The impact of muscle function, muscle mass and sarcopenia on independent ageing in very old Swedish men

Abstract

Background Preserved functions of daily life and cognition are cornerstones of independent aging, which is crucial for maintaining a high quality of life. The aim of this study was to examine the impact of sarcopenia, and its underlying components, on independent ageing in a cohort study of very old men. Methods The presence of sarcopenia and independent ageing at a mean age of 87 was investigated in 287 men from the Uppsala Longitudinal Study of Adult Men. Five years later 127 men were re-evaluated for independent ageing. Sarcopenia was defined by two different definitions from the European Working Group on Sarcopenia in Older People. In the first definition sarcopenia was defined as skeletal muscle index < 7.26 kg/m 2 and either gait speed ≤0.8 m/s or hand grip strength < 30 kg. In the later up-dated definition, HGS < 27 kg and/or chair stand test > 15 s defines probable sarcopenia, which is confirmed by SMI < 7.0 kg/m 2 . Independent ageing was defined as a Mini-Mental State Examination score of ≥25 points, absence of diagnosed dementia, community-dwelling, independency in personal care and ability to walk outdoors alone. Results Sarcopenia at baseline was observed in 21% (60/287) and 20% (58/287), respectively, due to definition. The prevalence of independent ageing was 83% (239/288) at baseline and 69% (87/127) five years later. None of the sarcopenia diagnoses were associated with independent ageing. In contrast, gait speed was both in cross-sectional (odds ratio (OR) per one standard deviation increase 2.15, 95% confidence interval (CI) 1.47–3.15), and in longitudinal multivariate analyses (OR 1.84, 95% CI 1.19–2.82). In the cross-sectional analysis also higher hand grip strength was associated with independent ageing (OR 1.58, 95% CI 1.12–2.22), while a slower chair stand test was inversely associated (OR 0.61, 95% CI 0.43–0.86). Muscle mass; i.e. skeletal muscle index, was not associated with independent ageing. Conclusions For very old men, especially a higher gait speed, but also a higher hand grip strength and a faster chair stand test, were associated with independent ageing, while skeletal muscle index alone, and the composite sarcopenia phenotype measured with two different definitions, were not.

Prevalence of sarcopenia among hospitalized internal medicine patients: A cross-sectional single-center pilot study according to EWGSOP2 criteria

“…Some prospective studies have reported, that in a particular group of patients, not all physical performance parameters have an equal impact on the outcome. For example, a study among very old men from Sweden, hand-grip strength and gait speed were associated with independent aging, but not muscle mass or diagnosed sarcopenia (15). Only the prospective arm of our study will fi nd the most informative parameter(s) in the prediction of the adverse outcome among our particular case-mix of inpatients.…”

Prevalence of probable sarcopenia in community-dwelling older Swiss people – a cross-sectional study

“…Participant numbers (n = 219) were estimated a priori based on previously published prevalence data for Swedish older adults [20]. The estimated number would be sufficient to detect a prevalence of 28% at a level of confidence of 0.1 and with 95% precision (d = 0.05).…”

“…To date, information about the prevalence of probable sarcopenia, defined by low muscle strength according to the latest guidelines of the EWGSOP is rare, especially in oldest old men, and not evaluated yet for community living, non-hospitalized women [20][21][22][23]. The primary objective of this study was, therefore, to provide data regarding the prevalence of probable sarcopenia in older, community-living women and men in Switzerland.…”

Corticospinal Control of Human Locomotion as a New Determinant of Age-Related Sarcopenia: An Exploratory Study

“…Both groups may exhibit superior maximum strength and rapid muscle force production, however, the magnitude of the efferent neural drive in active older adults is substantial lower compared to that of younger individuals [109,116]. Furthermore, using a composite sarcopenia phenotype applying two different widely accepted definitions for sarcopenia does not associate with independent aging [117]. This implies that training programs should be developed that explicitly target neural structures such as training programs that use motor-cognitive approaches through step-training exergames [80,[118][119][120] that also effect on leg muscles strength [121,122].…”