Prevalence Of Locomotive Syndrome Research Articles

Identifying factors associated with locomotive syndrome using machine learning methods: The third survey of the research on osteoarthritis/osteoporosis against disability study.

To identify factors associated with locomotive syndrome (LS) using medical questionnaire data and machine learning. A total of 1575 participants underwent the LS risk tests from the third survey of the research on osteoarthritis/osteoporosis against disability study(ROAD) study. LS was defined as stage 1 or higher based on clinical decision limits of the Japanese Orthopaedic Association. A total of 1335 items of medical questionnaire data came from this study. The number of medical questionnaire items was reduced from 1335 to 331 in data cleaning. From the 331 items, identify factors associated with LS use by light gradient boosting machine-based recursive feature elimination with cross-validation. The performance of each set was evaluated using an average of seven performance metrics, including 95% confidence intervals, using a bootstrapping method. The smallest set of items is determined with the highest average of receiver operating characteristic area under the curve (ROC-AUC) under 20 items as association factors of LS. Additionally, the performance of the selected items was compared with the LS risk tests and Loco-check. The nine items have the best average ROC-AUC under 20 items. The nine items show an average ROC-AUC of 0.858 (95% confidence interval 0.816-0.898). Age and back pain during walking were strongly associated with the prevalence of LS. The ROC-AUC of nine items is higher than that of existing questionnaire-based LS assessments, including the 25-question Geriatric Locomotor Scale and Loco-check. The identified nine items could aid early LS detection, enhancing understanding and prevention. Geriatr Gerontol Int 2024; 24: 806-813.

Prevalence and associated factors of locomotive syndrome in young Japanese adults: a cross-sectional study

BackgroundThe onset of locomotive syndrome (LS) precedes that of frailty. Therefore, the first step in extending healthy life expectancy is to implement measures against LS in young adults. The aim of this study was to investigate the prevalence of LS and its associated factors in young adults for early detection and prevention of LS.MethodsThe participants of this study comprised 413 university students specializing in health sciences (192 males and 221 females) with an average age of 19.1 ± 1.2 years. All participants voluntarily participated in the study and reported no serious health problems. The presence or absence of LS was evaluated using the stand-up test, two-step test, and the 25-question Geriatric Locomotive Function Scale. Additionally, musculoskeletal assessment (one-leg standing, squatting, shoulder elevation, and standing forward bend), body composition analysis (weight, body mass index, body fat mass, body fat percentage, skeletal muscle mass index (SMI), and phase angle), handgrip strength test, physical activity assessment, and nutritional assessment were conducted. Sex-stratified analyses were performed, comparing groups with and without LS. Factors associated with LS were explored using binomial logistic regression.ResultsOf the 413 young adults studied, 86 individuals (20.8%) were found to have LS. When stratified by sex, LS was observed to have a considerably higher prevalence in females (55, 24.9%) than in males (31, 16.1%). In males, the notable differences between the groups with and without LS were observed in one-leg standing and phase angle, whereas in females, differences were identified in body fat mass, body fat percentage, SMI, musculoskeletal pain, and handgrip strength. Two types of binomial logistic regression analysis revealed that the inability to perform one-leg standing was associated with LS in males, while the presence of musculoskeletal pain and a high body fat percentage were identified as factors associated with LS in females.ConclusionsOne in five young adults were found to have LS in this study, underscoring the necessity for early intervention and LS health education. Furthermore, effective management of musculoskeletal pain is also crucial.

The relationship between locomotive syndrome anddepression inyoung Chinese college students.

This study investigates the relationship between locomotive syndrome (LS) and mental disorder (depression) in young Chinese college students. Our study population (n = 165; mean age of 19.82 ±1.90 years) comprises college student residents at Tsinghua University in Beijing, China. Three screening methods were used to evaluate LS: 25-question Geriatric Locomotive Function Scale (GLFS-25), a two-step test, and a stand-up test. Depression was screened by the Chinese version of the Zung Self-Rating Depression Scale (ZSDS). The prevalence of LS and depression was 20.1% and 30.9%, respectively. The LS group had lower grip strength and higher ZSDS scores than the non-LS group. Young Chinese college students have a relatively high prevalence of LS, and LS and GLFS-25 scores were significantly related to depression. The present results suggest that management strategies for LS should consider depressive symptoms among young adults.

