Disability, physical activity, and muscle strength in older women: The women's health and aging study

doi:10.1016/S0003-9993(99)90109-0

Archives of Physical Medicine and Rehabilitation

Volume 80, Issue 2, February 1999, Pages 130-135

https://doi.org/10.1016/S0003-9993(99)90109-0 Get rights and content

Abstract

Objective: To study associations of motor disability, physical activity, and muscle strength in older women, in particular to investigate whether model of spiraling decrease is expressed in the data.

Design: Cross-sectional analysis using data from the base-line measurements of The Women's Health and Aging Study (WHAS).

Setting: Participants' homes.

Participants: A total of 1,002 disabled women aged 65 years and older living in the community.

Outcome Measures: Motor disability was measured by the number of self-reported difficulties in grasping, lifting 101b, walking across a small room, walking $14$ mile, climbing 10 steps, and doing heavy housework. Level of physical activity was determined from response to a series of questions on the frequency and amount of common activities and physical exercise. Hand grip and knee extension forces were measured using portable hand-held dynamometers.

Results: Disability and physical activity were inversely associated, with inactivity being most common among the most disabled women. Those with poorer strength reported more difficulties in motor activities. Greater strength was found among the physically more active. In stratified analyses, the positive association of physical activity on knee extension strength was consistent across disability levels. Multiple regression analysis showed that both physical activity and muscle strength were significant predictors for severity of disability. Structural equation model (LISREL) showed that muscle strength had a mediating role between physical activity and disability; disability was associated with physical inactivity, which correlated with lower muscle strength, which was associated with greater degree of disability.

Conclusion: Even though causality cannot be confirmed in this cross-sectional analysis, our findings suggested a spiraling model of decline in which muscle strength has a significant role.

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Citation Excerpt :
Muscle weakness and dysfunction, as typically characterized as sarcopenia, has been commonly regarded as a disease with an independent risk factor for higher mortality.25 The impact of muscle strength on mortality may be connected with its function during the disabled process, as muscle is the greatest reserve of protein in the body.26 As indicated in previous literature, people with weak strength were prone to difficulties in daily physical activities.26
Handgrip strength is considered a vital and reliable measure of comprehensive physical assessments, whereas the association of handgrip strength with overall mortality risk among Chinese adults was less studied. We prospectively investigated the association between handgrip strength and all-cause mortality among Chinese middle-aged and older people based on data from the China Health and Retirement Longitudinal Study (CHARLS).³
Longitudinal cohort study.
Grip strength was assessed for both hands by a dynamometer. Odds ratios (ORs)⁴ and 95 % confidence intervals (CIs)⁵ were estimated applying logistic regression models with adjustments for age, body mass index, ethnicity, education level, annual household income, marital status, drinking, smoking, physical activity, and medical insurance among men and women. Deaths were ascertained by each follow-up survey in which the household member who lived with the participants were inquired.
Over an average follow-up period of approximately 8 years among the screened 11,618 participants ≥45 years old, 1290 deaths were documented. The age range was 45–93 for men and 45–96 for women. Greater handgrip strength was associated with a lower overall mortality risk, with adjusted ORs (comparing with extreme tertiles) of 0.47 (95 % CI: 0.35–0.64; P-trend<0.001) in men and 0.51 (95 % CI: 0.24–1.08; P-trend = 0.059) in women. Such inverse association seemed stronger among younger men (OR = 0.29, 95 % CI: 0.18–0.45), compared with the older men (OR = 0.49, 95 % CI: 0.33–0.73; P-interaction = 0.023).
Handgrip strength was inversely associated with all-cause mortality risk, especially among the younger men. Further investigations are warranted to elucidate the underlying mechanism.
Postganglionic sympathetic neurons, but not locus coeruleus optostimulation, activates neuromuscular transmission in the adult mouse in vivo
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Recent work demonstrated that sympathetic neurons innervate the skeletal muscle near the neuromuscular junction (NMJ), and muscle sympathectomy and sympathomimetic agents strongly influence motoneuron synaptic vesicle release ex vivo. Moreover, reports attest that the pontine nucleus locus coeruleus (LC) projects to preganglionic sympathetic neurons and regulates human mobility and skeletal muscle physiology. Thus, we hypothesized that peripheral and central sympathetic neurons projecting directly or indirectly to the skeletal muscle regulate NMJ transmission. The aim of this study was to define the specific neuronal groups in the peripheral and central nervous systems that account for such regulation in adult mice in vivo by using optogenetics and NMJ transmission recordings in 3–5-month-old, male and female ChR2(H134R/EYFP)/TH-Cre mice. After detecting ChR2(H134R)/EYFP fluorescence in the paravertebral ganglia and LC neurons, we tested whether optostimulating the plantar nerve near the lumbricalis muscle or LC neurons effectively modulates motor nerve terminal synaptic vesicle release in living mice. Nerve optostimulation increased motor synaptic vesicle release in vitro and in vivo, while the presynaptic adrenoceptor blockers propranolol (β1/β2) and atenolol (β1) prevented this outcome. The effect is primarily presynaptic since miniature end-plate potential (MEPP) kinetics remained statistically unmodified after stimulation. In contrast, optostimulation of LC neurons did not regulate NMJ transmission. In summary, we conclude that postganglionic sympathetic neurons, but not LC neurons, increased NMJ transmission by acting on presynaptic β1-adrenergic receptors in vivo.
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^☆: No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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ArticleDisability, physical activity, and muscle strength in older women: The women's health and aging study☆

Abstract

Soc Sci Med

J Psychiatr Res

An epidemiology of disability among older adults in the United States

Milbank Mem Fund Q

Biological age in adulthood

Muscle strength in male athletes aged 70–81 years and a population sample

Eur J Appl Physiol

Physical activity and the changes in maximal isometric strength in men and women from the age of 75 to 80 years

J Am Geriatr Soc

Maximal isometric muscle strength and functional ability among 75-year-old men and women

Scand J Med Sci Sport

Maximal isometric strength and mobility among 75-year-old men and women

Age Ageing

The role of exercise in fall prevention: developing targeting criteria for exercise programs

Departures from the linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women's Health and Aging Study

J Gerontol Med Sci

Disability in older adults: evidence regarding significance, etiology, and risk

J Am Geriatr Soc

Risk due to inactivity in physically capable older adults

Am J Public Health

Article
Disability, physical activity, and muscle strength in older women: The women's health and aging study☆