Strength In Older Adults Research Articles

Prognostic Value of Handgrip Strength in Older Adults Undergoing Cardiac Surgery

BackgroundAlthough multidimensional frailty scales have been proven to predict mortality and morbidity in cardiac surgery, there is a need for rapid tools that could be easily administered at the point of care. Handgrip strength (HGS) is an attractive option that can be measured in acutely ill and bed-bound patients, although it has yet to be validated in a large cardiac surgery cohort. MethodsThis is a post hoc analysis of a multicentre prospective study in older patients undergoing coronary artery bypass grafting and/or valve surgery from 2011 to 2019. HGS was measured before surgery and classified by sex-stratified cutoffs. The primary outcome was 1-year mortality and secondary outcomes were 30-day mortality, discharge disposition, and prolonged length of stay. ResultsThere were 1245 patients included in the analysis (mean age 74.0 ± 6.6 years; 30% female). Weak HGS was associated with advanced age, heart failure, kidney disease, malnutrition, and various frailty scales. In those with weak vs normal HGS, respectively, 1-year mortality was 17% vs 6%, 30-day mortality was 10% vs 3%, prolonged length of stay was 34% vs 19%, and discharge to a health care facility was 45% vs 26% (all P < 0.001). After adjustment, HGS was predictive of 1-year and 30-day mortalities, with odds ratios of 2.44 (95% confidence interval [CI] 1.39-4.29) and 2.83 (1.38-5.81), respectively. HGS cutoffs of < 26 kg in men and < 16 kg in women had the highest predictive performance. ConclusionsHGS is a simple and effective tool to identify patients at higher risk of mortality and protracted recovery after cardiac surgery.

Maslinic Acid Attenuates Denervation-Induced Loss of Skeletal Muscle Mass and Strength.

Maslinic acid (MA) is a pentacyclic triterpene abundant in olive peels. MA reportedly increases skeletal muscle mass and strength in older adults; however, the underlying mechanism is unknown. This study aimed to investigate the effects of MA on denervated muscle atrophy and strength and to explore the underlying molecular mechanism. Mice were fed either a control diet or a 0.27% MA diet. One week after intervention, the sciatic nerves of both legs were cut to induce muscle atrophy. Mice were examined 14 days after denervation. MA prevented the denervation-induced reduction in gastrocnemius muscle mass and skeletal muscle strength. Microarray gene expression profiling in gastrocnemius muscle demonstrated several potential mechanisms for muscle maintenance. Gene set enrichment analysis (GSEA) revealed different enriched biological processes, such as myogenesis, PI3/AKT/mTOR signaling, TNFα signaling via NF-κB, and TGF-β signaling in MA-treated mice. In addition, qPCR data showed that MA induced Igf1 expression and suppressed the expressions of Atrogin-1, Murf1 and Tgfb. Altogether, our results suggest the potential of MA as a new therapeutic and preventive dietary ingredient for muscular atrophy and strength.

Dietary phytochemicals as a promising nutritional strategy for sarcopenia: a systematic review and meta-analysis of randomized controlled trials

The decline in skeletal muscle mass and strength, also called sarcopenia, accelerates with age, leading to negative health outcomes and poor quality of life. Diet is important to promote health and plays a key role in muscle aging. Plant-based foods have recently received attention as sources of phytochemical components to attenuate loss of muscle mass and strength in older adults. This systematic review and meta-analysis evaluated the benefits of botanical extracts and their phytochemical compounds for muscle health in older adults. Randomized controlled trials were identified via systematic searches of four electronic databases (PubMed, Cochrane Library, Web of Science, and KoreaMed) up to June 2021 and were quality assessed. The results of muscle strength, mass, and physical performance were pooled using a random-effects model. Fourteen studies involving 528 subjects aged between 50 and 80 years met the inclusion criteria. Dietary phytochemicals significantly increased handgrip strength [0.90 kg; 95% confidence interval (CI) 0.26–1.53, p = 0.01] and physical performance (timed up-and-go test: − 0.5 s, 2.73 times; 95% CI − 0.84 to − 0.15, p < 0.01; 30-s chair stand test: 95% CI 0.88–4.59, p < 0.01; 6-min walk test: 29.36 m; 95% CI 14.58–44.13, p < 0.0001) but had no effect on improvement in muscle mass. Publication bias evaluated by funnel plots and Egger’s regression test demonstrated no evidence of substantial publication bias (p > 0.05). The findings of this systematic review and meta-analysis suggest that phytochemicals are a potential nutritional strategy to improve muscle health in older adults.

