Sex differences in the contribution of different physiological systems to physical function in older adults

Abstract

Having the physical function to undertake activities of daily living (ADLs) is essential in order to maintain independence. The aim of this study is to investigate factors associated with physical function in older adults and determine if these associations differ in men versus women. In total, 726 participants (57% men; 73±7 years old) from a population-based cohort, the Southall and Brent Revisited (SABRE) study, completed questionnaires permitting a physical function score (PFS) to be calculated. Detailed phenotyping was performed including cardiovascular (echocardiography and macrovascular and microvascular functions), skeletal muscle (grip strength and oxidative capacity) and lung (pulmonary) function measurements. In a sub-group, maximal aerobic capacity was estimated from a sub-maximal exercise test. In women versus men, the association between grip strength and PFS was nearly 3 times stronger, and the association between microvascular dysfunction and PFS was over 5 times stronger (standardized β-coefficient (95% CI) 0.34 (0.22, 0.45) versus 0.11 (0.01,0.22) and −0.27 (−0.37, −0.17) versus −0.05 (−0.14, 0.04), respectively). In men, the association between cardiorespiratory fitness and PFS was 3 times greater than that in women (standardized β-coefficient (95% CI) 0.33 (0.22, 0.45) versus 0.10 (−0.04, 0.25). Cardiovascular, skeletal muscle and pulmonary factors all contribute to self-reported physical function, but the relative pattern of contribution differs by sex. Grip strength and microvascular function are most strongly associated with physical function in women while cardiorespiratory fitness is most strongly associated with physical function in men. This is relevant to the design of effective interventions that target maintenance of physical function in old age.

Probing polypharmacy, ageing and sex effects on physical function using different tests

“…40 Furthermore, human males also show higher grip strength than females throughout the lifespan, including studies with young adults 41 and older adults averaging in their late 60s 42 and early 70s. 43 Reduced grip strength as part of sarcopenia assessments in older adults was associated with loss of type 2 muscle fibres within the vastus lateralis quadriceps muscle of males, but not females. 44 Behavioural measures revealed no additional differences between groups compared with time-based assessments but provided further information from the tests.…”

“…Females performing better in endurance assessments are task‐specific, with sex differences in the fatiguability of elbow flexors more significant than knee extensors 40 . Furthermore, human males also show higher grip strength than females throughout the lifespan, including studies with young adults 41 and older adults averaging in their late 60s 42 and early 70s 43 . Reduced grip strength as part of sarcopenia assessments in older adults was associated with loss of type 2 muscle fibres within the vastus lateralis quadriceps muscle of males, but not females 44 …”

A Scoping Review on Biopsychosocial Predictors of Mental Health among Older Adults

“…Physical function is the ability to perform motor tasks that involve complex integration of several physiological systems such as the neuromotor, musculoskeletal, and cardiorespiratory systems [ 43 , 44 ]. When the elderly experience a decline in physical function, they face difficulty in engaging in activities of daily living and try to avoid or limit this activity.…”

The association of proBNPage with manifestations of age-related cardiovascular, physical, and psychological impairment in community-dwelling older adults

“…Nevertheless, the possible relationships involving proBNPage not only with death and the number of diseases but also with aging-related negative events remain to be examined. In particular, the aging process is often characterized by variable degrees of impairment of physical and mental health [25][26][27], and B-type natriuretic peptides have been found to be inversely associated with both muscle strength [28][29][30] and cognitive function and are even able to predict the risk of dementia [31][32][33][34].…”