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Tian Q, Montero-Odasso M, Buchman AS, Mielke MM, Espinoza S, DeCarli CS, Newman AB, Kritchevsky SB, Rebok GW, Resnick SM, Thambisetty M, Verghese J, Ferrucci L. Dual cognitive and mobility impairments and future dementia - Setting a research agenda. Alzheimers Dement 2023; 19:1579-1586. [PMID: 36637077 PMCID: PMC10101877 DOI: 10.1002/alz.12905] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 01/14/2023]
Abstract
Dual cognitive and mobility impairments are associated with an increased risk of dementia. Recent studies examining temporal trajectories of mobility and cognitive function in aging found that dual decline is associated with higher dementia risk than memory decline or gait decline only. Although initial data show that individuals with dual decline or impairment have excessive cardiovascular and metabolic risk factors, the causes of dual decline or what underlies dual decline with a high risk of dementia remain largely unknown. In December 2021, the National Institute on Aging Intramural and Extramural Programs jointly organized a workshop on Biology Underlying Moving and Thinking to explore the hypothesis that older persons with dual decline may develop dementia through a specific pathophysiological pathway. The working group discussed assessment methods for dual decline and possible mechanisms connecting dual decline with dementia risk and pinpointed the most critical questions to be addressed from a translational perspective.
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Affiliation(s)
- Qu Tian
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Manuel Montero-Odasso
- Schulich School of Medicine and Dentistry, Department of Medicine and Division of Geriatric Medicine, The University of Western Ontario, London, ON, Canada
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, ON, Canada
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sara Espinoza
- Division of Geriatrics, Gerontology & Palliative Medicine, Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio, San Antonio, TX, USA
- Geriatrics Research, Education and Clinical Center, South Texas Veterans Health Care System, Audie Murphy Veterans Hospital, San Antonio, TX, USA
| | | | - Anne B. Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen B. Kritchevsky
- Department of Internal Medicine: Gerontology & Geriatric Medicine, The Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - George W. Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Madhav Thambisetty
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
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Yoshida Y, Zeni JA, Zhu Y, Rhyne RL. Concurrent Validity Between Potential Screening Tests for Early Mobility Decline in Independent Community Dwellers. J Geriatr Phys Ther 2022; 45:E161-E168. [PMID: 36112039 PMCID: PMC9588461 DOI: 10.1519/jpt.0000000000000350] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
BACKGROUND AND PURPOSE Standardized screening tests that detect early mobility decline, regardless of etiology, are needed for healthy aging. The locomotive syndrome (LS) tests are designed to identify stages of mobility decline and inform appropriate levels of intervention. The long-term goal of this research is to develop standardized mobility screening tests that can be used across health care settings and throughout a patient's lifespan to guide appropriate medical care. As the first step in this process, this study examines the concurrent validity between the reference and the LS tests. METHODS This cross-sectional study examined correlations between the LS functional tests and a set of reference tests and the ability to differentiate the 3 stages of mobility decline. The reference tests included the stair-climbing test, the 30-second chair rise test, the 6-minute walk test, the Global Physical Health (GPH) portion of the PROMIS, and the Lower Extremity Functional Scale (LEFS). The LS tests included the Stand-Up Test, the 2-Step Test, and the 25-question Geriatric Locomotive Function Scale (25-GLFS). A total of 115 community dwellers of 61.2 years old on average (±10.0 years), with n = 71 (61%) older than 60 years, voluntary participated in this prospective study. Nonparametric analyses of variance and correlations were used to examine the concurrent validity. RESULTS AND DISCUSSION Performance-based tests were significantly correlated (| r | = 0.38-0.61, P < .001) with LS tests. The LEFS was correlated with all LS tests, but the GPH was only correlated with the 25-GLFS. Also, significant differences were found in reference test scores between the 3 LS stages ( P < .05). CONCLUSIONS The LS tests and reference tests demonstrated significant correlations, and participants performed significantly worse on reference tests as LS severity increased. Given these results, it is possible that the LS standardized tests may play an important role in mobility screening. Future research should investigate feasibility, sensitivity, and specificity of these tests.
