Dietary variety and decline in lean mass and physical performance in community-dwelling older Japanese: A 4-year follow-up study

Objectives

To examine associations of dietary variety with changes in lean mass and physical performance during a 4-year period in an elderly Japanese population. Design: Four-year prospective study.

Setting

The Hatoyama Cohort Study and Kusatsu Longitudinal Study, Japan.

Participants

935 community-dwelling Japanese aged 65 years or older.

Measurements

Dietary variety was assessed using a 10-item food frequency questionnaire. Body composition was determined by multifrequency bioelectrical impedance analysis, and physical performance (grip strength and usual gait speed) was measured in surveys at baseline and 4 years later. Longitudinal analysis included only participants who were originally in the upper three quartiles of lean body mass, appendicular lean mass, grip strength, and usual gait speed. The outcome measures were decline in lean body mass, appendicular lean mass, grip strength, and usual gait speed, defined as a decrease to the lowest baseline quartile level at the 4-year follow-up survey. Associations of dietary variety with the outcome measures were examined by logistic regression analysis adjusted for potential confounders.

Results

In the fully adjusted model, the odds ratios for decline in grip strength and usual gait speed were 0.43 (95% confidence interval, 0.19–0.99) and 0.43 (confidence interval, 0.19–0.99), respectively, for participants in the highest category of dietary variety score as compared with those in the lowest category. Dietary variety was not significantly associated with changes in lean body mass or appendicular lean mass.

Conclusion

Among older adults, greater dietary variety may help maintain physical performance, such as grip strength and usual gait speed, but not lean mass.

     

Association between the Mediterranean-style dietary pattern score and physical performance: Results from TRELONG study

Objectives

To determine the association between Mediterranean-Style Dietary Pattern Score and physical performance.

Design

Data analysis of a longitudinal study of a representative, age stratified, population sample.

Setting

The TREVISO LONGEVA (TRELONG) Study, in Treviso, Italy.

Participants

In 2010, 123 men and 181 women, age 77 years and over (mean age 86.3 ± 6.8 years).

Measurements

Performing a logistic regression in a multivariate analysis, hand grip strength and Short Physical Performance Battery (SPPB) were tested in relation to Mediterranean-Style Dietary Pattern Score (MSDPS).

Results

The hand grip mean value was 10.9 kg (± 9.5) and the SPPB score was 6.3 (± 3.8). The MSDPS mean value in this study sample was 38.1/100 (± 8.1). A significant association (p=0.036) between a high adherence to the Mediterranean diet (fourth quartile) and higher performance lower limbs (SPPB>7) was found. No correlation was reported for the hand grip strength.

Conclusion

We found an association statistically significant between a high adherence to the Mediterranean diet and higher physical performance.

     

Fruit and vegetable intake and physical activity as predictors of disability risk factors in African-American middle-aged individuals

Objective

To investigate fruit and vegetable intake (FVI) and different dimensions of physical activity (PA) as predictors of change in disabilities and other known precursors of progressive disability in a populationbased sample of African Americans.

Design

Longitudinal investigation of the independent associations of reported FVI and PA with six-year changes in disabilities and other known precursors of progressive disability.

Setting

Longitudinal study of a population-representative cohort of late middle-aged African Americans.

Participants

432 cohort participants with complete information on all measures.

Measurements and Analytic Approach

During wave 8 (2008), FVI was measured using 2005 Behavioral Risk Factor Surveillance System questions and PA dimensions using the Yale Physical Activity Survey (YPAS). Disability measures included basic activities of daily living (ADLs) and instrumental ADLs (IADLs); other precursors included measured gait speed, grip strength, and short physical performance battery (SPPB) and reported lower body functional limitations (LBFLs) and FRAIL scale; these were measured at wave 4 (2004) and wave 10 (2010). Residualchange score linear regression was used to identify FVI and PA factors that were independently associated with six-year changes in disability and other precursors.

Results

The study cohort was less active than the YPASdevelopment group. Longitudinally, leisurely walking was independently associated with better ADL, IADL, grip strength, SPPB, LBFL, and frailty outcomes; standing with better IADL and SPPB; intake of vegetables other than carrots, salads, or potatoes with better grip strength and frailty; and fruit juice intake with worse grip strength and frailty.

Conclusions

In this relatively inactive cohort, leisurely walking was associated with multiple beneficial outcomes. Benefits were also seen with vegetables other than potato intake, and fruit juice intake was associated with detrimental effects. This study highlights the importance of finding strategies to help this population increase PA (especially leisurely walking) and intake of whole fruits and vegetables.

