Impact of relative muscle power on hospitalization and all-cause mortality in older adults

2021 ◽  
Author(s):  
Jose Losa-Reyna ◽  
Julian Alcazar ◽  
Jose Carnicero ◽  
Ana Alfaro-Acha ◽  
Carmen Castillo-Gallego ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Healthy Aging ◽  
Muscle Power ◽  
Handgrip Strength ◽  
Relative Power ◽  
Men And Women ◽  
Adjusted Risk ◽  
Power Group ◽  
All Cause Mortality

Abstract Background The purpose of this study was to evaluate the relationship of lower-limb muscle power with mortality and hospitalization. Methods A total of 1928 subjects from the Toledo Study for Healthy Aging were included. Muscle power was assessed with the 5-repetition STS test and subjects were classified into different groups of relative power (i.e. normalized to body mass) according to sex-specific tertiles and their inability to perform the test. Mean follow-up periods for hospitalization and all-cause mortality were 3.3 and 6.3 years, respectively. Results Compared to the high relative muscle power group, men with low (HR [95%CI]= 2.1 [1.2-3.6]) and women with very low and low (HR [95%CI]= 4.7 [3.0-7.4] and 1.8 [1.2-2.7]) relative power had an increased age-adjusted risk of hospitalization. After adjusting for several covariates (age, physical activity, BMI education, depression, comorbidities, disability and handgrip strength) these effects were attenuated (men and women with very low relative power: HR [95%CI]= 1.6 [0.9-2.9] and 2.8 [1.6-4.9]). The very low relative muscle power group had also an increased all-cause mortality risk (age-adjusted) in both men and women (HR [95%CI]= 2.3 [1.4-3.9] and 2.9 [1.6-5.3]). After adjusting for all the covariates, a significantly increased mortality risk was observed only in men (HR [95% CI]= 2.1 [1.1-3.8], (women HR [95% CI]= 1.6 [0.8-3.2]), with very low levels of relative power. Conclusion Relative muscle power was independently and negatively associated with mortality and hospitalization in older adults. An augmented all-cause mortality risk was noted in the lowest group of relative muscle power.

scholarly journals ‘Fat but powerful’ paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study

2021 ◽  
pp. bjsports-2020-103720
Author(s):  
Julian Alcazar ◽  
David Navarrete-Villanueva ◽  
Asier Mañas ◽  
Alba Gómez-Cabello ◽  
Raquel Pedrero-Chamizo ◽  
...  
Keyword(s):  
Older Adults ◽  
Waist Circumference ◽  
Older People ◽  
Multicentre Study ◽  
Mortality Risk ◽  
Muscle Power ◽  
Smoking Status ◽  
Relative Power ◽  
Fat Percentage ◽  
All Cause Mortality

ObjectivesTo assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the ‘fat but powerful’ (F+P) (or ‘fat but fit’) paradox in older adults.MethodsA total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated.ResultsAccording to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively).ConclusionPowerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

scholarly journals The ‘fat but powerful’ paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET Multi-center Study

2020 ◽  
Author(s):  
Julian Alcazar ◽  
David Navarrete-Villanueva ◽  
Asier Mañas ◽  
Alba Gómez-Cabello ◽  
Raquel Pedrero-Chamizo ◽  
...  
Keyword(s):  
Older Adults ◽  
Waist Circumference ◽  
Older People ◽  
Mortality Risk ◽  
Muscle Power ◽  
Smoking Status ◽  
Relative Power ◽  
All Cause Mortality ◽  
Multi Center Study ◽  
Center Study

AbstractObjectivesTo assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the ‘fat but powerful’ (or ‘fat but fit’) paradox in older adults.MethodsA total of 2563 older adults (65‒91 years old) from the EXERNET Multi-center study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status, and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), fat but powerful (F+P), lean but weak (L+W) and fat and weak (F+W). Cox proportional hazard regression models and adjusted hazard ratios (HR) were calculated.ResultsAccording to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, respectively; p≤0.049) and L+P (HR=0.57 and 0.58, respectively; p≤0.043) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, respectively; p≤0.011).ConclusionPowerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

Office-Based Physical Assessment in Patients Aged 75 Years and Older with Cardiovascular Disease

Gerontology ◽  
2019 ◽  
Vol 65 (2) ◽  
pp. 128-135 ◽  
Author(s):  
Ryota Matsuzawa ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Kohei Nozaki ◽  
Shinya Tanaka ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Physical Performance ◽  
Mortality Risk ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Walk Distance ◽  
Physical Assessment ◽  
All Cause Mortality ◽  
Usual Gait Speed

