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Improving Physical Function, Bone and Muscle Health in Older Adults
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Improving Physical Function, Bone and Muscle Health in Older Adults

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 31763

Special Issue Editors

Dr. David Scott

grade E-Mail Website
Guest Editor
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
Interests: sarcopenia; obesity; osteoporosis; exercise; nutrition
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Itamar Levinger

E-Mail Website
Guest Editor
Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
Interests: clinical exercise rehabilitation; bone-muscle interaction; sarcopenia; cardiometabolic diseases

Special Issue Information

Dear Colleagues,

Maintaining optimal muscle and bone health is crticial to healthy ageing. Poor muscle mass, strength and physical performance ("sarcopenia") contribute to outcomes including disability, falls and the development of cardiometabolic diseases, while poor bone structure ("osteoporosis") is associated with increased risk of low trauma fracture. These outcomes are inter-related, and alone, or in combination, can have devastating health and social consequences for older adults, which result in significant costs to economies worldwide.

In recent years, there has been growing interest in the relationships between muscle and bone, and increased recognition that common factors exacerbate age-related muscle and bone loss. Moreover, there is evidence that therapies, such as exercise and nutritional interventions, which improve muscle health can be beneficial for bone health, and vice versa. In this Special Issue of the Journal of Clinical Medicine, we aim to provide our readers, including clinicians, allied health professionals, researchers and older adults themselves, with the latest evidence on the relationships between muscle and bone health. We invite manuscripts describing pre-clinical, epidemiological, intervention and implementation studies which explore potential strategies to promote the maintenance of muscle and bone health throughout the lifespan.

Dr. David Scott
Prof. Dr. Itamar Levinger
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • muscle
  • bone
  • sarcopenia
  • osteoporosis
  • osteosarcopenia
  • physical performance
  • falls and fractures
  • ageing
  • older adults

Published Papers (6 papers)

