Loss of Muscle Strength, Mass (Sarcopenia), and Quality (Specific Force) and Its Relationship with Functional Limitation and Physical Disability: The Concord Health and Ageing in Men Project
Noran N. Hairi MPH
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorRobert G. Cumming PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorVasi Naganathan PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorDavid J. Handelsman PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorDavid G. Le Couteur PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorHelen Creasey MBBS
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorLouise M. Waite PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorMarkus J. Seibel MD, PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorPhilip N. Sambrook PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorNoran N. Hairi MPH
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorRobert G. Cumming PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorVasi Naganathan PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorDavid J. Handelsman PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorDavid G. Le Couteur PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorHelen Creasey MBBS
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorLouise M. Waite PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorMarkus J. Seibel MD, PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorPhilip N. Sambrook PhD
From the * Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; † School of Public Health; § Centre for Education and Research on Ageing and ∥ ANZAC Research Institute, Concord Repatriation General Hospital; and # Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia; and ‡ Julius Center University of Malaya, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Search for more papers by this authorAbstract
OBJECTIVES: To determine the association between loss of muscle strength, mass, and quality and functional limitation and physical disability in older men.
DESIGN: Cross-sectional study of older men participating in the Concord Health and Ageing in Men Project (CHAMP).
SETTING: Elderly men living in a defined geographical region in Sydney, Australia.
PARTICIPANTS: One thousand seven hundred five community-dwelling men aged 70 and older who participated in the baseline assessments of CHAMP.
MEASUREMENTS: Upper and lower extremity strength were measured using dynamometers for grip and quadriceps strength. Appendicular skeletal lean mass was assessed using dual X-ray absorptiometry. Muscle quality was defined as the ratio of strength to mass in upper and lower extremities. For each parameter, subjects in the lowest 20% of the distribution were defined as below normal. Functional limitation was assessed according to self-report and objective lower extremity performance measures. Physical disability was measured according to self-report questionnaire.
RESULTS: After adjusting for important confounders, the prevalence ratio (PR) for poor quadriceps strength and self-reported functional limitation was 1.91 (95% confidence interval (CI)=1.10–2.40); for performance-based functional limitation the PR was 1.81 (95% CI=1.45–2.24). The adjusted PR for poor grip strength and physical disability in instrumental activities of daily living (IADLs) was 1.37 (95% CI=1.20–1.56). The adjusted PR for low skeletal lean mass (adjusted for fat mass) and physical disability in basic activities of daily living was 2.08 (95% CI=1.37–3.15). For muscle quality, the PR for lower extremity specific force and functional limitation and physical disability was stronger than upper extremity specific force.
CONCLUSION: Muscle strength is the single best measure of age-related muscle change and is associated with physical disability in IADLs and functional limitation.
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