Impact of spinal sagittal malalignment on locomotive syndrome and physical function in community-dwelling middle aged and older women

BackgroundAdult spinal deformity has a substantially debilitating effect on older people’s physical and mental health. However, the impact of sagittal malalignment on locomotive syndrome (LS), sarcopenia, and physical function in community-dwelling older women has not yet been clarified. This study aimed to investigate the association between these factors in community-dwelling middle aged and older women.MethodsA total of 361 women were recruited from participants performing aquatic exercises in a rural area of Japan. The body mass index, skeletal muscle mass index, trunk muscle mass, spinal inclination angle (SIA), grip strength, timed up-and-go test (TUG), maximum stride of the participants, and one-leg standing time were measured. Low back pain (LBP)- and health-related quality of life (HRQOL) were evaluated using the Oswestry Disability Index (ODI) and the Short-Form 8 questionnaire. Associations between the global sagittal alignment using SIA and investigating parameters were analyzed.ResultsThe prevalence of sarcopenia was 3.6%. The prevalence of LS (stages 1, 2, and 3) was 43.8% (158 of 361), and the number of participants in each LS stage was 203 (stage 0), 95 (stage 1), 28 (stage 2), and 35 (stage 3). The SIA was significantly correlated with the 25-question geriatric locomotive function scale (r′ = 0.292, p < 0.001), ODI (r′ = 0.267, p < 0.001), and TUG (r′ = 0.453, p < 0.001) after adjusting for age. In the receiver-operating characteristic curve analysis, the cutoff values of SIA for LS ≥ stage 2 and ODI ≥ 20% were 5°.ConclusionsLBP-related QOL and physical performance were significantly associated with global sagittal alignment. Global sagittal alignment was correlated with the three-stage category of LS. The spinal inclination of 5° was a cutoff value to predict exacerbation of mobility function and HRQOL status.

Relationship between Locomotive Syndrome and Musculoskeletal Pain and Generalized Joint Laxity in Young Chinese Adults

This study aims to investigate the prevalence of locomotive syndrome (LS) and to examine the relationship of LS with musculoskeletal symptoms (pain, generalized joint laxity (GJL)) in young Chinese adults. Our study population (n = 157; mean age of 19.8 ± 1.2 years) comprises college student residents at Tsinghua University in Beijing, China. Three screening methods were used to evaluate LS: 25-question Geriatric Locomotive Function Scale (GLFS-25), a two-step test, and a stand-up test. Musculoskeletal pain was assessed by self-report and visual analog scale (VAS), and joint body laxity was evaluated using the GJL test. The prevalence of LS was 21.7% of all participants. Musculoskeletal pain affected 77.8% of the college students with LS and was strongly associated with LS. A total of 55.0% of college students with LS had four or more site joints that were positive for GJL, and higher scores of GJL were associated with a higher prevalence rate of LS. Young Chinese college students have a relatively high prevalence of LS, and musculoskeletal pain and GJL were significantly related to LS. The present results suggest that we need early screening of musculoskeletal symptoms and LS health education in young adults to prevent the mobility limitations of LS in the future.

The prevalence of locomotive syndrome and its associated factors in patients with Type 2 diabetes mellitus.