     

A comparison of objective physical activity,muscle strength,and depression among community-dwelling older women living in sloped versus non-sloped environments

Objective

To examine the relationship between the living location and outcomes of physical activity level and physical and psychological functioning in older women. The specific aim was to understand the association between living in a sloped versus non-sloped environment and these outcomes.

Design

Cross-sectional study.

Setting and Participants

108 older women aged 65 years or older who resided in Nagasaki prefecture participated.

Measurements

Physical activity, lung function, muscle strength (hand grip and quadriceps force) and depressive symptoms were assessed objectively.

Results

In logistic regression, activity counts per day (OR 0.779, 95%CI 0.715-0.841, p<0.01), activity times per day (OR 0.821, 95%CI 0.801-0.913, p<0.01), hand grip force (OR 0.666, 95%CI 0.558-0.796, p<0.001), and depressed (Center for Epidemiological Studies Depression Scale score ≥16) (OR 1.093, 95%CI 1.019-1.427, p<0.05) showed statistically significant inverse associations with living in a sloped ground.

Conclusions

Since dwelling on sloped ground was associated with negative (lower physical activity levels, lower grip strength, and more depression) outcomes, a comprehensive geriatric assessment, related to all aspects of older women, is recommended. Planning of home exercise programs for the elderly should take such environmental factors into consideration.

     

Association of dietary variety with body composition and physical function in community-dwelling elderly Japanese

Objectives

To examine the associations of dietary variety with body composition and physical function in community-dwelling elderly Japanese

Design

Cross-sectional study.

Setting

Community-based.

Participants

A total of 1184 community-dwelling elderly adults aged 65 and over.

Measurements

Dietary variety was assessed with a food frequency questionnaire (maximum, 10 points) that encompassed the 10 main food components of Japanese meals (meat, fish/shellfish, eggs, milk, soybean products, green/yellow vegetables, potatoes, fruit, seaweed, and fats/oils). Body composition was determined by multifrequency bioelectrical impedance analysis. Physical function was assessed by measuring grip strength and usual walking speed. Multiple linear regression analysis was used to examine the associations of dietary variety with body composition and physical function.

Results

After adjusting for potential confounders, higher dietary variety scores were independently associated with higher lean mass (β (SE): 0.176 (0.049), p<0.001) and appendicular lean mass (β (SE): 0.114 (0.027), p<0.001) but not with body fat mass. Elders with a higher dietary variety score had greater grip strength and faster usual walking speed (β (SE): 0.204 (0.071), p=0.004, and β (SE): 0.008 (0.003), p=0.012, respectively).

Conclusion

Greater dietary variety was significantly associated with greater lean mass and better physical function in Japanese elders. The causal relationship warrants investigation in a prospective study.

     

Association of grip strength,upper arm circumference,and waist circumference with dementia in older adults of the wise study: A cross-sectional analysis

Objective

We examined the associations of handgrip strength, upper arm circumference, and waist circumference with dementia among Singapore older adults.

Design

Cross-sectional epidemiological study.

Setting

Residential homes, day care centres, nursing homes and institutions.

Participants

2,565 men and women aged 60 years and above who participated in the Well-being of the Singapore Elderly (WiSE) study in 2013.

Measurements

Socio-demographic correlates, dietary habits, health behaviours, grip strength, upper arm circumference, and waist circumference were collected. Grip strength was measured using a hand dynamometer with the dominant hand. Upper arm circumference was measured using a measuring tape around the thickest part of the upper arm while waist circumference measured in centimetres was measured at the narrowest part of the body between the chest and hips for women, and measured at the level of the umbilicus for men. Dementia was diagnosed using the 10/66 dementia diagnostic criteria.

Results

Mean grip strength was 13.07 kg (SE=0.60) for people with dementia and 21.98 kg (SE=0.26) for people without dementia. After adjusting for all factors, grip strength remained significantly associated with dementia (p <0.0001). Upper arm circumference was associated with dementia (p <0.0001) but this association was only significant in the univariate analysis. Waist circumference was not significantly associated with dementia.

Conclusions

Lower grip strength was independently associated with dementia in the older adult population in Singapore. Further research needs to be done to ascertain whether this association exists for specific types of dementia and look into the relationship of other anthropometric measurements with dementia in Singapore.

