed all outcome measures. "BreatheHappy" was therefore considered practical. The programme was not implemented as planned, with only 10 sessions running rather than the 12 intended. There was a significant increase in daily step counts (MD: 1284 95% CI: 240-2329 p: 0.024 effect size: 0.988), stepping time (MD: 16 min 95% CI: 5-27 min p: 0.011 effect size: 1.36) and daily minutes completing light physical activity (MD: 23 95% CI: 6-38 p: 0.006 effect size: 1.6). However, time spent sitting for ≥30min but ≤60min significantly increased (MD: 26 95% CI: 0.2-52min p: 0.049 effect size: 0.931), showing signs of efficacy and changing physical activity behaviour patterns. A 10-week programme of low-moderate physical activity training, education and social activities shows signs of feasibility for future research. Suggested adaptions for future study include using physical activity measures such as daily step count or light physical activity for a primary outcome, and mental health and social health related outcome measures relatable to participant's beneficial experiences of the programme. Recruitment in future studies will try and reach both those less socially active and possibly those who have completed pulmonary rehabilitation (PR). Venues should be close to efficient transport links whilst different frequencies and durations of programme delivery should be trialled. Adequate funding should be provided for both staff running the programme and blinded research staff for outcome measurement.

The Diagnostic Value of Musculoskeletal Ultrasound in the Quantitative Evaluation of Skeletal Muscle in Chronic Thyrotoxic Myopathy: A Single-Center Study in China.

This study aimed to evaluate the quadriceps femoris in patients with chronic thyrotoxic myopathy (CTM) using musculoskeletal ultrasound and to explore its practical clinical value for the diagnosis of CTM. A total of 241 subjects recruited from the First Affiliated Hospital of Guangxi Medical University were surveyed for detailed medical history and underwent grip strength tests, fixed-distance walking, and quadriceps femoris ultrasound examinations. Differences in muscle parameters between the CTM, non-CTM, and healthy groups were analyzed. An Receiver operating characteristic (ROC) curve was established to analyze the predictive value of various ultrasound measurements for CTM, and Spearman correlation analysis and binary logistic regression were applied to explore the factors associated CTM. The quadriceps femoris contraction index, muscle thickness, muscle cross-sectional area, and pennation angle in the CTM group were significantly lower than those in the non-CTM and healthy groups (p<0.01). The ROC curve prediction showed that the pennation angle had the best sensitivity and specificity for diagnosing myogenesis, with an area under the curve of 89%. Moreover, the pennation angle of the CTM group was positively correlated with step speed (r=0.245, p=0.031) and body surface area (r=0.276, p=0.014), but negatively correlated with age (r=-0.306, p=0.007). Regression analysis showed that the quadriceps femoris contraction index, muscle thickness, pennation angle, and cross-sectional area were factors that related the CTM. After adjusting for potential confounding factors, the association between Muscle Bundle Length and CTM became significant (OR=1.99, 95% CI: 1.22, 3.35, p=0.007). Muscular echo in patients was observed to varying degrees of enhancement. Musculoskeletal ultrasonography in the quantitative analysis of muscle parameters and muscle echo of the quadriceps femoris can provide essential imaging evidence for predicting CTM.

Grip strength, working memory, and emotion perception in middle-aged males.

This study examined the association between grip strength and emotional working memory in middle-aged adults. Seventy-six males aged 40-60years (mean=48.5years, SD=5.4) participated in this cross-sectional study. They completed a muscular fitness assessment using a maximum grip strength test and emotional n-back tasks under two emotion conditions (fearful and neutral facial pictures) and two working memory loads (1-back and 2-back tasks). Hierarchical regression analyses indicated that greater muscular fitness was associated with superior working memory performance in the fearful condition in both the 1-back and 2-back tasks, after controlling for confounders. Greater muscular fitness was also associated with superior working memory performance in the neutral condition when the working memory load was high (2-back task) but not low (1-back task). These findings suggest a positive association between muscular fitness and emotional working memory and highlight the importance of maintaining muscular fitness for physical and cognitive-emotional well-being in middle-aged adults.

Effect of post COVID-19 on body composition, physical fitness, sleep quality and quality of life among young adults: a cross-sectional study of matched pairs.

Coronavirus 2019 (COVID-19) causes lung tissue inflammation, affects mental health, and disturbs sleep and the musculoskeletal system. This study aimed to investigate the effects of COVID-19 on physical function and quality of life by comparing the body composition, physical fitness, sleep quality and quality of life between Thai young adults with and without post COVID-19 infection. A cross-sectional study was comprised of two matched groups (post COVID-19 group and non COVID-19 group) with 36 participants in each group. Data about body composition, physical fitness, sleep quality and quality of life were collected using the bioelectrical impedance analysis, the 1-min sit-to-stand test, the hand grip strength test, the Pittsburgh sleep quality questionnaire and the EuroQol-5D-5L, respectively. Independent samples T-test, Mann-Whitney U test and Chi-square test were used to compare between the two groups. The changes in oxygen saturation and respiratory rate after the physical fitness test and the sleep quality analysis showed a statistically significant difference between the groups with and without post COVID-19 infection (p = 0.006, p = 0.003 and p = 0.003, respectively). However, quality of life and body composition were not significantly different between groups. COVID-19 influenced the changes in oxygen saturation and respiratory rate after the physical fitness test and the sleep quality analysis in young adults. The results should be utilized to facilitate physical rehabilitation for COVID-19-infected individuals following infection. Those who have not been infected with COVID-19 must be informed of self-protection measures to avoid contracting the virus.