Weight Loss and Exercise Differentially Affect Insulin Sensitivity, Body Composition, Cardiorespiratory Fitness, and Muscle Strength in Older Adults With Obesity: A Randomized Controlled Trial.

Aging-related disease risk is exacerbated by obesity and physical inactivity. It is unclear how weight loss and increased activity improve risk in older adults. We aimed to determine the effects of diet-induced weight loss with and without exercise on insulin sensitivity, VO2peak, body composition, and physical function in older obese adults. Physically inactive older (68.6 ± 4.5 years) obese (body mass index 37.4 ± 4.9 kg/m2) adults were randomized to health education control (HEC; n = 25); diet-induced weight loss (WL; n = 31); or weight loss and exercise (WLEX; n = 28) for 6 months. Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamp, body composition by dual-energy X-ray absorptiometry and MRI, strength by isokinetic dynamometry, and VO2peak by graded exercise test. WLEX improved (p < .05) peripheral insulin sensitivity (+75 ± 103%) versus HEC (+12 ± 67%); WL (+36 ± 47%) versus HEC did not reach statistical significance. WLEX increased VO2peak (+7 ± 12%) versus WL (-2 ± 24%) and prevented reductions in strength and lean mass induced by WL (p < .05). WLEX decreased abdominal adipose tissue (-16 ± 9%) versus HEC (-3 ± 8%) and intermuscular adipose tissue (-15 ± 13%) versus both HEC (+9 ± 15%) and WL (+2 ± 11%; p < .01). Exercise with weight loss improved insulin sensitivity and VO2peak, decreased ectopic fat, and preserved lean mass and strength. Weight loss alone decreased lean mass and strength. Older adults intending to lose weight should perform regular exercise to promote cardiometabolic and functional benefits, which may not occur with calorie restriction-induced weight loss alone.

The Effects Of Dance-based Exercise On Body Composition, Physical Fitness, And Cognitive Function In Elderly

PURPOSE: The purpose of this study was to determine the effects of dance-based exercise training compared with traditional chair-based exercise on body composition, physical fitness, and cognitive function in the older adults. METHODS: Fourteen older adults (female: 11, male: 3), aged 71.2 ± 8.0 years, were assigned into two groups: dance-based exercise (DE; n = 8) and traditional chair-based exercise (TE; n = 6). Both forms of exercise training were provided twice a week during 8 weeks and were performed for 60 min per session. Each session included 30 min main exercises, a 10 min warm-up, a 10 min cool-down, and short breaks between the different exercises or movements adding another 10 min. The intensity of two different types of exercise programs was adjusted (60-80% of maximal heart rate) by a physical activity tracker, which recorded heart rates (HR) during the exercise session. The DE program focused on elementary spins (longitudinal turns), shifts of center of gravity (COG), single-leg stances, skips and hops, different steps (i.e., mambo, cha cha, grapevine, jazz square) to challenge the balance system. Height (cm), body mass (kg), waist circumference (cm), hip circumference (cm), percent body fat (%), blood pressure (mmHg), resting HR (b·min-1), muscular strength (kg), balance ability (s), and cognitive function (score) were measured pre- and post-intervention, and the results were analyzed utilizing a repeated measures two-way ANOVA (p < 0.05). RESULTS: Balance ability (one-leg standing with eyes open, left leg) was significantly increased only in DE (13.2 ± 17.8 to 21.6 ± 19.5 s, p = .007). Systolic blood pressure was significantly decreased only in TE (142.0 ± 16.4 to 127.0 ± 13.8 mmHg, p = .024). Waist circumference (p = .006) and 30-second chair stand (p = .004) were significantly improved in both groups. There was no significant difference in other variables after 8 weeks of training. CONCLUSION: The results indicate that dance-based exercise is an effective exercise regimen compared to the traditional chair-based exercise to improve balance ability and lower body muscular strength in older adults.

