Background The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants – Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) – with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults. Methods This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance. Results Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST, r = 0.290; 5TSTS, r = − 0.242; both p< 0.01), and stronger correlations with gait speed (30CST, r = 0.517; 5TSTS, r = − 0.533; both p< 0.01), endurance (30CST, r = 0.558; 5TSTS, r = − 0.531; both p < 0.01) and dynamic balance (30CST, r = − 0.501; 5TSTS, r = 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%; p = 0.276). When both measures are used, prevalence is significantly higher (42.0%; p = 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%; p< 0.05). Conclusion In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.

Introduction: Frailty begins in middle life and manifests as a decline in functional fitness. We described a model for community frailty screening and factors associated with prefrailty and frailty and fitness measures to distinguish prefrail/frail from robust older adults. We also compared the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (FRAIL) scale against Fried frailty phenotype and Frailty Index (FI). Materials and Methods: Community-dwelling adults >55 years old were designated robust, prefrail or frail using FRAIL. The multidomain geriatric screen included social profiling and cognitive, psychological and nutritional assessments. Physical fitness assessments included flexibility, grip strength, upper limb dexterity, lower body strength and power, tandem and dynamic balance and cardiorespiratory endurance. Results: In 135 subjects, 99 (73.3%) were robust, 34 (25.2%) were prefrail and 2 (1.5%) were frail. After adjusting for age and sex, depression (odds ratio [OR], 2.90; 95% confidence interval [CI], 1.05-7.90; P = 0.040) and malnutrition (OR, 6.07; 95% CI, 2.52-14.64; P<0.001) were independently associated with prefrailty/frailty. Prefrail/frail participants had significantly poorer performance in upper limb dexterity (P = 0.030), lower limb power (P = 0.003), tandem and dynamic balance (P = 0.031) and endurance (P = 0.006). Except for balance and flexibility, all fitness measures differentiated prefrail/frail from robust women. In men, only lower body strength was significantly associated with frailty. Area under receiver operating characteristic curves for FRAIL against FI and Fried were 0.808 (0.688-0.927, P <0.001) and 0.645 (0.546-0.744, P = 0.005), respectively. Conclusion: Mood and nutrition are targets in frailty prevention. Physical fitness declines early in frailty and manifests differentially in both genders. Key words: Elderly, Frail, Function

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Background Intrinsic capacity (IC) and frailty are complementary in advancing disability prevention through maintaining functionality. Objectives We examined the relationship between IC and frailty status at baseline and 1-year, and evaluated if IC decline predicts frailty onset among robust older adults. The secondary objectives investigated associations between IC, physical fitness and health-related outcomes. Design Prospective cohort study. Setting Community-based assessments. Participants Older adults aged>55 years, who were independent in ambulation (walking aids permitted). Measurements 5 domains of IC were assessed at baseline: locomotion (Short Physical Performance Battery, 6-minute walk test), vitality (nutritional status, muscle mass), sensory (self-reported hearing and vision), cognition (self-reported memory, age- and education adjusted cognitive performance), psychological (Geriatric Depression Scale-15, self-reported anxiety/depression). Composite IC (0–10) was calculated, with higher scores representing greater IC. Frailty status was based on modified Fried criteria, with frailty progression defined as incremental Fried score at 1-year. Results 809 participants (67.6+6.8 years) had complete data for all 5 IC domains. 489 (60.4%) participants were robust but only 213 (26.3%) had no decline in any IC domain. Pre-frail and frail participants were more likely to exhibit decline in all 5 IC domains (p<0.05), with decremental composite IC [9 (8–9), 8 (6–9), 5.5 (4–7.5), p<0.001] across robust, prefrail and frail. IC was significantly associated with fitness performance, independent of age and gender. Higher composite IC reduced risk for frailty progression (OR=0.62, 95% CI 0.48–0.80), and reduced frailty onset among robust older adults (OR=0.53, 95% CI 0.37–0.77), independent of age, comorbidities and social vulnerability. Participants with higher IC were less likely to experience health deterioration (OR=0.70, 95% CI 0.58–0.83), falls (OR=0.76, 95% CI 0.65–0.90) and functional decline (OR=0.64, 95% CI 0.50–0.83) at 1-year. Conclusion Declining IC may present before frailty becomes clinically manifest, increasing risk for poor outcomes. Monitoring of IC domains potentially facilitates personalized interventions to avoid progressive frailty. Electronic Supplementary Material Supplementary material is available for this article at 10.14283/jfa.2022.28 and is accessible for authorized users.

ObjectivesTo examine the association of intrinsic capacity (IC) with life-space mobility (LSM) among community-dwelling older adults and to determine whether age and gender modify this relationship.DesignCross-sectional study.SettingPublic housing blocks, senior activity centres and community centres in the Northeastern region of Singapore.Participants751 community-dwelling older adults aged ≥55 years old and able to ambulate independently with or without walking aid.Primary and secondary outcome measuresIC and LSM. Standardised IC factor scores were calculated through confirmatory factor analysis using variables representing the five IC domains cognition, locomotion, sensory, vitality and psychological. LSM was measured using the University of Alabama at Birmingham Study of Aging Life-Space Assessment instrument. Association of IC with LSM and its effect modification by age and gender were examined with regression analyses.ResultsThe participants had a mean age of 67.6 and mean LSM score of 88.6. IC showed a positive and significant association with LSM (β=6.33; 95% CI=4.94 to 7.72) and the effect remained significant even after controlling for potential confounders (β=4.76; 95% CI=3.22 to 6.29), with p<0.001 for both. Age and gender did not demonstrate significant modification on this relationship.ConclusionsOur findings support the empirical rigour of the International Classification of Functioning, Disability and Health framework, which suggests that IC influences the extent to which a person participates in the community. Our findings also provide guidance for healthcare providers who aim to enhance LSM and promote healthy ageing in older adults.