Lower Gait Speed Research Articles

SARC-F: an effective screening tool for detecting sarcopenia and predicting health-related quality of life in older women in Sri Lanka

ObjectiveThe "Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls" (SARC-F) is a simple, five-item tool used to identify individuals with suggestive signs of sarcopenia. This study assessed the validity of the Sinhala version of the SARC-F, evaluating its ability to detect sarcopenia in older women and its potential to predict health-related quality of life (HRQoL).MethodsThe culturally adapted Sinhala version of the SARC-F, along with the Short Form-36 (SF-36) survey, was administered among 350 older women (aged ≥ 65) attending medical clinics at National Hospital Galle, Sri Lanka. Handgrip strength (HGS) was measured using a handheld dynamometer, and relative appendicular skeletal muscle mass index (RSMI) was estimated with a Sri Lankan-specific anthropometry-based equation. Gait speed (GS) was assessed using 4-m customary-paced walk test.ResultsThe mean (± SD) age of the participants was 72 (± 5) years, with 56.3% (n = 197) having sarcopenia based on a SARC-F score of ≥ 4. The Sinhala version of SARC-F demonstrated a good internal consistency (Cronbach’s alpha = 0.72). A significant positive correlation between SARC-F and HGS indicated concurrent validity (r = 0.23, p < 0.001). Women with sarcopenia had significantly lower HRQoL scores, HGS and GS compared to those without, confirming discriminant validity (p < 0.01). The sensitivity, specificity, and accuracy of the Sinhala SARC-F were 54.8%, 67.3%, and 60.3%, respectively, with an Area Under the Curve (AUC) of 0.61 (95% CI: 0.55–0.67) in detecting probable sarcopenia. The HRQoL domains of SF-36 (excluding emotional well-being), HGS and GS were inversely correlated with SARC-F (Spearman’s rho range: -0.19 to -0.56, p < 0.001). SARC-F significantly associated with the physical function and pain domains of SF-36 explained 42% of the variance in the model (r = 0.65, R2 = 0.42).ConclusionsThe Sinhala version of SARC-F is a reliable and valid tool for screening sarcopenia in Sinhala-speaking older women in Sri Lanka. It can be integrated into clinical practice to identify those with suggestive signs of sarcopenia and to predict HRQoL enabling timely interventions. Future studies with larger, more diverse populations, including men, are needed to enhance the tool's generalizability and diagnostic accuracy.

Prognostic impact of gait speed, muscle strength and muscle mass in chronic heart failure-A prospective cohort study.

Heart failure (HF) impairs skeletal muscle mass and function, which contributes to reduced physical performance. We investigated the prognostic impact of gait speed (GS), handgrip strength (HG) and appendicular skeletal muscle index (ASMI) on cardiovascular outcomes in a prospective HF cohort. This single-centre prospective cohort study included adults with stable chronic HF with a previous diagnosis of overtly reduced left ventricular ejection fraction (LVEF) <40% and LVEF<50% at enrolment. GS was measured by the 4m GS test, maximal HG was measured with a hydraulic dynamometer, and ASMI was measured by dual-energy X-ray absorptiometry. The primary combined outcome was cardiovascular death or worsening HF. Fine and Gray regression models were calculated, treating non-cardiovascular death as the competing event. Two hundred five patients (78% male) were analysed. The median age was 66 (quartiles: 58-74) years, 31% had diabetes mellitus, and the median LVEF was 37 (30-43) %. Median GS was 1.0 (0.8-1.0) m/s, median HG was 32 (24-40) kg, and median ASMI was 8.0 (7.2-8.9) kg/m2. During a median follow-up of 4.7 (4.0-5.3) years, the primary outcome was observed in 52 patients. In models adjusted for key clinical covariates, lower GS predicted a higher risk of cardiovascular death or worsening HF [subdistribution hazard ratio (SHR) per 0.1m/s increase=0.81, 95% confidence interval (CI) 0.68-0.95], whereas HG (SHR per 5kg increase=0.97, 95% CI 0.84-1.10) and ASMI (SHR per 1kg/m2 increase=1.17, 95% CI 0.94-1.44) did not. In the analysis of effect modification, these associations were consistent across key clinical subgroups. Higher GS was independently associated with a lower risk of cardiovascular death or worsening HF, whereas HG and ASMI were not. We prospectively confirm GS as a physical performance measure with clear prognostic significance for patients with HF.

