Weak Handgrip Strength Research Articles

Familial Correlation and Heritability of Hand Grip Strength in Korean Adults (Korea National Health and Nutrition Examination Survey 2014 to 2019).

The onset and progression of sarcopenia are highly variable among individuals owing to genetic and environmental factors. However, there are a limited number of studies measuring the heritability of muscle strength in large numbers of parent-adult offspring pairs. We aimed to investigate the familial correlation and heritability of hand grip strength (HGS) among Korean adults. This family-based cohort study on data from the Korea National Health and Nutrition Examination Survey (2014 to 2019) included 5,004 Koreans aged ≥19 years from 1,527 families. HGS was measured using a digital grip strength dynamometer. Familial correlations of HGS were calculated in different pairs of relatives. Variance component methods were used to estimate heritability. The heritability estimate of HGS among Korean adults was 0.154 (standard error, 0.066). Correlation coefficient estimates for HGS between parent-offspring, sibling, and spouse pairs were significant at 0.07, 0.10, and 0.23 (P<0.001, P=0.041, and P<0.001, respectively). The total variance in the HGS phenotype was explained by additive genetic (15.4%), shared environmental (11.0%), and unique environmental (73.6%) influences. The odds of weak HGS significantly increased in the offspring of parents with weak HGS (odds ratio [OR], 1.69-3.10; P=0.027-0.038), especially in daughters (OR, 2.04-4.64; P=0.029-0.034). HGS exhibits a familial correlation and significant heritable tendency in Korean adults. Therefore, Asian adults, especially women, who have parents with weak HGS, need to pay special attention to their muscle health with the help of healthy environmental stimuli.

Risk factors associated with weak and asymmetric handgrip strength in older Chinese adults.

This study sought to investigate the potential risk factors associated with weak and asymmetric handgrip strength (HGS) in older Chinese adults. A total of 2702 participants aged ≥65 years from the two waves of data (2011 and 2013) from the China Health and Retirement Longitudinal Study were analyzed. The highest recorded HGS values (Method A) or the average HGS values (Method B) for the dominant hand were used to compute the HGS asymmetry (nondominant HGS/dominant HGS out of 0.9-1.1) and HGS weakness (male <28 kg, female <18 kg). Risk factors associated with the weak and asymmetric HGS were identified by logistic regression analysis. Risk factors associated with weak and asymmetric HGS of varying severity differed between the two methods. Both methods identified age and illiteracy as risk factors for weak HGS with 10%-20% asymmetry. Method A also identified speech impediment, stroke, and sleep duration as additional risk factors. Similarly, both methods identified age, illiteracy, primary school education and below, diabetes, and stroke as risk factors for weak HGS and asymmetry over 30.1%. Method B additionally identified a history of falls as a risk factor. However, apart from age, the risk factors for weak HGS with 20.1%-30% asymmetry differed between the two methods-Method A identified kidney disease, while Method B identified illiteracy and asthma. The results revealed that risk factors associated with the abnormal HGS in older adults varied based on the methods used to define these conditions.

Associations among body mass index, handgrip strength, and cognitive impairment in older men and women in India

BackgroundThis study examined the associations among body mass index (BMI), handgrip strength (HGS) and cognitive impairment among older adults in India. We also assessed whether these associations vary by gender. MethodsWe used data from baseline wave of the Longitudinal Aging Study in India (2017–18) with a sample of 31,464 adults age 60 and above. Cognitive impairment was assessed using different domains of cognition, including memory, orientation, arithmetic functioning, and visuospatial and constructional ability. We used multivariable logistic regression and interaction analyses to test the research hypotheses. ResultsOlder women had 2.25 times the odds of cognitive impairment than older men [AOR: 2.25; CI: 2.01–2.53]. The odds of cognitive impairment were 1.36 times among underweight older adults [AOR: 1.36; CI: 1.23–1.50], 0.72 times among overweight [AOR: 0.72; CI: 0.62–0.83], and 0.66 times among obese older adults [AOR: 0.66; CI: 0.51–0.84] compared to peers with normal BMI. Underweight women had 3.14 times the odds of being cognitively impaired [AOR: 3.14; CI: 2.67–3.68] compared to older men with normal BMI. Further, older men who were underweight and had a weak HGS had higher odds of cognitive impairment than older men with a normal BMI and strong HGS. Conversely, older women who were overweight or obese and had strong HGS reported lower odds of cognitive impairment than older women with normal BMI and strong HGS. ConclusionsThat the association between BMI and cognitive impairment differs between men and women and by HGS gives health care providers and practitioners additional information needed to identify groups of older adults most susceptible to cognitive impairment. In particular, gender specific policies and an assessment of HGS may be useful when crafting interventions to minimize the negative consequences of varying body types on later life cognitive function.