     

Muscle,Health and Costs: A Glance at their Relationship

Objective

To assess the association between muscle parameters (mass, strength, physical performance) and activities of daily living (ADL), quality of life (QoL), and health care costs.

Design

Cross-sectional Maastricht Sarcopenia Study (MaSS).

Setting

Community-dwelling, assisted-living, residential living facility.

Participants

227 adults aged 65 and older.

Measurements

Muscle mass, hand grip strength and physical performance were assessed by bio-electrical impedance, JAMAR dynamometer and the Short Physical Performance Battery, respectively. Health outcomes were measured by the Groningen Activity Restriction Scale (disability in ADL) and the EQ-5D-5L (QoL). Health care costs were calculated based on health care use in the past three months.

Results

Muscle strength and physical performance showed a strong correlation with ADL, QoL, and health care costs (P<.01); for muscle mass no significant correlations were observed. Regression analyses showed that higher gait speed (OR 0.06, 95%CI 0.01-0.55) was associated with a lower probability of ADL disability. Furthermore, slower chair stand (OR 1.23, 95%CI 1.08-1.42), and more comorbidities (OR 1.58, 95%CI 1.23-2.02) were explanatory factors for higher ADL disability. Explanatory factors for QoL and costs were: more disability in ADL (OR 1.26, 95%CI 1.12-1.41 for QoL; B = 0.09, P<.01 for costs) and more comorbidities (OR 1.44, 95%CI 1.14-1.82 for QoL; B = 0.35, P<.01 for costs).

Conclusion

Lower gait speed and chair stand were potential drivers of disability in ADL. Disability in ADL and comorbidities were associated with QoL and health care costs in community-dwelling older adults. Improving physical performance may be a valuable target for future intervention and research to impact health burden and costs.

     

Muscle Weakness and Physical Disability in Older Americans: Longitudinal Findings from the U.S. Health and Retirement Study

Importance

Muscle weakness is an important indicator of disability, chronic disease and mortality. While we recently proposed sex/race specific grip strength cutpoints for clinical muscle weakness in a diverse, nationally representative sample of older Americans, the extent to which these cutpoints predict physical disability remains unknown.

Objective

To examine whether sex/race specific muscle weakness cutpoints predict physical disability status in a nationally representative sample of Americans age 65+.

Design

We used data from the 2006-2010 Health and Retirement Study. Fully-adjusted, weighted multinomial logistic regression models were used to quantify the odds of experiencing the onset, progression or persistence of disability in activities of daily living (ADL) among weak versus non-weak individuals over a 2-year period.

Setting

General community, nationally representative sample of older Americans.

Participants

Population-based, community dwelling sample of older American adults aged 65-years+; 57 percent were women, 91% were White and the mean age was 75 years.

Main Outcome(s) and Measure(s)

The primary outcome of interest was disability dynamics, defined by changes in ADL status across at 2- year period. The primary exposure was clinical muscle weakness as defined by previously identified cutpoints. Hypotheses were formulated before analyses were conducted.

Results

In this nationally representative sample (n= 8,725), 44% of individuals were classified as weak at baseline. At follow-up, 55% remained independent with no change in their ADL status, 11% had an onset of disability and 4% progressed in their disability status. The odds of experiencing an onset of ADL disability was 54% higher among weak individuals compared those who were not weak at baseline (OR= 1.54, 95% CI= 1.54, 1.5, p<.0001); the odds of experiencing a progression in physical disability status was 2.16 times higher among those who were weak at baseline compared to non-weak individuals (OR= 2.16, 95% CI= 2.15, 2.16, p<.0001).

Conclusions

This is the first study to use grip strength weakness cut-points to identify those who may be at greatest risk for experiencing physical disability in later life. Results underscore the importance of using population-specific cutpoints for clinical weakness in order to identify individuals at greatest risk for adverse health outcomes.

     

Association of sleep problems and sleep duration with self-rated health and grip strength among older adults in India and China: results from the study on global aging and adult health (SAGE)

Background

Sleep is an important predictor of health and quality of life. This study examined the association between sleep problems and sleep duration with self-rated poor health and grip strength among respondents aged 50 years and above in India and China.Methods: The data for this study were derived from the first wave of WHO’s Study on Global Aging and Adult Health (SAGE), a nationally representative panel survey conducted in six LMICs. Grip strength and poor self-rated health were the main outcome variables, while sleep problems and sleep duration were the main predictors. Multivariate logistic regression models and ordinary least squares regression models were used to understand the association between sleep problems and sleep duration with poor self-rated health and grip strength.

