The aim was to explore the self-reported impact of the COVID-19 pandemic on nutrition and physical activity behaviour in Dutch older adults and to identify subgroups most susceptible to this impact. ...Participants (N = 1119, aged 62-98 y, 52.8% female) of the Longitudinal Aging Study Amsterdam living independently completed a COVID-19 questionnaire. Questions on diagnosis, quarantine and hospitalization were asked, as well as impact of the pandemic on ten nutrition and physical activity behaviours. Associations of pre-COVID-19 assessed characteristics (age, sex, region, household composition, self-rated health, BMI, physical activity, functional limitations) with reported impact were tested using logistic regression analyses. About half of the sample (48.3-54.3%) reported a decrease in physical activity and exercise due to the pandemic. An impact on nutritional behaviour predisposing to overnutrition (e.g., snacking more) was reported by 20.3-32.4%. In contrast, 6.9-15.1% reported an impact on behaviour predisposing to undernutrition (e.g., skipping warm meals). Those who had been in quarantine (
= 123) more often reported a negative impact. Subgroups with higher risk of impact could be identified. This study shows a negative impact of the COVID-19 pandemic on nutrition and physical activity behaviour of many older adults, which may increase their risk of malnutrition, frailty, sarcopenia and disability.
Abstract
Background
The aim was to investigate the associations of sarcopenia as defined by European Working Group on Sarcopenia in Older People (EWGSOP) and Foundation for the National Institutes of ...Health (FNIH) Sarcopenia Project, and their underlying components, with the incidence of recurrent falling and fractures.
Methods
In 498 older men and women (mean age = 75.2 SD = 6.4) from the Longitudinal Aging Study Amsterdam (LASA), the sarcopenia components lean mass (DXA), handgrip strength (handheld dynamometer), and gait speed were measured. Data on falls (3-year follow-up) and fractures (10-year follow-up) were collected. Cox regression analyses were performed, adjusting for age, sex, and total body fat.
Results
Recurrent falling occurred in 130 persons and 60 persons experienced a fracture during follow-up. Participants who were identified as sarcopenic based on the FNIH definitions had a more than 2-fold increased risk to become a recurrent faller. There was no association between sarcopenia based on the EWGSOP definition and incidence of recurrent falling. When the sarcopenia components were examined individually, only a low grip strength was associated with incidence of recurrent falling, independent of a low lean mass or a slow gait speed. Sarcopenia according to both definitions was not associated with incident fractures, which may be caused by low statistical power.
Conclusion
Sarcopenia according to the FNIH definitions, but not according to the EWGSOP definition was associated with recurrent falling. When examining the individual components, only a low grip strength was independently associated with recurrent falling. No associations between sarcopenia with incidence of fractures were found.
Aging is associated with changes in body composition and muscle strength. This review aimed to determine the relation between different body composition measures and muscle strength measures and ...functional decline in older men and women. By use of relevant databases (PubMed, Embase, and CINAHL) and keywords in a search from 1976 to April 2012, 50 articles were reviewed that met the inclusion criteria (written in English, a prospective, longitudinal design, involving older persons aged 65 years or more, and at least one of the measures that follow: body mass index (BMI), waist circumference, waist/hip ratio, midarm circumference, fat mass, muscle fat infiltration, muscle mass, or strength as independent variables and a measure of functional decline as outcome measure). Meta-analyses were performed and revealed that BMI ≥30 and low muscle strength were associated with functional decline (pooled odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.43, 1.80, for BMI ≥30 and OR = 1.86, 95% CI: 1.32, 2.64, for muscle strength). Low muscle mass was not significantly associated with functional decline (pooled OR = 1.19, 95% CI: 0.98, 1.45). Future intervention research should focus on positive changes in body composition to prevent onset or worsening of functional decline in old age.
D3-Creatine Dilution to Assess Muscle Mass Schaap, Laura A
The journals of gerontology. Series A, Biological sciences and medical sciences,
05/2019, Volume:
74, Issue:
6
Journal Article
Peer reviewed
Cawthon et al report on D3-creatine dilution, a novel method to assess muscle mass in human populations, finding a more robust association with function in older men in the osteoporosis in men (MrOs) ...cohort study than has been seen with dual-energy x-ray absorptiometry (DXA). Previous studies have relied on DXA to assess sarcopenia. Health ABC used both DXA and cross-sectional thigh and abdominal computed tomography (CT) scanning to determine how body composition relates to disability.