Background: The detection of impaired physical performance in older adults with cardiovascular disease is essential for clinical management and therapeutic decision-making. There is a requirement for an assessment tool that can be used conveniently, rapidly, and securely in clinical practice for screening decreased physical performance. Objective: The present study was performed to evaluate the association of office-based physical assessments with decreased physical performance and to compare the prognostic capability of these assessments in older adults with cardiovascular disease. Methods: A total of 1,040 patients aged 75 years and older with cardiovascular disease were included in this analysis. One-leg standing time (OLST) and handgrip strength were measured as office-based physical assessment tools, and short physical performance battery (SPPB), 6-min walk distance, and usual gait speed were also measured at hospital discharge as measurements of physical performance. All-cause mortality was assessed by death registry at the hospital. We examined the association of office-based measures with physical performance and all-cause mortality. Results: The areas under the curve of OLST for SPPB < 10, 6-min walk distance < 300 m, and usual gait speed < 1.0 m/s were 0.87 (95% CI 0.83–0.91), 0.83 (95% CI 0.80–0.86), and 0.81 (95% CI 0.78–0.85), respectively. The discrimination abilities of OLST for decreased physical performance were significantly higher than those of handgrip strength. After adjusting for the effects of patient characteristics, the hazard ratio for all-cause mortality in the < 3 s group for OLST was 1.68 (95% CI 1.06–2.67, p = 0.03). Handgrip strength, however, was not significantly associated with mortality risk in these participants. Conclusion: Short OLST, in particular < 3 s, is associated with decreased physical performance and elevated mortality risk in elderly patients with cardiovascular disease. OLST can be conveniently measured in the clinician’s office as a screening tool for impaired physical performance.

scholarly journals Waist Circumference and All-Cause Mortality among Older Adults in Rural Indonesia

2019 ◽  
Vol 16 (1) ◽  
pp. 116 ◽  
Author(s):  
Cahya Utamie Pujilestari ◽  
Lennarth Nyström ◽  
Margareta Norberg ◽  
Nawi Ng
Keyword(s):  
Older Adults ◽  
Waist Circumference ◽  
Abdominal Obesity ◽  
Mortality Risk ◽  
Cox Regression ◽  
Public Health Intervention ◽  
World Health ◽  
Men And Women ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Waist circumference, a measure of abdominal obesity, is associated with all-cause mortality in general adult population. However, the link between abdominal obesity with all-cause mortality in the studies of older adults is unclear. This study aims to determine the association between waist circumference and all-cause mortality in older adults in Indonesia. The association between waist circumference and all-cause mortality was examined in 10,997 men and women aged 50 years and older, in the World Health Organization (WHO) and International Network of field sites for continuous Demographic Evaluation of Populations and their Health in developing countries (INDEPTH) collaboration Study on global AGEing and adult health (SAGE) in Purworejo District Central Java, Indonesia during 2007–2010. Multivariate Cox regression analysis with restricted cubic splines was used to assess the non-linear association between waist circumference and all-cause mortality. During the 3-year follow-up, a total of 511 men and 470 women died. The hazard ratio plot shows a pattern of U-shape relationship between waist circumference and all-cause mortality among rich women, though the result was significant only for women in the lower end of waist circumference distribution (p < 0.05). Poor men with a low waist circumference (5th percentile) have a two times higher mortality risk (HR = 2.1; 95% CI = 1.3, 3.3) relative to those with a waist circumference of 90 cm. Poor women with a low waist circumference (25th percentile) have a 1.4 times higher mortality risk (HR = 1.4; 95% CI = 1.1, 1.8) relative to those with a waist circumference of 80 cm. This study shows a significant association between low waist circumference measure and mortality, particularly among poor men and women. Though the association between large waist circumference and mortality was not significant, we observed a trend of higher mortality risk particularly among rich women with large waist circumference measure. Public health intervention should include efforts to improve nutritional status among older people and promoting healthy lifestyle behaviours including healthy food and active lifestyle.

scholarly journals Effects of social network diversity in the disablement process: a comparison of causal inference methods and an outcome-wide approach to the Indonesian Family Life Surveys, 2007–2015

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Julia Schröders ◽  
Fatwa Sari Tetra Dewi ◽  
Maria Nilsson ◽  
Mark Nichter ◽  
Miguel San Sebastian
Keyword(s):  
Older Adults ◽  
Social Network ◽  
Health Outcomes ◽  
Health Effects ◽  
Family Life ◽  
Process Model ◽  
Healthy Aging ◽  
Men And Women ◽  
Disablement Process ◽  
Wide Range