Impact of Codonopsis decoction on cerebral blood flow and cognitive function in rats with chronic cerebral ischemia

Ethnopharmacological relevanceSome species of Codonopsis (local name in Shanxi: Ludang) have long demonstrated high medicinal and economic value. Radix Codonopsis, the dried root of Codonopsis pilosula (Franch.) Nannf. (C. pilosula), Codonopsis pilosula var. modesta (Nannf.) L.D.Shen (C. pilosula var. modesta), or Codonopsis pilosula subsp. tangshen (Oliv.) D.Y.Hong (C. pilosula subsp. tangshen), was recorded as a traditional Chinese medicine back in the Qing Dynasty in Ben Cao Cong Xin. Radix Codonopsis, a valuable medicinal herb certified by the Chinese National Geographic Indication, is known for invigorating the spleen, nourishing the lungs, promoting blood circulation, and generating fluid properties. Given that chronic cerebral ischemia (CCI) is often associated with the symptoms of qi and blood deficiencies and fluid depletion, we explored the potential of Codonopsis decoction in the treatment of CCI. Study aimsWe investigated the effects of Codonopsis decoction on cerebral blood flow (CBF) and cognitive function in rats with bilateral carotid artery occlusion after surgery; explored whether Codonopsis decoction alleviates pathological injuries in brain tissue of rats after 2-VO surgery; and assessed the impact of Codonopsis decoction on the expression of chemokines, hypoxia-inducible factors, and inflammatory mediators in rats after 2-VO surgery. Materials and methodsWe used a 2-VO rat model to simulate CCI. We used a laser speckle imaging (LSI) system to observe changes in CBF before and after surgery. The goal was to examine variations in CBF at different time points after 2-VO surgery. For 4 weeks, the rats were orally administered Codonopsis decoction at doses of 2.7, 5.4, and 10.8 g/kg/day, or Ginaton at a dose of 43.2 mg/kg/day. To assess the effect of Codonopsis on cerebral hypoperfusion symptoms in rats, we conducted the Morris water maze (MWM), Barnes maze (BM), and forelimb grip strength tests. Additionally, pathological experiments including hematoxylin and eosin, Nissl, and Luxol fast blue staining were conducted. Furthermore, we used western blotting to detect changes in the levels of proteins such as the chemotactic factor CKLF1 and hypoxia-inducible actor 1-alpha (HIF-1α). ResultsOne week after 2-VO surgery, cerebral arterial blood supply in the rats rapidly reduced to approximately 43.39% ± 3.53% of the preoperative level. Cerebral cortex perfusion reached its nadir within 24 h of surgery, gradually recovering and stabilizing by the fourth week after surgery. An integration of the results from the BM, MWM, and grip strength tests, which assessed cognitive function and forelimb strength in rats after 2-VO surgery, unequivocally revealed that Codonopsis treatment significantly reduced the latency period and increased the number of platform crossings in the MWM test. Ginaton exhibited a comparable effect. Moreover, both Codonopsis and Ginaton decreased the number of errors and the time required to locate the target hole in the BM test. Histopathological staining revealed that Codonopsis and Ginaton could ameliorate pathological damage in rats after CCI and reduce the release of factors such as CKLF1 and HIF-1α. ConclusionCodonopsis decoction exerted its protective effects on CCI rats possibly by modulating the levels of chemokines, hypoxia-inducible factors, and neuroinflammatory mediators.

Betaine attenuates age-related suppression in autophagy via Mettl21c/p97/VCP axis to delay muscle loss

Age-related impairment of autophagy accelerates muscle loss and lead to sarcopenia. Betaine can delay muscle loss as a dietary methyl donor via increasing S-adenosyl-L-methionine (SAM, a crucial metabolite for autophagy regulation) in methionion cycle. However, whether betaine can regulate autophagy level to attenuate degeneration in aging muscle remains unclear. Herein, male C57BL/6J young mice (YOU, 2-month-old), old mice (OLD, 15-month-old), and 2%-betaine-treated old mice (BET, 15-month-old) were employed and raised for 12 weeks. All mice underwent body composition examination and grip strength test before being sacrificed. Betaine alleviated age-related decline in muscle mass and strength. Meanwhile, betaine preserved the expression autophagy markers (Atg5, Atg7, LC3-II, and Beclin1) both at transcriptional and translational level during the aging process. RNA-sequencing results generated from mice gastrocnemius muscle found Mettl21c, a SAM-dependent autophagy-regulating methyltransferase, was significantly higher expressed in BET and YOU group. Results were further validated by qPCR and western bloting. In vitro, C2C12 cells with or without Mettl21c RNA interference were treated different concentration of betaine (0 mM, 10 mM) under methionine-starved condition. Compared with control group, betaine upregulated autophagy markers expression and autophagy flux. By increasing the SAM level, betaine facilitated trimethylation of p97 (Mettl21c downstream effector) into valosin-containing protein (VCP). Increased VCP promoted autophagic turnover of cellular components, ATP production, and cell differentiation. Knock-down of Metthl21c dismissed improvements mentioned above. Collectively, betaine could enhance aged skeletal muscle autophagy level via Mettl21c/p97/VCP axis to delay muscle loss.