Consequences of sarcopenia Visser, Marjolein; Schaap, Laura A
Clinics in geriatric medicine,
08/2011, Volume:
27, Issue:
3
Journal Article
Peer reviewed
This article describes the relationship of sarcopenia and dynapenia with three important outcomes in aging research: functional status, falls, and mortality. The data from epidemiologic studies ...conducted in large samples of older men and women suggest that muscle functioning, as indicated by muscle strength or muscle power, has a strong impact on functional status, falls, and mortality. Furthermore, there is evidence that the relationship between poor muscle strength and these three different outcomes is not influenced by muscle size. For the prevention of functional decline, falls, and early mortality in older men and women a major focus on maintaining or increasing muscle strength instead of muscle size seems warranted.
It is well recognized that poor muscle function and poor physical performance are strong predictors of clinically relevant adverse events in older people. Given the large number of approaches to ...measure muscle function and physical performance, clinicians often struggle to choose a tool that is appropriate and validated for the population of older people they deal with. In this paper, an overview of different methods available and applicable in clinical settings is proposed. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were organized afterwards where the whole group could amend and discuss the recommendations further. Several characteristics should be considered when choosing a tool: (1) purpose of the assessment (intervention, screening, diagnosis); (2) patient characteristics (population, settings, functional ability, etc.); (3) psychometric properties of the tool (test–retest reliability, inter-rater reliability, responsiveness, floor and ceiling effects, etc.); (4) applicability of the tool in clinical settings (overall cost, time required for the examination, level of training, equipment, patient acceptance, etc.); (5) prognostic reliability for relevant clinical outcomes. Based on these criteria and the available evidence, the expert group advises the use of grip strength to measure muscle strength and the use of 4-m gait speed or the Short Physical Performance Battery test to measure physical performance in daily practice. The tools proposed are relevant for the assessment of muscle weakness and physical performance. Subjects with low values should receive additional diagnostic workups to achieve a full diagnosis of the underlying condition responsible (sarcopenia, frailty or other).
The objective of this study was to investigate whether high levels of serum interleukin (IL)-6, C-reactive protein (CRP), and α1-antichymotrypsin (ACT) were associated with the loss of muscle ...strength or muscle mass (sarcopenia) in older persons.
The study included 986 men and women of the Longitudinal Aging Study Amsterdam, with a mean age of 74.6 years (standard deviation 6.2).
Grip strength (n = 986) and appendicular muscle mass (n = 328, using dual-energy x-ray absorptiometry) were obtained in 1995 and 1996 and repeated after a 3-year follow-up. Loss of muscle strength was defined as a loss of grip strength greater than 40%, and sarcopenia was defined as a loss of muscle mass greater than 3%, approximating the lowest 15% of the study sample.
Multiple linear and logistic regression analyses revealed that higher levels of IL-6 were associated with greater decline in muscle strength, which decreased by −3.21 kg (standard error 0.81) per standard deviation increase in log-transformed IL-6. After adjustment for confounders, including sociodemographic, health, and lifestyle factors, high IL-6 (>5 pg/mL) and high CRP (>6.1 μg/mL) were associated with a 2 to 3-fold greater risk of losing greater than 40% of muscle strength. Persons with high levels of ACT (>181% of the normal human pooled plasma) were 40% less likely to experience loss of muscle strength and tended (
P = .07) to have a smaller decline in muscle mass compared with those in the lowest quartile of ACT. No consistent associations of IL-6 and CRP with sarcopenia were found.
The findings of this prospective, population-based study suggest that higher levels of IL-6 and CRP increase the risk of muscle strength loss, whereas higher levels of ACT decrease the risk of muscle strength loss in older men and women.
The assessment of weight loss as an indicator of poor nutritional status in older persons is currently widely applied to establish risk of mortality. Little is known about the relationship between ...changes in mid-upper arm circumference (MUAC) and mortality in older individuals. The aim of the present study was to examine the association between 3-year change in MUAC and 20-year mortality in community-dwelling older adults and compare this to the association between body mass index (BMI) change and mortality.
Data on changes in MUAC (cm) and BMI (kg/m2), covariates, and mortality were available for 1307 Dutch older adults (49.7% men) aged 65 years and older in 1995/96 (mean 75.6 years, SD 6.5) from Longitudinal Aging Study Amsterdam (LASA). Anthropometric measurements were performed in 1992/93 with repeated measurements in 1995/96 (baseline), and a mortality follow up until July 2015. BMI and MUAC change were divided into quintiles, with the quintile including zero defined as the reference category. Cox regression analyses were performed to examine the associations of 3-year changes in MUAC and BMI with subsequent 20-year all-cause mortality, adjusted for demographic and health factors. Age, sex and initial measurement of BMI and MUAC (1992/93) were tested for effect modification (P = <0.10).
