Muscle Strength In Older Adults Research Articles

Relationship between muscle mass and muscle strength with physical performance in older adults: A systematic review.

Declining muscle mass is not always accompanied by declining muscle strength in older adults, challenging the notion that low muscle mass is the sole criterion for diagnosing sarcopenia. This review aims to find out the relationships between muscle mass and muscle strength with physical performance in older adults. This article was a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We do a systematic search of observational studies that are published between 2013 and August 2023 in PubMed, ScienceDirect, Sage journal, Tripdatabase, Cochrane Library, Embase, and CINAHL. Two reviewers selected and extracted data independently and an association measure was recorded from included studies. The review analyzed 17 observational studies conducted between 2013 and September 2023. The findings suggest that while declining muscle mass is often associated with sarcopenia, it may not always correspond to declining muscle strength in older individuals. The most common method used to measure muscle mass was bioelectrical impedance analysis, while handgrip strength was the predominant measure of muscle strength. Tests such as timed up and go and gait speed were used to assess physical performance. Physical performance in older adults is significantly related to muscle strength, whereas the relationship between muscle mass and physical performance is either weak or negligible. Therefore, when evaluating physical performance in older individuals, focusing on muscle strength is more important than muscle mass alone.

Can the timed up and go test be used as a predictor of muscle strength in older adults?

RESUMO Este estudo analisou o uso do timed up and go test (TUG) como ferramenta de avaliação da força muscular em idosos da comunidade. Como metodologia, foi realizado um estudo observacional, transversal e analítico. Foram analisados dados de 442 idosos, do sexo feminino (71,7%) e do masculino (28,3%), com idades entre 62 e 104 anos, e média de 80,85 (±8,047) anos. O TUG foi utilizado como instrumento de avaliação da força muscular. Foram realizadas análises de comparação e correlação entre o desempenho no TUG e no teste de sentar e levantar (TSL), e entre o TUG e a força de preensão manual. Também foram realizadas análises de concordância entre diagnóstico de baixo desempenho físico no TUG e diagnóstico de fraqueza muscular no TSL e na força de preensão manual. Os valores preditivos foram traçados por meio da curva receiver operating characteristic (ROC). As análises mostraram correlação diretamente proporcional moderada entre o desempenho no TUG e no TSL e correlações inversamente proporcionais baixas entre o desempenho no TUG e a força de preensão manual e entre o TSL e a força de preensão manual (p<0,001). Nas análises de acurácia, observou-se que o TUG apresentou capacidade de prever a força muscular no TSL (S 34,4%; VPP 91,5%; VPN 26,1%; AUC=0,779; 95% IC 0,724-0,835; p<0,001) e na dinamometria de preensão palmar (S 44,2%; VPP 77,4%; VPN 67,2%; AUC=0,652; 95% IC 0,599-0,705; p<0,001). Conclui-se que o TUG apresentou capacidade de indicar de forma satisfatória os indivíduos com força muscular normal no TSL.

HUMAN AGING INTERVENTIONS

Abstract Biological aging is the greatest risk factor for multiple non-communicable diseases affecting multiple organ systems. Evidence from animal studies suggest that the rate of biological aging is modifiable and that slowing the rate of biological aging may decrease the incidence of age-related morbidity and mortality. Based on these findings, several approaches are currently being studied to slow the rate of biological aging in humans. This symposium features internationally renowned aging research scientists whose work focuses on clinical interventions to modify biological aging in humans. We will hear from Rajagopal Sekhar from the Baylor College of Medicine who will present his research on “Improving oxidative stress, mitochondrial dysfunction, inflammaging, aging hallmarks and muscle strength in older adults: the novel role of GlyNAC and the 'Power of 3'”; Jamie Justice from the Wake Forest School of Medicine will present her work on “Response to dietary restriction interventions in older adults: biomarkers of cellular senescence and biological aging”; Reem Waziry from the Columbia University Mailman School of Public Health will present her work “Does Caloric Restriction Slow the Process of Biological Aging in Non-Obese Healthy Adults? Evidence from the CALERIE™ Trial”; and Daniel Parker from the Duke University School of Medicine will present his work “Does APOE genotype moderate the impact of diet modification and exercise training on age-related outcomes?”. Attendees will learn about recent advances in interventions targeting human aging.

