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Background and Objectives: Skeletal muscle is characterized by its mass, strength and performance. These normative values are pivotal in defining sarcopenia. Sarcopenia is associated with poor outcome of numerous medical and surgical conditions. This study aimed to establish normative benchmarks for skeletal muscle mass, strength and performance within the context of the Asian (Indian) population. Methods: Our investigation utilized the computed tomography (CT) skeletal muscle index (SMI), handgrip strength (HGS), gait velocity and chair-stand test to construct reference values for muscle characteristics in the Indian population. Results: The SMI analysis incorporated 1485 cases of acute abdomen (54.7%) males). The calculated SMI (kg/m2) was 38.50 (35.05–42.30) in males and 36.30 (32.20–41.20) in females (p = 0.510). The study also involved 3083 healthy individuals (67.6% males) evaluated for muscle strength and performance between August 2017 and August 2018. Notably, HGS (kg force) was recorded at 34.95 (26.50–43.30) in males and 25.50 (18.60–31.20) in females (p < 0.001). Gait velocity (metres/second) exhibited values of 1.25 (1.04–1.56) in males and 1.24 (1.03–1.56) in females (p = 0.851). Additionally, chair-stand test (seconds) results were 10.00 (9.00–13.00) in males and 12.00 (10.00–14.00) in females (p < 0.001). Conclusions: The investigation determined that males had greater muscle strength and performance than females. But gender wise, there was no significant difference in muscle mass. Interestingly, our population's muscle parameters were consistently lower compared to western literature benchmarks. These normative values will help to define sarcopenia parameters in our population, which have prognostic value in multiple ailments. [ABSTRACT FROM AUTHOR]

Objective: While the association between depression and frailty in the elderly population has been investigated, the psychological factors that mediate such a relationship remain unknown. The identification of psychological factors in interventions for depression treatment in the elderly may assist in the treatment and care. We aimed to explore the mediating effects of anger, anxiety, and resilience on the link between frailty and depression symptoms in patients with late-life depression. Methods: A sample of 203 older adults completed questionnaires that assessed depression, anger, resilience, and anxiety. To measure frailty, participants were evaluated using a self-rated health questionnaire, weight-adjusted waist index related to sarcopenia, and weight-adjusted handgrip strength to evaluate weakness. A mediation model was tested, hypothesizing that anger, anxiety, and resilience would partially mediate the strength of the frailty-depression link in the elderly. Results: Only self-rated health showed a significant association with depressive symptoms in late-life depression. Our study demonstrated that frailty has both direct and indirect associations with depression, mediated by anger, resilience, and anxiety. Conclusion: Given that anger, resilience, and anxiety influence the link between self-rated health and depression, interventions that lead to increased resilience and decreased anger and anxiety may be promising to reduce depressive symptoms in older adults with depression. [ABSTRACT FROM AUTHOR]

Background and Methods: Pancreatico-duodenectomy (PD) carries significant morbidity and mortality, with very few modifiable risk factors. Radiological evidence of sarcopenia is associated with poor outcomes. This retrospective study aimed to analyse the relationship between easy-to-use bedside nutritional assessment techniques and radiological markers of muscle loss to identify those patients most likely to benefit from prehabilitation. Results: Data were available in 184 consecutive patients undergoing PD. Malnutrition was present in 33–71%, and 48% had a high visceral fat-to-skeletal muscle ratio, suggestive of sarcopenic obesity (SO). Surgical risk was higher in patients with obesity (OR 1.07, 95%CI 1.01–1.14, p = 0.031), and length of stay was 5 days longer in those with SO (p = 0.006). There was no correlation between skeletal muscle and malnutrition using percentage weight loss or the malnutrition universal screening tool (MUST), but a weak correlation between the highest hand grip strength (HGS; 0.468, p < 0.001) and the Global Leadership in Malnutrition (GLIM) criteria (−0.379, p < 0.001). Conclusions: Nutritional assessment tools give widely variable results. Further research is needed to identify patients at significant nutritional risk prior to PD. In the meantime, those with malnutrition (according to the GLIM criteria), obesity or low HGS should be referred to prehabilitation. [ABSTRACT FROM AUTHOR]

BackgroundRecent research has indicated a potential association between thyroid function and sarcopenia, but the specific mechanisms and a definitive causal relationship have yet to be established. Therefore, the objective of this study is to examine the potential causal connection between thyroid function and sarcopenia-related traits, including hand-grip strength, appendicular lean mass (ALM), and walking pace.MethodsThe study used a bi-directional two-sample MR design, with thyroid function examined as the exposure and sarcopenia-related traits as the outcome in the first stage, and then reversed in the second stage. The genetic instruments for thyroid function were obtained from a comprehensive meta-analysis involving 271,040 participants. Data on sarcopenia-related traits based on GWASs were collected from the UK Biobank, which includes up to 461,026 European participants. The estimates for MR were calculated using the inverse-variance weighted (IVW) method, and several sensitivity analyses were performed.ResultsAfter applying the Bonferroni correction for multiple testing, our MR analyses revealed no significant impact of thyroid function liability on sarcopenia-related traits. Similarly, our reverse MR analysis did not provide evidence supporting the influence of liability to sarcopenia-related traits on thyroid function. The results of the primary IVW MR analyses were largely in line with those obtained from our sensitivity MR analyses.ConclusionOur research findings do not suggest a link between thyroid function and sarcopenia-related traits. The associations identified in epidemiological studies may be influenced, at least in part, by shared biological mechanisms or environmental confounders.

Abstract Background Incidence of hip fracture is estimated to rise, increasing demands on healthcare. Our objective was to compare patients with hip fracture, a decade apart, regarding surgical characteristics and functional outcome in relation to morbidity. A secondary aim was to analyse postoperative hand-grip strength (HGS) in relation to walking ability 4 months postoperatively. Methods This is a cross-sectional comparative study of patients with hip fracture, included in 2008 (n = 78) and 2018 (n = 76) at Örebro University Hospital. Patient-data (age, gender, morbidity, fall-circumstances, fracture, surgical characteristics, and length of stay) were collected from medical records. HGS was measured postoperatively. Data on functional outcome in terms of housing, walking ability and need of walking aids at 4 months postoperatively was collected from the Swedish Hip Fracture Register RIKSHÖFT. Statistical analyses adapted were hypothesis tests and regression analysis. Results Patients in 2018 presented a significantly higher morbidity than patients in 2008 and there were significant differences in adapted surgical methods. Functional outcome at 4-months postoperatively was analysed by logistic regression where Cohort 2018 was associated with higher odds of independent walking ability (OR 5.7; 95%CI 1.9–17.2) and not needing any walking aids (OR 5.1; 95%CI 1.9–17.2). Postoperative HGS was higher among patients in 2018 and a multiple regression analysis revealed a significant association between HGS and walking ability at 4 months postoperatively. Conclusions This study supports the since previously reported development in hip fracture surgery in Sweden while also presenting that functional outcome seems to have improved despite a concomitant increase in morbidity. Results suggest an improvement in postoperative HGS, predicting walking ability at 4 months postoperatively.

Background: Incidence of hip fracture is estimated to rise, increasing demands on healthcare. Our objective was to compare patients with hip fracture, a decade apart, regarding surgical characteristics and functional outcome in relation to morbidity. A secondary aim was to analyse postoperative hand-grip strength (HGS) in relation to walking ability 4 months postoperatively. Methods: This is a cross-sectional comparative study of patients with hip fracture, included in 2008 (n = 78) and 2018 (n = 76) at Örebro University Hospital. Patient-data (age, gender, morbidity, fall-circumstances, fracture, surgical characteristics, and length of stay) were collected from medical records. HGS was measured postoperatively. Data on functional outcome in terms of housing, walking ability and need of walking aids at 4 months postoperatively was collected from the Swedish Hip Fracture Register RIKSHÖFT. Statistical analyses adapted were hypothesis tests and regression analysis. Results: Patients in 2018 presented a significantly higher morbidity than patients in 2008 and there were significant differences in adapted surgical methods. Functional outcome at 4-months postoperatively was analysed by logistic regression where Cohort 2018 was associated with higher odds of independent walking ability (OR 5.7; 95%CI 1.9–17.2) and not needing any walking aids (OR 5.1; 95%CI 1.9–17.2). Postoperative HGS was higher among patients in 2018 and a multiple regression analysis revealed a significant association between HGS and walking ability at 4 months postoperatively. Conclusions: This study supports the since previously reported development in hip fracture surgery in Sweden while also presenting that functional outcome seems to have improved despite a concomitant increase in morbidity. Results suggest an improvement in postoperative HGS, predicting walking ability at 4 months postoperatively. [ABSTRACT FROM AUTHOR]