Associations between moderate-to-vigorous physical activity, p-tau181, and cognition in healthy older adults with memory complaints: a secondary analysis from the MAPT.

Physical activity provides benefits against cognitive decline but its associations with Alzheimer's disease pathophysiology are not fully understood. We investigated cross-sectional and longitudinal associations between moderate-to-vigorous physical activity and phosphorylated (p)-tau181 blood concentrations, and the role of p-tau181 in the associations between moderate-to-vigorous physical activity and cognition. In this post-hoc secondary analysis, we used data from a multicentre, randomised, placebo-controlled superiority trial (the Multidomain Alzheimer's Preventive Trial [MAPT]), in which adults aged 70years and older were recruited from the community in 13memory centres in France and Monaco. Individuals were eligible if they met at least one of the following criteria: spontaneous memory complaints, low gait speed (≤0·77m/s), or limitation in at least one instrumental activity of daily living. Exclusion criteria included a dementia diagnosis, a Mini Mental State Examination score below 24, and having limitations in basic activities of daily living. For this secondary analysis, participants from MAPT were included if they had blood p-tau181 concentrations measured at baseline or at 3years, or both timepoints. Self-reported moderate-to-vigorous physical activity (in metabolic equivalent of task min per week) and a cognitive composite score (calculated by averaging the Zscores of four cognitive tests) were assessed at baseline and at 6months and at 1, 2, and 3years. Mixed-effect models were used to examine the cross-sectional and longitudinal associations between moderate-to-vigorous physical activity and p-tau181 concentrations and to explore the mediating and moderating role of p-tau181 concentration on the association between moderate-to-vigorous physical activity and cognition. Between May 30, 2008, and Feb 24, 2011, 1679individuals were enrolled in the MAPT, of whom 558adults had measurements of p-tau181 concentrations at baseline, 3years, or both timepoints. Higher levels of moderate-to-vigorous physical activity were associated with slower changes in p-tau181 concentrations over time. Compared with inactive individuals, those with low levels of activity (low moderate-to-vigorous physical activity × time: B = -0·109 [95%CI -0·206to -0·012; p=0·028]) or high levels of activity (high moderate-to-vigorous physical activity × time: B=-0·114 [95% CI -0·208to -0·020; p=0·018) had a slower increase in p-tau181 concentrations. We did not identify any association between baseline p-tau181 concentrations and baseline moderate-to-vigorous physical activity levels. The cross-sectional and longitudinal associations between moderate-to-vigorous physical activity and cognition were attenuated with increasing baseline p-tau181 concentrations. Specifically, moderate-to-vigorous physical activity was no longer favourably associated with the cognitive composite score when baseline p-tau181 concentration exceeded 9·36pg/mL and 3·5pg/mL for the cross-sectional association and longitudinal association, respectively. Our findings suggest that engaging in more moderate-to-vigorous physical activity might help to slow the age-related neurodegenerative process, although p-tau pathophysiology seems to mitigate the beneficial associations between moderate-to-vigorous physical activity and cognition in older adults. Verification of these findings in larger population samples will be needed. Toulouse Gérontopôle, French Ministry of Health, and Pierre Fabre Research Institute.

Gait Speed and All-Cause Mortality in Whole-Spectrum Chronic Kidney Disease: A Systematic Review and Meta-Analysis Included 6217 Participants.

The quantitative relationship between gait speed and mortality risk in patients with chronic kidney disease remains unclear. This study aimed to conduct a meta-analysis to estimate the risk of mortality associated with gait speed in chronic kidney disease (CKD) patients. Relevant studies published were identified through literature searches using Embase, PubMed and Web of Science. Prospective cohort studies of adult CKD patients that examined the relationship between gait speed and mortality were included. Random effects meta-analyses based on restricted maximum likelihood to were used to calculate relative risk (RR) and 95% confidence interval (95% CI). The results of meta-analyses were assessed using Grading of Recommendations, Assessment, Development and Evaluation framework. Seventeen prospective cohort studies involving 6217 CKD patients (mean age range: 51.6-81.85 years; 44.3%-84% male) were included. Pooled analysis of 12 studies (n = 4233) showed that lower gait speed was associated with a higher risk of all-cause mortality compared to higher gait speed (RR = 2.138; 95% CI: 1.794-2.548; p < 0.001; I2 = 16.0%; high-certainty evidence) in CKD patients. Dose-response meta-analysis of 6 studies (n = 1650) revealed that each 0.1 m/s increase in gait speed was associated with a 25.7% lower risk of all-cause mortality (RR = 0.743; 95% CI: 0.580-0.955; p = 0.018; I2 = 45.0%; high-certainty evidence). Slower gait speed is a strong predictor of all-cause mortality in CKD patients, including those undergoing dialysis or kidney transplantation. Gait speed assessment should be incorporated into routine clinical evaluations to identify high-risk patients and guide interventions aimed at improving physical function and survival outcomes. PROSPERO registration number: CRD42022340135.

