Generic placeholder image

Current Aging Science

Author(s): Pinelopi S. Stavrinou*, George Aphamis, Eleni Andreou, Marios Pantzaris and Christoforos D. Giannaki

DOI: 10.2174/1874609814666210831155002

DownloadDownload PDF Flyer Cite As
Association of Body Composition with Functional Capacity and Cognitive Function in Older Adults Living in Nursing Homes

Page: [77 - 82] Pages: 6

  • * (Excluding Mailing and Handling)

Abstract

Background: Older adults living in nursing homes have an increased risk of adverse outcomes. However, the role of body composition in vital health and quality of life parameters such as functional capacity and cognitive function is less studied in this group of older adults compared to community-dwelling counterparts.

Objective: The aim of the present study was to examine the association of body composition with functional capacity and cognitive function in nursing home residents.

Methods: Fifty-three older adults (82.8 ± 7.3 years) were enrolled in this study and they underwent body composition evaluation, functional capacity and cognitive function measurements.

Results: The results showed a high prevalence of obesity accompanied by functional capacity limitations and cognitive impairment in older adults living in nursing homes. Partial correlations, controlling for age, showed that body fat percentage was positively correlated with sit-to-stand-5 (r = 0.310, p = 0.025) and timed-up-and-go (r = 0.331, p = 0.017), and negatively correlated with handgrip strength test results (r = -0.431, p<0.001), whereas greater lean body mass was associated with better sit-to-stand-5 (r = -0.410, p = 0.003), handgrip strength (r=0.624, p<0.001) and cognitive function performance (r = 0.302, p = 0.037).

Conclusions: These important associations reinforce the need to develop effective healthy lifestyle interventions targeting both lean mass and body fat to combat functional and cognitive decline in nursing home residents.

Keywords: Elderly, lean body mass, body fat, strength, cognition, long-term care facilities.

