Effects of whey protein nutritional supplement on muscle function among community-dwelling frail older people: A multicenter study in China

BackgroundFrailty, featured by the presence of fatigue, weight loss, decrease in grip strength, decline gait speed and reduced activities substantially increase the risk of falls, disability, hospitalizations, and mortality of older people. Nutritional supplementation and resistance exercise may improve muscle function and reverse frailty status.ObjectiveTo evaluate whether whey protein supplements can improve muscle function of frail older people in addition to resistance exercise.Methods115 community-dwelling older adults who met the Fried's criteria for frailty from four hospitals’ out-patients clinic in Beijing, China completed the study. It's a case–control study which whey protein was used as daily supplementation for 12 weeks for active group and regular resistance exercise for active group and control group. Handgrip strength, gait speed, chair-stand test, balance score, and SPPB score were compared in both groups during the 12-week follow-up.ResultsOverall, 115 subjects were enrolled for study with 66 in active group and 49 in control group. Handgrip strength, gait speed, and chair-stand time were all significantly improved in both groups with significant between-group differences. The active group improved significantly in handgrip strength compared with the control group, which between-group effect (95% confidence interval) for female was 0.107 kg (0.066–0.149), p = 0.008 and for male was 0.89 kg (0.579–1.201), p = 0.007. For chair-stand time, between-group effect (95% confidence interval) was −2.875 s (−3.62 to −2.124), p = 0.004 and for gait speed, between-group effect (95% confidence interval) was 0.109 m/s (0.090 to 0.130), p = 0.003.ConclusionsThe 12-week intervention of whey protein oral nutritional supplement revealed significant improvements in muscle function among the frailty elderly besides aiding with resistance exercise. These results warrant further investigations into the role of a multi-modal supplementation approach which could prevent adverse outcomes among frailty elderly at risk for various disabilities.     

Chair sit-to-stand performance is associated with diagnostic features of sarcopenia in older men and women

BackgroundStanding from a chair is a fundamental activity of daily living, and it can be applied to assess the physical function, especially in older individuals.AimThe aim of this study was to elucidate the characteristics of mechanical and temporal parameters during chair stand based on the relationship with skeletal muscle and physical functional parameters in older men and women.MethodsEighty older men and women participated in this study. We measured four parameters of chair stand performance: ground reaction force (GRF), rate of force development (RFD), and chair rise time (CRT) were calculated from the foot-floor force data; sit-to-stand (STS) was also assessed by measuring the time needed to complete 10 chair stand repetitions. The muscle thickness (MT) and echo intensity, as indexes of muscle size and quality, respectively, were measured using axial B-mode ultrasound images from quadriceps femoris. The gait speed and handgrip strength were measured as physical functional parameters.ResultsPartial correlation was used to determine the association of chair stand performance with MT, echo intensity, and physical parameters while considering the height, body mass, and age. GRF, RFD, and STS were significantly correlated with MT (r = 0.35, 0.26, and -0.49), gait speed (r = 0.32, 0.31, and -0.67), and handgrip strength (r = 0.57, 0.59, and -0.49). As the result of regression analysis, MT, gait speed, and handgrip strength were estimated by GRF and STS.ConclusionThese results suggest that chair stand performance is useful as it reflects the muscle size and physical functions in older individuals.     

The effect of protein supplements on functional frailty in older persons: A systematic review and meta-analysis