Reproducibility of isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with Alzheimer’s disease

BackgroundTo interpret changes of muscle strength in older adults with Alzheimer’s disease (AD), determining the reliability of outcome measures is necessary. Therefore, the purpose of the present study was to investigate the relative and absolute intra-rater reliability of concentric isokinetic measures of the knee and ankle muscle strength in community-dwelling older adults without and with AD in the mild and moderate stages.MethodsA methodological study was conducted. The participants were submitted to two isokinetic evaluations with an interval of three to seven days. The evaluations consisted of knee extension and flexion at 60°/s (five repetitions) and 180°/s (15 repetitions) and plantar flexion and dorsiflexion of the ankle at 30°/s (five repetitions). The measures of interest were peak torque, average peak torque and total work. The intraclass correlation coefficient two-way mixed model of a single-measure (ICC3,1), standard error of measurement (SEM) and minimal detectable change at the 95% confidence interval (MDC95) were calculated. The ICC3,1 was interpreted based on Munro’s classification. Standard error of measurement and MDC95 were analyzed in absolute and relative values (percentage of error [SEM%] and change [MDC95%]).ResultsA total of 62 older adults were included and allocated to the three groups: mild-AD (n = 22, 79.9 years, 15 female and seven male), moderate-AD (n = 20, 81.6 years, 15 female and five male) and without-AD (n = 20, 74.3 years, 10 female and seven male). The ICCs3,1 of the measures of knee were high/very high in the three groups (0.71–0.98). The ICCs3,1 of the measures of ankle were high/very high in the mild-AD group (0.78–0.92), moderate/high/very high in the moderate-AD group (0.63–0.93) and high/very high in the group without-AD (0.84–0.97). The measurements of knee extensors at 60°/s, knee extensors (peak torque and total work), with the exception of peak torque in the mild-AD group, and flexors (average peak torque) at 180°/s, and ankle dorsiflexors at 30°/s had the lowest of SEM% and MDC95% in the three groups.ConclusionConcentric isokinetic measures are reliable for the assessment of knee and ankle muscle strength in community-dwelling older adults without and with AD in the mild and moderate stages.

Serum α-Carotene, but Not Other Antioxidants, Is Positively Associated with Muscle Strength in Older Adults: NHANES 2001-2002.

Aging is associated with an increased reactive oxygen species that can decrease muscle strength. Thus, antioxidant substances could be positively associated with muscle strength in older adults. To investigate the association between serum antioxidants and muscle strength in older adults. A cross-sectional study evaluating 1172 individuals (627 men and 545 women), aged 50 to 85 years from NHANES 2001-2002, was performed. Carotenoids (α-carotene, trans-β-carotene, cis-β-carotene, β-cryptoxanthin, lutein/zeaxanthin combination, trans-lycopene), vitamin E, and retinol were analyzed via the high-performance liquid chromatography method. Muscle strength was evaluated by the isokinetic knee extension test. Linear regression was performed to evaluate the association between tertiles of serum antioxidant levels and strength, adjusted for confounders (energy and protein intake, body mass index, sex, age, C-reactive protein, uric acid, race/ethnicity, marital status, annual household income, educational level, physical activity, smoking, hypertension, arthritis, and diabetes). Alpha-carotene levels (p-trend = 0.027) were positively associated with muscle strength. However, serum vitamin E, trans-β-carotene, cis-β-carotene, β-cryptoxanthin, carotenoids, and retinol levels were not associated with strength. Serum α-carotene, but not other antioxidants, was positively associated with muscle strength in older adults.

Protein intake and physical function in older adults: A systematic review and meta-analysis.

