Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: a systematic review.

BACKGROUND This study critically appraises the measurement properties of tools to measure muscle mass, strength, and physical performance in community-dwelling older people. This can support the selection of a valid and reliable set of tools that is feasible for future screening and identification of sarcopenia. METHODS The databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane were systematically searched (January 11, 2012). Studies were included if they investigated the measurement properties or feasibility, or both, of tools to measure muscle mass, strength, and physical performance in community-dwelling older people aged ≥60 years. The consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist was used for quality appraisal of the studies. RESULTS Sixty-two publications were deemed eligible, including tools for muscle mass (n = 16), muscle strength (n = 15), and physical performance (n = 31). Magnetic resonance imaging, computed tomography, and a 4-compartment model were used as gold standards for muscle mass assessment. Other frequently used measures of muscle mass are dual-energy x-ray and the bioelectrical impedance (BIA); however, reliability data of the BIA are lacking. Handheld dynamometry and gait speed or a short physical performance battery provide a valid and reliable measurement of muscle strength and physical performance, respectively. CONCLUSIONS It can be concluded that several tools are available for valid and reliable measurements of muscle mass, strength, and performance in clinical settings. For a home-setting BIA, handheld dynamometry and gait speed or a short physical performance battery are the most valid, reliable, and feasible. The combination of selected instruments and its use for the screening and identification of sarcopenia in community-dwelling older people need further evaluation.

[1]  I. H. Rosenberg,et al.  Summary comments : Epidemiological and methodological problem in determining nutritional status of older persons , 1989 .

[2]  S. Seino,et al.  Validation of lower extremity performance tests for determining the mobility limitation levels in community-dwelling older women , 2009, Aging clinical and experimental research.

[3]  J. VanSwearingen,et al.  Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test , 2010, Physical Therapy.

[4]  N. Alexander,et al.  ‘The Multiple-Sit-to-Stand’ Field Test for Older Adults: What Does It Measure? , 2004, Gerontology.

[5]  W. Beam,et al.  A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. , 1999, Research quarterly for exercise and sport.

[6]  R. Westendorp,et al.  Defining sarcopenia: the impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort , 2012, AGE.

[7]  A. D. de Craen,et al.  Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population. , 2011, Clinical nutrition.

[8]  H. Suominen,et al.  Quantitative ultrasonography of muscle: detection of adaptations to training in elderly women. , 1996, Archives of physical medicine and rehabilitation.

[9]  L. Lissner,et al.  Body composition estimated by bioelectrical impedance in the Swedish elderly. Development of population-based prediction equation and reference values of fat-free mass and body fat for 70- and 75-y olds , 2003, European Journal of Clinical Nutrition.

[10]  P. Abizanda,et al.  Validity and usefulness of hand-held dynamometry for measuring muscle strength in community-dwelling older persons. , 2012, Archives of gerontology and geriatrics.

[11]  Mark Latt,et al.  Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. , 2004, Gait & posture.

[12]  D. Schoeller,et al.  Prediction of fat-free mass by bioelectrical impedance analysis in older adults from developing countries: A cross-validation study using the deuterium dilution method , 2010, The journal of nutrition, health & aging.

[13]  Andrea Russo,et al.  Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. , 2012, Clinical nutrition.

[14]  L. Mollinger,et al.  Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. , 2002, Physical therapy.

[15]  Nicola Maffulli,et al.  Sarcopenia: characteristics, mechanisms and functional significance. , 2010, British medical bulletin.

[16]  R. Kington,et al.  Reliability and Prevalence of Physical Performance Examination Assessing Mobility and Balance in Older Persons in the US: Data from the Third National Health and Nutrition Examination Survey , 2000, Journal of the American Geriatrics Society.

[17]  Gerry Purdy,et al.  Summary comments , 1981, SIGB.

[18]  J. Morris,et al.  A brief clinical tool to assess physical function: the mini-physical performance test. , 2010, Archives of gerontology and geriatrics.

[19]  C. Wang,et al.  Grip strength in older adults: test-retest reliability and cutoff for subjective weakness of using the hands in heavy tasks. , 2010, Archives of physical medicine and rehabilitation.

[20]  A. LaCroix,et al.  Dual-energy X-ray absorptiometry is a valid tool for assessing skeletal muscle mass in older women. , 2007, The Journal of nutrition.

[21]  L. Ferrucci,et al.  International working group on Sarcopenia , 2011 .

[22]  P. Deurenberg,et al.  Assessment of body composition by bioelectrical impedance in a population aged greater than 60 y. , 1990, The American journal of clinical nutrition.

[23]  J. Baeyens,et al.  European working group on sarcopenia in older people. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people , 2010 .

[24]  K L Beissner,et al.  Muscle force and range of motion as predictors of function in older adults. , 2000, Physical therapy.

