Jesse Zanker1, Terri Blackwell2, Sheena Patel2, Kate Duchowny3, Sharon Brennan-Olsen4, Steven R Cummings3, William J Evans5, Eric S Orwoll6, David Scott7, Sara Vogrin1, Gustavo Duque1, Peggy M Cawthon8. 1. Department of Medicine-Western Health, University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, Melbourne, Victoria, Australia. 2. Research Institute, California Pacific Medical Center, San Francisco, United States of America. 3. Research Institute, California Pacific Medical Center, San Francisco, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, United States of America. 4. Department of Medicine-Western Health, University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, Melbourne, Victoria, Australia; School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia; Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; Department of Nutritional Sciences and Toxicology, University of California, Berkeley, United States of America. 5. Department of Medicine, Duke University, Durham, NC, United States of America; Department of Medicine, Oregon Health and Science University, Portland, United States of America. 6. Department of Medicine, Duke University, Durham, NC, United States of America. 7. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia. 8. Research Institute, California Pacific Medical Center, San Francisco, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, United States of America. Electronic address: eggy.caewthon@ucsf.edu.
Abstract
BACKGROUND: It is not known how measures of body composition, strength and physical performance are interrelated or how empirical groupings of these measures relate to disability and mobility disability. METHODS: Muscle mass was assessed by D3-creatine dilution (D3Cr muscle mass) in 1345 men (84.1 ± 4.1 years) enrolled in the Osteoporotic Fractures in Men (MrOS) study. Participants completed anthropomorphic measures, walk speed, grip strength, chair stands, and dual x-ray absorptiometry (DXA) estimated appendicular lean mass (ALM) and body fat percentage. Men reported limitations in mobility, activities of daily living (ADLs) and instrumental ADLs at initial and over 2.2 ± 0.3 years. Factor analysis reduced variables into related groups and negative binomial models calculated relative risk (RR) of factors with mobility and disability outcomes. RESULTS: Factor analysis reduced 10 variables into four factors: Factor 1, body composition, including ALM, body fat percentage, weight and muscle mass; Factor 2, body size and lean mass, including height, weight and ALM; Factor 3, muscle mass, strength and performance, including walk speed, chair stands, grip strength, and muscle mass; and Factor 4, lean mass and weight, including ALM and weight. Only Factor 3 was significantly associated (p-value < .001) with prevalent disability (RR per standard deviation increment in factor score (reflecting higher muscle mass, strength and physical performance) 0.44, 0.35-0.56) and mobility disability (RR 0.22, 0.17 0.28), and incident mobility disability (RR 0.37, 0.27-0.50). CONCLUSION: D3Cr muscle mass was the only body composition variable that co-segregated with strength and physical performance measures, and contributed to a factor that was associated with disability outcomes in older men.
BACKGROUND: It is not known how measures of body composition, strength and physical performance are interrelated or how empirical groupings of these measures relate to disability and mobility disability. METHODS: Muscle mass was assessed by D3-creatine dilution (D3Cr muscle mass) in 1345 men (84.1 ± 4.1 years) enrolled in the Osteoporotic Fractures in Men (MrOS) study. Participants completed anthropomorphic measures, walk speed, grip strength, chair stands, and dual x-ray absorptiometry (DXA) estimated appendicular lean mass (ALM) and body fat percentage. Men reported limitations in mobility, activities of daily living (ADLs) and instrumental ADLs at initial and over 2.2 ± 0.3 years. Factor analysis reduced variables into related groups and negative binomial models calculated relative risk (RR) of factors with mobility and disability outcomes. RESULTS: Factor analysis reduced 10 variables into four factors: Factor 1, body composition, including ALM, body fat percentage, weight and muscle mass; Factor 2, body size and lean mass, including height, weight and ALM; Factor 3, muscle mass, strength and performance, including walk speed, chair stands, grip strength, and muscle mass; and Factor 4, lean mass and weight, including ALM and weight. Only Factor 3 was significantly associated (p-value < .001) with prevalent disability (RR per standard deviation increment in factor score (reflecting higher muscle mass, strength and physical performance) 0.44, 0.35-0.56) and mobility disability (RR 0.22, 0.17 0.28), and incident mobility disability (RR 0.37, 0.27-0.50). CONCLUSION: D3Cr muscle mass was the only body composition variable that co-segregated with strength and physical performance measures, and contributed to a factor that was associated with disability outcomes in older men.
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