The present study explored cross-sectional and longitudinal associations between protein intake and physical function in older adults. We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and measures of physical function in older adults. Cross-sectional, case-control, and longitudinal cohort studies that investigated the association between protein intake and physical function as a primary or secondary outcome in people aged 60+years were included. Studies published in languages other than English, Italian, Portuguese, or Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences (SMD), MD, log odds ratio (OR) and Z-score.. Twenty-two cross-sectional studies examined a total of 11,332 community-dwellers, hospitalized older adults, and elite senior athletes with a mean age of approximately 75 years. The pooled analysis indicated that a protein intake higher than the recommended dietary allowance (RDA) was significantly associated with higher Short Physical Performance Battery (SPPB) scores (SMD: 0.63, 95% CI: 0.27, 0.99, P-value: 0.0006), faster walking speed, greater lower-limb (SMD: 0.22, 95% CI: 0.04, 0.40, P-value: 0.02) and isometric handgrip strength (Z-score: 0.087, 95% CI: 0.046-0.128, P-value: 0.0001), and better balance (SMD: 0.33, 95% CI: 0.05, 0.62, P-value: 0.02). Nine longitudinal studies investigated 12,424 community-dwelling and native older adults with a mean age of approximately 85 years. A protein intake higher than the current RDA was not associated with lower decline in either isometric handgrip strength (logOR: 0.99, 95% CI: 0.97-1.02, P-value= 0.67) or walking speed (logOR: 0.92, 95% CI: 0.77-1.10, P-value= 0.35). A protein intake higher than the RDA is cross-sectionally associated with better physical performance and greater muscle strength in older adults. However, a high consumption of proteins does not seem to prevent physical function decline over time.

Effectiveness of Elastic Band Exercises on the Functional Fitness of Older Adults in Long-Term Care Facilities.

Population aging has caused a rise in the institutionalization, disability, and mortality rates of older adults worldwide. Older adults are able to engage in muscle training. Elastic band exercises can safely and effectively improve the upper and lower muscle strength and balance of older adults. This study was developed to examine the effects of a 3-month elastic band exercise program on the activities of daily living (ADLs), hand muscle strength, balance, and lower limb muscle strength of older adults living in institutional settings. This was a randomized controlled trial. Sixty-one participants were randomly sampled from two long-term care facilities (LTCFs) in northern Taiwan (31 participants in the experimental group and 30 participants in the control group). Both groups underwent pretesting concurrently. The experimental group participated in 3 months of elastic band exercises, whereas the control group participated in the routine exercise program in their LTCFs. All of the participants were tested 1 and 3 months after the intervention. The average ADL, hand muscle strength, balance, and lower limb muscle strength scores of participants in the experimental group had improved significantly more than those of the control group at posttest (all p s < .05). Elastic band exercises positively affect ADLs, hand muscle strength, balance, and lower limb muscle strength in older adults living in LTCFs. Moreover, the high benefit-to-cost ratio of these exercises helps lower the threshold of health promotion. We recommend including elastic band exercises in routine activities and designing different elastic band exercises for older adults at different proficiency levels. Furthermore, an elastic band exercise network should be established to improve the policy and implementation aspects of elastic band activities, raise awareness among community-dwelling and institutionalized older adults, and promote elastic band exercises to LTCFs nationwide.

Longitudinal association of handgrip strength with all-cause and cardiovascular mortality in older adults using a causal framework.

To date, there is no study addressing the time-varying confounding bias in the association of handgrip strength (HGS) with all-cause or cardiovascular mortality. Therefore, we conducted marginal structural models (MSM) to provide causal estimations on the associations of HGS with all-cause and cardiovascular mortality in a representative sample of adults aged 50years or older. Data from 29 countries including 121,116 participants (276,994 observations; mean age 63.7years; 56.3% women) free from prior heart attack or stroke were retrieved from consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). During a median of 7.7years follow-up (interquartile range 3.8-11.8) and 1,009,862 person-years, 6407 participants (5.3%) died due to all causes, and 2263 (1.9%) died due to cardiovascular diseases. Using repeated measures of handheld dynamometry, we determined absolute and relative to body mass index HGS of each participant. We applied adjusted MSM to estimate hazard ratios (HRs) associated with changes over time in HGS addressing the time-varying confounding bias. An increase of 5kg in HGS was associated with a reduced risk of all-cause [HR 0.86, 95% confidence interval (CI), 0.86-0.90], overall cardiovascular (HR 0.86, 95% CI 0.82-0.86), heart attack (HR 0.90, 95% CI 0.86-0.95), and stroke (HR 0.86, 95% CI 0.82-0.90) mortality. The associations of relative HGS were of stronger magnitude in all cases. Our findings provide critical evidence on the importance of increasing general muscle strength in older adults to reduce mortality risk, particularly concerning cardiovascular causes.

