Kg For Men Research Articles

S1309 Can Sarcopenia Diagnosed by Hand Grip Strength Provide a Better MELD-Na Cutoff in Predicting Complications of Cirrhosis?

Introduction: Computerized Tomography (CT) measured Skeletal Muscle Index (SMI) is the best investigation to diagnose sarcopenia. However, in developing countries, it is not feasible due to cost and unavailability. Hand grip strength using hand grip dynamometry is a simple, economical and repeaTable bedside tool to assess sarcopenia in cirrhotics. MELD-Na score is a better marker for short term mortality and transplant allocation rather than predicting decompensation events in cirrhotics. In the present study, we showed that hand grip strength with MELD-Na score can correlate with complications of cirrhosis and predict survival. Methods: A total of 72 patients between December 2019 and June 2021 diagnosed with liver cirrhosis on the basis of imaging were included in our study. Hand grip strength was measured by hand grip dynamometer in the non-dominant hand in sitting position with semi-flexed arm. Mean of three values was taken as final reading. Cut-offs of < 26 kg for men and < 18 kg for women were taken from Asian Working Group for Sarcopenia 2014 consensus. Patients were followed up for a period of 6 months. Results: In our study, the prevalence of sarcopenia was 83.3%. The mean MELD-Na score was 20. Presence of sarcopenia correlated with complications like bleeding esophageal varices (p = 0.01), Hepatic Encephalopathy (HE) (p = 0.002) and Hepatorenal Syndrome (HRS) (p = 0.006). On univariate analysis, when MELD-Na was > 20.5, sarcopenia was significantly associated with HE [Odd’s Ratio (OR), 9.33; 95% confidence interval (CI), 1.86 - 46.68; p = 0.007], bleeding esophageal varices [OR, 4.29; 95% CI, 1.35 - 13.58; p = 0.01] and HRS [OR, 12.43; 95% CI, 1.46 -105.74; p = 0.02]. The MELD-Na score of more than 20.5 with sarcopenia predicted mortality with sensitivity 100%, specificity 65% and p = 0.038. The estimated survival of sarcopenics at 6 months with MELD-Na > 20.5 was 83.3%. Conclusion: Hand grip strength is a simple, non-expensive test to diagnose sarcopenia. In resource limited countries, it can be used instead of CT scan measured SMI. As a measure of sarcopenia, it shows a statistically significant association with decompensation events of cirrhosis. In patients not yet listed for transplant, hand grip strength measured sarcopenia along with MELD-Na score cut-off of 20.5 can be utilized to optimize medical treatment, to prevent decompensation, recurrent hospitalization and ensure good quality of life.

Dynapenia in all-cause mortality and its relationship with sedentary behavior in community-dwelling older adults

The aim of the present study was to investigate the relationship of dynapenia combined with sedentary behavior (SB) on the risk of mortality in older adults living in a Brazilian community. A total of 322 participants aged ≥ 60 years from the ELSIA (Longitudinal Study of Elderly Health in Alcobaça) prospective cohort were included. Dynapenia was diagnosed when the handgrip strength was < 27 ​kg for men and < 16 ​kg for women. The exposure time to SB was assessed considering the total time spent sitting during one day in the week and one day on the weekend. When combined with dynapenia, we derived the construction of four groups: best behavior (absence of dynapenia and low SB), intermediate behavior (absence of dynapenia and high SB; presence of dynapenia and low SB) and worst behavior (presence of dynapenia and high SB). Mortality was assessed by the follow-up time until death and/or censorship. During the 5-year follow-up of the study, 55 participants progressed to death. In the adjusted models, the dynapenia and the time spent exposed to SB were analyzed in a combined way, the older adults with worse behavior (high SB and dynapenia) had higher risk ratios for mortality (hazard ratio 2.46; 95% confidence interval 1.01–5.97) than the best behavior group. Older adults with dynapenia are at greater risk for all-cause mortality, which is aggravated by the addition of longer exposure to SB.

Are Serum 25-Hydroxyvitamin D Deficiency and Insufficiency Risk Factors for the Incidence of Dynapenia?