Cross-sectional association of skeletal muscle mass and strength with dietary habits and physical activity among first-year university students in Japan: Results from the KEIJI-U study

ObjectiveRecently, the high prevalence of young Japanese individuals who are underweight has received attention because of the potential risk for sarcopenia. The aim of this study was to examine the prevalence and characteristics of sarcopenia in Japanese youth. MethodsIn this cross-sectional study, we measured skeletal muscle mass using a multifrequency bioelectrical impedance analysis device and handgrip strength (HGS) and administered questionnaires on dietary habits and physical activity in 1264 first-year university students ages 18 to 20 y (838 men and 426 women). Sarcopenia was confirmed based on the presence of both low skeletal muscle mass and weak muscle strength. ResultsIn all, 145 men (17%) and 69 women (16%) were diagnosed as underweight. Sarcopenia was diagnosed in 8 men (1%) and 5 women (1%). There was a significantly higher prevalence of low skeletal muscle mass index (SMI) and/or weak HGS in underweight individuals than in those in other body mass index (BMI) ranges. The multivariate analyses indicated that SMI and HGS were significantly associated with BMI in both sexes. Furthermore, after adjusting for BMI, both SMI and HGS were significantly associated with physical activity in men, and SMI was significantly associated with energy intake in women. ConclusionsFirst-year university students showed a high incidence of being underweight with low SMI and/or weak HGS, but the prevalence of sarcopenia was low in both sexes. There may be sex differences in factors related to muscle mass and strength, but further research is needed to clarify this.

Prevalence of depression, anxiety and suicidal ideas and associated factors, in particular sensory impairments, in a population of Bashkortostan in Russia

To assess prevalence and associated factors of depression, anxiety and suicidal ideas in populations from Russia, we conducted in rural and urban regions in Bashkortostan/Russia two population-based studies (Ural Eye and Medical Study (UEMS), performed from 2015 to 2017; Ural Very Old Study (UVOS), performed from 2017 to 2020) which included participants aged 40 + years and 85 + years, respectively. Depression was assessed using the questionnaire of the Center for Epidemiologic Studies Depression Scale Scoresheet, and anxiety was examined applying the State Trait Inventory Anxiety Test. Suicidal ideas were explored by the question whether suicide had previously been thought of or attempted (and if yes, for what reasons). In the statistical analysis we assessed the mean of the main outcome parameter (depression score and anxiety score) and searched for associations between these parameters and other parameters in univariable and multivariable regression analyses. In the UEMS with 5893 individuals (age: 59.0 ± 10.7 years; range 40–94 years), higher depression score and anxiety score were associated (multivariable analysis) with more marked hearing loss (beta: 0.07; P < 0.001, and beta: 0.07; P < 0.0012, respectively) and worse visual acuity (beta: 0.04; P = 0.02; and beta: 0.03; P = 0.03, resp.), in addition to female sex, Russian ethnicity, lower educational level, less alcohol consumption, weaker hand grip strength, less physical activity, and higher prevalence of dry eye disease. Attempted suicide was reported by 88 (1.5%; 95% CI 1.2, 1.8) participants. Having thought of suicide within the last 6 months was reported by 63 (1.1%) individuals. Out of 1491 UVOS participants (age: 88.2 ± 2.8 years; range 85–100 years) with a mean depression score of 20.0 ± 10.3 (median 18; range 0–58), 916 (61.4%; 95% CI 59.0, 63.9) fulfilled the definition of depression (depressions core ≥ 16). Higher depression score and higher anxiety score correlated (multivariable analysis) with higher hearing loss score (beta: 0.07; P = 0.02, and beta: 0.08; P = 0.009, resp.) and worse visual acuity (beta: 0.13; P < 0.001, and beta: 0.09; P = 0.007, resp.), in addition to female sex, urban region, less physical activity, less fruit intake, and lower cognitive function. Overall, 15 (1.0%; 95% CI 0.50, 1.50) individuals had attempted or thought of suicide. In conclusion, the findings suggest that besides female sex, lower level of education and lower cognitive function, it was sensory impairment, namely vision and hearing impairment, which belonged to the determinants of depression and anxiety in these populations from Russia.