GERIATRIC MEASURES OF PHYSICAL FUNCTION HAVE THEIR ROOTS IN EARLY CHILDHOOD BRAIN HEALTH

Abstract Midlife is a pivotal period in the life course in terms of investing resources to mitigate challenges that can come in older age. It is important to understand the relationship between childhood and midlife health, as it could have predictive properties for aging. We investigated the association between early childhood brain health and midlife physical function in the Dunedin Study, a longitudinal birth cohort (n=1,037). Brain health was measured when Study members were age 3 using a neurological examination, tests of cognitive functioning, and temperament rating. Physical function was measured at age 45 using gait speed, step-in-place, chair stands, balance, and grip strength tests. Children with worse brain health had significantly worse physical function as adults (β, 0.23; 95% CI, 0.16 to 0.30; P &amp;lt; .001), after controlling for sex and childhood socioeconomic status. This relationship supports a link between cognitive and physical function in the aging and development process, the reconceptualization of aging and development on the same ontological path, and the utility of physical function tests – which can be used in many clinical settings – as reflections of lifelong, integrated health in addition to indicators of musculoskeletal integrity in older adults.

SHARED AND DISTINCT ASSOCIATIONS OF MANUAL DEXTERITY AND GROSS MOTOR FUNCTION WITH BRAIN ATROPHY

Abstract Poor motor function is associated with brain volume and cognitive impairment. Less is known about the associations among motor domains and brain atrophy and whether associations are affected by cerebrovascular burden and/or physical activity. We analyzed data from 726 Baltimore Longitudinal Study of Aging participants (mean age 70.6±10.1 years, 56%women, 27%Black), 525 of whom had repeat MRI scans over 5.0±2.1 years. Two motor domains were operationalized as latent variables. Manual dexterity using the Purdue Pegboard and gross motor function using grip strength and comprehensive physical performance testing. Associations between the latent variables and cortical and subcortical brain volumes of interest were examined using latent growth curve modeling, adjusted for demographics, white matter hyperintensities, and physical activity. Both higher manual dexterity and gross motor function were cross-sectionally associated with smaller ventricular volume and greater white matter volumes in the frontal, parietal, and temporal lobes (all p&amp;lt;.05). Higher manual dexterity was also cross-sectionally associated with greater parietal gray matter ( =0.14;95%CI:0.05,0.23), hippocampal ( =0.10;95%CI:0.01,0.20), postcentral gyrus ( =0.11;95%CI:0.01,0.20), and occipital white matter ( =0.10;95%CI:0.01,0.21) volumes, and better gross motor function with greater temporal gray matter volume ( =0.16;95%CI:0.05,0.26). Longitudinally, higher manual dexterity and gross motor function were associated with lower temporal white matter and occipital gray matter atrophy (all p&amp;lt;0.05). Greater manual dexterity was also associated with a slower rate of ventricular enlargement ( =-0.17;95%CI:-0.29,-0.05) and less atrophy of occipital white matter ( =0.39;95%CI:0.04,0.71). Among cognitively normal middle- and older-aged adults, manual dexterity and gross motor function exhibited shared as well as distinct associations with brain atrophy over time.

PREDICTORS OF MAXIMUM STEP LENGTH IN OLDER ADULTS: ROLES FOR STRENGTH AND ACE GENOTYPE

Abstract Deficits in step length, assessed clinically by the maximum step length (MSL) test, are associated with poor balance and falls, in older adults. Determining predictors of MSL would facilitate targeted interventions to improve balance and reduce falls in older adults. Angiotensin-converting enzyme (ACE) insertion/deletion polymorphism genotypes interact with strength to predict stepping speed, but the interplay between ACE genotype, strength and MSL is unclear. Our objective was to determine whether strength and ACE DD genotype, through main effects or interactively, are associated with MSL, in older adults. Adults (N=103, female=58.2%, mean age 72.1 years, range 65-85 years) provided demographic, health and balance confidence information, completed grip strength and MSL testing, and provided saliva for genotyping. Multiple regression determined variance in MSL explained by strength, DD genotype (present/absent), and strength x genotype interaction, while controlling for covariates (age, sex, self-rated health and balance confidence). Covariates (model 1) explained 47.7% of MSL variance, while adding grip strength (model 2) explained additional 9.7% of variance. Adding DD genotype (model 3) explained .2%, while adding a strength x genotype interaction term (model 4) explained additional 3.4%, of MSL variance. The final model explained 61% of the variance in MSL (p&amp;lt;.001). DD genotype did not independently predict MSL (β=-.053; p=.421), but was interactively with strength, a significant predictor (β=.216; p=.005) of MSL. Strength was a significant predictor (β=.264; p=.003) of MSL, and as a modifiable physiological factor should be a focus of rehabilitation interventions to improve MSL and reduce falls risk in older adults.