Epidemiological evidence showing the association between low 25(OH)D and age-related reduction in neuromuscular strength (dynapenia) is a paucity and controversial and, to date, the effect of osteoporosis and vitamin D supplementation on these associations has not been measured. Thus, we analyze whether serum 25(OH)D deficiency and insufficiency are risk factors for the incidence of dynapenia in individuals aged 50 or older and whether osteoporosis or vitamin D supplementation modify these associations. For that, 3205 participants of the ELSA study who were non-dynapenic at baseline were followed for 4 years. Vitamin D was measured at baseline by the serum concentration of 25(OH)D and classified as sufficient (> 50 nmol/L), insufficient (≥ 30 and ≤ 50 nmol/L) or deficient (< 30 nmol/L). The incidence of dynapenia was determined by a grip strength < 26 kg for men and < 16 kg for women at the end of the 4-year follow-up. Poisson regression models were adjusted by sociodemographic, behavioral, clinical and biochemical characteristics. Serum 25(OH)D deficient was a risk factor for the incidence of dynapenia (IRR = 1.70; 95% CI 1.04–2.79). When only individuals without osteoporosis and those who did not use vitamin D supplementation were analyzed, both serum 25(OH)D deficiency (IRR = 1.78; 95% CI 1.01–3.13) and insufficiency (IRR = 1.77; 95% CI 1.06–2.94) were risk factors for the incidence of dynapenia. In conclusion, a serum level of 25(OH)D < 30 nmol/L is a risk factor for the incidence of dynapenia. Among individuals without osteoporosis and those who do not take vitamin D supplementation, the threshold of risk is higher (≤ 50 nmol/L).

Associations Of Physical Activity, Mental Health, And Quality Of Life With Sarcopenic Obesity In Elderly

PURPOSE: This study aimed to evaluate the associations of physical activity (PA), mental health, and quality of life (QoL) with sarcopenic obesity (SO) in Korean older adults. METHODS: This cross-sectional study included 11,253 participants (men: 5040, women: 6213) over 60 years who participated in Korea National Health and Nutrition Examination Survey from 2014 to 2019. SO is defined as the maximum handgrip strength value of <26 kg in men and < 18 kg in women and waist circumference value of ≥90 cm for men and ≥ 85 cm for women. Participants were divided into four groups: normal, obesity, sarcopenia, and SO. PA data were obtained from the Korean version of the Global Physical Activity Questionnaire (GPAQ), and mental health data were based on the self-report portion of the Mental Health Questionnaire. Furthermore, the QoL section used the Korean version of the European Health-Related QoL Questionnaire. In addition, we performed multivariate logistic regression analyses adjusted for covariates including age, sex, height, weight, income level, education level, occupation, smoking, alcohol consumption status, and medical history to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS: Participants who met both the aerobic and muscle-strengthening PA guidelines had significantly decreased the prevalence of SO (OR 0.18, 95% CI 0.10-0.32) compared to the normal group after adjusting for age. Moreover, participants with poor-perceived health status, higher perceived stress, depression symptoms, or lower QoL had an increased prevalence of SO (perceived health status: OR 2.00, 95% CI 1.58-2.54; perceived stress: OR 1.70, 95% CI 1.39-2.07; depression symptom: OR 1.98, 95% CI 1.48-2.67; and QoL OR 3.35, 95% CI 2.74-4.09) compared to participants without each condition. CONCLUSIONS: Adherence to PA guidelines, good mental health, and high QoL was associated with a lower prevalence of SO in Korean older adults.

Comparison of different obesity indicators with dyslipidemia and hypertension in adults of Guangxi Yao ethnic group

To investigate the relationship between obesity indicators and dyslipidemia and hypertension in the Yao population of Guangxi. In 2015, we examined the body composition data of 784 Yao residents aged 18 years or older in Guangxi using a multi-stage whole-group random sampling method, analyzed the association between 10 indicators responding to the degree of obesity and dyslipidemia and hypertension, and analyzed the predictive value of each obesity indicator for dyslipidemia and hypertension by receiver operating characteristic(ROC) curves. There were 58.80% of Yao adults with dyslipidemia, with no difference between men and women(χ~2=0.24, P&gt;0.05); 15.94% of Yao adults had hypertension, with a higher prevalence in men than in women(χ~2=4.76, P&lt;0.05). ROC curves plotted with dyslipidemia as the dependent variable showed that the best predictor of risk of dyslipidemia prevalence in the Yao adult population was waist-to-hip ratio(WHR)(AUC=0.62, 95% CI 0.56-0.68) with a cut point of 0.86 in men and waist circumference(AUC=0.64, 95% CI 0.59-0.69) with a cut point of 75.50 cm in women. The ROC curves were plotted with hypertension as the dependent variable, and the result showed that the best predictor of risk of hypertension in the Yao adult population was: visceral fat content(AUC=0.62, 95% CI 0.56-0.68) with a cut point of 0.65 kg in men and WHR(AUC=0.67, 95% CI 0.62-0.72) with a cut point of 0.82 in women. Compared with indicators reflecting general obesity such as body mass index and percentage of body fat, indicators reflecting abdominal obesity such as waist circumference, WHR and visceral fat content are more closely related to two metabolic diseases such as dyslipidemia and hypertension in the Yao population.