Skeletal muscle mass, muscle strength, and physical performance in children and adolescents with obesity.

Sarcopenic obesity (SO) is defined as obesity with low skeletal muscle function and mass. This study aimed to evaluate the presence of sarcopenic obesity according to different diagnostic criteria and assess the elements of sarcopenia in children and adolescents with obesity. A total of 95 children and adolescents with obesity (diagnosed with the use of International Obesity Task Force (IOTF) criteria) with a mean age of 12.7( ± 3) years participated in the study. Body composition was assessed with the use of bioelectrical impedance-BIA (Tanita BC480MA) and dual-energy X-ray absorptiometry-DXA (Hologic). Fat mass (FM) and appendicular skeletal muscle mass (SMMa) were expressed as kilograms (kg) and percentage (%). Muscle-to-fat ratio (MFR) was defined as SMMa divided by FM. A dynamometer was used in order to measure grip strength. Six-minute walk test (6MWT) and a timed up-and-go test (TUG) were used to assess physical performance. The presence of SO ranged from 6.32% to 97.89%, depending on the criteria used to define sarcopenia. Children with sarcopenia, defined as a co- occurrence of low skeletal muscle mass % (SMM%) measured by DXA (≤9th centile) according to McCarthy et al. and weak handgrip strength (≤10th centile) according to Dodds et al., had significantly lower SMMa measured by both DXA and BIA, lower maximal handgrip strength, and lower physical performance. Maximal handgrip was positively correlated with SMMa (kg) and SMMa% derived from both DXA and BIA and BIA-MFR. Maximal handgrip was negatively correlated with waist-to-height ratio (WHtR). The distance of 6MWT correlated positively with BIA-measured SMMa% and BIA-MFR. 6MWT distance correlated negatively with BIA-FM% and body mass index (BMI) z-score. TUG was positively correlated with BIA-FM%, BMI z-score, WHtR, and IOTF categories and negatively correlated with BIA-SMMa% and BIA-MFR. The presence of sarcopenia in our study varied depending on the diagnostic criteria used. This is one of the first studies evaluating muscle mass, muscle strength, and physical performance in children and adolescents with obesity. The study highlighted the need for the implementation of a consensus statement regarding SO diagnostic criteria in children and adolescents.

A Scoping Review of the Physiological Profiles of Motorsport Drivers: Implications for Athlete Training

ABSTRACT Automotive racing is one of the most internationally recognized sports. Drivers within their respective disciplines are exposed to a variety of forces throughout the race, each of which is theorized to inflict a physiological adaptation within the driver. Therefore, the aim of this scoping review was to collate the evidence and provide a summary of the physiological profiles of these drivers and provide practitioners with recommendations to optimize these adaptations. Of the 1,304 articles screened, 24 met the inclusion criteria. Of the included studies, 13 reported on the anthropometric and physiological measures of 4-wheeled racing athletes from both open and closed-wheel disciplines. The remaining 11 studies reported on the physiological profiles of 2-wheeled racing athletes from both on-road and off-road riding disciplines. Open-wheel racers have greater cardiopulmonary fitness than close-wheel racers, as well as greater strength throughout movements of neck lateral flexion and isometric knee extension. Close-wheel racers were shown to be heavier with greater fat mass than the open-wheel racers but exhibited greater isometric shoulder flexion and plantarflexion strength. Female 2-wheeled racers were also shown to have a weaker handgrip strength than their male counterparts. Whereas male on-road riders demonstrated greater levels of handgrip strength than their off-road counterparts.

Eight-year trajectories and predictors of cognitive function in community-dwelling Korean older adults with cardiovascular diseases.