DEVELOPMENT OF A PHYSICAL PERFORMANCE SUMMARY SCORE IN MIDDLE AGE: FINDINGS FROM THE CARDIA FUNCTION ANCILLARY STUDY

Abstract Recent evidence suggests that ~20% of middle-aged adults report mobility limitations, supporting the need for assessment strategies to detect early-onset limitations, appropriate for this population. Coronary Artery Risk Development in Young Adults (CARDIA) enrolled 5,115 Black and White men and women ages 18-30 years from four sites (Birmingham, AL; Oakland, CA; Minneapolis, MN; and Chicago, IL) in 1985-86. The CARDIA Function Study added self-reported function (PROMIS SF20a) and 5 physical performance measures (gait speed, single-leg balance, lower extremity strength, grip strength, and 6-minute walk test) to the Year 35 in-person follow-up exam conducted in 2020-22. The CARDIA Physical Performance (CAPP) score was developed by calculating sex-specific quartiles separately for each performance measure, assigning points based on these quartiles (0 for not attempted, 1-4 for each quartile), and summing points across all 5 performance measures (range 0-20, higher scores = greater performance). Among 2,021 CARDIA Function participants [mean age: 60.1 (±3.6) years; 57% female; 45% Black] the mean CAPP score was 12.3 (±4.1; range 0-20). Mean CAPP scores differed by age &amp;lt; 60 vs. ≥60 years old (12.7 vs.12.1, p&amp;lt; 0.05) and self-reported function above vs. below the median SF20a score (14.0 vs. 10.6, p&amp;lt; 0.001), but as expected, not sex (12.3 vs. 12.3, p=0.99). Among middle-aged adults, the newly developed CAPP score captured a wide range of physical performance. Lower CAPP score was associated with lower than median self-reported function suggesting that the CAPP score may be helpful assessment tool for detecting early-onset limitations to attenuate functional declines with aging.

Effects of a multilevel intervention of resistance training with or without beta-hydroxy-beta-methylbutyrate in medical ICU patients during entire hospitalisation: a four-arm multicentre randomised controlled trial

BackgroundIntensive care unit-acquired weakness (ICU-AW) is a prevalent and severe issue among ICU patients. Resistance training and beta-hydroxy-beta-methylbutyrate (HMB) intervention have demonstrated the potential to enhance muscle function in patients with sarcopenia and in older adults. The purpose of this study was to determine whether resistance training and/or HMB administration would improve physical function, muscle strength, and quality of life in medical ICU patients.MethodsIn this multicentre, four-arm, single-blind randomised control trial, a total of 112 adult patients with internal medical diagnoses admitted to the ICU were enrolled. These participants were then randomly assigned to one of four treatment groups: the resistance training group received protocol-based multilevel resistance exercise, the HMB group received 3 g/day of HMBCa, combination group and control groups received standard care, from the ICU to the general ward until discharge. The primary outcomes assessed at discharge included six-minute walking distance (6MWD) and short physical performance battery (SPPB). Secondary outcomes measured included muscle mass, MRC score, grip strength, and health reports quality of life at different time points. Data analysis was performed using a generalised linear mixed model, adhering to the principles of intention-to-treat analysis.ResultsResistance training and combination treatment groups exhibited significant increases in SPPB scores (3.848 and 2.832 points, respectively) compared to the control group and substantial improvements in 6WMD (99.768 and 88.577 m, respectively) (all with P < 0.01). However, no significant changes were observed in the HMB group. Muscle strength, as indicated by MRC and grip strength tests conducted at both ICU and hospital discharge, showed statistically significant improvements in the resistance training and combination groups (P < 0.05). Nevertheless, no significant differences were found between the treatment groups and usual care in terms of 60-day mortality, prevalence of ICU-AW, muscle mass, quality of life, or other functional aspects.ConclusionsResistance training with or without beta-hydroxy-beta-methylbutyrate during the entire hospitalisation intervention improves physical function and muscle strength in medical ICU patients, but muscle mass, quality of life, and 60-day mortality were unaffected.Trial registrationChiCTR2200057685 was registered on March 15th, 2022.

Correlates of physical activity levels, muscle strength, working memory, and cognitive function in older adults.

To explore the relationship between physical activity level, muscle strength, working memory and cognitive function in older adults. A cross-sectional research design was employed to recruit 120 older adults individuals aged 70 and above. Participants were asked to complete the International Physical Activity Questionnaire-Short Form and the Montreal Cognitive Assessment Scale. Data on variables such as grip strength and performance on the N-back task were collected. Data analysis involved the use of independent samples t-tests, χ2 tests, linear regression analysis, Pearson correlation analysis, and one-way analysis of variance (ANOVA). The detection rate of cognitive dysfunction in older adults was 53.211%; 1-back correct rate had an explanatory power of 11.6% for the cognitive function scores of older adults (R2 = 0.116, p < 0.001); grip strength showed a significant positive correlation with 1-back correct rate (r = 0.417, p < 0.001), and was significantly correlated with the 0-back response time (r = -0.478), 1 -back response time (r = -0.441) were significantly negatively correlated (p < 0.001); physical activity level was significantly positively correlated with grip strength (r = 0.559, p < 0.001), and the difference in grip strength among older adults with different physical activity levels was statistically significant (F = 19.685, p < 0.001). Physical activity level, muscle strength, working memory, and cognitive function are closely related in older adults, and the relational pathway of physical activity → muscle strength → working memory → cognitive function may serve as a useful addition to promote the field of cognitive research in older adults. To identify and prevent cognitive decline in older adults, physical activity questionnaires, grip strength tests, and 1-back task tests can be extended to nursing homes and communities.