[25]  Suzanne G. Leveille,et al.  The 6-minute walk test in mobility-limited elders: what is being measured? , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[26]  M. E. Cress,et al.  Continuous-scale physical functional performance in healthy older adults: a validation study. , 1996, Archives of physical medicine and rehabilitation.

[27]  Kerianne Greene.  Mobility Related Function in Older Adults: Assessment With a 6-Minute Walk Test. , 2000 .

[28]  J. Guralnik,et al.  Concordance and discordance between two measures of lower extremity function: 400 meter self-paced walk and SPPB , 2006, Aging clinical and experimental research.

[29]  Suzanne G. Leveille,et al.  Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[30]  C. Jessie Jones,et al.  The Reliability and Validity of a 6-Minute Walk Test as a Measure of Physical Endurance in Older Adults , 1998 .

[31]  René Fejer,et al.  Hand‐held Dynamometry Correlation With the Gold Standard Isokinetic Dynamometry: A Systematic Review , 2011, PM & R : the journal of injury, function, and rehabilitation.

[32]  R. Reed,et al.  A Comparison of Hand‐Held Isometric Strength Measurement with Isokinetic Muscle Strength Measurement in the Elderly , 1993, Journal of the American Geriatrics Society.

[33]  Avan Aihie Sayer,et al.  A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. , 2011, Age and ageing.

[34]  S. Seino,et al.  Is a composite score of physical performance measures more useful than usual gait speed alone in assessing functional status? , 2012, Archives of gerontology and geriatrics.

[35]  V. Hughes,et al.  Sarcopenia: current concepts. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[36]  S. Owen,et al.  Development and validation of a performance-based measure of upper extremity functional limitation , 2005, Aging clinical and experimental research.

[37]  M. Tinetti,et al.  Validation and use of performance measures of functioning in a non-disabled older population: MacArthur studies of successful aging , 1994, Aging.

[38]  R. J. Shephard,et al.  Objectively measured physical capability levels and mortality: systematic review and meta-analysis , 2011 .

[39]  Michael E. Miller,et al.  Reliability of the 400‐M Usual‐Pace Walk Test as an Assessment of Mobility Limitation in Older Adults , 2004, Journal of the American Geriatrics Society.

[40]  Laura Ray,et al.  The reliability of upper- and lower-extremity strength testing in a community survey of older adults. , 2002, Archives of physical medicine and rehabilitation.

[41]  M. Di Monaco,et al.  Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture. , 2011, Archives of gerontology and geriatrics.

[42]  Evaluation of air-displacement plethysmography and bioelectrical impedance analysis vs dual-energy X-ray absorptiometry for the assessment of fat-free mass in elderly subjects , 2008, European Journal of Clinical Nutrition.

[43]  Sandrine Andrieu,et al.  Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. , 2011, Journal of the American Medical Directors Association.

[44]  Hylton B. Menz,et al.  Foot and Ankle Strength Assessment Using Hand-Held Dynamometry: Reliability and Age-Related Differences , 2009, Gerontology.

[45]  C. Terwee,et al.  The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study , 2010, Quality of Life Research.

[46]  M. Visser,et al.  Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, Aging, and Body Composition Study--Dual-Energy X-ray Absorptiometry and Body Composition Working Group. , 1999, Journal of applied physiology.

[47]  H. Payette,et al.  Muscle strength and functional mobility in relation to lean body mass in free-living frail elderly women , 1998, European Journal of Clinical Nutrition.

[48]  J. Desrosiers,et al.  Comparison of the Jamar dynamometer and the Martin vigorimeter for grip strength measurements in a healthy elderly population. , 1995, Scandinavian journal of rehabilitation medicine.

[49]  T. Manini,et al.  Evaluating task modification as an objective measure of functional limitation: repeatability and comparability. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[50]  B. Manor,et al.  Validity and Reliability of Measurements of Elbow Flexion Strength Obtained from Older Adults Using Elastic Bands , 2006, Journal of geriatric physical therapy.

[51]  E. Petróski,et al.  Validation of bioelectrical impedance for the prediction of fat-free mass in Brazilian elderly subjects. , 2008, Arquivos brasileiros de endocrinologia e metabologia.

[52]  Shalender Bhasin,et al.  Tests of Muscle Strength and Physical Function: Reliability and Discrimination of Performance in Younger and Older Men and Older Men with Mobility Limitations , 2008, Journal of the American Geriatrics Society.

[53]  C. Phillips,et al.  Objectively measuring physical ability in elderly persons: the Physical Capacity Evaluation. , 1995, American journal of public health.

[54]  M. Horvat,et al.  Repeated chair stands as a measure of lower limb strength in sexagenarian women. , 2004, The journals of gerontology. Series A, Biological sciences and medical sciences.

[55]  Catherine Sherrington,et al.  Reliability of clinical tests of foot and ankle characteristics in older people. , 2003, Journal of the American Podiatric Medical Association.

