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

Handgrip weakness and overall life satisfaction decline: derivation of cutoff values and analysis of sex differences in older Chinese adults

Background and aims

Handgrip strength (HGS) is a cost-effective indicator of skeletal muscle function. However, the sex-specific association between HGS and life satisfaction decline among older Chinese adults remains largely unknown.

Methods

This observational, cross-sectional multicenter study included 3,649 older adults (age range: 60-101 years) from a nationally representative survey in China. Overall life satisfaction was determined using a life satisfaction score (LSS). Correlations between variables were examined using a Spearman's correlation analysis. Receiver operating characteristic (ROC) curves were utilized to determine the HGS cutoffs for predicting a decline in LSS. Restricted cubic spline (RCS) analysis and multivariate logistic regression were employed to investigate the associations between low HGS and LSS.

Results

This study included 1,762 women and 1,887 men (median age = 68.3 years). LSS decline was observed in 485 (13.3%) participants. HGS was positively correlated with LSS in both men and women (both P < 0.05). Individuals with low HGS were associated with a higher rate of LSS decline (16.2% vs. 10.8%, P < 0.001). RCS analysis demonstrated a linear-like association between HGS and life satisfaction in men (P < 0.001, P nonlinear = 0.099), but not in women (P = 0.110, P nonlinear = 0.329). ROC analysis revealed that the optimal HGS cutoff for indicating the presence of LSS was 27.5 kg for men and 22.3 kg for women. Multivariable analysis showed that participants with low HGS had higher odds of experiencing a decline in LSS [odds ratios (OR) = 1.509, 95% confidence interval (CI) = 1.218-1.867]. This association was observed only in men (OR = 1.871, 95% CI = 1.358-2.562, P < 0.001), while it was attenuated in women (OR = 1.281, 95% CI = 0.964-1.701, P = 0.087).

Conclusion

This study establishes sex-specific cutoffs of HGS for identifying a decline in LSS among older Chinese adults. Low HGS is positively associated with LSS decline among men in a linear-like manner, but not among women. These findings might facilitate the development of strategies to promote healthy aging.

Cystatin-c / total cholesterol ratio as a predictor of probable sarcopenia in geriatric population from 12 European countries

BACKGROUND

A low handgrip strength (HGS) is associated with several diseases in older adults. However, predictive biomarkers of future low HGS are poorly known. We investigated the prognostic efficacy of the ratio of plasma cystatin-c and total cholesterol (CT ratio) levels for predicting future low HGS in Europe.

METHODS

The data was collected from the Survey of Health, Ageing, and Retirement in Europe (SHARE) between 2015 and 2021-22. The study participants were geriatric adults aged 50 or above (n = 17,698) from 12 European countries. The baseline data in 2015 included the measurements of CT ratio from participants with normal HGS. The participants who developed low HGS in subsequent years were included. We also investigated the quality of life, difficulties performing daily activities, and several comorbidities in the study population.

RESULTS

In a multivariate-adjusted model, male gender, advancing age, poor quality of life, difficulties performing daily activities, and the presence of depression, high blood pressure, diabetes mellitus, Alzheimer's disease, and osteoarthritis were associated with a higher risk of developing low HGS. CT ratio exhibited significant prognostic accuracy for low HGS among men and women aged 60-79, irrespective of the quality of life, degree of depression, difficulties performing daily activities, and the presence of comorbidities, including depression, high blood pressure, diabetes mellitus, Alzheimer's disease, and osteoarthritis.

CONCLUSION

Collectively, the CT ratio exhibits adequate prognostic accuracy for low HGS, which is not significantly affected by comorbidities and functional limitations. Our findings have clinical and policy implications in timely identifying older adults at risk of developing low HGS.

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.

Probiotics Supplements Improve the Sarcopenia-Related Quality of Life in Older Adults with Age-Related Muscle Decline

A pathological increase in intestinal leak is implicated in age-associated muscle loss, termed sarcopenia, and reduced sarcopenia-related quality-of-life (SarQoL). However, the potential therapies remain elusive. We investigated the effects of probiotic supplementation on sarcopenia and SarQoL in geriatric older adults. We randomized sarcopenic men into placebo (age = 71.4 ± 3.9 years, n = 63) and probiotic (age = 73 ± 4.1 years, n = 60) groups for 16 weeks. The probiotic used was one capsule daily of Vivomix 112 billion for 16 weeks. We measured sarcopenia parameters of handgrip strength (HGS) and skeletal mass index (SMI), plasma zonulin (marker of the intestinal leak), and SarQoL using a targeted questionnaire. Probiotics improved the SarQoL scores for locomotion, functionality, and activities of daily living and prevented a decline in cumulative SarQoL observed in the placebo group (all p < 0.05). Probiotic supplementation also reduced plasma zonulin and marker of systemic bacterial load. These changes were accompanied by an increase in HGS and maintenance of gait speed in the probiotic group compared to the placebo group. Correlation analysis revealed significant associations of cumulative SarQoL scores with plasma zonulin and HGS in the probiotic group. Collectively, probiotics improved SarQoL and HGS by repairing pathological intestinal leak. Future studies may further dissect the relation between intestinal leak and SarQoL in older adults taking probiotics.