Results

Sleep problems and sleep duration were strongly and significantly associated with poor self-rated health and grip strength in India and China. Compared to older adults with no sleep problems, the odds ratio for poor self-rated health among older adults with sleep problems was 4.86 (95% CI?=?4.12, 5.73, p?<?0.01) and 5.06 (95% CI?=?3.93, 6.51, p?<?0.01) higher for India and China, respectively. The likelihood of reporting poor health was higher among older adults who got ≤ 6 or 10+ h of sleep in both India and China. A negative and significant association was found between longer sleep duration and grip strength only in China (β?=??1.19, 95% CI?=??1.78, ?0.60, p?<?0.01).

Conclusion

We observed a significant association between sleep problems and sleep duration with poor self-rated health and grip strength. Results suggested that sleep problems are important factors in determining the health of older adults in low- and middle-income countries.

     

Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis

Introduction

Identifying risk factors associated with the development of work-related neck pain in office workers is necessary to facilitate the development of prevention strategies that aim to minimise this prevalent and costly health problem. The aim of this systematic review is to identify individual worker (e.g., lifestyle activity, muscular strength, and posture) and workplace (e.g., ergonomics and work environment) physical factors associated with the development of non-specific neck pain in office workers.

Methods

Studies from 1980 to 2016 were identified by an electronic search of Pubmed, CINAHL, EMBASE, Psychlnfo and Proquest databases. Two authors independently screened search results, extracted data, and assessed risk of bias using the epidemiological appraisal instrument (EAI). A random effect model was used to estimate the risk of physical factors for neck pain.

Results

Twenty papers described the findings of ten prospective cohort studies and two randomized controlled trials. Low satisfaction with the workplace environment (pooled RR 1.28; CI 1.07–1.55), keyboard position close to the body [pooled RR 1.46; (CI 1.07–1.99)], low work task variation [RR 1.27; CI (1.08–1.50)] and self-perceived medium/high muscular tension (pooled RR 2.75/1.82; CI 1.60 /1.14–4.72/2.90) were found to be risk factors for the development of neck pain.

Conclusions

This review found evidence for a few number of physical risk factors for the development of neck pain, however, there was also either limited or conflicting factors. Recommendations for future studies evaluating risk factors are reported and how these may contribute to the prevention of neck pain in office workers.

     

Assessment of diagnostics tools for sarcopenia severity using the item response theory (IRT)

Objective

To use the item response theory (IRT) methods to examine the degree to which the four selected tools reflect sarcopenia and to arrange them according to their ability to estimate sarcopenia severity.

Design

A cross-sectional study aimed at verifying the possibilities of using diagnostic tools for sarcopenia.

Setting and Participants

The study included residents living in an assisted living unit at the Senior Centre in Blansko (South Moravia, Czech Republic) (n=77). Sarcopenia was estimated according to the proposals of the European Working Group on Sarcopenia in Older People (EWGSOP) using calf circumference, the EWGSOP algorithm, hand grip strength, and the Short Physical Performance Battery (SPPB).

Results

The results from the IRT model showed that these four methods indicate strong unidimensionality so that they measure the same latent variable. The methods ranked according to the discrimination level ranging from high to low discrimination where the calf circumference was the most discriminatory (Hi = 0.86) and the SPPB together with hand grip strength were the least discriminatory (both Hi = 0.44).

Conclusion

We are recommending to identify mild sarcopenia by SPPB or hand grip strength, moderate sarcopenia by the EWGSOP algorithm and severe sarcopenia by the calf circumference.

     

Accelerometer assessment of physical activity and its association with physical function in older adults residing at assisted care facilities

Objectives

To describe levels of physical activity among older adults residing at assisted care facilities and their association with physical function.

Design

Cross-sectional analysis.

Setting

Assisted care facilities within the greater Boston, MA area.

Participants

Older adults aged 65 years and older (N = 65).

Measurements

Physical Activity Level (PAL) as defined by quartiles from accelerometry (counts and steps), Short Physical Performance Battery (SPPB) Score, gait speed, and handgrip strength.

Results

Participants in the most active accelerometry quartile engaged in 25 minutes/week of moderate to vigorous physical activity (MVPA) and walked 2,150 steps/day. These individuals had an SPPB score, 400 meter walk speed, and handgrip strength that was 3.7–3.9 points, 0.3–0.4 meters/second, and 4.5–5.1 kg greater respectively, than individuals in the lowest activity quartile, who engaged in less than 5 min/wk of MVPA or took fewer than 460 steps/day.

