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Introduction: The assessment and treatment of low relative muscle power in older people has received little attention in the clinical setting when compared to sarcopenia. Our main goal was to assess the associations of low relative power and sarcopenia with other negative outcomes in older people., Methods: The participants were 1189 subjects (54% women; 65-101 years old) from the Toledo Study for Healthy Aging. Probable sarcopenia was defined as having low handgrip strength, while confirmed sarcopenia also included low appendicular skeletal muscle index (assessed by dual energy X-ray absorptiometry) (EWGSOP2's definition). Low relative (i.e. normalized to body mass) muscle power was assessed with the 5-repetition sit-to-stand power test (which uses an equation that converts sit-to-stand performance into mechanical power) and diagnosed in those subjects in the lowest sex-specific tertile. Low usual gait speed (UGS), frailty (according to Fried's criteria and the Frailty Trait Scale), limitations in basic (BADL) and instrumental activities of daily living (IADL) and poor quality of life were also recorded., Results: Age-adjusted logistic regression analyses demonstrated that low relative muscle power was associated with low UGS (odds ratio (OR) = 1.9 and 2.5), frailty (OR = 3.9 and 4.7) and poor quality of life (OR = 1.8 and 1.9) in older men and women, respectively, and with limitations in BADL (OR = 1.6) and IADL (OR = 3.8) in older women (all p < 0.05). Confirmed sarcopenia was only associated with low UGS (OR = 2.5) and frailty (OR = 5.0) in older men, and with limitations in IADL in older women (OR = 4.3) (all p < 0.05)., Conclusions: Low relative muscle power had a greater clinical relevance than low handgrip strength and confirmed sarcopenia among older people. An operational definition and algorithm for low relative muscle power case finding in daily clinical practice was presented., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim was to establish whether a short supervised facility-based exercise program improved frailty, physical function and performance in comparison with usual care treatment., Methods: This was a quasi-experimental, non-randomized controlled intervention study in frail (2.75 ± 1.25 Frailty Phenotype criteria) older adults (range:77.2-95.8 years). The exercise (EX) group (n = 11) performed concurrent training (power training + high-intensity interval training, HIIT) twice weekly for 6 weeks while the control (CT) group (n = 9) followed usual care., Results: The exercise intervention improved frailty status in 64% of the subjects improving Frailty Phenotype by 1.6 points (95%CI 0.8-2.5, p < 0.05), and increasing SPPB score by 3.2 points (95%CI: 2.4-4.0, Cohen's d = 2.0, p < 0.05), muscle power by 47% (95%CI: 7-87%, Cohen's d = 0.5, p < 0.05), muscle strength by 34%(95%CI: 7-60, Cohen's d = 0.6, p < 0.05) and the aerobic capacity by 19% (6 minute walking test +45 m, 95%CI: 7-83, Cohen's d = 0.7, p = 0.054). The CT did not experience any significant changes in frailty status, physical function or performance., Conclusions: A short concurrent exercise program of muscle power and walking-based HIIT training is a feasible and safe method to increase physical performance and improve function and frailty in elder (pre)frail patients., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: Skeletal muscle power has been demonstrated to be a stronger predictor of functional limitations than any other physical capability. However, no validated alternatives exist to the usually expensive instruments and/or time-consuming methods to evaluate muscle power in older populations. Our aim was to validate an easily applicable procedure to assess muscle power in large cohort studies and the clinical setting and to assess its association with other age-related outcomes., Methods: Forty community dwelling older adults (70-87 years) and 1804 older subjects (67-101 years) participating in the Toledo Study for Healthy Aging were included in this investigation. Sit-to-stand (STS) velocity and muscle power were calculated using the subject's body mass and height, chair height and the time needed to complete five STS repetitions, and compared with those obtained in the leg press exercise using a linear position transducer. In addition, STS performance, physical (gait speed) and cognitive function, sarcopenia (skeletal muscle index (SMI)) and health-related quality of life (HRQoL) were recorded to assess the association with the STS muscle power values., Results: No significant differences were found between STS velocity and power values and those obtained from the leg press force-velocity measurements (mean difference ± 95% CI = 0.02 ± 0.05 m·s -1 and 6.9 ± 29.8 W, respectively) (both p > 0.05). STS muscle power was strongly associated with maximal muscle power registered in the leg press exercise (r = 0.72; p < 0.001). In addition, cognitive function and SMI, and physical function, were better associated with absolute and relative STS muscle power, respectively, than STS time values after adjusting by different covariates. In contrast, STS time was slightly more associated with HRQoL than STS muscle power measures., Conclusion: The STS muscle power test proved to be a valid, and in general, a more clinically relevant tool to assess functional trajectory in older people compared to traditional STS time values. The low time, space and material requirements of the STS muscle power test, make this test an excellent choice for its application in large cohort studies and the clinical setting., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: The actual mechanisms leading to a reduced muscle power and functional ability in older adults are poorly understood. We investigated the association between different force-velocity (F-V) profiles and impaired muscle power, physical and cognitive function, frailty, and health-related quality of life (HRQoL) in older people., Methods: Physical function (habitual gait speed, timed up-and-go test, sit-to-stand and stair-climbing ability), cognitive function, HRQoL and frailty were evaluated in 31 older subjects (70-85 years). The F-V relationship and maximal muscle power (P max ) were assessed in the leg press exercise. The skeletal muscle index (SMI) and fat index, moderate-to-vigorous physical activity (MVPA) and sedentary time were obtained from DXA scans and accelerometry, respectively., Results: While some subjects showed a force deficit (F DEF ), others presented a velocity deficit (V DEF ), both leading to an impaired muscle power [Effect size (ES) = 1.30-1.44], and to a likely-very likely moderate harmful effect in their physical and cognitive function, HRQoL and frailty levels (except the V DEF group for cognitive function) [ES = 0.76-1.05]. Leg muscle mass and specific force were similarly associated with force at P max , while MVPA but not sedentary time was related to fat index, force at P max , and power values (all p < 0.05). A trend was found for the negative association between fat index and relative P max (p = 0.075)., Conclusion: Older subjects exhibited different mechanisms (force vs. velocity deficits) leading to impaired muscle power. Both deficits were associated with a lower physical function and quality of life, and a higher frailty, whereas only a force deficit was associated with a lower cognitive function. Interventions aimed at reversing age- and/or disuse-related impairments of muscle power might evaluate the specific responsible mechanism and act accordingly., (Copyright © 2018 Elsevier Inc. All rights reserved.)