Cut-Off Points for Low Relative 30-s Sit-to-Stand Power and Their Associations With Adverse Health Conditions.

Despite muscle power derived from the 5-rep sit-to-stand (STS) test having been demonstrated to be a valuable biomarker in older individuals, there is limited information regarding muscle power derived from the 30-s STS test, a widely used test in the clinical setting. This study aimed (i) to compare relative 30-s STS power values between older men and women, (ii) to identify cut-off points for low relative 30-s STS power, (iii) to compare the prevalence of low relative STS power between sexes and (iv) to evaluate the association of low relative 30-s STS power with adverse conditions in older people. A total of 1475 community-dwelling older adults (65-98 years; 45% men) from the Toledo Study for Healthy Aging were included. Relative STS power was assessed using the 30-s STS test and the Alcazar's equation. Adverse health conditions considered encompassed frailty, depression, disability in basic (BADL) and instrumental activities of daily living (IADL), cognitive impairment and low habitual gait speed (HGS). Relative STS power decreased linearly at an average rate of 1.0% year-1 in men and 1.5% year-1 in women. The cut-off points for low relative STS power were 2.53 and 2.01 W·kg-1 for men and women, respectively. The prevalence of low relative STS power was significantly lower in older men compared with older women (43.5% vs. 50.0%, respectively; p = 0.005). In men, low relative STS power was associated with frailty (OR [95% CI] = 4.4 [2.4-8.0]), cognitive impairment (OR [95% CI] = 1.7 [1.0-2.7]), disability in BADL (OR [95% CI] = 4.5 [1.5-13.8]) and low HGS (OR [95% CI] = 3.4 [1.9-5.9]). In women, low relative STS power was associated with frailty (OR [95% CI] = 5.2 [3.5-7.7]), disability in BADL (OR [95% CI] = 4.3 [1.8-9.9]) and IADL (OR [95% CI] = 3.1 [2.2-4.3]) and low HGS (OR [95% CI] = 6.1 [2.8-13.1]). No associations were found between low relative STS power and disability in IADL or depression in men, nor between low relative STS power and cognitive impairment or depression in women. Relative STS power decreased with increasing age in both men and women. The provided sex-specific cut-off points for low relative STS power using the 30-s STS test adequately identified older people with frailty and were associated with an increased risk of experiencing adverse conditions.

Association of frailty and pre-frailty with all-cause and cardiovascular mortality in diabetes: Three prospective cohorts and a meta-analysis.

Association of frailty and pre-frailty with all-cause and cardiovascular mortality in diabetes: Three prospective cohorts and a meta-analysis.

Effects of Exergaming on Frailty: A Systematic Review and Meta-Analysis.

To evaluate the effects of exergaming on physical frailty in older adults. Systematic review with meta-analysis. Six electronic databases were searched for randomised controlled trials evaluating the effects of exergaming on frailty in older adults. Data were synthesised using narrative synthesis and meta-analysis. The risk of bias and the certainty of the evidence were assessed. CINAHL, Cochrane Library, Embase, PubMed, Web of Science, and China Academic Journal Network Publishing Database were searched from their inception through February 2024. Five studies (n = 391) were included. Exergaming, which was delivered in 20-36 sessions over 8-12 weeks, resulted in improvements in frailty scores and indices, frailty status, and frailty phenotypes, including exhaustion, low physical activity levels, gait speed, and muscle weakness over time. There was no effect on unintentional weight loss. Meta-analyses showed that the effects of exergaming were not significantly different from those observed in the control groups. The rate of adherence to the intervention of the exergaming group was slightly higher than that of the comparison group (87.3%-87.7% vs. 81.1%-85.4%). The overall risk of bias was high in all studies. The certainty of the evidence was very low. Exergaming exerts effects on frailty comparable to those of conventional physical exercises. Participants appeared to have better adherence to exergaming. Future studies with robust designs are warranted. With effects comparable to those of conventional physical exercises, exergaming could be considered in clinical settings to address frailty. This review addressed the effects of exergaming on frailty instead of physical outcomes. Exergaming was comparable to conventional physical exercises in improving frailty scores and indices, frailty status, and four frailty phenotypes. The findings provide insights to healthcare providers on the design of exergames. PRISMA guidelines. PROSPERO number: CRD42023460495. No Patient or Public Contribution.

