The increase in health care costs associated with muscle weakness in older people without long-term illnesses in the Czech Republic:results from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Michal Steffl,1 Jan Sima,2 Kate Shiells,3 Iva Holmerova3 1Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic; 2Department of Sport Management, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic; 3Centre of Expertise in Longevity and Long-term Care, Faculty of Humanities, Charles University, Prague, Czech Republic Abstract: Muscle weakness and associated diseases are likely to place a considerable economic burden on government health care expenditure. Therefore, our aim for this study was to estimate the direct and indirect costs associated with muscle weakness in the Czech Republic. We applied a cost-of-illness approach using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Six hundred and eighty-nine participants aged 70 years and over and without any long-term illnesses were included in our study. A generalized linear model with gamma distribution was used, and odds ratio (OR) was calculated in order to explore the effect of muscle weakness on direct and indirect costs. For both genders, muscle weakness had a statistically significant impact on direct costs (OR =2.11), but did not have a statistically significant impact on indirect costs (OR =1.08) or on total cost (OR =1.51). Muscle weakness had the greatest statistically significant impact on direct costs in females (OR =2.75). In conclusion, our study has shown that muscle weakness may lead to increased direct costs, and consequently place a burden on health care expenditure. Therefore, the results of this study could lead to greater interest in the prevention of muscle weakness among older people in the Czech Republic. Keywords: direct cost, indirect cost, economic burden, sarcopenia, frailt

Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis

Physical activity (PA) has been identified as beneficial for many diseases and health disorders, including sarcopenia. The positive influence of PA interventions on sarcopenia has been described previously on many occasions. Current reviews on the topic include studies with varied PA interventions for sarcopenia; nevertheless, no systematic review exploring the effects of PA in general on sarcopenia has been published. The main aim of this study was to explore the relationship between PA and sarcopenia in older people on the basis of cross-sectional and cohort studies. We searched PubMed, Scopus, EBSCOhost, and ScienceDirect for articles addressing the relationship between PA and sarcopenia. Twenty-five articles were ultimately included in the qualitative and quantitative syntheses. A statistically significant association between PA and sarcopenia was documented in most of the studies, as well as the protective role of PA against sarcopenia development. Furthermore, the meta-analysis indicated that PA reduces the odds of acquiring sarcopenia in later life (odds ratio [OR] =0.45; 95% confidence interval [CI] 0.37–0.55). The results of this systematic review and meta-analysis confirm the beneficial influence of PA in general for the prevention of sarcopenia.<br/

Field-Based and Lab-Based Assisted Jumping: Unveiling the Testing and Training Implications

Purpose: Assisted jumping can supplement resistance training and traditional plyometric training to increase vertical jump performance. However, as coaches may choose to make field-based decisions based on lab-based research, this study determined whether a field-based assisted jumping set-up results in different ground contact times (CT), take off forces (TOF), flight times (FT), and impact forces (IF) compared to a lab-based set-up.Methods: Eighteen active males (24.8 ± 3.0 yr; 178.8 ± 7.8 cm; 77.8 ± 7.8 kg) performed two sessions of assisted jumping: one with each hand holding a commercially available resistance band (1m) that was attached to a pull-up bar (FIELD), and the other with assistance from a custom-built system of ropes, pulleys, and long (3 m) elastic bands (LAB). With each set-up, subjects performed five sets of five countermovement jumps on a force plate. Each set was performed with either bodyweight (BW), 90, 80, 70, or 60% of BW, which was achieved by either grabbing higher or lower on the bands during FIELD, or by being pulled upward via a full-body harness during LAB. The order of each visit was counter-balanced, and the order of jumps within each visit was quasi-randomized. Data from the 90, 80, 70, and 60% trials for each set-up were then expressed relative to the data of BW jumps, and these relative values were then used for analysis.Results: CTFIELD was less than CTLAB at 80, 70, and 60%. FTFIELD was greater than FTLAB at 90 and 80%, but FTLAB became greater at 60%. TOF and IF remained unchanged during LAB, but TOFFIELD was consistently less than TOF during BW, with IFFIELD generally being greater than IFLAB.Conclusion: If the purpose of assisted jumping is to spend less time on the ground without decreasing force, systems with finite adjustments and longer bands like LAB should be used. However, shorter bands similar to FIELD may also be used; but due to the larger variability of assistance throughout the range of motion, such systems may alter the neuromuscular characteristics of the jump in other ways that should be investigated in future research

mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED): rationale and study protocol for a pragmatic randomised controlled trial

