Lower extremity muscle mass predicts functional performance in mobility-limited elders

Abstract

Objectives: This study examined the influence of lower extremity body composition and muscle strength on the severity of mobility-disability in community-dwelling older adults.

Methods: Fifty-seven older males and females (age 74.2 +/- 7 yrs; BMI 28.9 +/- 6 kg/m2) underwent an objective assessment of lower extremity functional performance, the Short Physical Performance Battery test (SPPB). Participants were subsequently classified as having moderate (SPPB score 7: n = 38) or severe mobility impairments (SPPB score <or= 7: n = 19). Body composition was assessed using dual-energy X-ray absorptiometry and provided measures of bone mineral density (BMD), total leg lean mass (TLM) and total body fat. Maximal hip extensor muscle strength was estimated using the bilateral leg press exercise. Multiple logistic regression analysis was utilized to identify the significant independent variables that predicted the level of mobility-disability.

Results: TLM was a strong independent predictor of the level of functional impairment, after accounting for chronic medical conditions, BMD, body fat, body weight and habitual physical activity. In a separate predictive model, reduced muscle strength was also a significant predictor of severe functional impairment. The severity of mobility-disability was not influenced by gender (p = 0.71). A strong association was elicited between TLM and muscle strength (r = 0.78, p < 0.01).

Conclusions: These data suggest that lower extremity muscle mass is an important determinant of physical performance among functionally-limited elders. Such findings may have important implications for the design of suitable strategies to maintain independence in older adults with compromised physical functioning. Additional studies are warranted to assess the efficacy of lifestyle, exercise or therapeutic interventions for increasing lean body mass in this population.

Figure 1

Correlation between total leg lean mass and leg strength (n = 57)

Figure 2

Figure 2a. Univariate association between SPPB score and TLM threshold suggested by GAM plot (n = 57) Figure 2b. Univariate association between SPPB score and muscle strength suggested by GAM plot (n = 57)

Figure 2

Figure 2a. Univariate association between SPPB score and TLM threshold suggested by GAM plot (n = 57) Figure 2b. Univariate association between SPPB score and muscle strength suggested by GAM plot (n = 57)