We investigated the prevalence of locomotive syndrome (LS) and related musculoskeletal diseases [osteoarthritis (OA), lumbar spondylosis, and spinal alignment] in Type 2 diabetes mellitus (DM) patients. Clinical data were collected from 101 patients (55 males; 46 females) admitted to our hospital for diabetes education from October 2018 to April 2021. Patients underwent full-spine and whole-legs standing radiography and physical measurements (10-m walking and grip strength tests and three LS risk tests). The estimated prevalence of LS was 86.1% (Stage 1: 44.5%, Stage 2: 41.6%), lumbar spondylosis was 11.9%, and hip, knee, and ankle OA were 16.9%, 51.5%, and 12.9%, respectively. Multiple logistic regression analysis identified grip strength [odds ratio (OR) = 0.89, confidence interval (CI) = 0.83-0.94], diabetic retinopathy (OR = 5.85, CI = 1.64-20.78), knee OA (OR = 3.34, CI = 1.11-10.02), and a sagittal vertical axis >40 mm (OR = 3.42, CI = 1.13-10.39) as significantly associated risk factors for worsening LS in Type 2 DM patients. This study clarified the epidemiological indicators of LS and associated factors in DM patients. Exercise therapy and DM management are effective strategies to reduce the occurrence and progression of LS.

Does Locomotive Syndrome, Associated with Sarcopenia or otherwise, Influence Quality of Life in Individuals Aged over 80 years? Third Wave of the LOCOMOV Project

Introduction: Locomotion is a determinant of intrinsic capacity ofolder people and can be limited by dysfunction in locomotory organs,characterizing Locomotive Syndrome (LoS). Knowledge on locomotiveproblems and sarcopenia, and their interface with quality of life, in theoldest old in the literature is scarce.Objective: To evaluate the correlation between LoS and sarcopenia andtheir influence on quality of life in oldest old.Methods: A cross-sectional study of an observational, descriptive andanalytical epidemiological survey in independent older adults aged 80and over from São Paulo, Brazil and who participated in the third waveof the LOCOMOV Project, was carried out. Sociodemographic data,comorbidities, functioning in activities of daily living, physical functioning,quality of life, and presence of sarcopenia and LoS were assessed. Thestatistical analyses included the Test-for-Comparing-Two-Proportions,Pearson's Correlation Coefficient, the chi-Square test and Student´s t-test.Results: Thirty oldest old with a mean age of 89.1 years were evaluated.The prevalence of LoS was high (53.3%) and correlated significantly withchronic pain (p-value 0.024), worse performance on the SPPB and Gaitspeed (p-value &lt;0.001). Sarcopenia was not correlated with LoS, but worsequality of life on the physical domain was significantly associated with LoS(p-value &lt;0.001) regardless of the presence of sarcopenia.Conclusions: LoS was highly prevalent among the oldest old studied andnegatively impacted their quality of life, regardless of the presence ofsarcopenia.

Prevalence and physical characteristics of locomotive syndrome stages as classified by the new criteria 2020 in older Japanese people: results from the Nagahama study

BackgroundThe Japanese Orthopaedic Association (JOA) proposed the concept of locomotive syndrome (LS) in 2007 for detecting high-risk individuals with mobility limitation. In 2020, the JOA revised the clinical decision limits and introduced LS stage 3, which carried the highest-risk for LS compared to the conventional stages, 1 and 2. The purpose of this study was to characterize the prevalence, comorbidities, and physical characteristics in each LS stage, as per the LS criteria 2020.MethodsWe analyzed 2077 participants (64.9% women; mean age, 68.3 ± 5.4 years) from the Nagahama Study aged ≥60 years. Participants were classified into 4 groups, non-LS and LS stages 1, 2, and 3, based on a 25-question Geriatric Locomotive Function Scale. The prevalence of comorbidities (sarcopenia, osteoporosis, diabetes mellitus, low back pain [LBP], and knee pain) were investigated. Physical characteristics were measured based on the physical performance tests including gait speed, five-times chair-stand, single-leg stand, and short physical performance battery; muscle strength tests including grip, knee extension, hip flexion, and abduction; and body-composition analysis including muscle quantity and quality. Differences in the prevalence of comorbidities between LS stages were tested using the chi-square test. The general linear model was performed for univariate and multivariate analyses with post-hoc test to compare the differences in physical characteristics among the LS stages.ResultsThe prevalence of LS increased with age, and the mean prevalence of LS stages 1, 2, and 3 were 24.4, 5.5, and 6.5%, respectively. The prevalence of comorbidities, including sarcopenia, osteoporosis, LBP, and knee pain, increased with worsening LS stage. Physical performance tests were significantly different between LS stages 2 and 3; and muscle strength differed significantly between LS stages 1 and 2. Additionally, in terms of body composition analysis, muscle quality but not muscle quantity showed significant differences among all the LS stages.ConclusionsOur findings suggest that muscle strengthening and dynamic training, including balance training in LS stage 1 and 2, respectively, were needed for preventing the LS progression. Individuals with LS stage 3 should perform dynamic training and muscle strengthening exercises while receiving treatment for comorbidities.

