Strength and Function Response to Clinical Interventions of Older Women Categorized by Weakness and Low Lean Mass Using Classifications From the Foundation for the National Institute of Health Sarcopenia Project

Fragala, Maren S.; Dam, Thuy Tien L.; Barber, Vanessa; Judge, James O.; Studenski, Stephanie A.; Cawthon, Peggy M.; McLean, Robert R.; Harris, Tamara B.; Ferrucci, Luigi; Guralnik, Jack M.; Kiel, Douglas P.; Kritchevsky, Stephen B.; Shardell, Michelle; Vassileva, Maria T.; Kenny, Anne M.

doi:10.1093/gerona/glu110

Cited by 48 publications

(40 citation statements)

References 51 publications

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“…Positive treatment effects among these frailty constructs may partially explain why pulmonary rehabilitation improves exercise capacity, disability, and health-related quality of life and reduces hospitalizations and mortality 106,107. Recent work in older populations has shown that frailty may be reversible through targeted exercise and nutritional interventions 108–110. It has been postulated that nutritional interventions may be suitable for frail patients with nutritional deficiency and weight loss; however, the evidence for this has been scarce.…”

Section: Interventionmentioning

confidence: 99%

Frailty assessment in older adults with chronic obstructive respiratory diseases

Guan¹,

Huang²

2018

CIA

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The number of patients with chronic obstructive pulmonary disease (COPD) has been rising with continued exposure to environmental risk factors and aging of populations around the world. Frailty is a geriatric syndrome with a decline in physiological reserve and often coexists with chronic diseases such as COPD. Frailty is an independent risk factor for the development and progression of COPD, and COPD can lead to frailty; treating one might improve the other. Thus, there is an increasing interest in the assessment of frailty in patients with COPD. Furthermore, early identification and assessment of frailty in patients with COPD may affect the choice of intervention and improve its effectiveness. Based on the current literature, the intent of this review was to summarize and discuss frailty assessment tools used for COPD patients and the relevant clinical practices for predicting outcomes. We ascertain that using suitable frailty assessment tools could facilitate physicians to screen and stratify physically frail patients with COPD. Screening appropriately targeted population can achieve better intervention outcomes and pulmonary rehabilitation among frail COPD patients.

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Section: Interventionmentioning

confidence: 99%

Frailty assessment in older adults with chronic obstructive respiratory diseases

Guan¹,

Huang²

2018

CIA

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“…Recent work in older populations shows that frailty may be reversible through targeted exercise and nutrition interventions (11,98,99). That muscle wasting, weakness, and malnutrition (hallmarks of frailty) are common in those with lung disease and should be responsive to physical exercise training and nutrition optimization underscores the importance of rehabilitation.…”

Section: Frailty As a Therapeutic Target In Pulmonary Disease And Crimentioning

confidence: 99%

Frailty in Pulmonary and Critical Care Medicine

Singer

Lederer²,

Baldwin

2016

Annals ATS

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Conceptualized first in the field of geriatrics, frailty is a syndrome characterized by a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems. This accumulation of deficits results in poorer functional status and disability. Frailty is a "state of risk" for subsequent disproportionate declines in health status following new exposure to a physiologic stressor. Two predominant models have emerged to operationalize the measurement of frailty. The phenotype model defines frailty as a distinct clinical syndrome that includes conceptual domains such as strength, activity, wasting, and mobility. The cumulative deficit model defines frailty by enumerating the number of age-related things wrong with a person. The biological pathways driving frailty include chronic systemic inflammation, sarcopenia, and neuroendocrine dysregulation, among others. In adults with chronic lung disease, frailty is independently associated with more frequent exacerbations of lung disease, all-cause hospitalization, declines in functional status, and all-cause mortality. In addition, frail adults who become critically ill are more likely develop chronic critical illness or severe disability and have higher in-hospital and long-term mortality rates. The evaluation of frailty appears to provide important prognostic information above and beyond routinely collected measures in adults with chronic lung disease and the critically ill. The study of frailty in these populations, however, requires multipronged efforts aimed at refining clinical assessments, understanding the mechanisms, and developing therapeutic interventions.Keywords: frailty; body composition; disability; health-related quality of life; mortality Correspondence and requests for reprints should be addressed to Jonathan P. Singer, M.D., M.S.,

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“…Muscle quality (MQ) can be conceptualized as the capacity to generate force relative to the mass/volume of contractile tissue (1–3). Declines in muscle strength with aging are not explained by declines in muscle mass; the concept of MQ was meant to describe this phenomenon (1, 2, 4–6).…”

Section: Introductionmentioning

confidence: 99%

“…While strength alone quantifies the amount of force a muscle can generate, bigger muscles are not necessarily stronger. A smaller muscle may be more effective due to more contractile proteins, less fat infiltration, or other physiological properties that can alter the quality of the muscle (3, 6, 7). Therefore, MQ could be useful to comprehensively quantify physiological changes in skeletal muscle that occur with aging.…”

Section: Introductionmentioning

confidence: 99%

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Muscle Quality, Strength, and Lower Extremity Physical Performance in the Baltimore Longitudinal Study of Aging

Shaffer

Fabbri²,

Ferrucci³

et al. 2017

J Frailty Aging

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Background: Muscle quality is defined as the force generated by each volumetric unit of muscle tissue. No consensus exists on an optimal measure of muscle quality, impeding comparison across studies and implementation in clinical settings. It is unknown whether muscle quality measures that rely on complex and expensive tests, such as isokinetic dynamometry and computerized tomography correlate with lower extremity performance (LEP) any better than measures derived from simpler and less expensive tests, such as grip strength (Grip) and appendicular lean mass (ALM) assessed by DXA. Additionally, whether muscle quality is more strongly associated with LEP than strength has not been fully tested. Objectives: This study compares the concurrent validity of alternative measures of muscle quality and characterizes their relationship with LEP. We also whether muscle quality correlates more strongly with LEP than strength alone. Design: Cross-sectional analysis. Setting: Community. Participants: 365 men and 345 women 65 years of age and older in the Baltimore Longitudinal Study of Aging. Measures: Thigh cross-sectional area (TCSA), isokinetic and isometric knee extension strength (ID), BMI adjusted ALM (ALMBMI) from DXA, and Grip. Concurrent validity was assessed as the percent variance of different measures of LEP explained by each muscle quality measure. In addition, we compared LEP relationships between each measure of strength and its correspondent value of muscle quality. Confidence intervals for differences in percent variance were calculated by bootstrapping. Results: Grip/ALMBMI explained as much variance as ID/TCSA across all LEP measures in women and most in men. Across all LEP measures, strength explained as much variance of LEP as muscle quality. Conclusions: Grip/ALMBMI and ID/TCSA measures had similar correlations with LEP. Muscle quality did not outperform strength. Although evaluating muscle quality may be useful to assess age-related mechanisms of change in muscle strength, measures of strength alone may suffice to understand the relationship between muscle and LEP.

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Strength and Function Response to Clinical Interventions of Older Women Categorized by Weakness and Low Lean Mass Using Classifications From the Foundation for the National Institute of Health Sarcopenia Project

Cited by 48 publications

References 51 publications

Frailty assessment in older adults with chronic obstructive respiratory diseases

Frailty assessment in older adults with chronic obstructive respiratory diseases

Frailty in Pulmonary and Critical Care Medicine

Muscle Quality, Strength, and Lower Extremity Physical Performance in the Baltimore Longitudinal Study of Aging

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