This study aims to identify longitudinal patterns and predictors of cognitive function trajectories among Korean older adults with cardiovascular diseases. This study is a longitudinal panel analysis based on secondary data. Data from the the Korean Longitudinal Study of Ageing (KLoSA) were used for analysis. The KLoSA is a representative panel survey of older Koreans. We analyzed responses from 301 participants aged ≥65 years who completed the same survey more than three times out of five waves between 2012 and 2020. Latent class growth modeling identified two trajectories of cognitive function in older people with cardiovascular diseases: "low and declining" (n = 81, 26.9%) and "high and declining" (n = 220, 73.1%). Participants in "the low and declining trajectory group" were more likely to have a low educational level, weak handgrip strength, depression, and low social participation at baseline than those in "the high and declining trajectory group." Our results indicate a need to develop community-based tailored interventions for improving handgrip strength, mental health, and social participation in delaying cognitive decline in older people with cardiovascular diseases considering their educational level. Healthcare providers should be more concerned about older people with a weaker handgrip, depression, and low social activities as a high-risk group for cognitive decline over time in cardiovascular care. Therefore, it is necessary to evaluate them early with standardized tools and make subsequent strategies for the older population with cardiovascular diseases.

Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption, and Sarcopenia in Older Chinese Adults: A Cross-Sectional Study.

The purpose of this study was to investigate the association between moderate to vigorous physical activity (MVPA), sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia among older Chinese adults. This cross-sectional study enrolled 5418 older Chinese adults who participated in the Study on Global Aging and Adult Health (SAGE). Participants reported information about their physical activity, sedentary behavior, and dietary habits (fruit and vegetable intake). Sarcopenia was defined as the presence of low skeletal muscle mass and either a slow gait speed or weak handgrip strength. A multiple logistic regression model was employed to determine the relationship between MVPA, sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia. Only 32.63% of participants met all three recommendations (for MVPA, sedentary behavior, and fruit and vegetable intake). Compared with meeting none of the recommendations, meeting all three recommendations was associated with a lower risk of sarcopenia (OR = 0.63, 95% CI = 0.41-0.98). Moreover, meeting the recommendation for sufficient fruit and vegetable intake (OR = 0.69, 95% CI = 0.58-0.83), MVPA and fruit/vegetable intake (OR = 0.67, 95% CI = 0.52-0.86), and sedentary behavior and fruit/vegetable intake (OR = 0.69, 95% CI = 0.48-0.98) was associated with a lower risk of sarcopenia. Our findings indicate that in this large representative sample of older Chinese adults, meeting lifestyle recommendations for MVPA, sedentary behavior, and fruit and vegetable intake protected against sarcopenia.

Hand grip strength in venous thromboembolism: risk of recurrence and mortality

BackgroundThere is limited information on the relationship between muscle strength and recurrence and mortality after incident venous thromboembolism (VTE). ObjectivesTo investigate whether weak hand grip strength (HGS) was associated with risk of recurrence and mortality in patients with VTE recruited from the general population. MethodsParticipants from the Tromsø Study with a first-time VTE (n = 545) were included, and all VTE recurrences and deaths among the participants were recorded in the period 1994 to 2020. Weak HGS was defined as lowest 25th percentile of the general population, and incidence rates for VTE recurrence and mortality according to weak vs normal (>25th percentile) HGS, with 95% CIs, were estimated. ResultsThere were 90 recurrences and 350 deaths during a median of 3.7 years of follow-up. The fully adjusted hazard ratio (HR) for overall VTE recurrence for those with weak HGS vs those with normal HGS was 2.02 (95% CI, 1.23-3.30). The corresponding HRs for recurrence were 2.22 (95% CI, 1.18-4.17) in patients with a first deep vein thrombosis and 1.60 (95% CI, 0.72-3.57) in patients with a first pulmonary embolism. The cumulative 1-year survival was 74.9% and 77.8% in those with weak and normal HGS, respectively. For overall mortality after incident VTE, the fully adjusted HR for those with weak HGS was 1.34 (95% CI, 1.04-1.72). ConclusionWeak HGS was associated with an increased risk of recurrent VTE, and the association appeared to be particularly pronounced after incident deep vein thrombosis. There was a slightly lower survival probability among those with weak HGS than among those with normal HGS.

