الفهرس | Only 14 pages are availabe for public view |
Abstract The aging process is characterized by changes in body composition. Elderly individuals experience decrease in muscle mass and increase in fat mass or fat redistribution with increase in visceral fat mass. The changes in body composition may lead to functional decline and decrease in elderly physical performance. The degree and speed of these changes in muscle mass, fat mass and physical performance is different in elderly population and determined by many social and environmental factors. Elderly who experience decline in physical performance have higher rates of dependency, institutionalization, and mortality. Identification of factors that leads to functional decline and disability is important to set strategies and interventions that counteract their effect and improve physical outcome. In elderly population, the changes in body composition, especially changes in muscle and fat mass, and their relation to physical performance are a point of interest in different researches. Previous epidemiological studies showed inconsistent results examining muscle, and fat relation with physical performance in elderly.Several studies have reported an association between low muscle mass and limited physical performance. The aim of this work was to study the relationship between body composition (skeletal muscle mass, fat mass, BMI and WHR) and physical performance in elderly, and to evaluate the risk factors for poor physical performance in this population. The study sample included two hundred sixty seven participants aged sixty years and above. They included eighty seven males and one hundred eighty females. Study participants were recruited from geriatric clubs and geriatric homes in Cairo governorate, Egypt. After obtaining informed consent, every study participant underwent assessment of physical performance using hand grip strength and walking speed, assessment of self-reported function using ADL and IADL, determination of body composition using BIA; and measuring anthropometric measures BMI and WHR. Our study revealed significant relation between low skeletal muscle index and low physical performance measured by hand grip strength, walking speed, ADL and IADL. Regarding fat mass percentage, there was significantly inverse relation with physical performance measures except ADL. Combination of both increased fat percentage and low skeletal muscle mass index showed the worst physical performance measures.While low BMI was significantly related to low hand grip only and waist hip ratio showed no significant relation with physical performance. Body composition assessment using BIA was more conclusive than BMI and WHR. Logistic regression analysis revealed that low skeletal muscle index, high fat mass and low BMI are independent predictors of low hand grip strength. Also increasing age, institutionalization, smoking and low nutritional state have the same effect. Low skeletal muscle mass and high fat mass were also independent risk factors for low gait speed. Other risk factors for low gait speed were found such as institutionalization, number of chronic diseases, smoking and low nutritional state. As regard self-reported function, low skeletal muscle index and low nutritional state were both independent predictors of dependence on ADL. While increased age, institutionalization and high fat mass were independent predictors of dependence in IADL. |