Performance-based physical functioning in African-American and Caucasian women at midlife: considering body composition, quadriceps strength, and knee osteoarthritis.

In 2000, body composition, x-ray-defined knee osteoarthritis, and self-reported knee pain information from a cross-sectional, community-based study of 211 African-American and 669 Caucasian women in southeast Michigan (mean age, 47 years) was related to performance-based physical functioning measures to characterize development of functional limitations. Body composition was assessed with bioelectrical impedance. Functioning measures were gait assessment, timed walk, timed stair climb with and without videography, and isometric quadriceps strength. Knee osteoarthritis was determined by Kellgren-Lawrence score from radiography, whereas knee pain was self-reported. Almost 31% of mid-aged women walked at functionally inadequate speeds, and over 12% walked at speeds considered typical of frailty in older women. Ten percent of women had skeletal muscle mass levels less than a proposed cutpoint for increased physical disability risk in older adults. Gait measures correlates included increasing age, increasing fat mass (in kilograms), knee joint pain, and reduced quadriceps strength. Stair climbing correlates included skeletal muscle mass (in kilograms) and its change, painful knee osteoarthritis, and reduced quadriceps strength. Race differences in walking measures and stair climbing time diminished when the authors accounted for other factors. Compromised physical functioning began earlier than expected, with indications that approximately 12-31% of women might benefit from interventions to forestall future decline.

Sarcopenia is related to physical functioning and leg strength in middle-aged women.

BACKGROUND: In the aging process, loss of muscle is relatively continuous, but the initiation, timing, and amount of muscle loss that relate to functional compromise are poorly described. Also poorly understood is whether strength and functioning in aging are related to the amount of lean mass and its change as well as to the amount of fat mass and its change. METHODS: The purpose of the study was to ascertain whether 3-year lean and fat mass change predicted functional status in 712 African American and Caucasian women, aged 34-58 years. Fat and lean mass were assessed with bioelectrical impedance. Lower leg strength (torque) was measured with a portable isometric chair, and two indices of physical functioning, walking velocity and double support (both feet touching the surface while walking), were measured with an instrumented gait mat. RESULTS: Almost 9% of middle-aged women had at least a 6% loss (>2.5 kg) of lean mass over the 3-year observation period. Women who lost at least 2.5 kg of lean mass had slower walking velocity and less leg strength, although women who simultaneously gained more than 2.5 kg of fat mass (at least 7.5%) did not have less leg strength. Age was significantly associated with less velocity, less leg strength, and more time in double support. CONCLUSIONS: Even in middle-aged women, there is loss of lean mass among almost 1 woman in 10, and this loss of lean mass (sarcopenia) is associated with greater compromise in physical functioning.

A longitudinal study of the predictors of prevalence and severity of symptoms commonly associated with menopause.

OBJECTIVE: To delineate the role of hormone levels, menopause status, exogenous hormone use, and personal characteristics in the changing prevalence and impact of menopause symptoms. DESIGN: Annual longitudinal data were from Michigan Bone Health Study enrollees aged 24 to 44 years at baseline and followed up for a 10-year period beginning in 1992. In self-administered interviews, women reported the presence of and degree of bother (values from 1 = low to 8 = high) for symptoms related to sexuality, vasomotor, sleep/fatigue, negative mood, hair/skin, and urinary problems. Annually, collected sera samples were analyzed for estradiol, follicle-stimulating hormone, and testosterone concentrations. RESULTS: Increasing age consistently predicted the development and bother of the measured symptoms. Transition to postmenopause and higher levels of follicle-stimulating hormone were significantly predictive only of the sexuality and vasomotor constructs, whereas higher estradiol levels were protective against increasing frequency and bother from sexuality and vasomotor constructs. Problems with sleeping, and secondarily, vasomotor symptoms, were the most bothersome constructs. Higher body mass index and current smoking behavior were highly related to increased bother with many symptom constructs, but especially vasomotor symptoms. Exogenous hormone use was associated with more bother from all symptom constructs. CONCLUSIONS: Sexuality and vasomotor symptom constructs seem to be more related to menopause than other constructs. The frequency of other constructs in the pre-menopause and their very strong association with increasing age suggest caution in attributing these factors directly to neuroendocrine events of the menopause transition. The strong associations between smoking and body size with symptoms, particularly vasomotor symptoms, suggest that interventions directed at these personal characteristics might be effective in dampening their impact.