Amount of Daily Protein Intake Is Not Associated with Skeletal Muscle Strength in Older Adults

Amount of Daily Protein Intake Is Not Associated with Skeletal Muscle Strength in Older Adults

Brainstem Dysfunction in Healthy Aging

The brainstem controls sub-cortical and cortical activity and influences the processing of incoming information. The goal of this study was to characterize age related alterations of brainstem-brain interactions during different brain states detected by dynamic analysis of task-free fMRI. 79 young (20-40 years) and 51 older adults (55-80 years) were studied. Internal brainstem structures were segmented using a new multi-contrast segmentation approach. Brain and brainstem gray matter segmentations were warped onto a population template. The ICV-corrected Jacobian determinants were converted into z-score maps and the means from 420 cortical/subcortical/brainstem rois extracted. The fMRI was preprocessed in SPM12/Conn18 and the BOLD signal from 420 cortical/subcortical/brainstem rois extracted. A dynamic task-free analysis approach based on hierarchical cluster analysis was used to identify 15 brain states that were characterized using graph analysis (strength, diversity, modularity). Kruskal-Wallis tests and Spearman correlations were used for statistical analysis. One brain state (cluster 21) occurred more often in older adults (p=0.008). It was characterized by a lower mean modular strength and brainstem-cortical strength in older adults compared to younger adults. Global age related gray matter differences were positively correlated with brain state 21’s modular strength. Furthermore, brain state 21 duration was negatively correlated with working memory (r = -0.28, p=0.002). The findings suggest an age related weakening of the within and between network synchronization at the brainstem level during brain state 21 in older adults that negatively affects cortical and subcortical synchronization and working memory performance.

Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults.

Creatine supplementation in conjunction with resistance training (RT) augments gains in lean tissue mass and strength in aging adults; however, there is a large amount of heterogeneity between individual studies that may be related to creatine ingestion strategies. Therefore, the purpose of this review was to (1) perform updated meta-analyses comparing creatine vs. placebo (independent of dosage and frequency of ingestion) during a resistance training program on measures of lean tissue mass and strength, (2) perform meta-analyses examining the effects of different creatine dosing strategies (lower: ≤5 g/day and higher: >5 g/day), with and without a creatine-loading phase (≥20 g/day for 5–7 days), and (3) perform meta-analyses determining whether creatine supplementation only on resistance training days influences measures of lean tissue mass and strength. Overall, creatine (independent of dosing strategy) augments lean tissue mass and strength increase from RT vs. placebo. Subanalyses showed that creatine-loading followed by lower-dose creatine (≤5 g/day) increased chest press strength vs. placebo. Higher-dose creatine (>5 g/day), with and without a creatine-loading phase, produced significant gains in leg press strength vs. placebo. However, when studies involving a creatine-loading phase were excluded from the analyses, creatine had no greater effect on chest press or leg press strength vs. placebo. Finally, creatine supplementation only on resistance training days significantly increased measures of lean tissue mass and strength vs. placebo.

Body composition associations with muscle strength in older adults living in Auckland, New Zealand.

BackgroundAging is associated with decreases in muscle strength and simultaneous changes in body composition, including decreases in muscle mass, muscle quality and increases in adiposity.MethodsAdults (n = 369; 236 females) aged 65–74 years living independently were recruited from the cross-sectional Researching Eating Activity and Cognitive Health (REACH) study. Body fat percentage and appendicular skeletal muscle mass (ASM) (sum of lean mass in the arms and legs) were assessed using Dual-energy X-ray Absorptiometry (Hologic, QDR Discovery A). The ASM index was calculated by ASM (kilograms) divided by height (meters) squared. Isometric grip strength was measured using a hand grip strength dynamometer (JAMAR HAND).ResultsLinear regression analyses revealed that muscle strength was positively associated with the ASM index (R2 = 0.431, p < 0.001). When exploring associations between muscle strength and muscle mass according to obesity classifications (obesity ≥30% males; ≥40% females), muscle mass was a significant predictor of muscle strength in non-obese participants. However, in participants with obesity, muscle mass was no longer a significant predictor of muscle strength.ConclusionsBody fat percentage should be considered when measuring associations between muscle mass and muscle strength in older adults.

Associations between inflammatory markers and muscle strength in older adults according to the presence or absence of obesity.

