Dynapenia in all-cause mortality and its relationship with sedentary behavior in community-dwelling older adults

Abstract

The aim of the present study was to investigate the relationship of dynapenia combined with sedentary behavior (SB) on the risk of mortality in older adults living in a Brazilian community. A total of 322 participants aged ≥ 60 years from the ELSIA (Longitudinal Study of Elderly Health in Alcobaça) prospective cohort were included. Dynapenia was diagnosed when the handgrip strength was < 27 ​kg for men and < 16 ​kg for women. The exposure time to SB was assessed considering the total time spent sitting during one day in the week and one day on the weekend. When combined with dynapenia, we derived the construction of four groups: best behavior (absence of dynapenia and low SB), intermediate behavior (absence of dynapenia and high SB; presence of dynapenia and low SB) and worst behavior (presence of dynapenia and high SB). Mortality was assessed by the follow-up time until death and/or censorship. During the 5-year follow-up of the study, 55 participants progressed to death. In the adjusted models, the dynapenia and the time spent exposed to SB were analyzed in a combined way, the older adults with worse behavior (high SB and dynapenia) had higher risk ratios for mortality (hazard ratio 2.46; 95% confidence interval 1.01-5.97) than the best behavior group. Older adults with dynapenia are at greater risk for all-cause mortality, which is aggravated by the addition of longer exposure to SB.

Keywords

Mortality / Muscle strength / Aging / Sedentary behavior

References

[[1]] M Tieland, I Trouwborst, BC Clark. Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle, 9 (1) ( 2018), pp. 3-19, DOI: 10.1002/jcsm.12238

[[2]] BC Clark, TM Manini. Sarcopenia ≠ dynapenia. J Gerontol A Biol Sc Med Sci, 63 (8) ( 2008), pp. 829-834, DOI: 10.1093/gerona/63.8.829

[[3]] M Iwamura, M Kanauchi. A cross-sectional study of the association between dynapenia and higher-level functional capacity in daily living in community-dwelling older adults in Japan. BMC Geriatr, 17 (1) ( 2017), pp. 1-6, DOI: 10.1186/s12877-016-0400-5

[[4]] TDS Alexandre, S Scholes, JLF Santos, C de Oliverira. Dynapenic abdominal obesity as a risk factor for worse trajectories of ADL disability among older adults: the ELSA cohort study. J Gerontol A Biol Sc Med Sci, 74 (7) ( 2019), pp. 1112-1118, DOI: 10.1093/gerona/gly182

[[5]] C Beaudart, et al..Y Rolland, AJ Cruz-Jentoft, Assessment of muscle function and physical performance in daily clinical practice: a position paper endorsed by the European society for clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases (ESCEO). Calcif Tissue Int, 105 (1) ( 2019), pp. 1-14, DOI: 10.1007/s00223-019-00545-w

[[6]] D Scott, RM Daly, KM Sanders, PR Ebeling. Fall and fracture risk in sarcopenia and dynapenia with and without obesity: the role of lifestyle interventions. Curr Osteoporos Rep, 13 (4) ( 2015), pp. 235-244, DOI: 10.1007/s11914-015-0274-z

[[7]] AP Rossi, F Fantin, P Abete, et al.. Association between hospitalization-related outcomes, dynapenia and body mass index: the Glisten Study. Eur J Clin Nutr, 73 (5) ( 2019), pp. 743-750, DOI: 10.1038/s41430-018-0184-0

[[8]] EJ Bae, NJ Park, HS Sohn, YH Kim.Handgrip strength and all-cause mortality in middle-aged and older Koreans. Int J Environ Res Publ Health, 16 (5) ( 2019), p. 740, DOI: 10.3390/ijerph16050740

[[9]] M Bertoni, S Maggi, E Manzato, N Veronese, G Weber. Depressive symptoms and muscle weakness: a two-way relation?. Exp Gerontol, 108 ( 2018), pp. 87-91, DOI: 10.1016/j.exger.2018.04.001

[[10]] VS Borges, MFF Lima-Costa, FB de Andrade. A nationwide study on prevalence and factors associated with dynapenia in older adults: elsi-Brazil. Cad Saúde Pública, 36 (4) ( 2020), Article e00107319, DOI: 10.1590/0102-311X00107319

[[11]] VTS Lino, NCP Rodrigues, G O’Dwyer, MKDN Andrade, IE Mattos, MC Portela. Handgrip strength and factors associated in poor elderly assisted at a primary care unit in Rio de Janeiro, Brazil. PLoS One, 11 (11) ( 2016), Article e0166373, DOI: 10.1371/JOURNAL.PONE.0166373

