Quality of life and subjective health status according to handgrip strength in the elderly: a cross-sectional study

Objectives: The purpose of this cross-sectional study was to examine potential associations between handgrip strength and health-related quality of life, or subjective health status, in the elderly.

Method: We performed secondary data analysis on 2377 elderly individuals aged >65 years. Raw data from the Korea National Health and Nutrition Examination Survey VI (2014–2015), were drawn from a representative national sample.

Results: Of those aged ≥65 years or older, 25.4% had low handgrip strength. After adjusting for confounding variables, the odds ratios of elderly individuals with low handgrip strength were 1.30 (95% confidence interval [CI]: 1.00–1.69) for mobility, 2.18 (95% CI: 1.47–3.22) for self-care, 1.70 (95% CI: 1.30–2.23) for usual activities, 1.30 (95% CI: 1.01–1.67) for pain/discomfort, 1.03 (95% CI: 0.74–1.44) for anxiety/depression, 1.44 (95% CI: 1.10–1.87) for the EQ-5D index, and 1.37 (95% CI: 1.08–1.73) for subjective health status.

Conclusion: Health-related quality of life and subjective health status differ according to handgrip strength. Therefore, handgrip strength should be addressed to improve quality of life in elderly individuals. Elderly individuals require exercise education and adequate nutritional intake to increase handgrip strength.     

Weakness May Have a Causal Association With Early Mortality in Older Americans: A Matched Cohort Analysis

ObjectivesQuantifying the association between muscle weakness and mortality with carefully matched cohorts will help to better establish the impact of weakness on premature death. We used a matched cohort analysis in a national sample of older Americans to determine if those who were weak had a higher risk for mortality compared with control groups with incrementally higher strength capacities.DesignLongitudinal panel.SettingDetailed interviews that included physical measures were conducted in person, whereas core interviews were often performed over the telephone.ParticipantsData from 19,729 Americans aged at least 50 years from the 2006-2014 waves of the Health and Retirement Study were analyzed.MeasuresA handgrip dynamometer was used to assess handgrip strength (HGS) in each participant. Men with HGS <26 kg were considered weak, ≥26 kg were considered not weak, and ≥32 kg were considered strong. Women with HGS <16 kg were classified as weak, ≥16 kg were classified as not-weak, and ≥20 kg were classified as strong. The National Death Index and postmortem interviews determined the date of death. The greedy matching algorithm was used to match cohorts.ResultsOf the 1077 weak and not-weak matched pairs, 401 weak (37.2%) and 296 not-weak (27.4%) older Americans died over an average 4.4 ± 2.5-year follow-up. There were 392 weak (37.0%) and 243 strong (22.9%) persons who died over a mean 4.5 ± 2.5-year follow-up from the 1057 weak and strong matched pairs. Those in the weak cohort had a 1.40 [95% confidence interval (CI) 1.19, 1.64] and 1.54 (CI 1.30, 1.83) higher hazard for mortality relative to persons in the not-weak and strong control cohorts, respectively.Conclusions and ImplicationsOur findings may indicate a causal association between muscle weakness and mortality in older Americans. Health care providers should include measures of HGS as part of routine health assessments and discuss the health risks of muscle weakness with their patients.     

Single leg aerobic capacity and strength in individuals with surgically repaired anterior cruciate ligaments

ObjectivesCompare single-leg aerobic capacity and strength differences between the surgically repaired ACL leg (injured) and the uninjured leg.DesignCross-sectional study.SettingLaboratory.ParticipantsEight participants (5 female, 3 male, age = 23 ± 3.5 y, mass = 72.3 ± 17.3 kg, height = 169.7 ± 9.4 cm) that returned to play from ACL surgery between six and 18 months.Main outcome measuresParticipants performed an aerobically-based, single-leg cycling protocol to determine maximum oxygen consumption, ventilatory threshold, heart rate, rating of perceived exertion, and maximal watts cycled. Participants also performed isokinetic knee flexion and extension on a dynamometer to assess peak torque, total work, work fatigue, and power.ResultsThere were no statistical differences in single-leg aerobic capacity or strength outcomes between the injured and uninjured legs.ConclusionsIndividuals who have had an ACL surgically repaired six to 18 months after return to play do not appear to have aerobic capacity or strength deficits between the injured leg and uninjured leg.     

