Weaker Grip Strength Research Articles

Association between sleep quality, sleep duration, and physical frailty among adults aged 50 years and older in India.

Considering the significant growth in India's aging population, it is imperative to identify factors associated with frailty among older Indians. This study examined the association between sleep quality, sleep duration, and physical frailty among older adults in India. Moreover, we examined whether the associations between sleep quality, sleep duration, and physical frailty varied by gender. In this secondary analysis, we used data from the 2015 wave 2 of the Study on Global Aging and Adult Health (WHO-SAGE) in India, comprising a sample of 6,512 older adults aged 50 years and above. Pre-frailty and frailty were assessed using the modified version of the frailty phenotype developed by Fried and colleagues. Sleep was assessed by self-reported quality and duration. Multinomial and multivariable logistic regression models were used to examine the associations between sleep quality, sleep duration, and physical frailty (including its components), as well as to explore the moderating effect of gender. 66.8% of older Indians were pre-frail, while 25.2% were frail. Relative to those with good sleep quality, older adults with poor sleep quality had significantly higher odds of frailty [AOR: 2.79; CI: 1.37-5.66]. Compared to those receiving the recommended age-appropriate 7-8h of sleep, older adults sleeping ≥ 9h reported a significantly lower likelihood of both pre-frailty [AOR: 0.73; CI: 0.57-0.93] and frailty [AOR: 0.68; CI: 0.51-0.91]. Analysis of specific components of frailty showed that older adults with long sleep had lower odds of exhaustion [AOR: 0.86; CI: 0.73-1.00] compared to those with age-appropriate sleep duration. Moreover, frailty was more pronounced in older men with poor sleep quality and short sleep duration (< 7h/night) than in older women with similar sleep patterns. Poor sleep quality was not linked to any of the frailty components in older women; however, in older men, it was associated with exhaustion [AOR: 4.28; CI: 2.28-8.06], weak grip strength [AOR: 2.31; CI: 1.46-3.67], and low physical activity [AOR: 2.81; CI: 1.10-7.21]. The findings indicate potential associations between sleep quality, sleep quantity, and physical frailty among older Indians. Poor sleep quality was associated with frailty, yet long sleep duration was associated with a lower prevalence of frailty, independent of sleep quality. Moreover, the prevalence of frailty associated with poor sleep quality and shorter sleep duration was more pronounced among older Indian men than women, underscoring the need for targeted interventions to address sleep-related concerns in this demographic.

Associations of childhood socioeconomic position and health with trajectories of grip strength from middle to older ages in populations from China and from England

BackgroundWe investigated associations of childhood socioeconomic position and health with trajectories of grip strength from middle to older ages in two distinct populations. MethodsWe used data from the China Health and Retirement Longitudinal Study (CHARLS, n = 16,701) and English Longitudinal Study of Ageing (ELSA, n = 12,695). Hand grip strength was measured at three timepoints in CHARLS (2011–2015) and four in ELSA (2001−2020). Random-effects growth models were applied to assess associations between each childhood factor and age trajectories of grip strength. FindingsLower parental education was associated with weaker grip strength, by 0·36 kg(95 % CI:0·17,0·56) for participants of illiterate (vs literate) parents in CHARLS and 1·88 kg(0·43,3·33) for participants of parents without education (vs ≥ high school) in ELSA, after adjusting for parental occupation and own adult socioeconomic position. Low parental occupation was associated with weaker grip strength, although the difference diminished after adjustment for adult socioeconomic position. Financial hardship was associated with weaker grip strength only in CHARLS, by 0·19 kg(0·01,0·38) after adjustment. Self-rated poor childhood health and school absenteeism were associated with weaker grip strength (both studies). Being confined to bed and hospitalised for more than a month due to health were associated with weaker grip strength only in CHARLS. Each additional childhood illness (only reported in ELSA) was associated with 0·52 kg(0·28,0·81) lower mean grip strength. Reported poor childhood health (CHARLS), low parental education and school absenteeism (ELSA) were associated with grip strength decline. InterpretationLower socioeconomic position and poor health in childhood were associated with weaker grip strength in later life in both Chinese and English populations. Addressing socioeconomic disparities and promoting health of children may enhance life-course physical capacity, promote healthy ageing and reduce age-related adversities.