[[12]] L Smith, L Yang, M Hamer. Handgrip strength, inflammatory markers, and mortality. Scand J Med Sci Sports, 29 (8) ( 2019), pp. 1190-1196, DOI: 10.1111/sms.13433

[[13]] R Li, J Xia, X Zhang, et al.. Associations of muscle mass and strength with all-cause mortality among US older adults. Med Sci Sports Exerc, 50 (3) ( 2018), pp. 458-467, DOI: 10.1249/MSS.0000000000001448

[[14]] AB Newman, V Kupelian, M Visser, et al.. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sc Med Sci, 61 (1) ( 2006), pp. 72-77, DOI: 10.1093/gerona/61.1.72

[[15]] CHY Ling, J Gussekloo, S Trompet, CGM Meskers, AB Maier. Clinical determinants of low handgrip strength and its decline in the oldest old: the Leiden 85-plus Study. Aging Clin Exp Res, 33 (5) ( 2021), pp. 1307-1313, DOI: 10.1007/s40520-020-01639-4

[[16]] PD Loprinzi, E Frith. Effects of sedentary behavior, physical activity, frequency of protein consumption, lower extremity strength and lean mass on all-cause mortality. J Lifestyle Med, 8 (1) ( 2018), pp. 8-15, DOI: 10.15280/jlm.2018.8.1.8

[[17]] M Hamer, E Stamatakis. Screen-based sedentary behavior, physical activity, and muscle strength in the English longitudinal study of ageing. PLoS One, 8 (6) ( 2013), Article e66222, DOI: 10.1371/journal.pone.0066222

[[18]] World Health Organization. Global Recommendations on Physical Activity for Health. ( 2015). Accessed September 22, 2020.

[[19]] JL Copeland, J Clarke, S Dogra. Objectively measured and self-reported sedentary time in older Canadians. Prev Med Reports, 2 ( 2015), pp. 90-95, DOI: 10.1016/j.pmedr.2015.01.003

[[20]] SK Keadle, H Arem, SC Moore, JN Sampson, CE Matthews. Impact of changes in television viewing time and physical activity on longevity: a prospective cohort study. Int J Behav Nutr Phys Activ, 12 (1) ( 2015), pp. 1-11, DOI: 10.1186/s12966-015-0315-0

[[21]] CA Celis-Morales, DM Lyall, L Steell, et al.. Associations of discretionary screen time with mortality, cardiovascular disease and cancer are attenuated by strength, fitness and physical activity: findings from the UK Biobank study. BMC Med, 16 (1) ( 2018), p. 77, DOI: 10.1186/s12916-018-1063-1

[[22]] LL Galvão, RR Silva, RM Ribeiro, S Tribess, DAT Santos,JS Virtuoso Júnior. Effects of reallocating time spent engaging in sedentary behavior and physical activity on mortality in older adults: ELSIA study. Int J Environ Res Publ Health, 18 (8) ( 2021), p. 4336, DOI: 10.3390/ijerph18084336

[[23]] MF Folstein, SE Folstein, PR McHugh. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 12 (3) ( 1975), pp. 189-198, DOI: 10.1016/0022-3956(75)90026-6

[[24]] OP Almeida. Mini exame do estado mental e O diagnóstico de Demência no Brasil. Arq Neuropsiquiatr, 56 (3 B) ( 1998), pp. 605-612, DOI: 10.1590/S0004-282X1998000400014

[[25]] ML Lebrão, R Laurenti. Saúde, bem-estar e envelhecimento: o estudo SABE no Município de São Paulo. Rev Bras Epidemiol, 8 (2) ( 2005), pp. 127-141, DOI: 10.1590/S1415-790X2005000200005

[[26]] TM Manini, BC Clark. Dynapenia and aging: an update. A. J Gerontol A Biol Sc Med Sci, 67 (1) ( 2012), pp. 28-40, DOI: 10.1093/gerona/glr010

[[27]] MM Reis, P Maria, M Arantes. Assessment of hand grip strength - validity and reliability of the saehan dynamometer. Fisioter e Pesqui, 18 (2) ( 2011), pp. 176-181, DOI: 10.1590/S1809-29502011000200013

[[28]] Saehan Corporation. Hydraulic hand dynamometer SH 001 operating manual.

