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Sufficient physical activity (PA) is highly recommended to improve the prognosis after stroke. However, there have been only a few studies evaluating the changes in PA level after stroke. We aimed to identify the changes in PA level between before and after stroke, and to determine the association between PA and adverse outcomes. This observational, retrospective cohort study was performed using the Nationwide Health Insurance Service (NHIS) database in South Korea. Subjects between the ages of 20 to 80 years, who had a first-ever ischemic stroke from 2010 to 2013, were included. Subjects were divided into either the "sufficient" or "insufficient" subgroups, depending on the result of the self-reported PA questionnaire. Adverse outcomes, including all-cause mortality, stroke recurrence, and myocardial infarction (MI), were collected from a post-stroke health checkup to 2017. Of the 34,243 subjects with ischemic stroke, only 21.24% had sufficient PA level after stroke. Among those with insufficient PA level, only 17.34% improved their PA level after stroke. Subjects with sufficient PA level after stroke, regardless of their PA level prior to stroke, showed a lower risk of composite adverse outcomes (adjusted Hazard Ratio [HR], 95% CI: 0.85, 0.80–0.90). Subjects who went from insufficient to sufficient PA level (HR 0.87, 95% CI: 0.81–0.93) showed a significantly lower risk of composite adverse outcomes. Achieving a sufficient PA level after ischemic stroke appears to significantly reduce major adverse events. Further effort is needed to promote the PA level after ischemic stroke. [ABSTRACT FROM AUTHOR]

Background/Aims: The early cognitive continuum has been emphasized recently. We sought to characterize the functional and physical aspects of the cognitive continuum in subjects with no cognitive impairment (NCI), subjective cognitive impairment (SCI), nonamnestic (NA-MCI), and amnestic mild cognitive impairment (A-MCI). Furthermore, we identified the potential diagnostic utility of specific functional tasks. Methods: A total of 702 participants, aged ≥65 years and defined as NCI, SCI, NA-MCI, and A-MCI according to the original Petersen criteria, were included. They completed the Korean basic (K-ADL) and Instrumental Activities of Daily Living Scales (K-IADL) and the Performance-Oriented Mobility Assessment (POMA). Results: Significant differences were observed between the different cognitive status groups in three items and total scores on the K-ADL, six items and total scores on the K-IADL and POMA. Controlling for confounding factors revealed that subjects from the A-MCI group performed poorly at bathing, shopping, handling money, and the sum of assorted functional items. Conclusion: These findings demonstrated the declining feature of functional and physical performance according to the cognitive continuum, with A-MCI being discriminative with respect to specific functional tasks as compared to milder cognitive statuses. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objectives To investigate the relationship between dysphagia and mild cognitive impairment ( MCI) in older adults residing in an independent-living facility in Korea. Design Population-based, cross-sectional study. Setting Seongnam, Korea. Participants Korean men and women aged 65 and older living in a typical South Korean city (n = 415) were enrolled in the Korean Longitudinal Study on Health and Aging. Measurements Dysphagia was assessed using the Standardized Swallowing Assessment ( SSA). Cognitive function was evaluated using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery, digit span test, and lexical fluency test. MCI was diagnosed using operational diagnostic criteria and further classified into amnestic and nonamnestic MCI. Results Men with nonanmestic MCI had a greater likelihood of having dysphagia (odds ratio ( OR) = 3.77, 95% confidence interval ( CI) = 1.12-12.72) than men without MCI. Men with nonanmestic MCI were almost six times as likely to have dysphagia ( OR = 5.78, 95% CI = 1.15-29.27) as men with no neurological disorder after adjusting for age, education level, current smoking and drinking, diabetes mellitus, and apolipoprotein E-4 carrier status. Conclusion Men with nonamnestic MCI were more likely to have dysphagia than were their counterparts without MCI, whereas this difference was not found in men with amnestic MCI and women. Assessment of executive functions that interfere with planning of motor activities may be useful in predicting dysphagia and in planning preventive and therapeutic strategies for older men. [ABSTRACT FROM AUTHOR]

Background: the relationship between muscle mass and physical performance has not been consistent among studies.Objective: to clarify the relationship between muscle mass and physical performance in older adults with weak muscle strength.Design: cross-sectional analysis using the baseline data of 542 older men and women from the Korean Longitudinal Study on Health and Aging.Methods: dual X-ray absorptiometry, isokinetic dynamometer and the Short Physical Performance Battery (SPPB) were performed. Two muscle mass parameters, appendicular skeletal mass divided by weight (ASM/Wt) and by height squared (ASM/Ht2), were measured. We divided the participants into a lower-quartile (L25) group and an upper-three-quartiles (H75) group based on the knee-extensor peak torque. Correlation analysis and logistic regression models were used to assess the association between muscle mass and low physical performance, defined as SPPB scores <9, after controlling for confounders.Results: in the L25 group, no correlation between mass and SPPB was detected, whereas the correlation between peak torque and SPPB was significant and higher than that in the H75 group. Results from the logistic models also showed no association between muscle mass and SPPB in the L25 group, whereas muscle mass was associated with SPPB in the H75 group.Conclusion: muscle mass was not associated with physical performance in weak older adults. Measures of muscle strength may be of greater clinical importance in weak older adults than is muscle mass per se. [ABSTRACT FROM AUTHOR]