Association between fish intake and incidence of sarcopenia in community-dwelling older adults after a 6-year follow-up: the Korean frailty and aging cohort study.

Previous studies have suggested beneficial effects of n-3 polyunsaturated fatty acids on sarcopenia. However, the associations of dietary fish intake with the prevalence of sarcopenia are inconsistent, and those with the incidence of sarcopenia has not been studied. This study investigated the hypothesis that seafood and fish consumption is inversely associated with the subsequent incidence of sarcopenia. Using data from the Korean Frailty and Aging Cohort Study, 503 non-sarcopenic community-dwelling Korean adults aged 70-84 years were followed-up for 6 years. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 consensus. Dietary intake was assessed using two non-consecutive 24-h dietary recalls at baseline. The incidence of sarcopenia was 37.8% after the 6-year follow-up. The intake of oily fish was inversely associated with the incidence of sarcopenia (OR 0.99; 95% CI 0.98-1.00; p for trend = 0.046) and that of low gait speed (OR 0.98; 95% CI 0.97-1.00; p for trend = 0.016) after the 6-year follow-up, adjusting for confounding factors. Consumption of total seafood, fish, non-oily fish, or shellfish was not significantly associated with the incidence of sarcopenia or its parameters, such as muscle mass, handgrip strength, usual gait speed, 5-times sit-to-stand test, or the Short Physical Performance Battery. The findings demonstrate that the consumption of oily fish could be beneficial in preventing sarcopenia, particularly by improving usual gait speed in Korean community-dwelling older adults, suggesting oily fish as a strategy to reduce sarcopenia risk.

P0987 Muscle function deficits in Crohn’s Disease patients treated with Infliximab - tertiary single centre experience

Abstract Background Sarcopenia is an important consideration in the management of inflammatory bowel disease (IBD), in both prognosis and treatment. Since current data on sarcopenia in IBD are limited and based mostly on muscle quantity, it’s important to incorporate muscle function assessment into the evaluation of sarcopenia and to identify patient groups at increased risk. Methods A cross-sectional study included 84 Crohn’s Disease (CD) patients undergoing Infliximab therapy (64 males, mean age 34). Bioelectrical Impedance Analysis (InBody170) was done to estimate body composition parameters (BCP) which were then adjusted for height squared. Muscle strength was assessed by hand grip strength (HGS), measured using a dynamometer and muscle performance by gait speed test. Results Our results revealed that 6% of patients were underweight, 44% had normal body weight, 36.9% were overweight, and 13.2% obese. None of the patients exhibited low skeletal muscle mass index (SMI), however, half showed reduced muscle strength relative to age and sex adjusted norms in the general population. In relation to HGS, we found no significant differences in BCP, except for SMI (p=0.02) and body mass index (p=0.03), which were higher in patients with normal HGS. There were no differences between the groups in terms of physical activity levels, disease phenotype, prior surgeries, extraintestinal manifestations, clinical and endoscopic remission status. We observed significant differences in muscle quantity and quality based on disease localisation. Patients with ileocolonic CD had higher SMI (11.25±1.5 vs. 9.51±1.2 kg/m2, p=0.009) and HGS (41.1±6.6 vs. 31±6.7 kg, p=0.006) compared to those with colonic CD. Patients requiring biologic therapy due to immunosuppressive resistance had higher fat free mass index (19.4±2.4 vs. 18.2±3 kg/m2, p=0.05) and HGS (44.2 (24.9-45.3) vs. 39.3 kg (13.6-54.3), p=0.03), compared to patients on biologic therapy due to corticosteroid dependence or aggressive phenotype requiring top down approach. Patients diagnosed before 16 and after 40 years of age had lower gait speed (p=0.002), reflecting worse muscle performance. Conclusion Disease localisation, age at diagnosis and disease severity, as reflected by the indication for biologic therapy, may influence muscle composition and function. Our results emphasize the need for different and individualized management strategies based on disease localisation, especially in supporting muscle health among patients with isolated colonic CD and need for age-specific interventions, mainly in early and late onset CD, to support physical performance in these populations.

