Correlation between Health-Related Quality of Life and Hand Grip Strength among Older Adults

Handgrip strength assessment in geriatric populations: digital dynamometers comparative study

BACKGROUND/OBJECTIVES

Handgrip strength is a critical indicator of overall health, particularly in older adults, and is associated with frailty, sarcopenia and risk of adverse health outcomes. Precise and reliable measurement instruments are necessary to ensure accuracy in personalised diagnostic evaluations. This study aimed to assess the inter-instrument reliability and agreement between the Jamar Plus+ digital and Jamar hydraulic dynamometers in measuring handgrip strength.

METHODS

A cross-sectional study was conducted to assess the handgrip strength of older individuals in the community aged more than 60, using the Jamar Plus+ digital and Jamar hydraulic dynamometers. The inter-instrument reliability and agreement between the devices were evaluated using Intraclass Correlation Coefficients (ICCs) and Bland-Altman analysis.

RESULTS

A total of 109 participants with a mean age of 66±5.3 years were included in this study. The Jamar Plus+ digital dynamometer recorded significantly higher handgrip strength measurements (27.0±7.1 kg) compared with the Jamar hydraulic dynamometer (21.0±6.7 kg). The ICCs between the two devices ranged from 0.67 to 0.70, indicating moderate reliability. Bland-Altman analysis revealed a consistent overestimation of handgrip strength by the Jamar Plus+ digital dynamometer, with systematic biases of 4.8 kg in men and 6.26 kg in women compared with the Jamar hydraulic dynamometer.

CONCLUSION

The Jamar Plus+ digital dynamometer consistently overestimated handgrip strength compared with the Jamar hydraulic dynamometer, but both devices demonstrated moderate reliability. The Jamar Plus+ showed greater responsiveness to variations in strength. Selecting appropriate diagnostic tools is crucial for optimising individualised health assessments in older adults.

Effects of Physical Activity Level, Strength, Balance, and Body Composition on Perceived Health in Healthy Adults

BACKGROUND

Nowadays, not only is a high, long life expectancy desired, but also longevity with quality. Quality of life in adulthood is a multidimensional construct related to the perception of one's own health, psychological and socio-emotional factors, functionality for daily activities, and body composition.

OBJECTIVE

This study evaluates the effects of physical activity level (PAL), strength, balance, and body composition on perceived health in healthy adults.

METHODS

An observational, cross-sectional study with consecutive, non-probabilistic inclusion of cases was conducted. Body fat percentage (BFP) was measured by DXA. Physical activity level was assessed using accelerometry. The strength index (S_Index) was estimated using dynamometry. Postural control was assessed through posturography. The composite equilibrium score from the Sensory Organization Test (SOT_CES) was conducted to measure postural stability under various sensory conditions using dynamic posturography. Perceived health was calculated using the SF36 questionnaire, which detects health states, both positive and negative. A linear regression model was generated between each domain of SF36 with SOT_CES, BFP, PAL, and S_Index.

RESULTS

A total of 64 males with a mean age of 55 ± 5 years and a mean body mass index of 27 ± 4 kg/m2 were recruited. Results showed a negative correlation between physical function (ß = -0.7; t = -3.163; p = 0.003; R2 = 23.7%) and general health (ß = -0.227; t = -3.425; p = 0.001; R2 = 17.4%) with BFP. Also, it showed a negative correlation between physical function (ß = 0.047; t = -2.643; p = 0.011; R2 = 17.5%) and general health (ß = 0.016; t = -3.044; p = 0.004; R2 = 14.6%) with S_Index. On the other hand, no relation was observed between SF36 and SOT_CES. Finally, only the emotional role showed a positive correlation (ß = -0.02; t = -2.629; p = 0.011; R2 = 23.1%) with PAL.

CONCLUSION

A lower BFP and higher S_Index are associated with increased physical function and general health. Also, the higher the PAL, the greater the emotional health. On the other hand, no relation was observed between SF36 and the balance detected from SOT_CES.

Hand grip strength and quality of life among adults aged 50-90 years from South West Poland

With advancing age, progressive loss of muscle strength, as assessed by hand grip strength, may result in a poorer health-related quality of life. The aim of this study is to determine the associations of hand grip strength with quality of life among people aged 50-90 years from South West Poland. The study group comprised 1 446 people, including 351 men and 1 095 women, aged between 50 and 90 years. The WHOQoL-BREF questionnaire was used to assess quality of life. Hand grip strength of the dominant hand was measured. The general assessment of quality of life shows a significant relationship with hand grip strength. Two domains of quality of life: social and environmental also significantly differentiate hand grip strength. As the number of points in given domains increases, the hand grip strength increases. Among men, the relationship between the environmental domain and hand grip strength is significantly stronger compared to women. Hand grip strength is related to the quality of life among older adults, especially in the social and environmental domains. The results of our study suggest that measures need to be taken to improve the strength of skeletal muscles in adults, which might improve their quality of life.

Association between hand grip strength and quality of life in children with cerebral palsy: a cross-sectional study

Background

Cerebral palsy (CP) covers a wide range of causes and symptoms. It is characterized by persistent motor and postural dysfunction caused by a non-progressing pathological lesion of the immature brain. Development of fine motor skills, such as the ability to manipulate objects with smaller muscles, is crucial for a child's development. It is evident that there is a lack of hand grip strength (HGS) and quality of life (QoL) data in children with CP compared to typically developed (TD) children. Understanding the relationship between these factors might help facilitate healthcare provision and provide insight into rehabilitation programs. The aim of this study is to investigate the relationship between HGS and health-related quality of life (HRQoL) in children with CP compared to TD children.

Methods

An experimental cross-sectional study was conducted and 60 children (30 CP and 30 TD) were chosen; age, gender, height, weight, body mass index, preferred hand, number of siblings, school attendance, and housing type data were collected. HGS was measured using a standard hand dynamometer, and HRQoL was measured using the KIDSCREEN-10 item questionnaire.

Results

There was a statistically significant main effect of gender on the average HGS, F (1, 56) = 24.09, p < 0.001, and the KIDSCREEN-10 sum score, F (1, 56) = 8.66, p < 0.001, and the main effect of group on the KIDSCREEN-10 sum score, F (1, 56) = 17.64, p < 0.001. A significant correlation between HGS and the KIDSCREEN-10 sum score in the CP group (r = 0.35, p = 0.03), and the TD group (r = 0.56, p = 0.001).

Conclusion

HGS was lower in children with CP, and girls had significantly lower HGS compared to boys in both groups, CP and TD children. HRQoL was significantly lower in children with CP, with boys reporting higher HRQoL on the KIDSCREEN-10 questionnaire compared to girls. Our data showed that the higher the KIDSCREEN-10 sum score is, the stronger the HGS of children in both groups. The results of this study indicate that hand grip strength may significantly impact the QoL of children with CP. A correlation between HGS and HRQoL points to the importance of improving strength in children with CP through interventions and directed rehabilitation programs.