Graphical Abstract

[1]
Kontis V, Bennett JE, Mathers CD, Li G, Foreman K, Ezzati M. Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble. Lancet 2017; 389(10076): 1323-35.
[http://dx.doi.org/10.1016/S0140-6736(16)32381-9] [PMID: 28236464]
[2]
Gonçalves Damascena K, Batisti Ferreira C, Dos Santos Teixeira P, et al. Functional capacity and obesity reflect the cognitive performance of older adults living in long-term care facilities. Psychogeriatrics 2017; 17(6): 439-45.
[http://dx.doi.org/10.1111/psyg.12273] [PMID: 28589705]
[3]
Kazoglu M, Yuruk ZO. Comparison of the physical fitness levels in nursing home residents and community-dwelling older adults. Arch Gerontol Geriatr 2020; 89: 104106.
[http://dx.doi.org/10.1016/j.archger.2020.104106] [PMID: 32447125]
[4]
Hoffmann F, Kaduszkiewicz H, Glaeske G, van den Bussche H, Koller D. Prevalence of dementia in nursing home and community-dwelling older adults in Germany. Aging Clin Exp Res 2014; 26(5): 555-9.
[http://dx.doi.org/10.1007/s40520-014-0210-6] [PMID: 24647931]
[5]
Peralta M, Ramos M, Lipert A, Martins J, Marques A. Prevalence and trends of overweight and obesity in older adults from 10 European countries from 2005 to 2013. Scand J Public Health 2018; 46(5): 522-9.
[http://dx.doi.org/10.1177/1403494818764810] [PMID: 29569525]
[6]
Arterburn DE, Crane PK, Sullivan SD. The coming epidemic of obesity in elderly Americans. J Am Geriatr Soc 2004; 52(11): 1907-12.
[http://dx.doi.org/10.1111/j.1532-5415.2004.52517.x] [PMID: 15507070]
[7]
Osher E, Stern N. Obesity in elderly subjects: in sheep’s clothing perhaps, but still a wolf! Diabetes Care 2009; 32(Suppl. 2): S398-402.
[http://dx.doi.org/10.2337/dc09-S347] [PMID: 19875588]
[8]
Wilkinson DJ, Piasecki M, Atherton PJ. The age-related loss of skeletal muscle mass and function: Measurement and physiology of muscle fibre atrophy and muscle fibre loss in humans. Ageing Res Rev 2018; 47: 123-32.
[http://dx.doi.org/10.1016/j.arr.2018.07.005] [PMID: 30048806]
[9]
Mitchell WK, Williams J, Atherton P, Larvin M, Lund J, Narici M. Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Front Physiol 2012; 3: 260.
[http://dx.doi.org/10.3389/fphys.2012.00260] [PMID: 22934016]
[10]
Wannamethee SG, Shaper AG, Lennon L, Whincup PH. Decreased muscle mass and increased central adiposity are independently related to mortality in older men. Am J Clin Nutr 2007; 86(5): 1339-46.
[http://dx.doi.org/10.1093/ajcn/86.5.1339] [PMID: 17991644]
[11]
McGrath RP, Kraemer WJ, Snih SA, Peterson MD. Handgrip strength and health in aging adults. Sports Med 2018; 48(9): 1993-2000.
[http://dx.doi.org/10.1007/s40279-018-0952-y] [PMID: 29943230]
[12]
Gaugler JE, Duval S, Anderson KA, Kane RL. Predicting nursing home admission in the U.S: A meta-analysis. BMC Geriatr 2007; 7: 13.
[http://dx.doi.org/10.1186/1471-2318-7-13] [PMID: 17578574]
[13]
Benito-León J, Mitchell AJ, Hernández-Gallego J, Bermejo-Pareja F. Obesity and impaired cognitive functioning in the elderly: a population-based cross-sectional study (NEDICES). Eur J Neurol 2013; 20(6): 899-906, e76-e77.
[http://dx.doi.org/10.1111/ene.12083] [PMID: 23323838]
[14]
Pataky Z, Armand S, Müller-Pinget S, Golay A, Allet L. Effects of obesity on functional capacity. Obesity (Silver Spring) 2014; 22(1): 56-62.
[http://dx.doi.org/10.1002/oby.20514] [PMID: 23794214]
[15]
Cui C, Mackey RH, Shaaban CE, Kuller LH, Lopez OL, Sekikawa A. Associations of body composition with incident dementia in older adults: Cardiovascular Health Study-Cognition Study. Alzheimers Dement 2020; 16(10): 1402-11.
[http://dx.doi.org/10.1002/alz.12125] [PMID: 32803916]
[16]
Batsis JA, Mackenzie TA, Bartels SJ, Sahakyan KR, Somers VK, Lopez-Jimenez F. Diagnostic accuracy of body mass index to identify obesity in older adults: NHANES 1999-2004. Int J Obes 2016; 40(5): 761-7.
[http://dx.doi.org/10.1038/ijo.2015.243] [PMID: 26620887]
[17]
Villareal DT, Apovian CM, Kushner RF, Klein S. Obesity in older adults: Technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obes Res 2005; 13(11): 1849-63.
[http://dx.doi.org/10.1038/oby.2005.228] [PMID: 16339115]
[18]
Jones CJ, Rikli RE, Beam WCA. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport 1999; 70(2): 113-9.
[http://dx.doi.org/10.1080/02701367.1999.10608028] [PMID: 10380242]
[19]
Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39(2): 142-8.
[http://dx.doi.org/10.1111/j.1532-5415.1991.tb01616.x] [PMID: 1991946]
[20]
Rikli RE, Jones CJ. The reliability and validity of a 6-minute walk test as a measure of physical endurance in older adults. J Aging Phys Act 1998; 6: 363-75.
[http://dx.doi.org/10.1123/japa.6.4.363]
[21]
Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing 2019; 48(1): 16-31.
[http://dx.doi.org/10.1093/ageing/afy169] [PMID: 30312372]
[22]
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189-98.