The Association of Sarcopenia and Body Composition With Benign Positional Paroxysmal Vertigo in Older Adults.

One-third of older adults suffer from dizziness and vertigo. Benign positional paroxysmal vertigo (BPPV), which occurs due to otoconia moving into the semicircular canal, is the most common vestibular disorder. We evaluated the connection between BPPV and geriatric symptoms. A comprehensive geriatric evaluation included daily living activities, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale tests for all patients. Patients' nutritional status was assessed using the Mini-Nutritional Assessment. Body weight and fat free mass were determined from the bioimpedance analyzer. Hand grip strength was measured using an electronic hand dynamometer to determine muscle strength. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People-2 recommendations. The patients were divided into three groups as BPPV-positive, BPPV-negative, and healthy (control). Obesity, low muscle mass, dynapenia, gait speed, low gait speed, and history of falling statistically significantly differed between the three groups, but age, gender, smoking, alcohol consumption, body mass index, MMSE, depression, number of falls, and comorbid diseases did not differ. The BPPV-positive group had greater rates of obesity, low muscle mass, dynapenia, and sarcopenia than the control group (p = 0.008, 0.007, 0.01, 0.03). In the unadjusted univariate analysis, low muscle mass, sarcopenia, and obesity were risk factors for "BPPV" (Odds Ratio [OR]: 3.43, Confidence Interval [Cl]: 1.25-9.37, p = 0.016; OR: 3.47, Cl: 1.32-9.13, p = 0.011; OR: 2.71, Cl: 1.09-6.70, p = 0.031). Obesity, sarcopenia, and low muscle mass are risk factors for BPPV, and we urge the older population to adopt healthy diet and exercise regimens to reduce BPPV-related falls. Level 3 Laryngoscope, 2025.

The disease burden of earlier and late‐onset rheumatoid arthritis on depression and related geriatric syndromes

AbstractPurposeThis study aims to compare the prevalence of depression and related geriatric syndromes in earlier‐onset rheumatoid arthritis (EORA) patients, who have experienced prolonged inflammation and medication use, with those with late‐onset rheumatoid arthritis (LORA) patients, who often present with an acute and severe course.MethodsIn this multidisciplinary study, patients with EORA and LORA aged 60 and over who were referred to a tertiary rheumatology clinic underwent a geronto‐rheumatologic evaluation. Muscle mass and handgrip strength, cognitive function, nutritional status, Fried frailty index, fall history, gait speed, depression according to Geriatric Depression Scale and Insomnia Severity Index were recorded. The disease characteristics and geriatric syndromes were compared in the two groups. The regression analysis was used to evaluate the association between depression and related variables.ResultsThe mean age of the 129 patients (F:M ratio = 4.15; comprising 64 EORA and 65 LORA) was 67.42 ± 5.18 years. The prevalence of depression, undernutrition, and frailty was observed in 36.4% (47; 129), 41.08% (53; 129), and 47.3% (61; 129), respectively. Patients with EORA presented with a significantly higher prevalence of female gender (87.7% vs. 73.4%, P = 0.033), depression (47.7% vs. 25.0%, P = 0.006), low gait speed (50.0% vs. 32.8%, P = 0.036) and polypharmacy (83.1% vs. 64.1% vs. P = 0.012) compared to patients with LORA. In the regression analysis, insomnia and undernutrition were significantly related to depression (OR: 3.29; 95%Cl: 1.41–7.69, P = 0.006, and OR: 3.03; 95% Cl: 1.33–7.03, P = 0.010, respectively).ConclusionDepression is more prevalent, particularly in patients with EORA, and is associated with malnutrition and insomnia in patients with RA. Thus, geronto‐rheumatologic evaluation should be taken into account in RA management.

Agreement analysis and associated factors of SARC-F and SARC-CALF in screening of risk sarcopenia in people living with human immunodeficiency virus.