Association between Plasma Omega-3 and Handgrip Strength According to Glycohemoglobin Levels in Older Adults: Results from NHANES 2011-2012.

Background: Low muscle strength is a predictor of mortality in older adults. Although the evidence concerning hyperglycemia is limited, evidence shows that omega-3 (ω-3) intake may be positively associated with muscle strength. However, the association between plasma ω-3 and muscle strength in older adults according to glycohemoglobin (HbA1c) levels has not yet been investigated. Objective: To evaluate whether plasma ω-3 levels are associated with handgrip strength in individuals over 50 years according to HbA1c levels. Methods: This cross-sectional study included 950 older adults (50–85 years) from NHANES 2011–2012. Linear regression analysis was performed to evaluate the association between plasma ω-3 and handgrip strength in individuals with elevated (≥5.7%) or normal HbA1c levels after adjustments for confounders. Results: Total plasma ω-3, docosahexaenoic acid, eicosapentaenoic acid and alpha-linolenic acid were not associated with handgrip strength in older adults regardless of HbA1c levels. Conclusion: Plasma ω-3 levels are not associated with handgrip strength in individuals over 50 years old independent of HbA1c levels.

Effect of Multicomponent Home-Based Training on Gait and Muscle Strength in Older Adults After Hip Fracture Surgery: A Single Site Randomized Trial

ObjectiveTo investigate the effect of 16-week home-based physical therapy interventions on gait and muscle strength. DesignA single-blinded randomized controlled trial. SettingGeneral community. ParticipantsThirty-four older adults (N=34) post hip fracture were randomly assigned to either experimental group (a specific multi-component intervention group [PUSH], n=17, 10 women, age=78.6±7.3 years, 112.1±39.8 days post-fracture) or active control (a non-specific multi-component intervention group [PULSE], n=17, 11 women, age=77.8±7.8 years, 118.2±37.5 days post-fracture). InterventionPUSH and PULSE groups received 32-40 sessions of specific or non-specific multi-component home-based physical therapy, respectively. Training in the PUSH group focused on lower extremity strength, endurance, balance, and function for community ambulation, while the PULSE group received active movement and transcutaneous electrical nerve stimulation on extremities. Main Outcome MeasuresGait characteristics, and ankle and knee muscle strength were measured at baseline and 16 weeks. Cognitive testing of Trail Making Test (Part A: TMT-A; Part-B: TMT-B) was measured at baseline. ResultsAt 16 weeks, both groups demonstrated significant increases in usual (P<.05) and fast (P<.05) walking speed, while there was no significant difference in increases between the groups. There was only 1 significant change in lower limb muscle strength over time (non-fractured side) between the groups, such that PUSH did better (mean: 4.33%, 95% confidence interval:1.43%-7.23%). The increase in usual and fast walking speed correlated with the baseline Trail-making Test-B score (r=-0.371, P=.037) and improved muscle strength in the fractured limb (r=0.446, P=.001), respectively. ConclusionGait speed improved in both home-based multicomponent physical therapy programs in older adults after hip fracture surgery. Muscle strength of the non-fractured limb improved in the group receiving specific physical therapy training. Specific interventions targeting modifiable factors such as muscle strength and cognitive performance may assist gait recovery after hip fracture surgery.