Background and aimsThe cachexia index (CXI) is a novel biomarker for estimating cancer cachexia. The cachexia index based on hand-grip strength (H-CXI) has been recently developed as a simple proxy for CXI. The present study aims to compare both the H-CXI and CXI for the prediction of cancer cachexia and postoperative outcomes in patients who underwent radical colectomy for colorectal cancer.MethodsPatients who underwent radical operations for colorectal cancer were included in this study. Cancer cachexia was diagnosed according to the international consensus outlined by Fearon et al. The cachexia index (CXI) was calculated as [skeletal muscle index (SMI) × serum albumin/neutrophil-to-lymphocyte ratio (NLR)]. The H-CXI was calculated as [hand-grip strength (HGS)/height2 × serum albumin/NLR]. The SMI was measured based on the preoperative CT images at the third lumbar vertebra (L3) level. HGS was measured before surgery.ResultsFrom July 2014 to May 2021, a total of 1,411 patients were included in the present study, of whom 361 (25.6%) were identified as having cancer cachexia. Patients with cachexia had a lower CXI (p

Background and Methods: Pancreatico-duodenectomy (PD) carries significant morbidity and mortality, with very few modifiable risk factors. Radiological evidence of sarcopenia is associated with poor outcomes. This retrospective study aimed to analyse the relationship between easy-to-use bedside nutritional assessment techniques and radiological markers of muscle loss to identify those patients most likely to benefit from prehabilitation. Results: Data were available in 184 consecutive patients undergoing PD. Malnutrition was present in 33–71%, and 48% had a high visceral fat-to-skeletal muscle ratio, suggestive of sarcopenic obesity (SO). Surgical risk was higher in patients with obesity (OR 1.07, 95%CI 1.01–1.14, p = 0.031), and length of stay was 5 days longer in those with SO (p = 0.006). There was no correlation between skeletal muscle and malnutrition using percentage weight loss or the malnutrition universal screening tool (MUST), but a weak correlation between the highest hand grip strength (HGS; 0.468, p < 0.001) and the Global Leadership in Malnutrition (GLIM) criteria (−0.379, p < 0.001). Conclusions: Nutritional assessment tools give widely variable results. Further research is needed to identify patients at significant nutritional risk prior to PD. In the meantime, those with malnutrition (according to the GLIM criteria), obesity or low HGS should be referred to prehabilitation.

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It is estimated that about 50% of geriatric rehabilitation patients suffer from sarcopenia. Thereby, malnutrition is frequently associated with sarcopenia, and dietary intake is the main modifiable risk factor. During hospitalization, older adults are recommended to consume more dietary protein than the current recommended dietary allowance of 0.8 g/kg body weight per day to optimize the recovery of muscular strength and physical function. This prospective pilot study examined the feasibility and preliminary efficacy of short-term protein supplementation with protein-enriched foods and drinks on the hand-grip strength, nutritional status, and physical function of older patients at risk of malnutrition during a three-week inpatient orthopedic rehabilitation stay. The Mini Nutritional Assessment (MNA) tool was used to assess malnutrition. Patients with an MNA score ≤ 23.5 points were randomly assigned to an intervention group (goal: to consume 1.2–1.5 g protein/kg body weight per day) or a control group (standard care). Both groups carried out the same rehabilitation program. Physical recovery parameters were determined at admission and discharge. A trend was recognized for participants in the intervention group to consume more protein than the control group (p = 0.058): 95.3 (SD 13.2) g/day as compared to 77.2 (SD 24.2) g/day, which corresponds to a mean protein intake of 1.6 (SD 0.3) g/kg/day vs. 1.3 (SD 0.5) g/kg/day. Dietary protein supplementation increased body weight by an average of 0.9 (SD 1.1) kg and fat mass by an average of 0.9 (SD 1.2) kg as compared to the baseline (p = 0.039 and p = 0.050, respectively). No significant change in hand-grip strength, body composition, or physical function was observed. In conclusion, short-term intervention with protein-enriched foods and drinks enabled older patients at risk of malnutrition to increase their protein intake to levels that are higher than their required intake. In these older individuals with appropriate protein intake, dietary protein supplementation did not result in a greater improvement in physical recovery outcomes during short-term inpatient rehabilitation. The intervention improved dietary protein intake, but further research (e.g., a full-scale, randomized, controlled trial with sufficient power) is required to determine the effects on physical function outcomes. [ABSTRACT FROM AUTHOR]

Background and purpose: Sarcopenia is highly prevalent (28.5-40.3%) in patients undergoing hemodialysis and leads to poor clinical outcomes. However, the association between muscle quality and sarcopenia in patients receiving hemodialysis remains unclear. Therefore, we aimed to explore the association between muscle cross-sectional area (CSA) and proton-density fatfraction (PDFF) in patients with sarcopenia undergoing hemodialysis. Methods: Seventy-six patients undergoing hemodialysis for > 3 months were enrolled. Their handgrip strength (HGS), short physical performance battery (SPPB) performance, and appendicular skeletal muscle mass index (ASMI) were measured. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 consensus update. All patients underwent quantitative magnetic resonance imaging. CSA and PDFF were measured for the thigh, trunk, and gluteus muscles. Results: The prevalence of probable, confirmed, and severe sarcopenia in this study was 73.7%, 51.3%, and 22.4%, respectively. Older age (OR: 1.061, P < 0.003); lower body mass index (BMI) (OR: 0.837, P = 0.008), albumin (OR: 0.765, P = 0.004), prealbumin (OR: 0.987, P = 0.001), predialysis blood urea nitrogen (BUN) (OR: 0.842, P < 0.001), predialysis creatinine (OR: 0.993, P < 0.001), phosphorus (OR: 0.396, P = 0.047); lower CSA of the thigh (OR: 0.58, P = 0.035), third lumbar (L3) trunk (OR: 0.37, P = 0.004), gluteus minimus and medius (OR: 0.28, P = 0.001), and gluteus maximus (OR: 0.28, P= 0.001); and higher PDFF of the thigh (OR: 1.89, P = 0.036) and L3 trunk (OR: 1.71, P = 0.040) were identified as sarcopenia risk factors. The gluteus minimus and medius CSA was lower in patients with sarcopenia than in those without after adjusting for age and BMI (OR: 0.37, P = 0.017). Higher thigh (P = 0.031) and L3 trunk (P = 0.006) muscle PDFF were significantly associated with lower HGS. Furthermore, higher thigh (P = 0.011) and L3 trunk (P = 0.010) muscle PDFF were also inversely correlated with lower ASMI. Conclusion: Our findings demonstrate the high prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis and might trigger a paradigm shift in intervention strategies for patients receiving hemodialysis. [ABSTRACT FROM AUTHOR]

Hospitalized patients with respiratory failure due to SARS-CoV-2 pneumonia are at increased risk of malnutrition and related mortality. The predictive value of the Mini-Nutritional Assessment short form (MNA-sf®), hand-grip strength (HGS), and bioelectrical impedance analysis (BIA) was determined with respect to in-hospital mortality or endotracheal intubation. The study included 101 patients admitted to a sub-intensive care unit from November 2021 to April 2022. The discriminative capacity of MNA-sf, HGS, and body composition parameters (skeletal mass index and phase angle) was assessed computing the area under the receiver operating characteristic curves (AUC). Analyses were stratified by age groups (<70/70+ years). The MNA-sf alone or in combination with HGS or BIA was not able to reliably predict our outcome. In younger participants, HGS showed a sensitivity of 0.87 and a specificity of 0.54 (AUC: 0.77). In older participants, phase angle (AUC: 0.72) was the best predictor and MNA-sf in combination with HGS had an AUC of 0.66. In our sample, MNA- sf alone, or in combination with HGS and BIA was not useful to predict our outcome in patients with COVID-19 pneumonia. Phase angle and HGS may be useful tools to predict worse outcomes in older and younger patients, respectively. [ABSTRACT FROM AUTHOR]