Depression and Quality of Life in Patients With Chronic Kidney Disease: A Mediation Analysis of Handgrip Strength and Demoralization

BACKGROUND

Chronic kidney disease (CKD) is a progressive disease impacting the physical function and mental health of sufferers. Depression is known to negatively impact quality of life, whereas handgrip strength and demoralization are important factors affecting physical and mental health. Lower handgrip strength has been associated with sarcopenia and higher risk of hospitalization in patients and higher workloads for nurse caregivers. Few studies have investigated the complex relations among these factors in patients with CKD.

PURPOSE

This study was designed to investigate the mediating effects of grip strength and demoralization on the relationship between depression and quality of life in patients with CKD.

METHODS

Two hundred fifty patients with CKD comprised the study sample. The hypotheses were tested using the PROCESS macro.

RESULTS

Depression was found to be negatively associated with handgrip strength and quality of life but positively associated with demoralization. The results indicate that both handgrip strength and demoralization mediate the association between depression and quality of life. Moreover, the results of multiple mediation model analysis showed handgrip strength and demoralization both play important roles in the link between depression and quality of life.

CONCLUSIONS

The results of this study indicate that handgrip strength and demoralization mediate the relationship between depression and quality of life in patients with CKD. Thus, increasing handgrip strength and decreasing demoralization levels may mitigate the impact of depression on quality of life. Therefore, nurses should better appreciate the importance of handgrip strength for patients with CKD and evaluate handgrip strength. Nurses should also develop physical and mental interventions to increase handgrip strength and decrease demoralization.

Impact of Mediterranean Diet Pattern Adherence on the Physical Component of Health-Related Quality of Life in Middle-Aged and Older Active Adults

Background/Objectives: The Mediterranean dietary pattern (MedDiet) has numerous health benefits, particularly in preventing chronic diseases and improving well-being. Given the ageing population, understanding its impact on older adults' physical health is essential. This study examines how adherence to the MedDiet influences the physical component (Comp-p) of health-related quality of life (HRQoL) across various age groups, providing insights for tailored dietary interventions. Methods: A cross-sectional study was conducted with active adults aged 41-80, categorised into four age groups (41-50, n = 116; 51-60, n = 225; 61-70, n = 135; 71-80, n = 44). Data were collected using the SF-36 and MEDAS questionnaires. Com-p scores were analysed based on MedDiet adherence (poor or good) and age. Results: In the 71-80 age group, a significant correlation was found between Comp-P and MedDiet adherence (r = 0.367, p = 0.014), with significantly higher Com-P scores in the good adherence group (50.10 ± 7.39) compared to the poor group (44.46 ± 7.73; p = 0.015; d = 0.74). The loss of adherence to the Mediterranean diet in this age group was attributed to low consumption of vegetables (36.36%), tree nuts (47.73%), legumes (50.00%), fish (52.27%), and fruit (56.82%). Conclusions: In individuals aged 71-80, lower adherence to the Mediterranean diet is associated with a decline in self-perceived physical health, attributed to the reduced intake of fresh vegetables, legumes, fish, and fruit. These findings emphasise the importance of promoting Mediterranean dietary adherence in later life to maintain optimal physical well-being.

Association between handgrip strength and physical activity: A nationwide population-based study in Korea

BACKGROUND

This study investigated the association between handgrip strength (HGS) and physical activity (PA) at different levels in Korean adults for the purpose of providing direction for increasing HGS, which represents muscular strength, and increasing understanding of PA and HGS.

METHODS

This study targeted adults aged ≥30 years from the Korean National Health and Nutrition Examination Survey (2014-2019), including 31,888 participants for analysis. HGS was defined as the maximum value of the three measurements of the dominant hand. PA was defined as an activity that causes shortness of breath or a fast heartbeat. Data were weighted according to survey district and household data; p < .05 was considered statistically significant.

RESULTS

In men, HGS in those aged 30-64 years was significantly associated with high-intensity PA and in those aged ≥65 years was associated with moderate-intensity PA. In women, HGS in those aged 30-64 years was also significantly associated with high-intensity PA, and in those aged ≥65 years, it was significantly associated with both moderate- and high-intensity PA. Moreover, compared to participants who did not participate in weight training, those who participated showed higher HGS in both sexes.

CONCLUSIONS

This study demonstrated age- and sex-specific characteristics of the association between HGS and PA in Koreans. The findings suggest the importance of managing health by considering differences in age- and sex-related PA. In particular, this study suggests that adequate PA is necessary despite its importance of PA for elderly individuals.

Predictors of the onset of low handgrip strength in Europe: a longitudinal study of 42,183 older adults from 15 countries

OBJECTIVES

A low handgrip strength (HGS) is a significant risk factor for multiple diseases. However, most relevant studies investigate the complications of a low HGS, while the risk potential of causative factors of low HGS remain poorly characterized.

METHODS

We investigated the potentials of quality of life, depression, dyslipidaemia, diabetes mellitus, cancer, Alzheimer's disease, stroke, frailty, and difficulties performing daily activities in predicting low HGS (≤ 27 kg for men, ≤ 16 kg for women) in European older adults aged 50 or above from 15 countries (n = 42,183). All data was collected from four successive waves of survey of health, ageing, and retirement in Europe (SHARE) conducted between 2013 and 2020. Logistic models are applied, and estimated effects are presented as odds ratios and probabilities.

RESULTS

Collectively, 3016 participants (men; n = 1395; 7.38%, women; n = 1621, 6.97%) developed low HGS during the 6.5 years study period. After adjusting for covariables, we identified an advancing age (1.6-48.1% points higher risk of low HGS), male gender (1.0%-point higher risk of low HGS), lower quality of life (1.6%-point higher), and stroke (1.5%-points) as significant risk factors for low HGS. We also found a dose-dependent association of Euro-D depression scores with the risk of low HGS, as the higher scores were associated with between 0.6- and 2.3%-points higher risk of developing low HGS than participants without depression. Among physical performance indicators, difficulty climbing stairs (2.0%-points higher low HGS risk) or rising from a chair (0.7%-points) were significantly associated with developing low HGS. Lastly, frailty (0.9%-points higher risk of low HGS) and the fear of falling down (1.6%-points higher risk) also increased the risk of developing low HGS.

CONCLUSION

Altogether, we report several risk factors for developing low HGS. Our observations may help evaluating and monitoring high-risk population for developing low HGS in pre-clinical settings.