Impact of the COVID-19 pandemic on the development of locomotive syndrome.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has affected people in various ways, including restricting their mobility and depriving them of exercise opportunities. Such circumstances can trigger locomotor deterioration and impairment, which is known as locomotive syndrome. The purpose of this study was to investigate the incidence of locomotive syndrome in the pandemic and to identify its risk factors. Methods: This was a multicenter questionnaire survey performed between 1 November 2020 and 31 December 2020 in Japan. Patients who visited the orthopedics clinic were asked to answer a questionnaire about their symptoms, exercise habits, and locomotor function at two time points, namely, pre-pandemic and post-second wave (current). The incidence of locomotive syndrome in the COVID-19 pandemic was investigated. Additionally, multiple logistic regression analysis was used to identify the risk factors for developing locomotive syndrome during the pandemic. Results: A total of 2829 patients were enrolled in this study (average age: 61.1 ± 17.1years; 1532 women). The prevalence of locomotive syndrome was 30% pre-pandemic, which increased significantly to 50% intra-pandemic. Among the patients with no symptoms of locomotive syndrome, 30% developed it in the wake of the pandemic. In the multinomial logistic regression analysis, older age, deteriorated or newly occurring symptoms of musculoskeletal disorders, complaints about the spine or hip/knee joints, and no or decreased exercise habits were independent risk factors for developing locomotive syndrome. Conclusions: The prevalence of locomotive syndrome in patients with musculoskeletal disorders has increased during the COVID-19 pandemic. In addition to age, locomotor symptoms, especially spine or hip/knee joint complaints, and exercise habits were associated with the development of locomotive syndrome. Although the control of infection is a priority, the treatment of musculoskeletal disorders and ensuring exercise habits are also essential issues to address during a pandemic such as COVID-19.

Differences in the prevalence of locomotive syndrome and osteoporosis in Japanese urban and rural regions: The Kashiwara and Yakumo studies.

To clarify whether the prevalence of locomotive syndrome (LS) and osteoporosis differed according to region, gender, and physical functions in Japan. Data were collected in Kashiwara City (urban region) and Yakumo Town (rural region). Totally, 208 participants from the urban region and 782 participants from the rural region were included in this study. LS was assessed using the 25-item Geriatric Locomotive Function Scale and osteoporosis was assessed using a quantitative ultrasound. Physical functions were measured using grip strength and the 3-m timed up-and-go test. Differences between urban and rural regions were investigated using standardized incidence ratio and multivariate analysis. The prevalence of LS and osteoporosis was 24.5% and 42.8% in the urban region and 10.9% and 28.8% in the rural region, respectively. The standardized incidence ratio of the urban region versus the rural region was 1.80 (95% confidence intervals [CI] = 1.35-2.39) for LS and 1.21 (95% CI = 1.32-2.43) for osteoporosis, showing that the prevalence of LS was significantly higher in the urban region. Multivariate analysis indicated that LS was significantly associated with the urban sample and timed up-and-go was significantly longer in the urban sample. Regional differences may be considered when evaluating LS in health checkups. Understanding the results of this study may help reduce LS prevalence.