Association Between The Status Of Sarcopenic Obesity And Osteoarthritis Using The KNHANES 2014-2019 Data

PURPOSE: To investigate the association between the 4 body composition status of sarcopenic obesity and the prevalence of osteoarthritis (OA). METHODS: 10,514 participants aged over 60 years in the Korean National Health and Nutrition Examination Survey 2014-2019 (KNHANES VI-II-VIII) were included in this study. Sarcopenia was defined by the value of hand grip strength of <26 kg for men and < 18 kg for women. Obesity was defined as waist circumference of ≥90 cm for men and ≥ 85 for women. OA was defined as who responded ‘yes’ for whether the participant being diagnosed as OA in the past (yes/no) and whether currently receiving treatments for OA (yes/no). Logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of OA according to the 4 body composition categories, classifying participants into groups of sarcopenic obesity (48%), nonsarcopenic obesity (33%), sarcopenic nonobesity (11%), and nonsarcopenic nonobesity (8%). RESULTS: Sarcopenic obesity (OR 1.77; 95% CI 1.45-2.15) and nonsarcopenic obesity (OR 1.70; 95% CI 1.48-1.94) demonstrated significantly higher prevalence of OA compared to nonsarcopenic nonobesity reference group after adjusting for age and sex. However, sarcopenic nonobesity (OR 1.18; 95% CI 0.97-1.44) did not show significant association with OA. CONCLUSIONS: The existence of obesity was rather more strongly associated with the prevalence of OA than the presence of sarcopenia in the aspect of the 4 body composition categories. These findings support the importance of the status of obesity and its systemic metabolic effects on the prevalence of OA. Furthermore, group of sarcopenic obesity showing slightly stronger association with the prevalence of OA than nonsarcopenic obesity group suggests the impact of the sarcopenia among obese population in the prevalence of OA.

Muscle strength, but not body mass index, is associated with mortality in patients with non-alcoholic fatty liver disease.

BackgroundWhether adiposity and muscle function are associated with mortality risk in patients with non‐alcoholic fatty liver disease (NAFLD) remains unknown. We examine the independent and combined associations of body mass index (BMI) and muscle strength with overall mortality in individuals with NAFLD.MethodsWe analysed data from 7083 participants with NAFLD in the Thai National Health Examination Survey and their linked mortality. NAFLD was defined using a lipid accumulation product in participants without significant alcohol intake. Poor muscle strength was defined by handgrip strength of <28 kg for men and <18 kg for women, according to the Asian Working Group on Sarcopenia. The Cox proportional‐hazards model was constructed to estimate the adjusted hazard ratio (aHR) for overall mortality.ResultsThe mean age was 49.3 ± 13.2 years, and 69.4% of subjects were women. According to the Asian‐specific criteria, 1276 individuals (18.0%) were classified as lean NAFLD (BMI 18.5–22.9 kg/m2), 1465 (20.7%) were overweight NAFLD (BMI 23–24.9 kg/m2), and 4342 (61.3%) were obese NAFLD (BMI ≥ 25 kg/m2). Over 60 432 person‐years, 843 participants died. In Cox models adjusted for physiologic, lifestyle, and comorbid factors, individuals with lean NAFLD [aHR 1.18, 95% confidence interval (CI): 0.95–1.48; P = 0.138] and subjects with overweight NAFLD (aHR 1.28, 95% CI: 0.89–1.84; P = 0.158) had mortality risk estimates similar to their obese counterparts, whereas participants with lower handgrip strength had significantly higher mortality risk than those with higher handgrip strength in men and women. Compared with obese individuals with the highest handgrip strength, elevated mortality risk was observed among men (aHR 3.21, 95% CI: 1.35–7.62, P = 0.011) and women (aHR 2.22, 95% CI, 1.25–3.93, P = 0.009) with poor muscle strength. Among men, poor muscle strength was associated with increased risk of mortality with obese NAFLD (aHR 3.94, 95% CI, 1.38–11.3, P = 0.013), overweight NAFLD (aHR 2.93, 95% CI, 1.19–7.19, P = 0.021), and lean NAFLD (aHR 2.78, 95% CI, 0.93–8.32, P = 0.065). Among women, poor muscle strength was associated with increased mortality risk with obese NAFLD (aHR 2.25, 95% CI, 1.06–4.76, P = 0.036), overweight NAFLD (aHR 1.69, 95% CI, 0.81–3.51, P = 0.153), and lean NAFLD (aHR 2.47, 95% CI, 1.06–5.73, P = 0.037).ConclusionsIn this nationwide cohort of individuals with NAFLD, muscle strength, but not BMI, was independently associated with long‐term overall mortality. Measuring handgrip strength can be a simple, non‐invasive risk stratification approach for overall mortality in patients with NAFLD.

