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de Lucena Alves CP, de Almeida SB, Lima DP, Neto PB, Miranda AL, Manini T, Vlietstra L, Waters DL, Bielemann RM, Correa-de-Araujo R, Trussardi Fayh AP, Costa EC. Muscle Quality in Older Adults: A Scoping Review. J Am Med Dir Assoc 2023; 24:462-467.e12. [PMID: 36963436 DOI: 10.1016/j.jamda.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE This scoping review aimed to map out currently available definitions and assessment methods of muscle quality in older adults. DESIGN Scoping review. SETTING AND PARTICIPANTS All available studies. METHODS Four databases (PubMed, EMBASE, Web of Science, and Cochrane Library) were searched from inception to May 2022. Title, abstract, and full-text screening were undertaken by 2 reviewers independently. Observational and experimental studies were eligible for inclusion if there was a clear description of muscle quality assessment in individuals aged 60+ years. RESULTS A total of 96 articles were included. Several definitions and assessment methods of muscle quality were identified and divided into 2 main domains: (1) functional domain, and (2) morphological domain. A total of 70% and 30% of the included studies assessed muscle quality in the functional and morphological domains, respectively. In the functional domain, most studies defined muscle quality as the ratio of knee extension strength by leg lean mass (45.9%). In the morphological domain, most studies defined muscle quality as the echo intensity of quadriceps femoris by ultrasound (50.0%). CONCLUSIONS AND IMPLICATIONS There is a substantial heterogeneity of definitions and assessment methods of muscle quality in older adults. Herein, we propose a standardized definition of muscle quality to include terminology, domain, and assessment methods (tests, tools, and body sites). Such standardization may help researchers, clinicians, and decision makers use muscle quality as a potential marker of "skeletal muscle health" in older adults.
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Affiliation(s)
| | - Samuel Brito de Almeida
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Division of Geriatrics, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Danielle Pessoa Lima
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Division of Geriatrics, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Medical School, University of Fortaleza, Fortaleza, CE, Brazil
| | - Pedro Braga Neto
- Medical School, University of Fortaleza, Fortaleza, CE, Brazil; Division of Neurology, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil; Center of Health Sciences, State University of Ceará, Fortaleza, Brazil
| | - Ana Lúcia Miranda
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil
| | - Todd Manini
- Institute on Aging, Department of Health Outcomes and Biomedical Informatics, University of Florida, USA
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Debra L Waters
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Internal Medicine/Geriatrics, University of New Mexico, Albuquerque, NM, USA
| | - Renata Moraes Bielemann
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Graduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Rosaly Correa-de-Araujo
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Ana Paula Trussardi Fayh
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Eduardo Caldas Costa
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza, CE, Brazil; ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
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Vlietstra L, Kirk B, Duque G, Qualls C, Vellas B, Andrieu S, Morley JE, Waters DL. Using minimal clinically important differences to measure long-term transitions of osteosarcopenia: The New Mexico Aging Process Study. Exp Gerontol 2023; 173:112106. [PMID: 36708751 DOI: 10.1016/j.exger.2023.112106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND/OBJECTIVE By having a better understanding of transitions in osteosarcopenia, interventions to reduce morbidity and mortality can be better targeted. The aim of this study was to show the rationale and method of using minimal clinically important differences (MCID's) to classify transitions, and the effects of demographic variables on transitions in a 9-year follow-up data from the New Mexico Aging Process Study (NMAPS). METHODS Transitions were identified in four aspects of osteosarcopenia: bone mineral density (BMD), appendicular skeletal muscle mass/body mass index ratio (ASM/BMI), grip strength and gait speed. Transitions were identified using a MCID score. As there is currently no available MCID for BMD and ASM/BMI, those were determined using a distribution-based and an anchor-based method. Total transitions were calculated for all four measures of osteosarcopenia in all transition categories (maintaining a health status, beneficial transition, harmful transitions). Poisson regression was used to test for effects of demographic variables, including age, sex, physical activity, medication, and health status, on transitions. RESULTS Over the 9-year follow-up, a total of 2163 MCID-derived BMD transitions were reported, 1689 ASM/BMI transitions, 2339 grip strength transitions, and 2151 gait speed transitions. Additionally, some MCID-derived transition categories were associated with sex, age, and health status. CONCLUSION Use of MCID-derived transitions reflected the fluctuation and the dynamic nature of health in older adults. Future research should focus on transitions of modifiable markers in osteosarcopenia to design intervention trials.