Association between Grip Strength and Future Cognitive Function in male

AbstractBackgroundFrailty is an aging‐related syndrome of physiological decline, and has been associated with cognitive function.Grip strength, could be used as a marker for frailty and older adult health status. Frailty has been associated with cognitive function. However, its mechanism has not been fully investigated.We aimed to investigate the association between grip strength with cognitive function.MethodWe prospectively recruited 184 participants who underwent a grip strength test, cognitive function test. Data was collected from the Korean Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE), an ongoing prospective cohort study which started in 2014. Frailty was represented by grip strength (kg). Cognitive function was assessed using Mini‐Mental State Examination(MMSE) and The Consortium to Establish a Registry for Alzheimer’s Disease‐K(CERAD‐K).Multiple linear regression models were used to analyze the associations between grip strength and cognitive function. We adjusted age, gender, years of education, and BMI.ResultAmong 184 participants, 119 (64.7%) were cognitively normal. 32 (17.4%) were diagnosed with mild cognitive impairment and 33 (17.9) were a probable AD. Mean age of the participants was 69.4 (8.2) years. 43.5% of the participants were female. Grip strength was positively associated with MMSE at 1 year later in male (ß = 0.182 p = 0.004). In terms of cognitive domain, verbal and visual memory, language, visuospatial, and frontal‐executive functions were related to grip strength (vebal memory: ß = 0.037 p = 0.022, visual memory: ß = 0.046 p = 0.002, language: ß = 0.055 p&lt;0.001, visuospatial: ß = 0.068 p = 0.0213, frontal‐executive: ß = 0.050 p&lt;0.001).ConclusionWeakness of grip strength is associated with decreased future cognitive function. This support concept that grip strength could be a marker for cognitive decline.

Influence of hand grip strength test and short physical performance battery on FRAX in post-menopausal women: a machine learning cross-sectional study.

Impaired physical performance and muscle strength are recognized risk factors for fragility fractures, frequently associated with osteoporosis and sarcopenia. However, the integration of muscle strength and physical performance in the comprehensive assessment of fracture risk is still debated. Therefore, this cross-sectional study aimed to assess the potential role of hand grip strength (HGS) and short physical performance battery (SPPB) for predicting fragility fractures and their correlation with Fracture Risk Assessment Tool (FRAX) with a machine learning approach. In this cross-sectional study, a group of postmenopausal women underwent assessment of their strength, with the outcome measured using the HSG, their physical performance evaluated using the SPPB, and the predictive algorithm for fragility fractures known as FRAX. The statistical analysis included correlation analysis using Pearson's r and a decision tree model to compare different variables and their relationship with the FRAX Index. This machine learning approach allowed to create a visual decision boundaries plot, providing a dynamic representation of variables interactions in predicting fracture risk. Thirty-four patients (mean age 63.8±10.7 years) were included. Both HGS and SPPB negatively correlate with FRAX major (r=-0.381, P=0.034; and r=-0.407, P=0.023 respectively), whereas only SPPB significantly correlated with an inverse proportionality to FRAX hip (r=-0.492, P=0.001). According to a machine learning approach, FRAX major ≥20 and/or hip ≥3 might be reported for an SPPB<6. Concurrently, HGS<17.5 kg correlated with FRAX major ≥20 and/or hip ≥3. In light of the major findings, this cross-sectional study using a machine learning model related SPPB and HGS to FRAX. Therefore, a precise assessment including muscle strength and physical performance might be considered in the multidisciplinary assessment of fracture risk in post-menopausal women.

Associations between grip strength, cardiorespiratory fitness, cardiovascular risk and mental health in forcibly displaced people from a Greek refugee camp

Muscular strength represents a specific component of health-related fitness. Hand grip strength is used as a simple and dynamic marker of maximum voluntary force of the hand and to estimate overall strength. Today, little is known about the relationship between grip strength and health in forcibly displaced populations. In the present study, we examined whether grip strength is associated with various health outcomes in a sample of forcibly displaced people living in a Greek refugee camp. The present analyses are part of a larger pragmatic randomized controlled trial. In this paper, cross-sectional baseline data of 143 participants (71 men, 72 women) will be presented. In addition to grip strength, the following physical and mental health outcomes were assessed: body weight and body composition, blood pressure, total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, blood glucose levels (HbA1c), post-traumatic stress disorder (PTSD) symptoms, depressive and anxiety symptoms, pain, and quality of life. Linear regression analyses were carried out to examine how grip strength is associated with the health outcomes, separately for absolute and normalized grip strength scores. Grip strength was positively and strongly associated with percentage muscle mass (normalized grip strength: Stand. B = 0.58, p < .001), whereas a negative association existed for percentage body fat (normalized grip strength: Stand. B = − 0.58, p < .001). No statistically significant associations occurred between grip strength and the other cardiovascular risk markers. In contrast, we found that participants with higher normalized grip strength reported higher levels of PTSD (normalized grip strength: Stand. B = 0.36, p < .05) and depressive symptoms (normalized grip strength: Stand. B = 0.29, p < .05). No significant association occurred between grip strength, anxiety, pain and quality of life. Measuring grip strength in forcibly displaced people can be a useful way to assess their overall muscle strength. Grip strength tests are easy to implement, and results can be used to assess the effects of specific intervention measures. Nevertheless, our results question the usefulness of grip strength as a marker of cardiovascular health and mental wellbeing in a refugee camp setting.