Physical inactivity is one of the leading causes of chronic metabolic disease including obesity. Increasing physical activity (PA) has been shown to improve cardiometabolic and musculoskeletal health and to be associated with a distinct gut microbiota composition in trained athletes. However, the impact of PA on the gut microbiota is inconclusive for individuals performing PA in their day‐to‐day life. This study examined the role of PA and hand‐grip strength on gut microbiome composition in middle‐aged adults (40–65 years, n = 350) with normal (18.5–24.9 kg/m2) and overweight (25–29.9 kg/m2) body mass index (BMI). PA was recorded using the International Physical Activity Questionnaire, and hand‐grip strength was measured using a dynamometer. Serum samples were assessed for lipidomics while DNA was extracted from fecal samples for microbiome analysis. Overweight participants showed a higher concentration of triacylglycerols, and lower concentrations of cholesteryl esters, sphingomyelin, and lyso‐phosphotidylcholine lipids (p <.05) compared with those with normal BMI. Additionally, overweight participants had a lower abundance of the Oscillibacter genus (p <.05). The impact of PA duration on the gut microbiome was BMI dependent. In normal but not overweight participants, high PA duration showed greater relative abundance of commensal taxa such as Actinobacteria and Proteobacteria phyla, as well as Collinsella and Prevotella genera (p <.05). Furthermore, in males with normal BMI, a stronger grip strength was associated with a higher relative abundance of Faecalibacterium and F. prausnitzii (p <.05) compared with lower grip strength. Taken together, data suggest that BMI plays a significant role in modeling PA‐induced changes in gut microbiota. [ABSTRACT FROM AUTHOR]

Background: Previous studies have reported an association between sarcopenia and type 2 diabetes mellitus (T2DM), but causation was prone to confounding factors. A more robust research approach is urgently required to investigate the causal relationship between sarcopenia and T2DM. Methods: The bi-directional two-sample MR study was carried out in two stages: Sarcopenia-related traits were investigated as exposure while T2DM was investigated as an outcome in the first step, whereas the second step was reversed. The GWAS summary data for hand-grip strength (n = 256,523), appendicular lean mass (ALM, n = 450,243), and walking pace (n = 459,915) were obtained from the UK Biobank. T2DM data were obtained from one of the biggest case-control studies on diabetes (DIAGRAM; n = 180,834 cases and 492,191 controls), which was published in 2022. The inverse-variance weighted (IVW) approach was used to obtain MR estimates, and various sensitivity analysis was also performed. Results: Low hand-grip strength had a potential causal relationship with an increased incidence of T2DM (OR = 1.109; 95% CI, 1.008-1.222; p = 0.0350). T2DM risk was reduced by increasing ALM and walking pace: A 1 kg/m² increase in ALM decreased the risk of T2DM by 10.2% (OR = 0.898; 95% CI, 0.830-0.952; p < 0.001). A1 m/s increase in walking pace decreased the risk of T2DM by 90.0% (OR = 0.100; 95% CI, 0.053-0.186; p < 0.001). The relationship was bidirectional, with T2DM as a causative factor of sarcopenia-related traits (p < 0.05) except for ALM (β = 0.018; 95% CI, -0.008 to -0.044; p = 0.168). Conclusions: Hand-grip strength and T2DM had a potential bidirectional causal relationship, as did walking pace and T2DM. We suggest that sarcopenia and T2DM may mutually have a significant causal effect on each other. [ABSTRACT FROM AUTHOR]

• Impaired nutritional status frequently occurs in hepatocellular carcinoma. • Baseline hand-grip strength is associated with complication-free survival. • Deteriorated liver function 3 months post-treatment is associated with overall and complication-free survival. Impaired nutritional status is a risk factor for unfavorable outcome in cirrhosis. In this prospective cohort study in hepatocellular carcinoma patients referred for tumor-specific therapy, nutritional status was assessed before and 3 months post-treatment using 4 complementary tools: hand-grip strength (HGS), Liver Frailty Index (LFI), Patient-Generated Subjective Global Assessment (PG-SGA) and skeletal muscle index (L3-SMI). Uni- and multivariable analyses were performed using Kaplan Meier curves and Cox's regression analyses with correction for Barcelona Clinic Liver Cancer (BCLC) stage, alpha-fetoprotein and age. 56 patients were evaluated at baseline and 38 patients 3 months post-treatment. Baseline BCLC stage was 0 in 14%, A in 27%, B in 36%, C in 21%, and D in 2%. HGS, LFI, PG-SGA and L3-SMI were impaired in 13%, 95%, 21% and 71% respectively. Of all patients, 52% died after (median, range) 373 (32–962) days. Of the nutritional assessment tools, only HGS was independently associated with complication-free survival (HR 0.304, 95%CI 0.10–0.88: p = 0.028) and, approaching significance, with overall survival (HR 0.323, 95%CI 0.103–1.008: p = 0.052). Tumor-specific therapy was administered in 50 patients (20% radiofrequency / microwave ablation, 4% resection, 74% transarterial radio- or chemoembolization, 2% sorafenib). Three months post-treatment, complete response occurred in 44%, partial response in 20%, stable disease in 20% and progressive disease in 16%. Child-Pugh scores deteriorated and such deterioration was independently associated with reduced overall and complication-free survival. reduced baseline HGS and deteriorated post-treatment Child-Pugh score are associated with reduced overall and complication-free survival in HCC. [ABSTRACT FROM AUTHOR]

It is estimated that about 50% of geriatric rehabilitation patients suffer from sarcopenia. Thereby, malnutrition is frequently associated with sarcopenia, and dietary intake is the main modifiable risk factor. During hospitalization, older adults are recommended to consume more dietary protein than the current recommended dietary allowance of 0.8 g/kg body weight per day to optimize the recovery of muscular strength and physical function. This prospective pilot study examined the feasibility and preliminary efficacy of short-term protein supplementation with protein-enriched foods and drinks on the hand-grip strength, nutritional status, and physical function of older patients at risk of malnutrition during a three-week inpatient orthopedic rehabilitation stay. The Mini Nutritional Assessment (MNA) tool was used to assess malnutrition. Patients with an MNA score ≤ 23.5 points were randomly assigned to an intervention group (goal: to consume 1.2–1.5 g protein/kg body weight per day) or a control group (standard care). Both groups carried out the same rehabilitation program. Physical recovery parameters were determined at admission and discharge. A trend was recognized for participants in the intervention group to consume more protein than the control group (p = 0.058): 95.3 (SD 13.2) g/day as compared to 77.2 (SD 24.2) g/day, which corresponds to a mean protein intake of 1.6 (SD 0.3) g/kg/day vs. 1.3 (SD 0.5) g/kg/day. Dietary protein supplementation increased body weight by an average of 0.9 (SD 1.1) kg and fat mass by an average of 0.9 (SD 1.2) kg as compared to the baseline (p = 0.039 and p = 0.050, respectively). No significant change in hand-grip strength, body composition, or physical function was observed. In conclusion, short-term intervention with protein-enriched foods and drinks enabled older patients at risk of malnutrition to increase their protein intake to levels that are higher than their required intake. In these older individuals with appropriate protein intake, dietary protein supplementation did not result in a greater improvement in physical recovery outcomes during short-term inpatient rehabilitation. The intervention improved dietary protein intake, but further research (e.g., a full-scale, randomized, controlled trial with sufficient power) is required to determine the effects on physical function outcomes.

