Differential Associations Between Two Markers of Probable Sarcopenia and Continuous Orthostatic Hemodynamics in The Irish Longitudinal Study on Ageing

Duggan, Eoin; Murphy, Colette; Knight, Silvin P.; Davis, James; O’Halloran, Aisling; Kenny, Rose Anne; Romero-Ortuño, Román

doi:10.1093/gerona/glac243

Cited by 4 publications

(4 citation statements)

References 46 publications

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“…As such, only a specific subgroup of older adults, who exhibited STS times consistently above 16 s (mean = 18.97 s, range of 16.7–33.9 s), exhibited significantly less precise patterns of temporal audio–visual integration. Interestingly, previous empirical research involving the TILDA sample has suggested a cut-off of 15 s for probable sarcopenia (Duggan et al 2022 ), a condition typified by a loss of skeletal muscle mass, muscle strength and muscle quality (Duggan et al 2022 ; Kim et al 2020 ). Sarcopenia can be associated with postural dysfunction and balance disorders (Gadelha et al 2018 ; Kim et al 2020 ; Muhlberg and Sieber 2004 ), likely reflecting the critical contribution of lower limb muscle strength to postural stability (Horlings et al 2008 ; Orr 2010 ).…”

Section: Discussionmentioning

confidence: 99%

Older adults with slow sit to stand times show reduced temporal precision of audio–visual integration

et al. 2023

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Sustained integration of sensory inputs over increased temporal delays is associated with reduced cognitive and physical functioning in older adults and adverse outcomes such as falls. Here, we explored the relationship between multisensory integration and a clinically relevant measure of balance/postural control; Sit-to-Stand Time, the efficiency with which an older adult can transition between a seated and a standing posture. We investigated whether temporal multisensory integration was associated with performance on the Five-Times Sit-to-Stand Test (FTSST) in a large sample of 2556 older adults (mean age = 63.62 years, SD = 7.50; 55% female) drawn from The Irish Longitudinal Study on Ageing (TILDA). K-means clustering was applied to FTSST data, yielding three clusters characterised by fast (mean = 10.88 s; n = 1122), medium (mean = 14.34 s; n = 1133) and slow (mean = 18.97 s; n = 301) sit-to-stand times. At wave 3 of TILDA, older adults participated in the Sound Induced Flash Illusion (SIFI), a measure of the precision of temporal audio–visual integration, which included three audio–visual stimulus onset asynchronies (SOAs): 70, 150 and 230 ms. Older adults with the slowest sit-to-stand times were more susceptible to the SIFI at the longest SOA (230 ms) compared to the shortest SOA (70 ms) relative to those with the fastest times (p = 0.02). Older adults who take longer to repeatedly transition from a seated to a standing posture exhibit an expanded temporal binding window for audio–visual events, supporting a link between multisensory perception and balance/postural control in ageing.

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Section: Discussionmentioning

confidence: 99%

Older adults with slow sit to stand times show reduced temporal precision of audio–visual integration

et al. 2023

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“…Statistical analysis was performed with Stata ® version 15.1 (StataCorp LLC, College Station, TX, USA). To assess the relationship between sarcopenia and each of the haemodynamic parameters, we used multi-level mixed-effects models, as previously employed by our group and others [ 16 , 17 , 26 , 27 ]. The fixed and random effects accounted for the repeated measures within participants.…”

Section: Methodsmentioning

confidence: 99%

“…Previous research has demonstrated an association between classic OH, assessed with intermittent BP measurement, and sarcopenia [ 14 , 15 ]. We previously found an association between beat-to-beat orthostatic BP recovery and both probable sarcopenia in a population study [ 16 ] and sarcopenia in a clinical setting [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Haemodynamic Parameters Underlying the Relationship between Sarcopenia and Blood Pressure Recovery on Standing