BackgroundThe effect of protein supplementation in attenuating loss of muscle mass, strength and function in community-dwelling older people has been promising, however, its benefits in pre-frail and frail older people remains unclear.ObjectiveTo determine the effect of protein supplementation on muscle mass, strength and function in frail older people by reviewing and conducting meta-analysis of relevant randomized controlled trials (RCTs).DesignThis review was registered at PROSPERO (CRD42017079276) and conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Using a pre-determined e-search strategy, we searched PubMed, Medline, EMBASE, CINAHL, LILACS, Web of Science, Cochrane and Scopus databases. Inclusion criteria were RCTs that assessed the effect of protein supplementation on muscle mass, strength and function in frail individuals aged ≥65 years. The main outcomes were lean body mass (LBM), handgrip, leg extension, leg press strength, short physical performance battery (SPPB) score, and gait velocity.ResultsOf the eight studies included in this review, 503 subjects were enrolled and four different protein supplements were assessed. Despite the variation in methodology, studies were homogenous with I-squared <10.0%. The meta-analysis showed no significant effect of protein supplementation on LBM (mean difference 1.17 kg, 95% CI: −1.97–4.3), handgrip (mean difference 0.15, 95% CI: −0.95–1.24), leg extension (mean difference −3.68 kg, 95% CI: −12.72–5.36), leg press (mean standardized difference 0.26 kg, 95% CI: −0.30–0.82), SPPB (mean difference 0.61, 95% CI: −0.02–1.23), or gait velocity (mean difference -0.20 m/s, 95% CI: −0.95–0.55).ConclusionProtein supplementation alone does not significantly improve muscle mass, strength or function in pre-frail or frail older people.     

Diagnostic criteria for sarcopenia relate differently to insulin resistance

Skeletal muscle is important in insulin-stimulated glucose uptake. Sarcopenia is, therefore, a possible risk factor for insulin resistance. Currently, different diagnostic criteria for sarcopenia include low muscle mass, muscle strength, and walking speed. We assessed these muscle characteristics in relation to insulin resistance in nondiabetics. This cross-sectional study included 301 nondiabetics, mean age 65.9 years. Area under curve (AUC) calculations of insulin and glucose from a 2-h oral glucose tolerance test (OGTT) and homeostasis model assessment of insulin resistance (HOMA-IR) were used as measures of insulin resistance. Muscle characteristics were relative muscle mass (total or appendicular lean mass (ALM) as percentage of body mass), absolute muscle mass (ALM/height² and total lean mass), handgrip strength, and walking speed. All muscle characteristics were standardized and analyzed in linear regression models, stratified by gender. For both males and females, relative muscle mass was inversely associated with AUC insulin, AUC glucose, and HOMA-IR (ALM percentage all p ≤ 0.004). Absolute muscle mass was positively associated with AUC insulin and HOMA-IR (ALM/height² all p < 0.001) but not with AUC glucose. Adjustments for fat mass attenuated aforementioned associations. There were no associations between handgrip strength and insulin resistance. Walking speed was inversely associated with AUC insulin in males (p = 0.032). The association between muscle characteristics and insulin resistance was strongest for relative muscle mass. Diagnostic criteria for sarcopenia relate differently to insulin resistance. The role of muscle tissue as an internal glucose-regulating organ is better reflected by relative muscle mass than by absolute muscle mass, muscle strength, or walking speed.     

Lower extremity mobility limitation and impaired muscle function in women with ulcerative colitis

Background and aimFatigue, weakness and musculoskeletal manifestations are associated with IBD. An impaired nutritional status and a reduced physical activity can contribute to these clinical outcomes, impacting quality of life and increasing disability. This study aims to assess muscle strength and lower limb physical performance in female UC patients, taking into consideration disease activity, body composition and habitual physical activity.MethodsA case-control study was performed including 23 UC female outpatients and 23 age- and BMI-matched healthy women as controls. Quadriceps strength (QS), handgrip strength (HGS), physical performance based measures (five repetitions sit-up test and 4 meter gait speed test), body composition (bioelectrical impedance analysis, anthropometry), and habitual physical activity (HPA) levels were assessed.ResultsUC group had decreased QS (− 6%; P = 0.012), slower sit-up test (− 32%; P = 0.000), slower gait speed (− 17% P = 0.002) and decreased HPA level (− 30%, P = 0.001) compared with controls. No difference in HGS was observed between groups. Logistic regression showed that UC was an independent factor for decreased QS and slower sit-up test, while HPA was a protective factor for impaired gait speed. Multivariate linear regression showed that BMI was independently associated with an improved QS and slower sit-up test in the UC group.ConclusionWomen with UC had decreased lower limb strength and mobility limitations, which were associated with BMI and the level of physical activity. Early evaluation of nutritional status and performance of the lower limbs could identify UC patients with pre-clinical disability who may benefit from earlier health lifestyle modifications.     