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Research

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12 pages, 1101 KiB  
Article
Predictors of Referral to Cardiac Rehabilitation in Patients following Hospitalisation with Heart Failure: A Multivariate Regression Analysis
by Catherine Giuliano, Don Vicendese, Sara Vogrin, Rebecca Lane, Andrea Driscoll, Diem Dinh, Katie Palmer, Itamar Levinger and Christopher Neil
J. Clin. Med. 2022, 11(5), 1232; https://doi.org/10.3390/jcm11051232 - 24 Feb 2022
Cited by 3 | Viewed by 2015
Abstract
Background: This exploratory observational case–control study investigated the rate of referral to cardiac rehabilitation (CR) among patients hospitalised with heart failure (HF) and identified factors associated with referral. Methods: Patients hospitalised with HF as identified by the Victorian Cardiac Outcomes Registry HF study [...] Read more.
Background: This exploratory observational case–control study investigated the rate of referral to cardiac rehabilitation (CR) among patients hospitalised with heart failure (HF) and identified factors associated with referral. Methods: Patients hospitalised with HF as identified by the Victorian Cardiac Outcomes Registry HF study were included. Factors found to be univariately associated with referral were selected for multivariate logistic regression. Results: Among 1281 patients (mean age: 76.9 years; 32.8% HFrEF and 33.9% HfpEF), 125 (9.8%) were referred to CR. Patients referred were younger (73.6 (2.7, 81.5) vs. 80.2 (71.1, 86.5) p < 0.001) and were more likely to be men (72%, p < 0.001). Factors associated with referral included inpatient percutaneous coronary intervention (OR, 3.31; 95% CI, 1.04–10.48; p = 0.04), an aetiology of ischaemic or rhythm-related cardiomyopathy, and anticoagulants prescribed on discharge. Factors that lowered the likelihood of referral included older age, female, receiving inpatient oxygen therapy, and the presence of chronic obstructive pulmonary disease (COPD) or anaemia. Conclusions: The rate of referral to CR following hospitalisation with HF is low. Shortfalls are particularly evident among females, older patients, and in those with COPD or anaemia. Future studies should focus on improving referral processes and translating proven strategies that increase referrals to CR into practice. Full article
(This article belongs to the Special Issue Improving Physical Function, Bone and Muscle Health in Older Adults)
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11 pages, 701 KiB  
Article
Associations of Exercise Habits in Adolescence and Old Age with Risk of Osteoporosis in Older Adults: The Bunkyo Health Study
by Hikaru Otsuka, Hiroki Tabata, Huicong Shi, Hideyoshi Kaga, Yuki Someya, Abudurezake Abulaiti, Hitoshi Naito, Futaba Umemura, Saori Kakehi, Muneaki Ishijima, Ryuzo Kawamori, Hirotaka Watada and Yoshifumi Tamura
J. Clin. Med. 2021, 10(24), 5968; https://doi.org/10.3390/jcm10245968 - 19 Dec 2021
Cited by 6 | Viewed by 3435
Abstract
We investigated effects of exercise habits (EHs) in adolescence and old age on osteoporosis prevalence and hip joint and lumbar spine bone mineral density (BMD). Body composition and BMD in 1596 people aged 65–84 years living in Bunkyo-ku, Tokyo, were measured using dual-energy [...] Read more.
We investigated effects of exercise habits (EHs) in adolescence and old age on osteoporosis prevalence and hip joint and lumbar spine bone mineral density (BMD). Body composition and BMD in 1596 people aged 65–84 years living in Bunkyo-ku, Tokyo, were measured using dual-energy X-ray absorptiometry. We divided participants into four groups by a combination of EHs in adolescence and old age: none in either period (None-None), only in adolescence (Active-None), only in old age (None-Active), and in both periods (Active-Active). Logistic regression models were employed to estimate multivariable-adjusted odds ratios (ORs) for osteoporosis determined by T-score (less than −2.5 SD) using the None-None reference group. In men, the combination of EHs in adolescence and old age was not associated with osteoporosis prevalence. However, the lumbar spine’s BMD was significantly higher in the Active-Active than the None-Active group (p = 0.043). In women, the Active-Active group had lower lumbar spine osteoporosis prevalence than the None-None group (OR 0.65; 95% CI, 0.42–1.00, p = 0.049). Furthermore, hip BMD was significantly higher in the Active-Active group than in the other three groups (p = 0.001). Older women with EHs in adolescence and old age had higher lumbar BMD and lower risk of osteoporosis. Full article
(This article belongs to the Special Issue Improving Physical Function, Bone and Muscle Health in Older Adults)
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9 pages, 260 KiB  
Article
Associations between Circulating Inflammatory Biomarkers and Indicators of Muscle Health in Older Men and Women
by Oscar Bergens, Andreas Nilsson and Fawzi Kadi
J. Clin. Med. 2021, 10(22), 5316; https://doi.org/10.3390/jcm10225316 - 15 Nov 2021
Cited by 7 | Viewed by 1658
Abstract
Systemic inflammation is believed to contribute to declining muscle health during aging. The present study aims to examine associations between indicators of muscle health and pro- and anti-inflammatory biomarkers in older men and women, while also considering the impacts of physical activity and [...] Read more.
Systemic inflammation is believed to contribute to declining muscle health during aging. The present study aims to examine associations between indicators of muscle health and pro- and anti-inflammatory biomarkers in older men and women, while also considering the impacts of physical activity and protein intake. An assessment of skeletal muscle index (SMI) by bioelectrical impedance analysis, handgrip strength, and 5-sit-to-stand time, using standardized procedures, was conducted in a population of older men (n = 90) and women (n = 148) aged 65–70 years. The inflammatory biomarkers C-reactive protein (CRP), fibrinogen, interleukin (IL)-6, IL-10, IL-18, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein-1, and macrophage inflammatory protein-1α were assessed in blood samples. Data were analyzed and stratified according to biological sex using multiple linear regression models. In older women, SMI was inversely associated with the pro-inflammatory markers CRP (β = −0.372; p < 0.05), fibrinogen (β = −0.376; p < 0.05), and IL-6 (β = −0.369; p < 0.05). Importantly, these associations were independent of abdominal adiposity (waist circumference), protein intake, physical activity level, as well as any adherence to muscle strengthening guidelines (≥2 sessions/week). In contrast, no corresponding associations were observed in men. In conclusion, our findings indicate the detrimental influence of a pro-inflammatory environment on muscle health regardless of important lifestyle-related factors in older women. However, the lack of such associations in older men highlights the importance of considering biological sex when examining the complex interaction between the systemic inflammatory environment and muscle health. Full article
(This article belongs to the Special Issue Improving Physical Function, Bone and Muscle Health in Older Adults)