Ultrasonografically assessed osteosarcopenic obesity is associated with frailty in community-dwelling older adults

ObjectivesOsteosarcopenic obesity (OSO; also known as adiposity) is the combination of three critical conditions. This study aimed to define OSO using muscle ultrasonography (US), and examine the relationship between OSO and frailty compared with its constituent components. MethodsA total of160 geriatric patients with a body mass index of ≥30 were enrolled in the study. We obtained US measurements of the rectus femoris thickness and cross-sectional area (RFCSA). OSO was defined as the combination of low muscle function (defined by handgrip strength <27 kg in men and <16 kg in women), low muscle mass (RFCSA ≤5.22 cm2), and the clinical diagnosis of osteoporosis. The modified Fried Frailty Index and Clinical Frailty Scale were used to identify frailty. ResultsThe median age of participants was 72 y, and 83% (n = 137) were female. Patients were divided into four categories: Obese (n = 72; 43.6%), osteoporotic obese (n = 44; 26.7%), sarcopenic obese (n = 19; 11.5%), and osteosarcopenic obese (n = 25; 15.2%). In the subgroup analysis, the prevalence of frailty was significantly higher in the OSO group than in the other groups on both frailty scales (P < 0.05). The regression analysis showed that OSO significantly increased frailty status when adjusted for confounders detailed in Table 1 (Fried Frailty Index: odds ratio: 5.10; 95% confidence interval, 1.669–15.132; P = 0.004; Clinical Frailty Scale: odds ratio: 3.765; 95% confidence interval, 1.236–11.465; P = 0.020). ConclusionsUS-defined OSO is strongly associated with frailty in older adults according to the first study to define OSO using RFCSA measures.

Associations of low handgrip strength and hand laterality with cognitive function and functional mobility – the Yishun Study

BackgroundEmerging evidence suggest that in addition to low hand grip strength (HGS), HGS asymmetry is associated with declining cognitive and physical functions. We examined the associations of low HGS and asymmetry with cognitive function and functional mobility in older adults.MethodsCross-sectional data of 330 community-dwelling adults (55.2% women) aged ≥ 55 years included HGS, Repeated Battery for the Assessment of Neuropsychological Status (RBANS), and Timed-Up-and-Go (TUG). Low HGS was defined as < 28 kg for men and < 18 kg for women. Participants with HGS above 10% stronger on either hand were considered as having HGS asymmetry. Multiple linear regression models were adjusted for sociodemographic, smoking, education, comorbidity count, physical activity participation, obesity, self-rated health and hand dominance.ResultsLow HGS, but not asymmetry, was independently associated with lower functional mobility performance (β = 1.3, 95%CI = 0.6,1.9), global cognitive function (β = -10.4, 95%CI = -17.0,-3.8), immediate (β = -2.6, 95%CI = -4.5,-0.7) and delayed (β = -2.8, 95%CI = -5.0,-0.7) memory. Compared to normal and symmetric HGS participants, low HGS in combination with HGS asymmetry was associated with poorer language scores. In participants with normal HGS, asymmetric HGS was associated with slower TUG than corresponding groups with symmetric HGS.ConclusionLow HGS, but not asymmetry, was associated with lower cognition and functional mobility. Associations of combined low HGS and asymmetry with cognitive and physical functions were driven by grip strength rather than asymmetry.