Objectives: The present study aimed to determine whether there is a relationship between carrying angle and some parameters such as the middle part of the deltoid muscle strength, hand grip muscle strength, lateral bridge times and push-up repeats for both genders. Methods: This study was carried out on 100 (48 male, 52 female) university students aged between 18-30 years. Individuals with known chronic systemic disease, congenital or acquired anomaly of the skeletal system and a body mass index of 30 and above were excluded. Only right-handed participants were included to eliminate the confusion of dominance. The participants' age, gender, height, body weight, and body mass index were recorded. The carrying angles were measured with a goniometer. The middle part of the deltoid muscle strength and hand grip strength measurements were used to evaluate muscle strength, and the lateral bridge test and push-up test were used for endurance. Results: A statistically significant difference was found between carrying angle values on the right and left sides in males (p=0.004), while there was no difference in the females (p=0.28). A statistically significant difference was found between the genders on the left carrying angle (p<0.001). A statistically significant difference was found in the total group and in both genders on middle part of the deltoid muscle strength and hand grip strength between the sides. In males, a significant positive correlation was found between carrying angle and the middle part of the deltoid muscle strength (r=0.29, p=0.04) on the right side. In females, a significant negative correlation was found between carrying angle and the hand grip test (r=-0.29, p=0.04) on the left side. There was no significant correlation between carrying angles and other parameters in both genders. Conclusion: Our results suggest that the carrying angle may be related to the middle part of the deltoid muscle strength in males on the right side and lateral bridge test in females on the right side, even though they are weak. [ABSTRACT FROM AUTHOR]

Hospitalized patients with respiratory failure due to SARS-CoV-2 pneumonia are at increased risk of malnutrition and related mortality. The predictive value of the Mini-Nutritional Assessment short form (MNA-sf®), hand-grip strength (HGS), and bioelectrical impedance analysis (BIA) was determined with respect to in-hospital mortality or endotracheal intubation. The study included 101 patients admitted to a sub-intensive care unit from November 2021 to April 2022. The discriminative capacity of MNA-sf, HGS, and body composition parameters (skeletal mass index and phase angle) was assessed computing the area under the receiver operating characteristic curves (AUC). Analyses were stratified by age groups (

Background: Exposure to air pollution is associated with several chronic diseases and subclinical processes that could subsequently contribute to physical disability. However, whether and to what extent air pollution exposure is associated with objective measures of physical functioning remains understudied.Methods: We used longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) and included 10 823 participants who were surveyed at least twice. Annual average exposure to fine particulate matter (PM2.5) was assessed using a state-of-the-art estimator. Physical functioning was assessed with 4 objective tests covering hand-grip strength, balance, repeated chair stands, and gait speed. Mixed-effects models with participants as a random term were used to estimate associations with multiple adjustments.Results: We found a significant and robust association between exposure to increased PM2.5 and the reduction in hand-grip strength and balance ability. Each 10 μg/m3 increase in annual averaged concentrations of PM2.5 was associated with a 220-g (95% confidence interval [CI]: 127, 312 g) reduction in hand-grip strength per 60 kg of body weight and a 5% risk (95% CI: 2, 7) of reduced balance ability. The estimated effect of each 10 μg/m3 increase in PM2.5 on hand-grip strength and balance ability was equivalent to the effect of aging (1.12 [95% CI: 0.76, 1.48] and 0.98 [95% CI: 0.50, 1.50] years, respectively).Conclusions: PM2.5 may be differentially associated with various dimensions of physical functioning. Improving air quality can prevent physical disability. [ABSTRACT FROM AUTHOR]

Background: To evaluate age- and sex-specific differences in the distribution of cardiometabolic diseases and associations of hand-grip strength (HGS) indices with type 2 diabetes (T2D). Methods: This cross-sectional observational study enrolled participants from the Korea National Health and Nutrition Examination Survey (n = 16,126, age ≥19 years). Information on cardiometabolic diseases was obtained through surveys or proper criteria applied for undiagnosed participants. Absolute and body size-adjusted HGS indices were evaluated. Clinical manifestations were compared, and associations of HGS indices with T2D were estimated by using odd ratio (OR). Results: Prevalence of T2D in all, younger, and older groups were 13.1%, 4.2%, and 21.4%, respectively. Proportions of cardiometabolic diseases were all higher in those with than without T2D in sex-stratified age groups, whereas obesity (OB) and nonalcoholic fatty liver disease (NAFLD) were higher in younger T2D, and hypertension (HTN) was higher in older T2D in both sexes. Adjusted HGS significantly correlated with cardiometabolic parameters, and thus, high ORs for T2D in low tertiles of adjusted HGS were shown in all groups, whereas high ORs for T2D in low tertiles of absolute HGS were observed only in older men. Conclusions: Among highly prevalent cardiometabolic diseases associated with T2D, OB and NAFLD were more prevalent in younger T2D, but HTN was more prevalent in older T2D in both sexes. Low adjusted HGS was associated with higher T2D risk in all groups, whereas low absolute HGS was associated with higher T2D risk in older men. Thus, adjusted HGS might be useful in screening especially younger or obese T2D. [ABSTRACT FROM AUTHOR]

Objective: Dynapenia involves decline in a range of functional abilities and phenotypes, many of which are associated with socioeconomic status (SES) and depressive symptoms. Reduced handgrip strength (HGS) predicts disability, morbidity and mortality but it is unclear if it is influenced by socioeconomic factors and depression. This study therefore, aimed to assess SES, depressive symptoms and HGS among older adults. Methods: A total of 33 community dwelling older adults aged 65 years and older were recruited in this cross-sectional study. Kuppuswamy socioeconomic scale, geriatric depression scale (GDS) and handheld dynamometer were used to assess socioeconomic status, depressive symptoms and handgrip strength respectively. Results: The mean HGS was 22.8 kg for men and 17.4 kg for women. In adjusted linear regression analysis among both men and women SES has a significant association with HGS and depressive symptoms in older adults. Depressive symptoms were negatively associated with grip strength while positively associated with SES. Conclusion: Our results suggest that lower HGS, using standardised age and gender is associated with depressive symptoms and SES. HGS can be a simple tool and guidelines for health workers and caregivers to identify and reduce clinical, functional, psychological, social and economic risk factors for disability. [ABSTRACT FROM AUTHOR]

Abstract Background The use of smartphones has become widely popular, especially among young people, for multiple purposes other than communication, including gaming and internet browsing. The hand and wrist weakness is one of the main complications associated with the increased use of smartphones. This weakness occurs due to the repetitive flexion and extension of the wrist, thumb, and fingers, leading to a significant musculoskeletal pathology. Little is known about the relationship between smartphone usage duration (using the phones ability to monitor screen time) and hand-grip, pinch-grip strength. Therefore, the study was aimed to investigate the association between smartphone usage duration and hand-grip, pinch-grip strength among young people. Methods One hundred young males volunteered to participate in the study. Participants were briefly examined for height and weight using a portable stadiometer and a digital scale. Hand-grip, pinch-grip strength measurement was performed using a hand-held dynamometer. Smartphones usage duration was obtained from the daily average screen time reported in the last seven days. Results Mean daily usage of smartphone among the participants was 7.8 ± 2.2. There was a weak significant inverse relationship between smartphone usage duration and hand-grip strength (r=-.22, p = .03) and pinch-grip strength (r=-.28, p = .004). Linear regression revealed that 18.8 % of the variance in hand-grip strength and 20.4 % of the variance in pinch-grip strength was explained by age, and smartphone usage duration, with the addition of BMI only to hand-grip strength (p’s

Background: Sarcopenia, loss of muscle mass and strength, has been associated with more frequent complications after esophagectomy. This study compared hand-grip strength, muscle mass, and intramuscular adipose tissue as predictors of postoperative outcomes and mortality after esophagectomy.Methods: Minimally invasive esophagectomy was performed on 175 patients with esophageal cancer. Skeletal muscle index and skeletal muscle density were derived from preoperative CTs. Hand-grip strength was measured using dynamometer. Univariate and multivariable analyses were performed.Results: Preoperative hand-grip strength was normal in 91 (52%), intermediate in 43 (25%), and weak in 41 (23%) patients. Hand-grip strength was significantly correlated with both skeletal muscle index and skeletal muscle density. Postoperative pneumonia occurred in 8/41 (20%) patients with weak strength compared to 4/91 (4%) with normal strength (p = 0.006; Cochran-Armitage Test). Prolonged postoperative ventilation occurred in 11/41 (27%) patients with weak strength compared to 11/91 (12%) with normal strength (p = 0.036). Median length of stay was 9 days in patients with weak strength compared to 7 days for those with normal strength (p = 0.005; Kruskal-Wallis Test). Discharge to non-home location occurred in 15/41 (37%) with weak strength compared to 8/91 (9%) with normal strength (p < 0.001). Postoperative mortality at 90 days was 4/41 (10%) with weak strength compared with no mortalities (0/91) in the normal strength group (p = 0.004). Mortality at 1 year was 18/39 (46%) in patients with weak strength compared to 6/81 (7%) with normal strength, among 158 patients with 1-year follow-up (p < 0.001).Conclusions: Preoperative hand-grip strength was found to be a powerful predictor of postoperative pneumonia, length of stay, discharge to non-home location, and mortality after esophagectomy. [ABSTRACT FROM AUTHOR]

