We have studied the association of muscle strength (quadriceps, biceps, handgrip), measured by a portable chair technique, with functional status (Barthel Index, manual dexterity, Mental Test Score, history of falls, fracture, prescribed drugs), in a sample of 92 elderly subjects attending a Local Authority Day Centre and Day Hospital. Anthropometric measurements and hand-grip strength were also measured in 30 young controls. Muscle area, mass and strength were significantly greater in young controls. Elderly men had significantly greater muscle area, mass and strength than elderly women. Muscle strength correlated with several measures of functional status. Using stepwise multiple regression, an independent association of muscle strength with manual dexterity, Barthel Index and receipt of domiciliary services is demonstrated.

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– Seven patients with Heredopathia Atactica Polyneuritiformis are described. There were 3 groups of clinical characteristics: first, congenital abnormalities such as skeletal deformities, unrelated to phytanic acid levels; second, signs and symptoms such as retinitis pigmentosa which come on slowly and are not directly related to the plasma phytanic acid level; third, lesions such as the neuropathy, rash and cardiac arrhythmias which can change quickly and are linked to the plasma phytanic acid level. Exacerbations of the signs in the third group are precipitated by a low calorie intake and mobilisation of phytanic acid from the adipose tissue. Poor vision is due not only to retinitis but also to small pupils which fail to dilate in the dark. The use of plasma exchange is discussed. With good dietary supervision it is possible to produce a considerable clinical recovery for the neuropathy.

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