[http://dx.doi.org/10.1016/0022-3956(75)90026-6] [PMID: 1202204]
[23]
Tombaugh TN, McIntyre NJ. The mini-mental state examination: A comprehensive review. J Am Geriatr Soc 1992; 40(9): 922-35.
[http://dx.doi.org/10.1111/j.1532-5415.1992.tb01992.x] [PMID: 1512391]
[24]
Brydges CR. Effect size guidelines, sample size calculations, and statistical power in gerontology. Innov Aging 2019; 3(4): igz036.
[http://dx.doi.org/10.1093/geroni/igz036] [PMID: 31528719]
[25]
Harris JA, Castle NG. Obesity and nursing home care in the united states: A systematic review. Gerontologist 2019; 59(3): e196-206.
[http://dx.doi.org/10.1093/geront/gnx128] [PMID: 29253135]
[26]
Leong DP, Teo KK, Rangarajan S, et al. Prognostic value of grip strength: Findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet 2015; 386(9990): 266-73.
[http://dx.doi.org/10.1016/S0140-6736(14)62000-6] [PMID: 25982160]
[27]
Lee J. Associations between handgrip strength and disease-specific mortality including cancer, cardiovascular, and respiratory diseases in older adults: A meta-analysis. J Aging Phys Act 2020; 28(2): 320-31.
[http://dx.doi.org/10.1123/japa.2018-0348] [PMID: 31810062]
[28]
Sampaio A, Marques-Aleixo I, Seabra A, Mota J, Marques E, Carvalho J. Physical fitness in institutionalized older adults with dementia: association with cognition, functional capacity and quality of life. Aging Clin Exp Res 2020; 32(11): 2329-38.
[http://dx.doi.org/10.1007/s40520-019-01445-7] [PMID: 31927709]
[29]
Prado CMM, Wells JCK, Smith SR, Stephan BCM, Siervo M. Sarcopenic obesity: A Critical appraisal of the current evidence. Clin Nutr 2012; 31(5): 583-601.
[http://dx.doi.org/10.1016/j.clnu.2012.06.010] [PMID: 22809635]
[30]
Papachristou E, Ramsay SE, Lennon LT, et al. The relationships between body composition characteristics and cognitive functioning in a population-based sample of older British men. BMC Geriatr 2015; 15: 172.
[http://dx.doi.org/10.1186/s12877-015-0169-y] [PMID: 26692280]
[31]
Livingston G, Sommerlad A, Orgeta V, et al. The lancet international commission on dementia prevention and care. Lancet 2017; 390: 2673-734.
[http://dx.doi.org/10.1016/S0140-6736(17)31363-6] [PMID: 28735855]
[32]
Modgil S, Lahiri DK, Sharma VL, Anand A. Role of early life exposure and environment on neurodegeneration: Implications on brain disorders. Transl Neurodegener 2014; 3: 9.
[http://dx.doi.org/10.1186/2047-9158-3-9] [PMID: 24847438]
[33]
Teixeira RB, Dos Santos Amorim PR, Marins JCB, et al. Physical inactivity is liable to the increased cardiovascular risk and impaired cognitive profile. Curr Alzheimer Res 2020; 17(4): 365-72.
[http://dx.doi.org/10.2174/1567205017666200522205646] [PMID: 32442085]
[34]
Smith E, Bailey PE, Crawford J, et al. Adiposity estimated using dual energy X-ray absorptiometry and body mass index and its association with cognition in elderly adults. J Am Geriatr Soc 2014; 62(12): 2311-8.
[http://dx.doi.org/10.1111/jgs.13157] [PMID: 25516027]
[35]
Dinu M, Colombini B, Pagliai G, et al. BMI, functional and cognitive status in a cohort of nonagenarians: Results from the Mugello study. Eur Geriatr Med 2021; 12(2): 379-86.
[http://dx.doi.org/10.1007/s41999-020-00417-9] [PMID: 33085046]
[36]
Wang C, Fu W, Cao S, et al. Weight loss and the risk of dementia: A meta-analysis of cohort studies. Curr Alzheimer Res 2021; 18(2): 125-35.
[http://dx.doi.org/10.2174/1567205018666210414112723] [PMID: 33855945]
[37]
Mavros Y, Gates N, Wilson GC, et al. Mediation of cognitive function improvements by strength gains after resistance training in older adults with mild cognitive impairment: Outcomes of the study of mental and resistance training. J Am Geriatr Soc 2017; 65(3): 550-9.
[http://dx.doi.org/10.1111/jgs.14542] [PMID: 28304092]
[38]
Hunter GR, McCarthy JP, Bamman MM. Effects of resistance training on older adults. Sports Med 2004; 34(5): 329-48.
[http://dx.doi.org/10.2165/00007256-200434050-00005] [PMID: 15107011]
[39]
Herold F, Törpel A, Schega L, Müller NG. Functional and/or structural brain changes in response to resistance exercises and resistance training lead to cognitive improvements - A systematic review. Eur Rev Aging Phys Act 2019; 16: 10.
[http://dx.doi.org/10.1186/s11556-019-0217-2] [PMID: 31333805]
[40]
Stavrinou PS, Andreou E, Aphamis G, et al. The effects of a 6-month high dose omega-3 and omega-6 polyunsaturated fatty acids and antioxidant vitamins supplementation on cognitive function and functional capacity in older adults with mild cognitive impairment. Nutrients 2020; 12(2): 1-17.
[http://dx.doi.org/10.3390/nu12020325] [PMID: 31991898]
[41]
Levin O, Netz Y, Ziv G. The beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: A systematic review. Eur Rev Aging Phys Act 2017; 14: 20.
[http://dx.doi.org/10.1186/s11556-017-0189-z] [PMID: 29276545]