[56]  Constantinos N. Maganaris,et al.  Ultrasonographic assessment of human skeletal muscle size , 2003, European Journal of Applied Physiology.

[57]  M. Valencia,et al.  Body composition by hydrometry (deuterium oxide dilution) and bioelectrical impedance in subjects aged >60 y from rural regions of Cuba, Chile and Mexico , 2003, International Journal of Obesity.

[58]  F. Blyth,et al.  Estimation of lean body weight in older community-dwelling men. , 2010, British journal of clinical pharmacology.

[59]  C. Pichard,et al.  Comparison of Four Bioelectrical Impedance Analysis Formulas in Healthy Elderly Subjects , 2001, Gerontology.

[60]  N. Norgan,et al.  Laboratory and field measurements of body composition. , 2005, Public health nutrition.

[61]  S. Bandinelli,et al.  Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI study. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[62]  P. Rowe,et al.  An investigation of the association between grip strength and hip and knee joint moments in older adults. , 2012, Archives of gerontology and geriatrics.

[63]  I. Bosaeus,et al.  Comparison of bioelectrical impedance prediction equations for fat-free mass in a population-based sample of 75 y olds: the NORA study. , 2003, Nutrition.

[64]  G E Dallal,et al.  Application of bioelectrical impedance analysis to elderly populations. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[65]  V. Parmar,et al.  Menz HB, Latt MD, Tiedemann A, Mun San Kwan M, Lord SR. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait & Posture 2004;20(1):20–25 , 2006 .

[66]  G. Ostir,et al.  Reliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women's Health and Aging Study. , 2002, Journal of clinical epidemiology.

[67]  Bart Jansen,et al.  Reliability and clinical correlates of 3D-accelerometry based gait analysis outcomes according to age and fall-risk. , 2011, Gait & posture.

[68]  E. Rydwik,et al.  Muscle strength testing with one repetition maximum in the arm/shoulder for people aged 75 + - test-retest reliability , 2007, Clinical rehabilitation.

[69]  Pekka Oja,et al.  A health-related fitness and functional performance test battery for middle-aged and older adults: feasibility and health-related content validity. , 2002, Archives of physical medicine and rehabilitation.

[70]  W. Satariano,et al.  Reliability of physical performance and self-reported functional measures in an older population. , 1998, The journals of gerontology. Series A, Biological sciences and medical sciences.

[71]  Y. Boirie,et al.  Toward a definition of sarcopenia. , 2011, Clinics in geriatric medicine.

[72]  T. Amaral,et al.  Comparison of hand dynamometers in elderly people , 2009, The journal of nutrition, health & aging.

[73]  W. Rejeski,et al.  Development and Validation of a Video-Animated Tool for Assessing Mobility , 2010, The journals of gerontology. Series A, Biological sciences and medical sciences.

[74]  L. Niskanen,et al.  Anthropometry, bioelectrical impedance and dual‐energy X‐ray absorptiometry in the assessment of body composition in elderly Finnish women , 2002, Clinical physiology and functional imaging.

[75]  K. Rockwood,et al.  Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[76]  J. E. Morley,et al.  Sarcopenia: Its assessment, etiology, pathogenesis, consequences and future perspectives , 2008, The journal of nutrition, health & aging.

[77]  Richard W. Bohannon.  Alternatives for measuring knee extension strength of the elderly at home , 1998, Clinical rehabilitation.

[78]  Luigi Ferrucci,et al.  Sarcopenia with limited mobility: an international consensus. , 2011, Journal of the American Medical Directors Association.

[79]  Richard W. Bohannon,et al.  Five-repetition sit-to-stand test performance by community-dwelling adults: A preliminary investigation of times, determinants, and relationship with self-reported physical performance , 2007 .

[80]  C. Terwee,et al.  Quality criteria were proposed for measurement properties of health status questionnaires. , 2007, Journal of clinical epidemiology.

[81]  J. Michel,et al.  Understanding sarcopenia as a geriatric syndrome , 2010, Current opinion in clinical nutrition and metabolic care.

[82]  D Kromhout,et al.  Reproducibility of performance-based and self-reported measures of functional status. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[83]  J. Baeyens,et al.  Sarcopenia: European consensus on definition and diagnosis , 2010, Age and ageing.

[84]  Sharon L Olson,et al.  Test-retest strength reliability: hand-held dynamometry in community-dwelling elderly fallers. , 2002, Archives of physical medicine and rehabilitation.

[85]  Wojtek Chodzko-Zajko,et al.  Reliability and Validity of the Fullerton Functional Fitness Test: An Independent Replication Study , 1999 .

[86]  Y. Rolland,et al.  Sarcopenia, Calf Circumference, and Physical Function of Elderly Women: A Cross‐Sectional Study , 2003, Journal of the American Geriatrics Society.

[87]  Jonathan F. Bean,et al.  Muscle Power of the Ankle Flexors Predicts Functional Performance in Community‐Dwelling Older Women , 2001 .