Do Muscle Mass, Muscle Density, Strength, and Physical Function Similarly Influence Risk of Hospitalization in Older Adults?

Abstract

Objectives To examine the association between strength, function, lean mass, muscle density and risk of hospitalization. Design Prospective cohort stud Setting Two U.S. clinical centers Participants Adults aged 70 – 80 years (N=3,011) from the Health, Aging and Body Composition Study. Measurements Measures included grip strength; knee extension strength; lean mass; walking speed; chair stand pace. Thigh computed tomography scans assessed muscle area and density (a proxy for muscle fat infiltration). Hospitalizations were confirmed by local review of medical records. Negative binomial regression models estimated incident rate ratios (IRRs) of hospitalization for race/sex specific quartiles of each muscle/function parameter separately. Multivariate models adjusted for age, body mass index, health status and coexisting medical conditions. Results During an average 4.7 years of follow-up, 1,678 (55.7%) participants experienced ≥1 hospitalization. Participants in the lowest quartile of muscle density were more likely to be subsequently hospitalized (multivariate IRR: 1.47, 95% CI: 1.24, 1.73) compared to the highest quartile. Similarly, participants with the weakest grip strength were at increased risk of hospitalization (MIRR: 1.52, 95% CI: 1.30, 1.78, Q1 vs. Q4). Comparable results were seen for knee strength, walking pace and chair stands pace. Lean mass and muscle area were not associated with risk of hospitalization. Conclusion Weak strength, poor function and low muscle density, but not muscle size or lean mass, were associated with an increased risk of hospitalization. Interventions to reduce the disease burden associated with sarcopenia should focus on increasing muscle strength and improving physical function rather than simply increasing lean mass.

Sex Differences in Health and Survival

“…Moreover, handgrip strength has been found to be associated with disability at older ages (Giampaoli et al 1999;Rantanen et al 1999;Taekema et al 2010), cognitive decline (Alfaro-Acha et al 2006), and hospitalization (Cawthon et al 2009). While there is compelling evidence that men outperform women on handgrip tests at all ages and across all continents (Bohannon et al 2006;Dodds et al 2014;Leong et al 2015), the magnitude of the male advantage appears to vary across national populations, ethnicities, and age groups.…”

Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care

“…In clinical practice, handgrip strength is often used as a surrogate measure representative of the sarcopenic condition, as measuring handgrip strength is a simple, accessible, and inexpensive method to use (Cruz-Jentoft et al 2010). Handgrip strength has been shown to associate with several adverse health outcomes in the elderly, including functional impairment (Femia et al 1997;Giampaoli et al 1999;Hairi et al 2010;Rantanen et al 1994), morbidity (Rantanen et al 1998), hospitalization (Cawthon et al 2009) and mortality (Laukkanen et al 1995;Newman et al 2006;Rantanen et al 2003).…”

“…Similar to handgrip strength, quadriceps strength correlates with various negative health outcomes in older adults. These include functional impairment (Hairi et al 2010;Rantanen et al 1994Rantanen et al , 2001Visser et al 2005), hospitalization (Cawthon et al 2009) and mortality (Laukkanen et al 1995;Newman et al 2006).…”

Força de membros inferiores como indicador de incapacidade funcional em idosos

“…A habilidade de sentar e levantar da cadeira no período de 30 segundos envolvem mecanismos da função muscular e fatores complexos relacionados aos aspectos comportamentais (Cawthon et al, 2009;Jones, Rikli, & Beam, 1999). Além desses aspectos, a redução da área muscular da coxa e/ou a redução da força muscular de membros inferiores estão relacionados à imobilidade e a redução de uma vida social ativa (Vaillancourt & Newell, 2002).…”