Background: Interpreting the impact of hand osteoarthritis (OA) on hand function is complicated owing to the multiple digits and joints in the hand. Questions/purpose: We determined the impact of digit-related radiographic OA on hand function in patients 65 years or older. Methods: We evaluated hand radiographs in 196 men and 182 women older than 65 years without shoulder or elbow pain who participated in the Korean Longitudinal Study on Health and Aging. Using the Kellgren and Lawrence criteria, we graded the 15 joints in each hand from 0 to 4 for OA, and evaluated hand function by measuring DASH scores and grip and pinch strength of dominant hands. We performed multiple linear regression analyses to evaluate associations between hand functions and the sum of Kellgren and Lawrence grade of each digit. Results: The sums of Kellgren and Lawrence grades for thumbs and middle fingers were independently associated with grip strength, and the sums of the Kellgren and Lawrence grades for thumbs and index fingers were independently associated with pinch strength after controlling for age and sex. DASH scores were independently associated with OA of the thumb, or index or middle finger, but not with OA of the ring or small finger. Conclusions: This study revealed cumulative effects of joint involvement and Kellgren and Lawrence grades of thumb and middle finger OA on grip strength, and thumb and index finger OA on pinch strength. Furthermore, OA of either of three radial digits was associated with more severe upper extremity disabilities. Level of Evidence: Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Abstract: The objective of the study was to investigate the association between metabolic syndrome (MS) and muscle strength in community-dwelling older men and women in Korea. Korean men and women 65 years and older living in a single, typical South Korean city (n = 647) were enrolled in the Korean Longitudinal Study on Health and Aging study. The diagnosis of MS was evaluated according to the definition of the National Cholesterol Education Program Adult Treatment Panel III. Isokinetic muscle strength of the knee extensors, as determined by peak torque per body weight (newton meter per kilogram) and hand-grip strength per body weight (newton per kilogram), was measured. Participants without MS had greater leg muscle strength and grip strength per weight. The effect of MS on muscle strength was more prominent in men than in women in our study population. Only men showed a significant interaction between MS and age for muscle strength (P = .014), and the effect was greater in men aged 65 to 74 years compared with those older than 75 years (119.2 ± 31.2 vs 134.5 ± 24.3 N m/kg). Participants with MS had weaker knee extensor strength after controlling the covariates (β = −90.80, P = .003), and the interaction term (age × MS × male sex) was significant (β = 1.00, P = .017). Metabolic syndrome is associated with muscle weakness, and this relationship is particularly pronounced in men. Age can modify the impact of MS on muscle strength. Men aged 65 to 74 years with MS need a thorough assessment of muscle strength to prevent disability. [Copyright &y& Elsevier]

Abstract: The aim of the study is to compare factors associated with physical performance in older individuals with severe knee osteoarthritis and those with less-severe osteoarthritis. This is an ancillary cross-sectional study to a population-based cohort study focusing on Koreans age 65 years or older. The analysis included 553 subjects with information about knee pain, depressive symptoms, and comorbidities collected by self-reported questionnaire, and body weight, knee osteoarthritis severity, muscle strength, and physical measures by observer-rated tests. Stepwise logistic regression analyses were performed with physical performance as an outcome variable and the others as independent variables across radiographic knee osteoarthritis severity. In the minimal-to-moderate-severity group, muscle strength, knee pain, BMI, and age were related to poor performance (OR [CI] 0.81 [0.73–0.90], 1.12 [1.03–1.21], 0.87 [0.79–0.96], and 1.09 [1.05–1.14], respectively). In the severe group, muscle strength was the only factor significantly associated with poor performance (OR [CI] 0.72 [0.58–0.89]). Muscle strength, knee pain, and BMI were important determinants of physical performance in the older population with knee osteoarthritis. In severe knee osteoarthritis patients, muscle strength was the only significant determinant. [Copyright &y& Elsevier]

Abstract: Reduced executive function and physical performance are common age-related conditions. This study evaluated the associations between executive function and physical performance in a representative sample of older adults. Cross-sectional data were analyzed from a population-based sample of 629 men and women aged 65 or older and living in one typical city in Korea. Specific aspects of executive function were assessed using the trail making test, digit span test, and lexical fluency test to measure set shifting, working memory and cognitive flexibility functions. Physical performance was measured using performance-oriented mobility assessment (POMA) scores and isokinetic muscle strength. Subjects’ self-efficacy was also assessed using the activities-specific balance confidence (ABC) scale. Results of the lexical fluency test were associated with POMA scores and muscle strength, independent of age, gender, education, comorbidity, physical activity status, depression, and global cognition, suggesting that reduced cognitive flexibility is associated with reduced physical performance and muscle strength. Self-efficacy was also independently associated with physical performance and muscle strength. Clinicians need to consider the association between executive function and physical performance when working to improve physical functioning in an aged population. [Copyright &y& Elsevier]

The aim of this study is to estimate the prevalence of musculoskeletal (MSK) pain in the upper extremities (UE), low back, and lower extremities (LE) in an elderly population, and to identify related factors. In this cross-sectional cohort study, 1118 Korean elderly subjects were randomly selected from residents aged ≥65 years living in an urban city of Korea. The study data included presence of MSK pain, educational levels, activity levels over a 24h, monthly income, body mass indices and presence of depression. Estimated age- and gender-standardized prevalences of UE, low back, and LE pain were 62.6%, 72.6%, and 45.7%, respectively. The prevalence of LE pain increased with age, whereas those of UE pain and back pain did not. By multivariate analysis, a female gender and a low income were found to be significantly associated with pain at all sites, and obesity was related with low back and LE pain. Furthermore, an uneducated state was found to be associated with LE pain, and major depressive disorder to be obviously related to UE and LE pain. MSK pain was identified to be a common problem in the elderly Korean population, and a female gender was consistently associated with MSK pain. [Copyright &y& Elsevier]