Prevalence and Risk Factors for Hand-Grip-Determined Dynapenia in the Korean Population: A Cross-Sectional Study

Dynapenia refers to muscle weakness related to aging and is defined as a loss of muscle strength associated with muscle quality. The purpose of this study is to identify the prevalence of dynapenia and associated risk factors by gender and age in domestic adults and to provide customized basic data for the prevention of dynapenia through its management. Based on the data from 2014 to 2019 of the Korea National Health and Nutrition Survey, 20,950 adults over the age of 20 who participated in grip strength tests and health surveys were selected as participants. Factors related to dynapenia were analyzed using complex sample multilogistic regression analysis. The prevalence of dynapenia in domestic adults was 6.3%, 4.1% in men, and 8.7% in women. Prevalence in the second decade was 5.3%, in the third decade was 3.2%, in the fourth decade was 3.3%, in the fifth decade was 4.8%, in the sixth decade was 8.9%, and was 24.6% for participants in their seventh decade or beyond. Among the factors related to dynapenia, age, BMI, and alcohol status were common in both men and women; education level, HDL-C, and resistance exercise were common in men; and high blood pressure, high blood sugar, and aerobic exercise were common in women. Our findings indicate that several factors are associated with dynapenia, which should be considered as potential targets for interventions focused on both individual and public health measures.

Role of handgrip strength in predicting the quality of life in older adults: A cross-sectional study

BACKGROUND

Quality of life (QOL) is a vital component in assessing the standard of living for seniors. Hand grip strength (HGS) is a widely used measure to diagnose muscle strength decline that often occurs due to age-related loss of skeletal muscle mass and function. This study focuses on the HGS in predicting the QOL of older adults who are referred to retirement centers in Guilan Province.

MATERIALS AND METHODS

In 2021, a cross-sectional analytical study was conducted among 115 older adults who were residing in retirement centers located in Guilan Province, Northern Iran. The participants were selected using a two-stage sampling method, where three retirement centers were randomly chosen followed by convenience sampling from each center. The selected retirement centers were situated in Langrod, Sowme'eh Sara, and Rasht cities in the east, west, and center of the province, respectively. The data were collected through a demographic information questionnaire, QOL scale (CASP-19), and HGS measurement using a dynamometer.

RESULTS

Of the participants, 57.4% were male, 51.3% had middle income, and 96.5% were categorized as young elderly. The mean overall QOL score was found to be 37.026 ± 6.123, while the mean HGS level was 31.74 ± 7.45 and 18.48 ± 5.13 among males and females, respectively. There was a significant association between the level of education and QOL (P = 0.002). Moreover, there was a positive and significant correlation between HGS and QOL (r = 0.54, P = 0.001). The results of the multiple linear regression identified HGS as a predictor of QOL (Adj R2 = 0.44, βHGS = 0.79).

CONCLUSION

Given that HGS has been identified as a predictor of QOL in older adults, improving this factor through exercise can lead to enhancement in their QOL. Therefore, regular sports exercises can be recommended as a means of improving HGS and subsequently enhancing the QOL of older adults.

Association between grip strength and albuminuria in the general United States population: NHANES 2011-2014

Background

Grip strength has been shown to be associated with chronic renal insufficiency, but the relationship between grip strength and albuminuria has not been confirmed. In this study, we used NHANES data to explore the association between grip strength and albuminuria in a US population.

Methods

In this analytical study, we utilized data sourced from the National Health and Nutrition Examination Survey (NHANES), specifically spanning the years 2011 to 2014. The dataset included 9,638 participants aged 20 years or older. After adjusting for potential confounders, multiple regression models were developed to infer the interrelationship between grip strength and albumin to creatinine ratio (ACR), and subgroup analyses were conducted.

Results

After adjusting for all covariates, ACR by 0.49 mg/g [-0.49 (95% CI: -0.93, -0.04)] for each 1 kg increase in grip strength decreased. Subgroup analysis showed that gender, age, hyperlipidemia, hypertension, diabetes mellitus, smoking, alcohol consumption and body mass index did not influence the negative correlation between grip strength and albuminuria.

Conclusion

There is a negative correlation between grip strength and albuminuria in the general U.S. population.

Factors associated with improved health-related quality of life due to improvements in physical function and dialysis-related symptoms following intradialytic exercise in outpatients undergoing haemodialysis

PURPOSE

Exercise therapy is a crucial intervention for improving health-related quality of life (HRQOL) in patients undergoing haemodialysis. However, factors that improve HRQOL by improving physical function and dialysis-related symptoms remain unknown. This study aimed to examine the physical function parameters and dialysis-related symptoms that improve HRQOL following intradialytic exercise.

METHODS

This multicentre cohort study included 596 patients who participated in an intradialytic exercise program three times per week for a period of 6 months, which comprised of stretching and resistance training. EuroQol 5 dimensions 5-level (EQ5D-5L), grip strength, isometric knee extension strength, 10-m walking speed, Short Physical Performance Battery (SPPB), and improvement in dialysis-related symptoms were measured at the baseline and post-intervention. A linear mixed model was used to analyse the effects of improved physical function and dialysis-related symptoms on improvements in EQ5D-5L.

RESULTS

As a physical function index affecting ΔEQ5D-5L, only SPPB showed a significant increase in ΔEQ5D-5L compared with the non-improved group [difference in ΔEQ5D-5L, 0.05 (0.004 to 0.092) point; p < 0.05]). In addition, dialysis-related symptoms with Improved physical conditions [difference in ΔEQ5D-5L, 0.07 (0.02 to 0.13) point] and an Extended walking distance [difference in ΔEQ5D-5L was 0.07 (0.01 to 0.12) point] significantly influenced ΔEQ5D-5L (p < 0.05, both).

CONCLUSIONS

The improvements observed in the SPPB scores and self-percieved physical fitness and ambulation range, attributable to intradialytic exercise, may potentially improve HRQOL.

Differential association between physical activity behaviours and dynapenia by comorbid diseases in community-dwelling Korean older adults

BACKGROUND

Physical activity (PA) behaviours and comorbid diseases are associated with muscle strength. However, the association between dynapenia and detailed PA behaviours, including participation in aerobic and resistance exercises and sedentary behaviour (SB), in relation to comorbid diseases has not yet been investigated. Using nationwide data, this study aimed to evaluate the independent association of dynapenia with detailed PA behaviour (participation in aerobic and resistance exercises and SB), and assess the differential associations of detailed PA behaviour with dynapenia according to comorbid diseases with prevalent sarcopenia.

METHODS

A total of 7,558 community-dwelling older adults aged ≥ 65 years who were included in the Korea National Health and Nutrition Examination Survey from 2014 to 2019 were included in the present study. Cross-sectional associations between PA behaviours (participation in aerobic exercise, participation in resistance exercise, and SB) and dynapenia were analysed using complex-sample multivariable-adjusted logistic regression models according to the type of comorbid disease (cardiovascular disease [CVD], diabetes mellitus [DM], and chronic lung disease [CLD]).