Review

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20 pages, 1768 KiB  
Review
Strength Training to Prevent Falls in Older Adults: A Systematic Review with Meta-Analysis of Randomized Controlled Trials
by João Gustavo Claudino, José Afonso, Javad Sarvestan, Marcel Bahia Lanza, Juliana Pennone, Carlos Alberto Cardoso Filho, Julio Cerca Serrão, João Espregueira-Mendes, Ana Luiza Vilefort Vasconcelos, Monique Paula de Andrade, Sílvia Rocha-Rodrigues, Renato Andrade and Rodrigo Ramirez-Campillo
J. Clin. Med. 2021, 10(14), 3184; https://doi.org/10.3390/jcm10143184 - 20 Jul 2021
Cited by 13 | Viewed by 8052
Abstract
We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted [...] Read more.
We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus and Web of Science), without limitations on language or publication date. Eligibility criteria were as follows: RCTs with humans ≥60 years of age of any gender with one group performing supervised ST and a group performing another type of exercise training, reporting data pertaining falls. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis used a random effects model to calculate the risk ratio (RR) for number of falls. Five RCTs with six trials were included (n = 543, 76% women). There was no difference between ST and alternative exercise interventions for falls (RR = 1.00, 95% CI 0.77–1.30, p = 0.99). The certainty of evidence was very low. No dose–response relationship could be established. In sum, ST showed comparable RR based on number of falls in older adults when compared to other multimodal or unimodal exercise modalities, but evidence is scarce and heterogeneous, and additional research is required for more robust conclusions. Registration: PROSPERO CRD42020222908. Full article
(This article belongs to the Special Issue Improving Physical Function, Bone and Muscle Health in Older Adults)
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12 pages, 721 KiB  
Review
Can Transcranial Direct Current Stimulation Enhance Functionality in Older Adults? A Systematic Review
by Andrés Pino-Esteban, Álvaro Megía-García, David Martín-Caro Álvarez, Hector Beltran-Alacreu, Juan Avendaño-Coy, Julio Gómez-Soriano and Diego Serrano-Muñoz
J. Clin. Med. 2021, 10(13), 2981; https://doi.org/10.3390/jcm10132981 - 03 Jul 2021
Cited by 2 | Viewed by 2787
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive, easy to administer, well-tolerated, and safe technique capable of affecting brain excitability, both at the cortical and cerebellum levels. However, its effectiveness has not been sufficiently assessed in all population segments or clinical applications. This [...] Read more.
Transcranial direct current stimulation (tDCS) is a non-invasive, easy to administer, well-tolerated, and safe technique capable of affecting brain excitability, both at the cortical and cerebellum levels. However, its effectiveness has not been sufficiently assessed in all population segments or clinical applications. This systematic review aimed at compiling and summarizing the currently available scientific evidence about the effect of tDCS on functionality in older adults over 60 years of age. A search of databases was conducted to find randomized clinical trials that applied tDCS versus sham stimulation in the above-mentioned population. No limits were established in terms of date of publication. A total of 237 trials were found, of which 24 met the inclusion criteria. Finally, nine studies were analyzed, including 260 healthy subjects with average age between 61.0 and 85.8 years. Seven of the nine included studies reported superior improvements in functionality variables following the application of tDCS compared to sham stimulation. Anodal tDCS applied over the motor cortex may be an effective technique for improving balance and posture control in healthy older adults. However, further high-quality randomized controlled trials are required to determine the most effective protocols and to clarify potential benefits for older adults. Full article
(This article belongs to the Special Issue Improving Physical Function, Bone and Muscle Health in Older Adults)
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34 pages, 5968 KiB  
Review
Benefits of Resistance Training in Early and Late Stages of Frailty and Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies
by Karolina Talar, Alejandro Hernández-Belmonte, Tomas Vetrovsky, Michal Steffl, Ewa Kałamacka and Javier Courel-Ibáñez
J. Clin. Med. 2021, 10(8), 1630; https://doi.org/10.3390/jcm10081630 - 12 Apr 2021
Cited by 78 | Viewed by 12746
Abstract
Sarcopenia and frailty are age-related syndromes with negative effects on the quality of life of older people and on public health costs. Although extensive research has been carried out on the effects of physical exercise and physical syndromes, there is a knowledge gap [...] Read more.
Sarcopenia and frailty are age-related syndromes with negative effects on the quality of life of older people and on public health costs. Although extensive research has been carried out on the effects of physical exercise and physical syndromes, there is a knowledge gap when it comes to the effect of resistance training on muscular strength, physical performance, and body composition at early (prevention) and late (treatment) stages in both syndromes combined. We conducted this systematic review and meta-analysis (CRD42019138253) to gather the evidence of randomized controlled trials examining the effects of resistance training programs lasting ≥8 weeks on strength, physical function, and body composition of adults ≥65 years old diagnosed with pre-sarcopenia, sarcopenia, pre-frailty, or frailty. A search from the earliest record up to and including December 2020 was carried out using the PubMed, Scopus, Web of Science, and Cochrane Library databases. A total of 25 studies (n = 2267 participants) were included. Meta-analysis showed significant changes in favour of resistance training for handgrip (ES = 0.51, p = 0.001) and lower-limb strength (ES = 0.93, p < 0.001), agility (ES = 0.78, p = 0.003), gait speed (ES = 0.75, p < 0.001), postural stability (ES = 0.68, p = 0.007), functional performance (ES = 0.76, p < 0.001), fat mass (ES = 0.41, p = 0.001), and muscle mass (ES = 0.29, p = 0.002). Resistance training during early stages had positive effects in all variables during early stages (ES > 0.12), being particularly effective in improving gait speed (ES = 0.63, p = 0.016) and functional strength (ES = 0.53, p = 0.011). Based on these results, resistance training should be considered as a highly effective preventive strategy to delay and attenuate the negative effects of sarcopenia and frailty in both early and late stages. Full article
(This article belongs to the Special Issue Improving Physical Function, Bone and Muscle Health in Older Adults)
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