Grip strength and depressive symptoms in Chinese middle-aged and older adults: the mediating effects of cognitive function.

This study investigates the associations and mediating pathways between grip strength, cognitive function, and depression in middle-aged and elderly individuals in China. Utilizing data from the 2011 China Health and Retirement Longitudinal Study (CHARLS), we employed logistic regression and mediation analysis to examine the relationships and mediating factors between grip strength, cognitive function, and depression, while adjusting for potential confounders. The study included 6,841 participants, of whom 1,734 (25.35%) exhibited symptoms of depression. Our findings indicate that weak grip strength is significantly associated with an increased risk of depression (OR: 1.57, 95% CI: 1.32-1.87) among the middle-aged and elderly population. Conversely, good cognitive function was found to be protective against depression (OR: 0.94, 95% CI: 0.93-0.95). Grip strength indirectly affected depression through cognitive function, accounting for 9.4% of the total effect (β = -0.008, 95% CI [-0.013, -0.004]). This mediating effect was 23.8% in men (β = -0.013, 95% CI [-0.020, -0.007]); and 23.2% in those aged 60 years and over (β = -0.015, 95% CI [-0.022, -0.009]). This study highlights that weak grip strength increases risk of depressive symptoms, and adequate cognitive function can mitigate the association between weak grip strength and an increased risk of depression among middle-aged and elderly individuals in China. Psychological care for elder adults with weak grip strength and poor cognitive function should be strengthened.

Purpose in life and grip strength: An individual-participant meta-analysis of 115,972 participants from 24 countries across four continents.

This research examines the replicability and generalizability of the association between purpose in life and grip strength. An individual-participant meta-analysis of 27 samples (total N=115,972) from 24 countries that spanned four continents (Asia, Europe, North and South America) with self-reported purpose in life and dynamometer-assessed grip strength. Purpose in life was associated with stronger grip strength in every sample and aggregated in a random-effects meta-analysis (meta-analytic estimate=.06, p<.001). The association was similar across samples from different world regions and not moderated by methodological factors (e.g., scale content). The association was apparent across age, sex, race, and education and slightly stronger among males and participants with relatively less education. Every standard deviation in purpose was associated with a 23% lower likelihood of weak grip strength (meta-analytic OR=.81, 95% CI=.79-.84, p<.001) based on a standard threshold. Purpose in life is associated with grip strength, a marker of overall musculoskeletal health. The association replicates across diverse locations around the world and generalizes across sociodemographic groups.

Frailty, Physical Function Impairment and Pulmonary Function in Aging Men with and without HIV from the Multicenter AIDS Cohort Study (MACS).

People aging with HIV (PAWH) experience greater impairment in physical and pulmonary function than individuals aging without HIV. We examined whether baseline physical function was associated with subsequent pulmonary impairments. Associations of frailty and physical function (gait speed [m/sec], grip strength [kg]) with pulmonary function (< 80% predicted diffusing capacity for carbon monoxide [DLCO] and forced expiratory volume [FEV1]) 3 years later were modeled; age, HIV status, and smoking were assessed as effect modifiers. Among1,024 men, (54% PAWH, 10% frail, 51% pre-frail), mean (SD) age = 53 (12) years, cumulative smoking = 12 (19) pack-years, gait speed = 1.1 (0.2) m/sec, and grip strength = 36.6 (9.2) kg. Frailty, pre-frailty, and weak grip strength were associated with higher odds of subsequent impaired DLCO and FEV1. Slow gait speed was associated with higher odds of DLCO impairment but not FEV1. No statistically significant modifications were found. Interventions to improve physical function may help preserve pulmonary function.

Risk factors predicting subtypes of physical frailty incidence stratified by musculoskeletal diseases in community-dwelling older adults: The SONIC study.