[[29]] S Volpato, L Bianchi, A Cherubini, et al.. Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm. J Gerontol A Biol Sc Med Sci, 69 (4) ( 2014), pp. 438-446, DOI: 10.1093/gerona/glt149

[[30]] RM Dodds, HE Syddall, R Cooper, et al.. Grip strength across the life course: normative data from twelve British studies. PLoS One, 9 (12) ( 2014), pp. 1-15, DOI: 10.1371/journal.pone.0113637

[[31]] AJ Cruz-Jentoft, G Bahat, J Bauer, et al.. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 48 (1) ( 2019), pp. 16-31, DOI: 10.1093/ageing/afy169

[[32]] TR Bertoldo Benedetti, PDC Antunes, CR Rodriguez-Añez, GZ Mazo, ÉL Petroski. Reprodutibilidade e validade do Questionário Internacional de Atividade Física (IPAQ) em homens idosos. Rev Bras Med do Esporte, 13 (1) ( 2007), pp. 11-16, DOI: 10.1590/s1517-86922007000100004

[[33]] T Bertoldo Benedetti, G Zarpellon Mazo, M Virgilio Gomes de Barros. Application of the International Physical Activity Questionnaire (IPAQ) [Aplicação do Questionário Internacional de Atividades Físicas para avaliação do nível de atividades físicas de mulheres idosas: validade concorrente e reprodutibilidade teste-reteste]. Rev Bras Ciência Mov, 12 (1) ( 2004), pp. 25-34

[[34]] T da Silva Alexandre, YA De Oliveira Duarte, JL Ferreira Santos, R Wong, ML Lebrão. Sarcopenia according to the European Working Group on Sarcopenia in older people (EWGSOP) versus dynapenia as a risk factor for disability in the elderly. J Nutr Health Aging, 18 (5) ( 2014), pp. 547-553, DOI: 10.1007/s12603-014-0465-9

[[35]] KA Volaklis, M Halle, C Meisinger. Muscular strength as a strong predictor of mortality: a narrative review. Eur J Intern Med, 26 (5) ( 2015), pp. 303-310, DOI: 10.1016/j.ejim.2015.04.013

[[36]] T da Silva Alexandre, S Scholes, JL Ferreira Santos, YA de Oliveira Duarte, C de Oliveira. Dynapenic abdominal obesity increases mortality risk among English and Brazilian older adults: a 10-year follow-up of the ELSA and SABE studies. J Nutr Health Aging, 22 (1) ( 2018), pp. 138-144, DOI: 10.1007/s12603-017-0966-4

[[37]] A García-Hermoso, I Cavero-Redondo, R Ramírez-Vélez, et al.. Muscular strength as a predictor of all-cause mortality in an apparently healthy population: a systematic review and meta-analysis of data from approximately 2 million men and women. Arch Phys Med Rehabil, 99 (10) ( 2018), pp. 2100-2113 e5, DOI: 10.1016/j.apmr.2018.01.008

[[38]] BC Clark, TM Manini. Functional consequences of sarcopenia and dynapenia in the elderly. Curr Opin Clin Nutr Metab Care, 13 (3) ( 2010), pp. 271-276, DOI: 10.1097/MCO.0b013e328337819e

[[39]] SR Fisher, JE Graham, CJ Brown, et al.. Relationship between sedentary behaviour, physical activity, muscle quality and body composition in healthy older adults. Age Ageing, 41 (1) ( 2012), pp. 107-111, DOI: 10.1093/ageing/afr110

[[40]] N Reid, GN Healy, J Gianoudis, et al.. Association of sitting time and breaks in sitting with muscle mass, strength, function, and inflammation in community-dwelling older adults. Osteoporos Int, 29 (6) ( 2018), pp. 1341-1350, DOI: 10.1007/s00198-018-4428-6

[[41]] PD Loprinzi.Lower extremity muscular strength, sedentary behavior, and mortality. Age (Omaha), 38 (2) ( 2016), p. 32, DOI: 10.1007/s11357-016-9899-9

[[42]] U Ekelund, J Tarp, J Steene-Johannessen, et al.. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ, 366 ( 2019), DOI: 10.1136/bmj.l4570

[[43]] TR Komatsu, FSA Borim, AL Neri, LP Corona. Association of dynapenia, obesity and chronic diseases with all-cause mortality of community-dwelling older adults: a path analysis. Geriatr Gerontol Int, 19 (2) ( 2019), pp. 108-112, DOI: 10.1111/ggi.13555

[[44]] L Bey, MT Hamilton. Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity. J Physiol, 551 (2) ( 2003), pp. 673-682, DOI: 10.1113/jphysiol.2003.045591

[[45]] J Gianoudis, CA Bailey, RM Daly. Associations between sedentary behaviour and body composition, muscle function and sarcopenia in community-dwelling older adults. Osteoporos Int, 26 (2) ( 2014), pp. 571-579, DOI: 10.1007/s00198-014-2895-y

We would like to thank all of the participants who volunteered to participate in the study. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.