Identifying Geriatric Syndromes in Adults with Sickle Cell Disease Using the Sickle Cell Disease Functional Assessment (SCD-FA): The Sickle Cell Disease Functional Assessment Validation and Refinement (SILVR) Study

Introduction As people with sickle cell disease (SCD) age, they experience accelerated functional decline. Since historically survival for SCD has been limited to middle age, geriatric syndromes in adults with SCD remains understudied. Chronological age does not accurately represent a person's health status; thus, valid functional measures for adults with SCD are required. Geriatric assessments are commonly used to measure function in older adults in the general population. We previously demonstrated feasibility, safety, and acceptability of a geriatric assessment battery called the Sickle Cell Disease Functional Assessment (SCD-FA) in adults with SCD. The SCD-FA includes physical performance test and surveys evaluating multiple health domains. The purpose of this study was to evaluate the construct validity of the SCD-FA. Methods We enrolled younger (age 18-39) and older (age ≥ 40 years) adults with SCD in a single center prospective study. We assessed construct validity of each SCD-FA measure by determining known-group validity. Specifically, we evaluated whether the SCD-FA could distinguish between participants known to differ based on the following: age (&amp;lt; 40 vs ≥ 40), SCD genotype non-severe (HbSC/HbSβ +-thalassemia) vs severe (HbSS/HbSβ 0-thalassemia), and dependence in Activities of Daily Living/Instrumental Activities of Daily Living (no ADL/IADL deficit vs ≥ 1 ADL/IADL deficits). We used Student's t-tests and Wilcoxon rank sum test to gauge significant differences between groups. Results We performed the SCD-FA in 111 adults with SCD at steady state, with 93 (84%) having complete data. Most participants (58%) were female. The mean age of all participants was 44 ± 14 (range 19-82 years), with most (56%) age ≥ 40 years. The mean age for younger adults (18-39 years) was 30 ± 5.8 and 54 ± 9.3 for older adults (≥ 40 years). When evaluating SCD-FA measures by age, older adults had lower scores on PROMIS Physical Function (younger 52 ± 6.9 vs older 46 ± 8.4; p&amp;lt;0.001). Although there was no difference in number of falls by age, there were several participants with ≥ 1 fall (15%) or near fall (36%) in the last 6 months. Older adults had higher scores on the Social Support Survey (implying better support) (younger 69 ± 30 vs older 80 ± 20; p&amp;lt; 0.05). Older adults had more non-SCD comorbidities (younger 0.5 ± 0.7 vs older 1.7 ± 1.7; p&amp;lt;0.001), with no younger adults with ≥ 3 comorbidities vs. 33% of older adults with ≥ 3 comorbidities, more SCD conditions (younger 2.0 ± 1.5 vs older 2.7 ± 1.7; p&amp;lt; 0.05), and more reports of fair or poor hearing (0% younger vs 8% older; p = 0.01). Older adults took more prescribed medications (younger 3.9 ± 2.4 vs older 6.3 ± 3.9; p = 0.001) and were more likely to meet criteria for polypharmacy (defined as ≥ 5 prescribed medications) with 30% of younger adults vs 64% of older adults (Figure). Most participants (64%) had HbSS/HbSβ 0 (severe genotype) and 36% had HbSC/HbSβ + (non-severe genotype). When comparing groups by genotype, participants with severe genotypeshad a lower body mass index (severe25 ± 5.8 vs non-severe 31 ± 8.4 kg/m2; p &amp;lt; 0.005) and fewer non-SCD comorbidities (severe 0.75 ± 1.0 vs non-severe 1.9 ± 1.8; p&amp;lt; 0.005). There was no difference in physical performance, falls, psychological state, SCD conditions, and number of medications by genotypes. Of all participants, 34% reported dependence in ≥ 1 ADL/IADL. When comparing groups by ADL/IADL dependence, those who were dependent in ≥ 1 ADL/IADL had worse physical performance for all measures (gait speed, grip strength, 6-minute walk, Timed Up and Go test, and 30-Second Chair Stands). ADL/IADL dependent participants had more falls, higher PHQ-9 scores, lower MiniCog scores, more non-SCD comorbidities, and were more likely to report fair or poor vision. There was no difference in reported hearing deficits. (Table) Conclusion The SCD-FA was able to distinguish between known-groups by age and ADL/IADL dependence and identify deficits in adults with SCD such as falls, polypharmacy, comorbidities, and sensory deficits. Geriatric syndromes did increase with age in adults with SCD and were more common than in the general population (34% ADL dependent SCD participants vs 15% of middle-aged U.S. adults). Therefore, there is a need for early initiation of interventions to improve function and quality of life. We are currently adapting geriatric interventions for older adults with SCD. In future studies we will assess the predictive validity of the SCD-FA.

