Dysphagia is more strongly associated with increased intramuscular adipose tissue of the quadriceps than with loss of muscle mass in older inpatients

Akazawa, Naoki; Okawa, Naomi; Hino, Toshikazu; Tsuji, Ryota; Tamura, Kimiyuki; Moriyama, Hideki

doi:10.1016/j.nutres.2019.02.006

Cited by 19 publications

(16 citation statements)

References 49 publications

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“…The validity of intramuscular adipose tissue and muscle mass measurements using ultrasound has been confirmed in recent studies using magnetic resonance imaging 25–27 . Images of the rectus femoris and vastus intermedius were obtained at 30% of the distance from the anterior superior iliac spine to the proximal end of the patella 4,6,11,18,19,24 . The participants lay in the supine position with their lower limbs relaxed, while a water‐soluble transmission gel was applied to the skin surface of the thigh.…”

Section: Methodsmentioning

confidence: 91%

“…Transverse ultrasound images were obtained using a B‐mode ultrasound system (NanoMaxx; SonoSite Japan, Tokyo, Japan) with a linear‐array probe (L25n/13–6 MHz; Nanomaxx; SonoSite Japan). The intramuscular adipose tissue and muscle mass of the rectus femoris and vastus intermedius of all participants were assessed based on the echo intensity and muscle thickness 1–8,10,11,18,19,21–24 . The validity of intramuscular adipose tissue and muscle mass measurements using ultrasound has been confirmed in recent studies using magnetic resonance imaging 25–27 .…”

Section: Methodsmentioning

confidence: 99%

“…All ultrasound images were recorded by the same investigator, who had sufficient training in echo intensity and muscle thickness measurements. Echo intensity was measured in one region of interest in the rectus femoris and vastus intermedius; the region selected included the maximum possible regions, while avoiding the bone and surrounding fascia 4,6,11,18,19,24 . To standardize all echo intensity measurements, the gain status was normalized to the initial setting of the ultrasound system.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, the image depth was uniformed at 60 mm for all echo intensity and muscle thickness measurements. The rectus femoris thickness was determined as the distance between the superficial adipose tissue–muscle interface and the deep muscle–muscle interface, 4,6,11,18,19,24 and that of the vastus intermedius was determined as the distance between the superficial muscle–muscle interface and the bone–muscle interface 4,6,11,18,19,24 . Echo intensity and muscle thickness were measured using ImageJ 1.49 software (National Institutes of Health, Bethesda, MD, USA) 1–8,11,18,19,21,22,24,26,27 .…”

Section: Methodsmentioning

confidence: 99%

“… 16 In support of these findings, it has been reported that the amount of intramuscular adipose tissue in the quadriceps in older frail individuals and older inpatients is greater than that of healthy persons matched for age, sex, and body mass index (BMI). 11 , 17 In addition, greater intramuscular adipose tissue in the quadriceps in older inpatients is related to decreased gait independence 11 and swallowing function 18 than less muscle mass.…”

Section: Introductionmentioning

confidence: 99%

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Intramuscular adipose tissue in the quadriceps is more strongly related to recovery of activities of daily living than muscle mass in older inpatients