This study aims to identify the key risk factors that lead to subtypes of physical frailty assessed by walking speed and grip strength among community-dwelling Japanese individuals, stratified by the presence of musculoskeletal diseases (MSDs) and age group. We included 302 participants aged 70 or 80 years who did not exhibit subtypes of physical frailty at baseline through the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. Our study was a longitudinal study. The outcome was the incidence of subtypes of physical frailty after 3 years. Subtypes of physical frailty were defined as a weak grip strength or slow walking speed, or both, based on the Japanese version of the Cardiovascular Health Study Index. The risk factors for subtypes of physical frailty incidence were examined by age group and MSD, using multivariate logistic regressions. Of the 302 participants, 110 (36.4%) had MSD. Those with MSD were significantly more likely to have subtypes of physical frailty after 3 years compared with those without MSD. Among all participants, older age was a risk factor of subtypes of physical frailty (P < 0.05). Without MSD, older age and dissatisfied financial status were risk factors (P < 0.05). With MSD, older age was a risk factor (P < 0.05). By age group, in individuals aged 70 years old, a dissatisfied financial status was a risk factor for those without MSD (P < 0.05), and a higher BMI was one for those with MSD (P < 0.05). Older age was a risk factor for subtypes of physical frailty, but other risk factors differed according to the presence of MSD and age. Geriatr Gerontol Int 2024; 24: 797-805.

Adult Physical Function Has Roots in Early Childhood Brain Function: A Five-Decade Cohort Study.

Tests of physical function are often thought to measure functioning that is (1) musculoskeletal, and (2) newly declining in adult life. In contrast, this study aimed to: (1) add to evidence that physical-function tests also measure brain function, and (2) test the novel hypothesis that adult physical function is associated with brain function beginning in early childhood. We investigated early childhood brain function and midlife physical function in the Dunedin Study, a 5-decade longitudinal birth cohort (n = 1,037). Brain function was measured at age 3 using 5 measures which formed a reliable composite (neurological examination, cognitive and motor tests, and temperament ratings). Physical function was measured at age 45 using 5 measures which formed a reliable composite (gait speed, step-in-place, chair stands, balance, and grip strength). Children with worse age-3 brain function had worse midlife physical function as measured by the age-45 composite, even after controlling for childhood socioeconomic status (β: 0.23; 95% CI: 0.16 to 0.30; p < .001). Worse age-3 brain function significantly predicted slower gait speed, fewer steps-in-place and chair-stands, worse balance, and weaker grip strength. Children with poorer brain function were more likely to have poorer physical-function scores as adults. In addition to indicating recent musculoskeletal decline, physical-function tests may also provide indications of lifelong, integrated brain-body health. By reconceptualizing the meaning of physical-function scores, clinicians can orient the use of physical-function tests in a more holistic approach to health care.

Is There a Relationship Between Grip Strength and Injuries in Professional Baseball Players?

Injuries in professional baseball players have become exceedingly common. Efforts to mitigate injury risk have focused on the kinetic chain, shoulder motion, and so forth. It is unclear whether grip strength is related to injury risk in professional baseball pitchers. The purpose of this study was to determine if grip strength was a risk factor for injury. It was hypothesized that pitchers with weaker grip strength would have a higher likelihood of sustaining a shoulder or elbow injury compared with pitchers with stronger grip strength. Case-control study; Level of evidence, 3. All professional pitchers from a single Major League Baseball organization were included. Dominant and nondominant grip strength were measured after each pitching outing throughout the 2022 season. Injuries over the course of the season were recorded, and data were compared between pitchers who sustained a shoulder or elbow injury and those who did not. Overall, 213 pitchers were included, of whom 53 (24.9%) sustained a shoulder or elbow injury during the season. The mean grip strength for all pitchers was 144.0 ± 20.8 lb (65.3 ± 9.4 kg). The mean dominant-arm grip strength was 142.6 ± 20.8 lb (64.7 ± 9.4 kg) for pitchers who did not sustain a shoulder or elbow injury and 148.2 ± 20.9 lb (67.2 ± 9.5 kg) for pitchers who did sustain an injury, with no significant group difference in grip strength (P > .05). Furthermore, there were no significant differences in change in grip strength over the course of the season between the groups. There was no significant difference in mean grip strength or change in grip strength over the course of a single season between professional baseball pitchers who sustained a shoulder or elbow injury and those who did not.