RESULTS

Sufficient aerobic exercise, sufficient resistance exercise, and low sedentary time of < 420 min/day showed independent negative associations with dynapenia (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.60-0.83; OR, 0.54; 95% CI, 0.42-0.69; and OR, 0.84; 95% CI, 0.72-0.97, respectively). Among the participants with CVD or CLD, the associations of sufficient resistance exercise (OR, 0.46; 95% CI, 0.26-0.82 and OR, 0.51; 95% CI, 0.35-0.75 for CVD and CLD, respectively) and low sedentary time (OR, 0.66; 95% CI, 0.45-0.98 and OR, 0.71; 95% CI, 0.55-0.93 for CVD and CLD, respectively) with dynapenia were significant, whereas the association of sufficient aerobic exercise with dynapenia was insignificant. Meanwhile, in participants with DM, sufficient aerobic exercise (OR, 0.70; 95% CI, 0.52-0.94) and sufficient resistance exercise (OR, 0.45; 95% CI, 0.29-0.70) were independently associated with dynapenia, whereas no association between SB and dynapenia was found.

CONCLUSION

We observed an independent inverse association between PA behaviours and dynapenia. Disease-specific associations between each PA behaviour (sufficient aerobic exercise, sufficient resistance exercise, and low sedentary time) and dynapenia differed in the older adults. Therefore, these differences should be acknowledged during interventions for this population.

Relationship between Pulse Pressure and Handgrip Strength in the Korean Population: A Nationwide Cross-Sectional Study

Background: Sarcopenia is defined as the loss of muscle mass and strength and low physical performance, and it is closely related to the risk of cardiovascular disease and mortality. Pulse pressure (PP) is a biomarker of arterial stiffness and compliance. Elevated PP levels increase the risk of cardiovascular diseases and all-cause mortality. Nevertheless, the association between PP and sarcopenia has not yet been clearly established. Methods: Participant data were extracted from the Korea National Health and Nutrition Examination Survey conducted from 2014 to 2020. The study population was classified into three groups (PP < 40 mmHg, 40 mmHg ≤ PP < 60 mmHg, and PP ≥ 60 mmHg). PP was calculated by deducting the diastolic blood pressure from the systolic blood pressure. For handgrip strength, the maximum value measured with a grip dynamometer was adopted (weak handgrip strength: <28 kg for men, <18 kg for woman; normal handgrip strength: ≥28 kg for men, ≥18 kg for women). To determine the relationship between PP and the prevalence of weak handgrip strength, multiple logistic regression analysis was performed after adjusting for possible confounding factors. Results: The higher PP group had a higher age, body mass index; systolic blood pressure, prevalence of hypertension, diabetes, hyperlipidemia, and metabolic syndrome, and maximum handgrip strength. In all models, the prevalence of weak handgrip strength was significantly higher in the group with PP ≥ 60 mmHg compared to the control group (PP < 40 mmHg). Conclusions: Elevated PP was significantly associated with a higher prevalence of weak muscle strength. Thus, PP monitoring may be used to identify individuals at risk of sarcopenia and is helpful in improving health outcomes.

Higher handgrip strength is linked to higher salience ventral attention functional network segregation in older adults

Converging evidence suggests that handgrip strength is linked to cognition in older adults, and this may be subserved by shared age-related changes in brain function and structure. However, the interplay among handgrip strength, brain functional connectivity, and cognitive function remains poorly elucidated. Hence, our study sought to examine these relationships in 148 community-dwelling older adults. Specifically, we examined functional segregation, a measure of functional brain organization sensitive to ageing and cognitive decline, and its associations with handgrip strength and cognitive function. We showed that higher handgrip strength was related to better processing speed, attention, and global cognition. Further, higher handgrip strength was associated with higher segregation of the salience/ventral attention network, driven particularly by higher salience/ventral attention intra-network functional connectivity of the right anterior insula to the left posterior insula/frontal operculum and right midcingulate/medial parietal cortex. Importantly, these handgrip strength-related inter-individual differences in salience/ventral attention network functional connectivity were linked to cognitive function, as revealed by functional decoding and brain-cognition association analyses. Our findings thus highlight the importance of the salience/ventral attention network in handgrip strength and cognition, and suggest that inter-individual differences in salience/ventral attention network segregation and intra-network connectivity could underpin the handgrip strength-cognition relationship in older adults.

Evaluation of health factors on artificial intelligence and the internet of things-based older adults healthcare programmes

Objective

This study evaluates Artificial intelligence and the Internet of Things-based older adults' healthcare programmes (AI·IoT-OAHPs), which offer non-face-to-face and face-to-face health management to older adults for health promotion.

Methods

The study involved 146 participants, adults over 60 who had registered in AI·IoT-OAHPs. This study assessed the health factors as the outcome of pre- and post-health screening and health management through AI·IoT-OAHPs for six months.

Results

Preand post-health screening and management through AI·IoT-OAHPs were evaluated as significant outcomes in 14 health factors. Notably, the benefits of post-cognitive function showed a twofold increase in older female adults through AI·IoT-OAHPs. Adults over 70 showed a fourfold increase in post-walking days, a threefold in post-dietary practice, and a twofold in post-cognitive function in the post-effects compared with pre via AI·IoT-OAHPs.

Conclusions

AI·IoT-OAHPs seem to be an effective program in the realm of face-to-face and non-face-to-face AI·IoT-based older adults' healthcare initiatives in the era of COVID-19. Consequently, the study suggests that AI·IoT-OAHPs contribute to the upgrade in health promotion of older adults. In future studies, the effectiveness of AI·IoT-OAHPs can be evaluated as a continuous project every year in the short term and every two years in the long term.

Association of Nutritional Status and Diet Diversity with Skeletal Muscle Strength and Quality of Life among Older Arab Adults: A Cross-Sectional Study

There is little research evaluating skeletal muscle strength, nutritional status, and quality of life in older Arab adults. This study examined the association of nutritional status with skeletal muscle strength and quality of life among older adults living in Saudi Arabia. A cross-sectional study was conducted among older adults (n = 166 older adults; 57.8% females) who visited primary outpatient clinics at King Khalid University Hospital in Riyadh City. Sociodemographic data, Mini Nutritional Assessment short-form (MNA-SF), diet variety score (DVS), and health-related quality of life (HR-QoL) were assessed. Furthermore, handgrip strength (HGS) and knee extension strength (KES) were measured to evaluate skeletal muscle strength. Malnourishment and risk of malnutrition were found in 16.9% of our sample. Nutritional status was significantly associated with muscle strength and HR-QoL (p < 0.05). The well-nourished group had higher HGS, KES, and total HR-QoL scores compared to the at risk of malnutrition or malnourished group. Moreover, there was a moderate positive correlation between MNA-SF and total HR-QoL scores (r = 0.40). The percentage of individuals in the well-nourished group categorized with a high or moderate DVS was significantly higher than those at risk of malnutrition or are malnourished; however, DVS was not associated with muscle strength and HR-QoL. The MNA-SF score had a significant positive correlation with HGS (r = 0.30) and KES (r = 0.23). An increase in the MNA-SF score was significantly associated with higher odds of being moderate/high (HGS and HR-QoL) in the crude and adjusted models. In conclusion, maintaining adequate nutritional status is beneficial for preserving skeletal muscle strength and promoting better HR-QoL among older individuals. Therefore, applications of appropriate nutritional and muscle strength assessments in geriatric care institutions are recommended.