Prevalence of locomotive syndrome in Japanese patients more than 10 years after total hip arthroplasty: A cross-sectional cohort study

BackgroundLocomotive syndrome (LS) is a high risk condition that requires nursing care. It is important to investigate the prevalence of and factors related to LS to maintain a healthy life expectancy for patients; however, only a few reports have focused on the relationship between LS and total hip arthroplasty (THA). The purpose of this study was to evaluate the prevalence of LS and to identify factors associated with LS in patients more than 10 years after THA. MethodsThis is a cross-sectional cohort study. Patients were assessed via a mail survey that included items regarding demographic data, cardiometabolic and motor disorders, the incidence of falls, physical activity level, and the 25-question Geriatric Locomotive Function Scale (GLFS-25) questionnaire. LS was defined as having a score ≥16 on the GLFS-25, and the respondents were categorized into two groups: an LS group and a non-LS group. The prevalence of LS was calculated in each gender and age group. Differences in variables between the groups were determined using the unpaired t-test and chi-squared test. ResultsA total of 593 patients were included in the study (mean age, 70.4 years; 525/593 females). According to the GLFS-25, 164 patients (27.7%; 21.1% men and 28.8% women) were classified as having LS, which increased with age. In addition, compared with the non-LS group, the LS group had a significantly higher prevalence of motor diseases, cardiometabolic diseases, and falls and significantly lower levels of activity. ConclusionThese findings suggest that the prevalence of LS in patients more than 10 years after THA is 27.7%. The result suggest that the prevalence of LS in patients more than 10 years after THA is similar to the prevalence of LS in the general elderly population. Furthermore, LS is related to not only motor diseases but also cardiometabolic diseases.

PREVALENCE AND FACTORS ASSOCIATED WITH LOCOMOTIVE SYNDROME IN COMMUNITY-DWELLING OLDER ADULTS

ABSTRACT Objective: to analyze prevalence and the factors associated with locomotive syndrome in community-dwelling older adults. Method: a cross-sectional study, developed in a municipal center for the care of older adults in Teresina, Piauí, Brazil. The sample was for convenience and comprised 204 older adults aged 60 years or more, of both genders and with preserved cognitive capacity, according to parameters of the Mini Mental State Examination. Data collection occurred from March to November 2018, by applying a form for sociodemographic, clinical and falls occurrence characterization and the 25-item Geriatric Locomotive Function Scale. To measure the strength of the associations between the variables, odds ratios and 95% confidence intervals were adopted. The statistical significance level was set at 5% for the analyses. Results: the prevalence of locomotive syndrome found was 37.2%. The factors associated with the presence of locomotive syndrome were individual monthly income (p=0.005); existence of one of the following comorbidities: systemic arterial hypertension (p=0.039), osteoporosis (p=0.016), arthrosis (p&lt;0.001) or obesity (p=0.014); and history of hospitalization in the last year (p=0.007). Conclusion: the prevalence of locomotive syndrome found in this study was low and presented higher levels in older adults, with an individual monthly income of two to three minimum wages; who reported having hypertension, osteoporosis, arthrosis or obesity; and with a history of hospitalization in the last year. The health condition investigated showed to be related to aging, with significant repercussions on functionality.

Cognitive factors associated with locomotive syndrome in chronic pain patients: A retrospective study