We investigated the association between inflammatory markers and muscle strength in older adults according to the presence or absence of obesity. Dynapenia is the age-related decline in muscle strength and results in negative outcomes to older adults. Accordingly, obesity is more prevalent throughout aging and is associated with comorbidities, such as type 2 diabetes, dyslipidemia and cardiovascular diseases. Both dynapenia and obesity are strongly linked to chronic inflammation, sharing common signaling pathways. We recruited 247 older adults aged 60 or older and collected sociodemographic, anthropometric and metabolic data. Dynapenia was diagnosed according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Circulating inflammatory cytokines were measured in plasma using a multiplex panel kit. Anthropometric, sociodemographic, lipid profile, and fasting blood glucose were also assessed. Dynapenic participants were predominantly males (74.4%), had insufficiently active lifestyle and higher IL-10 plasma levels (0.95pg/mL; 0.40-2.12). The prevalence of obesity was higher among non-dynapenic participants (45.3%; 95% CI, 37.7-53). In dynapenic older adults, obesity was predominant in males (53.6%) and subjects with normal muscle strength had higher serum levels of TNF-β (0.63pg/mL; 0.30-1.30) and lower hand-grip strength (24kg; 20.00-28.00). Using a multivariate quantile regression analysis, we found a strong and negative association between IL-10 and muscle strength. This study can help to understand the association of inflammation, obesity and muscle strength to promote interventions in order to avoid or delay the negative outcomes associated with dynapenia and sarcopenia in older adults.

Sarcopenic Obesity Indices Are Major Determinants of Bone Strength in Older Adults With Obesity

Background: The increasing number of older adults with obesity is a growing public health problem because of increased risk of fractures especially at the ankle and upper leg despite normal or high bone mineral density. Among the contributory factors for fracture risk in this population may be aging- and obesity- associated physical frailty and impaired bone quality. However, how the adverse changes in physical function and body composition in this aging and obese population contribute to bone quality as assessed by finite element analyses (FEA) of bone strength has not been determined. Methods: One-hundred sixty-nine older (age ≥ 65 yrs.) adults with obesity (BMI ≥ 30 kg/m2) were recruited to participate in lifestyle intervention trials at our Medical Center. All underwent baseline measurements of bone strength (failure load [N] and stiffness [N.mm-1]) as estimated using FEA from high-resolution peripheral quantitative tomography (HR-pQCT) of the distal radius and tibia. In addition, body composition (appendicular lean mass/BMI [ALMBMI], fat mass/height2 [FMI]) was assessed by dual-energy x-ray absorptiometry (DXA) and physical function by the modified physical performance test (PPT), knee extension strength (isokinetic dynamometry), hand grip strength, and 4-meter gait speed. Results: Bivariate analyses showed that ALMBMI (r=.57 to .58), FMI (r=-.16 to -.17), gait speed (r=.20 to .21), grip strength (.56 to .57), and knee extension strength (r=.40 to .42) correlated with stiffness and failure load at the distal radius (all P<0.05). In addition, ALMBMI (r=.65 to .67), FMI (r=-.22 to .23), gait speed (r+.18 to .19), grip strength (r=.58 to .59), and knee extension strength (r=.44 to .45) correlated with stiffness and failure load at the distal tibia (all P<0.05). Controlling for age and sex, multiple regression analyses revealed that ALMBMI (β=.34 to .35) and grip strength (β=.28 to .29) were the independent predictors of stiffness and failure load at the distal radius, explaining 45% to 46% of the variance in stiffness and failure load (P<0.001). On the other hand, multiple regression analyses revealed that ALMBMI (β=.45 to .52), grip strength (β=.27 to .28), and FMI (β=.17 to .18) were the independent predictors of stiffness and failure load at the distal tibia, explaining 74% to 75% of the variance in stiffness and failure load (P<0.001). Conclusions: These findings suggest the importance of preserving muscle mass while reducing fat mass and improving physical function to maintain bone quality and decrease the risk of fractures when older adults with obesity undergo lifestyle intervention.

Differential relationship of uric acid to mortality and clinical biomarkers of aging according to grip strength in older adults: a cohort study.

