Longitudinal Changes in Muscle Mass, Muscle Strength, and Physical Performance in Acutely Hospitalized Older Adults

Aarden, Jesse J; Reijnierse, Esmee M.; Schaaf, Marike van der; Esch, M. van der; Reichardt, Lucienne A.; Seben, Rosanne van; Bosch, Jos A.; Twisk, Jos W. R.; Maier, Andrea B.; Engelbert, Raoul; Buurman, Bianca M.

doi:10.1016/j.jamda.2020.12.006

Cited by 23 publications

(34 citation statements)

References 47 publications

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“…Overall, minimal changes in muscle quantity, quality or function were shown at the study population level. This is consistent with previous studies that have not shown significant change in handgrip strength in acutely admitted older adults during hospitalization, 15,16 or at 3 months post‐hospitalization 13 . A previous systematic review showed declines in handgrip strength in electively admitted older adults, but not in acutely admitted patients 16 .…”

Section: Resultssupporting

confidence: 92%

“…A previous systematic review showed declines in handgrip strength in electively admitted older adults, but not in acutely admitted patients 16 . Conversely, muscle quantity has been shown to decline at 3 months post‐hospitalization, 13 but not during hospitalization, 14 and physical performance has actually been shown to improve in other studies 13,15 . This shows complexities in measuring dynamic changes in muscle quantity, quality and function in heterogeneous populations.…”

Section: Resultsmentioning

confidence: 98%

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Trajectories of muscle quantity, quality and function measurements in hospitalized older adults

Welch

Greig

Lewis

et al. 2022

Geriatrics Gerontology Int

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Acute sarcopenia is defined by the development of incident sarcopenia (low muscle quantity/quality and function) within 6 months of a stressor event. However, outcome measures for clinical trials have not been validated. This study aimed to characterize changes in muscle quantity, quality, strength, and physical function during and after hospitalization.Methods: Patients aged ≥70 years admitted for elective colorectal surgery, emergency abdominal surgery or acute infections were recruited from a single university hospital. Assessments were carried out at baseline, and within 7 AE 2 days and 13 AE 1 weeks postoperatively or post-admission.Results: A total of 79 participants (mean age 79 years, 39% female) were included. Physical function defined by the Patient-Reported Outcome Measures Information System T-score declined from baseline (42.3, 95% CI 40.2-44.3) to 7 days (36.6, 95% CI 34.5-38.8; P = 0.001), with improvement after 13 weeks (40.5, 95% CI 37.9-43.0). Changes in muscle quantity, quality and function measurements were overall heterogeneous, with few significant changes at the study population level. Change in rectus femoris echogenicity over 13 weeks correlated with changes in handgrip strength (r = 0.53; P < 0.001) and gait speed (r = 0.59; P = 0.003) over the same period.Conclusions: Patient-Reported Outcome Measures Information System T-score provides a sensitive measure of change in physical function in hospitalized older patients. However, changes in muscle quantity, quality and function measurements were heterogeneous, and not significant at the study population level. Further research should assess for factors that might be predictive of changes within individuals to enable stratified interventions. Geriatr Gerontol Int 2022; 22: 311-318.

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Section: Resultssupporting

confidence: 92%

Section: Resultsmentioning

confidence: 98%

Trajectories of muscle quantity, quality and function measurements in hospitalized older adults

Welch

Greig

Lewis

et al. 2022

Geriatrics Gerontology Int

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“…Decline in physical performance during hospitalization and up to 3 months post discharge has been attributable to loss of muscle mass and muscle strength, and exercise programs in the hospital and post discharge is crucial to reduce the impact of acute illness on physical performance and enhance recovery (21,49,50). Most studies have focused on high intensity resistance training.…”