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Affiliation(s)
- Yuri Yoshida
- Division of Physical Therapy at the University of New Mexico
| | - Joseph A. Zeni
- Department of Rehabilitation and Movement Science, Rutgers the State University of New Jersey
| | - YiLiang Zhu
- Department of Internal Medicine, University of New Mexico School of Medicine
| | - Robert L. Rhyne
- Department of Family and Community Medicine, University of New Mexico School of Medicine
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Tian Q, Mitchell BA, Zampino M, Fishbein KW, Spencer RG, Ferrucci L. Muscle mitochondrial energetics predicts mobility decline in well-functioning older adults: The baltimore longitudinal study of aging. Aging Cell 2022; 21:e13552. [PMID: 35048491 PMCID: PMC8844110 DOI: 10.1111/acel.13552] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [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: 06/21/2021] [Revised: 11/18/2021] [Accepted: 01/05/2022] [Indexed: 12/31/2022] Open
Abstract
Background Muscle mitochondrial dysfunction is associated with poor mobility in aging. Whether mitochondrial dysfunction predicts subsequent mobility decline is unknown. Methods We examined 380 cognitively normal participants aged 60 and older (53%women, 22%Black) who were well‐functioning (gait speed ≥ 1.0 m/s) and free of Parkinson's disease and stroke at baseline and had data on baseline skeletal muscle oxidative capacity and one or more mobility assessments during an average 2.5 years. Muscle oxidative capacity was measured by phosphorus magnetic resonance spectroscopy as the post‐exercise recovery rate of phosphocreatine (kPCr). Mobility was measured by four walking tests. Associations of baseline kPCr with mobility changes were examined using linear mixed‐effects models, adjusted for covariates. In a subset, we examined whether changes in muscle strength and mass affected these associations by adjusting for longitudinal muscle strength, lean mass, and fat mass. Results Lower baseline kPCr was associated with greater decline in all four mobility measures (β, p‐value: (0.036, 0.020) 6‐m usual gait speed; (0.029, 0.038) 2.5‐min usual gait speed; (0.034, 0.011) 6‐m rapid gait speed; (−0.042, <0.001) 400‐m time). In the subset, further adjustment for longitudinal muscle strength, lean mass, and fat mass attenuated longitudinal associations with changes in mobility (Δβ reduced 26–63%). Conclusion Among initially well‐functioning older adults, worse muscle mitochondrial function predicts mobility decline, and part of this longitudinal association is explained by decline in muscle strength and mass. Our findings suggest that worse mitochondrial function contributes to mobility decline with aging. These findings need to be verified in studies correlating longitudinal changes in mitochondrial function, muscle, and mobility performance.
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Affiliation(s)
- Qu Tian
- Translational Gerontology Branch National Institute on Aging National Institutes of Health Baltimore Maryland USA
| | - Brendan A. Mitchell
- Translational Gerontology Branch National Institute on Aging National Institutes of Health Baltimore Maryland USA
| | - Marta Zampino
- Translational Gerontology Branch National Institute on Aging National Institutes of Health Baltimore Maryland USA
| | - Kenneth W. Fishbein
- Laboratory of Clinical Investigation National Institute on Aging National Institutes of Health Baltimore Maryland USA
| | - Richard G. Spencer
- Laboratory of Clinical Investigation National Institute on Aging National Institutes of Health Baltimore Maryland USA
| | - Luigi Ferrucci
- Translational Gerontology Branch National Institute on Aging National Institutes of Health Baltimore Maryland USA
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Chu CH, Quan AML, McGilton KS. Depression and Functional Mobility Decline in Long Term Care Home Residents with Dementia: a Prospective Cohort Study. Can Geriatr J 2021; 24:325-331. [PMID: 34912487 PMCID: PMC8629506 DOI: 10.5770/cgj.24.511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 11/22/2022] Open
Abstract
Objective Assess the association between depression among new long-term care residents (<3 months stay) with dementia and functional mobility decline. Methods A multi-site prospective cohort study was carried out among 26 participants diagnosed with dementia. Functional mobility was measured by Timed-Up-and-Go (TUG) and 2-Minute walk test (2MWT) at baseline, and 60-day post-baseline while participants received usual care. Linear mixed models were applied to examine the association between depression and functional mobility decline. Results Residents experienced a statistically significant decline in functional mobility in as soon as 60 days. Each additional year of age was associated with a 2% increase in TUG. The interaction between depression and time spent in LTC was statistically significant. Age and time living in LTC were significantly associated with functional mobility decline in new residents with dementia. Discussion Further work determining why residents with dementia experience decline in functional mobility at an accelerated rate is needed.