Uric acid is both a pro-oxidant and antioxidant. We investigated serum uric acid's association with mortality and aging biomarkers in older adults with varying levels of grip strength. A total of 5329 community-dwelling adults aged ≥55 years underwent assessments of serum uric acid levels, grip strength, and biomarkers of diverse physiological systems. The primary outcome was all-cause mortality. We observed a significant (P < .001) interaction between uric acid levels and grip strength on all-cause mortality risk. Among participants with low grip strength, a nonlinear association (P for nonlinearity = .006) was observed between serum uric acid levels and mortality risk after multivariate adjustment. Compared with participants with neither extreme uric acid levels nor low grip strength, those with a combination of high serum uric acid and low grip strength exhibited greater risks of mortality (adjusted hazard ratio [aHR], 1.52; 95% confidence interval [CI], 1.15–2.02) and deviations in biomarkers of specific systems, so did those with a combination of low serum uric acid and low grip strength (aHR, 1.52; 95% CI, 1.13–2.05). In conclusion, there was a J-shaped association between serum uric acid and the risk of all-cause mortality in older adults. This was primarily true for those with low grip strength.

Effects of aerobic training combined with strength training with elastic resistance on functional capacity of older adults: a controlled randomized clinical trial

The combination of aerobic (AT) and strength (ST) training, i.e., Combined Training (CT) is a strategy used to combat the deleterious effects of aging. However, ST requires specialized equipment and environments that hinder the practice of the elderly population; thus, elastic devices can help in the practice of ST because they are easy to apply. To evaluate the effects of CT on the functional capacity (FC) of older adults after 8 weeks of intervention. Participants were randomly allocated to the combined training group (CTG) or control group (CG). The CTG performed, with 3 weekly sessions, a TA (70–85% of the heart rate reserve) followed by ST with elastic tubes (6 exercises; 2 × 15 repetitions) with load progression through the perception of effort scale, color, and elastic extension. Before and after the intervention, six FC tests and a maximum isometric strength test of the knee extensors were evaluated. Two-way ANOVA was applied, with Bonferroni post hoc, adopting a p < 0.05. Twenty-two older people participated in the study (CTG, 62.91 ± 5.88; CG, 62.70 ± 5.29), of both sexes (CTG, 8/4; CG, 6/4). An improvement of 6.60% was observed in the Timed Up and Go test (p = 0.026), 20.56% in the sit and stand test (p = 0.007), 17.71% in the elbow flexion test (p = 0.026), and 15.64% and 26.94% for the right (p = 0.026) and left knee extensors (p = 0.006), respectively, for the CTG compared to the CG. AT associated with ST with elastic tubes was effective in improving FC and knee extensor muscle strength in older adults. RBR-8FDWTH; retrospectively registered. March 10, 2020.

Association between serum FGF21 level and sarcopenia in older adults.

With emerging basic research evidence suggesting that fibroblast growth factor (FGF) 21 is a catabolic molecule on muscle metabolism, we aimed to analyze the serum FGF21 level in relation to sarcopenia in older adults. Blood samples were collected from 125 participants who underwent evaluation for muscle mass and function in an outpatient geriatric clinic of a teaching hospital. Sarcopenia and related components were determined using cutoff values for the Asian population. The serum FGF21 level was measured using enzyme linked immunosorbent assay. After controlling for age, sex, and body mass index (BMI), participants with sarcopenia, low muscle mass, and weak muscle strength had 2.3-, 2.0-, and 1.5-fold higher serum FGF21 levels than controls, respectively (p=.033 to <0.001). The serum FGF21 level was positively correlated with sarcopenia phenotype score and inversely correlated with skeletal muscle mass index and grip strength by both crude and multivariate analysis adjusting potential confounders (p=.017 to <0.001). Consistently, higher serum FGF21 level was significantly associated with increased odds for sarcopenia, low muscle mass, and low muscle strength after adjusting for age, sex, and BMI (odds ratio, 1.53-2.61; p=.048 to <0.001). Higher circulating FGF21 was associated with the likelihood of sarcopenia, lower muscle mass, and worse grip strength in older adults, supporting a potential catabolic role of FGF21 on human muscle health.

Effect of Antihypertensive and Statin Medication Use on Muscle Performance in Community-Dwelling Older Adults Performing Strength Training.