Elevated serum γ-glutamyl transferase is associated with low muscle function in adults independent of muscle mass

ObjectiveElevated serum γ-glutamyl transferase (GGT), a hepatic cholestasis or liver damage marker, has been associated with low lean mass and adiposity. However, whether serum GGT can predict muscle function in adults remains unclear. The aim of this study was to determine whether an elevated serum GGT is associated with low peak weight-corrected jump power (JP) and low handgrip strength (HGS). MethodsThis study included 662 individuals aged ≥50 y in the final cohort (women, 86%; mean age, 64.8 y). The primary outcome was low peak weight-corrected JP defined as <23.8 W/kg and <19W/kg in men and women, respectively, and the secondary outcome was low HGS (<28 kg in men; <18 kg in women). ResultsParticipants with low JP had a higher GGT level, older age, lower HGS, and higher body fat than those without low JP. Serum GGT showed a negative association with JP (adjusted β = –1.16, P = 0.005) and HGS (adjusted β = –0.92, P = 0.018). One log-unit increment in GGT was associated with elevated odds of low JP (adjusted odds ratio [aOR] 2.13, P = 0.002) after adjustment for age, sex, lean mass, and body fat percentage, particularly in individuals without hepatic steatosis (aOR, 2.30) versus those with hepatic steatosis (aOR, 0.80; Pinteraction = 0.020). ConclusionElevated serum GGT was associated with low muscle function in adults independent of age, muscle mass, and adiposity, indicating that serum GGT may play a role as an independent marker of muscle function. <END ABSTRACT>

Handgrip strength weakness and asymmetry together are associated with cardiovascular outcomes in older outpatients: A prospective cohort study

AimThe evaluations of handgrip strength (HGS) weakness and asymmetry have implications for the comprehensive geriatric assessment. The aim of this study was to investigate the association of HGS weakness and asymmetry on cardiovascular outcomes in older outpatients.MethodsThis was a prospective observational cohort study of 364 Geriatrics outpatients aged ≥60 years, in which all participants carried out HGS tests at baseline. Patients with HGS <28 kg for men and <18 kg for women were diagnosed as HGS weakness, and HGS ratio <0.90 or >1.10 were diagnosed as HGS asymmetry. Primary outcomes defined as the major adverse cardiovascular event and composite end‐points were assessed during a 21‐month median follow‐up.ResultsAmong 364 participants, 155 (42.6%) showed HGS weakness, and 160 (44.0%) showed HGS asymmetry. HGS weakness was associated with major adverse cardiovascular events (HR 2.76, 95% CI 1.22–6.27) and composite end‐points (HR 2.84, 95% CI 1.40–5.77). However, no significant correlation between HGS asymmetry and cardiovascular outcomes was observed. Compared with the normal and symmetric HGS group, older adults with HGS weakness and asymmetry together had a higher risk of major adverse cardiovascular events (HR 5.23, 95% CI 1.56–17.54) and composite end‐points (HR 4.00, 95% CI 1.56–10.28).ConclusionsHGS weakness and asymmetry together might increase the risk of cardiovascular outcomes in older outpatients. HGS asymmetry offers complementary information to HGS weakness when making a comprehensive assessment of HGS. Geriatr Gerontol Int 2022; 22: 759–765.

Associations between dynapenia, cardiovascular hospitalizations, and all-cause mortality among patients on haemodialysis.

BackgroundLow muscle strength is associated with adverse clinical outcomes in patients undergoing haemodialysis (HD). No studies have reported the association between dynapenia, defined by both low handgrip strength (HGS) and quadriceps isometric strength (QIS), and long‐term clinical outcomes in patients on HD. We examined the associations between dynapenia, cardiovascular (CV) hospitalizations, and all‐cause mortality in the HD population.MethodsThis retrospective study used data from outpatients undergoing HD at two dialysis facilities between October 2002 and March 2020. We defined low muscle strength as an HGS of <28 kg for men and <18 kg for women and a QIS of <40% dry weight. Furthermore, we categorized dynapenia into three groups: robust (‘high HGS and high QIS’), either low HGS or low QIS (‘low HGS only’ or ‘low QIS only’), and dynapenia (‘low HGS and low QIS’). The outcomes were all‐cause mortality and a composite of CV hospitalizations and mortality. Cox proportional hazards and negative binomial models were used to examine these associations.ResultsA total of 616 patients (mean age, 65.4 ± 12.2 years; men, 61%) were included in the analyses. During the follow‐up (median, 3.0 years), a total of 163 deaths and 288 CV hospitalizations occurred. Patients with the either low HGS or low QIS [hazard ratio (HR), 1.75; 95% confidence intervals (CIs), 1.46–2.10] and dynapenia (HR, 2.80; 95% CIs, 2.49–3.14) had a higher risk of mortality than those in the robust group. When compared with the robust group, the either low HGS or low QIS [incidence rate ratio (IRR): 1.41, 95% CI: 1.00–1.99] and dynapenia (IRR: 2.04, 95% CI: 1.44–2.89) groups were associated with a significantly higher incident risk of CV hospitalizations.ConclusionsDynapenia (muscle weakness in both upper and lower extremities) was associated with increased risks of all‐cause mortality and CV hospitalizations among patients on HD. Screening for dynapenia using both HGS and QIS may be useful for prognostic stratification in the HD population.