Duggan,

Knight,

Xue

et al. 2023

JCM

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Background: Sarcopenia, delayed blood pressure (BP) recovery following standing, and orthostatic hypotension (OH) pose significant clinical challenges associated with ageing. While prior studies have established a link between sarcopenia and impaired BP recovery and OH, the underlying haemodynamic mechanisms remain unclear. Methods: We enrolled 107 participants aged 50 and above from a falls and syncope clinic, conducting an active stand test with continuous non-invasive haemodynamic measurements. Hand grip strength and five-chair stand time were evaluated, and muscle mass was estimated using bioelectrical impedance analysis. Participants were categorised as non-sarcopenic or sarcopenic. Employing mixed-effects linear regression, we modelled the effect of sarcopenia on mean arterial pressure and heart rate after standing, as well as Modelflow®-derived parameters such as cardiac output, total peripheral resistance, and stroke volume, while adjusting for potential confounders. Results: Sarcopenia was associated with diminished recovery of mean arterial pressure during the 10–20 s period post-standing (β −0.67, p < 0.001). It also resulted in a reduced ascent to peak (0–10 s) and recovery from peak (10–20 s) of cardiac output (β −0.05, p < 0.001; β 0.06, p < 0.001). Furthermore, sarcopenia was associated with attenuated recovery (10–20 s) of total peripheral resistance from nadir (β −0.02, p < 0.001) and diminished recovery from peak (10–20 s) of stroke volume (β 0.54, p < 0.001). Notably, heart rate did not exhibit a significant association with sarcopenia status at any time interval post-standing. Conclusion: The compromised BP recovery observed in sarcopenia appears to be driven by an initial reduction in the peak of cardiac output, followed by attenuated recovery of cardiac output from its peak and total peripheral resistance from its nadir. This cardiac output finding seems to be influenced by stroke volume rather than heart rate. Possible mechanisms for these findings include cardio-sarcopenia, the impact of sarcopenia on the autonomic nervous system, and/or the skeletal muscle pump.

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“…[11][12][13] OH also disproportionately affects adults with diabetes, heart failure, and chronic kidney disease and is strongly associated with sarcopenia and frailty. 10,[14][15][16][17] Population-based studies have examined the prevalence of OH by race or ethnicity and by sex in patients with hypertension with mixed findings. In the ARIC (Atherosclerosis Risk in Communities Study) cohort, OH was more common among Black adults than White adults (6.4% versus 4.4%), 18 whereas OH was more prevalent among women and among White participants compared with Black participants in ACCORD (Action to Control Cardiovascular Risk in Diabetes) BP trial 19 and SPRINT (Systolic Blood Pressure Intervention Trial).…”

Section: Epidemiologymentioning

confidence: 99%

Orthostatic Hypotension in Adults With Hypertension: A Scientific Statement From the American Heart Association

Juraschek,

Cortez,

Flack

et al. 2024

Hypertension

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Although orthostatic hypotension (OH) has long been recognized as a manifestation of autonomic dysfunction, a growing body of literature has identified OH as a common comorbidity of hypertension. This connection is complex, related to pathophysiology in blood pressure regulation and the manner by which OH is derived as the difference between 2 blood pressure measurements. While traditional therapeutic approaches to OH among patients with neurodegenerative disorders focus on increasing upright blood pressure to prevent cerebral hypoperfusion, the management of OH among patients with hypertension is more nuanced; resting hypertension is itself associated with adverse outcomes among these patients. Although there is substantial evidence that intensive blood pressure treatment does not cause OH in the majority of patients with essential hypertension, some classes of antihypertensive agents may unmask OH in patients with an underlying autonomic impairment. Practical steps to manage OH among adults with hypertension start with (1) a thorough characterization of its patterns, triggers, and cause; (2) review and removal of aggravating factors (often pharmacological agents not related to hypertension treatment); (3) optimization of an antihypertensive regimen; and (4) adoption of a tailored treatment strategy that avoids exacerbating hypertension. These strategies include countermaneuvers and short-acting vasoactive agents (midodrine, droxidopa). Ultimately, further research is needed on the epidemiology of OH, the impact of hypertension treatment on OH, approaches to the screening and diagnosis of OH, and OH treatment among adults with hypertension to improve the care of these patients and their complex blood pressure pathophysiology.

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Differential Associations Between Two Markers of Probable Sarcopenia and Continuous Orthostatic Hemodynamics in The Irish Longitudinal Study on Ageing

Cited by 4 publications

References 46 publications

Older adults with slow sit to stand times show reduced temporal precision of audio–visual integration

Older adults with slow sit to stand times show reduced temporal precision of audio–visual integration

Haemodynamic Parameters Underlying the Relationship between Sarcopenia and Blood Pressure Recovery on Standing

Orthostatic Hypotension in Adults With Hypertension: A Scientific Statement From the American Heart Association

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