Muscle Strength and Physical Performance as Predictors of Mortality, Hospitalization, and Disability in the Oldest Old
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Objectives To evaluate the predictive value of muscle strength and physical performance in the oldest old for all‐cause mortality; hospitalization; and the onset of disability, defined as a decline in activities of daily living ( ADL s), independent of muscle mass, inflammatory markers, and comorbidities. Design A prospective, observational, population‐based follow‐up study. Setting Three well‐circumscribed areas of Belgium. Participants Five hundred sixty participants aged 80 and older were followed for 33.5 months (interquartile range 31.1–35.6 months). Measurements Grip strength, Short Physical Performance Battery ( SPPB ) score, and muscle mass were measured at baseline; ADL s at baseline and after 20 months; and all‐cause mortality and time to first hospitalization from inclusion onward. Kaplan‐Meier curves and Cox proportional hazards models were calculated for all‐cause mortality and hospitalization. Logistic regression analysis was used to determine predictors of decline in ADL s. Results Kaplan–Meier curves showed significantly higher all‐cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score. The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization, independent of muscle mass, inflammatory markers, and comorbidity. A relationship was found between SPPB score and decline in ADL s, independent of muscle mass, inflammation, and comorbidity. Conclusion In people aged 80 and older, physical performance is a strong predictor of mortality, hospitalization, and disability, and muscle strength is a strong predictor of mortality and hospitalization. All of these relationships were independent of muscle mass, inflammatory markers, and comorbidity.Keywords:
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To evaluate the effectiveness of a 24-week nutritional supplementation program involving whey protein intake after resistance exercise in treatment of sarcopenia and quality of life (QOL) among older women with sarcopenia, we carried out a pilot study, randomized controlled trial among elderly individuals with sarcopenia, aged 65-years or older, who were allocated to three groups: exercise and whey protein supplementation (Ex+Whey) group, exercise (Ex) group, and whey protein supplementation (Whey) group. Sarcopenia was defined using the Asian Working Group for sarcopenia 2014 criteria, as follows: low hand-grip strength (<18.0 kg) or slow gait speed (<0.8m/sec), and low skeletal muscle mass index (SMI, <5.7kg/m2). A 24-week program of resistance exercise, carried out twice per week, was combined with whey protein supplementation, involving 11.0 g of protein and 2,300 mg of leucine. After the 24-week intervention period, the Ex+Whey group (n=20) showed a decrease in sarcopenia, lower SMI, lower grip strength, and increase in physical QOL score (sarcopenia; p=0.004, SMI and grip strength; p=0.008, QOL; p=0.027). After the 24-week intervention period, the Whey group (n=20) showed a decrease in sarcopenia and lower SMI (all p=0.017). The Ex-group (n=19) did not show a decrease in sarcopenia, lower SMI, and lower grip strength. These results suggest that resistance exercise and whey protein intake in older women with sarcopenia, on the multiple outcome measures such as improves lower SMI, lower grip strength, and physical QOL. However, there were no between-group differences in the change from the pre- to the post-intervention period at 24 weeks in the lower SMI and lower grip strength. In this study, the intervention effect of Ex+Whey could not be clearly shown in the outcome measures.
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Objective: The aim of this research was to assess the association between periodontitis and grip strength among older American adults.Data from the National Health and Nutrition Examination Survey 2011/2012 and 2013/2014 were used. Oral health status and hand grip strength were clinically assessed. Three outcome variables were used: (1) handgrip strength <30 kg for men, <20 kg for women; (2) handgrip strength <26 kg for men, <16 kg for women; and (3) mean maximum grip strength. The main exposure was the case definition of periodontitis. Logistic and linear regression models were constructed for grip strength definitions and the mean grip strength, respectively, adjusting for covariates.The study included 1953 participants. The mean age was 68.5 years, and 47.2% were males. The prevalence of low grip strength (<30 kg for men, <20 kg for women) was 7.4% in men and 13.6% in women. Periodontitis was significantly associated with grip strength (OR 1.53, 95% CI: 1.03, 2.27) in the unadjusted model. Periodontitis was also significantly associated with maximum grip strength (Coefficient 1.05, 95% CI -1.99, -0.09) in a model adjusted for age and gender. However, in all the fully adjusted models there was no statistically significant association between periodontitis and grip strength.Low grip strength appeared to be more common among persons with moderate/severe periodontitis. The observed association is probably attributed to older age and common risk factors for periodontitis and frailty.
