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Risk Factors in the Elderly

18 August 2009 5 Comments

In this study the investigators tried to assess which characteristics are related to the risk of being hospitalised in “older adults”. It has been established that as people get older they lose strength, but it is unclear whether having less muscle tissue necessarily means you are weaker per se, and it has also previously been unclear whether there are better ways to assess whether someone is at risk of being hospitalised. This study has answered those questions.

The goal of this study was to look at the link between “strength, function, lean mass, muscle density, and the risk for hospitalisation”. They assessed over 3000 people aged 70-80 years old, and took a bunch of measurements to see which ones would end up being important over time. They followed these people for the next few years and found the following to be important:

  • Grip Strength
  • Knee Strength
  • Muscle Density
  • Walking Pace
  • Chair Stand Pace (Amount of Time it takes to Stand Up)

The following were, surprisingly, not important predictors of hospitalisation:

  • Lean Mass
  • Muscle Area

That is, it doesn’t matter if you lose a little size, it’s your performace in tasks that is the key indicator. And what helps improve your physical function in everyday tasks? http://www.chrisjonesosteo.com.au/?p=351

So if you are concerned about a friend or relative, keep an eye on their walking pace, their ability to stand up from a chair, and maybe their handshake strength, and if you find it starting to drop a bit, see if you can find somewhere locally where they can get into a bit of strength training.

Do Muscle Mass, Muscle Density, Strength, and Physical Function Similarly Influence Risk of Hospitalization in Older Adults?
OBJECTIVES: To examine the association between strength, function, lean mass, muscle density, and risk of hospitalization.
DESIGN: Prospective cohort study.
SETTING: Two U.S. clinical centers.
PARTICIPANTS: Adults aged 70 to 80 (N=3,011) from the Health, Aging and Body Composition Study.
MEASUREMENTS: Measurements were of grip strength, knee extension strength, lean mass, walking speed, and 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- and sex-specific quartiles of each muscle and 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 one or more hospitalizations. Participants in the lowest quartile of muscle density were more likely to be subsequently hospitalized (multivariate IRR=1.47, 95% confidence interval (CI)=1.24–1.73) than those in the highest quartile. Similarly, participants with the weakest grip strength were at greater risk of hospitalization (multivariate IRR=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 greater 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.
J Am Geriatr Soc. Published online July 29, 2009.