Abstract
Objective
Although older inpatients are known to develop various conditions, whether aging affects
intramuscular adipose tissue in older inpatients remains unclear. In particular, an
increase in intramuscular adipose tissue in persons aged ≥85 years has previously
not been revealed in either older inpatients or community-dwelling older individuals.
This study therefore aimed to examine whether aging affects intramuscular adipose
tissue in older inpatients.
Design
Cross-sectional study.
Setting and Participants
This study was clinical-based and included 404 inpatients aged ≥65 years.
Methods
We divided the participants into the following age groups: 65–74 years (n = 63), 75–84 years
(n = 171), and ≥85 years (n = 170). B-mode ultrasound imaging was performed, and the
intramuscular adipose tissue of the quadriceps was assessed based on echo intensity.
One-way analysis of variance and analysis of covariance were used to compare the echo
intensity of the quadriceps between the 65–74-year, 75–84-year, and ≥85-year groups.
Results
The median (25th–75th percentile) ages of the 65–74-year group, 75–84-year group,
and ≥85-year group were 70.0 (68.0-73.0), 80.0 (77.0-82.0), and 89.0 (87.0-91.0),
respectively. In the one-way analysis of variance, the quadriceps echo intensity of
the ≥85-year group was significantly higher than that of the 65–74-year and 75–84-year
groups. In addition, the ≥85-year group had significantly higher quadriceps echo intensity
than the 65–74-year group, even after adjusting for other confounding factors.
Conclusions and Implications
The current study revealed that intramuscular adipose tissue in older inpatients increases
with age, and the levels of intramuscular adipose tissue of older inpatients aged
≥85 years is higher than those of older inpatients aged 65–74 years.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Sarcopenia: Revised European consensus on definition and diagnosis.Age Ageing. 2019; 48: 16-31
- Relationship between quadriceps femoris echo intensity, muscle power, and functional capacity of older men.Age. 2014; 36: 9625
- Relationships between intramuscular fat, muscle strength, and gait independence in older women: A cross-sectional study.Geriatr Gerontol Int. 2017; 17: 1683-1688
- Echo intensity independently predicts functionality in sedentary older men.Muscle Nerve. 2017; 55: 9-15
- Relationships of muscle echo intensity with walking ability and physical activity in the very old population.J Aging Phys Act. 2017; 25: 189-195
- Quantitative features of intramuscular adipose tissue of the quadriceps and their association with gait independence in older inpatients: A cross-sectional study.Nutrition. 2020; 71: 110600
- Computed tomographic measurements of thigh muscle cross-sectional area and attenuation coefficient predict hip fracture: The Health, Aging, and Body Composition Study.J Bone Miner Res. 2010; 25: 513-519
- Prognostic value of psoas muscle area and density in patients who undergo cardiovascular surgery.Can J Cardiol. 2017; 33: 1652-1659
- Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma.J Hepatobiliary Pancreat Sci. 2015; 22: 475-485
- The loss of skeletal muscle strength, mass, and quality in older adults: The Health, Aging and Body Composition Study.J Gerontol A Biol Sci Med Sci. 2006; 61: 1059-1064
- Longitudinal study of muscle strength, quality, and adipose tissue infiltration.Am J Clin Nutr. 2009; 90: 1579-1585
- Normal values for quantitative muscle ultrasonography in adults.Muscle Nerve. 2010; 41: 32-41
- Age-related ultrasound changes in muscle quantity and quality in women.Ultrasound Med Biol. 2015; 41: 3013-3017
- Age-related changes in muscle volume and intramuscular fat content in quadriceps femoris and hamstrings.Exp Gerontol. 2020; 132: 110834
- Age-related changes in muscle thickness and echo intensity of trunk muscles in healthy women: Comparison of 20-60s age groups.Eur J Appl Physiol. 2020; 120: 1805-1814
- Skeletal muscle sonography: A correlative study of echogenicity and morphology.J Ultrasound Med. 1993; 12: 73-77
- Skeletal muscle ultrasonography: Visual versus quantitative evaluation.Ultrasound Med Biol. 2006; 32: 1315-1321
- Higher malnutrition risk is related to increased intramuscular adipose tissue of the quadriceps in older inpatients: A cross-sectional study.Clin Nutr. 2020; 39: 2586-2592
- Dysphagia is more strongly associated with increased intramuscular adipose tissue of the quadriceps than with loss of muscle mass in older inpatients.Nutr Res. 2019; 65: 71-78
- Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function.J Crit Care. 2015; 30: 1151.e9-1151.e14
- Bedside ultrasound is a practical and reliable measurement tool for assessing quadriceps muscle layer thickness.JPEN J Parenter Enteral Nutr. 2014; 38: 886-890
- Relationships between muscle mass, intramuscular adipose and fibrous tissues of the quadriceps, and gait independence in chronic stroke survivors: A cross-sectional study.Physiotherapy. 2018; 104: 438-445
- The accuracy of volume estimates using ultrasound muscle thickness measurements in different muscle groups.Eur J Appl Physiol. 2004; 91: 264-272
- Measurement of intramuscular fat by muscle echo intensity.Muscle Nerve. 2015; 52: 963-971