BackgroundPrevention and treatment for locomotive syndrome (LS) are important for extending healthy life expectancy. The 25-question geriatric locomotive function scale (GLFS-25) was developed to diagnose LS. The Fear-Avoidance model was proposed to explain pain chronicity. LS and chronic pain decrease activities of daily living; however, the relationships between LS and factors related to chronic pain in the Fear-Avoidance model are unknown. Objective of the current study was to assess the prevalence of LS and examine the factors of the Fear-Avoidance model and the GLFS-25 that affect the prevalence of LS in patients with chronic pain. MethodsParticipants included 281 patients (99 men, 182 women) aged over 40 years with chronic pain who visited our outpatient clinic for chronic pain. All participants completed the GLFS-25, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), and Athene insomnia scale (AIS). According to a GLFS-25 cutoff point, participants were divided into three groups (LS-2; GLFS-25 ≥ 16, LS-1; 7 ≤ GLFS-25 < 16, and non-LS; GLFS-25 < 7 points) and each parameter was compared among the groups, followed by multiple logistic regression analysis. Next, multiple linear regression analysis was performed to determine the factors associated with the GLFS-25. ResultsOf all 281 patients, 241 (85.8%) patients were diagnosed with LS-2. Univariate analysis revealed there were significant differences in NRS, PCS, HADS anxiety, HADS depression, and AIS among groups. Multiple logistic regression analyses showed PCS was significantly associated with LS-2 prevalence. The GLFS-25 was positively correlated with NRS, HADS depression, AIS in multiple linear regression analysis. ConclusionsWe found that patients with chronic pain in our outpatient clinic had a significant rate of LS-2. The prevalence of LS-2 was significantly correlate with pain catastrophizing, and the GLFS-25 was significantly correlated with higher pain intensity, depression, and insomnia.

Handgrip measurement as a useful benchmark for locomotive syndrome in patients with type2 diabetes mellitus: A KAMOGAWA-DM cohort study.

Aims/IntroductionTo carry out a cross‐sectional single‐center study in a Japanese hospital to determine the diagnostic value of handgrip measurement to detect locomotive syndrome (LS).Materials and MethodsConsecutive outpatients underwent an LS risk test, which comprised a stand‐up test and a two‐step test, and a handgrip measurement, along with general diabetes‐related tests. We calculated the prevalence of LS, and evaluated the association between handgrip strength and LS.ResultsWe enrolled 234 patients in this study. The prevalence of LS in the stand‐up and two‐step tests was 51.5 and 79.0%, respectively. The prevalence of LS in the stand‐up or two‐step tests increased with age both in men and women. Using the stand‐up and two‐step tests, 107 patients (46.7%) were diagnosed with LS. The area under the receiver operating characteristic curve, used to assess our identification of LS in terms of grip strength in men and women, showed 95% confidence intervals of 0.703 (0.563–0.813) and 0.698 (0.500–0.842), respectively. The odds ratios of grip strength for LS were 0.90 (95% confidence interval 0.83–0.97) and 0.87 (95% confidence interval 0.76–0.98) in men and women, respectively.ConclusionsOur findings showed that handgrip measurement was useful in detecting LS, and LS should be considered when evaluating patients with type 2 diabetes mellitus.

Frequency of Going Out and Locomotive Syndrome Among Japanese Female Elderlies

Background: Japan is the world&amp;rsquo;s leading super-aged society, which makes locomotive syndrome an urgent issue. Because increasing the frequency of going out is considered a practical primary preventive measure against locomotive syndrome, we examined the relationship between the frequency of going out and locomotive syndrome in elderly females in Japan. &#x0D; &#x0D; Methods: The subjects were 8,027 females from 46 prefectures in Japan who were living at home and aged 65 and older as of November 1, 2012. The study period was from November 1 to December 31, 2012. The survey was implemented by distributing questionnaires, as well as conducting face&amp;ndash;to&amp;ndash;face interviews. Odds ratios were obtained using logistic regression models with locomotive syndrome as the dependent variable.&#x0D; &#x0D; Results: Eight thousands twenty seven females were analyzed in this study. There was a significant difference in the prevalence of locomotive syndrome depending on the frequency of going out (p&amp;lt;0.001) as the prevalence of locomotive syndrome decreased as the frequency of going out increased. When the results were adjusted for gender, the frequency of going out, age, use of national nursing&amp;ndash;care insurance services, household composition, severity of obesity, and self-rated health, the prevalence of locomotive syndrome was high in those whose frequency of going out was &amp;ldquo;twice or less a week&amp;rdquo; (Odds ratio: 1.41, 95% Confidence interval 1.20&amp;ndash;1.64). &#x0D; &#x0D; Conclusions: The results suggest that it is possible to prevent locomotive syndrome by encouraging elderly people to maintain and increase their frequency of going out.

