Phase angle as a key marker of muscular and bone quality in community-dwelling independent older adults: A cross-sectional exploratory pilot study

Abstract

The aim of the present cross-sectional exploratory pilot study was to analyze the ability of the Phase Angle (PhA) to predict physical function, muscle strength and bone indicators, upon adjusting for potential confounders [age, sex, lean mass, and body mass index (BMI)]. This study included 56 physically independent older adults (age, 68.29 ± 3.01 years; BMI, 28.09 ± 4.37 kg/m²). A multi-frequency segmental bioelectrical impedance analysis was used to measure PhA at 50 KHz. Additionally, physical function was assessed through four functional capacity tests [30-sec chair-stand; seated medicine ball throw (SMBT); timed up & go; and 6-min walking test (6 MWT)], muscle strength through the handgrip test (dominant side) and maximal isokinetic strength of the dominant knee flexor and extensor. Moreover, bone indicators and body composition were assessed through the dual energy X-ray absorptiometry. PhA was significantly associated with SMBT (r = 0.375, effect size (ES) = moderate); 6 MWT (r = 0.396, ES = moderate); 30-sec chair-stand (rho = 0.314, ES = moderate); knee extension (rho = 0.566, ES = large) and flexion (r = 0.459, ES = moderate); handgrip (rho = 0.432, ES = moderate); whole-body bone mineral content (BMC) (r = 0.316, ES = moderate); femoral neck BMC (r = 0.469, ES = moderate); and femoral neck bone mineral density (BMD) (rho = 0.433, ES = moderate). Additionally, the results of multiple regression analysis demonstrated that PhA is significantly associated with SMBT (p < 0.001; R² = 0.629), 6 MWT (p = 0.004; R² = 0.214), knee extension (p < 0.001; R² = 0.697), knee flexion (p < 0.001; R² = 0.355), handgrip test (p < 0.001; R² = 0.774), whole-body BMC (p < 0.001; R² = 0.524), femoral neck BMC (p = 0.001; R² = 0.249), and femoral neck BMD (p = 0.020; R² = 0.153). The results of the preliminary analysis suggested that PhA is linked to muscle strength and some factors related to physical function and bone quality in community-dwelling older adults.

Keywords: Aging; Bioelectrical impedance analysis; Bone mineral density; Elderly; Functional capacity; Skeleton.

Fig. 1

Study enrolment STROBE flow chart.

Fig. 2

Correlations between phase angle and: A), lean mass; B), seated medicine ball throw; C), 6-min walking test; D), knee extension; E), knee flexion; F), handgrip test; G), whole-body BMC; H), femoral neck BMC; and I), femoral neck BMD after controlling for age.