Antihypertensive drugs (AHTD) and statins have been shown to have effects beyond their primarily designed purpose; here we investigate their possible effect on muscle performance and strength in older adults following a physical exercise programme. The Senior PRoject INtensive Training (SPRINT) study is a randomised, controlled clinical trial designed to evaluate the effects of physical exercise on the immune system and muscle performance in older adults. In this secondary analysis, we included 179 independent participants (aged 65 years and above). We applied further categorisation based on medication use: AHTD (including, angiotensin-converting enzyme inhibitors [ACEI], angiotensin II receptor blockers [ARB], β-blockers, and other AHTD) and statins. Participants were allocated randomly to one of the three exercise protocols: intensive strength training 3 times/week (3 × 10 repetitions at 80% of one-repetition maximum), strength endurance training (2 × 30 repetitions at 40% of one-repetition maximum), or control (passive stretching exercise) for 6weeks. The change in maximal hand grip strength (GS), muscle fatigue resistance (FR), Muscle Strength Index (MSI), the 6-min walk test (6MWT), and Timed Up and Go Test (TUG) were assessed before and after 6weeks of training. After 6weeks, muscle strength (MSI and TUG) improved significantly in all training groups compared to baseline, independently of AHTD use. Moreover, AHTD had no effect on exercise improvements, with no significant differences between medication groups, except for TUG in ARB users, which exhibited a significantly lower performance. On the other hand, statin users presented a significantly longer FR time, indicating better performance compared to non-users. Finally, medication did not affect the participants' commitment to the training programme. Our study showed that statins and ARB usage might affect participant's response to strength training. Nevertheless, 6weeks of training significantly improved muscle strength and performance irrespective of AHTD or statin use.

Limited Benefit of Marine Protein Hydrolysate on Physical Function and Strength in Older Adults: A Randomized Controlled Trial.

Age-related muscle wasting can compromise functional abilities of the elderly. Protein intake stimulates muscle protein synthesis; however, ageing muscle is more resistant to stimuli. This double-blinded, randomized, controlled trial is one of the first registered studies to evaluate the effects of a supplement of marine protein hydrolysate (MPH) on measures of physical function and strength. Eighty-six older adults received nutritional supplements containing 3 g of MPH or a placebo for up to 12 months. Short Physical Performance Battery (SPPB), grip strength and gait speed were measured, and dietary intake was registered at baseline, 6 months, and 12 months. No difference was found between the intervention and control groups in mean change in SPPB (independent sample t-test, p = 0.41) or regarding time trend in SPPB, grip strength, or gait speed (linear mixed model). The participants in our study were well functioning, causing a ceiling effect in SPPB. Further, they had sufficient protein intake and were physically active. Differences in physical function between those completing the intervention and the dropouts might also have created bias in the results. We recommend that future studies of MPH be carried out on a more frail or malnourished population.

The Impact of Resistance Exercise on Skeletal Muscle in Older Adults: A Literature Review

Introduction: Sarcopenia is a prevalent disease characterized by the progressive loss of skeletal muscle mass and strength in older adults. Sarcopenia is associated with decreased mobility, quality of life; impaired metabolism, cell signalling; as well as an increased likelihood of disease, infection, falls, and early mortality rates. Resistance exercise (RE, i.e., weight-lifting) is an efficacious, non-pharmacological intervention used to mitigate the impacts of sarcopenia. The aim of this literature review is to summarize the effects of resistance exercise on skeletal muscle mass, strength, power, and function in community-dwelling older adults, as well as provide general resistance exercise recommendations for older adults to effectively counter sarcopenia. Methods: We conducted a literature review to assess the impact of resistance exercise on muscle mass, muscle strength, muscle power, and functional capacity in older adults based on three primary criteria: 1) tested healthy, community dwelling participants ≥ 60 years old; 2) assessed the effects of RE on at least one of the aforementioned outcomes; and 3) were peer-reviewed and written in English. Results: Studies involving both sexes and various RE programs regularly show increased skeletal muscle mass and strength following RE training. Additionally, RE appears to improve older adults’ neuromuscular performance, though improvements are significantly higher following high-intensity RE sessions. Further, RE improves skeletal muscle function as measured by various qualitative and quantitative tests. Although no specific RE program has been definitively shown to optimally support skeletal muscle adaptation in all older adults, RE, even in small doses, is clearly beneficial for older adults’ skeletal muscle health. Discussion: Undoubtedly, RE has shown to be an efficacious treatment for sarcopenia. To achieve a more comprehensive understanding of how RE counteracts sarcopenia, further research – particularly well controlled randomized trials – are needed to elucidate the cellular processes underlying skeletal muscle’s deterioration with advancing age and subsequent response to RE. Conclusion: Taken all together, RE has a positive impact on skeletal muscle mass, strength, neuromuscular performance, and muscle function in older adults.