Validity And Reliability Of Hand-held Dynamometer In Assessing Isometric Leg Strength In Older Adults

The hand-held dynamometer (HHD) is portable in measuring an isometric muscle strength at multiple angles and limbs. The accuracy and consistency of the HHD in measuring muscle strength in older adults remains less explored. PURPOSE:We investigated the sex-specific and overall concurrent validity and interclass reliability of the HHD (microFET 2) in assessing isometric leg muscle strength in older men and women. We also constructed the prediction model for isometric leg strength using HHD, gait-speed, sit-to-stand, handgrip strength, and sex. METHODS: Forty-eight older adults (12 males and 36 females), aged 60-85 years, were recruited for this study. All participants had anthropometric, dual-energy x-ray absorptiometry, gait speed, sit-to-stand, handgrip, and hand-held dynamometer measurements. All participants also had both isometric and isokinetic leg strengths assessed by a Biodex isokinetic dynamometer. Pearson partial correlations were used to investigate the concurrent validity of HHD compared with an isokinetic dynamometer after adjustment for age and race and additional adjustment for sex. Cronbach alpha coefficients (α) were used to estimate the interclass reliability of HHD. Multiple regression with stepwise selection procedures were used to develop the prediction models for isometric leg strength with HHD, gait-speed, sit-to-stand, handgrip strength, and sex. RESULTS: Age-, sex-, and race-adjusted partial Pearson correlation coefficients were 0.62 for isokinetic leg strength (p < 0.001) and 0.90 for isometric leg strength (p < 0.001) with the HHD. Age- and race-adjusted partial Pearson correlations between isometric leg strength and HHD were 0.93 for men and 0.81 for women, and between isokinetic leg strength and HHD were 0.45 for men and 0.59 for women. Stepwise regression procedures documented the prediction model for isometric leg strength with HHD, gait-speed, and sex (R2 = 0.93, SEE = 5.01). Cronbach α coefficients showed high interclass reliabilities in estimating the leg muscle strength using the HHD in men (α = 0.99) and women (α = 0.97). CONCLUSIONS: The HHD (microFET 2) had high concurrent validity and interclass reliability in assessing the isometric leg muscle strength in older adults.

Effect of concurrent and multi-component training on balance, fear of falling, and muscle strength in older adults: a review

Effect of concurrent and multi-component training on balance, fear of falling, and muscle strength in older adults: a review

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.

Diet-induced inflammation is associated with sarcopenia and muscle strength in older adults who visit a frailty clinic.

Diet-induced inflammation may be associated with sarcopenia; however, few reports have examined this relationship. To examine the association between the dietary inflammatory index (DII) and sarcopenia in older adults who visited a frailty clinic in Japan. This cross-sectional study used outpatient data from the Frailty Registry Study. The DII is an index of diet-induced inflammation, and a dietary assessment was performed using a brief self-administered diet history questionnaire to calculate the DII score. We classified DII scores by quartiles (Q1-Q4), and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. Logistic regression analyses for sarcopenia were performed. Age, sex, comorbidities, and physical activity were entered as confounding factors (Model 1) and Models 2, 3, and 4 with BMI, protein intake, and energy intake added to Model 1. We included 304 patients in the analysis (mean age, 77.6 ± 6.3years; female, 67.4%). The prevalence of sarcopenia was 14.5%. Logistic regression analyses showed that DII scores were significantly associated with sarcopenia in Model 1 and 2 (Model 1, reference: Q1, Q4: OR 3.10, P = 0.020; Model 2, Q4: OR 3.40, P = 0,022) but not in Model 3 and 4. Diet-induced inflammation is associated with a higher likelihood of sarcopenia; however, this association disappeared after confounding for protein and energy intake. The results demonstrated that dietary protein and energy parameters were the main drivers for muscle health in medical patients.

