Abstract Low BMD and impaired bone strength are established risk factors for fractures in older adults. Decreased muscle size also contributes to fracture risk; however, the relationship between muscle size and bone density, microarchitecture, and strength using state-of-the-art assessment methods is not clear. In The Study of Muscle, Mobility and Aging, muscle size was assessed using whole-body muscle mass (kg, deuterated creatine [D3Cr] dilution method) and thigh muscle volume (L, by MRI). We investigated cross-sectional associations between baseline D3Cr muscle mass and MRI thigh muscle volume with bone volumetric density, microarchitecture, and strength from HR-pQCT at the distal tibia (DT) and radius (DR), and hip areal BMD from DXA at the first annual follow-up visit (year 1). Muscle and bone parameters were standardized within sex and analyses were stratified by sex. Linear regression models were adjusted for age, race, weight, ≥1 alcoholic drink/wk, ever cigarette smoker, total activity from wrist-worn accelerometry, multimorbidity count (0-11), arthritis, and tibia or ulna length. In 181 women (age 76.2 ± 4.7 yr, 86% White) and 118 men (age 76.1 ± 4.3 yr, 93% White), higher thigh muscle volume (per SD: 1.1 L women; 1.5 L men) was associated with higher DT and DR failure load (p < .05). Greater thigh muscle volume was associated with higher DXA total hip BMD in men but not in women. Greater D3Cr muscle mass (per SD: 4.4 kg women; 5.5 kg men) was associated with higher DT and DR failure load (p < .05) in women only. Associations of muscle size with microarchitecture were variable and differed by sex. Given that failure load is a strong predictor of fracture risk, future studies should investigate whether interventions that target muscle size may impact fracture risk in older adults.
Nina Z. Heilmann, Kerri S. Freeland, L. Roe et al.· JBMR Plus· 0 citations
PURPOSE
Nursing home residents increasingly enter care with advanced frailty, multimorbidity, and functional dependence, underscoring the need for engaging, adaptable physical activity (PA) programmes. Join4Joy is a co-created approach designed to promote movement and social connection among older adults through enjoyable activities. This study examined its feasibility, acceptability, and preliminary effects across five nursing homes in Spain, France, and Germany.
METHODS
This multicentre mixed-method study (ClinicalTrials.gov: NCT06100835) was delivered in two phases. Residents aged ≥ 65 years participated in 12 weekly 60-min PA sessions. Feasibility was assessed through attendance, procedural indicators, data completion, and retention; acceptability was evaluated using participant satisfaction and qualitative feedback, while safety was monitored throughout. Quantitative assessments evaluated physical function (SPPB), daily functioning (modified Barthel Index), quality of life (EQ-5D-5L), PA and sedentary behaviour (IPAQ-SF, SBQ, accelerometry), perceived improvement (PGI-I), and enjoyment (PACES-SF). Qualitative interviews and focus groups explored participant experiences.
RESULTS
Of 81 enrolled residents, 75 completed the intervention (retention = 92.6%). Attendance was high (73.8-95.0%), no adverse events occurred. Quantitative outcomes indicated small favourable or no changes in physical and daily functioning, quality of life, PA and sedentary behaviour, perceived improvement, and enjoyment. Qualitative themes highlighted enjoyment, social connection, confidence, and the value of tailored, playful activities, confirming high acceptability.
CONCLUSION
Join4Joy is safe, feasible to deliver, and well received, demonstrating the viability of a future definitive trial. Future large-scale evaluations should integrate holistic psychosocial metrics like enjoyment and social connection alongside biomedical outcomes to fully assess co-created PA approaches in long-term care geriatric settings.
E. Karkauskienė, Laura Coll-Planas, A. Fuente-Vidal et al.· European Geriatric Medicine· 0 citations
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