#4818 IMPACT OF COMBINED PHYSICAL FRAILTY AND DEPRESSIVE SYMPTOMS ON MORTALITY IN PATIENTS ON HEMODIALYSIS

Abstract Background and Aims Patients receiving hemodialysis [HD] are getting older, with 38.8% of patients in Japan being 75 years or older. HD patients also have multiple comorbidities, which are known to be associated with poor clinical outcomes, especially in the older patients. Moreover, physical frailty and depressive symptoms are common in HD patients and these are known to be risk factors for poor prognosis. However, it is unclear whether the coexistence of physical frailty and depressive symptoms contributes to an increased risk of mortality in older patients with multiple comorbidities. As a result, the goal of this study was to look at the relationship between physical frailty and depressive symptoms and mortality in HD patients of different ages. Method This study included 409 Japanese outpatients with HD (mean age 65.9 years, 62.6% male, and 2.0 years of hemodialysis history). Slow walking speed and/or weak hand grip strength were used to define physical frailty. The Center for Epidemiological Studies-Depression scale was used to assess depressive symptoms. Patients were divided into four groups: (1) no depressive symptoms, no physical frailty; (2) depressive symptoms, no physical frailty; (3) no depressive symptoms, physical frailty; and (4) depressive symptoms, physical frailty. All-cause mortality was the outcome; Cox regression analysis was performed, with analysis stratified by age group (&amp;lt;75 years, ≥75 years) to examine differences by age. Results Physical frailty and depressive symptoms were prevalent in 268 (65.5%) and 143 (35.0%) of the population, respectively. Physical frailty and depressive were present in 103 people (25.2%). 129 (31.5%) people died during the follow-up period (median 49 months). In all patients, Cox regression analysis revealed that physical frailty and no depressive symptoms (hazard ratio [HR], 1.86, 95% confidence interval [CI], 1.01–3.44) and coexistence of physical frailty and depressive symptoms (HR, 2.30, 95% CI, 1.23–4.28) were significantly associated with an increased risk of death. In the &amp;lt;75-year-old group, a combination of physical frailty and depressive symptoms was significantly associated with an increased risk of death (HR, 2.45; 95% CI, 1.23–4.88). In the ≥75-year-old group, however combined physical frailty and depressive symptoms were not significantly associated with mortality (HR, 2.06; 95% CI, 0.34–12.55), whereas C-reactive protein was (HR, 1.59; 95% CI, 1.10–2.28). Conclusion Physical frailty and depressive symptoms were common in HD patients. In terms of prognosis, the coexistence of physical frailty and depressive symptoms were linked to mortality in the &amp;lt;75-year-old group, whereas in the &amp;lt;75-year-old group, the coexistence of physical frailty and depressive symptoms was not associated with death, but higher inflammation was associated.

Changes in blood pressure associated with frailty and sarcopenia in elderly outpatients with cardiometabolic diseases.

We aimed to examine the relationship between changes in clinic blood pressure (BP) and frailty and sarcopenia in elderly outpatients with cardiometabolic disease. In 691 elderly outpatients with cardiometabolic diseases, the associations of frailty according to the modified Japanese Cardiovascular Health Study score (J-CHS) and Kihon Checklist (KCL) criteria with clinic BP were evaluated at baseline and followed up for 3 years. Among the patients (79.2 ± 6.3 years, male 35.6%), 30.4% had frailty by the J-CHS criteria and 38.0% by the KCL criteria. A J-curve relationship was observed between BP and frailty; the prevalence of frailty was the lowest in patients with systolic BP (SBP) 119.5-130.5 mmHg and in those with diastolic BP (DBP) 72.0-80.5 mmHg. Frailty by the J-CHS criteria correlated with lower DBP (OR = 0.892 per 5 mmHg increase, 95% confidence interval [CI] 0.819-0.972, P = 0.009), whereas that by the KCL criteria correlated with lower SBP (OR = 0.872 per 10 mmHg increase, 95% CI 0.785-0.969, P = 0.011) in multivariate-adjusted models. In patients with frailty by the J-CHS criteria at baseline, changes in DBP (OR = 0.921 per 1 mmHg change, 95% CI 0.851-0.996, P = 0.038) were associated with sustained frailty 1 year later. Changes in DBP were associated with progression to a slow walking speed 1 year later (OR = 0.939, 95% CI 0.883-0.999, P = 0.047). Changes in SBP (OR = 0.928, 95% CI 0.878-0.981, P = 0.008) and DBP (OR = 0.926, 95% CI 0.859-0.997, P = 0.042) were associated with progression to a weak hand grip strength 3 years later. A J-curve relationship was observed between frailty and BP, and a decline in BP was associated with progression to a slow walking speed and weak hand grip strength in elderly outpatients with cardiometabolic diseases. Geriatr Gerontol Int 2023; 23: 506-516.