Abstract Background Social networks (SN) have been proven to be instrumental for healthy aging and function as important safety nets, particular for older adults in low and middle-income countries (LMICs). Despite the importance of interpreting health outcomes in terms of SN, in many LMICs – including Indonesia – epidemiological studies and policy responses on the health effects of SN for aging populations are still uncommon. Using outcome-wide multi-method approaches to longitudinal panel data, this study aims to outline more clearly the role of SN diversity in the aging process in Indonesia. We explore whether and to what degree there is an association of SN diversity with adult health outcomes and investigate potential gender differences, heterogeneous treatment effects, and effect gradients along disablement processes. Methods Data came from the fourth and fifth waves of the Indonesian Family Life Survey fielded in 2007–08 and 2014–15. The analytic sample consisted of 3060 adults aged 50+ years. The primary exposure variable was the diversity of respondents’ SN at baseline. This was measured through a social network index (SNI), conjoining information about household size together with a range of social ties with whom respondents had active contact across six different types of role relationships. Guided by the disablement process model, a battery of 19 outcomes (8 pathologies, 5 impairments, 4 functional limitations, 2 disabilities) were included into analyses. Evidence for causal effects of SN diversity on health was evaluated using outcome-wide multivariable regression adjustment (RA), propensity score matching (PSM), and instrumental variable (IV) analyses. Results At baseline, 60% of respondents had a low SNI. Results from the RA and PSM models showed greatest concordance and that among women a diverse SN was positively associated with pulmonary outcomes and upper and lower body functions. Both men and women with a high SNI reported less limitations in performing activities of daily living (ADL) and instrumental ADL (IADL) tasks. A high SNI was negatively associated with C-reactive protein levels in women. The IV analyses yielded positive associations with cognitive functions for both men and women. Conclusions Diverse SN confer a wide range of strong and heterogeneous long-term health effects, particularly for older women. In settings with limited formal welfare protection, intervening in the SN of older adults and safeguarding their access to diverse networks can be an investment in population health, with manifold implications for health and public policy.

scholarly journals Handgrip strength, depression, and all-cause mortality in Korean older adults

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Soohyun Park ◽  
Jinkyung Cho ◽  
Donghyun Kim ◽  
Youngyun Jin ◽  
Inhwan Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Handgrip Strength ◽  
All Cause Mortality

Associations Between Handgrip Strength and Disease-Specific Mortality Including Cancer, Cardiovascular, and Respiratory Diseases in Older Adults: A Meta-Analysis

2020 ◽  
Vol 28 (2) ◽  
pp. 320-331
Author(s):  
Junga Lee
Keyword(s):  
Older Adults ◽  
Older Women ◽  
Respiratory Diseases ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Adult Participants ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Several controversial studies linking handgrip strength and health have suggested that low handgrip strength in older adults may be related to health problems and have investigated whether there is a minimum handgrip strength level associated with reduced mortality. Thus, by meta-analysis, the authors identified an association between handgrip strength in older adults and disease-specific mortality and all-cause mortality. Thirty studies with a total of 194,767 older adult participants were included in this meta-analysis. Higher handgrip strength was associated with an 18% decrease in all-cause mortality. Lower handgrip strength was associated with increased all-cause mortality. The minimum handgrip strength in older women that did not increase all-cause mortality was 18.21 kg. Increased handgrip strength showed a decreased all-cause mortality, whereas decreased handgrip strength was associated with increased all-cause mortality. Strengthening the handgrip may help improve disease-specific mortality in older adults.

scholarly journals Changes in waist circumference and risk of all-cause and CVD mortality: results from the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Angela A. Mulligan ◽  
Marleen A. H. Lentjes ◽  
Robert N. Luben ◽  
Nicholas J. Wareham ◽  
Kay-Tee Khaw
Keyword(s):  
Weight Loss ◽  
Waist Circumference ◽  
Mortality Risk ◽  
Total Mortality ◽  
Later Life ◽  
Central Adiposity ◽  
Men And Women ◽  
All Cause Mortality ◽  
Cvd Mortality ◽  
Prospective Investigation