Section: Discussionmentioning

confidence: 99%

Possible Sarcopenia and Impact of Dual-Task Exercise on Gait Speed, Handgrip Strength, Falls, and Perceived Health

et al. 2021

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Background: Sarcopenia is defined as a progressive age-related loss in muscle mass and strength affecting physical performance. It is associated with many negative outcomes including falls, disability, cognitive decline, and mortality. Protein enriched diet and resistance training have shown to improve muscle strength and function but there is limited evidence on impact of dual-task exercise in possible sarcopenia.Objective: To evaluate impact of community-based dual-task exercise on muscle strength and physical function in possible sarcopenia defined by either slow gait (SG) or poor handgrip strength (HGS). The secondary aims include effect on cognition, frailty, falls, social isolation, and perceived health.Methods: Community-dwelling older adults ≥60 years old were recruited from screening program intended to identify seniors at risk, and invited to participate in dual-task exercise program called HAPPY (Healthy Aging Promotion Program for You). One hundred and eleven participants with possible sarcopenia completed 3 months follow-up. Questionnaire was administered on demographics, frailty, sarcopenia, falls, perceived health, social network, functional, and cognitive status. Physical performance included assessment of HGS, gait speed, and Short Physical Performance Battery test (SPPB).Results: The mean age of the Exercise group was 75.9 years old and 73.0% were women. The Exercise group had more female (73.0 vs. 47.5%), were older (75.9 vs. 72.5 years old), had higher prevalence of falls (32.4 vs. 15.0%), lower BMI (23.7 vs. 25.8), and education (4.0 vs. 7.2 years). The gait speed of the Exercise group increased significantly with significant reduction in the prevalence of SG and poor HGS. All components of SPPB as well as the total score increased significantly while the prevalence of pre-frailty and falls dropped by half. The risk of social isolation reduced by 25% with significant improvement in perceived health and cognition in the Exercise group. Significant impact on improvement gait speed and SPPB persisted after adjustment for baseline factors.Conclusion: Dual-task exercise program is effective in improving gait speed, SPPB score, and reducing the prevalence of poor HGS with significant improvement in perceived health, cognition, and reduction in falls and frailty. Future prospective randomized control trials are needed to evaluate the effectiveness of dual-task interventions in reversing sarcopenia.

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“…In a study of older adults who were followed up for 3 months after hospitalization, muscle strength and physical function recovered to the same level or even higher than that at the time of hospitalization. However, skeletal muscle mass did not recover during hospitalization (33) . Therefore, we believe that long-term nutritional physical therapy is necessary to improve skeletal muscle mass.…”

Section: The Effect Of Physical Therapy On Nutritionmentioning

confidence: 93%

Nutrition and Physical Therapy: A Position Paper by the Physical Therapist Section of the Japanese Association of Rehabilitation Nutrition (Secondary Publication)

Inoue

Iida

Takahashi³

et al. 2022

JMA J

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Several patients undergoing physical therapy have nutritional problems. Knowledge of nutrition is necessary for addressing nutritional problems, such as malnutrition, sarcopenia, frailty, and cachexia. However, the relationship between physical therapy and nutrition is not fully understood. Physical therapy plays an important role in nutritional management, and evaluations, such as muscle strength and muscle mass evaluations, play an important role in nutritional screening and diagnosis. Exercise, as the core of physical therapy, is essential for nutritional interventions. Several recent studies have suggested that a combination of nutrition and physical therapy interventions can maximize the function, activity, participation, and quality of life of patients. The combination of nutrition and physical therapy interventions is key to addressing the needs of modern and diverse populations. This position paper was developed by the Physical Therapist Section of the Japanese Association of Rehabilitation Nutrition in consultation with the Japanese Society of Nutrition and Swallowing Physical Therapy.

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Longitudinal Changes in Muscle Mass, Muscle Strength, and Physical Performance in Acutely Hospitalized Older Adults

Cited by 23 publications

References 47 publications

Trajectories of muscle quantity, quality and function measurements in hospitalized older adults

Trajectories of muscle quantity, quality and function measurements in hospitalized older adults

Possible Sarcopenia and Impact of Dual-Task Exercise on Gait Speed, Handgrip Strength, Falls, and Perceived Health

Nutrition and Physical Therapy: A Position Paper by the Physical Therapist Section of the Japanese Association of Rehabilitation Nutrition (Secondary Publication)

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