Association of Muscle Endurance, Fatigability, and Strength With Functional Limitation and Mortality in the Health Aging and Body Composition Study

Health ABC study

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND: Mobility limitation is highly prevalent among older adults and is central to the loss of functional independence. Dynamic isokinetic muscle fatigue testing may reveal increased vulnerability to disability and mortality beyond strength testing.

METHODS: We studied community-dwelling older adults enrolled in the Health Aging and Body Composition study (age range: 71-82) free of mobility disability and who underwent isokinetic muscle fatigue testing in 1999-2000 (n = 1,963). Isokinetic quadriceps work and fatigue index was determined over 30 repetitions and compared with isometric quadriceps maximum torque. Work was normalized to leg lean mass accounting for gender-specific differences (specific work). The primary outcome was incident persistent severe lower extremity limitation (PSLL), defined as two consecutive reports of either having a lot of difficulty or being unable to walk 1/4 mile or climb 10 steps without resting. The secondary outcome was all-cause mortality.

RESULTS: There were 608 (31%) occurrences of incident PSLL and 488 (25%) deaths during median follow-up of 9.3 years. After adjustment, lower isokinetic work was associated with significantly greater risks of PSLL and mortality across the full measured range. Hazard ratios per standard deviation lower specific isokinetic work were 1.22 (95% CI 1.12, 1.33) for PSLL and 1.21 (95% CI 1.13, 1.30) for mortality, respectively. Lower isometric strength was associated with PSLL, but not mortality. Fatigue index was not associated with PSLL or mortality.

CONCLUSIONS: Muscle endurance, estimated by isokinetic work, is an indicator of muscle health associated with mobility limitation and mortality providing important insight beyond strength testing.

Original languageEnglish (US)
Pages (from-to)284-291
Number of pages8
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Volume72
Issue number2
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

Fingerprint

Body Composition
Lower Extremity
Muscles
Mortality
Health
Mobility Limitation
Muscle Fatigue
Fatigue
Independent Living
Torque
Leg

Keywords

  • Fatigue
  • Mobility
  • Muscle
  • Sarcopenia
  • Strength

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

@article{0ec88510561b403cb936bbf0a7c090f3,
title = "Association of Muscle Endurance, Fatigability, and Strength With Functional Limitation and Mortality in the Health Aging and Body Composition Study",
abstract = "BACKGROUND: Mobility limitation is highly prevalent among older adults and is central to the loss of functional independence. Dynamic isokinetic muscle fatigue testing may reveal increased vulnerability to disability and mortality beyond strength testing.METHODS: We studied community-dwelling older adults enrolled in the Health Aging and Body Composition study (age range: 71-82) free of mobility disability and who underwent isokinetic muscle fatigue testing in 1999-2000 (n = 1,963). Isokinetic quadriceps work and fatigue index was determined over 30 repetitions and compared with isometric quadriceps maximum torque. Work was normalized to leg lean mass accounting for gender-specific differences (specific work). The primary outcome was incident persistent severe lower extremity limitation (PSLL), defined as two consecutive reports of either having a lot of difficulty or being unable to walk 1/4 mile or climb 10 steps without resting. The secondary outcome was all-cause mortality.RESULTS: There were 608 (31{\%}) occurrences of incident PSLL and 488 (25{\%}) deaths during median follow-up of 9.3 years. After adjustment, lower isokinetic work was associated with significantly greater risks of PSLL and mortality across the full measured range. Hazard ratios per standard deviation lower specific isokinetic work were 1.22 (95{\%} CI 1.12, 1.33) for PSLL and 1.21 (95{\%} CI 1.13, 1.30) for mortality, respectively. Lower isometric strength was associated with PSLL, but not mortality. Fatigue index was not associated with PSLL or mortality.CONCLUSIONS: Muscle endurance, estimated by isokinetic work, is an indicator of muscle health associated with mobility limitation and mortality providing important insight beyond strength testing.",
keywords = "Fatigue, Mobility, Muscle, Sarcopenia, Strength",
author = "{Health ABC study} and Baback Roshanravan and Patel, {Kushang V.} and Fried, {Linda F.} and Cassianne Robinson-Cohen and {de Boer}, {Ian H.} and Tamara Harris and Murphy, {Rachel A.} and Suzanne Satterfield and Goodpaster, {Bret H.} and Michael Shlipak and Newman, {Anne B.} and Bryan Kestenbaum",
year = "2017",
month = "2",
day = "1",
doi = "10.1093/gerona/glw210",
language = "English (US)",
volume = "72",
pages = "284--291",
journal = "The journals of gerontology. Series A, Biological sciences and medical sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Association of Muscle Endurance, Fatigability, and Strength With Functional Limitation and Mortality in the Health Aging and Body Composition Study

AU - Health ABC study

AU - Roshanravan, Baback

AU - Patel, Kushang V.