Mean baseline BMI was 26.7 kg/m2 (SD 4.2) with a 3-year change of −0.2 (SD 1.5). Mean baseline MUAC was 30.5 cm (SD 3.5) with a 3-year change of −0.8 (SD 1.6). Age, sex, and BMI and MUAC 3 years prior were effect modifiers in the associations between change in anthropometric measurement and mortality. Decrease in MUAC was not associated with mortality in persons with a higher initial MUAC (≥31 cm), while for persons with a lower initial MUAC, a decrease in MUAC of ≤−2.15 was associated with increased mortality risk (HR 1.54; 95% CI: 1.14–2.09), also when further stratified on median age and sex. In stratified analysis of BMI change for median initial BMI (26.5) and additionally stratified for median age and sex, the associations between a BMI decrease of ≤−1.19 and mortality fluctuated, mostly statistically not significant. No associations were found for gain in MUAC or BMI.
Given that MUAC loss is more strongly and consistently associated with an increased mortality risk in older individuals with a low initial MUAC compared to BMI loss, this may be a more recommendable measure to use in clinical practice for assessing poor nutritional status, instead of weight loss.
Diabetes and cardiovascular disease develop in concert with metabolic abnormalities mirroring and causing changes in the vasculature, particularly the microcirculation. The microcirculation can be ...affected in different parts of the body of which the skin is the most easily accessible tissue.
The association between diabetes and dermal microvascular dysfunction has been investigated in observational studies. However, the strength of the association is unknown. Therefore we conducted a systematic review with meta-analysis on the association between diabetes and dermal microvascular dysfunction as assessed by laser Doppler/laser speckle contrast imaging with local thermal hyperaemia as non-invasive indicator of microvascular functionality.
PubMed and Ovid were systematically searched for eligible studies through March 2015. During the first selection, studies were included if they were performed in humans and were related to diabetes or glucose metabolism disorders and to dermal microcirculation. During the second step we selected studies based on the measurement technique, measurement location (arm or leg) and the inclusion of a healthy control group. A random effects model was used with the standardised mean difference as outcome measure. Calculations and imputation of data were done according to the Cochrane Handbook.
Of the 1445 studies found in the first search, thirteen cross-sectional studies were included in the meta-analysis, comprising a total of 857 subjects. Resting blood flow was similar between healthy control subjects and diabetes patients. In contrast, the microvascular response to local skin heating was reduced in diabetic patients compared to healthy control subjects pooled effect of -0.78 standardised mean difference (95% CI -1.06, -0.51). This effect is considered large according to Cohen's effect size definition. The variability in effect size was high (heterogeneity 69%, p < 0.0001). However, subgroup analysis revealed no difference between the type and duration of diabetes and other health related factors, indicating that diabetes per se causes the microvascular dysfunction.
Our meta-analysis shows that diabetes is associated with a large reduction of dermal microvascular function in diabetic patients. The local thermal hyperaemia methodology may become a valuable non-invasive tool for diagnosis and assessing progress of diabetes-related microvascular complications, but standardisation of the technique and quality of study conduct is urgently required.
Older women perform consistently poorer on physical performance tests compared to men. Risk groups for this "female disadvantage" in physical performance and it's development over successive birth ...cohorts are unknown. This is important information for preventive strategies aimed to enhance healthy aging in all older women. This study aims to longitudinal investigate whether there are risk groups for a more apparent female disadvantage and study its trend over successive birth cohorts.
Data of the Longitudinal Aging Study Amsterdam (LASA) were used. All participants were aged 55-65 years at baseline. Longitudinal data of two birth cohorts with baseline measurements in 1992/1993 (n = 966, 24 year follow-up) and 2002/2003 (n = 1002, 12 year follow-up) were included. Follow-up measurements were repeated every three/four years. Cross-sectional data of two additional cohorts were included to compare ethnic groups: a Dutch cohort (2012/2013, n = 1023) and a Migration cohort (2013/2014, n = 478) consisting of migrants with a Turkish/Moroccan ethnicity.
Mixed model analysis showed that women aged 55 years and older had a lower age- and height-adjusted gait speed (-0.03 m/s; -0.063-0.001), chair stand speed (-0.05 stand/s; -0.071--0.033), handgrip strength (-14,8 kg; -15.69--13.84) and balance (OR = 0.71; 0.547-0.916) compared to men. The sex difference in handgrip strength diminished with increasing age, but remained stable for gait speed, chair stand speed and balance. In general, results were consistent across different, educational levels and Turkish/Moroccan ethnic groups and birth cohorts.
There is a consistent "female disadvantage" in physical performance among older adults, which remains stable with increasing age (except for handgrip strength) and is consistent across different educational levels, ethnic groups and successive birth cohorts. So, no specific risk groups for the female disadvantage in physical performance were identified. Preventive strategies aimed to enhance healthy aging in older women are needed and should target all older women.
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