Conclusion

Despite engaging in physical activity levels far below current recommendations (150 min/week of MVPA or > 7000 steps/day), the most active older adults in this study exhibited clinically significant differences in physical function relative to their less active peers. While the direction of causality cannot be determined from this cross-sectional study, these findings suggest a strong association between PAL and physical function among older adults residing in an assisted care facility.

     

Condoms and sexual health education as evidence: impact of criminalization of in-call venues and managers on migrant sex workers access to HIV/STI prevention in a Canadian setting

Background

Despite a large body of evidence globally demonstrating that the criminalization of sex workers increases HIV/STI risks, we know far less about the impact of criminalization and policing of managers and in-call establishments on HIV/STI prevention among sex workers, and even less so among migrant sex workers.

Methods

Analysis draws on ethnographic fieldwork and 46 qualitative interviews with migrant sex workers, managers and business owners of in-call sex work venues in Metro Vancouver, Canada.

Results

The criminalization of in-call venues and third parties explicitly limits sex workers’ access to HIV/STI prevention, including manager restrictions on condoms and limited onsite access to sexual health information and HIV/STI testing. With limited labour protections and socio-cultural barriers, criminalization and policing undermine the health and human rights of migrant sex workers working in –call venues.

Conclusions

This research supports growing evidence-based calls for decriminalization of sex work, including the removal of criminal sanctions targeting third parties and in-call venues, alongside programs and policies that better protect the working conditions of migrant sex workers as critical to HIV/STI prevention and human rights.

     

Effects of Resistance Exercise Training on Cognitive Function and Physical Performance in Cognitive Frailty: A Randomized Controlled Trial

Background

Cognitive frailty is defined as the presence of both physical frailty and cognitive impairment (clinical dementia rating score = 0.5), in the absence of dementia. It is characterized by concurrent physical frailty and potentially reversible cognitive impairment. In this study, we sought to elucidate the effects of high-speed resistance exercise training on cognitive function and physical performance in older adults with cognitive frailty.

Methods

We conducted a parallel-group, randomized controlled trial involving community-living older adults with cognitive frailty. The participants’ mean age was 73.9 (± 4.3 SD) years, and 69.8% (n=30) were female. Two different 4-month interventions included high-speed resistance exercise training group (n=22) and a control group (balance and band stretching, n=23). Frailty score, cognitive function (memory, processing speed, cognitive flexibility, working memory, executive function), physical function (SPPB, TUG, gait speed), and muscle strength (grip strength, knee extension strength) were assessed at baseline, 8 weeks, and 16 weeks.

Results

Statistical analysis showed that exercise improved performance significantly in the tests for cognitive function (processing speed and executive function, both p < 0.05), physical function (SPPB, TUG, gait speed, both p < 0.05), and muscle strength (grip strength, knee extension strength, both p < 0.05). However, no significant changes in frailty score were observed between intervention and either control group (p < 0.05).

Conclusion

In conclusion, our findings indicate that high-speed resistance exercise training approaches are effective in improving cognitive function and physical performance in older adults with cognitive frailty. This study shows that it is feasible to identify older adults with cognitive frailty in the community and primary care setting for effective intervention to reduce their level of frailty and cognitive impairment.

     

Handgrip strength predicts longitudinal changes in clock drawing test performance. An observational study in a sample of older non-demented adults

Objective

Impairment of physical performance might identify older people at higher risk of dementia over time. The present study evaluated handgrip strength as independent predictor of cognitive decline.

Design

Observational, prospective. Follow-up duration: 11.2 ± 0.8 months.

Setting and participants

Geriatric outpatients center. 104 consecutive stroke- and dementia-free older adults (44% men, ages 80.2±5.4 years).

Methods

The Clinical Dementia Rating scale and the Clock Drawing Test (CDT) were administered. Handgrip strength was assessed using a Jamar hand dynamometer. Brain magnetic resonance imaging studies at 1.5 T were performed. White matter damage was expressed as severity of white matter hyperintensities (WMHs). Longitudinal changes in cognitive function were expressed as 1-year decline in CDT performance.

