Gait speed assessed by a 4-m walk test is not representative of daily-life gait speed in community-dwelling adults

Objectives: Standardized tests of gait speed are regarded as being of clinical value, but they are typically performed under optimal conditions, and may not reflect daily-life gait behavior. The aim of this study was to compare 4-m gait speed to the distribution of daily-life gait speed. Study design: The cross-sectional Grey Power cohort included 254 community-dwelling participants aged 18 years or more. Main outcome measures: Pearson's correlations were used to compare gait speed assessed using a timed 4-m walk test at preferred pace, and daily-life gait speed obtained from tri-axial lower-back accelerometer data over seven consecutive days. Results: Participants (median age 66.7 years [IQR 59.4–72.5], 65.7% female) had a mean 4-m gait speed of 1.43 m/s (SD 0.21), and a mean 50th percentile of daily-life gait speed of 0.90 m/s (SD 0.23). Ninety-six percent had a bimodal distribution of daily-life gait speed, with a mean 1st peak of 0.61 m/s (SD 0.15) and 2nd peak of 1.26 m/s (SD 0.23). The percentile of the daily-life distribution that corresponded best with the individual 4-m gait speed had a median value of 91.2 (IQR 75.4–98.6). The 4-m gait speed was very weakly correlated to the 1st and 2nd peak (r = 0.005, p = 0.936 and r=0.181, p = 0.004), and the daily-life gait speed percentiles (range: 1st percentile r = 0.076, p = 0.230 to 99th percentile r = 0.399, p < 0.001; 50th percentile r = 0.132, p = 0.036). Conclusions: The 4-m gait speed is only weakly related to daily-life gait speed. Clinicians and researchers should consider that 4-m gait speed and daily-life gait speed represent two different constructs

Lack of Knowledge Contrasts the Willingness to Counteract Sarcopenia Among Community-Dwelling Adults

OBJECTIVE: Sarcopenia is highly prevalent in older adults. Knowledge among community-dwelling adults is important for effective prevention and treatment of sarcopenia. This study aims to assess current knowledge about sarcopenia, investigate willingness for treatment and prevention, and awareness of muscle health. METHOD: Participants who attended health educational events completed a questionnaire on knowledge about sarcopenia. Self-perceived muscle health was assessed by visual analog scale. Objective muscle measures included muscle mass, handgrip strength, and gait speed. RESULTS: Included participants were 197 (median aged 67.9 years [interquartile range = 57.0-75.1]). Eighteen participants (9%) reported to know what sarcopenia is. Participants' self-perceived muscle health showed a low correlation with all objective muscle measures. 76% were willing, in case of sarcopenia diagnosis, to start treatment and 71% were willing to prevent sarcopenia. DISCUSSION: Knowledge about sarcopenia is limited while participants were willing to start treatment and prevention. Strategies to increase knowledge among community-dwelling adults are needed

Lower cognitive function in older patients with lower muscle strength and muscle mass

Background: Low muscle strength and muscle mass are associated with adverse outcomes in older hospitalized patients. The aim of this study was to assess the association between cognitive functioning and muscle strength and muscle mass in hospitalized older patients. Methods: This prospective inception cohort included 378 patients aged 70 years or older. At admission patients were assessed for cognitive functioning by use of the Six-Item Cognitive Impairment Test (6-CIT). Muscle strength and muscle mass were assessed using handheld dynamometry and segmental multifrequency bioelectrical impedance analysis, within 48 h after admission and on day 7, or earlier on the day of discharge. Results: The data of 371 patients (mean age ± standard deviation 80.1 ± 6.4 years, 49.3% female) were available for analyses. The median (interquartile range) 6-CIT score was 4 (0-8) points. At admission, lower cognitive functioning was associated with lower muscle strength, lower skeletal muscle mass (SMM), lower appendicular lean mass, and lower SMM index. Cognitive functioning was not associated with change in muscle strength and muscle mass during hospitalization. Conclusion: This study further strengthens evidence for an association between lower cognitive functioning and lower muscle strength and muscle mass, but without a further decline during hospitalization

Erythrocyte sedimentation rate and albumin as markers of inflammation are associated with measures of sarcopenia: a cross-sectional study

10.1186/s12877-019-1253-5BMC GERIATRICS19

Acute inflammation is associated with lower muscle strength, muscle mass and functional dependency in male hospitalised older patients