Prognostic value of physical function tests and muscle mass in elderly hospitalized patients. A prospective observational study

Aim

To determine the prognostic value for mortality of physical function tests, muscle mass loss, disability and frailty in elderly hospitalized patients.

Methods

We prospectively included 298 hospitalized patients aged >60 years (152 men and 146 women). We assessed comorbidity using the Charlson Comorbidity Index; nutrition by body mass index, midarm muscle area and subjective nutritional score; physical muscle function by handgrip strength, gait speed, standing balance and stand up test; disability using the Barthel test and activities of daily living; frailty by the clinical frailty scale and Fried frailty index; and cognitive impairment by the Pfeiffer test. We assessed 100‐day and long‐term mortality.

Results

We found a high prevalence of malnutrition, comorbidity, cognitive impairment, physical function impairment, disability and frailty. Mortality at 100 days was 15.1%, with a long‐term median survival of 989 days. Mortality was significantly related to age, comorbidity, nutritional status, physical function, disability and frailty. Serum vitamin D₃ levels were not related to mortality. Independent prognostic value for long‐term mortality was shown by: (i) incapacity to carry out any of the walking, stand up and standing balance tests; (ii) male sex; (iii) aged >80 years; (iv) impaired handgrip strength or gait speed; (v) Charlson Comorbidity Index ≥1; and (6) impaired muscle mass of subjective nutritional score.

Conclusions

In elderly hospitalized patients, there is an important role of muscle regarding prognosis, mainly related to physical function, but also and independently regarding muscle mass. Geriatr Gerontol Int 2018; 18: 57–64 .     

Short-term strength training improves muscle quality and functional capacity of elderly women

To assess effects of a short-term strength training (ST) program on muscle quality (MQ) and functional capacity, 36 sedentary elderly women (age = 66.0 ± 8 year, height = 159.1 ± 9.2 cm, body mass = 68.3 ± 12.1 kg, body fat = 37.0 ± 4.2 %) were randomly divided into an experimental group (EG; n = 19) or a control group (CG; n = 17). The EG performed two to three sets of 12–15 repeats of leg press, knee extension, and knee flexion exercises, 2 days/week for 6 weeks. Before and after training, lower body one repetition maximum (1RM), functional performance tests, quadriceps femoris muscle thickness (MT), and muscle quality (MQ) (1RM and quadriceps MT quotient) were assessed. After training, only the EG showed significant improvements in 1RM (p < 0.05), 30-s sit-to-stand (p < 0.001), and 8 foot up-and-go (p < 0.001). In addition, only in the EG, significant increases in all quadriceps femoris MT measurements (vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris) (p ≤ 0.05), and MQ (p < 0.001) were demonstrated. No changes were observed in the CG. Furthermore, there were significant associations between individual changes in MQ and corresponding changes in 30-s sit-to-stand (r = 0.62, p < 0.001), and 8 foot up-and-go (r = −0.71, p < 0.001). In conclusion, a ST program of only 6 weeks was sufficient to enhance MQ of the knee extensors in elderly women, which resulted in beneficial changes in functional capacity.     

The efficacy of home-based muscle training for the elderly osteoporotic women: The effects of daily muscle training on quality of life (QoL)

There is little evidence that home-based muscle training through exercise improves the muscle strength and QoL of elderly osteoporotic women. The efficacy of home-based daily exercise on muscle strength of the upper and lower extremities and QoL were examined in elderly osteoporotic women by means of a case-controlled study that was designed and conducted between 2005 and 2006. Sixty-three osteoporotic women over 60 years of age were randomly assigned to 12 months of muscle exercise or to no intervention. The outcomes were changes in muscle strength and quality of life (QoL). Ultimately, sixty-two participants completed the 12 months program. Before the start of home-exercise training, the lumbar spine bone mineral density (BMD) and femoral neck BMD values in the intervention group were significantly lower than those in the control group (p < 0.05). Grip strength and maximum walking speed increased significantly in the intervention group (p < 0.05). In terms of QoL, physical functioning was improved by home-based exercise in the intervention group (p = 0.05), while there were no improvements in any of the categories of Short-Form 36 in the control group. Our results suggest that home-based training is effective for elderly osteoporotic women in improving not only muscle strength in upper and lower extremities but also physical functioning in QoL.     