Dietary Essential Amino Acid Intake Is Associated with High Muscle Strength in Korean Older Adults.

The relationship between daily dietary intake of an individual or all essential amino acids (EAAs) and muscle strength in older adults is still inadequately characterized. This population-based cross-sectional study included 5971 participants aged ≥65 years from the 2014–2019 Korea National Health and Nutrition Examination Survey. Dietary information was derived from the 24 h recall data. Total essential amino acid score (EAAS) was calculated with an intake that satisfied the recommended nutrient intake (RNI) in each essential amino acid (EAA). The mean handgrip strength was estimated from triplicate measurements obtained using the dominant hand, and high muscle strength was defined as handgrip strength ≥28 kg for men and ≥18 kg for women. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. After multivariable adjustment, we found that a high total EAAS was associated with high muscle strength in Korean older adults (OR: 1.38, 95% CI: 1.07–1.79). High muscle strength was significantly enhanced with increased total EAA intake from animal sources (OR: 1.27, 95% CI: 1.02–1.58), but there was no significant association with total EAA intake from non-animal sources. EAA intake and high muscle strength are associated based on a positive dose-response relationship in which high muscle strength is further increased when the overall EAA intake meets the RNI. Thus, Korean older adults should ensure an adequate intake of all EAAs from various food sources (especially animal sources) to meet the RNI as a prerequisite for achieving high muscle strength.

Reliability and validity of two hand dynamometers when used by community-dwelling adults aged over 50 years

BackgroundThe Jamar hydraulic dynamometer is a widely recognized tool for measuring grip strength. Nevertheless, the devices used most often in Asian countries are spring-type dynamometers, represented by the CAMRY dynamometer or Smedley dynamometer. We aimed to evaluate the reliability and validity of the CAMRY dynamometer compared with the Jamar dynamometer.MethodsThis was a cross-sectional study using a random crossover design in the grip strength test with two dynamometers. A total of 1064 healthy community-dwelling older adults aged 50–90 years old, which included 686 minorities and 378 Han Chinese, were recruited into the study from July to September 2021. We assessed the reliability and validity of the CAMRY EH101 dynamometer, and the Jamar dynamometer was regarded as the reference device. The order of testing with two dynamometers was randomized in a 1:1 ratio, with a 10-min gap between the two devices. Intraclass correlation coefficients (ICCs) and Bland–Altman analysis were calculated to assess reliability and validity between the two devices.ResultsThe average handgrip strength (HGS) values at six times by the Jamar and CAMRY devices were 25.0 ± 7.9 kg and 24.6 ± 7.5 kg, respectively. The ICC values between the two devices were 0.815–0.854, and the systematic bias underestimated by the CAMRY dynamometer was 0.5 kg in men and 0.6 kg in women. We carried out a linear regression equation by sex, and their relationship was found as follows: male HGS (kg)Jamar = 8.001 + 0.765 × HGS (kg)CAMRY; female HGS (kg)Jamar = 3.681 + 0.840 × HGS (kg)CAMRY.ConclusionsThe CAMRY EH101 dynamometer provides excellent reliability and validity. This device can serve as a reliable, inexpensive, and practical device to assess grip strength in geriatric clinical practice.Clinical trial registrationChinese Clinical Trial Registry: ChiCTR2100046367; Date of clinical trial reistration: 15/05/2021.

Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet in relation to age-associated poor muscle strength; a cross-sectional study from the Kurdish cohort study