The quality of life in Alzheimer's disease is not associated with handgrip strength but with activities of daily living-a composite study from 28 European countries

OBJECTIVES

The relationship between handgrip strength (HGS) and quality of life is inconsistent. The purpose of this study was to investigate the potential association between HGS and quality of life in the settings of ageing and Alzheimer's disease (AD).

METHODS

We investigated the HGS, CASP-12 (control, autonomy, self-realization, and pleasure) measure of quality of life, and physical capacity in European adults above 50, including controls (n = 38,628) and AD subjects (n = 460) using the survey of health, ageing, and retirement in Europe (SHARE; 2022).

RESULTS

AD subjects exhibited lower HGS and CASP-12 scores than controls (both p < 0.05). Participants with higher CASP-12 quartiles had higher HGS in controls but not in AD subjects. A linear positive relation was found between HGS and CASP-12 in controls (0.0842, p < 0.05) but not in AD subjects (0.0636, p = 0.091). There was no effect of gender on this finding. Lastly, we found significant negative associations of difficulties walking, rising from chair, climbing stairs, and fatigue with CASP-12 scores in controls and AD subjects (all p < 0.05).

CONCLUSIONS

Altogether, HGS was not associated with quality of life in individuals with AD. Conversely, difficulties in activities of daily living seem to be negatively associated with quality of life; thus, strategies are recommended to improve physical capacity.

Physical Activity in Long COVID: A Comparative Study of Exercise Rehabilitation Benefits in Patients with Long COVID, Coronary Artery Disease and Fibromyalgia

Exercise in long COVID is poorly studied. Nevertheless, exerciserehabilitation could improve cardiorespiratory, muscular and autonomic functions. We aimed to investigate improvement in physical and autonomic performances of long COVID patients (n = 38) after a 4-week exercise rehabilitation program (3 sessions/week) compared to two control groups composed of coronary artery disease (n = 38) and fibromyalgia patients (n = 38), two populations for whom exercise benefits are well known. Efficacy of exercise training was assessed by a cardiopulmonary exercise test, a handgrip force test, and a supine heart rate variability recording at rest before and after the rehabilitation program. Cardiorespiratory and muscular parameters were enhanced after exercise rehabilitation in the three groups (p < 0.001). No significant difference was observed for the autonomic variables. Through this comparative study with control groups, we confirm and reinforce the interest of caring for long COVID patients without post-exertional symptom exacerbation by exercise rehabilitation of both strength and endurance training, by personalizing the program to the patient and symptoms.

Development and validation of a portable articulated dynamometry system to assess knee extensor muscle strength

Muscle strength assessment is important in predicting clinical and functional outcomes in many disorders. Manual muscle testing, although commonly used, offers suboptimal accuracy and reliability. Isokinetic dynamometers (IKDs) have excellent accuracy and reliability; but are bulky and expensive, offering limited accessibility. This study aimed to design a portable dynamometer that is accessible, accurate and reliable, and to validate the device in a general population. The portable articulated dynamometry system (PADS) is a portable device with an embedded high-precision load cell, designed to measure muscle strength with optimal accuracy. Seventy-two participants underwent maximal isometric and isokinetic knee extensor torque measurement with the PADS and IKD, respectively. The PADS results were cross-validated against IKD results using change in mean (CIM). Interrater and intra-rater reliabilities were assessed using intraclass correlation coefficients, standard error of measurement, and minimal detectable change. The PADS maximal knee extensor strength results were not significantly different from those by IKD (CIM: - 2.13 Nm; 95% CI - 4.74, 0.49 Nm). The PADS showed interrater reliability (Pearson's r: 0.958; ICC: 0.979; SEM: 5.51%) and excellent intra-rater reliability (Pearson's r: 0.912; ICC: 0.954; SEM: 8.38%). The proposed PADS may be an effective alternative to IKD, offering good accuracy, reliability, and potentially better accessibility.

Aging reduces manual dexterity and force production asymmetries between the hands

Age-related effects on motor asymmetry provide insight into changes in cortical activation during aging. To investigate potential changes in manual performance associated with aging, we conducted the Jamar hand function test and the Purdue Pegboard test on young and older adults. All tests indicated reduced motor asymmetry in the older group. Further analysis suggested that a significant decline in dominant (right) hand function resulted in less asymmetric performance in older adults. The finding is inconsistent with the application of the HAROLD model in the motor domain, which assumes improved performance in the non-dominant hand, leading to a reduction of motor asymmetry in older adults. Based on the manual performance in young and older adults, it is suggested that aging reduces manual asymmetry in both force production and manual dexterity due to the reduced performance of the dominant hand.

Synergistic Effect of Increased Total Protein Intake and Strength Training on Muscle Strength: A Dose-Response Meta-analysis of Randomized Controlled Trials

Background

Protein supplementation augments muscle strength gain during resistance training. Although some studies focus on the dose-response relationship of total protein intake to muscle mass or strength, the detailed dose-response relationship between total protein intake and muscle strength increase is yet to be clarified, especially in the absence of resistance training.

Objective

We aimed to assess the detailed dose-response relationship between protein supplementation and muscle strength, with and without resistance training.

Design

Systematic review with meta-analysis.

Data Sources

PubMed and Ichushi-Web (last accessed on March 23, 2022).

Eligibility Criteria

Randomized controlled trials investigating the effects of protein intake on muscle strength.

Synthesis Methods

A random-effects model and a spline model.

Results

A total of 82 articles were obtained for meta-analyses, and data from 69 articles were used to create spline curves. Muscle strength increase was significantly augmented only with resistance training (MD 2.01%, 95% CI 1.09–2.93) and was not augmented if resistance training was absent (MD 0.13%, 95% CI − 1.53 to 1.79). In the dose-response analysis using a spline model, muscle strength increase with resistance training showed a dose-dependent positive association with total protein intake, which is 0.72% (95% CI 0.40–1.04%) increase in muscle strength per 0.1 g/kg body weight [BW]/d increase in total protein intake up to 1.5 g/kg BW/d, but no further gains were observed thereafter.

Conclusion

Concurrent use of resistance training is essential for protein supplementation to improve muscle strength. This study indicates that 1.5 g/kg BW/d may be the most appropriate amount of total protein intake for maintaining and augmenting muscle strength along with resistance training.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00508-w.