Nucleation efficacy and flexural strength of novel leucite glass-ceramics

ObjectivesTo optimize the nucleation mechanism in leucite glass-ceramics to allow more efficacious glass-ceramic manufacture and improvements in microstructure and mechanical reliability.Materials and methodsAn alumino-silicate glass was designed and synthesized using melt quench methods. The glass was crushed and milled using various milling times (48–93 h) and spray drying. Nucleation and growth heat treatment schedules were applied to synthesize glass-ceramics. Glass/glass-ceramic powders and frit specimens were characterized using differential scanning calorimetry (DSC), transmission electron microscopy (TEM), energy-dispersive X-ray spectrometry (EDX), magic angle spinning nuclear magnetic resonance spectroscopy (MAS-NMR) and X-ray diffraction analyses (XRD). Glass-ceramic specimens were tested using the biaxial flexural strength test (BFS).ResultsApplication of defined nucleation heat treatments resulted in the synthesis of Na/Ca titanates. NMR indicated changes to the ²³Na glass spectra in the nucleated glass and TEM/EDX the presence of Na/Ca/Ti domains (<200 nm) within the leucite crystals and associated with the nucleation of the leucite phase. XRD confirmed the presence of a bulk leucite phase in the glass-ceramics. SEM/TEM confirmed the crystallization of the leucite phase (65.5–69.3%) in a thermally matched glass, in conjunction with the nano Na/Ca titanate phase. The leucite glass-ceramics resulted in a high BFS (255–268 MPa), with reduction in powder milling time prior to heat treatments having no significant effect on flexural strength and reliability (p > 0.05).SignificanceNa/Ca titanates were synthesized in leucite glass-ceramics for the first time and associated with its nucleation and efficacious growth. This nucleation optimization provides opportunities for more efficient manufacturing and microstructural/mechanical reliability improvements. Improved synthesis of high strength/reliable leucite glass-ceramics is useful for construction of esthetic minimally invasive restorations.     

不同骨密度老年人群的体成分、肌力及心脏功能特点

目的 分析不同骨密度老年人群的体成分、肌力和心脏功能特点。方法 选择2019年1月至2021年12月在内蒙古自治区人民医院健康管理中心行骨密度检查年龄为65~80岁的500名受试者作为研究对象。采用人体成分分析仪检测并记录受试者骨骼肌指数、体脂肪率、脂肪控制、肌肉控制、右臂肌肉量、肌力；采用超声诊断仪检查并记录受试者心脏功能（EF、EDV、ESV、FS、HR、e/a）。结果 在500例研究对象中，骨量异常人数较多，占77 %，其中骨质疏松者93人（18.6 %），骨量减少者292人（58.4 %），骨量正常者115人（23%）。在男性中，骨质疏松者21人（8.4 %），骨量减少者153人（61.2 %），骨量正常者76人（30.4 %）；在女性中，骨质疏松者72人（28.8 %），骨量减少者139人（55.6 %），骨量正常者39人（15.6 %）；女性患骨质疏松的比例高于男性。女性的体脂肪率（37.20±4.13）高于男性（28.15±5.38）；女性骨骼肌指数（8.20±0.58）低于男性（9.23±0.55）（P＜0.05）。500例研究对象中需进行肌肉控制（增肌）的比例为55.6 % (278人),需进行脂肪控制（减脂）的比例为100 %（500人）。男性、女性分别按照骨密度分为骨质疏松组、骨量减少组及骨质正常组，三组体质量指数（body mass index, BMI)、T值、 Z值、骨骼肌指数、肌肉控制、右臂肌肉量、右手握力、左手握力比较，差异有统计学意义（P＜0.05）；年龄、体脂肪率、脂肪控制比较，差异无统计学意义（P＞0.05）。组间两两比较男性组BMI、T值、 Z值、骨骼肌指数、肌肉控制、右臂肌肉量、右手握力、左手握力组间比较差异有统计学意义（P＜0.05）；女性组T值、 Z值、骨骼肌指数、肌肉控制、右臂肌肉量、右手握力、左手握力组间比较差异有统计学意义（P＜0.05）。Pearson 相关分析显示，T值与骨骼肌指数、BMI、右臂肌肉量及右手握力呈正相关；相较BMI，T值与骨骼肌指数、右臂肌肉量相关性更高；与肌肉控制（增肌）呈负相关（r值= – 0.326，P=0.000）；与体脂肪率及脂肪控制无相关性。心脏功能EDV（F=0.042,P=0.958）、ESV（F=0.008,P=0.992）、EF值（F=0.060,P=0.942）、FS值（F=0. 057,P=0.945）、HR（F=0. 032,P=0.969）组间比较差异无统计学意义（P＞0.05）；e/a（F=3.768,P=0.034）比较差异有统计学意义（P＜0.05）。结论 老年人群骨量异常比率较高，随着骨密度减低，骨骼肌指数及肌力也会下降，且骨质疏松患者易出现心脏舒张功能减低。利用生物电阻抗测定人体成分可以分析骨质疏松患者人体成分变化，能够更细化地了解其肌肉和脂肪的含量，为进一步预防、治疗骨质疏松及优化老年人人体成分提供依据。     