Background Hospitalisation is associated with adverse health outcomes including loss of muscle strength, muscle mass and functional decline, which might be further aggravated by acute inflammation. This study aimed to determine whether acute inflammation, as denoted by C-reactive protein (CRP), is associated with muscle strength, muscle mass and functional dependency in hospitalised older patients. Methods The observational, prospective EMPOWER study included 378 hospitalised patients aged 70 years and older. As part of the hospital assessment, 191 patients (50.5%) had CRP measured. Muscle strength and mass were measured using handheld dynamometry and bioelectrical impedance analysis respectively. Activities of Daily Living (ADL) were assessed using Katz score and Instrumental ADL (IADL) by Lawton and Brody score. Linear regression analyses and logistic regression analyses were performed stratified by sex and adjusted for age and comorbidities. Results Mean age was 79.7 years (SD 6.4) and 50.8% were males. On admission and discharge, males with elevated CRP had significantly lower handgrip strength and lower absolute muscle mass compared with males with normal CRP and those with no CRP measured. At three months post-discharge, males with elevated CRP were more likely to be ADL dependent than those with normal CRP and with no CRP measured. In females, no associations were found between CRP and muscle strength, muscle mass, ADL or IADL. Conclusions Hospitalised older male patients with acute inflammation had lower muscle strength at admission and discharge and lower absolute muscle mass at admission and higher ADL dependency at three months post-discharge

Erythrocyte sedimentation rate and albumin as markers of inflammation are associated with measures of sarcopenia: A cross-sectional study

Background: Chronic inflammation is considered to affect physical performance, muscle strength and muscle mass, i.e. measures of sarcopenia. We need to identify a marker of inflammation that is univocally associated with measures of sarcopenia. We aimed to associate three markers of inflammation, erythrocyte sedimentation rate, albumin and white blood cell count, with measures of sarcopenia in geriatric outpatients. Methods: Data from the Centre Of Geriatrics Amsterdam cohort was used. Geriatric outpatients at the VU university medical centre in Amsterdam were recruited based on referral between January 1st 2014 and the 31st of December 2015. Erythrocyte sedimentation rate, albumin and white blood cell count were assessed from venous blood samples. Measures of sarcopenia included physical performance by measuring gait speed with the 4 meter walk test, duration of the timed up and go test and of the chair stand test, muscle strength by assessing handgrip strength using handheld dynamometry and skeletal muscle mass by performing bioelectrical impedance analysis. Multivariable linear regression analyses were performed to assess the associations between erythrocyte sedimentation rate, albumin, white blood cell count and measures of sarcopenia. Results: A total of 442 patients (mean age 80.8 years, SD 6.7, 58.1% female) were included. A higher erythrocyte sedimentation rate was significantly associated with lower gait speed (β = - 0.005; 95% CI = - 0.007, - 0.003), longer duration of timed up and go test (Ln β = 0.006; 95% CI = 0.003, 0.010), longer duration of chair stand test (Ln β = 0.005; 95% CI = 0.002, 0.008), lower handgrip strength (β = - 0.126; 95% CI = - 0.189, - 0.063) and lower relative skeletal muscle mass (β = - 0.179; 95% CI = - 0.274, - 0.084). Lower albumin levels were significantly associated with lower gait speed (β = - 0.020; 95% CI = - 0.011, - 0.028) and handgrip strength (β = - 0.596; 95% CI = - 0.311, - 0.881). Associations remained significant after adjustment for age, sex and number of morbidities. No significant associations were found for white blood cell count and measures of sarcopenia. Conclusions: In geriatric outpatients, erythrocyte sedimentation rate was associated with all three measures of sarcopenia, underpinning the potential role of inflammation in sarcopenia

Acute inflammation is associated with lower muscle strength, muscle mass and functional dependency in male hospitalised older patients

10.1371/journal.pone.0215097PLOS ONE14

Predictors of metabolic syndrome in community-dwelling older adults

OBJECTIVES: The metabolic syndrome has been associated with a variety of individual variables, including demographics, lifestyle, clinical measures and physical performance. We aimed to identify independent predictors of the prevalence and incidence of metabolic syndrome in a large cohort of older adults

Predictors of metabolic syndrome in community-dwelling older adults

10.1371/journal.pone.0206424PLOS ONE131