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is an eating pattern associated with multiple health benefits, including the conservation of skeletal muscle. The Hand Grip Strength (HGS) is the most frequently used indicator of muscle functional capacity and muscle strength for clinical purposes. The current study aims to investigate the association between adherence to MIND diet and prevention of age-associated decline in muscle strength among the Kurdish population in Iran. This cross-sectional study was performed using data from Ravansar non-communicable diseases (RaNCD) cohort study on 3181 adults (48.5% men) aged 35–65 years. The dietary intake of the studied participants was assessed using a 114-item food frequency questionnaire (FFQ) developed by RaNCD cohort study. The MIND diet and the major dietary patterns were identified based on the participants’ dietary intake and three dietary patterns emerged including plant-based diet, high protein diet, and unhealthy diet. Hand grip strength (HGS) was measured using a hand-held hydraulic handgrip dynamometer and poor HGS was defined as HGS less than 32.8 and 20.5 kg in men and women, respectively. Compared with participants in the lowest category of MIND diet, those in the highest category had lower odds of poor HGS (OR: 0.65; CI 95%: 0.51–0.83). Furthermore, participants who were in third tertiles of plant-based and high protein diet were more likely 37% and 33% lower odds ratio of poor HGS (OR: 0.63; CI 95%: 0.5–0.79), (OR: 0.67; CI 95%: 0.54–0.84), respectively. On the other hand, greater adherence to the unhealthy diet was increased odds of poor HGS (OR: 1.39; CI 95%: 1.11–1.74). Overall, our findings suggest that adherence to the MIND diet and high protein diet may be associated with higher HGS, while adherence to the unhealthy diet can increase the odds of age-associated poor HGS in the Kurdish population.

Estimation of Hand Grip Strength Using Foot motion Measured by In-shoe Motion Sensor.

There is a strong need to assess frailty in daily living. Hand grip strength (HGS) has been proven to be a very important factor for identifying frailty, however it is always assessed under the guidance of facility clinicians. Our purpose is to demonstrate the possibility of providing HGS estimation by using foot-motion signals measured by an in-shoe motion sensor (IMS) embedded in an insole to achieve high precision HGS assessment in daily living. The foot-motion signals were collected from 62 elder participants (27 men and 35 women). Their HGSs were assessed by a hand dynamometer. Gait parameters, individual properties, and predictors derived from foot-motion signal features in one gait cycle were selected as candidates. Statistical parametric mapping analyses were used to generate predictors from the foot-motion signals. Prior to estimation construction, least absolute shrinkage and selection operator was applied to reduce redundant predictors from candidates. Linear regression models for HGS estimation of men and women were constructed. As the results, we discovered new effective predictors for HGS estimation from foot motions and successfully constructed HGS estimation models that achieved "excellent" agreement with the reference according to intra-class coefficients, and mean absolute errors of 2.96 and 2.57 kg for men and women in leave-one-subject-out cross-validation, respectively. These results suggest that HGS can be estimated with high precision by IMS-measured foot motion and more effective frailty identification in daily living is possible through wearing an IMS.

Influence of Preoperative Handgrip Strength on Length of Stay after Lumbar Fusion Surgery.

Preoperative sarcopenic status can affect length of hospital stay and patient outcomes after surgery. The aim of this study was to investigate the impacts of preoperative handgrip strength (HGS) on length of stay (LOS) and outcomes after lumbar fusion surgery. HGS was measured preoperatively, and the cut-off value for low HGS was <28 kg for men and <18 kg for women. Perioperative patient outcomes were compared between patients with low and normal HGS. A total of 225 patients, consisting of 86 and 139 patients in the low and normal HGS groups, respectively, fully satisfied the study criteria for analysis. A longer LOS (median 10 vs. 8 days, p = 0.013) and a higher incidence of serious postoperative complications (15.1 vs. 3.6%, p = 0.002) were observed in the low HGS group. In the multivariate analysis, a low HGS (odds ratio (OR) = 1.917, 95% confidence interval (CI) = 1.046–3.513, p = 0.035) was significantly associated with a longer LOS after surgery. Preoperative HGS below the reference values by sex appeared to be an independent factor associated with longer LOS after lumbar fusion surgery.

Poor Physical Capacity Combined With High Body Fat Percentage as an Independent Risk Factor for Incident Hypertension in Chinese Suburb-Dwelling Older Adults.

BackgroundThis study examined the effects of poor physical capacity and high body fat percentage (BF%) on the incidence of hypertension in Chinese suburb-dwelling older adults.MethodsThis study was conducted on 368 Chinese suburb-dwelling participants aged ≥ 60 years without hypertension (mean age: 66.74 ± 5.59 years, 48.9% men). Poor physical capacity is defined by the Asian Working Group for Sarcopenia (AWGS) criteria as grip strength < 26 kg for men and < 18 kg for women or walking speed <0.8 m/s. High BF% was defined as values that are greater than the upper tertile for BF% as stratified by sex. The outcome was the incidence of hypertension.ResultsOverall, 5.7% of subjects had both poor physical capacity and high BF%. After the average follow-up duration of 2 years, the incidence of hypertension was 39.7%, and those experiencing both poor physical capacity and high BF% had the highest incidence (81.0%). After multivariate adjustments, the incidence of hypertension was associated with the combination of poor physical capacity and high BF% [odds ratio (OR) = 6.43, 95% CI = 1.91–21.64] but not solely with poor physical capacity (OR = 1.11, 95% CI = 0.55–2.25) or only high BF% (OR = 1.37, 95% CI = 0.80–2.34).ConclusionThe combination of poor physical capacity and high BF% can significantly increase the incidence of hypertension in Chinese suburb-dwelling older adults. For hypertension prevention, ideally, we should strive toward decreasing body fat mass while simultaneously improving physical capacity.

