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Bioimpedance spectroscopy as a measure of physical functioning in nursing home residents

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Abstract

Background and aims: Intracellular resistance (Ri), a raw measure of bioimpedance spectroscopy (BIS), has been suggested for assessment of muscle health. The associations of repeated BIS measurements with functioning and nutritional status were investigated in nursing home residents suffering from poor health and disabilities. Methods: A total of 106 nursing home residents (age 83±8 yrs, 75% women) were recruited. Whole body and calf BIS measures (lean body mass, resistance at 50 kHz, and Ri), height and calf electrode distance (D) were used to calculate six muscle indices. Hand grip and knee extension strengths were measured and data on Activities of Daily Living (ADL), mobility score, and Mini Nutritional Assessment (MNA) collected. Repeated measurements were performed at 3 (BIS) and 6 months (BIS, muscle strength, ADL, mobility, and MNA). Results: All bioimpedance muscle indices were lower in women than men and associated with MNA. However, the calf skeletal muscle index (SMI=D2/Ri) associated with muscle strength measurements at baseline and consistently with mobility and ADL also at 6-month re-examination. When compared to the highest tertile of SMI percent change (cut point +0.7%), the patients in the lowest tertile (cut point - 11.6%) had a 5.3-fold risk (p=0.004) for mobility decline within the 6-month follow-up. This risk association also remained significant after controlling for age, gender, baseline mobility, and percent change in body weight. Conclusions: Calf intracellular resistance related to electrode distance is associated with the activities of daily living reflecting mobility in typical nursing home residents and a decrease in this index indicates a markedly increased risk for mobility decline.

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References

  1. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39: 412–23.

    Article  PubMed  Google Scholar 

  2. Diaz EO, Villar J, Immink M, Gonzales T. Bioimpedance or anthropometry? Eur J Clin Nutr 1989; 43: 129–37.

    PubMed  CAS  Google Scholar 

  3. Ling CH, de Craen AJ, Slagboom PE et al. Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middleaged adult population. Clin Nutr 2011; 30: 610–5.

    Article  PubMed  Google Scholar 

  4. De Lorenzo A, Andreoli A, Matthie J, Withers P. Predicting body cell mass with bioimpedance by using theoretical methods: a technological review. J Appl Physiol 1997; 82: 1542–58.

    PubMed  Google Scholar 

  5. Norman K, Pirlich M, Sorensen J et al. Bioimpedance vector analysis as a measure of muscle function. Clin Nutr 2009; 28: 78–82.

    Article  PubMed  Google Scholar 

  6. Jaffrin MY, Morel H. Body fluid volumes measurements by impedance: A review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods. Med Eng Phys 2008; 30: 1257–69.

    Article  PubMed  Google Scholar 

  7. Diehl W, Schüle K, Kaiser T. Use of an assistive movement training apparatus in the rehabilitation of geriatric patients. NeuroGeriatrie 2008; 5: 3–12.

    Google Scholar 

  8. Carpenter GI, Hastie CL, Morris JN, Fries BE, Ankri J. Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment. BMC Geriatr 2006; 6: 7.

    Article  PubMed  Google Scholar 

  9. Morris JN, Fries BE, Mehr DR et al. MDS Cognitive Performance Scale. J Gerontol 1994; 49: M174–82.

    Article  PubMed  CAS  Google Scholar 

  10. Fries BE, Schneider DP, Foley WJ, Gavazzi M, Burke R, Cornelius E. Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG-III). Med Care 1994; 32: 668–85.

    Article  PubMed  CAS  Google Scholar 

  11. Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002; 18: 737–57.

    Article  PubMed  Google Scholar 

  12. Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther 2008; 31: 3–10.

    Article  PubMed  Google Scholar 

  13. Suzuki M, Yamada S, Inamura A et al. Reliability and validity of measurements of knee extension strength obtained from nursing home residents with dementia. Am J Phys Med Rehabil 2009; 88: 924–33.

    Article  PubMed  Google Scholar 

  14. Yamada Y, Masuo Y, Yokoyama K et al. Proximal electrode placement improves the estimation of body composition in obese and lean elderly during segmental bioelectrical impedance analysis. Eur J Appl Physiol 2009; 107: 135–44.