Lifestyle-related signs of locomotive syndrome in the general Japanese population: A cross-sectional study

BackgroundThis study aimed to estimate the prevalence of locomotive syndrome (LS) risk in age groups using the LS risk test proposed by the Japanese Orthopaedic Association. Based on this, this study identified the lifestyle-related signs that lead to LS, by clarifying the association between LS risk and lifestyle factors. MethodsA total of 728 individuals aged 20–91 years who were without specific mobility disorders were evaluated. Participants were asked to perform the LS risk test and complete a self-administered original questionnaire survey for this study. The Mann–Whitney U test was used to examine the relationships of sex and age with LS. The prevalence of LS by sex and age was compared using the Chi-squared test or Student's t-test, as appropriate. The Mantel–Haenszel test was used to examine the relationship of each component of the lifestyle factors. ResultsOverall, 36.4% of males and 49.1% of females were classified into the LS group; the prevalence of LS was significantly higher in females than males (p < .001). The prevalence of LS tended to increase with age in both males and females (p < .05). As for health condition, pain in the locomotive organs, knees, back, and hip joints was significantly associated with LS (p < .05). Of the lifestyle-related diseases, only hypertension (p < .05) was significantly associated with LS, and drug treatment was significantly associated with LS (p < .05). As for lifestyle, anxiety about physical fitness, self-assessed poor health, irregular dietary habits, and lack of exercise were also associated with LS (p < .05). ConclusionsInterventions to prevent LS are important during its early stages, especially for females, and lifestyle-related signs of LS, such as pain in the locomotive organs, lifestyle-related disease, drug treatment, and a lower subjective evaluation of health must not be overlooked.

Evaluation of factors associated with locomotive syndrome in Japanese elderly and younger patients with rheumatoid arthritis

Objectives: We aimed to determine the prevalence of locomotive syndrome (LS) using the 25-question geriatric locomotive function scale (GLFS-25) and identify factors associated with LS in elderly and younger patients with rheumatoid arthritis (RA).Methods: Overall, 390 patients with RA who underwent GLFS-25 measurement, bone mineral density determination, and bioelectrical impedance analysis were enrolled. Factors associated with LS were analyzed by comparing patients with and without LS among both elderly and younger patients with RA.Results: The prevalence of LS was 41.5%, 47.7% and 32.3% in all patients, elderly patients, and younger patients with RA, respectively. Pain visual analog scale (VAS) and Health Assessment Questionnaire Disability Index (HAQ-DI) were associated with LS in both elderly and younger patients. Moreover, in younger patients with RA, disease activity score in 28 joints (DAS28), erythrocyte sedimentation rate (ESR), basal metabolic rate, and legs muscle mass were identified as being associated with LS.Conclusion: This study demonstrated that to prevent LS, we should aim to control pain and maintain a low HAQ-DI in elderly and younger patients with RA, and improve disease activity and maintain a higher basal metabolic rate, and legs muscle mass in younger patients with RA.

Sub-analysis of the prevalence of locomotive syndrome and its relationship with health-related quality of life in patients with obstructive sleep apnea syndrome as classified by age and sex

The purpose of this study was to investigate the prevalence of locomotive syndrome (LS) in patients with obstructive sleep apnea syndrome (OSAS), and to compare the health-related quality of life (HRQOL) among patients with and without LS as classified by age and sex. A total of 1173 patients with OSAS (1013 males and 160 females) who were treated with continuous positive airway pressure (CPAP) therapy were enrolled in this cross-sectional study. Male participants were divided into 6 groups (30–39 years, 40–49 years, 50–59 years, 60–69 years, 70–79 years, and 80–89 years) and female participants were divided into 5 groups (40–49 years, 50–59 years, 60–69 years, 70–79 years, and 80–89 years). LS was evaluated using a “loco-check” established by the Japanese Orthopedic Association. HRQOL was evaluated using the EuroQol 5-dimensional questionnaire (EQ-5D). The prevalence of LS among the different age and sex groups was 19.6–79.4% in males and 27.0–95.5% in females and increased with age. In males aged 30–39 and 70–79 years, and in females aged 50–59 years, the EQ-5D scores were significantly lower in OSAS patients with LS than in OSAS patients without LS, even after adjusting for confounding factors. In OSAS patients, LS was closely linked to HRQOL. Preventing and improving the outcomes of LS would be beneficial for improving the HRQOL in OSAS patients.