Hierarchical clustering of the demographic, clinical profile and handgrip strength of patients after distal radius fracture

Objective: The aim of this study was to identify the profiles of patients after distal radius fracture treatment grouped according to demographic and clinical factors, and grip strength on the fracture contralateral side. Method: This was a retrospective and cross-sectional single-center study that included 141 patients with unilateral distal radius fractures treated at a public hospital by the physical therapy service. Results: Demographic and clinical data from all patients included in this study were collected from patients' medical records. Grip strength was assessed between 8 and 10 weeks after the fracture. We performed an exploratory multivariate analysis using Multiple Correspondence Analysis (MCA) followed by Agglomerative Hierarchical Cluster Analysis (AHC). Numerical values of coordinates of all the dimensions obtained in MCA were used as input variables in the cluster analysis and the perceptual map of hierarchical clustering (Dendrogram) was obtained. We highlighted three groups based on cluster analysis. One group included men, aged 18 to 59 years, with fractures either on the right or left side, trauma caused by traffic accidents or other causes, surgical treatment and normal grip strength on the contralateral side. The second group had women, aged 60 to 90 years, fracture resulting from falls from their own height, conservative treatment and intermediate grip strength on the contralateral side. The third group had only the weak grip strength on the contralateral side. Conclusion: This cluster analysis revealed three profiles of patients during the early period after distal radius fracture treatment.

Weak grip strength among persons with multiple sclerosis having minimal disability is not related to agility or integrity of the corticospinal tract

IntroductionMobility impairment is common in multiple sclerosis (MS); however, agility has received less attention. Agility requires strength and neuromuscular coordination to elicit controlled propulsive rapid whole-body movement. Grip strength is a common method to assess whole body force production, but also reflects neuromuscular integrity and global brain health. Impaired agility may be linked to loss of neuromuscular integrity (reflected by grip strength or corticospinal excitability). ObjectivesWe aimed to determine whether grip strength would be associated with agility and transcranial magnetic stimulation (TMS)-based indices of corticospinal excitability and inhibition in persons with MS having low disability. We hypothesized that low grip strength would predict impaired agility and reflect low corticospinal excitability. MethodsWe recruited 34 persons with relapsing MS (27 females; median [range] age 45.5 [21.0-65.0] years) and mild disability (median [range] Expanded Disability Status Scale 2.0 [0-3.0]), as well as a convenience sample of age- and sex-matched apparently healthy controls. Agility was tested by measuring hop length during bipedal hopping on an instrumented walkway. Grip strength was measured using a calibrated dynamometer. Corticospinal excitability and inhibition were examined using TMS-based motor evoked potential (MEP) and corticospinal silent period (CSP) recruitment curves, respectively. ResultsMS participants had significantly lower grip strength than controls independent of sex. Females with and without MS had weaker grip strength than males. There were no statistically significant sex or group differences in agility. After controlling for sex, weaker grip strength was associated with shorter hop length in controls only (r = 0.645, p < .05). Grip strength did not significantly predict agility in persons with MS, nor was grip strength predicted by corticospinal excitability or inhibition. ConclusionsIn persons with MS having low disability, grip strength (normalized to body mass) was reduced despite having intact agility and walking performance. Grip strength was not associated with corticospinal excitability or inhibition, suggesting peripheral neuromuscular function, low physical activity or fitness, or other psychosocial factors may be related to weakness. Low grip strength is a putative indicator of early neuromuscular aging in persons with MS having mild disability and normal mobility

Risk factors associated with the Motoric Cognitive Risk syndrome: A meta-analysis of data from a cross-national study.

Identifying risk factors associated with the Motoric Cognitive Risk (MCR) syndrome (a pre-dementia syndrome) can assist in developing risk reduction strategies and interventions to delay progression to dementia. Tailored interventions require comparisons of high- and middle-income countries to determine if the same or different risk factors should be targeted. We examined risk factors associated with MCR in seven Health and Retirement Studies with harmonized measures. Data from adults aged ≥65 years (n = 20,036, mean age 71.2(SD 6.2)-80.1(SD 4.1)) from the U.S. Health and Retirement Study, English Longitudinal Study of Aging, Survey of Health, Aging and Retirement in Europe, China Health and Retirement Longitudinal Study, Harmonized Diagnostic Assessment of Dementia for Longitudinal Aging Study in India, Mexican Health and Aging Study, and Brazilian Longitudinal Study of Aging was included. MCR was defined as the presence of cognitive complaints and slow gait (no mobility disability and dementia). Associations of demographic [education], medical [hypertension, diabetes, heart disease, obesity, stroke, Parkinson's, falls], psychological [depressive symptoms, psychiatric problems], sensorimotor [grip strength, hearing], and behavioral factors [smoking, sedentariness, sleep], with prevalent MCR were examined using age- and sex-adjusted logistic regression models. A meta-analysis was performed to compare risk factors for MCR in high- versus middle-income countries. Except for depressive symptoms and weak grip strength, different risk factor clusters were associated with individual studies. Poor sleep, hearing, weak grip, and multiple falls emerged as novel associations with MCR. When grouped by income, some risk factors (i.e., education) were associated with MCR in high- and middle-income countries. Others (i.e., obesity) were specific to high-income countries. This cross-sectional, cross-national study identified new, shared, and specific risk factors associated with MCR in high- and middle-income countries, providing insights to develop public health approaches and interventions to forestall the onset of dementia in those with MCR.