Relative Handgrip Strength Mediates the Relationship between Hemoglobin and Health-Related Quality of Life in Older Korean Adults

Background: Little is known regarding how anemia and handgrip strength influence the health-related quality of life (HRQoL) of older populations. This population-based study aimed to examine whether handgrip strength mediates the association between anemia and HRQoL in a representative sample of 6892 Korean adults aged ≥ 65 years (3753 females). Methods: HRQoL was assessed with the EuroQol-5 dimension. Anemia was defined according to World Health Organization (WHO) criteria, and handgrip strength was measured with a digital hand dynamometer. Results: Individuals with anemia were at increased risk for a lower HRQoL (odds ratio, OR = 1.285, p = 0.002) even after adjustment for age, sex, body mass index, income, marital status, education, physical activity, and multimorbidity compared with individuals without anemia (OR = 1). Individuals with weak handgrip strength were also at increased risk for a lower HRQoL (OR = 1.429, p < 0.001) even after adjustment for all the covariates compared with individuals with normal handgrip strength (OR = 1). Mediation analysis with a bootstrapping procedure showed that relative handgrip strength mediated the relationship between hemoglobin and HRQoL (95% confidence interval, CI 0.0192 to 0.0289) even after adjustment for all covariates, with 42.0% of the total effect of hemoglobin on HRQoL explained. Conclusions: The current findings suggest that the impact of anemia on HRQoL is partially mediated by weak handgrip strength, implying the clinical importance of having or maintaining adequate hemoglobin and handgrip strength via healthy lifestyle choices to maintain a high HRQoL later in life.

Feasibility and validity of the EQ-5D-3L in the elderly Europeans: a secondary data analysis using SHARE(d) data

PURPOSE

To determine feasibility and validity of the EQ-5D-3L in the elderly European population.

METHODS

Secondary data analysis based on the study of health, ageing, and retirement in Europe (SHARE) to determine the percentage of missing items for EQ-5D dimensions and EQ VAS, and to demonstrate convergent/divergent validity with measures included in the SHARE survey. Known-groups validity was tested using literature-based hypotheses. Correlation coefficients and Cohen's f are reported.

RESULTS

Missing values were below 3% across all EQ-5D dimensions and gender strata, slightly increasing with age. Individuals' responses to each EQ-5D dimension were related to their ratings of other measures in expected directions. The EQ VAS and all EQ-5D dimensions (except anxiety/depression) moderately to strongly correlated with physical [e.g. number of limitations in activities of daily living (ADL): r = 0.313-0.658] and generic measures [CASP (control, autonomy, self-realization, pleasure)-19 scale, self-perceived health, number of symptoms: r = 0.318-0.622], while anxiety/depression strongly correlated with the EURO-D scale (r = 0.527). Both EQ-5D dimensions and EQ VAS discriminated well between two [or more] groups known to differ [e.g. anxiety/depression discriminated well between persons classified as depressed/not depressed using the EURO-D scale, f = 0.51; self-care differentiated best between individuals without and with 1 + ADL limitations, f = 0.69]. Sociodemographic variables like gender, education, and partner in household were hardly associated with EQ VAS scores (f < 0.25).

CONCLUSION

With item non-response of less than 3%, good discriminatory, and construct properties, the EQ-5D-3L showed to be a feasible and valid measure in the elderly Europeans.

The association between physical performance and subjective wellbeing in Chinese older adults: A cross-sectional study

Purpose

This study aimed to investigate the association between physical performance and subjective wellbeing among Chinese older adults.

Methods

Data on the Chinese population were gathered from the Study on Global Aging and Adult Health Survey (SAGE). This survey used a stratified multistage cluster sample design based on geographical location and economic status. Chinese older adults aged 65 years old or above from eight provinces (Guangdong, Hubei, Jilin, Shaanxi, Shandong, Shanghai, Yunnan, and Zhejiang) were included in this cross-sectional study. Physical performance was measured using relative handgrip strength and normal gait speed. Subjective wellbeing was measured using quality-of-life (QOL), happiness, and mood through interviews with participants. Logistic regressions were used to examine the associations between physical performance and each of the three wellbeing variables (QOL, happiness, and mood).

Results

Data of 5,421 Chinese older adults (mean age: 72.93 ± 5.89 years old, 47.1% men) were analyzed. In this sample, individuals with a higher level of relative handgrip strength (rHGS) had better mood compared to those with a lower level of rHGS (p < 0.05), and persons with lower gait speed had poorer QOL, happiness, and mood compared to those with faster gait speed (p < 0.05).

Conclusion

Our findings suggest that a higher level of relative handgrip strength predicted better mood and lower gait speed predicted poor QOL, happiness, and mood in Chinese older adults.

Correlation of patient-reported outcome measures to performance-based function in critical care survivors: PREDICTABLE

BACKGROUND

Establishing sequela following critical illness is a public health priority; however, recruitment and retention of this cohort make assessing functional outcomes difficult. Completing patient-reported outcome measures (PROMs) via telephone may improve participant and researcher involvement; however, there is little evidence regarding the correlation of PROMs to performance-based outcome measures in critical care survivors.

OBJECTIVES

The objective of this study was to assess the relationship between self-reported and performance-based measures of function in survivors of critical illness.

METHODS

This was a nested cohort study of patients enrolled within a previously published study determining predictors of disability-free survival. Spearman's correlation (r_s) was calculated between four performance-based outcomes (the Functional Independence Measure [FIM], 6-min walk distance [6MWD], Functional Reach Test [FRT], and grip strength) that were collected during a home visit 6 months following their intensive care unit admission, with two commonly used PROMs (World Health Organization Disability Assessment Scale 2.0 12 Level [WHODAS 2.0] and EuroQol-5 Dimension-5 Level [EQ-5D-5L]) obtained via phone interview (via the PREDICT study) at the same time point.

RESULTS

There were 38 PROMs obtained from 40 recruited patients (mean age = 59.8 ± 16 yrs, M:F = 24:16). All 40 completed the FIM and grip strength, 37 the 6MWD, and 39 the FRT. A strong correlation was found between the primary outcome of the WHODAS 2.0 with all performance-based outcomes apart from grip strength where a moderate correlation was identified. Although strong correlations were also established between the EQ-5D-5L utility score and the FIM, 6MWD, and FRT, it only correlated weakly with grip strength. The EQ-5D overall global health rating only had very weak to moderate correlations with the performance-based outcomes.

CONCLUSION

The WHODAS 2.0 correlated stronger across multiple performance-based outcome measures of functional recovery and is recommended for use in survivors of critical illness.