People Living with Human Immunodeficiency Virus (PLHIV) appear to be at a higher risk of developing sarcopenia. Various factors seem to influence the risk of sarcopenia, and its prevalence may differ depending on the screening tool used. This study aimed to (i) Screen the risk of sarcopenia in PLHIV using the SARC-F and SARCCalf and identify associated factors; (ii) Analyze the agreement between the instruments in PLHIV. Cross-sectional study including PLHIV taking antiretroviral therapy. The authors assessed sarcopenia risk using the SARC-F and SARCCalf tools with ≥4 and ≥11 cutoff points, respectively, and a wide spectrum of variables was analyzed. Participated 76 patients (44.9 ± 12.7 years). Sarcopenia risk, according to the SARC-F, was 27.6 % and was associated with socioeconomic status (p = 0.004), smoking (p = 0.001), disease status (p < 0.001), opportunistic infections (p = 0.001), CD4 T-cell count (p < 0.001), Handgrip Strength (HGS) (p < 0.001), and Gait Speed (GS) (p = 0,001). Using the SARCCalf, sarcopenia risk was 36.8 % and was associated with work activity (p = 0.029), socioeconomic status (p = 0.004), smoking (p = 0.009), disease status (p < 0.001), opportunistic infections (p = 0.015), CD4 T-cell count (p = 0.002), HGS (p = 0.001), Appendicular Skeletal Muscle Mass Index (ASMMI) (p = 0.009), and GS (p < 0.001). The agreement between tools was moderate (k = 0.49). Sarcopenia risk, as determined by both tools, was higher in low-income PLHIV with opportunistic infections, CD4 T-cell count ≤ 200 cells/mm3, low HGS, and low GS, and lower in asymptomatic and non-smoking individuals. The authors recommend investigating these factors in hospital and outpatient settings. The SARCCalf proved to be more appropriate for screening sarcopenia risk in PLHIV.

Preoperative Posterior Pelvic Tilt Angle is Associated with Decreased Gait Speed and Hip Function in Older Patients with Hip Osteoarthritis.

This study examined the relationships between preoperative posterior pelvic tilt with muscle strength, gait speed, hip function, and quality of life in older patients with hip osteoarthritis. This cross-sectional study included 65 patients with hip osteoarthritis (75.0 ± 10.4 years; 83.1% female). Pelvic tilt angle was calculated from the frontal view of the hip joint in the standing position using radiographic images. The patients were divided into anterior (n=13) and posterior (n=52) groups based on a standard pelvic tilt angle of 27.9°. Clinical outcomes included preoperative isometric hip flexion and knee extension muscle strength, a five-time sit-to-stand test, gait speed, the Harris Hip Score (HHS), and the Japanese Orthopedic Association Hip-Disease Evaluation Questionnaire score. Multiple regression analysis was performed to clarify the relationships between the posterior pelvic tilt and clinical outcomes. The posterior pelvic tilt group had significantly lower isometric knee extension muscle strength (P=0.032), HHS (P=0.020), and gait speed (P=0.006) than the anterior pelvic tilt group. Multiple regression analysis showed that the posterior pelvic tilt was significantly associated with lower gait speed (β=-0.271, P=0.046) and HHS (β=-0.272, P=0.045). Preoperative posterior pelvic tilt is associated with decreased gait speed and hip function in patients with hip osteoarthritis. Given that a posterior pelvic tilt may compromise stability during gait, restrict daily activities, and increase the risk of falls, physical therapy interventions targeting these factors are essential, even before total hip arthroplasty.

Applying both the 30-s and the 5-repetition sit-to-stand tests captures dissimilar groups and abroader spectrum of physical abilities inmobility-limited older individuals: results from the BIOFRAIL study.

We aimed to assess differences among older patients demonstrating low STS performance in the 30s-STS and/or the5r-STS. 30s-STS and 5r-STS wereused to assess lower limb muscle strength and function in older adults. Analysis involved 376 patients (≥ 65years) from a geriatric outpatient clinic for fall assessment. The mean age of patients was 79.8 (± 6.1) years (67% female). In total, 40.6% had low STS performance with 9.3% presenting only low 30s-STS, 9.8% only low 5r-STS, and 21.5% low STS performance in both tests. Patients with low STS performance in both tests had lower gait speed, were more often frail, and had more prior falls compared to patients with low STS performance in one test only. The two STS tests are not interchangeable, and the use of both STS tests capture a wider range of physical abilities in mobility-limited older adults. NCT05795556.

