Accuracy of different handgrip values to identify mobility limitation in older adults

BACKGROUND/OBJECTIVE: Mobility limitation is commonly the first sign of impaired physical function and predisposes older adults to disability. Moreover, recent epidemiological studies have classified neuromuscular strength as the best explanator of mobility limitation. However, existing cutoffs have not been adequately analyzed regarding accuracy. Therefore, our aims were to define and compare the accuracy of different cutoff points of handgrip strength for the identification of mobility limitation. METHODS: Cross-sectional study with 5783 participants from the SABE (Saúde, Bem-Estar e Envelhecimento [Health, Wellbeing and Aging]) and ELSA (English Longitudinal Study of Ageing) cohorts aged 60 years or older. Handgrip strength was measured using a dynamometer. Walking speed <0.8 m/s was considered mobility limitation. Receiver operating characteristic curves and probabilities of presenting mobility limitation were calculated. RESULTS: Handgrip strength <32 kg for men and <21 kg for women demonstrated good diagnostic accuracy for mobility limitation, with 49.1% sensitivity and 79.8% specificity for men and 58.6% sensitivity and 72.9% specificity for women. The fully adjusted models had an area under the curve of 0.82 for men and 0.83 for women, with odds of presenting mobility limitation of 1.88 [95% CI: 1.50 - 2.37] for men and 1.89 [95% CI: 1.57 - 2.27] for women. CONCLUSIONS: The results of this study support the accuracy of handgrip strength as a clinical marker of mobility limitation. Furthermore, manual dynamometry is easily incorporated into clinical practice, has a good cost-benefit, besides being a simple, valid, reliable and effective method for use in both the scientific community and outpatient practice

Does abdominal obesity accelerate muscle strength decline in older adults? Evidence from the English Longitudinal Study of Ageing

BACKGROUND: Cross-sectional evidence has shown an association between abdominal obesity and lower muscle strength in older adults. However, no longitudinal findings have confirmed this association. In addition, the impact of abdominal fat on the reduction in muscle strength is not yet fully understood. METHODS: We investigated the longitudinal associations between abdominal obesity and handgrip strength in 5,181 older adults from the English Longitudinal Study of Ageing (ELSA) over eight years of follow-up. Muscular strength was measured using a manual dynamometer. Abdominal obesity was defined as a waist circumference >102cm for men and >88cm for women. Generalized linear mixed models were adjusted by measures of socioeconomic status, health conditions, lifestyle, cognition, depressive symptoms, biomarkers and disability. RESULTS: At baseline, the mean age of participants was 65.8 years and their mean waist circumference and BMI were 95 cm and 27.7 kg/m², respectively. Fully adjusted models showed that abdominal obese men and women had stronger muscle strength at baseline. The decline over time in muscle strength was accelerated in abdominal obese men (-0.12 kg per year, 95%CI = -0.24 – -0.01) compared to non-abdominal obese. This association was not found in women. Comparative analyses showed that overweight men according to their body mass index were not at greater risk of muscle strength decline. However, these men were at risk based on their waist circumference. CONCLUSIONS: Abdominal obesity is associated with accelerated muscle strength decline in men

Gender differences in the association between adverse events in childhood or adolescence and the risk of premature mortality

To examine, by gender, the relationship between adverse events in childhood or adolescence and the increased risk of early mortality (before 80 years). The study sample included 941 participants of the English Longitudinal Study of Aging who died between 2007 and 2018. Data on socioeconomic status, infectious diseases, and parental stress in childhood or adolescence were collected at baseline (2006). Logistic regression models were adjusted by socioeconomic, behavioral and clinical variables. Having lived with only one parent (OR 3.79; p = 0.01), overprotection from the father (OR 1.12; p = 0.04) and having had an infectious disease in childhood or adolescence (OR 2.05; p = 0.01) were risk factors for mortality before the age of 80 in men. In women, overprotection from the father (OR 1.22; p < 0.01) was the only risk factor for mortality before the age of 80, whereas a low occupation of the head of the family (OR 0.58; p = 0.04) and greater care from the mother in childhood or adolescence (OR 0.86; p = 0.03) were protective factors. Independently of one’s current characteristics, having worse socioeconomic status and health in childhood or adolescence increased the risk of early mortality in men. Parental overprotection increased the risk of early mortality in both sexes, whereas maternal care favored longevity in women

Inflammation and quality of life in later life: findings from the health, well-being and aging study (SABE)

BACKGROUND: Few studies have specifically investigated the inverse relationship between reduced quality of life in different domains and elevated C-reactive protein (CRP) serum levels in older adults. Therefore, this study investigates the cross-sectional association between quality of life and inflammation in older Brazilian adults. METHODS: Data were collected from 1255 participants from the third wave (2010) of the Brazilian Health, Well-being and Aging study (SABE), a community-based cohort study of aging. Inflammation was assessed using CRP serum levels and quality of life (QoL) was measured using the 12-item Short-Form Health Survey (SF-12) questionnaire. The covariates included age, sex, education level, financial sufficiency, number of non-communicable diseases, self-reported doctor diagnosed diseases, Activity of Daily Living (ADL) difficulties, Body Mass Index (BMI), and waist circumference. RESULTS: The fully adjusted models showed that older adults with low scores in the physical domain of the SF12 (OR 1.34, 95%CI 1.02;1.77) and high BMI values (> 30) (OR 2.05, 95%CI 1.50;2.81) were more likely to present high CRP serum levels. CONCLUSION: Our findings suggest a significant association of lower scores in the physical domain of quality of life and the presence of obesity with high CRP serum levels

Neonatal screening for cystic fibrosis in Sao Paulo State, Brazil: a pilot study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Cystic fibrosis is one of the most common autosomal recessive hereditary diseases in the Caucasian population, with an incidence of 1:2000 to 1:3500 liveborns. More than 1000 mutations have been described with the most common being F508del. It has a prevalence of 23-55% within the Brazilian population. The lack of population-based studies evaluating the incidence of cystic fibrosis in Sao Paulo State, Brazil, and an analysis concerning the costs of implantation of a screening program motivated the present study. A total of 60,000 dried blood samples from Guthrie cards obtained from April 2005 to January 2006 for neonatal screening at 4 reference centers in Sao Paulo State were analyzed. The immunoreactive trypsinogen (IRT)/IRT protocol was used with the cut-off value being 70 ng/mL. A total of 532 children (0.9%) showed IRT >70 ng/mL and a 2nd sample was collected from 418 (80.3%) of these patients. Four affected children were detected at two centers, corresponding to an incidence of 1:8403. The average age at diagnosis was 69 days, and 3 of the children already showed severe symptoms of the disease. The rate of false-positive results was 95.2% and the positive predictive value for the test was 8%. The cost of detecting an affected subject was approximately US$8,000.00 when this cystic fibrosis program was added to an existing neonatal screening program. The present study clearly shows the difficulties involved in cystic fibrosis screening using the IRT/IRT protocol, particularly in a population with no long-term tradition of neonatal screening.4210973978Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [03/12731-8