Abstract Background Measures of abdominal adiposity are strongly associated with all-cause mortality and cardiovascular disease (CVD). However, data are limited and conflicting regarding the consequences of changes in body fat distribution. The main aims of this paper are to investigate the association between changes in waist circumference (WC) and all-cause and CVD mortality and to examine these changes in relation to concurrent changes in weight. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study recruited 25,639 participants between 1993 and 1997, aged 39–79, a number of whom also attended a second examination (1998–2000), and were followed up to 2016 for mortality. Participants were eligible for inclusion if they had WC, weight and height measurements at both time-points; those with a self-reported history of CVD or cancer, body mass index < 18.5 kg/m2 or missing data on covariates were excluded, leaving 12,337 participants for analyses. The median (IQR) follow-up time was 16.4 (15.7, 17.2) years. Hazard Ratios (HRs) for all-cause (2866 deaths) and CVD mortality (822 deaths), by categories of WC change, were determined using Cox proportional hazards analyses. Results After multivariable adjustment, the HRs (95% CIs) for all-cause mortality for men and women with a WC gain (WCG) >  5 cm were 1.51 (1.29–1.75) and 1.25 (1.06–1.46) respectively. For CVD mortality in men and women with a WCG >  5 cm, the HRs were 1.84 (1.39–2.43) and 1.15 (0.85–1.55) respectively. In analyses of concurrent changes in WC and weight, the greatest risk (HRs) (95% CIs) in men occurred with weight loss and WCG: 1.80 (1.13–2.86) for all-cause and 2.22 (1.03–4.82) for CVD mortality. In women, the greatest risk for both all-cause (HR 1.50 (1.16–1.95)) and CVD mortality (HR 1.81 (1.15–2.85)) was observed in those with weight loss and maintenance of WC (WCM). Conclusions Objectively measured WCG > 5 cm, was associated with subsequent higher total mortality risk and higher CVD mortality risk in men. Interventions focusing on preventing increase in central adiposity rather than lowering weight per se in later life may potentially have greater health benefits.

scholarly journals Prospective GERiatric Observational (ProGERO) Study: Cohort Design and Preliminary Results

2020 ◽  
Author(s):  
Marcos Daniel Saraiva ◽  
Luís Fernando Rangel ◽  
Julia Lusis Lassance Cunha ◽  
Thereza Cristina Ariza Rotta ◽  
Christian Douradinho ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Hospital Admissions ◽  
Handgrip Strength ◽  
Academic Medical Center ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Charlson Comorbidity Index Score ◽  
Study Cohort ◽  
Demographic Changes

Abstract Background: The demographic changes in Brazil as a result of population aging is one of the fastest in the world. The far-reaching new challenges that come with a large older population are particularly disquieting in low- and middle-income countries (LMICs). Longitudinal studies must be completed in LMICs to investigate the social and biological determinants of aging and the consequences of such demographic changes in their context. Therefore, we designed the Prospective GERiatric Observational (ProGERO) study, a longitudinal study of older adults in Brazil, to collect data both on healthy aging and chronic diseases, and investigate characteristics associated with adverse outcomes in this population. Methods: The ProGERO study takes place in a geriatric outpatient clinic in the largest academic medical center in Latin America. We performed baseline health examinations in 2017 and will complete subsequent in-person visits every three years when new participants will also be recruited. We will use periodic telephone interviews to collect information on the outcomes of interest between in-person visits. The baseline evaluation included data on demographics, medical history, physical examination, and comprehensive geriatric assessment (CGA; including multimorbidity, medications, social support, functional status, cognition, depressive symptoms, nutritional status, pain assessment, frailty, gait speed, handgrip strength, and chair-stands test). We used a previously validated CGA-based model to rank participants according to mortality risk (low, medium, high). Our selected outcomes were falls, disability, health services utilization (emergency room visits and hospital admissions), institutionalization, and death. We will follow participants for at least ten years.Results: We included 1,336 participants with a mean age of 82±8 years old. Overall, 70% were women, 31% were frail, and 43% had a Charlson comorbidity index score ≥3. According to our CGA-based model, the incidence of death in one year varied significantly across categories (low-risk=0.6%; medium-risk=7.4%; high-risk=17.5%; P<0.001).Conclusion: The ProGERO study will provide detailed clinical data and explore the late-life trajectories of community-dwelling older patients during a follow-up period of at least 10 years. Moreover, the study will substantially contribute to new information on the predictors of healthy and pathological aging in older adults from LMICs.

scholarly journals Impact of Body Mass Index and Metabolic Health Status on All‐Cause Mortality Risk among Older Adults

2016 ◽  
Vol 30 (S1) ◽  
Author(s):  
Feon W. Cheng ◽  
Xiang Gao ◽  
Diane C. Mitchell ◽  
Craig Wood ◽  
Christopher Still ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Health Status ◽  
Body Mass ◽  
Mortality Risk ◽  
Metabolic Health ◽  
All Cause Mortality
Sign in / Sign up

Export Citation Format

Share Document