Association between dietary inflammatory index score and muscle mass and strength in older adults: a study from National Health and Nutrition Examination Survey (NHANES) 1999–2002

PurposeChronic low-grade systemic inflammation affects muscle protein metabolism. The dietary inflammatory index (DII®) is a tool designed to assess the inflammatory potential of the diet. The available data on the association between DII and sarcopenia are limited. We aimed to investigate the association of the DII with components of sarcopenia in individuals over 50 years of age.MethodsThis cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999–2002 dataset. Body composition was measured, and isokinetic strength of the knee extensors (peak force) was evaluated. Low muscle mass and strength were defined using sex-specific thresholds. Energy-adjusted DII (E-DII™) scores were calculated using 24-h dietary recall data. Regression models were fit to evaluate the association between E-DII scores and low muscle mass and low muscle strength, alone and combined.ResultsMean age of study participants was 62.1 ± 9.5 years, and 138 participants (7.4%) belonged to the combination group of low muscle mass and low muscle strength. In multivariable-adjusted regression models, higher E-DII score was associated with lower appendicular skeletal muscle index (ASMI) (β = − 0.03, P < 0.001, P trend <0.001), and lower peak force (β = −2.15, P = 0.04, P trend = 0.01) and higher likelihood for these components combined (OR = 1.12, 95% CI 1.01–1.25, P = 0.03).ConclusionHigher E-DII score is associated with lower muscle mass and muscle strength, and increased likelihood for the combination of low muscle mass and low muscle strength in older adults. This has important implications for healthy aging.

Protein intake, physical activity and grip strength in European and North American community-dwelling older adults: a pooled analysis of individual participant data from four longitudinal ageing cohorts.

Higher dietary protein, alone or in combination with physical activity (PA), may slow the loss of age-related muscle strength in older adults. We investigated the longitudinal relationship between protein intake and grip strength, and the interaction between protein intake and PA, using four longitudinal ageing cohorts. Individual participant data from 5584 older adults (52% women; median: 75, IQR: 71.6, 79.0 years) with up to 8.5 years (mean: 4.9, SD: 2.3 years) of follow-up from the Health ABC, NuAge, LASA and Newcastle 85+ cohorts were pooled. Baseline protein intake was assessed with food frequency questionnaires and 24h recalls and categorized into <0.8, 0.8-<1.0, 1.0-<1.2 and ≥1.2 g/kg adjusted body weight (aBW)/d. The prospective association between protein intake, its interaction with PA, and grip strength (sex- and cohort-specific) was determined using joint models (hierarchical linear mixed effects and a link function for Cox proportional hazards models). Grip strength declined on average by 0.018 SD (95%CI: -0.026, -0.006) every year. No associations were found between protein intake, measured at baseline, and grip strength, measured prospectively, or rate of decline of grip strength in models adjusted for sociodemographic, anthropometric, lifestyle and health variables (e.g., protein intake ≥1.2 vs <0.8 g/kg aBW/d: β= -0.003, 95%CI: -0.014,0.005 SD per year). There also was no evidence of an interaction between protein intake and PA. We failed to find evidence in this study to support the hypothesis that higher protein intake, alone or in combination with higher PA, slowed the rate of grip strength decline in older adults.

Use of Antipsychotics is Negatively Associated with Muscle Strength in Older Adults with Sarcopenia after Stroke

ObjectiveThe use of antipsychotics has been shown to affect activities of daily living during rehabilitation but reports regarding their effects on older patients with sarcopenia are insufficient. We aimed to examine the effect of the use of antipsychotics on muscle strength and muscle mass in older patients with sarcopenia undergoing convalescent rehabilitation after stroke. MethodsThis retrospective cohort study was conducted at a rehabilitation hospital between 2015 and 2020. The study outcomes included skeletal muscle mass index and hand grip strength at discharge. Multivariate analyses were used to determine whether the use of antipsychotics at admission and at 4 weeks after admission were independently associated with the study outcomes, after adjusting for potential confounders. ResultsOf the 619 stroke patients admitted, 196 (mean age 81 years; 44.4% men) had sarcopenia at admission and were included in the final analysis. The median hand grip strength and median skeletal muscle mass index values were 12.5 (5.9–17.9) kg and 5.1 (4.5–6.0) kg/m2, respectively. In the multivariate analyses, the use of antipsychotics at 4 weeks post-admission was independently associated with hand grip strength at discharge (β = –0.125, p = 0.008), which was not the case when used at admission. Furthermore, the use of antipsychotics at admission and at 4 weeks after admission were not significantly associated with the skeletal muscle mass index at discharge. ConclusionsThe use of antipsychotics in older patients with sarcopenia after stroke was negatively associated with handgrip strength at discharge.