Trial in Progress: Investigating the Prognostic Significance of Malnutrition and Sarcopenia in Older Adults with Acute Myeloid Leukemia

Background and Significance: For older adults (≥60 years) newly diagnosed with acute myeloid leukemia (AML), tumor-specific and patient-specific factors have been used to predict treatment-related mortality (TRM) and determine suitability for intensive antileukemic therapy. Comprehensive Geriatric Assessment (CGA) is a tool designed to comprehensively evaluate health among older adults. CGA assesses multiple health domains including physical function, cognition, nutrition, mental health, polypharmacy, comorbidities, and social support but does not currently incorporate body imaging. Sarcopenia is defined as loss of muscle mass and strength. It can be measured objectively by CT, DEXA or Bioimpedance Analysis (BIA) in combination with tests of muscle strength. It has been proposed as a more accurate nutritional marker compared to BMI or serum markers. Nearly all older adults with AML receive a CT scan during their cancer evaluation. Therefore, there is an opportunity to leverage CT sarcopenia measures to improve risk prediction. Our study aims to (1) assess the burden of malnutrition and sarcopenia in older adults with newly diagnosed AML undergoing induction and (2) determine the prognostic impact of traditional markers of nutrition and novel sarcopenia measures on TRM. Study Design and Methods: This is a prospective, observational study of 82 newly diagnosed, older adult patients with AML undergoing induction treatment at the University of Chicago Comprehensive Cancer Center (NCT05458258). Key inclusion criteria include age ≥60 years and receipt of induction therapy for newly diagnosed AML. Key exclusion criteria include presence of a pacemaker or defibrillator. To assess Aim 1, newly diagnosed older adult patients with AML will be undergo a subjective global nutrition assessment and serum nutritional markers [prealbumin, albumin, CRP, ferritin]. Body composition (fat-mass, fat-free mass, lean mass) will be assessed using BIA and CT. Sarcopenia will be defined by the CT Skeletal Muscle Index (SMI) at L3 plus impairment on either maximal hand grip strength, 6-minute walk, Timed Up and Go test (TUG), the Short Physical Performance Battery (SPPB). Patients will also undergo an assessment of disability (instrumental activities of daily living (IADL) and activities of daily living (ADL) surveys), Short Physical Performance Battery [SPPB], and Montreal cognitive assessment [MOCA]) prior to starting induction. All measures will be repeated at the start of post-remission therapy. Results from both timepoints will be compared against healthy controls matched by age, sex and Charlson Comorbidity Index. Healthy control data will come from the Frailty, Activity, Body Composition, and Energy Expenditure (FACE) Aging dataset housed by the Department of Geriatrics at the University of Chicago, a 1-year longitudinal, observation study of frailty in older adults residing around the university. We will match 1 AML case to 1 control. In order to ensure that all subjects are matched, 2:1 propensity score matching will be used to generate matching controls for each case. To assess Aim 2, multivariable Cox proportional hazards regression models will be performed for each of those nutrition status and sarcopenia markers significant for TRM in univariate analysis. In multivariable analyses, we will control for age, European Leukemia Net 2022 risk stratification, ECOG PS, and CGA measures as covariates. A sample size of 82 patients will give us 80% power to detect a hazard ratio of 3.0 for TRM, the primary end point, for CT diagnosed sarcopenia using a Cox proportional hazards model with a 0.05 significance level and a 60-day mortality rate of 18%. We anticipate completion of enrollment within two years of study initiation. To date, 17 patients have been approached for consent with 11 patients enrolled. When complete, this trial will provide initial evidence necessary to recommend nutritional assessment as a part of the Comprehensive Geriatric Assessment in all older adult AML patients. Furthermore, it may provide evidence to support a future interventional study assessing the impact of improved nutritional status on TRM. Figure 1. NCT05458258 study schema.

The Application of Gait Speed and Grip Strength As a Frailty Screening Tool in Elderly Patients with Mulitiple Myeloma

Introduction Gait speed and grip strength are easily obtainable objective measures of physical function, they are important diagnostic parameters for sarcopenia, and also representative geriatric index of frailty and function that performed well, even compared with more comprehensive frailty assessments. Brief screening tests for frailty that can easily fit into the clinic workflow and predict important clinical outcomes are needed. Geriatric assessment (GA) of the International Myeloma Working Group (IMWG) applying to the newly diagnosed MM, because of its subjectivity and relative complexity, obstructing widespread development in clinical. The purpose of our analysis was to examine the potential value of gait speed or grip strength as a screening test for frailty in elderly patients with MM. At the same time, efforts are ongoing to explore the significance of dynamic evaluation . Methods All 47 patients aged 60 years and older who presented for an initial consultation in our hospital were eligible for participation. Gait speed and grip strength and IMWG-GA were measured in all consented patients. Gait speed was obtained using the National Institutes of Health 4-m gait speed test, while grip strength was measured using a Hand Dynamometer. And the differences in SASP (Senescent Associated Secretory Phenotype) between different gait speed groups were compared. Results All enrolled patients underwent dynamic evaluation and completed 124 frequency IMWG-GA, 131 gait speed and 129 grip strength tests. IMWG-GA: fit group: 43.5%(54/124), intermediate fit: 7.3%(9/124), frail: 49.2%(61/124). Gait speed &amp;lt;0.8m/s: 53.4%(70/131), ≥0.8m/s：46.6%(61/131). Grip strength：Male group：&amp;lt;28kg group 51.5%(50/97), ≥28kg group 48.5%(47/97); Female group: &amp;lt;18kg group 59.4%(19/32), ≥18kg group 40.6%(13/32). Complete and analyzable data from all cases showed high consistency between gait speed and IMWG-GA (AUC=0.83), the “4-m gait speed test” can be used as an effective predictor for frailty. And between grip strength and IMWG-GA (AUC=0.68), “Grip strength ”can also be used as an effective predictor for frailty, but its performance seems to be slightly inferior to“ 4-m gait speed test ”. The combination of “4-m gait speed test” and “grip strength” can serve as an effective predictor for IMWG-GA(AUC=0.74), and its seems to be superior to using “4-m gait speed test” or “grip strength” alone. The incidence rate of sarcopenia is 49%(23/47). We further analyzed and found that, the differential expression of IL-6 (38.51±17.59 vs 8.09±3.97 pg/ml, p&amp;lt;0.05) and IFN-γ(2.0±0.49 vs 0.86±0.14 pg/ml, p&amp;lt;0.05) in SASP between the two groups with a gait speed of &amp;lt;0.8m/s and ≥0.8m/s. While there was no statistically significant difference in IL-8 and IL-1b between the two groups. We conducted a dynamic evaluation of IMWG-GA and gait speed and grip strength. As the number of treatment courses increases and the treatment effect becomes apparent, the proportion of patients with frail decreases and the proportion of patients with improved gait increases, while the difference in grip strength changes is not significant(Figure1-3). Conclusions In summary, gait speed and grip strength have strong diagnostic value in evaluating elderly frailty MM, and dynamic monitoring is simple and feasible in clinical practice. The relationship between sarcopenia and frailty, as well as the role of dynamic assessment, still needs further exploration.