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Affiliation(s)
- Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia; Research Institute of the McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada
| | - Clifford Qualls
- Department of Mathematics & Statistics and School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Bruno Vellas
- Department of Internal and Geriatrics Medicine, Gerontopole, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - Sandrine Andrieu
- Department of Clinical Epidemiology and Public Health, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University, 1402, South Grand Blvd, RoomM238, St. Louis, MO 63110-0250, USA
| | - Debra L Waters
- School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Medicine, University of Otago, Dunedin, New Zealand; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA.
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3
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Zanker J, Sim M, Anderson K, Balogun S, Brennan‐Olsen S, Dent E, Duque G, Girgis C, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth C, Iuliano S, Keogh J, Lewis JR, Lynch GS, Pasco JA, Phu S, Reijnierse EM, Russell N, Vlietstra L, Visvanathan R, Walker T, Waters DL, Yu S, Maier AB, Daly RM, Scott D. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) sarcopenia diagnosis and management task force: Findings from the consumer expert Delphi process. Australas J Ageing 2023; 42:251-257. [PMID: 36480154 PMCID: PMC10947359 DOI: 10.1111/ajag.13164] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To develop guidelines, informed by health-care consumer values and preferences, for sarcopenia prevention, assessment and management for use by clinicians and researchers in Australia and New Zealand. METHODS A three-phase Consumer Expert Delphi process was undertaken between July 2020 and August 2021. Consumer experts included adults with lived experience of sarcopenia or health-care utilisation. Phase 1 involved a structured meeting of the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force and consumer representatives from which the Phase 2 survey was developed. In Phase 2, consumers from Australia and New Zealand were surveyed online with opinions sought on sarcopenia outcome priorities, consultation preferences and interventions. Findings were confirmed and disseminated in Phase 3. Descriptive statistical analyses were performed. RESULTS Twenty-four consumers (mean ± standard deviation age 67.5 ± 12.8 years, 18 women) participated in Phase 2. Ten (42%) identified as being interested in sarcopenia, 7 (29%) were health-care consumers and 6 (25%) self-reported having/believing they have sarcopenia. Consumers identified physical performance, living circumstances, morale, quality of life and social connectedness as the most important outcomes related to sarcopenia. Consumers either had no preference (46%) or preferred their doctor (40%) to diagnose sarcopenia and preferred to undergo assessments at least yearly (54%). For prevention and treatment, 46% of consumers preferred resistance exercise, 2-3 times per week (54%). CONCLUSIONS Consumer preferences reported in this study can inform the implementation of sarcopenia guidelines into clinical practice at local, state and national levels across Australia and New Zealand.
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Grants
- Australian Government Research Training Program (TRP) Scholarship.
- Australian Medical REsearch Future Fund
- Dairy Australia, California Dairy Research Foundation, National Dairy Council, Aarhus University Hospital and Danish Dairy Research Foundation, Fonterra Co-operative Group Ltd, Dutch Dairy Association, Dairy Council of California, Dairy Farmers of Canada, the Centre national interprofessionnel de l'economie laitiere, University of Melbourne, Austin Hospital Medical Research Foundation and Sir Edward Dunlop Medical Research Foundation.
- Deakin University, Amgen, Department of Health and Human Services (DHHS), and the Norman Beischer Foundation.
- National Health and Medical Research Council
- National Heart Foundation Future Leader Fellowship (ID: 102817).
- NHMRC CRE 1102208 and Hospital Research Foundation.
- NHMRC Postgraduate Scholarship, grant number 2003179.
- NHMRC project grant (APP1099173).