Plasma levels of myokines and inflammatory markers are related with functional and respiratory performance in older adults with COPD and sarcopenia

This study investigated whether blood-based biomarkers were related to functional test performance and respiratory muscle strength in older adults with COPD and sarcopenia. The participants included in this cross-sectional study were from both sexes and sixty years or older. Based on clinical assessment, participants were categorized in COPD (n=43) and non-COPD (NCOPD) (n=43) groups. They were also assessed for body composition and muscular mass by dual-energy X-ray absorptiometry, using the relative skeletal muscle index for the diagnosis of sarcopenia. A series of functional tests, including short physical performance battery (SPPB), 6-minute walking test (6MWT), maximal inspiratory and expiratory pressures (MIP and MEP), were carried out. Plasma levels of myokines (Irisin and BDNF), and soluble TNF receptors (sTNFR1 and sTNFR2) were determined by ELISA. In the multivariate analysis, 6MWD was associated with age, COPD-related sarcopenia and BDNF (R2=0.29; f2=0.41). SPPB score was associated with COPD-related sarcopenia and sTNFR1 (R2=0.25; f2=0.33). MIP value was associated with sex, COPD-related sarcopenia, sTNFR2 and Irisin (R2=0.24; f2=0.31). Finally, MEP value was associated with sex COPD-related sarcopenia (R2=0.18; f2=0.22). Plasma levels of myokines and inflammatory markers are related with functional and respiratory performance in older adults with COPD and sarcopenia.

실내 및 실외 운동프로그램이 여성노인의 심혈관계와 근력에 미치는 영향

An exercise-based mindful program made effects on the cardiovascular system and muscle strength in older adults. Numerous studies have indicated that exercise training has a beneficial effect on health; but the results of mindful-based exercise program between acute indoor and outdoor programs were still unclear. This study conducted an acute mindful exercise program and outdoor midnful exercise program for 18 older women. The mindful exercise program was based on 12 movements, including controlling the breath in 23 minutes of exericse time. After the acute indoor and outdoor exercise programs, the participants showed significantly improved blood pressure, oxygen saturation, and branchial-ankle pulse wave velocity compared with acute indoor exercise program. In conclusion, the acute outdoor mindful exercise program had more beneficial effects on the cardiovascular system in older women compared with acute indoor exercise program.

Interventions for Body Composition and Upper and Lower Extremity Muscle Strength in Older Adults in Rural Taiwan: A Horizontal Case Study.

The purpose of this study was to understand the effects of a physical activity program and high-protein supplementation on body composition and upper and lower extremity muscle strength in male older adults in rural areas. In this study, 60 healthy male older adults (mean age 77.5 ± 4.6 years) from rural areas were recruited and randomly assigned to experimental group A (intervention of the physical activity program and high-protein supplementation), experimental group B (daily routine, with only intervention of high-protein supplementation), or control group C (daily routine). Experimental group A (EGa) carried out a physical activity plan three times a week, with an exercise intensity and calorie consumption of 250 kcal (5METs × ⅔hr × 75) for 3 months and drank a high-protein supplement (1.3 g/kg BW/day) after each exercise; experimental group B (EGb) followed only the intervention of high-protein supplementation. All the participants underwent pre- and post-tests for body composition, waist–hip circumference (WC, HC), handgrip strength (HS), 30 s dominant arm curl, 30 s sit to stand, and 2 min step tests. The results of the study showed that EGa significantly decreased body mass index (BMI), body fat mass (BFM), body fat percentage (BFP), WC, HC, and waist-to-hip ratio (WHR) and increased basal metabolic rate and muscle mass. Although both EGa and EGb used high-protein supplementation, EGa’s added three-month intervention of a physical activity program made it easier for that group to increase muscle mass and muscle strength. The WHR decreased from 1.015 to 0.931, representing a decrease of 8.28%, and an obvious weight loss effect was achieved. Thus, we concluded that the best way to maintain muscle strength in older adults is through physical activity with resistance and protein supplementation, which can reduce muscle loss in older adults.