Solanum melongena extract supplementation protected skeletal muscle and brain damage by regulation of BDNF/PGC1α/irisin pathway via brain function-related myokines in high-fat diet induced obese mice

In this study, we investigated the protective effects of SM on skeletal muscle and brain damage by regulation of BDNF/PGC1α/irisin pathway via brain function related myokines in high-fat diet-induced OB mice. OB was induced by high-fat diet for 6 weeks. SM extract (SME) was administered with 200 mg/kg BW (LSM) and 500 mg/kg BW (HSM) by oral gavage every day for 12 weeks. Behavior tests such as grip strength, Y-maze, and passive avoidance test were conducted to analyze muscle and cognitive function. Histopathological changes in skeletal muscle and brain were examined by hematoxylin and eosin staining and the protein levels of biomarkers related to oxidative stress, inflammation, protein degradation, neuro-plasticity, and cell cycling were measured by western blot. SME regulated morphological changes (muscle cross-sectional area: 1.23%, 1.40%; density of neurons in hippocampus:1.74%, 1.73%) in T2DM mice. Importantly, SME supplementation significantly increased several muscle-derived myokines which might influence the expression of neuronal markers in OB mice (FGF21: 1.27%, 1.34%; PGC1α: 1.0%, 1.32%; IRISIN: 1.9%, 1.08%; BDNF: 1.35%, 1.23%). Accordingly, SME activated hippocampal neurotrophic factors including BDNF (1.0%, 1.2%) and its associated PGC1α/irisin pathway (PGC1α :1.1%, 1.1%; IRISIN:1.1%, 0.9%) significantly. This study demonstrated the possibliy that protective myokines increased by SME supplementation may contribute to neuro-protection in OB mice. Taken together, the current study suggests that SME can be used to prevent skeletal muscle and brain damage in OB by protecting against oxidative stress and inflammatin via modulation of the BDNF/PGC1α/irisin pathway in the therapeutic approach of obese patients.

Evaluating the impact of aerobic and resistance green exercises on the fitness, aerobic and intrinsic capacity of older individuals

ObjectiveOur study determined the impact of 12-week aerobic exercise (AE) and aerobic + resistance exercises (AE + RE) within the green exercise concept, on senior fitness, aerobic capacity, and intrinsic capacity (IC). MethodsThe study was a multicenter, randomized controlled study conducted at two senior living facilities with individuals aged 65 and above whose cardiorespiratory and musculoskeletal conditions are suitable for moderate exercise and who have normal cognition levels. Block randomization was applied to 96 participants in a ratio of 1:1:1 to be assigned to AE, AE + RE, and control (C) groups. Intervention groups received exercise sessions led by physiotherapists within the senior living facilitiy gardens, with a frequency of once a week for 50 min, for 12 weeks. Also, they were prescribed additional exercise sessions on two additional days of the week. At the commencement of the study and 12th week, shuttle walking test, senior fitness test (SFT), intrinsic capacity assessment (with Timed Up and Go test, Mini Mental State Examination, Geriatric Depression Scale-15, Mini Nutritional Assessment, handgrip strength test) was conducted of all participants. The primary outcome was the Z score of IC, secondary outcomes were VO2max and SFT subparameters. The study was registered in the Protocol Registry and Results System (Clinicaltrials.gov PRS) with the registration number NCT05958745. Results90 participants successfully completed the study, with 30 individuals in each of the AE, AE + RE, and C groups. By the end of the 12th week, the arm curl score was significantly higher in the AE + RE compared to the C (mean difference: 3.96, 95 % CI= 2.47 to 5.46, p = 0.01). There were significant differences in chair stand, two-minute step, 8-foot up-and-go, chair sit and reach, and back scratch tests in both AE and AE + RE compared to C. AE and AE + RE exhibited significantly higher shuttle test distances and VO2max values compared to the C (p < 0.0001). AE + RE achieved a significantly higher total IC score than the C (mean difference: 0.59, %95 CI= -0.07 to 1.26, p = 0.025). ConclusionIn this study within the green exercise concept, both AE and AE + RE led to similar improvements in strength, flexibility, mobility, endurance, and aerobic capacity. Notably, AE + RE demonstrated an additional benefit by increasing the total IC, while AE alone did not exhibit the same effect.