Background The growing number of patients with type 2 diabetes and prediabetes is a major public health concern. Physical activity is a cornerstone of diabetes management and may prevent its onset in prediabetes patients. Despite this, many patients with (pre)diabetes remain physically inactive. Primary care physicians are well-situated to deliver interventions to increase their patients' physical activity levels. However, effective and sustainable physical activity interventions for (pre)diabetes patients that can be translated into routine primary care are lacking. Methods We describe the rationale and protocol for a 12-month pragmatic, multicentre, randomised, controlled trial assessing the effectiveness of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED). Twenty-one general practices will recruit 340 patients with (pre)diabetes during routine health check-ups. Patients allocated to the active control arm will receive a Fitbit activity tracker to self-monitor their daily steps and try to achieve the recommended step goal. Patients allocated to the intervention arm will additionally receive the mHealth intervention, including the delivery of several text messages per week, with some of them delivered just in time, based on data continuously collected by the Fitbit tracker. The trial consists of two phases, each lasting six months: the lead-in phase, when the mHealth intervention will be supported with human phone counselling, and the maintenance phase, when the intervention will be fully automated. The primary outcome, average ambulatory activity (steps/day) measured by a wrist-worn accelerometer, will be assessed at the end of the maintenance phase at 12 months. Discussion The trial has several strengths, such as the choice of active control to isolate the net effect of the intervention beyond simple self-monitoring with an activity tracker, broad eligibility criteria allowing for the inclusion of patients without a smartphone, procedures to minimise selection bias, and involvement of a relatively large number of general practices. These design choices contribute to the trial’s pragmatic character and ensure that the intervention, if effective, can be translated into routine primary care practice, allowing important public health benefits

Demographic and Lifestyle Factors and Memory in European Older People

Objectives: To investigate associations between demographic and lifestyle factors and memory performance in European people aged &ge;60 years. Methods: Data from 23,641 people with a mean age of 70.2 (95 % CI 70.1&ndash;70.3) were analyzed and drawn from the fourth wave of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Generalized linear models were carried out to estimate the associations for both men and women. Memory performance was tested using two word-list learning tests with immediate and delayed recall in SHARE. Results: age, severe limitations in physical activities, and any past alcohol problem were all negatively associated with memory performance. Contrarily, education level, higher nonalcoholic fluid intake, and engagement in sports activities more than once a week and in activities requiring a moderate level of energy were all positively associated with memory performance. Smoking showed a significant negative association only in the immediate recall test for both men and women together, whilst long-term illness showed association only in the delayed recall. Alcohol consumption was positively associated with memory performance in women, but in men, it depended on the drinking frequency. Conclusions: Demographic and lifestyle factors are associated with memory performance in the older population

Using relative handgrip strength to identify children at risk of sarcopenic obesity

Identifying children at risk of developing childhood sarcopenic obesity often requires specialized equipment and costly testing procedures, so cheaper and quicker methods would be advantageous, especially in field-based settings. The purpose of this study was to determine the relationships between the muscle-to-fat ratio (MFR) and relative handgrip strength, and to determine the ability of handgrip strength relative to body mass index (grip-to-BMI) to identify children who are at risk of developing sarcopenic obesity. Grip-to-BMI was measured in 730 Czech children (4 to 14 yrs). Bioelectrical impedance was used to estimate body fat mass and skeletal muscle mass, from which the MFR was calculated. The area under the curve (AUC) was 0.791 (95% CI 0.692-0.890, p ˂ 0.001) in girls 4-9; 0.789 (95% CI 0.688-0.890, p ˂ 0.001) in girls 10-14 years old; 0.719 (95% CI 0.607-0.831, p = 0.001) in boys 4-9; and 0.896 (95% CI 0.823-0.969, p ˂ 0.001) in boys 10-14 years old. Calculated using the grip-to-BMI ratio, the OR (95% CI) for girls to be at risk of sarcopenic obesity identified by MFR was 9.918 (4.243-23.186, p ˂ 0.001) and was 11.515 (4.280-30.982, p ˂ 0.001) for boys. The grip-to-BMI ratio can be used to predict the presence of sarcopenic obesity in children, which can play a role in pediatric health interventions