Serum albumin and muscle measures in a cohort of healthy young and old participants

Consensus on clinically valid diagnostic criteria for sarcopenia requires a systematical assessment of the association of its candidate measures of muscle mass, muscle strength, and physical performance on one side and muscle-related clinical parameters on the other side. In this study, we systematically assessed associations between serum albumin as a muscle-related parameter and muscle measures in 172 healthy young (aged 18–30 years) and 271 old participants (aged 69–81 year) from the European MYOAGE study. Muscle measures included relative muscle mass, i.e., total- and appendicular lean mass (ALM) percentage, absolute muscle mass, i.e., ALM/height² and total lean mass in kilograms, handgrip strength, and walking speed. Muscle measures were standardized and analyzed in multivariate linear regression models, stratified by age. Adjustment models included age, body composition, C-reactive protein and lifestyle factors. In young participants, serum albumin was positively associated with lean mass percentage (p = 0.007) and with ALM percentage (p = 0.001). In old participants, serum albumin was not associated with any of the muscle measures. In conclusion, the association between serum albumin and muscle measures was only found in healthy young participants and the strongest for measures of relative muscle mass.     

Efficacy of Multidomain Intervention Against Physio-cognitive Decline Syndrome: A Cluster-randomized Trial

BackgroundsTo investigate the efficacy of a community group-based intervention among community-dwelling older adults with physio-cognitive decline syndrome (PCDS).MethodsA prospective cluster randomized controlled trial included 733 community-dwelling older adults with adjusted Montreal Cognitive Assessment (MoCA adj) scores >18 from 40 community-based sites across Taiwan. PCDS was defined as the concomitant presence of physical declines, i.e., slowness and/or weakness plus dysfunction in any cognitive domain. The multidomain intervention integrated physical exercise, cognitive training, nutritional advices and health education lessons. Conventional health education in control group entailed periodic telephone calls to offer participants health education and advice. The primary outcome was the mean differences of MoCA adj total scores and all domains of MoCA adj between baseline and 6- and 12-month follow-up in each group of PCDS, cognitive dysfunction, mobility-type frailty and normal functioning, and the secondary outcomes included the changes of frailty score, handgrip strength, gait speed and physical activity. Intervention effects were analysed using a generalized linear mixed model.ResultsOverall, 18.9% of the study sample had PCDS. Multidomain intervention for 12 months significantly improved cognitive performance in people with PCDS, and those with cognitive dysfunction only. An early benefit on visuo-spatial executive function was seen in older adults with mobility-type frailty. Intervention also improved frailty scores among participants with mobility-type frailty, handgrip strength for participants with PCDS, and gait speed in the normal group.ConclusionsPCDS is a potentially reversible condition that may prevent subsequent disability and dementia, which deserves further investigation to confirm the long-term effects.     

Longitudinal impact of aging on muscle quality in middle-aged men

The present follow-up study aims at assessing the longitudinal changes in muscle quality after an interval of 9.45 years in middle-aged men. In addition, the relative contribution of muscle mass, muscle strength, and muscle power at middle age to these changes was investigated. The results showed a small, though unexpected, increase in total body and leg muscle mass (respectively 0.22 ± 0.04 and 0.29 ± 0.06 % yearly, p < 0.0001), whereas basic strength (−0.71 to −0.87 % yearly, p < 0.0001) and velocity-dependent strength and power (−1.19 to −1.86 % yearly, p < 0.0001) declined. Consequently, muscle quality, defined as the ratio of basic strength or velocity-dependent strength and power to muscle mass decreased (−1.46 to −2.43 % yearly, p < 0.0001) from baseline to follow-up. We found that baseline basic strength is a strong determinant of the decline in muscle quality basic strength with advancing age, whereas only a small part of the age-associated decline in muscle quality based on velocity-dependent strength and power could be explained. To conclude, our results indicate that muscle becomes less efficient at middle age and that baseline muscle strength is a strong predictor of this change. These findings imply that unmeasured neural factors, influencing both contraction speed and the capacity of muscle to produce strength, are possibly other involved determinants. Therefore, timely interventions including strength training and higher-velocity strength training at middle age are recommended.     