Information regarding correlations between physical activity (PA) level with physical fitness (PF) and respiratory function (RF) amongst undergraduates is limited. We aimed to determine the difference in PA level, PF and RF between genders amongst undergraduates. In this cross-sectional study, we recruited 62 undergraduates, with mean age of 22.09 ± 1.13 years, from the Kuala Lumpur Campus, University Kebangsaan Malaysia. PA level was evaluated using the International Physical Activity Questionnaire (IPAQ) and expressed as metabolic equivalents (METs). PF was evaluated using a hand-grip strength test and a 6-minute walk distance (6MWD) test. RF, which included FEV1, FVC and FEV1/FVC, was measured using a spirometer. About 45.16 and 40.33 % of undergraduates had high to moderate levels of physical activity, respectively. Males had significantly higher scores of METs compared to females, with p < 0.01. Males had significantly higher hand-grip strength compared to females, with p < 0.001. Higher FEV1 and FVC were found in males in comparison to their counterparts, with p < 0.001. Females had significantly higher FEV1/FVC compared to males, with p < 0.01. There were significant correlations between PA level with left hand-grip strength (r = 0.364, p < 0.01), right hand-grip strength (r = 0.264, p < 0.05), FEV1 (r = 0.423, p < 0.01), and FVC (r = 0.452, p < 0.01). Our findings suggest that an increase in physical activity level may lead to an increase in physical fitness and respiratory function. Higher levels of physical activity should be promoted among healthy young adults for improved physical fitness and respiratory function during their study at universities. [ABSTRACT FROM AUTHOR]

Abstract Background Haemodialysis (HD) patients may suffer symptoms during dialysis and take time to recover post HD. We wished to determine whether patients with symptomatic intra-dialytic hypotension (IDH), requiring nursing interventions, or an asymptomatic fall in systolic blood pressure (SBP) reported more symptoms during dialysis. Methods Six hundred three HD patients completed self-reported intra-dialytic symptom questionnaires and recovery using a visual analogue scale, which were compared with their dialysis session records. Results Twenty-nine (4.8%) of patients suffered symptomatic IDH, and 187 (31.0%) had a fall in SBP of > 20 mmHg. Symptomatic patients had greater total symptom scores (30 (23–44) vs 23 (10–38), p < 0.05, versus asymptomatic patients, with increased low blood pressure, dizziness, cramps, palpitations and feeling cold reported (all p < 0.05). Patients with a SBP fall of > 20 mmHg had greater total scores compared with those with a SBP increase of > 10 mmHg (26 (13–38) vs 17 (7–34), p < 0.05), with more dizziness, cramps, backache, shortness of breath and headache reported (all p < 0.05). Although ultrafiltration rates were similar, HD weight loss was greater for patients with a SBP fall of > 20 mmHg (2.5 ± 1.1 vs 2.0 ± 1.3%, p < 0.05). Patients with highest symptoms scores (highest vs lowest quartile) had longer recovery times (40.3 vs 7.6% > 4 h), p < 0.001. Multivariable analysis showed that patients reporting more intradialytic symptoms had higher psychological distress thermometer scores (odds ratio (OR) 1.34 (95% confidence limits 1.26–1.44)), systolic blood pressure < 100 mmHg (OR 2.53 (1.04–6.1)), whereas symptom scores were lower for male gender (OR 0.34 (0.22–0.51)), and with increasing age (OR 0.99 (0.97–0.99)). Conclusion Patients with both symptomatic and asymptomatic IDH, self-reported more symptoms during dialysis, and those patients reporting more symptoms had longer recovery times. We found that younger, female patients, those with greater psychological distress, and lower systolic blood pressure self-reported more intra-dialytic symptoms. More attention is required to prevent falls in intra-dialytic blood pressure to improve the patient experience of HD and shorten post-dialysis recovery times.

Objective: While the association between depression and frailty in the elderly population has been investigated, the psychological factors that mediate such a relationship remain unknown. The identification of psychological factors in interventions for depression treatment in the elderly may assist in the treatment and care. We aimed to explore the mediating effects of anger, anxiety, and resilience on the link between frailty and depression symptoms in patients with late-life depression., Methods: A sample of 203 older adults completed questionnaires that assessed depression, anger, resilience, and anxiety. To measure frailty, participants were evaluated using a self-rated health questionnaire, weight-adjusted waist index related to sarcopenia, and weight-adjusted handgrip strength to evaluate weakness. A mediation model was tested, hypothesizing that anger, anxiety, and resilience would partially mediate the strength of the frailty-depression link in the elderly., Results: Only self-rated health showed a significant association with depressive symptoms in late-life depression. Our study demonstrated that frailty has both direct and indirect associations with depression, mediated by anger, resilience, and anxiety., Conclusion: Given that anger, resilience, and anxiety influence the link between self-rated health and depression, interventions that lead to increased resilience and decreased anger and anxiety may be promising to reduce depressive symptoms in older adults with depression.

Background: Rapid nutrition screening (NS) is vital for apt management in patients with alcoholic liver cirrhosis (ALC)., Aim: To identify a quick method of NS having high reliability and prognostic significance., Methods: NS of patients with ALC was assessed using mid-upper arm circumference (MUAC), handgrip strength (HGS), fat-free mass index (FFMI), and the Royal Free Hospital-Global Assessment (RFH-GA). Baseline clinical and biochemical information were recorded along with 90-day survival data. The classification and regression tree method was used to classify HGS, MUAC, and FFMI values as well nourished (WN), moderately malnourished (MM), and severely malnourished (SM), and their concordance with RFH-GA categories was assessed using Kendall tau-b coefficient. The prognostic proficiency of each method was tested by Cox regression analysis., Results: According to the RFH-GA, of 140 male patients with ALC, 13 of 140 (9.3%) were WN, 93 of 140 (66.4%) were MM, and 34 of 140 (26.8%) were SM. HGS has the strongest association with the RFH-GA (Kendall tau-b = 0.772; diagnostic accuracy -81.4%). HGS was found to be the independent predictor of 90-day mortality (26 of 140 [18.6%]; hazard ratio, 0.93; 95% CI, 0.88-0.98; P = 0.002) after adjusting for age, body mass index, and disease severity. The hazard of mortality was 8.5-times higher in patients with ALC with HGS < 22 kg as compared with those with HGS > 29., Conclusion: HGS is a reliable tool for rapid NS. HGS < 22 kg suggests a high risk for severe malnutrition and is strongly associated with short-term mortality in male patients with ALC., (© 2022 American Society for Parenteral and Enteral Nutrition.)

The purpose of this study was to investigate bilateral deficit patterns during maximal hand-grip force production in late postmenopausal women. Twenty late postmenopausal and 20 young premenopausal women performed maximal isometric grip force production tasks with dominant and nondominant hands and both hands, respectively. For late postmenopausal women, pulse wave analysis was used for identifying a potential relationship between maximal hand-grip strength and risk factors of cardiovascular disease. The findings showed that late postmenopausal women produced significantly decreased maximal hand-grip strength in dominant and nondominant and bilateral hand conditions compared to those of premenopausal women. Bilateral deficit patterns appeared in late postmenopausal women. For late postmenopausal women, decreased dominant and bilateral hand-grip forces were significantly related to greater bilateral deficit patterns. Further, less maximal hand-grip strength in unilateral and bilateral hand conditions correlated with greater central pulse pressure. These findings suggested that age-related impairments in muscle strength and estrogen deficiency may interfere with conducting successful activities of bilateral movements. Further, assessing maximal dominant hand-grip strength may predict bilateral deficit patterns and risk of cardiovascular disease in late postmenopausal women. [ABSTRACT FROM AUTHOR]