The Interlink among Age, Functional Fitness, and Perception of Health and Quality of Life: A Mediation Analysis

In aging societies, physical activity may benefit functional fitness influencing the health of older people. The aim of this study was to explore the interrelation between age and perception of health and quality of life, and the mediating effects of functional fitness in older individuals. One hundred and sixty-six late middle-aged (55–64 years, young-old (65–74 years), and old (75–84 years) adults, divided into senior athletes (n = 44), physically active (n = 59), and sedentary individuals (n = 63) were evaluated for functional fitness (flexibility, strength, interlimb coordination, endurance) and physical (Physical Component Summary-PCS) and mental (Mental Component Summary-MCS) health and quality of life perception. Multiple mediation analyses were applied to assess the relationship between age and PCS and MCS indices and the role of functional fitness-related mediators. For MCS only, the mediation analysis showed a positive total and direct effect of age and a negative total indirect effect through mediators. No effects emerged for PCS. Despite a decline in their functional fitness, older individuals were able to maintain a mental health perception, also demonstrating how beneficial effects of physically active lifestyle on functional fitness can positively impact the cognitive-emotional dimension of mental health with advancing age.

Associations of Physical Activity and Handgrip Strength with Different Domains of Quality of Life in Pediatric Cancer Survivors

There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA level and HGS are associated with higher scores in different QoL domains (i.e., physical, emotional, social, and school functioning) in pediatric cancer survivors. PA was assessed with a validated self-reported PA rating scale. In total, 191 Chinese pediatric cancer survivors aged 9 to 16 years were included in the analysis. Results showed that engaging in a higher level of PA was significantly associated with improved QoL in different domains, including physical (β = 0.543, p < 0.001), emotional (β = 0.449, p < 0.001), social (β = 0.434, p < 0.001), and school functioning (β = 0.407, p < 0.001). Greater HGS was also associated with better physical (β = 0.230, p ≤ 0.001) and emotional (β = 0.261, p ≤ 0.001) functioning. Findings from this study provide evidence of the significant beneficial impact of regular PA on pediatric cancer survivors’ QoL along their survivorship trajectory.

Aging and Gait Function: Examination of Multiple Factors that Influence Gait Variability

This investigation aimed to identify parameters of reduced functionality that are responsible for variations in the normal gait cycle. Sixteen older adults (55–85 years; nine males) and eighteen young adults (18–40 years; eight males) were enrolled. Assessments included walking trials, questionnaires, and assessed maximal and submaximal dorsiflexors (DF) and plantar flexors (PF) force. Multiple relationships were found between the muscular capabilities of the ankle and gait variability in older adults. For both the DF and PF muscles, the older adults produced significantly lower maximal force production and higher levels of force variability than younger adults; physical activity (PA) level was also significantly correlated. The reduction in muscular strength was concurrent with increased force variability and deficits in spatiotemporal gait parameters, suggesting an age-related worsening of the central motor control. Our results found that PA engagement could preserve gait quality and independence. These are essential considerations for further research on the cause and reduction of falls in older adults.

Relation between Handgrip Strength and Quality of Life in Patients with Arthritis in Korea: The Korea National Health and Nutrition Examination Survey, 2015–2018

Background and Objectives: This study aimed to investigate the relationship between handgrip strength (HGS) and quality of life (QOL) in patients diagnosed with osteoarthritis (OA) or rheumatoid arthritis (RA). Materials and Methods: We enrolled 13,966 from the Korea National Health and Nutrition Examination Survey from 2015 to 2018. All participants underwent the health-related QOL assessment using the European Quality of Life Scale-Five dimensions (EQ-5D) and measured the HGS. The weak HGS was defined as the lowest quartile. We investigated the difference in QOL between patients with arthritis and the healthy control group and evaluated the correlation between weak HGS and QOL in arthritis patients. Results: Those diagnosed with OA or RA had significantly lower QOL than healthy controls. The weak HGS was significantly correlated with lower QOL in arthritis patients. Among OA patients, those with weak HGS revealed significantly higher odds ratios for impairment in all dimensions of EQ-5D. RA patients with weak HGS had significantly higher odds ratios for impairment in dimensions of mobility, self-care, usual activity, and pain/discomfort than those with normal HGS. Conclusions: These results suggest that weak HGS is significantly associated with decreased QOL in patients with arthritis.

Rejuvenation of standing and gait balance in community-dwelling older individuals: A comparative study between 2006 and 2019

AIM

The present study investigated the rejuvenation of physical function in terms of walking speed and grip strength. Specifically, it examined the rejuvenation of physical functions in community-dwelling older individuals between 2006 and 2019. The study is novel, because it analyzes this by focusing on gait balance.

METHODS

Data were collected from 339 participants (52 men, 287 women) in 2006, and 382 participants (83 men, 299 women) in 2019. They were categorized according to age: early-stage and late-stage groups for men, and early-stage, late-stage and latest-stage groups for women. These groups were analyzed by participants' walking speed, grip strength, Timed Up and Go test, Functional Reach test and One-Leg Standing test. The results were compared based on two factors: time (2006 to 2019) and age group.

RESULTS

The scores for the Timed Up and Go and One-Leg Standing tests were better in 2019 than in 2006 for all age groups in both older men and women. However, improvement in walking speed was observed only in women. Additionally, the decline in physical function with age was slower for walking speed among men, and Functional Reach and One-Leg Standing tests among women.

CONCLUSIONS

The changes over this 13-year period showed that the physical function of community-dwelling older individuals was rejuvenated in terms of improved standing and walking balance. These rejuvenations will aid in preventing falls among community-dwelling older individuals. Geriatr Gerontol Int 2021; 21: 975-980.

Associations between health-related quality of life and physical function in older adults with or at risk of mobility disability after discharge from the hospital

Aim

To investigate if health-related quality of life (HRQOL) is associated with physical function in older adults with or at risk of mobility disability after hospital discharge.

Findings

Better physical function (SPPB) was significantly associated with a higher level of physical HRQOL (SF-36 subscales physical functioning, role physical, bodily pain and general health).

Message

The positive associations between physical function and physical HRQOL might indicate that the exercise interventions aiming to improve physical function might also improve physical HRQOL in this group of older adults.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-021-00525-0.

Purpose

To optimise the treatment for older adults after hospitalisation, thorough health status information is needed. Therefore, we aimed to investigate the associations between health-related quality of life (HRQOL) and physical function in older adults with or at risk of mobility disability after hospital discharge.

Methods

This cross-sectional study recruited 89 home-dwelling older people while inpatients within medical wards at a general hospital in Oslo, Norway. HRQOL [the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36)] and physical function [the Short Physical Performance Battery (SPPB)] were measured a median of 49 [interquartile range (IQR) 26–116] days after discharge. Simple linear regression analyses were conducted, and multivariable regression models were fitted.

Results

The mean age of the patients was 78.3 years; 43 (48.9 %) were females. Multivariable regressions showed positive associations between SPPB and the physical subscales {physical functioning [B (95% CI) 4.51 (2.35–6.68)], role physical [B (95% CI) 5.21 (2.75–7.67)], bodily pain [B (95% CI) 3.40 (0.73–6.10)] and general health [B (95% CI) 3.12 (1.13–5.12)]}. Univariable regressions showed no significant associations between SPPB and the mental subscales {vitality [B (95% CI) 1.54 (− 0.10–3.18)], social functioning [B (95% CI) 2.34 (− 0.28–4.96)], role emotional [B (95% CI) 1.28 (− 0.96–3.52)] and mental health [B (95% CI) 1.00 (− 0.37–2.36)]}.

