Lifestyle-Related Factors Contributing to Decline in Knee Extension Strength among Elderly Women: A Cross-Sectional and Longitudinal Cohort Study

<div><p>This cross-sectional and 4-year longitudinal cohort study aimed to clarify how various lifestyle-related variables affect knee extension strength in elderly Japanese women. The participants were community-dwelling women (<i>n</i> = 575) living in the Itabashi Ward of Tokyo, Japan aged 75–85 years at baseline (in 2008) who returned for a follow-up examination 4 years later (in 2012). Maximum isometric knee extension strength in the dominant leg was measured during comprehensive medical check-ups at baseline and follow-up. Interviews with participants included questions on their history of 11 diseases and lifestyle-related factors such as physical activity as well as dietary, smoking, and drinking habits. Cross-sectional and longitudinal analyses yielded inconsistent results regarding the associations between lifestyle-related factors and knee extension strength. While going out more frequently and regular physical exercise positively affected baseline knee extension strength, they did not affect knee extension strength in the longitudinal analysis. The longitudinal analysis revealed that more frequent intake of soy products or green and yellow vegetables at baseline decreased age-related knee extension strength decline. The inconsistent results from the cross-sectional and longitudinal analyses indicate that conducting both types of analyses is crucial for researching this type of subject. The present study demonstrates that the age-related decline in muscle strength is lower in those who frequently eat soy products or green and yellow vegetables. Thus, recommending higher intake of soy products, and green and yellow vegetables for the elderly might help maintain their muscle health.</p></div

Subjects' characteristics at baseline and follow-up at 4 years (n = 575).

<p>SD = standard deviation, COPD = chronic obstructive pulmonary disease, P-Values were outcomes of paired t-tests for continuous variables, and of McNemar tests for binary variables.</p><p>Subjects' characteristics at baseline and follow-up at 4 years (n = 575).</p

Result of the longitudinal analysis showing the effect of baseline lifestyle factors on decline in muscle strength.

<p>SE; Standard Error, Analyses of covariance were applied incorporating baseline age, baseline knee extensor strength, and baseline status of all the diseases (hypertension, stroke, heart disease, diabetes mellitus, hyperlipidemia, osteoporosis, anemia, asthma, chronic obstructive pulmonary disease, hip osteoarthritis, and gonarthrosis) as covariates.</p><p>Result of the longitudinal analysis showing the effect of baseline lifestyle factors on decline in muscle strength.</p

Result of the cross-sectional analysis showing the average knee extension strength according to binarized baseline lifestyle factors.

<p>SE; Standard Error, Analyses of covariance were applied incorporating baseline age, and baseline status of all the diseases (hypertension, stroke, heart disease, diabetes mellitus, hyperlipidemia, osteoporosis, anemia, asthma, chronic obstructive pulmonary disease, hip osteoarthritis, gonarthrosis) as covariates.</p><p>Result of the cross-sectional analysis showing the average knee extension strength according to binarized baseline lifestyle factors.</p