Official tests are used to assess the fitness status of soccer referees, and their results correlate with match performance. However, FIFA-approved tests expose the referees to high physical demands and are difficult to implement during the sportive year. The aim of our study was to evaluate the correlation between the 6 - 40-m sprint and Yo-Yo Intermittent Recovery Level 1 (IR1) official tests and other field-based tests that require no or little equipment, are not time-consuming, and impose low physical demands. All tests were performed by male referees from the Regional Section of the Italian Referee Association (n = 30). We observed a strong correlation between 6 - 40-m sprint and Illinois agility tests (r = 0.63, p = 0.001) and a moderate correlation between Yo-Yo IR1 and hand-grip strength in the dominant (r = 0.45, p = 0.014) and non-dominant hand (r = 0.41, p = 0.031). Interestingly, only a moderate correlation (r = 􀀀0.42, p = 0.025) was observed between the FIFA official tests, 6 - 40-m sprint and Yo-Yo IR1. These results suggest that Illinois agility and hand-grip tests could represent simple and low-physical-impact tools for repeated assessment and monitoring of referee fitness throughout the sportive season. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a critical finding in patients with chronic heart failure (CHF). However, the search for a definitive biomarker to predict muscle and functional decline in CHF remains elusive. Objectives: We aimed to correlate the circulating levels of selected miRs with the indexes of sarcopenia during healthy aging and in patients with CHF. Methods: We analyzed the association of circulating microRNAs (miRs) levels including miR-21, miR-434-3p, miR424-5p, miR-133a, miR-455-3p and miR-181a with sarcopenia indexes in male, 61–73 years old healthy controls and patients with CHF (N = 89–92/group). Results: Patients with CHF had lower hand-grip strength (HGS), appendicular skeletal mass index (ASMI) and physical capacity than healthy controls. Circulating miR-21 levels were higher and miR-181a, miR-133a, miR-434-3p and miR-455-3p levels were lower in patients with CHF than healthy controls. Among the sarcopenia indexes, HGS showed the strongest correlation with miR-133a while ASMI showed the strongest correlations with miR-133a, miR-434-3p and miR-455-3p. Among the miRs, miR-434-3p showed the highest area under the curve in testing for sensitivity and specificity for CHF. These changes were associated with higher expressions of the markers of inflammation, oxidative stress and muscle damage in CHF patients. Conclusion: Taken together, our data show that circulating miRs can be useful markers of muscle health and physical capacity in the sarcopenic elderly with CHF.

Background: The use of smartphones has become widely popular, especially among young people, for multiple purposes other than communication, including gaming and internet browsing. The hand and wrist weakness is one of the main complications associated with the increased use of smartphones. This weakness occurs due to the repetitive flexion and extension of the wrist, thumb, and fingers, leading to a significant musculoskeletal pathology. Little is known about the relationship between smartphone usage duration (using the phones ability to monitor screen time) and hand-grip, pinch-grip strength. Therefore, the study was aimed to investigate the association between smartphone usage duration and hand-grip, pinch-grip strength among young people.Methods: One hundred young males volunteered to participate in the study. Participants were briefly examined for height and weight using a portable stadiometer and a digital scale. Hand-grip, pinch-grip strength measurement was performed using a hand-held dynamometer. Smartphones usage duration was obtained from the daily average screen time reported in the last seven days.Results: Mean daily usage of smartphone among the participants was 7.8 ± 2.2. There was a weak significant inverse relationship between smartphone usage duration and hand-grip strength (r=-.22, p = .03) and pinch-grip strength (r=-.28, p = .004). Linear regression revealed that 18.8 % of the variance in hand-grip strength and 20.4 % of the variance in pinch-grip strength was explained by age, and smartphone usage duration, with the addition of BMI only to hand-grip strength (p's < 0.00).Conclusions: Prolonged use of smartphones was related to weaker hand-grip and pinch-grip. Despite the weak relationship, the study showed that smartphone usage duration might contribute as a factor along with age to hand muscles' strength. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a critical finding in patients with chronic heart failure (CHF). However, the search for a definitive biomarker to predict muscle and functional decline in CHF remains elusive. Objectives: We aimed to correlate the circulating levels of selected miRs with the indexes of sarcopenia during healthy aging and in patients with CHF. Methods: We analyzed the association of circulating microRNAs (miRs) levels including miR-21, miR-434-3p, miR424-5p, miR-133a, miR-455-3p and miR-181a with sarcopenia indexes in male, 61-73 years old healthy controls and patients with CHF (N = 89-92/group). Results: Patients with CHF had lower hand-grip strength (HGS), appendicular skeletal mass index (ASMI) and physical capacity than healthy controls. Circulating miR-21 levels were higher and miR-181a, miR-133a, miR-434-3p and miR-455-3p levels were lower in patients with CHF than healthy controls. Among the sarcopenia indexes, HGS showed the strongest correlation with miR-133a while ASMI showed the strongest correlations with miR-133a, miR-434-3p and miR-455-3p. Among the miRs, miR-434-3p showed the highest area under the curve in testing for sensitivity and specificity for CHF. These changes were associated with higher expressions of the markers of inflammation, oxidative stress and muscle damage in CHF patients. Conclusion: Taken together, our data show that circulating miRs can be useful markers of muscle health and physical capacity in the sarcopenic elderly with CHF. [ABSTRACT FROM AUTHOR]

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Background and Aims: The cachexia index (CXI) is a novel biomarker for estimating cancer cachexia. The cachexia index based on hand-grip strength (H-CXI) has been recently developed as a simple proxy for CXI. The present study aims to compare both the H-CXI and CXI for the prediction of cancer cachexia and postoperative outcomes in patients who underwent radical colectomy for colorectal cancer., Methods: Patients who underwent radical operations for colorectal cancer were included in this study. Cancer cachexia was diagnosed according to the international consensus outlined by Fearon et al. The cachexia index (CXI) was calculated as [skeletal muscle index (SMI) × serum albumin/neutrophil-to-lymphocyte ratio (NLR)]. The H-CXI was calculated as [hand-grip strength (HGS)/height 2  × serum albumin/NLR]. The SMI was measured based on the preoperative CT images at the third lumbar vertebra (L3) level. HGS was measured before surgery., Results: From July 2014 to May 2021, a total of 1,411 patients were included in the present study, of whom 361 (25.6%) were identified as having cancer cachexia. Patients with cachexia had a lower CXI ( p  < 0.001) and lower H-CXI ( p  < 0.001) than those without cachexia. A low CXI but not low H-CXI independently predicted cancer cachexia in the multivariate analysis (OR 1.448, p  = 0.024). Both a low CXI (HR 1.476, p  < 0.001 for OS; HR 1.611, p  < 0.001 for DFS) and low H-CXI (HR 1.369, p  = 0.007 for OS; HR 1.642, p  < 0.001 for DFS) were independent predictors for overall survival (OS) and disease-free survival (DFS) after adjusting for the same covariates. A low H-CXI but not low CXI was an independent risk factor for postoperative complications (OR 1.337, p  = 0.044). No significant association was found between cancer cachexia and postoperative complications., Conclusion: The CXI and H-CXI exhibited better prognostic value than cancer cachexia for the prediction of postoperative outcomes in patients who underwent radical colectomy for colorectal cancer. The H-CXI was a superior index over the CXI in predicting short-term clinical outcomes, whereas the CXI demonstrated a closer correlation with Fearon's criteria for cancer cachexia. Ideal tools for the assessment of cancer cachexia should incorporate not only weight loss but also muscle mass, physical function, and inflammatory state., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yan, Wu, Tang, Li, Zhang, Jiang, Chen, Chen, Li, Shen and Huang.)

Purpose: This study investigated the frequency and characteristics of sarcopenia among patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with a specific focus on the chronic graft-versus-host disease (cGVHD) population and its association with malnutrition, vitamin D and clinical characteristics. Methods: We assessed sarcopenia, vitamin D levels, and nutritional status in 73 patients who underwent allo-HSCT, of which 45 were diagnosed with cGVHD. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Results: Sarcopenia was diagnosed in 19.2% of patients after allo-HSCT with statistically no significant difference between cGVHD and non-cGVHD patients. The risk factor for sarcopenia was the male gender. Sarcopenia in allo-HSCT patients correlated strongly with malnutrition and with current corticosteroid treatment (p < 0.005). Among cGVHD patients sarcopenia additionally correlated strongly with the number of prior systemic immunosuppressive therapy lines (p < 0.005) and moderately with the intensity of immunosuppression, cGVHD severity global rating assessed by both the health care provider and the patient and joint and fascia cGVHD involvement (p < 0.05). Vitamin D deficiency was found in more than 54.8% of patients, but the correlation to sarcopenia was not found. Conclusion: Sarcopenia was found to be common in long term survivors of allo-HSCT independently of the cGVHD diagnosis. Prospective longitudinal studies are needed for a better understanding of factors affecting the development of sarcopenia after allo-HSCT. [ABSTRACT FROM AUTHOR]

The standard approach for comparing the potential challenges of population aging across countries based on conventional old-age dependency ratios (OADR) does not account for cross-population differences in health, functional capacity or disability, despite their importance for labor force participation and dependency more broadly. We investigate how OADRs observed across selected low-, middle-, and high-income countries change if population differences in physical health measured by hand-grip strength are accounted for. Specifically, we propose and calculate an adjusted measure of the OADR based on hand-grip strength, which serves as an objective indicator of muscle function and has been shown to predict future morbidity, disability and mortality. We show that adjusting the OADR for differences in hand-grip strength results in substantial changes in country rankings by OADR compared to a ranking based on the conventional OADR definition. Accounting for cross-population differences in hand-grip strength, the estimated OADRs for low- and middle-income countries tend to increase compared to the conventional OADR approach based on age only, whereas the estimated OADRs in high-income countries decline substantially relative to the standard approach. Since hand-grip strength is an important prerequisite for maintaining functional capacity and productivity and preventing disability –especially in economies in low-income settings– our grip-strength-adjusted OADRs clearly show that population aging is not just a challenge in high-income countries but also an important concern for economies in the developing world.