Low-dose-rate iodine-125 seed air kerma strength measurement intercomparison

PurposeThe purpose of this study was to investigate the rate of compliance of air kerma strength (AKS) measurements of iodine-125 (I-125) seeds with international recommendations by departments in Australia and determine the potential impact of noncompliance.Methods and MaterialsTo achieve this aim, we present an intercomparison of AKS measurements for a single I-125 seed performed by 11 radiotherapy departments in Australia. Measurements were performed at two sites, with each participating department traveling to one of the two host sites and measuring the AKS using their own equipment and local protocols. Each of the AKS measurements was compared with each other and the manufacturer-certified AKS.ResultsNine of the 11 participating departments measured AKS fell within ±3% of the manufacturer's calibration certificate value, whereas all participating departments measured AKS within ±5% of the manufacturer's calibration certificate value. The total spread of the measured AKS among the 11 departments was 7.7%. Only two of the 11 participating departments complied with international recommendations and had their well chamber calibrated within the last 2 years. In addition, 2 of the 11 departments used a well chamber calibrated that was calibrated with a different seed model used during the intercomparison, whereas 4 of the 11 departments calibrated their well chamber “in-house” using a factory-calibrated seed provided by the seed manufacturer.ConclusionsA significant variation in the methods used and frequency of calibration of well chambers were observed among the participating departments. The results of this study support the international recommendations on frequency and methodology of well chamber calibration. Failure to follow these recommendations significantly increases the uncertainty in AKS measurement of I-125 seeds.     

Effectiveness and tolerance of an oral nutritional supplement highly concentrated in protein and energy in elderly subjects at risk of malnutrition

The aim of this study was to evaluate the effectiveness and tolerance of an oral nutritional supplement that is highly concentrated in protein and energy in elderly subjects who are malnourished or at risk of malnutrition. Twenty-four subjects aged between 70 and 94 years old, who had lost an average of 8.2% of their body weight and whose intake was 70% lower than their requirements, received a nutritional supplement (Fortimel® Protein 200 mL, NUTRICIA) over a period of four weeks at a rate of two bottles per day (one unit providing 480 kcal and 29 g of protein). The analysis carried out at the end of this period showed a significant increase in muscular strength measured by hand grip [on average 19.5 ± 7.05 kg at D0 and 21.0 ± 8.1 kg at D28 (P = 0.002)]. The patients’ weight rose on average by 0.6 ± 1.9 kg (P = 0.08). Patient appetite improved overall as evidenced by the significant increase in spontaneous intake and dietary protein contribution. Overall health status as perceived by patients did not significantly improve. The product was well received by patients (median adherence rate of 93.5%) and generally well tolerated, even if certain patients complained about minor digestive disorders, which led to reduced adherence.