Relationship Between Low Gait Speed and Geriatric Syndromes: Mortality in a University Geriatric Outpatients in Türkiye

Relationship Between Low Gait Speed and Geriatric Syndromes: Mortality in a University Geriatric Outpatients in Türkiye

Association Between Oral Hypofunction and Maximum Gait Speed in Older Adults: A Cross-Sectional Study.

Previous studies have reported an association between oral hypofunction and normal gait speed as a marker for physical function; however, the association between maximum gait speed as a more sensitive marker for physical function and poor oral function has not been investigated. To elucidate associations of oral hypofunction, comprising seven elements, with both normal and maximum gait speeds in an older population. Participants were recruited in 2018 from a hospital-based health checkup in Kyoto Prefecture. Seven oral function tests (oral hygiene, oral dryness, occlusal force or number of teeth, tongue-lip motor function, tongue pressure, masticatory function and swallowing function) were performed. Oral hypofunction was defined as an abnormality in at least three of these items. Gait speed was measured as normal and maximum gait speeds. The relationship between oral hypofunction and maximum gait speed was analysed using logistic regression. This study included 198 participants (130 men and 68 women; mean age: 75.0 years). Among them, 152 (76.7%) had oral hypofunction. After adjustment for age, sex and body mass index, oral hypofunction was significantly associated with a low maximum gait speed (odds ratio: 2.75, 95% confidence interval: 1.41-5.37). Oral hypofunction is associated with maximum gait speed in older people. The prevention of oral hypofunction may help maintain walking speed and promote an increase in healthy life expectancy.

Unraveling the stride: exploring the influence of neurogenic orthostatic hypotension on gait and balance in Parkinson’s disease

PurposeNeurogenic orthostatic hypotension (nOH) and gait impairment are frequent sources of disability in Parkinson’s disease (PD). However, the impact of nOH on balance and gait features remains unclear. This cross-sectional study aimed to assess the influence of nOH on postural and gait parameters in a cohort of patients with PD by means of wearable inertial sensors.MethodsGait and balance were assessed using Opal inertial sensors. nOH was defined as sustained systolic blood pressure (BP) drop ≥ 20 mmHg or diastolic BP drop ≥ 10 mmHg within 3 min of standing, with a ΔHR/ΔSBP ratio ≤ 0.5 bpm/mmHg. Analysis of covariance was performed to evaluate differences in gait/balance features between patients with and without nOH, adjusting for age, cognitive status, and motor disability. Moreover, we performed the same analysis considering the presence of hemodynamically relevant nOH (orthostatic mean BP ≤ 75 mmHg).ResultsA total of 82 patients were enrolled, 26 with nOH (31.7%), of which 13 presented with hemodynamically relevant nOH. After correcting for confounders, nOH was independently associated with lower gait speed (p = 0.027), shorter stride length (p = 0.033), longer time for postural transitions (p = 0.004), and increased postural sway (p = 0.019). These differences were even more pronounced in patients with hemodynamically relevant nOH. Higher postural sway was associated with a 7.9-fold higher odds of falls (p = 0.040).ConclusionsOur study presents an objective demonstration of the independent negative impact of nOH on gait and balance in PD, emphasizing the need for careful detection and management of nOH to mitigate gait and balance disturbances in PD.

Differences in sarcopenia indices in elderly Japanese women and their relationships with obesity classified according to waist circumference, BMI, and body fat percentage