Associations of indicators of sleep impairment and disorders with low muscle strength in middle-aged and older adults: The HypnoLaus cohort study

ObjectiveInvestigate associations of objective and subjective indicators of sleep impairment and disorders with low muscle strength (LMS) in different age groups and genders using data from a population-based cohort study. MethodsPolysomnographic and subjective sleep data from participants (aged 40–80 years) of the HypnoLaus study (Lausanne, Switzerland) were cross-sectionally analyzed. Indicators of sleep impairment and disorders were based on pre-defined cutoffs. LMS was defined according to the diagnosis of sarcopenia (grip strength <27 kg for men and <16 kg for women). Results obtained by multivariate logistic regression were controlled for confounders. Results1902 participants (mean [SD] age, 57.4 [10.5] years; 968 [50.9 %] female) were enrolled. Objective short (<6.2 h) and long sleep durations (>8.5 h) were associated with LMS (OR = 1.74, 95 % CI = 1.07–2.82; OR = 6.66, 95 % CI = 3.45–12.87, respectively). Increased nighttime wakefulness >90 min and severe obstructive apnea (OSA) (AHI > 30) were associated with LMS (OR = 1.60, 95 % CI = 1.01–2.56; OR = 2.36, 95 % CI = 1.29–4.31, respectively). In adults aged over 60 years, these associations persisted, and reduced sleep efficiency was associated with LMS (aOR = 1.81, 95 % CI 1.05–3.13). Objective long sleep duration was associated with LMS in both genders and severe OSA predicted LMS among women (aOR = 2.64, 95 % CI 1.11–6.24). ConclusionsMarkers of early sarcopenia are affected by long sleep duration from middle age onwards in both genders. Older adults are more susceptible to the effects of other indicators of inappropriate sleep duration and quality. The findings support a potential role of sarcopenia in age-related OSA. The intricate relationships between sleep and muscle health are potential targets of public health interventions and clinical research on preventive and therapeutic strategies against the increasing morbimortality observed with ageing.

European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) criteria or slowness: which is the best predictor of mortality risk in older adults?

Objectivesto analyse the accuracy of grip strength and gait speed in identifying mortality; to compare the association between mortality and sarcopenia defined by the EWGSOP1 and EWGSOP2 using the best cut-off found in the present study and those recommended in the literature and to test whether slowness is better than these two definitions to identify the risk of death in older adults.Methodsa longitudinal study was conducted involving 6,182 individuals aged 60 or older who participated in the English Longitudinal Study of Ageing. Sarcopenia was defined based on the EWGSOP1 and EWGSOP2 using different cut-off for low muscle strength (LMS). Mortality was analysed in a 14-year follow-up.Resultscompared with the LMS definitions in the literature (<32, <30, <27 and < 26 kg for men; <21, <20 and < 16 kg for women), the cut-off of <36 kg for men (sensitivity = 58.59%, specificity = 72.96%, area under the curve [AUC] = 0.66) and < 23 kg for women (sensitivity = 68.90%, specificity = 59.03%, AUC = 0.64) as well as a low gait speed (LGS) ≤0.8 m/s (sensitivity = 53.72%, specificity = 74.02%, AUC = 0.64) demonstrated the best accuracy for mortality. Using the cut-off found in the present study, probable sarcopenia [HR = 1.30 (95%CI: 1.16–1.46)], sarcopenia [HR = 1.48 (95%CI: 1.24–1.78)] and severe sarcopenia [HR = 1.78 (95%CI: 1.49–2.12)] according to EWGSOP2 were better predictors of mortality risk than EWGSOP1. LGS ≤0.8 m/s was a better mortality risk predictor only when LMS was defined by low cut-off.Conclusionsusing LMS <36 kg for men and < 23 kg for women and LGS ≤ 0.8 m/s, EWGSOP2 was the best predictor for mortality risk in older adults.