Methodology and Feasibility of a Home-Based Examination in Disabled Older Women: The Women's Health and Aging Study

Simonsick, Eleanor M.; Maffeo, Carla; Rogers, Sophie; Skinner, Elizabeth A.; Davis, Daniel; Guralnik, Jack M.; Fried, Linda P.

doi:10.1093/gerona/52a.5.m264

Cited by 104 publications

(86 citation statements)

References 19 publications

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“…Test-retest reliability for 4MGS is better than that reported over an 8-foot course [19] and as reliable as over 6 m [20]. A 4-m course has also been shown to be feasible in 90% of households [21], allowing the possibility of using the 4MGS as a tool in communityor home-based studies. Consistent with this, in our study, we observed very high ICCs for both test-retest and interobserver reliability.…”

Section: Discussionmentioning

confidence: 84%

Reliability and validity of 4-metre gait speed in COPD

et al. 2012

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In community-dwelling older adults, usual gait speed over 4 m (4MGS) consistently predicts greater risk of adverse health outcomes. The aims of the present study were to assess the reliability of the 4MGS and the relationship with established health outcome measures in chronic obstructive pulmonary disease (COPD).Test-retest and interobserver reliability of the 4MGS were measured in 80 and 58 COPD patients, respectively. In 586 COPD patients, the 4MGS, as well as forced expiratory volume in 1 s (FEV1), the incremental shuttle walk (ISW), Medical Research Council (MRC) dyspnoea scale and St George's Respiratory Questionnaire (SGRQ) were measured. Participants were stratified according to ''slow'' (,0.8 m?s -1 ) or ''normal'' 4MGS (o0.8 m?s -1 ). Intra-class correlation coefficients for test-retest and interobserver reliability were 0.97 and 0.99, respectively. There was a significant positive correlation between 4MGS with ISW (r50.78; p,0.001) and a negative correlation with MRC dyspnoea scale and SGRQ (r5 -0.55 and -0.44; p,0.001 for both). COPD patients with slow 4MGS had significantly reduced ISW and higher MRC dyspnoea scale and SGRQ than those with preserved walking speed, despite similar FEV1 % predicted.The 4MGS is reliable in COPD, correlates with exercise capacity, dyspnoea and health-related quality of life, and has potential as a simple assessment tool in COPD. @ERSpublications The 4-metre gait speed test is reliable and valid as a simple assessment tool in chronic obstructive pulmonary disease

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Section: Discussionmentioning

confidence: 84%

Reliability and validity of 4-metre gait speed in COPD

et al. 2012

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“…This site was chosen because it is the region of the lower leg with the largest circumference of the calf with very little variability across individuals. 25 Different tissues in the analyses were separated according to different density thresholds, using the ''soft tissue'' algorithm. On the basis of the calibration, AT, muscle, and cortical bone were measured with mineral equivalent densities of 0, 80, and 1,200 mg/cm 3 , respectively.…”

Section: Pqct Measuresmentioning

confidence: 99%

Markers of Inflammation Are Heritable and Associated with Subcutaneous and Ectopic Skeletal Muscle Adiposity in African Ancestry Families

Miljkovic

Kuipers

Kammerer

et al. 2011

Metabolic Syndrome and Related Disorders

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Background: Skeletal muscle adipose tissue (AT) infiltration, or myosteatosis, appears to be greater in African compared with European ancestry individuals and may play a role in type 2 diabetes mellitus (T2DM), a disease that disproportionally affects African ancestry populations. Inflammation is one mechanism that may link myosteatosis with increased T2DM risk, but studies examining the relationship between inflammation and myosteatosis are lacking. Methods: To examine these associations, we measured skeletal muscle subcutaneous AT, intermuscular AT, and skeletal muscle density using quantitative computed tomography and serum markers of inflammation in 471 individuals from 8 Afro-Caribbean multigenerational families [mean family size 67; mean age 43 years; mean body mass index (BMI) 28 kg/m 2 ]. Results: After removing the variation attributable to significant covariates, heritabilities of inflammation markers [C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-a (TNF-a)] ranged from 33% (TNFa) to 40% (CRP); all P < 0.01. Higher CRP, IL-6, and TNF-a were associated with lower subcutaneous AT around skeletal muscle (r = -0.13 to -0.19, P < 0.05). Higher CRP was additionally associated with lower skeletal muscle density, indicative of greater intramuscular AT (r = -0.10, P < 0.05), hyperinsulinemia (r = 0.12, P < 0.05), and increased homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.17, P < 0.01). Conclusions: Our findings suggest that heredity may play a significant role in the determination of several markers of inflammation in African ancestry individuals. Higher concentrations of CRP appear to be associated with greater skeletal muscle AT infiltration, lower subcutaneous AT, hyperinsulinemia, and insulin resistance. Longitudinal studies are needed to further evaluate the relationship between inflammation with changes in skeletal muscle AT distribution with aging and the incidence of T2DM.

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“…The three tests were administered after a standardized protocol as previously described (10). Using the results of the three performance tests, a summary performance score was calculated.…”

Section: Measures Of Physical Functionmentioning

confidence: 99%

Comorbidities and Impairments Explaining the Association Between Diabetes and Lower Extremity Disability

et al. 2002

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OBJECTIVE -To elucidate the role of diabetes-related impairments and comorbidities in the association between diabetes and physical disability, this study examined the association between diabetes and lower extremity function in a sample of disabled older women. RESEARCH DESIGN AND METHODS-Cross-sectional analysis of 1,002 women (aged Ն65 years) enrolled in the Women's Health and Aging Study (one-third most disabled of the total community-dwelling population). Diabetes and other medical conditions were ascertained by standard criteria that used multiple sources of information. Functional status was assessed using self-reported and objective performance measures.RESULTS -Women with diabetes were significantly more likely to have cardiovascular diseases, peripheral nerve dysfunction, visual impairment, obesity, and depression. After adjustment for age, women with diabetes had a greater prevalence of mobility disability (odds ratio [OR] 1.85, 95% CI 1.12-3.06), activities of daily living disability (1.61, 1.06 -2.43), and severe walking limitation (2.34, 1.56 -3.50), and their summary mobility performance score (0 -12 scale based on balance, gait speed, chair stands) was 1.4 points lower than in nondiabetic women (P Ͻ 0.001). Peripheral artery disease, peripheral nerve dysfunction, and depression were the main individual contributing factors; however, none of these conditions alone fully explained the association between diabetes and disability. Conversely, only after adjusting for all potential mediators was the relationship between diabetes and disability reduced to a large degree.CONCLUSIONS -Even among physically impaired older women, diabetes is associated with a major burden of disability. A wide range of impairments and comorbidities explains the diabetes-disability relationship, suggesting that the mechanism for such an association is multifactorial. Diabetes Care 25:678 -683, 2002

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Methodology and Feasibility of a Home-Based Examination in Disabled Older Women: The Women's Health and Aging Study

Abstract: Extensive, research-oriented physical evaluation can be successfully and safely performed in a home setting. In future studies, home-based examination may be preferable, as participation in the WHAS examination substantially exceeded rates for clinic-based exams in similar populations.

Cited by 104 publications

References 19 publications

Reliability and validity of 4-metre gait speed in COPD

Reliability and validity of 4-metre gait speed in COPD

Markers of Inflammation Are Heritable and Associated with Subcutaneous and Ectopic Skeletal Muscle Adiposity in African Ancestry Families

Comorbidities and Impairments Explaining the Association Between Diabetes and Lower Extremity Disability

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