- Royal Perth Hospital Career Advancement Fellowship (CAF 130/2020),
- National Health and Medical Research Council
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Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Marc Sim
- Nutrition and Health Innovation Research Institute, School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Kate Anderson
- Institute for Health Transformation – Determinants of Health, Faculty of HealthDeakin UniversityMelbourneVictoriaAustralia
- School of Health and Social Development, Faculty of HealthDeakin UniversityMelbourneVictoriaAustralia
| | - Saliu Balogun
- College of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Sharon L. Brennan‐Olsen
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- School of Health and Social Development, Faculty of HealthDeakin UniversityMelbourneVictoriaAustralia
- Institute for Health TransformationDeakin UniversityMelbourneVictoriaAustralia
| | - Elsa Dent
- Torrens University AustraliaAdelaideSouth AustraliaAustralia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- Department of MedicineResearch Institute of the McGill University Health CentreMcGill UniversityMontrealQuebecCanada
| | - Christian M. Girgis
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Department of Diabetes and EndocrinologyWestmead HospitalSydneyNew South WalesAustralia
| | - Mathis Grossmann
- Department of Medicine – Austin HealthThe University of MelbourneMelbourneVictoriaAustralia
- Department of EndocrinologyAustin HealthMelbourneVictoriaAustralia
| | - Alan Hayes
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Institute for Health and Sport (IHeS)Victoria UniversityMelbourneVictoriaAustralia
| | - Tim Henwood
- Human Movement and Nutritional ScienceUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Vasant Hirani
- Nutrition and Dietetics Group, School of Life and Environmental Sciences Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
| | - Charles Inderjeeth
- North Metropolitan Health Service and University of Western AustraliaPerthWestern AustraliaAustralia
| | - Sandra Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Justin Keogh
- Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
- Human Potential CentreAuckland University of TechnologyAucklandNew Zealand
- Cluster for Health Improvement, Faculty of Science, Health, Education and EngineeringUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
- Kasturba Medical College, MangaloreManipal Academy of Higher EducationManipalKarnatakaIndia
| | - Joshua R. Lewis
- Nutrition and Health Innovation Research Institute, School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical SchoolThe University of SydneySydneyAustralia
| | - Gordon S. Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, School of Biomedical SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Julie A. Pasco
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- IMPACT‐Institute for Mental and Physical Health and Clinical Translation, Barwon HealthDeakin UniversityMelbourneVictoriaAustralia
| | - Steven Phu
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- Falls, Balance, and Injury Research CentreNeuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
| | - Esmee M. Reijnierse
- Department of Medicine and Aged Care, The Royal Melbourne HospitalThe University of MelbourneMelbourneVictoriaAustralia
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation MedicineAmsterdamThe Netherlands
- Amsterdam Movement Sciences, Ageing and VitalityAmsterdamThe Netherlands
| | - Nicholas Russell
- Department of Medicine – Austin HealthThe University of MelbourneMelbourneVictoriaAustralia
- Department of EndocrinologyAustin HealthMelbourneVictoriaAustralia
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise SciencesUniversity of OtagoDunedinNew Zealand
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Aged and Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkAdelaideSouth AustraliaAustralia
| | - Troy Walker
- Institute for Health Transformation, Global Obesity CentreDeakin UniversityMelbourneVictoriaAustralia
| | - Debra L. Waters
- Department of Medicine, School of PhysiotherapyUniversity of OtagoDunedinNew Zealand
| | - Solomon Yu
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Aged and Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkAdelaideSouth AustraliaAustralia
| | - Andrea B. Maier
- Department of Medicine and Aged Care, The Royal Melbourne HospitalThe University of MelbourneMelbourneVictoriaAustralia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Centre for Healthy LongevityNational University Health SystemSingapore
- Department of Human Movement Sciences, Faculty of Behavioural and Movement SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Robin M. Daly
- Institute for Physical Activity and NutritionDeakin UniversityMelbourneVictoriaAustralia
| | - David Scott
- Institute for Physical Activity and NutritionDeakin UniversityMelbourneVictoriaAustralia
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