Results

A robust association was observed between baseline handgrip strength and 1-year cognitive decline after multiple adjustment. Of note, the strength of such association was only minimally attenuated after adjusting for deep WMHs extent (β coefficient for handgrip strength = 0.183, SE= 0.038, p= 0.007, R2= 0.58).

Conclusions

Handgrip strength predicted accelerated 1-year decline in cognitive function, assessed by CDT, in a sample of older adults. Future studies are needed to elucidate the causal mechanisms linking limitations in physical function with dementia risk.

     

Handgrip strength cutoff points to identify mobility limitation in community-dwelling older people and associated factors

Background

Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass and strength. The specific threshold of muscle weakness that leads to mobility limitations has not been identified.

Objectives

To determine the best cutoff point of handgrip strength for identifying mobility limitation and to investigate the factors associated with muscle weakness and mobility limitation in community-dwelling older people.

Design

Transversal study.

Setting

Cities of Belo Horizonte, Barueri and Santa Cruz in Brazil.

Participants

1374 community-dwelling older people from the Frailty study in Brazilian older people (FIBRA Study).

Measurements

Outcomes included muscle weakness determined according to gender-specific handgrip strength cutoff points generated by Receiver Operating Characteristic curves, mobility limitation defined as a gait speed = 0.8 m/s; and a combination of both muscle weakness and mobility limitation. Associated factors included socio-demographic variables, lifestyle, anthropometrics, health conditions, use of health services and disability.

Results

The cutoff points of handgrip strength with the best balancing between sensitivity and specificity for mobility limitation were 25.8 kgf for men (sensitivity 69%, specificity 73%) and 17.4 kgf (sensitivity 60%, specificity 66%) for women. Age and disability in instrumental activities of daily living were associated with all outcomes. Women had greater odds of mobility limitation than men. Physical inactivity, body fat, diabetes, depression, sleeping disturbances, number of medications and occurrence of falls remained as significant associated factors in the final model.

Conclusions

Handgrip strength can be a useful tool to identify mobility limitation in clinical practice. Interventions to prevent or minimize impacts of sarcopenia should stimulate physical activity and improvement of body composition in addition to the management of chronic diseases and disabilities.

     

A new adaptive home-based exercise technology among older adults living in nursing home: A pilot study on feasibility,acceptability and physical performance

Objectives

To explore the feasibility and acceptability of a new home-based exercise technology among older adults and to evaluate its efficacy on physical performance measures.

Design

Longitudinal clinical trial.

Setting

Oak Hammock at the University of Florida, a nursing home located in Gainesville, Florida.

Participants

Twelve pre-disabled older adults (≥75 years) living in a nursing home with a Short Physical Performance Battery (SPPB) score between 6 and 9 and no diagnosis of dementia.

Intervention

Thirty minutes of light intensity exercise (aerobic, strength and balance) two times per week for four weeks using a home-based physical activity technology called Jintronix.

Measurements

Feasibility and acceptability were assessed through a 9-item self-administered questionnaire and by exploring the percentage of quality of movements and time performing exercise which was calculated automatically by Jintronix technology. Physical performance measures were assessed through the SPPB score at baseline, after 4 weeks of intervention and after 3 months from the completion of the intervention.

Results

Twelve older adults (80.5±4.2 years old) performed light intensity exercise with Jintronix for a total of 51.9±7.9 minutes per week. Participants reached 87% score of quality of movements in strength and balance exercises, a global appreciation score of 91.7% and a global difficulty score of 36%. Compared to baseline, there was a significant improvement in SPPB score at the end of the intervention and at 3 months following the completion of the exercise program (0.67±0.98 and 1.08±0.99 respectively, p-value <0.05).

Conclusion

Jintronix technology is feasible and acceptable among pre-disabled older adults without dementia living in nursing home and is beneficial in improving their physical performance.

     

Arbeit und gesundheitliche Ungleichheit

Background

Health inequalities in the working population may partly be due to the unequal exposure to work-related risk factors among different occupational positions. Empirical data, however, exploring the distribution of exposures at work according to occupational position for Germany is missing.

Objectives

This paper summarizes existing literature on occupational inequalities and discusses the role of working conditions. In addition, using European survey data, we study how various exposures at work vary by occupational class.

Materials and methods

Analyses are based on the European Working Condition Survey, and we compare the German sample (n?=?2096) with the sample from the EU-27 countries (n?=?34,529). To measure occupational position we use occupational class (EGP-classes). First, we describe the prevalence of 16 different exposures at work by occupational class for men and women. Second, we estimate regression models, and thereby investigate if associations between occupational class and self-perceived health are related to an unequal distribution of exposures at work.