Serum uric acid is positively associated with muscle strength in older men and women: Findings from NHANES 1999–2002

One of the causes of strength loss in older adults is the increased oxidative stress; thus, substances with antioxidants properties may have protective effects on muscle strength. Uric acid (UA) is an important antioxidant and it seems to be positively associated with muscle strength in older adults; however, the current evidence is still limited. To investigate whether serum UA is associated with muscle strength in older men and women. A cross-sectional study was performed evaluating older adults aged from 50 to 85 years from National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. A total of 2361 individuals (1256 men and 1105 women) were evaluated. The peak isokinetic knee extensor strength was assessed by kinetic communicator isokinetic dynamometer; while UA levels were measured by colorimetric method. Linear regression analyses were performed to estimate the coefficients and 95% confidence intervals for muscle strength by quintiles of UA levels, adjusted for potential confounders. In the unadjusted analyses, serum UA was positively associated with peak force in men and total sample, but not in women. However, after adjustments for confounders, UA levels were positively associated with peak force in total sample (p-trend=0.007), men (p-trend=0.044) and women (p-trend=0.016). Serum UA is positively associated with muscle strength in older men and women. These results suggest that UA levels seem to be a protective factor for muscle strength in older adults independent of the sex.

Dietary Protein Intake in Older Adults from Ethnic Minorities in the Netherlands, a Mixed Methods Approach

Optimizing protein intake is a novel strategy to prevent age associated loss of muscle mass and strength in older adults. Such a strategy is still missing for older adults from ethnic minority populations. Protein intake in these populations is expected to be different in comparison to the majority of the population due to several socio-cultural factors. Therefore, the present study examined the dietary protein intake and underlying behavioral and environmental factors affecting protein intake among older adults from ethnic minorities in the Netherlands. We analyzed frequency questionnaire (FFQ) data from the Healthy Life in an Urban Setting (HELIUS) cohort using ANCOVA to describe dietary protein intake in older adults from ethnic minorities in the Netherlands (N = 1415, aged >55 years, African Surinamese, South Asian Surinamese, Moroccan, and Turkish). Additionally, we performed focus groups among older adults from the same ethnic minority populations (N = 69) to discover behavioral and environmental factors affecting protein intake; 40–60% of the subjects did not reach minimal dietary protein recommendations needed to maintain muscle mass (1.0 g/kg bodyweight per day (BW/day)), except for Turkish men (where it was 91%). The major sources of protein originated from animal products and were ethnic specific. Participants in the focus groups showed little knowledge and awareness about protein and its role in aging. The amount of dietary protein and irregular eating patterns seemed to be the major concern in these populations. Optimizing protein intake in these groups requires a culturally sensitive approach, which accounts for specific protein product types and sociocultural factors.

Do motor-cognitive and motor-motor dual task training effect differently balance performance in older adults?

Dual-task training (DTT) have been showed that have satisfying effects on older adults. The aim of this study was to compare the effect of motor-cognitive DTT (mCdtt) and motor-motor DTT (mMdtt) on balance, fear of falling, walking functionality and muscle strength in older adults. A total of 50 participants aged 60 and over (mean age: 67.72 ± 7.33years), having a score ≥ 24 on the Mini-Mental State Exam (MMSE), being in the category of walking ability ≥ 4 according to the Functional Ambulation Category (FAC), having no problem in visual ability and hearing were included for this study. The participants who received mCdtt (Group 1) counted back from the two-digit number; and the participants who received mMdtt (Group 2) held half-filled glasses with both hands near the trunk with 90° flexion of elbow while performing exercises. The intervention program had lasted for 8weeks. To assess balance, fear of falling, walking functionality and muscle strength of participants; Berg Balance Scale (BBS), Falls Efficacy Scale International (FES-I), Timed Up and Go (TUG) and the Hand-held dynamometer were used, respectively. The results of our study showed that 8-week mCdtt and mMdtt program did not differ in balance fear of falling, walking functionality and muscle strength in older adults, although both trainings had improved balance ability. It can be interpreted that both training programs can be suggested to enhance abovementioned parameters in older adults. Further studies are needed to elucidate the difference of clinical outcomes between the mCdtt and mMdtt program in older adults. NCT04577092. 09/30/2020 "Retrospectively registered".