- Intramuscular adipose tissue determined by T1-weighted MRI at 3T primarily reflects extramyocellular lipids.Magn Reson Imaging. 2016; 34: 397-403
- Reliability and validity of a tool to measure the severity of dysphagia: The Food Intake LEVEL Scale.J Pain Symptom Manage. 2013; 46: 201-206
- Geriatric Nutritional Risk Index: A new index for evaluating at-risk elderly medical patients.Am J Clin Nutr. 2005; 82: 777-783
- Updating and validating the Charlson Comorbidity Index and score for risk adjustment in hospital discharge abstracts using data from 6 countries.Am J Epidemiol. 2011; 173: 676-682
- The reliability of the functional independence measure: A quantitative review.Arch Phys Med Rehabil. 1996; 77: 1226-1232
- The influence of subcutaneous fat on the relationship between body composition and ultrasound-derived muscle quality.Appl Physiol Nutr Metab. 2016; 27: 1-4
- Association of physical activity with age-related changes in muscle echo intensity in older adults: A 4-year longitudinal study.J Appl Physiol 1985. 2018; 125: 1468-1474
- Effect of 12-month resistance and endurance training on quality, quantity, and function of skeletal muscle in older adults requiring long-term care.Exp Gerontol. 2017; 98: 230-237
- Nutritional supplementation with physical activity improves muscle composition in mobility-limited older adults, the VIVE2 study: A randomized, double-blind, placebo-controlled trial.J Gerontol A Biol Sci Med Sci. 2017; 73: 95-101
- Effects of 10-week walking and walking with home-based resistance training on muscle quality, muscle size, and physical functional tests in healthy older individuals.Eur Rev Aging Phys Act. 2018; 15: 13
- Atrophy of the lower limbs in elderly women: Is it related to walking ability?.Eur J Appl Physiol. 2011; 111: 989-995
- Age-related, site-specific muscle loss in 1507 Japanese men and women aged 20 to 95 years.J Sports Sci Med. 2011; 10: 145-150
- Muscle ultrasound and sarcopenia in older individuals: A clinical perspective.J Am Med Dir Assoc. 2017; 18: 290-300
- Skeletal muscle ultrasound: Correlation between fibrous tissue and echo intensity.Ultrasound Med Biol. 2009; 35: 443-446
- Application of ultrasound for muscle assessment in sarcopenia: Towards standardized measurements.Eur Geriatr Med. 2018; 9: 739-757
References
- Relationships between intramuscular fat, muscle strength, and gait independence in older women: A cross-sectional study.Geriatr Gerontol Int. 2017; 17: 1683-1688
- Quantitative features of intramuscular adipose tissue of the quadriceps and their association with gait independence in older inpatients: A cross-sectional study.Nutrition. 2020; 71: 110600
- Higher malnutrition risk is related to increased intramuscular adipose tissue of the quadriceps in older inpatients: A cross-sectional study.Clin Nutr. 2020; 39: 2586-2592
- Dysphagia is more strongly associated with increased intramuscular adipose tissue of the quadriceps than with loss of muscle mass in older inpatients.Nutr Res. 2019; 65: 71-78
- Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function.J Crit Care. 2015; 30: 1151.e9-1151.e14
- Bedside ultrasound is a practical and reliable measurement tool for assessing quadriceps muscle layer thickness.JPEN J Parenter Enteral Nutr. 2014; 38: 886-890
- Relationships between muscle mass, intramuscular adipose and fibrous tissues of the quadriceps, and gait independence in chronic stroke survivors: A cross-sectional study.Physiotherapy. 2018; 104: 438-445
- Relationship between quadriceps femoris echo intensity, muscle power, and functional capacity of older men.Age. 2014; 36: 9625
- Echo intensity independently predicts functionality in sedentary older men.Muscle Nerve. 2017; 55: 9-15
- Relationships of muscle echo intensity with walking ability and physical activity in the very old population.J Aging Phys Act. 2017; 25: 189-195
- Age-related changes in muscle thickness and echo intensity of trunk muscles in healthy women: Comparison of 20-60s age groups.Eur J Appl Physiol. 2020; 120: 1805-1814
- Normal values for quantitative muscle ultrasonography in adults.Muscle Nerve. 2010; 41: 32-41
- Age-related ultrasound changes in muscle quantity and quality in women.Ultrasound Med Biol. 2015; 41: 3013-3017
- Age-related changes in muscle volume and intramuscular fat content in quadriceps femoris and hamstrings.Exp Gerontol. 2020; 132: 110834
- Skeletal muscle ultrasonography: Visual versus quantitative evaluation.Ultrasound Med Biol. 2006; 32: 1315-1321
- Reliability and validity of a tool to measure the severity of dysphagia: The Food Intake LEVEL Scale.J Pain Symptom Manage. 2013; 46: 201-206
- Geriatric Nutritional Risk Index: A new index for evaluating at-risk elderly medical patients.Am J Clin Nutr. 2005; 82: 777-783
- Simplified nutritional screening tools for patients on maintenance hemodialysis.Am J Clin Nutr. 2008; 87: 106-113
- The reliability of the functional independence measure: A quantitative review.Arch Phys Med Rehabil. 1996; 77: 1226-1232
Article info
Publication history
Published online: October 27, 2020
Footnotes
Funding sources: This work was supported by JSPS KAKENHI Grant Number JP17K18294 (Grant-in-Aid for Young Scientists B).
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