Results

For various exposures at work we found a higher prevalence among manual workers and lower-skilled employees for both physical and psychosocial conditions. With few exceptions only, this finding was true for men and women and consistent for Germany and Europe.

Conclusion

Results indicate that the unequal distribution of health-adverse conditions at work contribute towards existing health inequalities among the working population.

     

Vitamin D Binding Protein and Vitamin D Levels in Multi-Ethnic Population

Introduction

Low levels of 25-hydroxyvitamin D (25(OH)D) has been associated with many negative health outcomes including falls and fractures. 25(OH)D is largely bound to vitamin D binding protein (VDBP). There is increasing evidence that free or bioavailable 25(OH)D may be a better measure of vitamin D deficiency.

Objective

To determine the prevalence of 25(OH)D deficiency and VDBP levels in multi-ethnic population, and its impact on muscle strength.

Design and methods

Cross-sectional study of older adults in Western region of Singapore. 295 participants from three ethnic groups were selected from the Healthy Older People Everyday (HOPE) cohort for measurements of total 25(OH)D and VDBP levels. Total 25(OH)D, VDBP, frailty status, Timed-Up-and-Go (TUG) and grip strength (GS) were assessed. Albumin, free and bioavailable 25(OH)D were only available for 256 participants.

Results

53% of Malay and 55% of Indians were deficient in 25(OH)D compared with 18.2% of ethnic Chinese participants. Chinese also had higher total 25(OH)D concentrations with a mean of 29.1 ug/l, (p = <0.001). Chinese had the lowest level of VDBP (169.6ug/ml) followed by Malay (188.8 ug/ml) and Indian having the highest (220.1 ug/ml). Calculated bioavailable and free 25(OH)D levels were significantly higher in Chinese, followed by Malays and Indians, which also correlated with better grip strength measures amongst the Chinese.

Conclusion

The Malays and Indians had overall lower free, bioavailable and total 25(OH)D compared with ethnic Chinese. Chinese ethnic group also had the lowest VDBP and better overall grip strength.

     

Respiratory Muscle Strength as a Discriminator of Sarcopenia in Community-Dwelling Elderly: A Cross-Sectional Study

Objectives

To compare the values obtained from maximum respiratory pressures (MRP) between sarcopenic and non-sarcopenic elderly; to verify the association of maximum respiratory pressures with sarcopenia and its indicators; and to establish cut-off points for MRP as a discriminator of sarcopenia.

Design

Cross-sectional study.

Location

Macapá, Brazil.

Participants

Community-dwelling elderly ≥ 60 years old, both sexes.

Measures

Evaluation of respiratory muscle strength (maximal inspiratory pressure - MIP and maximal expiratory pressure - MEP) and sarcopenia, according to the European Working Group on Sarcopenia in Older People (EWGSOP), in which the diagnosis of this condition considered the reduction of muscle mass (muscle mass index - MMI) associated with muscle strength reduction (hand grip strength - HGS) and / or impairment in physical performance (gait speed - GS).

Results

The sample consisted of 383 elderly individuals, with a mean age of 70.02 ± 7.3 years and a prevalence of sarcopenia of 12.53% (n = 48). Sarcopenic individuals presented significantly lower (obtained, obtained versus predicted) mean values for the maximal respiratory pressures compared to the non-sarcopenic elderly, and these were inversely associated with sarcopenia (an increase by 1 cmH2O in MIP and MEP reduced by 5% and 3%, respectively, the probability of sarcopenia). In relation to the association with the sarcopenia indicators, the increase by 1 cmH2O in MIP and MEP decreased, respectively, the probability of decreasing muscle strength (3% and 2%), GS (3% and 4%) and MMI (3 % - MIP). Cut-off points ≤60 cmH2O and ≤50 cmH2O for MEP and ≤55 cmH2O and ≤45 cmH2O for MEP, respectively for elderly men and women, served as a discriminant criterion for the presence of sarcopenia (area under the ROC curve superior to 0.70).

Conclusions

Elderly patients with sarcopenia had lower MIP and MEP values when compared to non-sarcopenic individuals, and respiratory muscle strength was inversely associated with the diagnosis of sarcopenia and its indicators (HGS, gait speed and MMI). Furthermore, cut-off points for MIP and MEP can be used in clinical practice as discriminators of sarcopenia in community-dwelling elderly.