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      Reference Values and Age and Sex Differences in Physical Performance Measures for Community-Dwelling Older Japanese: A Pooled Analysis of Six Cohort Studies

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          Abstract

          Objectives

          To determine age- and sex-specific reference values for six physical performance measures, i.e. hand-grip strength, one-legged stance, and gait speed and step length at both usual and maximum paces, and to investigate age and sex differences in these measures among community-dwelling older Japanese adults.

          Methods

          We conducted a pooled analysis of data from six cohort studies collected between 2002 and 2011 as part of the Tokyo Metropolitan Institute of Gerontology-Longitudinal Interdisciplinary Study on Aging. The pooled analysis included cross-sectional data from 4683 nondisabled, community-dwelling adults aged 65 years or older (2168 men, 2515 women; mean age: 74.0 years in men and 73.9 years in women).

          Results

          Unweighted simple mean (standard deviation) hand-grip strength, one-legged stance, usual gait speed, usual gait step length, maximum gait speed, and maximum gait step length were 31.7 (6.7) kg, 39.3 (23.0) s, 1.29 (0.25) m/s, 67.7 (10.0) cm, 1.94 (0.38) m/s, and 82.3 (11.6) cm, respectively, in men and 20.4 (5.0) kg, 36.8 (23.4) s, 1.25 (0.27) m/s, 60.8 (10.0) cm, 1.73 (0.36) m/s, and 69.7 (10.8) cm, respectively, in women. All physical performance measures showed significant decreasing trends with advancing age in both sexes (all P<0.001 for trend). We also constructed age- and sex-specific appraisal standards according to quintiles. With increasing age, the sex difference in hand-grip strength decreased significantly ( P<0.001 for age and sex interaction). In contrast, sex differences significantly increased in all other measures (all P<0.05 for interactions) except step length at maximum pace.

          Conclusion

          Our pooled analysis yielded inclusive age- and sex-specific reference values and appraisal standards for major physical performance measures in nondisabled, community-dwelling, older Japanese adults. The characteristics of age-related decline in physical performance measures differed between sexes.

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          Most cited references36

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          Frailty in older adults: evidence for a phenotype

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            Hand-grip dynamometry predicts future outcomes in aging adults.

            One use of clinical measures is the prediction of future outcomes. The purpose of this systematic review was to summarize the literature addressing the value of grip strength as a predictor of important outcomes. Relevant literature was located using 4 bibliographic databases, searching article reference lists, and perusing personal files. Forty-five relevant research articles were found. The research involved both healthy subjects and patients; it tended to focus on middle-aged and older adults. The primary outcome addressed was mortality/survival (24 articles), but disability (9 articles), complications and/or increased length of stay (12 articles), and other outcomes were also examined. Low grip strength was shown consistently to be associated with a greater likelihood of premature mortality, the development of disability, and an increased risk of complications or prolonged length of stay after hospitalization or surgery. Given its predictive validity and simplicity, dynamometrically measured grip strength should be considered as a vital sign useful for screening middle-aged and older adults.
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              Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants.

              to establish reference values for both comfortable and maximum gait speed and to describe the reliability of the gait speed measures and the correlation of selected variables with them. descriptive and cross-sectional. subjects were 230 healthy volunteers. Gait was timed over a 7.62 m expanse of floor. Actual and height normalized speed were determined. Lower extremity muscle strength was measured with a hand-held dynamometer. mean comfortable gait speed ranged from 127.2 cm/s for women in their seventies to 146.2 cm/s for men in their forties. Mean maximum gait speed ranged from 174.9 cm/s for women in their seventies to 253.3 cm/s for men in their twenties. Both gait speed measures were reliable (coefficients > or = 0.903) and correlated significantly with age (r > or = -0.210), height (r > or = 0.220) and the strengths of four measured lower extremity muscle actions (r = 0.190-0.500). The muscle action strengths most strongly correlated with gait speed were nondominant hip abduction (comfortable speed) and knee extension (maximum speed). these normative values should give clinicians a reference against which patient performance can be compared in a variety of settings. Gait speed can be expected to be reduced in individuals of greater age and of lesser height and lower extremity muscle strength.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                12 June 2014
                : 9
                : 6
                : e99487
                Affiliations
                [1 ]Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo, Japan
                [2 ]The Japan Society for the Promotion of Science, 8 Ichiban, Chiyoda, Tokyo, Japan
                Marienhospital Herne - University of Bochum, Germany
                Author notes

                ¶ Membership of the TMIG-LISA (Tokyo Metropolitan Institute of Gerontology-Longitudinal Interdisciplinary Study on Aging) Research Group is provided in the Acknowledgments.

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: S. Shinkai. Analyzed the data: S. Seino. Wrote the paper: S. Seino. Data acquisition: S. Shinkai YF SO HY. Comments and approval of final version: S. Shinkai YF SO HY HH HKK TI RT.

                Article
                PONE-D-13-53892
                10.1371/journal.pone.0099487
                4055685
                24923425
                f3031e39-68a4-4d2b-b85c-664abc4d3f72
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 December 2013
                : 15 May 2014
                Page count
                Pages: 14
                Funding
                This study was supported by grants from the Tokyo Metropolitan Government, the Japan Arteriosclerosis Prevention Fund (jals.gr.jp/en/index.html), the Research Institute of Science and Technology for Society, the Japan Science and Technology Agency ( www.ristex.jp/EN/index.html), International Life Sciences Institute of Japan ( www.ilsijapan.org/English/ILSIJapan/ILJ/IL.php), Grants-in-Aid for Scientific Research (B) (2) 14370150, (B) 17390194, (B) 21390212, and a Grant-in-Aid for Exploratory Research 17659192 from the Japan Society for the Promotion of Science, and Health Labour Sciences Research Grants H14-Chouju-006, H15-Ganyobo-065, H15-Seisaku-017, H16-Chouju-031, H23-Chouju-Ippan-001, and H23-Chouju-Ippan-002 from the Ministry of Health, Labour and Welfare of Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Biomechanics
                Hand Strength
                Developmental Biology
                Organism Development
                Aging
                Physiology
                Physiological Processes
                Psychology
                Behavior
                Human Performance
                Medicine and Health Sciences
                Epidemiology
                Epidemiology of Aging
                Geriatrics
                Health Care
                Long-Term Care
                Physiotherapy
                Public and Occupational Health
                Health Screening
                Sports and Exercise Medicine
                People and Places
                Demography
                Research and Analysis Methods
                Research Design
                Clinical Research Design
                Cohort Studies
                Cross-Sectional Studies
                Social Sciences

                Uncategorized
                Uncategorized

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