Lydia Lera, Cecilia Albala, Bárbara Leyton, Carlos Márquez, Bárbara Angel, Rodrigo Saguez, Hugo Sánchez Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile Aim: This study was aimed to set reference values of hand-grip strength by age and sex and validate cut points for risk of functional limitation and mortality in older Chileans.Methods: This was a pooled analysis of four studies including 6,426 people ≥60 years of nondependent community-dwelling Chileans. After exclusion criteria, the final sample included 5,250 subjects, from whom 2,193 were followed to study all-cause mortality associated with low hand-grip strength. Face-to-face interviews registering sociodemographic characteristics, self-reported chronic diseases, and functional limitations were conducted. Anthropometric measurements and observed mobility were performed by trained professionals. Hand-grip strength was measured with a hand dynamometer T-18 (Country Technology, Inc.) before 2008 or with JAMAR brand from 2008 onwards. Percentiles were calculated through descriptive analysis and quantile regression models for specific groups of age and sex. Adjusted Cox regression hazard models for mortality risk according to low dynamometry condition and covariates were developed.Results: We deliver reference values of hand-grip strength for older Chileans proposing the 25th percentile as the cut-off point for low dynamometry risk: men ≤27 kg, women ≤15 kg. Low hand-grip strength was associated with Instrumental Activities of Daily Living limitations (p=0.001), and altered physical performance evaluated through the Timed Up and Go test (p=0.0001), grasping (p=0.001), bending (p

Introduction: Strength level is a good predictor of health outcomes such as mortality or future disability. During an usual individual life span, strength and neuromuscular function are decreased, due to a reduction the muscle mass and the fiber type switch that manifests at the age of 50-60 years old. Physical activity can prevent, or at least reduce these changes. The fact that the physical activity level is also reduced by age, makes it difficult to distinguish between the effects of aging and those of a sedentary lifestyle. Therefore, this work attempts to study the differences in hand-grip strength, jump height and rate of force development as strength predictors, between physically active elderly and young adults. Material & Methods: 16 healthy and physically active adults formed 2 groups: experimental group (8 old adults, mean age 72.24 years old, SD 4.82) and control group (8 young adults, mean age 24.94 years old, SD 1.67). They all performed hand-grip strength, jump height and rate of force development tests. Statistical analysis were performed by using JASPS software. Results: Significant differences were found in hand-grip strength (t = 2.133, p = 0.07) and jump height (t = 9.949, p = 0.001), whereas no significant difference was obtained in rate of force development (t = -0.300, p = 0.773). Conclusions: There is a life-long reduction in whole body strength capabilities in active adults. Nevertheless, the importance of physical activity for keeping strength capabilities with increased age was evident. Furthermore, both hand-grip strength and jump height can be considered as reliable predictors of whole-body strength levels, whereas RFD should be taken with caution, due to its specifity. [ABSTRACT FROM AUTHOR]

Background: Cirrhosis is the end‐stage of progressive fibrosis, in which oxidative stress and inflammation‐related pathways can modulate the cellular and tissue events involved in the pathogenesis of liver fibrosis. Dietary intake of antioxidants has been suggested to protect against oxidative damage and related clinical complications. The present study aimed to investigate the potential association of the dietary total antioxidant capacity (dTAC) with anthropometric, functional and biochemical markers, as well as the severity of the disease, in cirrhotic outpatients. Methods: Sixty‐two outpatients (38 men and 24 women) with a mean (SD) age of 59.1 (9.9) years were evaluated. Dietary TAC was estimated from a food frequency questionnaire. Aetiology and severity of liver cirrhosis, lifestyle characteristics, occurrence of comorbidities and oedema, and anthropometric, functional and biochemical markers were all assessed. Results: Cirrhotic outpatients with higher dTAC also had higher values of the hand‐grip strength (P = 0.029) and arm muscle area (P = 0.027). After adjusting by sex, age, smoking and alcohol intake, the addition of 1 mmol day−1 of dTAC contributed to increase 0.552 kg f−1 in hand‐grip strength (P < 0.05). The addition of one mmol day−1 of dTAC contributed to an arm muscle area increase 0.565 cm2 (P < 0.05) on average. Conclusions: The dTAC was positively associated with hand‐grip strength and arm muscle area in cirrhotic outpatients. The implications of the present study are important in clinical practice because a diet rich in antioxidants may be an ally in the control of excessive reactive oxygen species production in cirrhotic outpatients with repercussion on muscle mass and strength. [ABSTRACT FROM AUTHOR]

Background: Air pollution has been associated with various health outcomes. Its effect on hand-grip strength, a measurement of the construct of muscle strength and health status, remains largely unknown.Methods: We used the survey data from 31,209 adults ≥ 50 years of age within Wave 1 of the Study on Global AGEing and Adult Health in six low- and middle-income countries. The outdoor concentration of fine particulate matter pollution (PM2.5) was estimated using satellite data. Domestic fuel type and ventilation were used as indicators of indoor air pollution. We used multilevel linear regression models to examine the association between indoor and outdoor air pollution and hand-grip strength, as well as the potential effect modifiers.Results: We found inverse associations between both indoor and outdoor air pollution and hand-grip strength. Each 10 μg/m3 increase in 3 years' averaged concentrations of outdoor PM2.5 corresponded to 0.70 kg (95% CI: -1.26, -0.14) lower hand-grip strength; and compared with electricity/liquid/gas fuel users, those using solid fuels had lower hand-grip strength (β = -1.25, 95% CI: -1.74, -0.75). However, we did not observe a statistically significant association between ventilation and hand-grip strength. We further observed that urban residents and those having a higher education level had a higher association between ambient PM2.5 and hand-grip strength, and men, young participants, smokers, rural participants, and those with lower household income had higher associations between indoor air pollution and hand-grip strength.Conclusion: This study suggests that both indoor and outdoor air pollution might be important risk factors of poorer health and functional status as indicated by hand-grip strength. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between hand-grip strength and site-specific risks of major osteoporotic fracture.Study Design: Prospective cohort study.Main Outcome: Associations between low hand-grip strength and increased risk of fracture at the distal forearm, vertebrae, and hip.Measures: We enrolled 1342 postmenopausal women aged 50 years or more into baseline and follow-up surveys of the Japanese Population-based Osteoporosis Cohort Study in 1996, 1999, 2002, or 2006. Fracture events were ascertained by follow-up surveys until 2011 or 2012. The Cox proportional hazards model was used to estimate hazard ratios (HRs) of hand-grip strength on fracture event.Results: During a median follow-up of 15.2 years, 162 women sustained at least one osteoporotic fracture and 135 of these women sustained at least one major osteoporotic fracture, the larger group including 65, 38, 35, and 8 women with fractures of the distal forearm, vertebrae, hip, and proximal humerus, respectively. In the crude models, the associations between low hand-grip strength and increased risk of fracture at the distal forearm, vertebrae, and hip were significant; the HRs (95% confidence interval) of the lowest tertile of hand-grip strength were 2.02 (1.10-3.71), 11.35 (4.07-31.63), and 4.72 (1.79-12.47), respectively. Age adjustment attenuated the significance of hip fracture risk, and adjusting for bone mineral density attenuated the significance of distal forearm fracture risk. After additional adjustment for body mass index, history of diabetes mellitus, and calcium intake, the HR for vertebral fracture risk was 4.55 (1.56-13.27). When limiting the follow-up period to 5 and 10 years, low hand-grip strength was associated with an increased risk of distal forearm fracture independently of the aforementioned covariates; the HRs were 4.22 (1.12-15.95) and 2.52 (1.03-6.17), respectively.Conclusions: Low hand-grip strength is specifically associated with the risk of distal forearm fractures within 10 years and clinical vertebral fractures within 15 years or more in Japanese postmenopausal women. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate bilateral deficit patterns during maximal hand-grip force production in late postmenopausal women. Twenty late postmenopausal and 20 young premenopausal women performed maximal isometric grip force production tasks with dominant and nondominant hands and both hands, respectively. For late postmenopausal women, pulse wave analysis was used for identifying a potential relationship between maximal hand-grip strength and risk factors of cardiovascular disease. The findings showed that late postmenopausal women produced significantly decreased maximal hand-grip strength in dominant and nondominant and bilateral hand conditions compared to those of premenopausal women. Bilateral deficit patterns appeared in late postmenopausal women. For late postmenopausal women, decreased dominant and bilateral hand-grip forces were significantly related to greater bilateral deficit patterns. Further, less maximal hand-grip strength in unilateral and bilateral hand conditions correlated with greater central pulse pressure. These findings suggested that age-related impairments in muscle strength and estrogen deficiency may interfere with conducting successful activities of bilateral movements. Further, assessing maximal dominant hand-grip strength may predict bilateral deficit patterns and risk of cardiovascular disease in late postmenopausal women.