Akazawa

Kishi

Hino

et al. 2021

J cachexia sarcopenia muscle

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Background The relationship between intramuscular adipose tissue at admission and recovery of activities of daily living (ADL) remains unclear. This study aimed to examine the relationship between intramuscular adipose tissue in the quadriceps at admission and recovery of ADL in older inpatients. Methods This prospective study included 404 inpatients aged ≥65 years (54.7% female). Recovery of ADL during hospital stay was assessed using the Barthel Index (BI) score at discharge, BI score change, and BI efficiency. Higher BI at discharge, BI score change, and BI efficiency indicate more improvement in ADL. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed using echo intensity and muscle thickness on ultrasound images, respectively. Multiple regression analysis was performed to identify factors independently associated with BI score at discharge, BI score change, and BI efficiency. The independent variables were BI score at admission, echo intensity and muscle thickness of the quadriceps, age, sex, number of medications, C‐reactive protein concentration, updated Charlson Comorbidity Index score, Food Intake Level Scale, Geriatric Nutritional Risk Index score, days from onset disease, length of hospital stay, number of units of rehabilitation therapy, and subcutaneous fat thickness of the thigh. Results The medians (inter‐quartile range) of the BI score at discharge, BI score change, and BI efficiency were 60.0 (35.0–80.0), 10.0 (0.0–25.0), and 0.11 (0.00–0.37), respectively. The median (inter‐quartile range) of the length of hospital stay (days) and days from onset disease were 58.0 (39.0–92.0) and 79.0 (49.0–112.0), respectively. Quadriceps echo intensity was independently and significantly associated with the BI score at discharge (β = −0.13, P < 0.01), BI score change (β = −0.23, P < 0.01), and BI efficiency (β = −0.21, P < 0.01). Quadriceps thickness was not independently and significantly associated with the BI score at discharge (β = −0.02, P = 0.68), BI score change (β = −0.02, P = 0.79), and BI efficiency (β = 0.03, P = 0.67). Conclusions Our study indicates that greater intramuscular adipose tissue in the quadriceps at admission is more strongly related to worse recovery of ADL than less muscle mass in older inpatients. Greater intramuscular adipose tissue in the quadriceps in older inpatients is considered to be a predictor of worse recovery of ADL, and intervening for greater intramuscular adipose tissue may be important for improving ADL in older inpatients.

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Section: Methodsmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Intramuscular adipose tissue in the quadriceps is more strongly related to recovery of activities of daily living than muscle mass in older inpatients

Akazawa

Kishi

Hino

et al. 2021

J cachexia sarcopenia muscle

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Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Akazawa

Kishi²,

Hino³

et al. 2021

J cachexia sarcopenia muscle

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Background The longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living (ADL) in older inpatients remains unclear. This study aimed to examine whether decrease of intramuscular adipose tissue of the quadriceps in older inpatients is related to the recovery of ADL than increase of muscle mass. Methods This longitudinal study included 202 inpatients aged ≥65 years [median age: 83.0 (77.0–88.0), 56.4% female]. Recovery of ADL during hospital stay was assessed using the change in Barthel index (BI) score (i.e. BI score at discharge minus BI score at admission) and BI score at discharge. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed using echo intensity and muscle thickness on ultrasound images, respectively. Higher echo intensity indicates greater intramuscular adipose tissue. Multiple regression analysis was performed to identify the factors independently associated with the change in BI score and BI score at discharge. Changes in quadriceps echo intensity and thickness and subcutaneous fat thickness of the thigh, quadriceps echo intensity and thickness, and subcutaneous fat thickness of the thigh at admission, age, sex, days from onset disease, BI score at admission, and disease were set as independent variables. Results The means of the change in quadriceps echo intensity and thickness were −2.3 ± 15.7 and 0.1 ± 0.4 cm, respectively. The median of the change in BI score was 15.0 (0.0–30.0). The quadriceps echo intensity at discharge was significantly lower than at admission (P = 0.043). The quadriceps thickness (P = 0.004) and BI score at discharge (P < 0.001) were significantly higher than those at admission. Change in quadriceps echo intensity was independently and significantly associated with the change in BI score (β = −0.25, P = 0.006) and BI score at discharge (β = −0.18, P = 0.006). In contrast, change in quadriceps thickness was not independently and significantly associated with the change in BI score (β = 0.09, P = 0.244) and BI score at discharge (β = 0.06, P = 0.244). Conclusions Our study indicates that a decrease of intramuscular adipose tissue of the quadriceps is related to the recovery of ADL than an increase of muscle mass in older inpatients. Intramuscular adipose tissue of the quadriceps in older inpatients is considered to be a predictor for the recovery of ADL, and intervening for intramuscular adipose tissue may be important for improving ADL in older inpatients.

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Associations of Trunk Muscle Mass and Muscle Quality Indicators with Self-Reported Dysphagia in Older Inpatients

et al. 2022

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Dysphagia is more strongly associated with increased intramuscular adipose tissue of the quadriceps than with loss of muscle mass in older inpatients

Cited by 19 publications

References 49 publications

Intramuscular adipose tissue in the quadriceps is more strongly related to recovery of activities of daily living than muscle mass in older inpatients

Intramuscular adipose tissue in the quadriceps is more strongly related to recovery of activities of daily living than muscle mass in older inpatients

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Associations of Trunk Muscle Mass and Muscle Quality Indicators with Self-Reported Dysphagia in Older Inpatients

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