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Zanker J, Sim M, Anderson K, Balogun S, Brennan-Olsen SL, Dent E, Duque G, Girgis CM, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth C, Iuliano S, Keogh J, Lewis JR, Lynch GS, Pasco JA, Phu S, Reijnierse EM, Russell N, Vlietstra L, Visvanathan R, Walker T, Waters DL, Yu S, Maier AB, Daly RM, Scott D. Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. J Cachexia Sarcopenia Muscle 2023; 14:142-156. [PMID: 36349684 PMCID: PMC9891980 DOI: 10.1002/jcsm.13115] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/18/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Sarcopenia is an age-associated skeletal muscle condition characterized by low muscle mass, strength, and physical performance. There is no international consensus on a sarcopenia definition and no contemporaneous clinical and research guidelines specific to Australia and New Zealand. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force aimed to develop consensus guidelines for sarcopenia prevention, assessment, management and research, informed by evidence, consumer opinion, and expert consensus, for use by health professionals and researchers in Australia and New Zealand. METHODS A four-phase modified Delphi process involving topic experts and informed by consumers, was undertaken between July 2020 and August 2021. Phase 1 involved a structured meeting of 29 Task Force members and a systematic literature search from which the Phase 2 online survey was developed (Qualtrics). Topic experts responded to 18 statements, using 11-point Likert scales with agreement threshold set a priori at >80%, and five multiple-choice questions. Statements with moderate agreement (70%-80%) were revised and re-introduced in Phase 3, and statements with low agreement (<70%) were rejected. In Phase 3, topic experts responded to six revised statements and three additional questions, incorporating results from a parallel Consumer Expert Delphi study. Phase 4 involved finalization of consensus statements. RESULTS Topic experts from Australia (n = 62, 92.5%) and New Zealand (n = 5, 7.5%) with a mean ± SD age of 45.7 ± 11.8 years participated in Phase 2; 38 (56.7%) were women, 38 (56.7%) were health professionals and 27 (40.3%) were researchers/academics. In Phase 2, 15 of 18 (83.3%) statements on sarcopenia prevention, screening, assessment, management and future research were accepted with strong agreement. The strongest agreement related to encouraging a healthy lifestyle (100%) and offering tailored resistance training to people with sarcopenia (92.5%). Forty-seven experts participated in Phase 3; 5/6 (83.3%) revised statements on prevention, assessment and management were accepted with strong agreement. A majority of experts (87.9%) preferred the revised European Working Group for Sarcopenia in Older Persons (EWGSOP2) definition. Seventeen statements with strong agreement (>80%) were confirmed by the Task Force in Phase 4. CONCLUSIONS The ANZSSFR Task Force present 17 sarcopenia management and research recommendations for use by health professionals and researchers which includes the recommendation to adopt the EWGSOP2 sarcopenia definition in Australia and New Zealand. This rigorous Delphi process that combined evidence, consumer expert opinion and topic expert consensus can inform similar initiatives in countries/regions lacking consensus on sarcopenia.
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Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Kate Anderson
- Institute for Health Transformation - Determinants of Health, Faculty of Health, Deakin University, Burwood, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Saliu Balogun
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Sharon L Brennan-Olsen
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Elsa Dent
- Torrens University Australia, Adelaide, South Australia, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Christian M Girgis
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Mathis Grossmann
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alan Hayes
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Institute for Health and Sport (IHeS), Victoria University, Footscray, Victoria, Australia
| | - Tim Henwood
- Human Movement and Nutritional Science, University of Queensland, Brisbane, Queensland, Australia
| | - Vasant Hirani
- Nutrition and Dietetics Group, School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - Charles Inderjeeth
- North Metropolitan Health Service & University of Western Australia, Perth, Western Australia, Australia
| | - Sandra Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Gordon S Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julie A Pasco
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,IMPACT-Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Steven Phu
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Falls, Balance, and Injury Research Centre, Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
| | - Nicholas Russell
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Troy Walker
- Institute for Health Transformation, Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Debra L Waters
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Solomon Yu
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.,Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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5
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Vlietstra L, Waters DL, Jones LM, Wilson L, Meredith-Jones K. High-intensity interval aerobic and resistance training to counteract low relative lean soft tissue mass in middle age: A randomized controlled trial. Exp Gerontol 2023; 171:111991. [PMID: 36403898 DOI: 10.1016/j.exger.2022.111991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Age-related loss of skeletal muscle mass and function begins in early middle age, yet research to date has focused on older individuals, limiting our understanding of interventions earlier in the lifespan. To date, no high-intensity interval training studies have been conducted in middle-aged adults with low relative lean soft tissue mass. METHODS Eighty-two middle-aged adults (40-50 years of age) with low appendicular lean soft tissue mass index confirmed with dual