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Affiliation(s)
- Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto.,Institute for Life Course and Aging, University of Toronto, Toronto
| | | | - Katherine S McGilton
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON
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Rizzo R, Knight SP, Davis JRC, Newman L, Duggan E, Kenny RA, Romero-Ortuno R. SART and Individual Trial Mistake Thresholds: Predictive Model for Mobility Decline. Geriatrics (Basel) 2021; 6:geriatrics6030085. [PMID: 34562986 PMCID: PMC8482118 DOI: 10.3390/geriatrics6030085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/12/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful outcomes. Here, we describe a new method to visualise individual trial (raw) information obtained from the SART test, vis-à-vis age, and groups based on mobility status in a large population-based study of ageing in Ireland. A thresholding method, based on the individual trial number of mistakes, was employed to better visualise poorer SART performances, and was statistically validated with binary logistic regression models to predict mobility and cognitive decline after 4 years. Raw SART data were available for 4864 participants aged 50 years and over at baseline. The novel visualisation-derived feature bad performance, indicating the number of SART trials with at least 4 mistakes, was the most significant predictor of mobility decline expressed by the transition from Timed Up-and-Go (TUG) < 12 to TUG ≥ 12 s (OR = 1.29; 95% CI 1.14–1.46; p < 0.001), and the only significant predictor of new falls (OR = 1.11; 95% CI 1.03–1.21; p = 0.011), in models adjusted for multiple covariates. However, no SART-related variables resulted significant for the risk of cognitive decline, expressed by a decrease of ≥2 points in the Mini-Mental State Examination (MMSE) score. This novel multimodal visualisation could help clinicians easily develop clinical hypotheses. A threshold approach to the evaluation of SART performance in older adults may better identify subjects at higher risk of future mobility decline.
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Affiliation(s)
- Rossella Rizzo
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Correspondence:
| | - Silvin Paul Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - James R. C. Davis
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Louise Newman
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Eoin Duggan
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St. James’s Hospital, D08 NHY1 Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, D02 R590 Dublin, Ireland; (S.P.K.); (J.R.C.D.); (L.N.); (E.D.); (R.A.K.); (R.R.-O.)
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St. James’s Hospital, D08 NHY1 Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
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Simonsick EM, Schrack JA, Santanasto AJ, Studenski SA, Ferrucci L, Glynn NW. Pittsburgh Fatigability Scale: One-Page Predictor of Mobility Decline in Mobility-Intact Older Adults. J Am Geriatr Soc 2018; 66:2092-2096. [PMID: 30315707 DOI: 10.1111/jgs.15531] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the Pittsburgh Fatigability Scale (PFS) as a predictor of performance and functional decline in mobility-intact older adults. DESIGN Longitudinal analysis of Baltimore Longitudinal Study of Aging data. SETTING National Institute on Aging, Clinical Research Unit, Baltimore, Maryland. PARTICIPANTS Mobility-intact men (46.8%) and women aged 60 to 89 with concurrent PFS administration and performance and functional assessment and follow-up assessment within 1 to 4 years (N=579). MEASUREMENTS The PFS is a self-administered, 1-page assessment of expected physical and mental fatigue with a score ranging from 0 (no) to 5 (extreme) associated with performing 10 activities. Analyses examined associations between each dimension scored continuously (0-50), categorically (0-5), and dichotomously and change in and likelihood of clinically meaningful decline in usual and fast gait speed, chair stand pace, and reported walking ability. Covariates included age, age2 , sex, race, visit status, baseline function, and follow-up time. We defined meaningful decline as 0.05 m/s per year for usual gait speed, 0.07 m/s per year for fast gait speed, 0.02 chair stands/s per year and 1 point or more for walking ability index. RESULTS Over a mean 2.2 years, 20.5% to 37.7% of participants experienced meaningful decline across assessments. Independent of covariates, higher PFS physical and mental scores were most consistently associated with greater decline in usual gait speed, chair stand pace, and reported walking ability regardless of scoring approach. For example, higher physical fatigability was associated with twice the likelihood of meaningful decline in gait speed as lower physical fatigability (p=.001). PFS scores were superior to fatigue symptoms such as tiredness and energy level in predicting performance decline, which showed no association. CONCLUSION Routine self-administered perceived fatigability assessment may help identify older persons vulnerable to accelerated mobility decline. J Am Geriatr Soc 66:2092-2096, 2018.