AU - Fried, Linda F.

AU - Robinson-Cohen, Cassianne

AU - de Boer, Ian H.

AU - Harris, Tamara

AU - Murphy, Rachel A.

AU - Satterfield, Suzanne

AU - Goodpaster, Bret H.

AU - Shlipak, Michael

AU - Newman, Anne B.

AU - Kestenbaum, Bryan

PY - 2017/2/1

Y1 - 2017/2/1

N2 - BACKGROUND: Mobility limitation is highly prevalent among older adults and is central to the loss of functional independence. Dynamic isokinetic muscle fatigue testing may reveal increased vulnerability to disability and mortality beyond strength testing.METHODS: We studied community-dwelling older adults enrolled in the Health Aging and Body Composition study (age range: 71-82) free of mobility disability and who underwent isokinetic muscle fatigue testing in 1999-2000 (n = 1,963). Isokinetic quadriceps work and fatigue index was determined over 30 repetitions and compared with isometric quadriceps maximum torque. Work was normalized to leg lean mass accounting for gender-specific differences (specific work). The primary outcome was incident persistent severe lower extremity limitation (PSLL), defined as two consecutive reports of either having a lot of difficulty or being unable to walk 1/4 mile or climb 10 steps without resting. The secondary outcome was all-cause mortality.RESULTS: There were 608 (31%) occurrences of incident PSLL and 488 (25%) deaths during median follow-up of 9.3 years. After adjustment, lower isokinetic work was associated with significantly greater risks of PSLL and mortality across the full measured range. Hazard ratios per standard deviation lower specific isokinetic work were 1.22 (95% CI 1.12, 1.33) for PSLL and 1.21 (95% CI 1.13, 1.30) for mortality, respectively. Lower isometric strength was associated with PSLL, but not mortality. Fatigue index was not associated with PSLL or mortality.CONCLUSIONS: Muscle endurance, estimated by isokinetic work, is an indicator of muscle health associated with mobility limitation and mortality providing important insight beyond strength testing.

AB - BACKGROUND: Mobility limitation is highly prevalent among older adults and is central to the loss of functional independence. Dynamic isokinetic muscle fatigue testing may reveal increased vulnerability to disability and mortality beyond strength testing.METHODS: We studied community-dwelling older adults enrolled in the Health Aging and Body Composition study (age range: 71-82) free of mobility disability and who underwent isokinetic muscle fatigue testing in 1999-2000 (n = 1,963). Isokinetic quadriceps work and fatigue index was determined over 30 repetitions and compared with isometric quadriceps maximum torque. Work was normalized to leg lean mass accounting for gender-specific differences (specific work). The primary outcome was incident persistent severe lower extremity limitation (PSLL), defined as two consecutive reports of either having a lot of difficulty or being unable to walk 1/4 mile or climb 10 steps without resting. The secondary outcome was all-cause mortality.RESULTS: There were 608 (31%) occurrences of incident PSLL and 488 (25%) deaths during median follow-up of 9.3 years. After adjustment, lower isokinetic work was associated with significantly greater risks of PSLL and mortality across the full measured range. Hazard ratios per standard deviation lower specific isokinetic work were 1.22 (95% CI 1.12, 1.33) for PSLL and 1.21 (95% CI 1.13, 1.30) for mortality, respectively. Lower isometric strength was associated with PSLL, but not mortality. Fatigue index was not associated with PSLL or mortality.CONCLUSIONS: Muscle endurance, estimated by isokinetic work, is an indicator of muscle health associated with mobility limitation and mortality providing important insight beyond strength testing.

KW - Fatigue

KW - Mobility

KW - Muscle

KW - Sarcopenia

KW - Strength

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U2 - 10.1093/gerona/glw210

DO - 10.1093/gerona/glw210

M3 - Article

C2 - 27907890

AN - SCOPUS:85021711782

VL - 72

SP - 284

EP - 291

JO - The journals of gerontology. Series A, Biological sciences and medical sciences

JF - The journals of gerontology. Series A, Biological sciences and medical sciences

SN - 1079-5006

IS - 2

ER -