energy x-ray absorptiometry (DXA) were randomly allocated (1:1) to group-based, 20-week, three times a week, high-intensity aerobic and resistance training (HIART) program or 60-min education session (Control). The primary outcome was change in total lean soft tissue mass measured by DXA. Secondary outcomes included cardiorespiratory fitness, physical function (handgrip strength, gait speed, 30-seconds sit-to-stand, quadriceps strength and muscle quality). Measures were obtained at baseline (0 weeks), mid-intervention (10 weeks) and post-intervention (20 weeks). RESULTS Mean age in HIART was 44.8 (SD 3.2) and 45.4 (SD 2.9) in Control group. The majority of the participants were female with 88 % in HIART and 83 % in Control group. Mean BMI in HIART was 25.8 kg/m2 (SD 3.5) and 26.4 kg/m2 (SD 4.1) Control group. Intention to treat analysis showed that post-intervention, HIART increased significantly more total lean soft tissue mass (0.8 kg, 95%CI 0.15, 1.46), appendicular lean soft tissue mass index (0.2 kg/m2, 95%CI 0.09, 0.33), peak oxygen uptake (5.18 mL/min/kg, 2.97 to 7.39 95%CI), grip strength (2.2 kg, 95%CI 0.09, 4.32), and 30-s sit-to-stand (1.3 times, 95%CI 0.43, 2.12) with significantly greater reductions in body fat percentage (-1.1 %, 95%CI -2.03, -0.10) and maximum gait speed (-0.2 m/s, 95 % CI -0.34, -0.03) compared Control. CONCLUSION The HIART program is an effective exercise intervention to increase total lean soft tissue mass in middle-aged adults with low relative lean soft tissue mass compared to a waitlist control group.
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Affiliation(s)
- Lara Vlietstra
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand.
| | - Debra L Waters
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand; School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin, New Zealand; Department of Internal Medicine, University of New Mexico, 915 Camino de Salud NE, Albuquerque, NM, USA
| | - Lynnette M Jones
- School of Physical Education, Sport & Exercise Sciences, University of Otago, 55/47 Union Street West, Dunedin, New Zealand
| | - Luke Wilson
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand
| | - Kim Meredith-Jones
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand
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Vlietstra L, Waters DL, Jones LM, Meredith-Jones K. High-Intensity Interval Aerobic Resistance Training to Counteract Low Relative Appendicular Lean Soft Tissue Mass in Middle Age: Study Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e22989. [PMID: 33064101 PMCID: PMC7600005 DOI: 10.2196/22989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sarcopenia is the age-related loss of skeletal muscle mass and function and may exist in early middle age. Previous research in this area has focused on resistance training in older individuals; however, there is a lack of intervention trials in middle-aged adults with low relative appendicular lean soft tissue mass who may be at risk for sarcopenia in older age. OBJECTIVE This randomized controlled trial aims to determine the effects of a high-intensity interval aerobic resistance training intervention on appendicular lean soft tissue mass in middle-aged adults with low relative appendicular lean soft tissue mass. METHODS We will conduct a 40-week, single-blinded randomized controlled trial in 84 middle-aged adults with low appendicular lean soft tissue mass in the wider Dunedin area, New Zealand. We will randomly allocate participants to receive either a group-based, 20-week high-intensity interval aerobic resistance training intervention program or a single, 60-minute education session on current exercise recommendations. After the first 20 weeks, both groups will be given a 20-week home program. The study will assess primary and secondary outcome measures, including body composition (regional and whole-body lean soft tissue mass, fat mass, percentage body fat, measured by dual x-ray absorptiometry), blood biomarkers (cortisol, creatinine, C-reactive protein, lipid profile, hemoglobin), physical fitness (maximum oxygen consumption, blood pressure), physical activity (accelerometry), physical function (handgrip strength, sit-to-stand, gait speed, quadriceps strength), and self-reported questionnaires (health outcomes, self-efficacy, perceived enjoyment of physical activity, and multifactorial lifestyle), at baseline, 20 weeks, and 40 weeks. Physical function and self-reported questionnaires will also be measured at 10 weeks. We will assess the primary outcome measure, total body lean soft tissue mass, at baseline, 20 weeks, and 40 weeks. Analyses will be performed using intention-to-treat principles, comparing the outcomes resulting from the intervention, using linear mixed models. RESULTS We obtained ethical approval for this study from The University of Otago Human Ethics Committee on December 10, 2018. Participant recruitment started on February 11, 2019 and was completed on May 14, 2019. Data collection started on February 25, 2019 and was completed on February 28, 2020. We expect to publish the results in January 2021. CONCLUSIONS High-intensity interval aerobic resistance training is a time-efficient form of exercise, enabling busy middle-aged adults to meet physical activity recommendations while maximizing training results. The findings can inform the development of future prevention-focused interventions aimed at counteracting the high prevalence of sarcopenia in the aging population. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12618001778279); https://tinyurl.com/y555z6fz. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/22989.