Effects of multimorbidity and polypharmacy on physical function in community-dwelling older adults: A 3-year prospective cohort study from the SONIC

BackgroundWe prospectively examined the effect of baseline multimorbidity and polypharmacy on the physical function of community-dwelling older adults over a three-year period. MethodsThe analysis included 1,401 older adults (51.5 % women) who participated in both wave 1 and wave 2 (3-year follow-up) of the Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians (SONIC) study. Grip strength and walking speed were binarized into poor/not poor physical function according to the frailty definition. The number of chronic conditions and the number of prescribed medications were categorized into 3 and 4 groups, respectively. Multivariable logistic regression was used to examine associations between the number of chronic conditions, medication use at baseline, and poor physical function over a three-year period. ResultsAfter adjusting for confounding factors, hyperpolypharmacy (≥ 10 medications) demonstrated associations with weak grip strength (adjusted odds ratio [aOR] = 2.142, 95 % confidence interval [CI] = 1.100–4.171) and slow walking speed (aOR = 1.878, 95 % CI = 1.013–3.483), while co-medication (1–4 medications) was negatively associated with slow walking speed (aOR = 0.688, 95 % CI = 0.480–0.986). There was no significant association between the number of chronic conditions and physical function. ConclusionThe findings suggest that the number of medications can serve as a simple indicator to assess the risk of physical frailty. Given that many older individuals receive multiple medications for extended durations, medical management approaches must consider not only disease-specific treatment outcomes but also prioritize drug therapy while actively avoiding the progression towards frailty and geriatric syndromes.

Relationship between Subjective Grip Strength and Physical Functioning among Community-Dwelling Older Women.

This study investigated the relationship between subjective grip strength and physical function in community-dwelling older women. Subjective grip strength was assessed using a questionnaire, and physical function and body composition were compared between groups with strong and weak subjective grip strength. Additionally, the two groups were compared in those with mild cognitive impairment (MCI) and those with normal cognitive function, respectively. The results showed significant differences in grip strength (p < 0.001), 30 s chair-stand (CS-30) test (p = 0.039), timed up-and-go (TUG) test (p = 0.027), maximal gait speed (p = 0.029), and skeletal muscle mass (p < 0.001). Older adults with normal cognitive function showed significant differences in grip strength (p < 0.001), quadriceps muscle strength (p < 0.009), one-leg standing time (p = 0.041), CS-30 (p = 0.002), TUG (p = 0.014), gait speed (p = 0.006), and skeletal muscle mass (p = 0.003). Older adults with low subjective grip strength had lower physical function and skeletal muscle mass. However, no items showed significant differences between groups among older adults with MCI. Thus, subjective grip strength is an indicator of an overall decline in physical function and a reduction in skeletal muscle mass in older adults, and cognitive function should be considered when assessing subjective grip strength in older adults.

Risk factors for decreased bone mineral density in patients with metabolic dysfunction-associated steatotic liver disease: A cross-sectional study at a health examination center

