Association between muscle quality and nutritional status among community-dwelling older adults: A cross-sectional study.

Background: Decline in muscle quality is associated with poorer health in community-dwelling older adults. Although there is evidence that malnutrition is associated with the decline of muscle quality in older adults, few analyses have considered important factors related to muscle quality. Aim: The purpose of this study was to determine the relationship between muscle quality and nutritional status in community-dwelling older adults, taking into account muscle mass, muscle strength, and amount of physical activity. Methods: This was a cross-sectional study. Data were obtained from a health checkup program in Japan. Participants were older adults aged ≥65 years living in the community who participated in the health checkup program. The data collected were echo intensity, scores on the Global Leadership Initiative on Malnutrition criteria, skeletal muscle mass, grip strength, physical activity level, and demographic data. Multiple regression analysis was used to examine the association between muscle quality and nutritional status. Results: Data were analyzed for 50 participants (mean age 77.62 years, standard deviation 6.16 years, 78.0% women). Multiple regression analysis showed that nutritional status affected muscle quality even when various factors were taken into account (B = 6.95, ß = 0.31, p = 0.04, 95% confidence interval: 0.01-0.62). Conclusion: The observed association suggests that providing nutritional support for older adults living in the community may be a useful strategy to maintain muscle quality.

Associations Between Cognitive Function and Muscle Quality Among Community-Dwelling Older Adults: A Cross-Sectional Study.

OBJECTIVE: To investigate whether muscle quality is related to cognitive function in older adults living in the community. METHODS: The participants were 40 community-dwelling older adults without a diagnosis of dementia (mean age, 78.85 ± 6.40 years; 31 women). The dependent variable was the score on the mild cognitive impairment (MCI) index of the Japanese version of the Neurobehavioral Cognitive Status Examination Five (range: 0-6; higher scores indicate MCI or possible dementia). RESULTS: Multiple regression with Bayesian statistics was performed for analysis of muscle quality, as indicated by echo intensity (EI), with skeletal muscle mass index, gait speed, physical activity level, age, and sex as covariates. EI was significantly associated with the MCI index (expected a posterior = 0.04 [95% Bayesian confidence interval: 0.01, 0.07], t = 2.47, ß = 0.41, p = 0.019). CONCLUSIONS: The results suggest that EI may be related to the cognitive function of older adults living in the community. Future studies should examine whether focusing on EI can help prevent cognitive decline among older adults..

Relationship between Phase Angle and Physical Activity Intensity among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study.

This cross-sectional study aimed to determine the association between phase angle (PhA) and physical activity intensity in community-dwelling older Japanese adults. The intensity and time of physical activity for predicting high PhA were also examined. This study involved 67 community-dwelling older adults (mean age: 78.3 ± 5.5; female: 83.6%). We measured the physical activity and body composition of the participants. Physical activity was measured using a triaxial accelerometer, and light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) hours per day were calculated from the results. Body composition was measured using Inbody S10, and the PhA was calculated from the measurements of the right side of the body. Bayesian statistical modeling revealed an association between PhA and MVPA (ß = 0.256; p = 0.022; 95% Bayesian confidence interval [CI] = 0.001, 0.012), but not LPA (ß = -0.113; p = 0.341; 95% Bayesian CI = -0.002, 0.001), even after adjustment for confounders. The cutoff value of MVPA predicting high PhA, calculated by the receiver operator characteristic curve, was 19.7 min/d (sensitivity = 0.906; specificity = 0.429). These results can be used to develop strategies to increase PhA in older adults and suggest that MVPA is important in this population.

Factorial validity and internal consistency of a practitioners' checklist for therapists in rehabilitation.

AIMS: The current study aimed to assess the validity and internal consistency of a 20-item checklist to help provide rehabilitation based on effective and clear goal setting. METHODS: A questionnaire survey was conducted regarding rehabilitation practices followed by physical, occupational, and speech-language therapists over the past month. The questionnaire was based on a checklist covering the following four areas, each comprising five items: goal setting based on patient and family intent and therapist perspective including long-term and short-term goals; therapist's specialized analysis and focalization of problems using the International Classification of Functioning, Disability and Health to clarify work processes and behaviors that hinder high-priority activities; proposal of plans considering the evidence and environment, which clarifies options for resolution methods (plans) and evidence; and formulation and implementation of plans including patient and family intent, which determines plan frequency and implementation period. The checklist was prepared based on medical records and previous studies by two occupational therapists who had experience in providing hospital and home-visit rehabilitation. To test the factorial validity of the 20-item checklist, confirmatory factor analysis was performed, and Cronbach's α coefficients were calculated. RESULTS: The participants' mean age was 28 (25-75th percentile, range: 25-32) years. Of the 385 participants, 163 were home-visit rehabilitation therapists. Our model revealed a fair fit to data (χ2 statistic = 602.0) and standardized path coefficients ranged from 0.67 to 0.95. Path coefficients were at least 0.41 for all 20 items. Cronbach's α for goal setting, problem analysis, problem solving method proposals, and formulation and implementation of specific plans were 0.896, 0.890, 0.935, and 0.925, respectively. CONCLUSION: Based on the assessment of therapists' practice over 1 month using the developed checklist, the factorial validity and internal consistency of these checklist items were considered acceptable. Education based on these checklist items might support goal setting and planning and improve patient outcomes.

The Optimal Rehabilitation Period for Patients with Distal Radius Fractures According to the MCID in DASH Scores; A Preliminary Study.

BACKGROUND: The statistical concept of minimal clinically important difference (MCID) enables the interpretation of small but meaningful changes that result from an intervention. This retrospective study aimed to examine the factors that influence the achievement of MCID after a distal radius fracture. METHODS: A total of 45 patients (mean age: 54.2 ± 16 years) were included. Of these, 27 patients started rehabilitation within 3 days of surgery (Early group), and 18 patients underwent immobilization for 2 weeks after surgery, before starting rehabilitation (Non-early group). Functional outcomes and DASH scores at 4 weeks (baseline) were compared with those measured at 8 and 12 weeks for both groups, to determine whether the MCID had been achieved. RESULTS: Our results showed that at 8 weeks after surgery in the early group, the grip strength, ulnar flexion, and baseline DASH score were significantly different between the groups that did and did not show an MCID ([Formula: see text]). There was also a significant difference in the baseline DASH score at 12 weeks after surgery ([Formula: see text]). None of these factors were significant in the non-early group. Logistic regression analysis revealed that the DASH score at 4 weeks (baseline) was an independent predictor for achieving a DASH MCID at 8 weeks postoperatively in the early group (odds ratio: 1.193). Those achieving a DASH MCID at 12 weeks postoperatively were completely separated by the baseline DASH score (≥ 29 points). CONCLUSIONS: If it is assumed that the effectiveness of rehabilitation depends upon achieving the DASH MCID by promoting functional recovery, early initiation might be recommended.