Understanding Heterogeneity in the Relationship Between Cancer and Hand Grip Strength: A Longitudinal Analysis.

This study examined whether the relationship between cancer and hand grip strength differs by sex and along the hand grip strength distribution. Using six waves of the Korean Longitudinal Study of Ageing (KLoSA) (N = 9735), sex-stratified unconditional quantile regression models with fixed effects were used to assess sex-specific effects of cancer for patients in different quantiles of the hand grip strength distribution. Cancer diagnosis was negatively associated with hand grip strength for males, but not females, and this sex difference was statistically significant. Quantile regression models showed that the stronger association between cancer and hand grip strength is observed among males with weaker hand grip strength. No statistically significant association was found between hand grip strength and cancer in females across the entire distribution of hand grip strength. This study provided evidence of the heterogeneity in the relationship between cancer and hand grip strength.

Leisure-time physical activity and sarcopenia among older adults from low- and middle-income countries.

There are no data on the association between leisure-time physical activity (LTPA) and sarcopenia in older adults from low- and middle-income countries (LMICs). This study aimed to investigate the association between LTPA and sarcopenia in individuals aged ≥65years living in six LMICs. Cross-sectional data from the Study on Global AGEing and Adult Health (China, Ghana, India, Mexico, Russia and South Africa) were analysed. Sarcopenia referred to the presence of both low skeletal muscle mass and weak handgrip strength. LTPA was assessed using the Global Physical Activity Questionnaire and was analysed as a dichotomized variable [high LTPA (>150min/week of moderate-to-vigorous LTPA) or low LTPA (≤150min/week)]. Multivariable logistic regression analysis was conducted to assess associations. There were 14585 individuals included in this study [mean (SD) age 72.6 (11.5) years; 55.0% women]. The prevalence of high LTPA and sarcopenia was 8.9% and 12.0%, respectively. After adjusting for potential confounders, low LTPA was significantly associated with higher odds for sarcopenia [prevalence odds ratio (POR)=1.85, 95% confidence interval (CI)=1.29-2.65] compared with high LTPA. Significant associations were found in women (POR=3.22, 95% CI=1.82-5.68) but not in men (POR=1.52, 95% CI=0.99-2.35). A positive and significant association between low LTPA and sarcopenia was found among older adults from LMICs. The promotion of LTPA among older adults in LMICs may aid in the prevention of sarcopenia, especially among females, pending future longitudinal research.

Association of Protein Intake with Handgrip Strength and Its Relation to Strength Exercise in Korean Adults Aged over 60 Years in the KNHANES (2014-18).

Weak handgrip strength (HGS) is associated with many negative health outcomes in older adults. There is evidence that with strength exercise, high protein intake leads to increased HGS. The goal of this study was to examine the relationship between weak HGS in older adults and dietary protein and it's relation to resistance exercise. Data on 8497 Korean adults aged over 60 years from the Korea National Health and Nutrition Examination Survey (2014-18) were analyzed. Dietary protein intake measured by 24-h recall were categorized as three levels: low (<0.8 g/kg body weight (BW)), adequate (≥0.8 g/kg BW and <1.2 g/kg BW), and high (≥1.2 g/kg BW). Complex sample multiple logistic regression analyses were carried out. The prevalence of weak HGS was 18.3 (0.7)% in men and 28.8 (0.9)% in women. In a multiple logistic regression analysis, low protein intake was significantly associated with higher risk of weak HGS in men, as compared with adequate protein intake, but this relationship was not statistically significant in women. The risk of weak HGS was significantly reduced for both men and women who engaged in strength exercise and increased their dietary protein intake. In this study, based on a representative sample of Koreans aged over 60, men with low protein intake had a higher risk of weak HGS than did men with adequate protein intake. Men and women with a higher protein intake who also engaged in strength exercises had a lower risk of weak HGS. Increasing protein intake and engaging in strength exercises may be an effective way to preserve muscle strength in older men and women.