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Affiliation(s)
- Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Jennifer A Schrack
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Adam J Santanasto
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Simonsick EM, Glynn NW, Jerome GJ, Shardell M, Schrack JA, Ferrucci L. Fatigued, but Not Frail: Perceived Fatigability as a Marker of Impending Decline in Mobility-Intact Older Adults. J Am Geriatr Soc 2016; 64:1287-92. [PMID: 27253228 DOI: 10.1111/jgs.14138] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate perceived fatigability as a predictor of meaningful functional decline in non-mobility-limited older adults. DESIGN Longitudinal analysis of data from the Baltimore Longitudinal Study of Aging (BLSA). SETTING National Institute on Aging, Clinical Research Unit, Baltimore, Maryland. PARTICIPANTS Men and women aged 60 to 89 participating in the BLSA with concurrent perceived fatigability and functional assessments and follow-up functional assessment within 1 to 3 years (N = 540). MEASUREMENTS Perceived fatigability was ascertained using the Borg rating of perceived exertion (RPE) after 5 minutes of treadmill walking at 1.5 miles per hour. Functional assessments included usual and fast gait speed, the Health, Aging and Body Composition physical performance battery (HABC PPB) and reported walking ability. Reported tiredness and energy level were examined as complementary predictors. Covariates included age, age squared, race, follow-up time, and baseline function. Meaningful decline was defined as 0.05 m/s per year for usual gait speed, 0.07 m/s per year for fast gait speed, 0.12 points/year for HABC PPB, and 1 point for walking ability index. RESULTS Over a mean 2.1 years, 20-31% of participants declined across functional assessments. Fatigability was associated with a 13-19% greater likelihood of meaningful decline in all measures (P = .002- .02) per 1-unit RPE increase. After considering tiredness and energy level separately, findings were essentially unchanged, and neither was associated with gait speed or physical performance decline. In contrast, each separately predicted decline in reported walking ability independent of fatigability (P = .03 and P < .001, respectively). CONCLUSION Routine assessment of fatigability may help identify older persons vulnerable to greater-than-expected functional decline.
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Affiliation(s)
- Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gerald J Jerome
- Department of Kinesiology, College of Health Professions, Towson University, Towson, Maryland
| | - Michelle Shardell
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Jennifer A Schrack
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
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Hicks GE, Shardell M, Alley DE, Miller RR, Bandinelli S, Guralnik J, Lauretani F, Simonsick EM, Ferrucci L. Absolute strength and loss of strength as predictors of mobility decline in older adults: the InCHIANTI study. J Gerontol A Biol Sci Med Sci 2012; 67:66-73. [PMID: 21546582 PMCID: PMC3260485 DOI: 10.1093/gerona/glr055] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [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: 11/13/2010] [Accepted: 03/02/2011] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Theoretical definitions of sarcopenia traditionally emphasize age-related loss of muscle strength; however, most analyses of the association between strength and mobility examine strength at a single time point. This study sought to identify sex-specific cutpoints for muscle strength and power (at one time point) and 3-year changes in strength and power that would maximize prediction of 3-year mobility decline. METHODS Longitudinal analysis of 934 adults aged ≥65 years enrolled in the Invecchiare in Chianti study was conducted. Grip strength, knee extension strength, and lower extremity power were measured at baseline and 3 years postenrollment. Mobility function (gait speed and self-reported mobility disability) was measured at 3 and 6 years postenrollment. Classification and regression tree analysis was used to predict mobility decline from Years 3 to 6. RESULTS Men with knee extension strength <19.2 kg and grip strength <39.0 kg had clinically meaningful declines in gait speed of .24 m/s. Furthermore, men with power <105 W were nearly nine times more likely to develop incident mobility disability (likelihood ratio = 8.68; 95% confidence interval = 3.91, 19.44). Among women, knee extension strength <18.0 kg was associated with a minimal gait speed decline of 0.06 m/s, and women with leg power <64 W were three times more likely to develop incident mobility disability (likelihood ratio = 3.01; 95% confidence interval = 1.79, 5.08). Three-year changes in strength and power did not predict mobility decline in either sex. CONCLUSIONS Findings suggest that strength and power measured at one time point are more predictive of mobility decline than 3-year changes and that low strength and power are particularly powerful risk factors in men.
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Affiliation(s)
- Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA.
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