Background & AimsSteatotic liver disease (SLD) is often detected in health examinations. However, although individuals with metabolic dysfunction-associated SLD (MASLD) may have decreased bone mineral density (BMD), the specific risk factors remain unclarified. The objective of this study was to identify the factors associated with decreased BMD in patients with MASLD. MethodsIndividuals who underwent abdominal ultrasonography and BMD measurements at our healthcare center were included. The BMD of the calcaneus was assessed using an AOS-10SA bone densitometer. Decreased BMD was defined as a T-score below -1.0 SD or the administration of osteoporosis treatment. SLD was diagnosed based on specific ultrasonographic criteria. ResultsA total of 1,410 patients were diagnosed with MASLD. The median age was 52 years. Multivariate analysis using a logistic regression model revealed that the independent predictors of decreased BMD were a low body mass index (BMI) or a small waist circumference (odds ratio (OR): 0.48, 95% confidence interval (CI): 0.34–0.67), hypertriglyceridemia (OR: 1.29, 95% CI: 1.00–1.65), and a weak grip strength (OR: 0.98, 95% CI: 0.97–1.00). Subgroup analyses of individuals aged 50 years or older, men, and individuals with a FIB-4 index of 1.3 or greater revealed that the absence of a high BMI or a large waist circumference was associated with decreased BMD. The subgroup analysis of men revealed that a weaker grip strength was associated with decreased BMD. ConclusionThe present study suggested several potential risk factors for decreased BMD in patients with MASLD. Individuals with the abovementioned risk factors should be encouraged to undergo BMD measurement from the perspective of preventive medicine.

Are women with endometriosis more likely to experience reduced physical performance compared to women without the condition?

Endometriosis is a condition of the female reproductive system associated with pelvic pain. Chronic pain can affect physical performance by limiting the functional activities, thus, it is hypothesized that women with endometriosis may also present decreased functional capacity, decreased strength, and mobility. The objective of this study is to compare physical performance in women with and without endometriosis. This is a cross-sectional study composed of 115 women equally divided into two groups: the endometriosis group (EG), composed of women with a confirmed diagnosis of the disease by magnetic resonance imaging, and the comparator group (CG), consisting of women without suspicion of the disease. Physical performance (dependent variable) was assessed using hand dynamometry, the 6-min walk test (6MWT), gait speed, and the chair stands test. CG participants performed the tests during the luteal phase of the menstrual cycle. Descriptive statistics, unpaired t-tests, and chi-square tests were used to describe and compare the groups. Multiple linear regression tested the associations adjusted for covariates (age, income, education, age at menarche, and body mass index). The EG had worse gait speed (mean difference: -0.11; 95% CI: [-0.18 to -0.04]), weaker grip strength (mean difference: -3.32; 95% CI: [-5.30 to -1.33]), shorter distance covered in the 6MWT (mean difference: -83.46; 95% CI: [-121.38 to -45.53]), and a lower number of repetitions in the chair stands test (mean difference: -8.44; 95% CI: [-10.64 to -6.25]) than the CG, even after adjusting for covariates. Grip strength, lower limb strength, mobility, and functional capacity were worse in women diagnosed with endometriosis. Women with endometriosis should be encouraged to engage in physical exercise, adopt healthy lifestyle habits, and participate in rehabilitation activities to control pain, with the aim of reducing functional impairments.

Association of Dietary Fiber and Measures of Physical Fitness with High-Sensitivity C-Reactive Protein.

Dietary fiber intake and physical fitness are independently associated with high-sensitivity C-reactive protein (hs-CRP) levels. Nevertheless, the association between dietary fiber intake, measures of physical fitness, and hs-CRP levels has not yet been fully evaluated. We investigated the influence of a combination of dietary fiber intake and measures of physical fitness, including hand grip strength, resistance training, and metabolic equivalents of tasks, on hs-CRP levels. Data collected from the Korea National Health and Nutrition Examination Survey (KNHANES) spanning 2015 to 2018 were used in this study. A total of 16,934 participants (7434 men and 9500 women aged ≥19 years) were included in this study. After adjusting for confounding factors (age, education, income, marital status, smoking status, drinking habits, total energy intake, and aerobic physical activity), we employed a multivariable logistic model to examine the association of dietary fiber intake and measures of physical fitness with hs-CRP levels. Among women, the odds of high hs-CRP levels were lower in those with the highest dietary fiber intake and superior grip strength compared to in women with the lowest dietary fiber intake and weaker grip strength (odds ratio [OR] = 0.40, 95% confidence interval [CI] = 0.24-0.68). The highest dietary fiber intake who participated in resistance exercise at least three times per week had a reduced odds of high hs-CRP levels compared with those with the lowest dietary fiber intake who did not engage in resistance exercise in both men and women (OR = 0.53, 95% CI = 0.32-0.89; OR = 0.40, 95% CI = 0.19-0.84, respectively). Our findings indicate that dietary fiber intake and high levels of physical fitness were associated with reduced odds of elevated hs-CRP levels.