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Affiliation(s)
- Lara Vlietstra
- Department of Medicine, Otago Medical School, Dunedin Campus, University of Otago, Dunedin, New Zealand.,School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Debra L Waters
- Department of Medicine, Otago Medical School, Dunedin Campus, University of Otago, Dunedin, New Zealand.,School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Lynnette M Jones
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Kim Meredith-Jones
- Department of Medicine, Otago Medical School, Dunedin Campus, University of Otago, Dunedin, New Zealand
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Hendrickx W, Vlietstra L, Valkenet K, Wondergem R, Veenhof C, English C, Pisters MF. General lifestyle interventions on their own seem insufficient to improve the level of physical activity after stroke or TIA: a systematic review. BMC Neurol 2020; 20:168. [PMID: 32357844 PMCID: PMC7195782 DOI: 10.1186/s12883-020-01730-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 04/15/2020] [Indexed: 12/31/2022] Open
Abstract
Background Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear. Therefore, the research question of this study was: what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA? Method A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Pubmed, Embase and Cumulative Index for Nursing and Allied Health Literature (CINAHL), were searched up to August 2018. Randomised controlled trials that compared lifestyle interventions, aimed to increase the amount of physical activity completed by participants with a stroke or TIA, with controls were included. The Physiotherapy Evidence Database (PEDro) score was used to assess the quality of the articles, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method for the best evidence synthesis. Results Eleven trials (n = 2403) met the inclusion criteria. The quality of the trials was mostly high, with 8 (73%) of trials scoring ≥6 on the PEDro scale. The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA. There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA. Conclusion Based on the results of this review, general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA. Lifestyle interventions that specifically encourage increasing physical activity may be more effective. Further properly powered trials using objective physical activity measures are needed to determine the effectiveness of such interventions. Trial registration PROSPERO, CRD42018094437.
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Affiliation(s)
- Wendy Hendrickx
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Emile Hullebroeckstraat 60, 3543 BZ, Utrecht, The Netherlands.
| | - Lara Vlietstra
- Department of Medicine, Dunedin School of Medicine and School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Karin Valkenet
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Roderick Wondergem
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Emile Hullebroeckstraat 60, 3543 BZ, Utrecht, The Netherlands.,Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Cindy Veenhof
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Emile Hullebroeckstraat 60, 3543 BZ, Utrecht, The Netherlands.,Innovation for Human Movement Care Research Group, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Coralie English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia.,Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience and Hunter Medical Research Institute, Newcastle, Australia
| | - Martijn Frits Pisters
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Emile Hullebroeckstraat 60, 3543 BZ, Utrecht, The Netherlands.,Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
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Waters DL, Vlietstra L, Qualls C, Morley JE, Vellas B. Sex-specific muscle and metabolic biomarkers associated with gait speed and cognitive transitions in older adults: a 9-year follow-up. GeroScience 2020; 42:585-593. [PMID: 32002783 PMCID: PMC7205909 DOI: 10.1007/s11357-020-00163-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 01/21/2020] [Indexed: 12/19/2022] Open
Abstract