BackgroundSarcopenic obesity (SO) is defined as a decrease in lean body mass and an increase in body fat mass (BFM) due to aging. Detecting SO in elderly women is important from the perspective of extending healthy life expectancy. While various indices of SO are currently used, there is no global consensus regarding diagnostic criteria for SO. This study aimed to examine the relationship between obesity indices (waist circumference (WC), body mass index (BMI), and body fat percentage (BFP)) and sarcopenia indices (total body muscle mass (TBM), appendicular lean mass (ALM), skeletal mass index (SMI)), and physical function (gait speed (GS), handgrip strength (HGS)).MethodsSubjects were 170 community-dwelling healthy elderly women aged 65–79 years (mean: 72.7 ± 5.78 years) who underwent measurements for WC, BMI, and BFP. A WC of ≥ 90cm was defined as the obese group, BMI was determined as weight (kg) divided by height squared (m2) and a cutoff of ≥ 25 kg/m2 was used to define the obesity group. BFM was measured using the bioelectrical impedance analysis (BIA) method and BFP was calculated from body weight and a cutoff of ≥ 30% was used to define the obesity group. TBM and ALM (kg) were measured using the BIA method, ALM (kg) was corrected for height (m2) to obtain SMI (kg/m2). Physical function was assessed by GS and HGS, which were measured by the 5-m walk test and a digital grip strength meter, respectively.ResultsWhen obesity was assessed using BMI, WC and BFP, obese individuals had higher TBM, ALM and SMI, and lower GS among the sarcopenia indicators. HGS did not differ significantly between the non-obese and obese groups.ConclusionOur findings suggest HGS is thought to reflect muscle strength without being affected by obesity indices, suggesting that it may be useful in detecting possible sarcopenia in obese individuals.

Association Between Disease Severity and Frailty in Patients with Aortic Stenosis

Frailty is highly prevalent among patients with aortic stenosis (AS). Nonetheless, the impact of AS severity on frailty remains unclear. This study aimed to clarify the association between AS severity and frailty in this population.This retrospective study included consecutive patients with AS who were hospitalized as candidates for transcatheter aortic valve implantation (TAVI). The prevalence of frailty, N-terminal pro B-type natriuretic peptide (NT-proBNP) level, gait speed, and geriatric nutritional risk index (GNRI) were compared between patients with severe and those with very severe AS. We employed multiple logistic regression analysis to examine the association between AS severity and frailty.A total of 137 patients were included. The prevalence of frailty was not significantly different between the severe and very severe AS groups (31% versus 30%). Similarly, no significant differences between the groups were observed for gait speed and GNRI, whereas the NT-proBNP level was significantly higher in the very severe group than in the severe AS group (P < 0.01). In the multiple logistic regression analysis, AS severity was not associated with frailty; however, gait speed and GNRI showed significant association with frailty independently of age, sex, and heart failure (very severe AS: odds ratio [OR] 1.051, 95% confidence interval [CI] 0.439-2.517; low gait speed: OR 5.109, 95% CI 1.556-16.775; malnutrition: OR 2.841, 95% CI 1.145-7.049).These findings suggest that low-intensity exercise training and nutritional therapy may be necessary in addition to AS treatment for the management of frailty in this population.

Prevalence, factors and quality of life associated with frailty and pre-frailty in middle-aged and older adults living with HIV in Zimbabwe: A cross-sectional study.

We investigated associations between HIV, frailty and health-related quality of life (HRQoL). This cross-sectional study recruited men and women aged ≥40 years in Zimbabwe. A researcher collected clinical and HRQoL data, and performed physical assessments and HIV testing. Frailty was defined using five criteria: unintentional weight loss, exhaustion, low physical activity, low gait speed, low handgrip strength. The presence of three or more criteria defined frailty, one to two pre-frailty, and zero non-frail. Data analysis used adjusted regression modelling. Of 1034 adults (mean ± SD, 62.0 ± 14.0 years), 21.6% (n = 223) were living with HIV: 93.3% knew their status, of whom 96.2% were on antiretroviral therapy (ART) and 89.7% of these had a viral load <50 copies/mL. Mean age at HIV diagnosis was 44.6 ± 10.4 years (only 8.1% were ≥70 years), people had been living with HIV for 9.8 ± 5.0 years and had been on ART for 9.4 ± 5.2 years. Overall, HIV was not associated with frailty: adjusted odds ratio (aOR) was 0.99 [95% confidence interval (CI): 0.42-2.33] for frailty versus non-frailty. However, each 5 years lived with HIV was associated with twice the odds of frailty/pre-frailty (aOR = 2.03, 95% CI: 1.03-4.13), independent of age and ART duration. Furthermore, each 5 years of ART use was associated with 60% lower odds of frailty/pre-frailty (aOR = 0.39, 95% CI: 0.19-0.78), independent of age and years lived with HIV. Older age, minimal education and poverty were associated with frailty. Frailty was associated with lower HRQoL in people both with and without HIV. Reduced survival and good viral suppression may explain the lack of association between HIV and frailty. Early ART initiation could reduce future risk of frailty.