A cross-sectional study of the association between dynapenia and higher-level functional capacity in daily living in community-dwelling older adults in Japan

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Abstract

Background

There are many reports that dynapenia, sarcopenia and frailty each have associations with bodily function or with Instrumental Activities of Daily Living (IADL). However, studies that compare all three conditions and their effects on IADL are lacking. The purpose of this study is to examine associations of sarcopenia, frailty, and dynapenia with IADL.

Methods

Participants included 123 community-dwelling older adults (31 men, 92 women,) aged 65 years or older (75.0 ± 5.3 years) who were independent in IADL. In terms of physical function, measurements were performed for muscle mass, grip strength, walking speed, isometric knee extension strength, and unipedal standing. A questionnaire survey was carried out, the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was administered, and participants were asked about sense of fatigue and amount of activity.

Results

Dynapenia was associated with classifications of both frailty and sarcopenia. In addition, sarcopenia had a sensitivity and specificity for dynapenia of 33 and 89%, respectively. Frailty had a sensitivity and specificity for dynapenia of 17 and 98%, respectively. Dynapenia was a significant independent related factor for the TMIG-IC (β = −0.21, P < 0.05).

Conclusions

Dynapenia, more than sarcopenia or frailty, was related to difficulties with IADL; therefore, assessment of dynapenia should be given greater emphasis in evaluating the physical functioning of older adults.

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Most cited references 17

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Unstable disability and the fluctuations of frailty.

Bruce Campbell, James D. Buchner (1997)

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Initial manifestations of frailty criteria and the development of frailty phenotype in the Women's Health and Aging Study II.

Jacquelyn L. Fried, Karen Bandeen-Roche, Qian Xue … (2008)

Understanding points of onset of the frailty syndrome is vital to early identification of at-risk individuals and to targeting intervention efforts to those components that are first affected, when reversal may be most possible. This study aims to characterize natural history by which commonly used frailty criteria manifest and to assess whether the rate of progression to frailty depends on initial manifestations. The investigation was based on a 7.5-year observational study of 420 community-dwelling women aged 70-79 years who were not frail at baseline, with frailty defined as meeting>or=3 of 5 criteria: weight loss, slow walking speed, weakness, exhaustion, and low physical activity level. The 7.5-year incidence of frailty was 9% among women who were nonfrail at baseline. Despite significant heterogeneity, weakness was the most common first manifestation, and occurrence of weakness, slowness, and low physical activity preceded exhaustion and weight loss in 76% of the women who were nonfrail at baseline. Women with exhaustion or weight loss as initial presenting symptoms were 3-5 times more likely to become frail than were women without any criterion (p<.05). Our findings suggest that weakness may serve as a warning sign of increasing vulnerability in early frailty development, and weight loss and exhaustion may help to identify women most at risk for rapid adverse progression.

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Skeletal muscle and mortality results from the InCHIANTI Study.

Fulvio Lauretani, Stefania Bandinelli, Luigi Ferrucci … (2009)

Sarcopenia, the age-related loss of muscle mass, may not be an isolated process but is associated with an increase in fat mass. The aim of this study was to estimate the mortality risk of sarcopenia in the presence or absence of obesity. Data are from 934 participants aged 65 years or older, enrolled in the "Invecchiare in Chianti" study, and followed for 6 years. At baseline, a peripheral quantitative computerized tomography (pQCT) scan was performed on all participants to evaluate the muscle density, and the muscular and fat cross-sectional areas of the calf. Walking speed was measured on a 7-m track. Cox proportional hazard models were performed to estimate the association of pQCT measures (per 1 standard deviation increase) with mortality. Unadjusted analyses showed significant associations of muscle density (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.69-0.88), muscle area (HR 0.75, 95% CI 0.66-0.86), and fat area (HR 0.82, 95% CI 0.73-0.92) with mortality. After adjustment for potential confounders, no body composition parameter was significantly associated with mortality. Walking speed (used as a reference measure to verify whether the negative results were due to peculiarities of the study sample) confirmed its well-established association with mortality risk (HR 0.73, 95% CI 0.60-0.88). These results did not change after the analyses were stratified according to sarcopenia and body mass index groups, and restricted to participants with frailty or a high inflammatory profile. Calf skeletal muscle and fat mass are not significant risk factors for mortality in community-dwelling older adults. Walking speed confirmed to be a powerful predictor of health-related events.

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Author and article information

Contributors

Masaki Iwamura:

ORCID: http://orcid.org/0000-0002-4657-1082

m-iwamura@pt-u.aino.ac.jp

Masao Kanauchi: m.kanauchi@kio.ac.jp

Journal

Journal ID (nlm-ta): BMC Geriatr

Journal ID (iso-abbrev): BMC Geriatr

Title: BMC Geriatrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2318

Publication date (Electronic): 3 January 2017

Publication date PMC-release: 3 January 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 1

Affiliations

[1 ]Graduate School of Health Science, Kio University, 4-2-2 Umaminaka, Koryocho, Kitakatsuragigun, Nara 635-0832 Japan

[2 ]Department of Physical Therapy, Faculty of Health Science, Aino University, 4-5-4 Higashioda, Ibaraki, Osaka 567-0012 Japan

Author information

Masaki Iwamura http://orcid.org/0000-0002-4657-1082

Article

Publisher ID: 400

DOI: 10.1186/s12877-016-0400-5

PMC ID: 5210273

PubMed ID: 28049446

SO-VID: 85343e11-5e30-456f-b260-16a69c572a0f

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 19 August 2016

Date accepted : 16 December 2016

Custom metadata

ScienceOpen disciplines: Geriatric medicine

Keywords: dynapenia,sarcopenia,frailty,tmig-ic,community-dwelling older adults

Data availability:

ScienceOpen disciplines: Geriatric medicine

Keywords: dynapenia, sarcopenia, frailty, tmig-ic, community-dwelling older adults

A cross-sectional study of the association between dynapenia and higher-level functional capacity in daily living in community-dwelling older adults in Japan

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Abstract

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Most cited references 17

Unstable disability and the fluctuations of frailty.

Initial manifestations of frailty criteria and the development of frailty phenotype in the Women's Health and Aging Study II.

Skeletal muscle and mortality results from the InCHIANTI Study.

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