Handgrip Strength Is Related to Hippocampal and Lobar Brain Volumes in a Cohort of Cognitively Impaired Older Adults with Confirmed Amyloid Burden.

Strength and mobility are essential for activities of daily living. With aging, weaker handgrip strength, mobility, and asymmetry predict poorer cognition. We therefore sought to quantify the relationship between handgrip metrics and volumes quantified on brain magnetic resonance imaging (MRI). To model the relationships between handgrip strength, mobility, and MRI volumetry. We selected 38 participants with Alzheimer's disease dementia: biomarker evidence of amyloidosis and impaired cognition. Handgrip strength on dominant and non-dominant hands was measured with a hand dynamometer. Handgrip asymmetry was calculated. Two-minute walk test (2MWT) mobility evaluation was combined with handgrip strength to identify non-frail versus frail persons. Brain MRI volumes were quantified with Neuroreader. Multiple regression adjusting for age, sex, education, handedness, body mass index, and head size modeled handgrip strength, asymmetry and 2MWT with brain volumes. We modeled non-frail versus frail status relationships with brain structures by analysis of covariance. Higher non-dominant handgrip strength was associated with larger volumes in the hippocampus (p = 0.02). Dominant handgrip strength was related to higher frontal lobe volumes (p = 0.02). Higher 2MWT scores were associated with larger hippocampal (p = 0.04), frontal (p = 0.01), temporal (p = 0.03), parietal (p = 0.009), and occipital lobe (p = 0.005) volumes. Frailty was associated with reduced frontal, temporal, and parietal lobe volumes. Greater handgrip strength and mobility were related to larger hippocampal and lobar brain volumes. Interventions focused on improving handgrip strength and mobility may seek to include quantified brain volumes on MR imaging as endpoints.

Physical activity in young hip fracture patients is associated with health-related quality of life and strength; results from a multicenter study

BackgroundThe World Health Organization recommends a minimum of 150 min of moderate intensity exercise per week or 75 min of strenuous activity weekly for adults. Younger hip fracture patients are often assumed less active than the general population, however, knowledge on physical activity (PA) and health-related quality of life (HRQoL) in younger hip fracture patients is limited. ObjectivesWe aimed to 1) investigate the variation in pre-fracture PA for adult patients with hip fractures under the age of 60; and 2) to quantify the association with patient characteristics, including outcomes of HRQOL and handgrip strength. Design and methodsA prospective multicenter cohort study of 207 adult hip fracture patients under 60 years admitted to four study hospitals from July 2015 to December 2018. Data was collected through medical records, questionnaires, physical tests and interviews. PA level was assessed using a validated questionnaire from the Swedish National Board of Health and Welfare, providing a total score from 3 to 19. A score ≥11 corresponds to fulfillment of the WHO recommendation for weekly PA. Handgrip strength was measured in kilograms using a handheld dynamometer following a standardized protocol. Recall pre-fracture HRQoL was assessed using the EQ-5D-3L questionnaire. ResultsFifty-nine percent had a PA score ≤10 out of these 46% had an ASA grade of 3 or 4, 38% had a BMI over 25 and 81% had a low energy fracture. A PA score ≤10 was associated with a lower HRQoL compared to those who had a PA score ≥11. PA score ≤10 points was associated with weaker hand grip strength and a worse health status (higher ASA-grade) p<0.001. ConclusionWe found that close to two-thirds of the patients had a pre-fracture PA level below WHO recommendations. Being more active was associated with better handgrip strength, HRQoL, and ASA score. Our findings indicate that individuals under 60 years who sustain a hip fracture form a heterogeneous group, some severely comorbid and others highly active and seemingly healthy. This suggests a more nuanced approach to rehabilitation, as the more active patient might need a more individualized plan than the standard program can offer.

Association Between Pain and Sarcopenia Among Adults Aged ≥65 Years from Low- and Middle-Income Countries.