Official tests are used to assess the fitness status of soccer referees, and their results correlate with match performance. However, FIFA-approved tests expose the referees to high physical demands and are difficult to implement during the sportive year. The aim of our study was to evaluate the correlation between the 6 × 40-m sprint and Yo-Yo Intermittent Recovery Level 1 (IR1) official tests and other field-based tests that require no or little equipment, are not time-consuming, and impose low physical demands. All tests were performed by male referees from the Regional Section of the Italian Referee Association (n = 30). We observed a strong correlation between 6 × 40-m sprint and Illinois agility tests (r = 0.63, p = 0.001) and a moderate correlation between Yo-Yo IR1 and hand-grip strength in the dominant (r = 0.45, p = 0.014) and non-dominant hand (r = 0.41, p = 0.031). Interestingly, only a moderate correlation (r = −0.42, p = 0.025) was observed between the FIFA official tests, 6 × 40-m sprint and Yo-Yo IR1. These results suggest that Illinois agility and hand-grip tests could represent simple and low-physical-impact tools for repeated assessment and monitoring of referee fitness throughout the sportive season.

Abstract Background Elderly patient with advanced cancer is one of the most vulnerable populations. Skeletal muscle depletion during chemotherapy may have substantial impact on their physical function. However, there is little information about a direct relationship between quantity of muscle and physical function. We sought to explore the quantitative association between skeletal muscle depletion, and muscle strength and walking capacity in elderly patients with advanced non–small cell lung cancer (NSCLC). Methods Thirty patients aged ≥70 years with advanced NSCLC (stage III-IV) scheduled to initiate first-line chemotherapy were prospectively enrolled between January 2013 and November 2014. Lumbar skeletal muscle index (LSMI, cm2/m2), incremental shuttle walking distance (ISWD, m), and hand-grip strength (HGS, kg) were assessed at baseline, and 6 ± 2 weeks (T2) and 12 ± 4 weeks (T3) after study enrollment. Associations were analyzed using linear regression. Results Altogether, 11 women and 19 men with a median age of 74 (range, 70–82) years were included in the study; 24 received cytotoxic chemotherapy and 6, gefitinib. Mean ± standard deviation of LSMI, ISWD and HGS were 41.2 ± 7.8 cm2/m2, 326.0 ± 127.9 m, and 29.3 ± 8.5 kg, respectively. LSMI and ISWD significantly declined from baseline to T2 and T3. HGS significantly declined from baseline to T2 and T3 only in men. Change in LSMI was significantly associated with change in HGS (β = 0.3 ± 0.1, p = 0.0127) and ISWD (β = 8.8 ± 2.4, p = 0.0005). Conclusions Skeletal muscle depletion accompanied with physical functional decline started in the early phase of the chemotherapy in elderly patients with advanced NSCLC. Our results suggest that there may be a need for early supportive care in these patients to prevent functional decline during chemotherapy. Trial registration Trial registration number: UMIN000009768 Name of registry: UMIN (University hospital Medical Information Network). URL of registry: Date of registration: 14 January 2013. Date of enrolment of the first participant to the trial: 23 January 2013.

Muscle strengthening activity and high muscle strength were reported to protect against the development of type 2 diabetes in middle age. On the other hand, the reported prevalence of type 2 diabetes is higher in former top-level power sports athletes compared to healthy non-athlete men. High muscle strength may be a risk factor for type 2 diabetes. However, it is not clear whether high muscle strength can predict the future development of type 2 diabetes. This study examined the relationship between muscle strength at a young age and the future development of type 2 diabetes in former Japanese college athletes by a historical cohort study. Subjects were male alumni who graduated from the Physical Education School of Juntendo University. Hand-grip strength at college age (1971-1991) and type 2 diabetes history, as determined by follow-up questionnaires (2007-2009, and 2011), were collected. Relationships between hand-grip strength and new cases of type 2 diabetes were analyzed by Cox proportional hazards models and adjusted for relative risks. Data of hand-grip strength and medical history of 617 subjects were collected. The median follow-up period was 27 years, and 29 men developed type 2 diabetes. There was no relationship between incidence of type 2 diabetes and muscle strength level after adjustment for potential risk factors. The adjusted hazard ratios (HRs) and 95% confidence intervals of the low, medium, and high muscle strength categories were 1.00 (reference), 1.12 (0.46-2.70) and 0.70 (0.25-1.92), respectively. We concluded that muscle strength at a young age does not predict the future development of type 2 diabetes in Japanese male athletes.

Objectives As people get older, their body systems become disrupted. As the elderly lose their abilities, they become more dependent on others. This study aimed to investigate the relationship between visual, hearing, and memory disabilities as well as hand grip strength and the systems usability available to the elderly living in nursing homes in Kerman, Iran. Methods & Materials This cross-sectional study was conducted on 110 elderly participants (58 men and 52 women) living in nursing homes in Kerman. To investigate hearing, memory, and visual disabilities, the audiometry method, standard memory assessment questionnaire and E chart were utilized, respectively. Jamar Dynamometer was used to measure hand grip strengths. The systems usability (television, radio, and refrigerator) was measured via System Usability Scale (SUS) and analyzed by statistical tests with 0.05 level of significance. Results The average age of the participants was 75.35 years. Hearing and visual disabilities were significantly different in left ears and eyes. There was no significant difference between men and women regarding their memory disability. However, hand grip strengths were significantly different in men and women (P=0.0001). The highest usability for both men and women groups was in using the refrigerator and the lowest in using television. The mentioned disabilities and hand grip strength of the elderly had a significant relationship with the ability to use television, refrigerator, and radio. Conclusion With increasing age, the disabilities of the elderly get intensified and their ability to use systems decrease. Thus, it is necessary to prevent their loss of abilities in order to enhance their systems usability.

Aims The purpose of this study was to describe the health hazards among child labourers in brickfields, and to assess occupational health problems, together with physiological and respiratory stress, compared with child control subjects. Methods A cross-sectional study was conducted on 112 child brickfield workers and 120 control subjects, and a modified Nordic Questionnaire was applied to assess the discomfort felt among both groups of workers. Physiological assessment of the workload was carried out by the measurement of heart rate, blood pressure and spirometry of the workers. Results Child brickfield workers suffer from pain, especially in the lower back (97%), shoulder (88%), hands (82%), wrist (76%), neck (73%) and ankle (71%). The post-activity heart rate of the child brickfield workers was 166.5 beats/min, whereas the systolic and diastolic blood pressures were 132.2 and 67.2 mm/Hg, respectively. The forced vital capacity value of child brickfield workers was 2.04, and in the case of the controls it was 2.18, which was significantly different. The forced expiratory volumes in 1 s of experimental and control subjects were 1.82 and 1.92, respectively. The peak expiratory flow rate was significantly different between the two groups. Conclusions Most of the brick-making activities were strenuous ones that affected the children. The cardiovascular and respiratory health of the child brickfield workers has changed markedly due to strenuous activity. The child brickfield workers also experienced other occupational health problems and severe musculoskeletal pain. [ABSTRACT FROM AUTHOR]