Impact of diabetes on muscle mass, muscle strength, and exercise tolerance in patients after coronary artery bypass grafting

Background

The impact of diabetes mellitus (DM) on muscle mass, muscle strength, and exercise tolerance in patients who had undergone coronary artery bypass grafting (CABG) has not been fully elucidated.

Methods

We enrolled 329 consecutive patients who received cardiac rehabilitation (CR) after CABG (DM group, n = 178; non-DM group, n = 151) and measured lean body weight, mid-upper arm muscle area (MAMA), and handgrip power (HGP) at the beginning of CR. We also performed an isokinetic strength test of the knee extensor (Ext) and flexor (Flex) muscles and a cardiopulmonary exercise testing at the same time.

Results

No significant differences in risk factors, including age, gender, number of diseased vessels, or ejection fraction were observed between the 2 groups. The levels of Ext muscle strength, peak oxygen uptake, and anaerobic threshold were significantly lower in the DM group than in the non-DM group (all p < 0.05). Both peak oxygen uptake and MAMA correlated with Ext and Flex muscle strength as well as HGP (all p < 0.005). The MAMA, HGP, and Ext muscle strength were lower in patients who received insulin therapy than in those who did not. Interestingly, fasting glucose levels significantly and negatively correlated with Ext muscle strength.

Conclusions

These data suggest that DM patients had a lower muscle strength and exercise tolerance than non-DM patients. Moreover, a high glucose level may affect these deteriorations in DM patients after CABG.     

The effect of dual task and executive training on pattern of gait in older adults with balance impairment: A Randomized controlled trial

ObjectiveThe purpose of this study was to compare the effect of two different approaches of dual-task training and executive training on pattern of gait in older adults with balance impairment.MethodsThirty older adults with the mean age of 73.8 participated in the study. They scored 52 or less on the Berg Balance Scale (BBS), and walked with a self-selected gait speed of 1.1 m/s or less. Participants were randomly assigned to one of the three groups: experimental group one (cognitive dual-task (CDT) training) that focused on gait performance under dual task condition; experimental group two (executive function (EF) training) who underwent 3 types of training on working memory, inhibition, speed of processing; and a control group. Subjects walked 10 m, under single-task and dual-task (DT) conditions where kinematics parameters were recorded. Participants in experimental groups received 45-min training sessions, 3 times a week for 8 weeks. The data obtained was analyzed using repeated measure at a criterion p-value of 0.05.ResultsThe results showed that after training, changes of walking speed, length of stride and step, times of stride, step, single support, and double support, were significant at p < 0.05. Asymmetry index in walking with dual task condition increased significantly, but after training asymmetry in DT condition decreased significantly in EF group.ConclusionsBoth training groups showed improvements in gait parameters in the post test compared with that in the control group; however, in EF training group, symmetry of limbs and inter-coordination, improved more than that in CDT group.     

Body composition,physical performance and muscle quality of active elderly women

Fat gain is one of the major factors aggravating physical disability in the elderly population, which presents an increase in fat mass and a decrease in lean mass compared to the young population. For this reason it is important to assess body composition and the effects of these alterations in obese elderly women. The purpose of this study was to assess body composition, physical performance and muscle quality in active elderly women. Cross-sectional study included 75 elderly women (29 eutrophic and 46 obese) 65–80 years old. Body composition was evaluated by dual energy X-ray absorptiometry (DXA) and the physical performance was determined by 6-minute walk test (6MWT), handgrip strength (HS) and knee extension strength (KES). Muscle quality was calculated as the ratio between muscle strength and lean mass. Fat free mass, lean mass, fat mass and percent body fat were significantly higher in the obese group (p < 0.05). Furthermore, the obese group showed a poorer performance than the eutrophic group in the 6MWT (432.31 ± 66.13 m and 472.07 ± 74.03 m, respectively, p = 0.01). HS and KES did not differ between groups, however, regarding muscle quality, the obese group exhibited a impaired in comparison to the eutrophic group in the upper (11.45 ± 2.57 kg and 13.31 ± 2.03 kg, respectively, p < 0.01) and lower limb (2.91 ± 1.16 kg and 3.44 ± 0.97 kg, respectively, p = 0.05). The increase in muscle mass detected in the obese elderly was not sufficient to maintain adequate muscle quality and physical function, showing a negative influence of the excess of body fat.     