Pain may increase the risk for sarcopenia, but existing literature is only from high-income countries, while the mediators of this association are largely unknown. Thus, we aimed to investigate the association between pain and sarcopenia using nationally representative samples of older adults from 6 low- and middle-income countries (LMICs), and to identify potential mediators. Cross-sectional data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Sarcopenia was defined as having low skeletal muscle mass and weak handgrip strength, while the presence and severity of pain in the last 30days were self-reported. Multivariable logistic regression and mediation analyses were performed. The control variables included age, sex, education, wealth, and chronic conditions, while affect, sleep/energy, disability, social participation, sedentary behavior, and mobility were considered potential mediators. Data on 14,585 adults aged ≥65years were analyzed (mean [SD] age 72.6 [11.5] years; 55.0% females). Compared to no pain, mild, moderate, severe, and extreme pain were associated with 1.42 (95% confidence interval [CI]=1.05-1.94), 1.43 (95%CI=1.02-2.00), 1.92 (95%CI=1.09-3.37), and 2.88 (95%CI=1.10-7.54) times higher odds for sarcopenia, respectively. Disability (mediated percentage 18.0%), sedentary behavior (12.9%), and low mobility (56.1%) were significant mediators in the association between increasing levels of pain and sarcopenia. Higher levels of pain were associated with higher odds for sarcopenia among adults aged ≥65years in 6 LMICs. Disability, sedentary behavior, and mobility problems were identified as potential mediators. Targeting these factors in people with pain may decrease the future risk of sarcopenia onset, pending future longitudinal research.

Physical Multimorbidity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries

Introduction: Physical multimorbidity is plausibly linked to sarcopenia. However, to date, only a few studies exist on this topic, and none have examined this association in low- and middle-income countries (LMICs). Thus, we aimed to investigate the association between multimorbidity and sarcopenia in a sample of older adults from six LMICs (China, Ghana, India, Mexico, Russia, South Africa). Methods: Cross-sectional, community-based data from the WHO Study on Global Ageing and Adult Health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. A total of 11 physical chronic conditions were assessed and multimorbidity referred to ≥2 chronic conditions. Multivariable logistic regression analysis was conducted. Results: Data on 14,585 adults aged ≥65 years were analysed (mean age 72.6 years, SD 11.5 years; 53.7% females). Adjusted estimates showed that compared to no chronic physical conditions, ≥2 conditions are significantly associated with 1.49 (95% CI = 1.02–2.19) and 2.52 (95% CI = 1.53–4.15) times higher odds for sarcopenia and severe sarcopenia, respectively. Conclusions: In this large sample of older adults from LMICs, physical multimorbidity was significantly associated with sarcopenia and severe sarcopenia. Our study results tentatively suggest that targeting those with multimorbidity may aid in the prevention of sarcopenia, pending future longitudinal research.

Clinical significance of physical frailty in SCD subjects: A prospective study with amyloid PET data

AbstractBackgroundPhysical frailty is known to be closely associated with cognitive impairment and that it could be an early sign of Alzheimer disease (AD). We aimed to understand the characteristics of physical frailty and define factors associated with physical frailty in SCD subjects with amyloid data.MethodWe prospectively enrolled SCD subjects from of cohort study to identify predictors for the clinical progression to mild cognitive impairment or dementia from subjective cognitive decline (CoSCo) study. They all went through brain magnetic resonance imaging (MRI), and Florbetaben brain amyloid‐beta Positron Emission Tomography (PET). For physical frailty, self‐reported exhaustion, hand grip strength and gait speed were measured.ResultOf total 120 SCD subjects, 26 (21.7%) subjects showed positivity in amyloid PET scan. Logistic regression analyses showed that women (OR 3.79, p = 0.002) and amyloid PET positive (OR 3.80, p = 0.008) SCD subjects showed significantly more self‐reported exhaustion. Weak hand grip strength was significantly associated with Amyloid PET positivity (OR 3.22, p = 0.047) and high burden of periventricular WMH (OR 3.34, p = 0.023). The SCD subjects with physical frailty showed lower cognitive performance in neuropsychological test, especially information‐processing speed and executive function.ConclusionThe components of physical frailty are closely related to amyloid and cerebral vascular pathology in SCD subjects and the SCD subjects with physical frailty showed lower cognitive performance in neuro‐psychological test, especially information‐processing speed and executive function.