Metabolomic profiles of ovariectomized mice and their associations with body composition and frailty-related parameters in postmenopausal women.

Menopause, a dramatical estrogen-deficient condition, is considered the most significant milestone in women's health. To investigate the metabolite changes attributed to estrogen deficiency using random forest (RF)-based machine learning (ML) modeling strategy in ovariectomized (OVX) mice as well as determine the clinical relevance of selected metabolites in older women. Untargeted and targeted metabolomic analyses revealed that metabolites related to TCA cycle, sphingolipids, phospholipids, fatty acids, and amino acids, were significantly changed in the plasma and/or muscle of OVX mice. Subsequent ML classifiers based on RF algorithm selected alpha-ketoglutarate (AKG), arginine, carnosine, ceramide C24, phosphatidylcholine (PC) aa C36:6, and PC ae C42:3 in plasma as well as PC aa 34:1, PC aa C34:3, PC aa C36:5, PC aa C32:1, PC aa C36:2, and sphingosine in muscle as top featured metabolites that differentiate the OVX mice from the sham-operated group. When circulating levels of AKG, arginine, and carnosine, which showed the most significant changes in OVX mice blood, were measured in postmenopausal women, higher plasma AKG levels were associated with lower bone mass, weak grip strength, poor physical performance, and increased frailty risk. Metabolomics- and ML-based methods identified the key metabolites of blood and muscle that were significantly changed after ovariectomy in mice, and the clinical implication of several metabolites was investigated by looking at their correlation with body composition and frailty-related parameters in postmenopausal women. These findings provide crucial context for understanding the diverse physiological alterations caused by estrogen deficiency in women.

Diet-induced hyperhomocysteinemia causes sex-dependent deficiencies in offspring musculature and brain function.

Hyperhomocysteinemia (HHcy), characterized by elevated homocysteine (Hcy) levels, is a known risk factor for cardiovascular, renal, and neurological diseases, as well as pregnancy complications. Our study aimed to investigate whether HHcy induced by a high-methionine (high-Met) diet exacerbates cognitive and behavioral deficits in offspring and leads to other breeding problems. Dietary HHcy was induced four weeks before mating and continued throughout gestation and post-delivery. A battery of behavioral tests was conducted on offspring between postnatal days (PNDs) 5 and 30 to assess motor function/activity and cognition. The results were correlated with brain morphometric measurements and quantitative analysis of mammalian target of rapamycin (mTOR)/autophagy markers. The high-Met diet significantly increased parental and offspring urinary tHcy levels and influenced offspring behavior in a sex-dependent manner. Female offspring exhibited impaired cognition, potentially related to morphometric changes observed exclusively in HHcy females. Male HHcy pups demonstrated muscle weakness, evidenced by slower surface righting, reduced hind limb suspension (HLS) hanging time, weaker grip strength, and decreased activity in the beaker test. Western blot analyses indicated the downregulation of autophagy and the upregulation of mTOR activity in HHcy cortexes. HHcy also led to breeding impairments, including reduced breeding rate, in-utero fetal death, lower pups' body weight, and increased mortality, likely attributed to placental dysfunction associated with HHcy. In conclusion, a high-Met diet impairs memory and cognition in female juveniles and weakens muscle strength in male pups. These effects may stem from abnormal placental function affecting early neurogenesis, the dysregulation of autophagy-related pathways in the cortex, or epigenetic mechanisms of gene regulation triggered by HHcy during embryonic development.

Abstract 20: Axonal Neuropathy and Inflammatory Response in Peripheral Nerves of a Murine Cerebral Amyloid Angiopathy Model

