Gender specific age-related changes in bone density, muscle strength and functional performance in the elderly: a-10 year prospective population-based study

BackgroundAge-related losses in bone mineral density (BMD), muscle strength, balance, and gait have been linked to an increased risk of falls, fractures and disability, but few prospective studies have compared the timing, rate and pattern of changes in each of these measures in middle-aged and older men and women. This is important so that targeted strategies can be developed to optimise specific musculoskeletal and functional performance measures in older adults. Thus, the aim of this 10-year prospective study was to: 1) characterize and compare age- and gender-specific changes in BMD, grip strength, balance and gait in adults aged 50 years and over, and 2) compare the relative rates of changes between each of these musculoskeletal and functional parameters with ageing.MethodsMen (n = 152) and women (n = 206) aged 50, 60, 70 and 80 years recruited for a population-based study had forearm BMD, grip strength, balance and gait velocity re-assessed after 10-years.ResultsThe annual loss in BMD was 0.5-0.7% greater in women compared to men aged 60 years and older (p < 0.05- < 0.001), but there were no gender differences in the rate of loss in grip strength, balance or gait. From the age of 50 years there was a consistent pattern of loss in grip strength, while the greatest deterioration in balance and gait occurred from 60 and 70 years onwards, respectively. Comparison of the changes between the different measures revealed that the annual loss in grip strength in men and women aged <70 years was 1-3% greater than the decline in BMD, balance and gait velocity.ConclusionThere were no gender differences in the timing (age) and rate (magnitude) of decline in grip strength, balance or gait in Swedish adults aged 50 years and older, but forearm BMD decreased at a greater rate in women than in men. Furthermore, there was heterogeneity in the rate of loss between the different musculoskeletal and function parameters, especially prior to the age of 70 years, with grip strength deteriorating at a greater rate than BMD, balance and gait.

[1]  K Masaki,et al.  Grip strength changes over 27 yr in Japanese-American men. , 1998, Journal of applied physiology.

[2]  N. Emaus,et al.  Longitudinal changes in forearm bone mineral density in women and men aged 45-84 years: the Tromso Study, a population-based study. , 2005, American journal of epidemiology.

[3]  G. Dutton,et al.  Relationship of Physical Performance with Body Composition and Bone Mineral Density in Individuals over 60 Years of Age: A Systematic Review , 2011, Journal of aging research.

[4]  Ack,et al.  LOWER-EXTREMITY FUNCTION IN PERSONS OVER THE AGE OF 70 YEARS AS A PREDICTOR OF SUBSEQUENT DISABILITY , 2001 .

[5]  S. Koskinen,et al.  Long-term changes in handgrip strength in men and women--accounting the effect of right censoring due to death. , 2012, The journals of gerontology. Series A, Biological sciences and medical sciences.

[6]  A. King,et al.  Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. , 2007, Medicine and science in sports and exercise.

[7]  R B Wallace,et al.  Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. , 1995, The New England journal of medicine.

[8]  R. Daly,et al.  Association Between Changes in Habitual Physical Activity and Changes in Bone Density, Muscle Strength, and Functional Performance in Elderly Men and Women , 2008, Journal of the American Geriatrics Society.

[9]  A. Bauman,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.

[10]  G E Dallal,et al.  Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  Leigh Blizzard,et al.  Sex modifies the relationship between age and gait: a population-based study of older adults. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[12]  T. Doherty Invited review: Aging and sarcopenia. , 2003, Journal of applied physiology.

[13]  L. Vianna,et al.  AGE‐RELATED DECLINE IN HANDGRIP STRENGTH DIFFERS ACCORDING TO GENDER , 2007, Journal of strength and conditioning research.

[14]  J. Nitz,et al.  Normal Values of Balance Tests in Women Aged 20–80 , 2004, Journal of the American Geriatrics Society.

[15]  J. Cauley,et al.  Patterns and determinants of muscle strength change with aging in older men. , 2005, The aging male : the official journal of the International Society for the Study of the Aging Male.

[16]  S. Studenski,et al.  Gait speed and survival in older adults. , 2011, JAMA.

[17]  J. Fleg,et al.  Age and gender comparisons of muscle strength in 654 women and men aged 20-93 yr. , 1997, Journal of applied physiology.

[18]  J. Wark,et al.  Relationship between age and measures of balance, strength and gait: linear and non-linear analyses. , 2008, Clinical science.

[19]  E. Bassey,et al.  Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. , 1993, Clinical science.

[20]  Luigi Ferrucci,et al.  Sex-specific correlates of walking speed in a wide age-ranged population. , 2010, The journals of gerontology. Series B, Psychological sciences and social sciences.

[21]  N. Emaus,et al.  Longitudinal changes in forearm bone mineral density in women and men aged 25-44 years: the Tromsø study: a population-based study. , 2005, American journal of epidemiology.

[22]  D. Kiel,et al.  Risk Factors for Longitudinal Bone Loss in Elderly Men and Women: The Framingham Osteoporosis Study , 2000, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[23]  S. Brauer,et al.  Changes in postural stability in women aged 20 to 80 years. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[24]  D. Cunningham,et al.  Age-related changes in speed of walking. , 1988, Medicine and science in sports and exercise.

[25]  S. Bandinelli,et al.  Age‐Associated Declines in Complex Walking Task Performance: The Walking InCHIANTI Toolkit , 2007, Journal of the American Geriatrics Society.

[26]  Heather M. Macdonald,et al.  Age‐related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: A population‐based HR‐pQCT study , 2011, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[27]  M. Schuurmans,et al.  Physical performance characteristics related to disability in older persons: a systematic review. , 2011, Maturitas.

[28]  P. Haavisto,et al.  Postural Balance in a Random Sample of 7,979 Subjects Aged 30 Years and Over , 2006, Gerontology.

[29]  Jane A. Cauley,et al.  Patterns and Correlates of Muscle Strength Loss in Older Women , 2006, Gerontology.

[30]  C. Christiansen,et al.  Changes in Bone Mineral Density with Age in Men and Women: A Longitudinal Study , 2002, Osteoporosis International.