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FCR-sling resectional arthroplasty does not definitely prevent a proximalisation of the first metacarpal bone. Since power transmission of the thenar muscles requires a particular length of the thumb, does proximalisation lead to a reduction of grip strength of the hand? In a prospective study, hand-, key- and pinch-grip strength was compared to preoperative data. Pain intensity and thumb mobility were also examined. In comparison to preoperative data, the pain-free pinch grip improved 60% after three months and 100% after 12 months (p < 0.01). The maximum pinch grip improved 11% after three and 34% after 12 months (p < 0.01). The pain-free key grip improved 22% after three months and 50% after 12 months (p < 0.01). The maximum key grip showed a fair reduction after three months, but after 12 months the key pinch strength came up to preoperative level. The hand grip strength showed a statistically significant improvement of 9% after three months and 34% after 12 months (p < 0.01). After one year, 80% of the patients were completely painfree. There was no clinically relevant disturbance of thumb movement following surgery. Owing to proximalisation of the first metacarpal, a scapho-metacarpal distance of 5.3 (2-9) mm was measured. Despite proximalisation of the first metacarpal, a significant improvement of the grip strength was observed, which was rooted in simultaneous pain reduction.
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Objetive: To determine if the hand grip strength can be a method predictor of sarcopenia in older adults. Method: A bibliographic search was carried out in the electronic data base PUBMED, including human clinical studies conducted in the last 5 years. Results and Conclusion: We included 9 studies that used hand grip strength for the detection of sarcopenia in older adults. It was found that sarcopenia is a multifactorial pathology, characterized by a low strength (dynapenia) and skeletal muscle mass in those who present this pathology. The handgrip strength has proven to be a valid, reliable method with an easy applicability to predict sarcopenia in older adults independent of the muscular strength of the lower limbs.
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Hand grip strength is an inevitable component in the evaluation of rheumatoid arthritis, neuromuscular, preoperative, post operative patients and community dwelling older adults' functional capacity. Hand grip varies greatly with age, gender and the anthropometric measures when measured by hand dynamometer. The influence of above variables on hand grip when measured by modified sphygmomanometer is unknown. Further, the prediction of hand grip from age and anthropometric traits is unknown. 229 subjects (115 males and 114 females) with age 23 ± 2 and 21 ± 2 respectively were included in the study after informed c nsent. Weight and height were obtained using standard techniques. Hand grip was measured using a modified sphygmomanometer. Information regarding physical activity and health status was obtained by interview, clinical screening and stratified. Stepwise multiple regression analysis was sought out for any influence of age, height, weight and Body Mass Index (BMI) on hand grip strength. Grip strength correlated moderate to high with age (r = 0.44, p = 0.00), height (r = 0.57, p = 0.00), weight (r = 0.57, p = 0.00) and BMI (r = 0.29, p = 0.00). The regression model for handgrip strength is Hand grip = -1790.54 + 4.93557 × Age-11.7429 × Weight + 1083.4 × Height + 34.194 × BMI. Age, height and weight are the i portant determinants of the handgrip evaluation. In clinical setting, the influence of age and anthropo etric traits on handgrip shall be borne in mind when measuring handgrip by modified sphygmomanometer in age group of 20-25 year patients.
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Hand grip strength is a simple tool to measure the muscle function and thereby nutrition in dialysis patients. We enrolled 30 Chronic Peritoneal Dialysis(CPD) patients and 50 maintenance Hemodialysis(MHD) patients and assessed hand grip strength. The study population consisted of 50 patients undergoing MHD (men - 78%) with a mean age of 53.62 ±12.45 years and 30 CPD (men - 63%) patients with a mean age of 58.6±11.52 years. Of these MHD population 30(60%) were diabetic and in CPD 20(66.7%) were diabetic. Other demographic and clinical details were collected. The hand grip strength was significantly different between men and women in the group on MHD (p=0.020) and CPD (p=0.016). The hand grip strength was also significantly higher among the employed patients (p<0.001). lt was not significantly different between vegetarians and non-vegetarians (13=0.655). The hand grip strength was significantly lower in patients with a Hb <10g/di, (p=0.023) The hand grip strength was not significantly associated with serum albumin level (p=0.219) or diabetic status W=0.908). To conclude, hand grip strength is a simple tool used to measure the muscle function and malnutrition in dialysis patient. In our centre Hemodialysis patient have more muscle mass strength compared to peritoneal dialysis patients.
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