Physical frailty and cognitive frailty share biological mechanisms, but sex-specific biomarkers associated with transitions in gait speed and cognition during ageing are poorly understood.Gait speed, cognition (3MSE), body composition (DXA) and serological biomarkers were assessed annually over 9 years in 216 males (72.7 + 8.07 years) and 384 females (71.1 + 8.44 years). In females, maintaining normal gait speed was associated with lower percent body fat (IRR 0.793, p = 0.001, 95%CI 0.691-0.910) and lower lactate dehydrogenase (LDH) (IRR 0.623, p = 0.00, 95%CI 0.514-0.752), and in males, the association was with higher cholesterol (IRR 1.394, p = 0.001, 95%CI 1.154-1.684). Abnormal to normal gait speed transitions were associated with higher insulin in females (IRR 1.325, p = 0.022, 95%CI 1.041-1.685) and lower creatinine in males (IRR 0.520, p = 0.01, 95%CI 0.310-0.870). Normal to slow gait speed transitions in males were associated with IGF-1 (IRR 1.74, p = 0.022, 95%CI 1.08-2.79) and leptin in females (IRR 1.39, p = 0.043, 95%CI 1.01-1.91.) Maintaining normal cognition was associated with lower LDH in females (IRR 0.276, p = 0.013, 95%CI 0.099-0.765) and higher appendicular skeletal muscle mass in males (IRR 1.52, p = 0.02, 95%CI 1.076-2.135). Improved cognition was associated with higher leptin (IRR 7.5, p = 0.03, 95%CI 1.282-44.34) and lower triglyceride (IRR 0.299, p = 0.017, 95%CI 0.110-0.809) in males. Education was protective against cognitive decline in females (IRR 0.84, p = 0.037, 0.732-0.982). Sex-specific biomarkers of muscle (LDH, Creatinine, IGF-1, APSM) and metabolism (%fat, insulin,cholesterol, leptin, tryglycerides) were associated with gait speed and cognitive transitions. These data suggest that modifiable biomarkers of muscle and metabolism could be targeted for interventions.
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Affiliation(s)
- D L Waters
- Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, 9054, New Zealand.
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA.
| | - L Vlietstra
- Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, 9054, New Zealand
| | - C Qualls
- Department of Mathematics & Statistics and School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - J E Morley
- Division of Geriatric Medicine, Saint Louis University, 1402 South Grand Blvd, Room M238, St. Louis, MO, 63110-0250, USA
| | - B Vellas
- Department of Internal and Geriatrics Medicine, Gerontopole, CHU de Toulouse, UMR 1027 INSERM, University Toulouse III, Toulouse, France
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Vlietstra L, Stebbings S, Meredith-Jones K, Abbott JH, Treharne GJ, Waters DL. Sarcopenia in osteoarthritis and rheumatoid arthritis: The association with self-reported fatigue, physical function and obesity. PLoS One 2019; 14:e0217462. [PMID: 31170172 PMCID: PMC6553728 DOI: 10.1371/journal.pone.0217462] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/06/2019] [Indexed: 12/12/2022] Open
Abstract
AIM To determine if there is an association between sarcopenia, physical function and self-reported fatigue in osteoarthritis (OA) and rheumatoid arthritis (RA). METHODS A cross-sectional analysis of measurements from a cohort of 157 participants with OA or RA was performed. The relationship between muscle mass (appendicular muscle index (AMI)), physical function (timed up and go, 30-seconds sit-to-stand test, 40-meter fast-paced walk test and grip-strength) and two fatigue measures (Multidimensional Assessment of Fatigue (MAF) and a fatigue Visual Analogue Scale (VAS)) was explored using hierarchical linear regression or logistic regression with established AMI cut-offs for sarcopenia. RESULTS There were no significant differences for perceived fatigue-related variables between OA or RA sarcopenic or non-sarcopenic participants. Participants with OA had worse physical function (TUG; P = 0.029, STS; P = 0.004, WS; P = 0.003), but participants with RA had lower grip strength (P<0.001). The RA group had higher CRP (P = 0.006), were more likely to receive glucocorticoids (P<0.001), and experienced worse fatigue (P = 0.050). The hierarchical multiple regression showed that self-reported fatigue (VAS/MAF-distress) had a significant but weak association with AMI in RA. Participants with higher percentage body fat had a significantly stronger association with sarcopenia in both OA and RA. CONCLUSION Sarcopenia, when assessed by AMI, does not appear to be strongly associated with self-reported fatigue or physical function in participants with either OA or RA. Higher body fat had a moderately strong association with sarcopenia in this cross-sectional study, suggesting that body composition may be an important factor in the health of patients with longstanding OA or RA.