Conclusion

The results reinforce that physical function and physical HRQOL are strongly linked, and interventions improving physical function might improve physical HRQOL. However, this hypothesis would have to be tested in a randomised controlled trial.

Trial registration

ClinicalTrials.gov. Registered 19 September 2016 (NCT02905383).

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-021-00525-0.

Characterization of physical, functional, and cognitive performance in 15 adults with hypophosphatasia

OBJECTIVE

Given the small but growing body of literature related to physical functioning and the scarce data related to fine motor and cognitive functioning in adults with hypophosphatasia (HPP), our objective was to characterize physical, functional, and cognitive performance in adults with HPP. A future objective is to utilize this characterization to develop guidelines for evaluation by physical therapists (PT), occupational therapists (OT), and speech-language pathologists (SLP).

METHOD

We evaluated physical, functional, and cognitive performance in 15 adults with HPP through standardized assessments of mobility, balance, fine motor control, activities of daily living, cognition, and self-reported measures of health-related quality of life, fatigue, depression, and anxiety. The median age at enrollment was 44 years (range 26-79 years). Among the participants, 11 (73%) were women. Five participants (33%) were on enzyme replacement therapy.

RESULTS

Compared with the general population, HPP participants traveled shorter distances on the Six-Minute Walk Test (420 m (m) [SD: 132] vs 620 m [SD: 49], p < 0.00005), had slower gait on the 10-Meter Walk Test [HPP men (3.71 ft/s (f/s) [SD: 0.77] vs 4.70 f/s [SD: 0.14], p < 0.00005) and HPP women (3.39 f/s [SD: 0.67] vs 4.56 f/s [SD: 0.09], p < 0.00005)]. HPP participants had decreased upper extremity (UE) dexterity by Nine Hole Peg Test [right UE in HPP men (22.7 s (s) [SD: 2.3] vs 19.0 s [SD: 3.9], p = 0.03), left UE in HPP men (23.3 s [SD: 0.7] vs 19.8 s [SD: 3.7], p = 0.03), right UE in HPP women (19.8 s [SD: 2.0] vs 17.7 s [SD: 3.2], p = 0.01), and left UE in HPP women (21.1 s [SD: 2.5] vs 18.9 s[SD: 3.4], p = 0.02)], and some had abnormally slow bilateral UE reaction times via Dynavision (0.9 s [0.85,0.96], functional speed <1.15 s). On the Short Form-36 (SF36), HPP patients reported worse energy/fatigue (30.4 [SD 22.7] vs 52.2 [SD: 22.4], p = 0.0001), social functioning (54.5 [SD: 34.2] vs 78.8 [SD: 25.5], p = 0.0002), pain (46.1 [SD: 27.3] vs 70.8 [SD: 25.5], p = 0.0001), general health (36.8 [SD: 24.0] vs 57.0 [SD: 21.1], p = 0.0002), and health change i.e. perception of health improvement (32.1 [SD: 15.3] vs 59.1 [SD: 23.1], p < 0.00005) than the general population. Fatigue Severity Scale scores were well above the median for a healthy population (5.21 [SD: 1.8] vs 2.3 [SD: 1.21], p < 0.00005), indicating significant fatigue. HPP participants had significantly higher DASS scores for depression (8.5 [SD: 6.5] vs 5.0 [SD: 7.5], p = 0.02), anxiety (7.9 [SD: 6.7] vs 3.4 [SD: 5.1], p = 0.00009), and stress (14.7 [SD: 12.4] vs 8.1 [SD: 8.4], p = 0.0003) compared to the general population.

CONCLUSION

Objective functional assessments demonstrated defects in physical functioning, including decreased ability to walk distances, slow gait speed, and diminished ability to repeatedly rise from a sitting position. In addition, participants self-reported significant limitations due to physical dysfunction. Decreased upper extremity dexterity may indicate problems with activities of daily living and delayed reaction times can have safety implications. Some patients with HPP have increased difficulties with depression, anxiety, and stress. PT, OT, and SLP specialists can aid in establishing baseline assessment of impairment and objective metrics for assessing efficacy of treatment.

Reference Values for Handgrip Strength in the Basque Country Elderly Population

Strength training is currently the most recommended primary therapeutic strategy to prevent and reverse the decline of muscle mass, strength, and functional deterioration associated with age. The aim is to provide reference values of handgrip strength (HGS) in the Basque Country population and compare the values with other populations. A total of 1869 subjects from the health-promoting programme for adults and older adults run by the Bilbao City Council were assessed using HGS with a digital dynamometer and anthropometric data measured by Tanita to obtain the mean values according to age distribution. From the 1869 subjects, 87.5% were women and 12.5% men. The HGS was higher among men than women, 32.4 ± 6.6 versus 20.1 ± 4.7 kg, respectively, p < 0.001 at all ages. Weak HGS cut-off points by age groups ranged from 31.0 to 23.8 and from 18.9 to 12.4 in men and women, respectively. The sample data were compared (d, t, and α) with those of other populations in all age groups (group > 60 years at 95% df, p < 0.05). A health-promoting programme appears to be effective in the general population in obtaining better values in the HGS test as age increases.

Association between muscle strength and sleep quality and duration among middle-aged and older adults: a systematic review

PURPOSE

To examine the relationship between sleep quality and duration and muscle strength among community-dwelling middle-aged and older adults.

METHODS

A systematic review was conducted from March 2020 until May 2020. Searches were done for peer-reviewed and English-written articles reporting results of studies in PubMed, Embase, Scopus, Cochrane Library, and in article references lists. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used as well as the Newcastle-Ottawa Scale (NOS) to appraise the methodological quality.

RESULTS

Twenty-one cross-sectional, three prospective studies and a total of 92,363 subjects were included. The majority of the included studies are classified as "high quality". Handgrip strength is the main method of muscle strength assessment. Sleep assessment is usually conducted using subjective measures, such as validated sleep scales or self-reported questionnaires. Actigraphy, as an objective measure, is used less often. Most studies support strong evidence on the association between weak muscle strength and poor sleep quality and duration among middle-aged and older adults; whereas the results for the gender-specific association and the impact of short or long sleep duration were inconclusive.

CONCLUSION

This review has identified strong evidence on the relationship between sleep quality and duration and muscle strength among middle-aged and older adults. Health professionals should consider this relationship as a component of geriatric assessment in community practice and geriatric settings. Future rigorous research with a combination of subjective and objective measurements is needed to explore whether gender and specific sleep duration are related to muscle strength.