Introduction: Cerebral amyloid angiopathy (CAA) induces intracerebral hemorrhages, small vessel disease, and cognitive decline in elderly individuals. CAA is also associated with slower walking speed and abnormal gait rhythms compared to healthy controls. Little is known regarding the impact of peripheral nervous system abnormalities on CAA-associated gait disturbance. Furthermore, it is unknown whether peripheral nerves pose extracerebral targets of amyloid-related endoneurial inflammation. Hypothesis: Gait disturbance in a CAA model is associated with peripheral neuropathy through endoneurial inflammation related to amyloid accumulation. Methods: Aged (19-24 months) Tg-SwDI mice (CAA mice) of both sexes harboring mutations of human amyloid precursor protein (APP) were used as a CAA model. Age-matched C57BL/6 wild-type (WT) mice were used as controls (n=6-11/grp). Gait disturbance and sensorimotor function were assessed via DigiGait and grip strength testing. Flow cytometry was used to analyze immune cells in the sciatic nerve. Tibial nerve morphometry was performed to assess for neuropathy. Results: CAA mice had weaker grip strength ( CAA: 97.7 ± 17.6 g, WT 111.5 ± 8.1 g, p=0.039 ) and evidence of neuropathic gait disturbances, reflected by increased paw angles ( CAA: 21.1 ± 4.8°, WT 11.7 ± 3.4°, p=0.0002 ) and reduced paw areas ( CAA: 0.4 ± 0.05 cm 2 , WT 0.5 ± 0.06 cm 2 , p=0.013 ) impacting the ground when walking compared to WT mice. Tibial nerve morphometry showed a reduced number of myelinated nerve fibers ( CAA: 1023 ± 230.1, WT 1318 ± 45.8, p=0.0047 ) suggesting potential axonal degeneration in CAA mice. Flow cytometry showed an increase in the count of macrophage (both M1 and M2 subtypes) lineage cells ( M1 CAA: 102.3 ± 29.2, WT 57.9 ± 36.3, p=0.009 ) as well as M1 macrophage associated pro-inflammatory cytokine TNF-α ( CAA: 99.7 ± 28.3, WT 53.8 ± 12.2, p=0.009 ) in sciatic nerves of CAA mice compared to WT mice. Conclusions: CAA mice display an enhanced inflammatory response within the endoneurium which may contribute to observed axonal degeneration, ultimately impairing sensorimotor function and gait. Further studies are needed to unravel the mechanistic interplay between amyloid pathology, endoneurial inflammation, and axonal neuropathy in this CAA model.

Multifactorial risk factors for hospital readmissions among patients with symptoms of advanced heart failure.

Economic burden of heart failure is attributed to hospital readmissions. Previous studies assessing risk factors for readmissions have focused on single group of risk factors, were limited to 30-day readmissions, or did not account for competing risk of mortality. This study investigates the biological, socio-economic, and behavioural risk factors predicting hospital readmissions while accounting for the competing risk of mortality. In this prospective cohort study, we recruited 250 patients hospitalized with symptoms of advanced heart failure [New York Heart Association (NYHA) Class III and IV] between July 2017 and April 2019. We analysed their baseline survey data and their hospitalization records over the next 4.5years (July 2017 to January 2022). We used a joint-frailty model to determine the multifactorial risk factors for all-cause and unplanned hospital readmissions and mortality. At the time of recruitment, patients' mean (SD) age was 66 (12) years, majority being male (72%) and NYHA class IV (68%) with reduced ejection fraction (72%). 87% of the patients had poor self-care behaviours, 51% had diabetes and 56% had weak grip strength. Within 2years of a hospital admission, 74% of the patients had at least one readmission. Among all readmissions during follow-up, 68% were unplanned. Results from the multivariable regression analysis shows that the independent risk factors for hospital readmissions were biologic-weak grip strength [hazard ratio (95% CI): 1.59 (1.06, 2.13)], poor functional status [1.79 (0.98, 2.61)], diabetes [1.42 (0.97, 1.86)]; behavioural-poor self-care [1.66 (0.84, 2.49)], and socio-economic-preference for maximal life extension at high cost for those with high education [1.98 (1.17, 2.80)]. Risk factors for unplanned hospital readmissions were similar. A higher hospital readmission rate increased the risk of mortality [1.86 (1.23, 2.50)]. Other risk factors for mortality were biologic-weak grip strength [3.65 (0.57, 6.73)], diabetes [2.52 (0.62, 4.42)], socio-economic-lower education [2.45 (0.37, 4.53)], and being married [2.53 (0.37, 4.69)]. Having a private health insurance [0.40 (0.08, 0.73)] lowered the risk for mortality. Risk factors for hospital readmissions and mortality are multifactorial. Many of these factors, such as weak grip strength, diabetes, poor self-care behaviours, are potentially modifiable and should be routinely assessed and managed in cardiac clinics and hospital admissions.