The effect of unilateral muscle fatigue of hip abductor muscles on balance and functional capacity in community-dwelling older women

BackgroundHip abductor muscles are important for the maintenance of postural stability, mainly on the mediolateral direction and unipodal support conditions. The objective of the present study was to evaluate the effect of unilateral induced fatigue of hip abductor muscles on balance and functional capacity of older women.MethodsThe study included physically independent women aged 60–75 years. We assessed static balance with the single limb stance test (SLS) and evaluated functional capacity with the maximum gait speed (MGS) and step test (ST). We ran the protocol of hip abductor muscle fatigue with a Biodex isokinetic dynamometer. Assessment of balance and functional capacity happened before and after the muscle fatigue protocol. We applied the t-test for repeated measures to determine whether unilateral hip abductor muscle fatigue influences the performance in the tests (SLS, MGS and ST).ResultsThe protocol of hip abductor muscle fatigue negatively affected all three evaluated tasks: SLS (p = 0.000), ST (p = 0.000) and MGS (p = 0.000). However, the single limb stance test was the most task affected (effect size = 0.51, pre- and post-fatigue difference = 28.1 %).ConclusionAfter the unilateral muscle fatigue of hip abductors, we observed the worst performance on clinical tests, mainly regarding the SLS test, which shows the involvement of hip abductors during usual motor tasks. However, the small magnitude of the limitation of functional tests (MGS and ST) suggests the presence of postural compensations.     

Visual dependence affects the motor behavior of older adults during the Timed Up and Go (TUG) test

BackgroundOlder adults show greater postural instabilities under misleading visual cues relative to younger adults. We investigated the effects of age-related visual dependence on motor performance under increased attention demands by adding a motor task and visual stimulus to the Timed Up and Go (TUG) test sub-components.MethodWe designed a cross-sectional quantitative study. Twenty-eight younger (n = 12) and older (n = 16) adults completed the TUG test while wearing a head-mounted display (HMD) that presented a visual stimulus and/or carrying a cup of water. Outcome measures were turning cadence; gait speed; pitch, yaw, and roll peak trunk velocities (PTVs); and acceleration ranges of sit-to-stand and stand-to-sit.ResultsWearing the HMD caused significant performance differences in the TUG test tasks due to age and visual dependence, although performance was lower across all groups with the HMD (p < 0.01). Older adults showed lower roll PTV in turning compared to younger adults (p = 0.03). Visually dependent older adults showed smaller mediolateral and vertical acceleration ranges (p < 0.04) in sit-to-stand compared to visually independent older adults.ConclusionThe demand for orienting posture to a vertical position during sit-to-stand may differentiate older adults who are more visually dependent—and thus at greater fall risk— from those who are more visually independent. Age-related differences in turning behavior suggest a relationship with fall risk that warrants further investigation.     

Can neuromuscular strength and function in people with dementia be rehabilitated using resistance-exercise training? Results from a preliminary intervention study

BACKGROUND: Neuromuscular weakness is a prominent symptom among people with central nervous system disorders, such as dementia, typically leading to disability in activities of daily life. We sought to evaluate the potential of resistance exercise to improve neuromuscular strength and function in the lower extremities among community-dwelling people with dementia. METHODS: Twenty-eight subjects, aged 70-88 years and with an average Mini-Mental State Examination score of 17.8 +/- 7.2, were recruited from a population of adult daycare facility users. Subjects underwent pre- and postintervention assessment of strength and physical function consisting of determination of bilateral maximum strength of the knee extensor, hip flexor, dorsiflexor muscles, and handgrip; and evaluation of lower-extremity function based on repeated chair stands and gait speed. The intervention consisted of moderate-intensity progressive resistance training of the hip extensors, abductors, knee extensors and flexors, and dorsiflexors using the Theraband resistance system for up to 3 days weekly over a 6-week period. RESULTS: Subjects completed an average of 11.4 +/- 2.5 exercise sessions. Among those who exercised at least twice per week (> or = 12), they improved an average of 15.6% in quadriceps strength, 10.1% in handgrip strength, 22.2% in sit-to-stand (STS) time, 9.9% in usual gait time, 5.4% in fast gait time (p =.03), and 14.0% in the timed-up-and-go (TUG) test. CONCLUSIONS: Subjects demonstrated improvements in some areas of muscular capacity (quadriceps and handgrip) and most tests of lower-extremity function (STS, gait, TUG), yet declines in other areas (dorsiflexion and iliopsoas strength). Although strength or functional deficits in all domains were not remediable, these results suggest the potential of a resistance-exercise intervention of longer duration and/or greater intensity to produce beneficial effects on the neuromuscular functioning of people with dementia.     