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Affiliation(s)
- Lara Vlietstra
- University of Otago, Department of Medicine, Dunedin, New Zealand
| | - Simon Stebbings
- University of Otago, Department of Medicine, Dunedin, New Zealand
| | | | - J. Haxby Abbott
- University of Otago, Dunedin School of Medicine, Department of Surgical Sciences, Dunedin, New Zealand
| | | | - Debra L. Waters
- University of Otago, Department of Medicine, Dunedin, New Zealand
- University of Otago, School of Physiotherapy, Dunedin, New Zealand
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Waters DL, Qualls CR, Cesari M, Rolland Y, Vlietstra L, Vellas B. Relationship of Incident Falls with Balance Deficits and Body Composition in Male and Female Community-Dwelling Elders. J Nutr Health Aging 2019; 23:9-13. [PMID: 30569062 DOI: 10.1007/s12603-018-1087-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Sarcopenia and obesity are reported risk factors for falls, although the data are not consistent and most studies do not make sex comparisons. We investigated whether falls were associated with balance, gait, and body composition, and whether these relationships are sex-specific. DESIGN Secondary analysis of 4-year follow-up data from of the New Mexico Aging Process Study. SETTING Albuquerque, New Mexico. PARTICIPANTS 307 participants (M, n=122, 75.8 yr. SD5.5; F, n=183, 74.6yr SD6.1). MEASUREMENTS Gait and balance were assessed annually using the Tinetti test. Lean body mass (LBM), appendicular skeletal muscle mass (ASM), fat free mass (FFM), total fat mass (FM) were assessed annually by DXA. Falls were assessed using bimonthly falls calendars. Hazard ratios (HR) for 2-point worsening in gait and balance score and falls were calculated by Cox proportional hazard for men and women. RESULTS Baseline balance deficits, and not body composition, represented the strongest predictor of falls. For the total balance score, the variables with significant sex interactions were ASM (Male-HR 1.02 95%CI 0.60-1.73; Female-HR 1.92 95%CI 1.05-3.52, p=0.03) and FFM (Male-HR 1.04 95%CI 0.64-1.70; Female-HR 1.91 95%CI 1.12-3.24, p=0.04), after adjustment for age, sarcopenia and physical activity. The body composition relationship with balance deficits was U-shaped with the strongest predictors being low LBM in males and high FM in females. CONCLUSIONS Specific body composition components and balance deficits are risk factors for falls following sex-specific patterns. Sex differences need to be explored and considered in interventions for worsening balance and falls prevention.
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Affiliation(s)
- D L Waters
- Debra Waters, Department of Medicine / School of Physiotherapy, University of Otago PO Box 56, Dunedin 9054, New Zealand, , +64 3 479 7222
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Vlietstra L, Meredith-Jones K, Stebbings S, Abbott JH, Treharne GJ, Waters DL. Sarcopenic obesity is more prevalent in osteoarthritis than rheumatoid arthritis: are different processes involved? Rheumatology (Oxford) 2018; 56:1816-1818. [PMID: 28957570 DOI: 10.1093/rheumatology/kex303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lara Vlietstra
- Physical Therapy Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - J Haxby Abbott
- Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences
| | | | - Debra L Waters
- Department of Medicine and School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Vlietstra L, Hendrickx W, Waters DL. Exercise interventions in healthy older adults with sarcopenia: A systematic review and meta-analysis. Australas J Ageing 2018; 37:169-183. [DOI: 10.1111/ajag.12521] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Lara Vlietstra
- Physical Therapy Sciences; Program in Clinical Health Sciences; University Medical Center Utrecht; Utrecht The Netherlands
| | - Wendy Hendrickx
- Physical Therapy Sciences; Program in Clinical Health Sciences; University Medical Center Utrecht; Utrecht The Netherlands
| | - Debra L Waters
- Department of Medicine; University of Otago; Dunedin New Zealand
- School of Physiotherapy; University of Otago; Dunedin New Zealand
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