The 25-question Geriatric Locomotive Function Scale predicts the risk of recurrent falls in postoperative patients with cervical myelopathy.

Fall-induced injuries represent a major public health concern for older individuals. The relationship between risk of falling and the severity of locomotive syndrome (LS) remains largely unknown. We conducted a retrospective analysis of patients who had undergone surgery from January 2012 to December 2013 and completed at least 1 year of follow-up at 12 participating institutes. Patients completed a questionnaire survey regarding their fall experience during a routine postoperative follow-up. Questionnaire items included the number of falls during the prior postoperative year and the 25-question Geriatric Locomotive Function Scale (GLFS-25). The severity of cervical myelopathy was assessed using the Japanese Orthopaedic Association (JOA) score. We analyzed the association between the incidence of falling and the severity of LS measured by the GLFS-25. Of 360 patients, 61 (16.9%) experienced 1 fall; 31 (8.6%), 2-3 falls; 4 (1.1%), 4-5 falls; and 6 (1.7%), ≥6 falls during the first postoperative year. Thus, 102 (28%) patients experienced at least 1 fall, and 41 (11%) experienced recurrent falls (2 or more falls) during the time period. The mean GLFS-25 score was 30.2±22.7, and 242 (62%) patients had GLFS-25 scores of 16 or higher, which fulfilled the diagnostic criteria for LS. When subjects were categorized into recurrent fallers and non-recurrent fallers, recurrent fallers had a significantly higher GLFS-25 score and a significantly lower extremity motor function score of the JOA score than non-recurrent fallers. The GLFS-25 and lower extremity motor function score of the JOA score yielded the areas under the receiver operating characteristic curves of 0.674 and 0.607, respectively, to differentiate recurrent fallers from non-recurrent fallers. Postoperative patients with cervical myelopathy had a 62% prevalence of LS. The GLFS-25 may be useful to predict the risk of recurrent falls in patients with cervical myelopathy.

Sarcopenia is a risk factor for falling in independently living Japanese older adults: A 2-year prospective cohort study of the GAINA study.

The purpose of the present study was to investigate whether sarcopenia was associated with future falls in the general Japanese older population. This study was a 2-year prospective observational study. Participants were recruited from individuals who had an annual town-sponsored medical check-up and had not received nursing care. The inclusion criteria for participants in our study were: (i) agreement to participate; (ii) living independently; and (iii) the ability to walk to where the survey was carried out and to provide self-reported data. A total of 223 residents (82 men, 141 women) participated in the baseline assessment in the study. Demographic information, previous fall history, locomotive syndrome, body function and structural measurements and pain at the knee and/or lumber spine were assessed. The Asian Working Group for Sarcopenia algorithm was used to classify the presence of sarcopenia, and assess the history of falling when the participant received their annual medical check-up. A total of 162 participants had an annual follow-up assessment, 50 of whom (30.8%) fell at least once during the 2-year observational period after baseline assessment. Previous falling history, prevalence of locomotive syndrome, sarcopenia and pain were significantly higher in participants who had fallen compared with participants who had not. Multiple logistic regression analysis showed the prevalence of sarcopenia was a significant predictor of falling. The key finding of the present study suggests that sarcopenia is a risk factor for falling in older adults who are living independently even after adjustment for previous falls and confounding factors. Geriatr Gerontol Int 2017; 17: 2124-2130.