Obestatin is associated to muscle strength,functional capacity and cognitive status in old women

Obestatin has been proposed to have anorexigenic and anti-ghrelin actions. The objective was to study obestatin concentrations in relation to handgrip strength, functional capacity and cognitive state in old women. The prospective study included 110 women (age, 76.93 ± 6.32) from the Mataró Ageing Study. Individuals were characterized by anthropometric variables, grip strength, Barthel and assessment of cognitive impairment [Mini Cognoscitive Examination (MCE) Spanish version], depressive status by the Geriatric Depression Scale (GDS) and frailty by the Fried criteria. Obestatin was measured by IRMA. Obestatin showed negative correlation to handgrip at basal time point (r = −0.220, p = 0.023) and at 2-year follow-up (r = −0.344, p = 0.002). Obestatin, divided into quartiles, showed a negative lineal association with handgrip: 11.03 ± 4.88 kg in first, 8.75 ± 4.08 kg in second, 8.11 ± 3.66 kg in third and 7.61 ± 4.08 kg in fourth quartile (p = 0.018). Higher obestatin levels were associated to increased weakness (categorized by handgrip of frailty criteria): 2.24 ± 0.42 ng/ml in weak vs. 1.87 ± 0.57 ng/ml in non-weak (p = 0.01). The decrease of either MCE or Barthel scores at 2-year follow-up was significantly higher in individuals in the fourth quartile of obestatin in comparison with individuals in the first quartile (p = 0.046 and p = 0.019, respectively). No association was found between obestatin and GDS score and neither with frailty as a condition. Obestatin is associated to low muscle strength, and impaired functional and cognitive capacity in old women participating in the Mataró Ageing Study.     

Effects of functional and traditional training in body composition and muscle strength components in older women: A randomized controlled trial

BackgroundWhile traditional resistance exercises have been widely used to promote muscle strength and hypertrophy in the elderly, few studies have reported the use of a functional approach in which common patterns for daily activities are considered the primary stimulus.ObjectiveInvestigate whether functional training has similar effects the traditional on body composition and muscle strength components in physically active older women.MethodsForty-seven older women completed a randomized and crossover clinical trial, distributed in three groups: Functional or Traditional Training (FUNCT/TRAD: n = 32; 65.28 ± 4.96 years) and Stretching Group (STRETCH: n = 15; 64.40 ± 3.68 years). Maximal dynamic strength was verified with the 1 repetition maximum (RM) test in the leg press and rowing machines. Muscular power was analyzed using 50% of the maximum load, speed was determined using a linear encoder, and isometric strength was analyzed with hand and lumbar dynamometers. ANOVA for repeated measures was applied for comparisons.ResultsThe FUNCT showed a significant decrease in fat percentage (p = 0.015, 3.51%) and the TRAD a significant increase in lean mass (p = 0.008, 2.92%). Both FUNCT and TRAD generated significant increases in all components of muscle strength compared to baseline whereas STRETCH showed declines in these variables. No statistically significant differences were observed between the experimental groups in body composition.ConclusionFunctional and traditional training are equally efficient in improving strength components in physically active older women and, therefore, they may be complementary to combat some of the deleterious effects of senescence. This trial was registered at Brazilian Registry of Clinical Trials (RBR-9Y8KJQ).