    Article  PubMed  Google Scholar 

  15. Yamada Y, Schoeller DA, Nakamura E, Morimoto T, Kimura M, Oda S. Extracellular water may mask actual muscle atrophy during aging. J Gerontol A Biol Sci Med Sci 2010; 65: 510–6.

    Article  PubMed  Google Scholar 

  16. Janssen I, Baumgartner R, Ross R et al. Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 2004; 159: 413–21.

    Article  PubMed  Google Scholar 

  17. Raimann J, Liu L, Ulloa D, Kotanko P, Levin NW. Consequences of overhydration and the need for dry weight assessment. Contrib Nephrol 2008; 161: 99–107.

    Article  PubMed  CAS  Google Scholar 

  18. Zhu F, Kotanko P, Handelman GJ et al. Estimation of normal hydration in dialysis patients using whole body and calf bioimpedance analysis. Physiol Meas 2011; 32: 887–902.

    Article  PubMed  Google Scholar 

  19. Bartok C, Schoeller DA. Estimation of segmental muscle volume by bioelectrical impedance spectroscopy. J Appl Physiol 2004; 96: 161–6.

    Article  PubMed  Google Scholar 

  20. Stahn A, Strobel G, Terblanche E. VO(2max) prediction from multi- frequency bioelectrical impedance analysis. Physiol Meas 2008; 29: 193–203.

    Article  PubMed  Google Scholar 

  21. Wallace JI, Schwartz RS, LaCroix AZ, Uhlmann RF, Pearlman RA. Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc 1995; 43: 329–37.

    PubMed  CAS  Google Scholar 

  22. Ritchie CS, Locher JL, Roth DL, McVie T, Sawyer P, Allman R. Unintentional weight loss predicts decline in activities of daily living function and life-space mobility over 4 years among community- dwelling older adults. J Gerontol A Biol Sci Med Sci 2008; 63: 67–75.

    Article  PubMed  Google Scholar 

  23. Salva A, Coll-Planas L, Bruce S et al. Nutritional assessment of residents in long-term care facilities (LTCFs): recommendations of the task force on nutrition and ageing of the IAGG European region and the IANA. J Nutr Health Aging 2009; 13: 475–83.

    Article  PubMed  CAS  Google Scholar 

  24. Simmons SF, Peterson EN, You C. The accuracy of monthly weight assessments in nursing homes: implications for the identification of weight loss. J Nutr Health Aging 2009; 13: 284–8.

    Article  PubMed  CAS  Google Scholar 

  25. Szulc P, Munoz F, Marchand F, Chapurlat R, Delmas PD. Rapid loss of appendicular skeletal muscle mass is associated with higher all-cause mortality in older men: the prospective MINOS study. Am J Clin Nutr 2010; 91: 1227–36.

    Article  PubMed  CAS  Google Scholar 

  26. Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 2008; 11: 693–700.

    Article  PubMed  Google Scholar 

  27. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults,1999–2008. JAMA 2010; 303: 235–41.

    Article  PubMed  CAS  Google Scholar 

  28. Villareal DT, Banks M, Sinacore DR, Siener C, Klein S. Effect of weight loss and exercise on frailty in obese older adults. Arch Intern Med 2006; 166: 860–6.

    Article  PubMed  Google Scholar 

  29. Villareal DT, Chode S, Parimi N et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med 2011; 364: 1218–29.

    Article  PubMed  CAS  Google Scholar 

  30. Shea MK, Nicklas BJ, Houston DK et al. The effect of intentional weight loss on all-cause mortality in older adults: results of a randomized controlled weight-loss trial. Am J Clin Nutr 2011; 94: 839–46.

    Article  PubMed  CAS  Google Scholar 

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Björkman, M.P., Finne-Soveri, H., Pilvi, T.K. et al. Bioimpedance spectroscopy as a measure of physical functioning in nursing home residents. Aging Clin Exp Res 24, 612–618 (2012). https://doi.org/10.3275/8719

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